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Shariff A, Kumar TMP, Siddalingegowda SM, Wani SUD, Elsobky Y. PharmD students experiences on end year clerkship evaluation using objective structured clinical exam (OSCE) method at JSS College of Pharmacy, Mysuru, India. PEC Innov 2024; 4:100271. [PMID: 38495318 PMCID: PMC10940797 DOI: 10.1016/j.pecinn.2024.100271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 02/09/2024] [Accepted: 03/03/2024] [Indexed: 03/19/2024]
Abstract
Objectives To assess the PharmD student's experiences about end year clerkship evaluation conducted using Objective Structured Clinical Exam (OSCE) format at JSS College of Pharmacy, Mysuru, India. Methods The student's experiences were captured using a newly developed, 14-item, 5-point Likert's scale feedback form. The results were analyzed and presented descriptively. The Mann-Whitney U test was used to compare the Likert's scale responses between the sex, entry level for PharmD and performance in the end year exam, whereas the Spearman's rank correlation coefficient test was used to measure the strength of association between the Likert's' scale responses and these variables. A p value of <0.05 was considered statistically significant. Results Thirty-seven students of fifth year PharmD attended the end year clerkship evaluation and provided their feedback. Out of the 14-items, the most frequent response in eleven items was strongly agree and in three items it was agree. The Mann-Whitney U test revealed statistically significant differences between regular and postbaccalaureate students with respect to Likert's scale responses in all the domains (p < 0.02). The Spearman's rank correlation test revealed no association between the students' performance and their experiences with OSCE as an assessment tool for the end year clerkship exam. Conclusions The study results demonstrate that OSCE is an alternative and preferred method of evaluating the clinical skills and competencies of fifth year PharmD students in their end year clerkship exam in India. Innovation For the first time in India, the JSS College of Pharmacy, Mysuru, had successfully implemented the OSCE method for evaluating PharmD students' clerkship in their end year exam and had assessed their experiences about OSCE as an assessment tool.
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Affiliation(s)
- Atiqulla Shariff
- Research Scholar, Department of Pharmacy Practice, JSS College of Pharmacy, Mysuru, JSS Academy of Higher Education and Research, Mysuru-570015, Karnataka, India
| | - Teggina Math Pramod Kumar
- Dean, Faculty of Pharmacy, JSS Academy of Higher Education and Research, Mysuru-570015, Karnataka, India
| | - Srikanth Malavalli Siddalingegowda
- Lecturer, Department of Pharmacy Practice, JSS College of Pharmacy, Mysuru, JSS Academy of Higher Education and Research, Mysuru-570015, Karnataka, India
| | - Shahid Ud Din Wani
- Department of Pharmaceutical Sciences, School of Applied Science and Technology, University of Kashmir, Srinagar 190006, India
| | - Yasmin Elsobky
- Senior Research Specialist, ALNAS Hospital, Shubra El Kheima, Egypt 6210120
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Ford C, Hill B. A guide to removing surgical staples. Br J Nurs 2024; 33:372-380. [PMID: 38639750 DOI: 10.12968/bjon.2024.33.8.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
This article provides a comprehensive overview of the wound healing process, emphasising the critical role of surgical staples in primary intention healing. It outlines the four distinct phases of wound healing including haemostasis, inflammation, proliferation, and maturation - and discusses the mechanisms by which surgical staples enhance this natural biological process. Special focus is given to the aseptic non-touch technique (ANTT), which is crucial in preventing infections during the staple removal procedure. The article further explores the procedural steps involved in the removal of surgical staples and highlights the holistic aspects of patient care that need to be considered. This includes strategies for effective pain management, ensuring informed consent, and maintaining a sterile environment. By integrating clinical skills with a thorough understanding of wound care, this article aims to improve nursing practices in surgical settings, promoting better patient outcomes and recovery.
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Affiliation(s)
- Claire Ford
- Assistant Professor, Adult Nursing, Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne
| | - Barry Hill
- Associate Professor of Nursing and Critical Care, Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne
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Guyer C, Stewart B, Khalifa Z, Pham L, Saad AH. Implementation and evaluation of an interprofessional prescription writing workshop with a simulated electronic prescribing activity for preclerkship medical students. BMC Med Educ 2024; 24:394. [PMID: 38600534 PMCID: PMC11005250 DOI: 10.1186/s12909-024-05326-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 03/18/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Prescription writing skills are essential for physician practice. This study describes the development and implementation of a curricular intervention focused on improving the knowledge and confidence of preclerkship medical students' prescription writing practices utilizing an interprofessional education model, with a focus on electronic prescribing. METHODS Medicine and Pharmacy Faculty from a large, urban university collaborated to develop the content of the workshop and a simulation platform was used for the e-prescribing activity. Second-year medical students attended a mandatory in-person workshop facilitated by fourth-year pharmacy students. A pre and post knowledge test and confidence survey were used to assess students' knowledge, confidence, and satisfaction. Outcomes from the knowledge test were evaluated with paired-samples proportions tests, and confidence survey data was evaluated with paired t-tests and Wilcoxon signed-rank tests in a pre-post study design. RESULTS Students demonstrated a significant increase in prescription writing knowledge and confidence after completing the workshop. On the pre-test, 7% of students (21/284) completed the electronic prescribing assessment correctly and 51% of students (149/295) completed it correctly on the post-test. All items on the confidence survey showed a significant increase in pre- versus post-survey comparisons (p < 0.001). CONCLUSIONS This interprofessional prescription writing workshop facilitated by pharmacy students shows promise for improving the knowledge and confidence of prescription writing and electronic prescribing practices in preclerkship medical students.
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Affiliation(s)
- Christopher Guyer
- Clinical Skills Center, School of Medicine, Wayne State University, 320 E Canfield St, Suite 206, Detroit, MI, 48201, USA
| | - Brittany Stewart
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave, Suite 2190, Detroit, MI, 48201, USA.
| | - Ziad Khalifa
- Clinical Skills Center, School of Medicine, Wayne State University, 320 E Canfield St, Suite 206, Detroit, MI, 48201, USA
| | - Linh Pham
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave, Suite 2190, Detroit, MI, 48201, USA
| | - Aline H Saad
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave, Suite 2190, Detroit, MI, 48201, USA
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Thursby S, Dismore L, Swainston K. Clinical skills development for healthcare practitioners working with patients with persistent physical symptoms (PPS) in healthcare settings: a systematic review and narrative synthesis. BMC Med Educ 2024; 24:328. [PMID: 38519955 PMCID: PMC10960475 DOI: 10.1186/s12909-024-05306-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/13/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND The complexity and uncertainty around Persistent Physical Symptoms (PPS) make it difficult to diagnose and treat, particularly under time-constrained consultations and limited knowledge. Brief interventions that can be utilised in day-to-day practice are necessary to improve ways of managing PPS. This review aimed to establish (i) what training primary and secondary healthcare practitioners have undertaken to develop their clinical skills when working with PPS, (ii) what training techniques or theoretical models have been used within these interventions, and (iii) how effective was the training. METHOD A systematic literature search was undertaken on eight databases to identify professional development interventions for healthcare practitioners working with PPS, were of any study design, and at a minimum were single measure studies (i.e., training outcome alone). Studies were assessed using the Mixed Methods Appraisal Tool (MMAT) and narratively synthesised. RESULTS Despite high methodological heterogeneity across the six included studies, they all aimed to improve healthcare practitioners' communication skills through educational (theory, awareness, attitudes, assessment, treatment, and management of PPS) and experiential (role play) learning. CONCLUSIONS The review findings demonstrate that developing healthcare practitioners' communicative behaviours led to increased confidence and self-efficacy when working with PPS, which facilitated improved consultations and improvements on some patient outcomes. Barriers to the uptake of training programmes and implementation into daily clinical practice are discussed, including the need for PPS to be formally implemented into undergraduate teaching and post-qualification continuous professional development. TRIAL REGISTRATION This review was registered at PROSPERO [CRD42022315631] prior to the review starting.
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Affiliation(s)
- Stacie Thursby
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, NE29 8NH, United Kingdom
| | - Lorelle Dismore
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, NE29 8NH, United Kingdom
| | - Katherine Swainston
- Faculty of Medical Sciences, School of Psychology, Newcastle University, 4 Floor Dame Margaret Barbour Building, Wallace Street, Newcastle Upon Tyne, NE1 7RU, England.
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Cecilio-Fernandes D, Steenhof N, Sandars J. The challenge of transfer to clinical practice: The illusion of learning and illusion of teaching. Med Teach 2024:1-2. [PMID: 38460499 DOI: 10.1080/0142159x.2024.2323243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/21/2024] [Indexed: 03/11/2024]
Abstract
There is increasing pressure to accelerate health professions education programs and educators have the challenge of ensuring that students can effectively transfer their learning into clinical practice. In this personal view, we discuss how insights from cognitive science can inform the redesign of current curricula and highlight the challenge of implementing these new approaches for instructional design and assessment. We also recommend that educators disseminate the important lessons learned from their endeavors.
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Affiliation(s)
- Dario Cecilio-Fernandes
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Naomi Steenhof
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - John Sandars
- Edge Hill University Medical School, Edge Hill University, Ormskirk, UK
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Wehling J, Dombrowski T, Johannsen K, Volkenstein S, Dazert S, Weiss NM. [Providing practical skills in curricular teaching-effect of SkillsLab and flipped classroom]. HNO 2024; 72:143-153. [PMID: 38224355 PMCID: PMC10879220 DOI: 10.1007/s00106-023-01408-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND In the course of the restructuring of medical studies, practical competencies are clearly defined as learning objectives for the first time. In order to make most effective use of the short attendance time available in otolaryngology, the aim of this study was to teach practical skills with the help of flipped classroom, digital teaching, and a newly established SkillsLab. MATERIALS AND METHODS During their ENT internship, two groups of students-group A = 93 students (male n = 42, female n = 51) and group B = 113 students (male n = 42, female n = 71)-first worked through material provided online, which explained the individual examinations. This was followed by face-to-face teaching, which consisted of observation and practical exercise of the different examination techniques. While group A practiced on each other or on dummies, group B used structured workstations in the ENT SkillsLab, which was newly built for this purpose. The effects on motivation and subjective competence were measured using a questionnaire developed for this study. RESULTS After working through the online material, both groups showed a high level of motivation and competence. On the day of face-to-face teaching, there was a gain in motivation and competence, which was statistically significant only in the SkillsLab group (p < 0.001). Although the SkillsLab group was inferior in terms of its subjective competence at the beginning, it was superior to the other group after the face-to-face teaching. CONCLUSION Combination of digitized teaching in the flipped classroom with structured workstations in the setting of a SkillsLab enables more effective teaching of practical skills, which was reflected by increases in motivation and subjective competence in group B. In particular, the presentation of all collected findings on monitors allows verification of learning success and stimulates discussion.
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Affiliation(s)
- Judith Wehling
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, St. Elisabeth-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland.
| | - Tobias Dombrowski
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, St. Elisabeth-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - Katharina Johannsen
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, St. Elisabeth-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Stefan Volkenstein
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, St. Elisabeth-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde der Ruhr-Universität Bochum, Johannes Wesling Klinikum Minden, Minden, Deutschland
| | - Stefan Dazert
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, St. Elisabeth-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Nora M Weiss
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, St. Elisabeth-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland
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Liang Y, Liu W, Li X, Zhang Y, Yang L. 2022 Shandong Province university medical technical skills competition nursing track: An effective project to improve core competencies of nursing students. Heliyon 2024; 10:e26208. [PMID: 38434087 PMCID: PMC10906172 DOI: 10.1016/j.heliyon.2024.e26208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 03/05/2024] Open
Abstract
Background The core competencies of nursing students have gradually become the focus of attention of nursing educators. Nursing skills competitions are an important form of educational and teaching activity in universities and the nursing track at the Shandong Provincial University Students' Medical Technical Skills Competition gives nursing students an opportunity to demonstrate their clinical skills and knowledge. This study aims to describe the organisation and procedures of the nursing track, analyse the competition results and explore the impact the competition has on the core competencies of the nursing students. This will provide new ideas for future nursing professional education. Methods Statistical analysis of the competition results was performed as a means of understanding the current status of theoretical knowledge and clinical skills of nursing students in Shandong Province. The impact of the competition on the core competencies of participating students was analysed by distributing questionnaires to universities in Shandong Province that participated in the competition. Results 14 universities with nursing programmes participated in the competition, including eight public universities and six private universities. 220 questionnaires were distributed to nursing students at the participating universities and 218 were ultimately included, demonstrating an efficiency rate of 99.09%. Conclusions The 2022 nursing track included the addition of a comprehensive written examination as a means of judging the competencies of nursing students in Shandong Province from a variety of aspects. Skills competitions are effective for improving the core competencies of nursing students and they will become an important means for nursing educators to reform education and improve the core competencies of nursing students in the future.
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Affiliation(s)
- Yahui Liang
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, 271016, PR China
| | - WeiHua Liu
- School of Chemistry and Pharmaceutical Engineering, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, 271016, PR China
| | - Xiaolei Li
- Shandong Medicine Technician College, Taian, Shandong, 271000, PR China
| | - Yan Zhang
- School of Nursing, Shandong Liming Polytechnic Vocational College, Taian, Shandong, 271000, PR China
| | - Li Yang
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, 271016, PR China
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Cecilio-Fernandes D, Carvalho DRDS, Sandars J, Santos TM. Self-regulated learning microanalysis feedback for developing clinical skills: A pilot study. Med Teach 2024:1-6. [PMID: 38295519 DOI: 10.1080/0142159x.2024.2308060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/17/2024] [Indexed: 02/02/2024]
Abstract
INTRODUCTION The development of clinical skills requires the appropriate use of self-regulated learning (SRL). Students' use of key SRL processes as they perform a clinical skill can be identified by SRL microanalysis and used to provide feedback. SRL-microanalysis feedback only on students' key SRL processes has not been previously researched for developing clinical skills. The aim of this study was to investigate whether SRL-microanalysis feedback only on students' key SRL processes can improve both their use of SRL and their clinical skill performance. METHODS Twenty-three final year medical students with no experience in the clinical skill required for mechanical ventilation participated in this study. Key SRL processes and clinical skill performance were measured before and after SRL microanalysis feedback. RESULTS Overall, we found an improvement in the key SRL processes of planning and monitoring of performance, with a significant difference in monitoring. We also found an increase in students' clinical skill performance. DISCUSSION This study, which is the first in clinical skills, demonstrated that SRL microanalysis feedback only on key SRL processes can improve both students' SRL and their clinical skill performance. studies are recommended with a great number of students and across a variety of clinical skills.
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Affiliation(s)
- Dario Cecilio-Fernandes
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | | | - John Sandars
- Edge Hill University Medical School, Edge Hill University, Ormskirk, UK
| | - Thiago Martins Santos
- Department of Internal Medicine, School of Medical Sciences, University of Campinas, Campinas, Brazil
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Johnson JI, Beasley H, Southwick D, Lords AM, Kessler R, Vrablik ME, Baker RT. Development of a hybrid point-of-care ultrasound curriculum for first year medical students in a rural medical education program: a pilot study. BMC Med Educ 2024; 24:16. [PMID: 38172848 PMCID: PMC10765644 DOI: 10.1186/s12909-023-05005-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND The field of point-of-care ultrasound (POCUS) has advanced in recent decades due to the benefits it holds for medical providers. However, aspiring POCUS practitioners require adequate training. Unfortunately, there remains a paucity of resources to deliver this training, particularly in rural and underserved areas. Despite these barriers, calls for POCUS training in undergraduate medical education are growing, and many medical schools now deliver some form of POCUS education. Our program lacked POCUS training; therefore, we developed and implemented a POCUS curriculum for our first-year medical students. METHODS We developed a POCUS curriculum for first year medical students in a rural medically underserved region of the United States. To evaluate our course, we measured learning outcomes, self-reported confidence in a variety of POCUS domains, and gathered feedback on the course with a multi-modal approach: an original written pre- and post-test, survey tool, and semi-structured interview protocol, respectively. RESULTS Student (n=24) knowledge of POCUS significantly increased (pre-test average score = 55%, post-test average score = 79%, P<0.0001), and the course was well received based on student survey and interview feedback. In addition, students reported increased confidence toward a variety of knowledge and proficiency domains in POCUS use and their future clinical education and practice. CONCLUSIONS Despite a lack of consensus in POCUS education, existing literature describes many curricular designs across institutions. We leveraged a combination of student initiatives, online resources, remote collaborations, local volunteers, and faculty development to bring POCUS to our institution in a rural and medically underserved region. Moreover, we demonstrate positive learning and experiential outcomes that may translate to improved outcomes in students' clinical education and practice. Further research is needed to evaluate the psychomotor skills, broader learning outcomes, and clinical performance of students who take part in our POCUS course.
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Affiliation(s)
- Joshua I Johnson
- WWAMI Medical Education Program, University of Idaho, Moscow, Idaho, USA.
- University of Washington School of Medicine, Seattle, Washington, USA.
| | - Heather Beasley
- WWAMI Medical Education Program, University of Idaho, Moscow, Idaho, USA
- University of Washington School of Medicine, Seattle, Washington, USA
| | - Derek Southwick
- WWAMI Medical Education Program, University of Idaho, Moscow, Idaho, USA
- University of Washington School of Medicine, Seattle, Washington, USA
| | - Allie M Lords
- WWAMI Medical Education Program, University of Idaho, Moscow, Idaho, USA
- University of Washington School of Medicine, Seattle, Washington, USA
| | - Ross Kessler
- University of Washington School of Medicine, Seattle, Washington, USA
- Department of Emergency Medicine, University of Washington, Seattle, Washington, USA
| | - Michael E Vrablik
- University of Washington School of Medicine, Seattle, Washington, USA
- Department of Emergency Medicine, University of Washington, Seattle, Washington, USA
| | - Russell T Baker
- WWAMI Medical Education Program, University of Idaho, Moscow, Idaho, USA
- University of Washington School of Medicine, Seattle, Washington, USA
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Simes T, Cutmore E, Le Lagadec D, Bell T, Bradshaw J, Wirihana L. Preparing nursing students for clinical placement using synchronous role-play telesimulation: A descriptive survey study. Nurse Educ Today 2024; 132:106012. [PMID: 37956568 DOI: 10.1016/j.nedt.2023.106012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 10/23/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Contemporary teaching modalities in nurse education include teaching clinical skills via telesimulation. The effectiveness of this modality has not been evaluated. OBJECTIVE To evaluate undergraduate nursing students' and clinical facilitators' perceptions of student preparedness for placement when clinical skills are taught via role-play telesimulation using home equipment packs. DESIGN A descriptive survey study was employed to measure and explore perceptions using Likert scales and open-structured questions delivered via an anonymous online survey. SETTING Clinical placement after undertaking preparation via role-play telesimulation for students at an Australian university. PARTICIPANTS Data were collected from 180 undergraduate nursing students and 22 clinical facilitators. METHODS Quantitative data were analysed using statistical analysis software, SPPS. Open ended responses to survey questions were analysed through the application of Elo and Kyngas (2008) three phases of content analysis. RESULTS Seventy-eight percent of students felt prepared for placement, and 86 % of clinical facilitators believed that students were adequately prepared. Three major categories were identified from students' responses: sense of community, learning logistics, and sense of comfort. Three categories emerged from clinical facilitators' responses: nervous and anxious, confidence and preparedness. CONCLUSIONS Findings from this study suggest that role-play telesimulation with home equipment packs is a viable, achievable, sustainable and effective modality for teaching hands-on practical skills to prepare undergraduate nursing students for industry placement.
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Affiliation(s)
- Tracey Simes
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, 160 Ann Street, Brisbane, Queensland 4000, Australia.
| | - Ellie Cutmore
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, 160 Ann Street, Brisbane, Queensland 4000, Australia.
| | - Danielle Le Lagadec
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, 6 University Drive, Bundaberg, Queensland 4670, Australia.
| | - Tracey Bell
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, 160 Ann Street, Brisbane, Queensland 4000, Australia.
| | - Julie Bradshaw
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Building 18, Bruce Highway, North Rockhampton, Queensland 4702, Australia.
| | - Lisa Wirihana
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Building 18, Bruce Highway, North Rockhampton, Queensland 4702, Australia.
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Nugraha D, Melbiarta RR, Visuddho V, Rimbun R, Sakina S, Herawati L, Ummah FC, Rejeki PS, Romdhoni AC. Hybrid learning as alternative approach to improve Indonesian medical students' attitude towards clinical skills during COVID-19 pandemic. Korean J Med Educ 2023; 35:377-388. [PMID: 38062684 PMCID: PMC10704053 DOI: 10.3946/kjme.2023.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/14/2023] [Accepted: 10/05/2023] [Indexed: 12/18/2023]
Abstract
PURPOSE Hybrid learning has been chosen as an alternative method in the conduction of clinical skill lectures during coronavirus disease 2019 (COVID-19) pandemic since students need to learn skills applied in emergency situations. This study aims to analyze students' attitudes between hybrid and online learning methods. METHODS A non-randomized study was conducted between hybrid group (HG) and online group (OG) on three courses (intravenous [IV]-line insertion, nasogastric tube [NGT] insertion, and neonatal resuscitation). We developed a preformed validated questionnaire to assess students' attitudes in five domains (willingness, understanding, capacity, self-efficacy, and intended behavior). The questionnaire was applied at the pre- and post-intervention. RESULTS A total of 100 participants were included (n=49 in HG, n=51 in OG). Post-course attitudes were significantly higher in online (IV-line, p=0.000; NGT, p=0.000; resuscitation, p=0.000) and hybrid (IV-line, p=0.000; NGT, p=0.000; resuscitation, p=0.000) groups compared to their pre-course. There were no significant differences in post-course attitude between groups (IV-line, p=0.072; NGT, p=0.163; resuscitation, p=0.146). Normalized-gain scores of all subjects were higher in HG (IV-line, p=0.012; NGT, p=0.085; resuscitation, p=0.033). CONCLUSION In conclusion, hybrid learning could be considered as a better alternative in clinical skill lectures to maximize students' attitudes, especially during COVID-19 pandemic.
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Affiliation(s)
- David Nugraha
- Medical Program, Faculty of Medicine, Universitas Airlangga, Indonesia
| | | | - Visuddho Visuddho
- Medical Program, Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Rimbun Rimbun
- Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Sakina Sakina
- Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Indonesia
- Medical Program, Faculty of Medicine and Health, Institut Teknologi Sepuluh Nopember, Indonesia
| | - Lilik Herawati
- Department of Medical Physiology and Biochemistry, Faculty of Medicine, Universitas Airlangga, Indonesia
- Medical Education Research and Staff Development Unit, Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Fithriyah Cholifatul Ummah
- Department of Medical Physiology and Biochemistry, Faculty of Medicine, Universitas Airlangga, Indonesia
- Medical Education Research and Staff Development Unit, Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Purwo Sri Rejeki
- Department of Medical Physiology and Biochemistry, Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Achmad Chusnu Romdhoni
- Department of Otorhinolaryngology-Head & Neck Surgery, Dr. Soetomo General Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
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Tamblyn R, Moraga T, Girard N, Boulet J, Chan FKI, Habib B. Do clinical and communication skills scores on credentialing exams predict potentially inappropriate antibiotic prescribing? BMC Med Educ 2023; 23:821. [PMID: 37915014 PMCID: PMC10621187 DOI: 10.1186/s12909-023-04817-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/29/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND There is considerable variation among physicians in inappropriate antibiotic prescribing, which is hypothesized to be attributable to diagnostic uncertainty and ineffective communication. The objective of this study was to evaluate whether clinical and communication skills are associated with antibiotic prescribing for upper respiratory infections and sinusitis. METHODS A cohort study of 2,526 international medical graduates and 48,394 U.S. Medicare patients diagnosed by study physicians with an upper respiratory infection or sinusitis between July 2014 and November 2015 was conducted. Clinical and communication skills were measured by scores achieved on the Clinical Skills Assessment examination administered by the Educational Commission for Foreign Medical Graduates (ECFMG) as a requirement for entry into U.S residency programs. Medicare Part D data were used to determine whether patients were dispensed an antibiotic following an outpatient evaluation and management visit with the study physician. Physician age, sex, specialty and practice region were retrieved from the ECFMG databased and American Medical Association (AMA) Masterfile. Multivariate GEE logistic regression was used to evaluate the association between clinical and communication skills and antibiotic prescribing, adjusting for other physician and patient characteristics. RESULTS Physicians prescribed an antibiotic in 71.1% of encounters in which a patient was diagnosed with sinusitis, and 50.5% of encounters for upper respiratory infections. Better interpersonal skills scores were associated with a significant reduction in the odds of antibiotic prescribing (OR per score decile 0.93, 95% CI 0.87-0.99), while greater proficiency in clinical skills and English proficiency were not. Female physicians, those practicing internal medicine compared to family medicine, those with citizenship from the US compared to all other countries, and those practicing in southern of the US were also more likely to prescribe potentially unnecessary antibiotics. CONCLUSIONS Based on this study, physicians with better interpersonal skills are less likely to prescribe antibiotics for acute sinusitis and upper respiratory infections. Future research should examine whether tailored interpersonal skills training to help physicians manage patient expectations for antibiotics could reduce unnecessary antibiotic prescribing.
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Affiliation(s)
- Robyn Tamblyn
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 2001 McGill College Avenue, H3A 1G1, Montreal, QC, Canada.
- Department of Medicine, McGill University Health Center, Montreal, QC, Canada.
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.
| | - Teresa Moraga
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada
| | - Nadyne Girard
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada
| | - John Boulet
- Foundation for Advancement of International Medical Education and Research (FAIMER), Philadelphia, PA, USA
| | - Fiona K I Chan
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 2001 McGill College Avenue, H3A 1G1, Montreal, QC, Canada
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada
| | - Bettina Habib
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada
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Almarwani AM, Alzahrani NS. Factors affecting the development of clinical nurses' competency: A systematic review. Nurse Educ Pract 2023; 73:103826. [PMID: 37951064 DOI: 10.1016/j.nepr.2023.103826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 10/22/2023] [Accepted: 10/30/2023] [Indexed: 11/13/2023]
Abstract
AIM To synthesize and analyze the literature on nursing clinical competence to assess the factors affecting nursing clinical competency. BACKGROUND Nursing competence affects not only patients but also nurses themselves. Competent nurses contribute to patient safety. Prioritizing clinical competency enables nurses to deliver high-quality care. Clinical nursing competency is influenced by various factors including education and training, experience, professional development, clinical judgment, decision-making skills and communication. DESIGN This was a systematic review. METHODS This study utilized an extensive literature search of online databases, including SCOPUS, Web of Science and PubMed. This review followed the guidelines provided by the Effective Practice and Organization of Care (EPOC) Cochrane Group and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS This systematic review provided 20 valuable articles, with a total of 6273 participants across the 20 studies, including 18 cross-sectional studies and two descriptive-correlational studies, predominantly using quantitative research methods. The analysis revealed several key factors that significantly affect nurses' clinical competency. These factors included years of experience, workplace environment, theoretical knowledge and educational level, marital status, clinical training, job satisfaction, turnover intention, job stress and critical thinking. CONCLUSIONS Understanding and addressing these factors are crucial for enhancing nurses' clinical competence and ultimately improving patient outcomes. Further research and interventions should be directed towards promoting supportive work environments, continuous education and the development of critical thinking skills among nurses to optimize their clinical competencies.
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Affiliation(s)
- Abdulaziz Mofdy Almarwani
- Department of Psychiatric Nursing, College of Nursing, Taibah University, Medina 42353, Saudi Arabia.
| | - Naif S Alzahrani
- Department of Medical-Surgical Nursing, College of Nursing, Taibah University, Medina 42353, Saudi Arabia
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14
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Boten DN, Daum N, Schutz T, Spethmann S. From Videogames to Teaching - Different Camera Perspectives in an Interactive Synchronous Online Tutorial. Med Sci Educ 2023; 33:1029-1031. [PMID: 37886296 PMCID: PMC10597901 DOI: 10.1007/s40670-023-01833-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 10/28/2023]
Abstract
The global COVID-19 pandemic has required clinical skills training to be transferred to an online format. An interactive synchronous online tutorial with different camera perspectives was developed. In a survey, 79% of the students preferred the first-person perspective, which allowed students to view the abdominal examination through the examiner's eyes.
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Affiliation(s)
- David Niklas Boten
- Brandenburg Medical School Theodor Fontane (MHB), Campus Neuruppin, Fehrbelliner Straße 38, 16816 Neuruppin, Germany
| | - Nils Daum
- Brandenburg Medical School Theodor Fontane (MHB), Campus Neuruppin, Fehrbelliner Straße 38, 16816 Neuruppin, Germany
| | - Thomas Schutz
- Brandenburg Medical School Theodor Fontane (MHB), Campus Neuruppin, Fehrbelliner Straße 38, 16816 Neuruppin, Germany
- Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, the Brandenburg University of Technology Cottbus-Senftenberg and the Brandenburg Medical School Theodor Fontane (MHB), Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
| | - Sebastian Spethmann
- Brandenburg Medical School Theodor Fontane (MHB), Campus Neuruppin, Fehrbelliner Straße 38, 16816 Neuruppin, Germany
- Deutsches Herzzentrum der Charité – Medical Heart Center of Charité and German Heart Institute Berlin, Clinic for Cardiology, Angiology and Intensive Care, Campus Charité Mitte, Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
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15
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Schroers G, Shrikanth S, Pfieffer J. Undergraduate nursing student experiences in American clinical learning environments: A descriptive study. Nurse Educ Today 2023; 129:105895. [PMID: 37451031 DOI: 10.1016/j.nedt.2023.105895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/08/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Newly qualified nurses are often considered inadequately prepared for practice. During nursing students' educational preparation, clinical learning environments are intended to provide experiences for students to develop skills and clinical judgments needed for safe practice. Yet, a recent systematic review found no quantitative evidence that clinical education models facilitate student learning. In addition, little is known about the frequency and type of skills students perform when in clinical settings. OBJECTIVE To investigate undergraduate nursing student experiences with skills and the quality of supervision and feedback received when performing skills in clinical settings. DESIGN Retrospective descriptive. SETTING A mid-sized private university in the Midwestern part of the United States. METHODS Students completed an online survey after clinical days during one semester. Students self-reported their experiences with medication administration, psychomotor skills and physical assessments via multiple choice items. Descriptive statistics were calculated using Microsoft 365 Excel. Content analysis was performed of one open-response survey item. RESULTS A total of 496 surveys were completed. On average, during one clinical day, 13.5 % of students administered medication, 20.5 % performed a psychomotor skill, and 64 % completed a physical assessment. Students were most frequently supervised by bedside nurses and reported the quality of their supervision and feedback as "very good" or "good". Some students reported being restricted from administering medication and performing other skills due to a clinical site policy. CONCLUSIONS In this study, students performed few skills and assessments when in clinical settings. Increased clinical experiences are needed for students to develop competencies to better prepare them for safe practice. The findings contribute to the dearth of knowledge related to the clinical learning experiences of undergraduate nursing students, and can guide strategies to improve new nurse preparedness.
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Affiliation(s)
- Ginger Schroers
- Loyola University Chicago, Marcella Niehoff School of Nursing, 2160 S. 1st Avenue, Maywood, IL 60153, United States of America.
| | - Shalini Shrikanth
- Loyola University Chicago, Marcella Niehoff School of Nursing, 2160 S. 1st Avenue, Maywood, IL 60153, United States of America.
| | - Jill Pfieffer
- Loyola University Chicago, Marcella Niehoff School of Nursing, 2160 S. 1st Avenue, Maywood, IL 60153, United States of America.
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McLinden D, Hailstone K, Featherston S. History and physical exam: a retrospective analysis of a clinical opportunity. BMC Med Educ 2023; 23:699. [PMID: 37752450 PMCID: PMC10523620 DOI: 10.1186/s12909-023-04696-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 09/18/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND All learners at the Northern Ontario School of Medicine University complete a longitudinal integrated clerkship experience in their third year, which serves to improve learner experience with community and clinical acute and chronic health needs. Early in the program, Muskoka faculty (two of the 15 LIC sites of NOSM U) became aware that learners never had the occasion to complete a full history and physical exam on a real patient with complex needs. Recognizing this as a critical experience, a program was initiated to provide learners with this opportunity. This manuscript reports on the effectiveness and impact of this novel program and outlines the procedure developed to incorporate a similar program should communities see the relevance. METHODS Using a mixed method design, feedback was collected from learners and preceptors following the implementation of a novel learning opportunity for clinical clerks. Learners completed a full history and physical exam on volunteer complex patients, with supervision and immediate feedback. Using semi structured surveys, data was collected from each learner and preceptor to determine the program impact and optimize the program. Laurentian University research ethics board, certificate number 6021120. RESULTS Both learners and preceptors agreed this was a valuable experience for learners, a good use of their time and contributed to essential skills including, communication, time management and appropriate data collection. The use of real patients was reported to be very appropriate by learners and faculty and often highlighted gaps in the learner's knowledge that they were then able to address. CONCLUSION Feedback collected in this study confirms that providing medical learners the opportunity to complete a full history and physical exam with supervision and feedback was significantly beneficial from both a clinical and a skills-based aspect. Requiring learners to complete this task within the established period forced them to manage their time, focus on clinical consideration and remain on task. Enhancing learning opportunities is associated with improved outcomes and understanding in medical learners. Positive community experience is also related to learner retention, which is paramount for attracting new physicians in a time with significantly limited human health resources.
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Affiliation(s)
- David McLinden
- Northern Ontario School of Medicine University, 935 Ramsey Lake Road, Sudbury, ON, P3E 2C6, Canada
- Huntsville Physicians Local Education Group, 100 Frank Miller Drive, Huntsville, ON, P1H 1H7, Canada
- Algonquin Family Health Team, Howland Building, 100 Frank Miller Drive, Huntsville, ON, P1H 1H7, Canada
| | - Krista Hailstone
- Northern Ontario School of Medicine University, 935 Ramsey Lake Road, Sudbury, ON, P3E 2C6, Canada.
- Huntsville Physicians Local Education Group, 100 Frank Miller Drive, Huntsville, ON, P1H 1H7, Canada.
| | - Sue Featherston
- Huntsville Physicians Local Education Group, 100 Frank Miller Drive, Huntsville, ON, P1H 1H7, Canada
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O’Brien A, Forde C. Health science staff and student experiences of teaching and assessing clinical skills using digital tools: a qualitative study. Ann Med 2023; 55:2256656. [PMID: 37725836 PMCID: PMC10512752 DOI: 10.1080/07853890.2023.2256656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023] Open
Abstract
INTRODUCTION Once considered a supplement to traditional teaching approaches, digital tools now play a pivotal role in building core clinical competencies. This study aims to explore staff and student experiences of navigating the challenges of teaching and assessing clinical skills using digital technology. It also aims to provide insight into what skills, or aspects of skills, may be best suited to digitally enhanced teaching, thereby advancing the future of health science education. METHODS This qualitative study comprises the second phase of data generation for a mixed-methods research project entitled DEPTH (Digitally Enhanced Practical Teaching in Health Science). Health science staff and students expressed interest in taking part in the current study during the first stage of data collection. Qualitative data was collected in January 2022 through semi-structured group interviews and individual semi-structured interviews. An interpretivist qualitative research design underpinned by a critical realist epistemological position was used. Themes were generated following Braun and Clarke's 6-step process for reflexive thematic analysis. RESULTS Overall, 10 staff and 8 students across 11 health science disciplines participated in this research. Fourteen hours of transcripts were analysed and 4 themes generated. Our findings highlight the suitability of digitally enhanced teaching for low-stake skills requiring visual and auditory training, while skills requiring tactile training require in-person practice to build student competency. Importantly, our findings indicate a desire for increased remote teaching. While our work was not specifically aimed at documenting experiences related to the Covid-19 pandemic, all participants had lived experience teaching or learning during the pandemic and many spoke specifically about this. CONCLUSIONS The timing of this paper captures a novel moment in the history of clinical pedagogy. Staff and students advocate for the continued integration of technology into health science education generally, and clinical skills teaching specifically. For this to be successful, judicious selection of methods, skills, skill components and technology, that can be appropriately mapped onto specific learning outcomes, is required.
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Affiliation(s)
- Annie O’Brien
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Cuisle Forde
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
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18
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Berg H, Prasolova-Førland E, Steinsbekk A. Developing a virtual reality (VR) application for practicing the ABCDE approach for systematic clinical observation. BMC Med Educ 2023; 23:639. [PMID: 37670300 PMCID: PMC10478466 DOI: 10.1186/s12909-023-04625-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 08/28/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND The Airways, Breathing, Circulation, Disability, Exposure (ABCDE) approach is an international approach for systematic clinical observation. It is an essential clinical skill for medical and healthcare professionals and should be practiced repeatedly. One way to do so is by using virtual reality (VR). The aim was therefore to develop a VR application to be used by inexperienced health students and professionals for self-instructed practice of systematic clinical observation using the ABCDE approach. METHODS An iterative human-centred approach done in three overlapping phases; deciding on the ABCDE approach, specifying the requirements, and developing the application. RESULTS A total of 138 persons were involved. Eight clinical observations were included in the ABCDE approach. The requirements included making it possible for inexperienced users to do self-instructed practice, a high level of immersion, and a sense of presence including mirroring the physical activities needed to do the ABCDE approach, allowing for both single and multiplayer, and automatic feedback with encouragement to repeat the training. In addition to many refinements, the testing led to the development of some new solutions. Prominent among them was to get players to understand how to use the VR hand controllers and start to interact with the VR environment and more instructions like showing videos on how to do observations. The solutions in the developed version were categorised into 15 core features like onboarding, instructions, quiz, and feedback. CONCLUSION A virtual reality application for self-instructed practice of systematic clinical observation using the ABCDE approach can be developed with sufficient testing by inexperienced health students and professionals.
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Affiliation(s)
- Helen Berg
- Department of Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway.
| | - Ekaterina Prasolova-Førland
- Department of Education and Lifelong Learning, Norwegian University of Science and Technology, Trondheim, Norway
| | - Aslak Steinsbekk
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
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Luginbuehl H, Nabecker S, Greif R, Zuber S, Koenig I, Rogan S. Transforming traditional physiotherapy hands-on skills teaching into video-based learning. BMC Med Educ 2023; 23:624. [PMID: 37658348 PMCID: PMC10474678 DOI: 10.1186/s12909-023-04556-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 07/31/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND Pandemic-induced restrictions forced curriculum transformation from on-site education to virtual learning options. This report describes this transition, the challenge of creating technology-enhanced learning for hands-on psychomotor skills teaching in physiotherapy, and students' evaluations of the new technology-enhanced learning approach in Complex Decongestive Physiotherapy. METHODS On-site theoretical background lectures were replaced with e-learning sessions. Faculty hands-on skills demonstrations for the entire class were replaced with video-recorded demonstrations. Videos included verbal and written instructions and were complemented with checklists guiding the students, training in pairs, through their learning tasks. A cross-sectional observational survey for teaching quality evaluated this new technology-enhanced learning approach and assessed students' preference for traditional or video-based hands-on skills learning. RESULTS Survey return rate was > 50% (46 participating students). Teaching quality was rated between 1.5 ± 0.5 and 1.8 ± 0.4 (Likert scale from - 2 to + 2). Most students (66.7%) preferred the new approach. They appreciated for example that videos were available all the time, enabling self-paced learning, providing an equally good view on skills demonstrations, and the convenience to be able to rewind, re-view, and use speed adjustment options. CONCLUSIONS Students preferred the new video-based learning of skills for Complex Decongestive Physiotherapy. Because in-class live skills demonstrations were omitted, faculty had more time to provide individual feedback and answer questions. The shift from teacher- to student-centered learning enabled students to control their own learning pace. The innovative program was maintained after pandemic-induced restrictions were lifted. The success of this approach should be tested in other physiotherapy settings and different educational institutions.
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Affiliation(s)
- Helena Luginbuehl
- School of Health Professions, Division of Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, Bern, 3008, Switzerland.
| | - Sabine Nabecker
- Department of Anesthesiology and Pain Management, Sinai Health System, University of Toronto, Toronto, Canada
| | - Robert Greif
- University of Bern, Bern, Switzerland
- School of Medicine, Sigmund Freud University Vienna, Vienna, Austria
| | - Stefan Zuber
- School of Health Professions, Division of Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, Bern, 3008, Switzerland
| | - Irene Koenig
- School of Health Professions, Division of Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, Bern, 3008, Switzerland
| | - Slavko Rogan
- School of Health Professions, Division of Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, Bern, 3008, Switzerland
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Saeed S, Khan MH, Siddiqui MMU, Dhanwani A, Hussain A, Ali MM. Hybridizing video-based learning with simulation for flipping the clinical skills learning at a university hospital in Pakistan. BMC Med Educ 2023; 23:595. [PMID: 37605200 PMCID: PMC10463664 DOI: 10.1186/s12909-023-04580-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/09/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND While learning and practicing on actual patients is a major mode of teaching clinical skills, concerns about patient safety, unavailability, and lack of standardization have led to the development of simulation for medical education. Simulation-based teaching is affected by challenges such as lack of protected time for faculty, inexperienced learners, and the number of students per group. These have led to the integration of various eLearning formats in the curriculum. The hybridized format changes the traditional clinical skills teaching into the flipped classroom. This study aims to measure the effectiveness of hybridizing video-based learning with simulation for flipping the clinical skills teaching of fourth-year medical students at the Department of Paediatrics and Child Health at Aga Khan University, Pakistan. METHODS The study employed a mixed-methods design. Fourth-year medical students of the batch 2020-21 (n = 100) consented to participate in the study. The quantitative component focuses on identifying the effect of the intervention on the perceived self-efficacy of medical students (batch 2020-21) relevant to the clinical skill. Along with this, the performance of the intervention batch of 2020-21 on the end of clerkship objective structured clinical exam (OSCE) was compared with the previous batch of 2019-20, taught using simulation alone. Focused group discussions (FGDs) were used to explore the experiences of medical students (batch 2020-21) about the intervention. Quantitative data underwent descriptive and inferential analysis using Stata v16 while qualitative data underwent content analysis using NVivo software. RESULTS Hybridization of video-based learning with simulation significantly improved self-efficacy scores for all examinations (cardiovascular, respiratory, neurological, and abdomen) with p-value < 0.05. OSCE scores of the intervention group were significantly higher on the neurological and abdominal stations as compared to the previous batch (p-value < 0.05). In addition, the overall structure of the intervention was appreciated by all the students, who stated it allowed reinforcement of basic concepts, retention, and further insight into clinical applications. CONCLUSION The hybridization of video-based learning with simulation facilitated in creation of better opportunities for medical students to revive their prior knowledge, apply core concepts for the problem and engage in clinical reasoning.
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Affiliation(s)
- Sana Saeed
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
| | - Maryam Hameed Khan
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Anny Dhanwani
- Department of Community Health Sciences, Resident Physician, Aga Khan University, Karachi, Pakistan
| | - Areeba Hussain
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
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Rollmann I, Lauter J, Kuner C, Herrmann-Werner A, Bugaj TJ, Friederich HC, Nikendei C. Tutors´ and Students' Agreement on Social and Cognitive Congruence in a Sonography Peer-assisted-learning Scenario. Med Sci Educ 2023; 33:903-911. [PMID: 37546194 PMCID: PMC10403448 DOI: 10.1007/s40670-023-01814-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 08/08/2023]
Abstract
Purpose Peer-assisted learning has become an integral part within medical education and has been proven to be effective in teaching medical skills. Cognitive and social congruence are important factors that explain the effectiveness of peer-assisted learning. However, although theory suggests this, there is no study to date that demonstrates that students and tutors agree upon the level of cognitive and social congruence. Thus, we compared tutors' and students' perception of cognitive and social congruence and their agreement on the causes of congruence. Methods 36 students and 9 tutors from 9 courses were asked to answer questionnaires for their perception of cognitive and social congruence in a peer-assisted learning sonography scenario. Results Students and tutors experienced cognitive congruence (t = 0.8277, df = 8, p = .4318, 95% CI = [-0.232; 0.491]) and social congruence (t = 0.962, df = 8, p = .364, 95% CI = [-0.145; 0.354]) similarly. In contrast, students and tutors disagreed on causes of cognitive congruence (agreement = 53.90%) and social congruence (agreement = 58.49%). Tutors rated their empathy and interest toward students as the main cause. Students rated the helpfulness, effectiveness, and approachableness of the tutor as the main cause. Conclusions Our study filled the gap in previous research on cognitive and social congruence. Consistent with theoretical considerations, it was shown that students and tutors do indeed experience cognitive and social congruence similarly. Nevertheless, differences also emerged that may carry more or less weight depending on the research question. Future studies should therefore carefully examine whether the assessment of cognitive and social congruence of students and tutors is necessary.
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Affiliation(s)
- Ivo Rollmann
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstraße 4, 69115, Heidelberg, Germany
| | - Jan Lauter
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstraße 4, 69115, Heidelberg, Germany
| | - Charlotte Kuner
- Clinical Ultrasound Course at Medical Faculty, University of Heidelberg, Heidelberg, Germany
| | - Anne Herrmann-Werner
- Medical Department VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Medical Faculty Tübingen, Tübingen Institute for Medical Education, Tübingen, Germany
| | - Till J. Bugaj
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstraße 4, 69115, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstraße 4, 69115, Heidelberg, Germany
| | - Christoph Nikendei
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstraße 4, 69115, Heidelberg, Germany
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Saad S, Richmond C, King D, Jones C, Malau-Aduli B. The impact of pandemic disruptions on clinical skills learning for pre-clinical medical students: implications for future educational designs. BMC Med Educ 2023; 23:364. [PMID: 37217918 DOI: 10.1186/s12909-023-04351-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 05/11/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Pandemic disruptions to medical education worldwide resulted in rapid adaptations to clinical skills learning. These adaptations included moving most teaching to the online environment, decreasing the accepted "hands-on" methods of teaching and learning. While studies have shown significant impacts on student confidence in skills acquisition, there is a paucity of assessment outcome studies which would contribute a valuable perspective on whether measurable deficits were incurred. Here, a preclinical (Year 2) cohort was investigated for clinical skills learning impacts that could influence their transition to hospital-based placements. METHODS A sequential mixed methods approach was used on the Year 2 Medicine cohort, including: focus group discussions with thematic analysis; a survey derived from the themes observed; and a cohort comparison of the clinical skills examination results of the disrupted Year 2 cohort, compared to pre-pandemic cohorts. RESULTS Students reported experiencing benefits and disadvantages of the shift to online learning, including a decrease in confidence in their skills acquisition. End of year summative clinical assessments showed non-inferior outcomes when compared to previous cohorts for the majority of clinical skills. However, for procedural skills (venepuncture) the disrupted cohort had significantly lower scores compared to a pre-pandemic cohort. CONCLUSIONS Rapid innovation during the COVID-19 pandemic provided the opportunity to compare online asynchronous hybrid clinical skills learning with the usual practice of face-to-face synchronous experiential learning. In this study, students' reported perceptions and assessment performance data indicate that careful selection of skills suitable for online teaching, supported by timetabled "hands-on" sessions and ample practice opportunities, is likely to provide non-inferior outcomes for clinical skills learning in students about to transition to clinical placements. The findings can be used to inform clinical skills curriculum designs that incorporate the virtual environment, and assist with future-proofing skills teaching in the case of further catastrophic disruptions.
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Affiliation(s)
- Shannon Saad
- School of Medicine, Notre Dame University, Sydney, NSW, Australia.
| | | | - Dane King
- School of Medicine, Notre Dame University, Sydney, NSW, Australia
| | - Caelyn Jones
- School of Medicine, Notre Dame University, Sydney, NSW, Australia
| | - Bunmi Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
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Korkut S, Ünsal A, Kaplan A. Comparison of Turkish and English YouTube videos on phlebotomy in terms of content, reliability and quality. Nurse Educ Pract 2023; 70:103669. [PMID: 37211006 DOI: 10.1016/j.nepr.2023.103669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 05/23/2023]
Abstract
AIM This study was conducted to evaluate the content, reliability and quality of YouTube videos about phlebotomy. METHOD A retrospective, register-based study was conducted exclusively with videos publicly available on YouTube in June 2022. Ninety videos have been evaluated in terms of content, reliability and quality. This evaluation was performed by two independent researchers. The skill checklist created with reference to the WHO blood collection guide was used for the content evaluation of the videos. The short form of the DISCERN questionnaire was used to evaluate the reliability of the video. The quality of the videos was evaluated with a 5-point Global Quality Scale. RESULTS The mean validity score of the English videos was 2.58 ± 0.88, the quality score was 2.98 ± 1.02 and the content score was 8.78 ± 1.47. In the Turkish videos, the mean validity score was 1.90 ± 1.27, the quality score was 2.35 ± 0.97 and the content score was 8.02 ± 1.07. The content, validity and quality scores of the English videos were found to be significantly higher than the Turkish videos. CONCLUSION Some videos do not include evidence-based practice and some videos contain technical differences as in the literature. In addition, in some videos, non-recommended techniques such as touching the cleaning area, opening and closing the fist were used. For these reasons, the results show that YouTube videos on phlebotomy are a limited resource for students.
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Affiliation(s)
- Sevda Korkut
- Erciyes University, Faculty of Health Sciences, Department of Nursing, Kayseri, Türkiye.
| | - Ayla Ünsal
- Kırşehir Ahi Evran University, Faculty of Health Sciences, Department of Nursing, Kırşehir, Türkiye
| | - Ali Kaplan
- Kayseri University, Incesu Ayşe and Saffet Arslan Health Services Vocational School, Department of Medical Services and Techniques, Kayseri, Türkiye
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24
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Lau ST, Liaw SY, Loh WL, Schmidt LT, Yap J, Lim FP, Ang E, Jiat C, Siah R. Mid-career switch nursing students' perceptions and experiences of using immersive virtual reality for clinical skills learning: A mixed methods study. Nurse Educ Today 2023; 124:105760. [PMID: 36857881 DOI: 10.1016/j.nedt.2023.105760] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/25/2022] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND There has been an increase of mid-career professionals joining nursing. These adult students possess significant expertise in other areas and may benefit substantially in deliberate practice to acquire skills competency using immersive virtual reality (IVR) for clinical procedures before they practise in actual clinical settings. OBJECTIVES This study aims to (1) examine the impact of IVR clinical procedures on mid-career switch students in knowledge, game perception and user reaction; (2) to explore the mid-career switch students' perceptions and experiences in using the IVR clinical procedures. DESIGN A mixed methods feasibility study was used. SETTING AND PARTICIPANTS This study was conducted at a university in Singapore with 34 first-year mid-career switch students. METHODS This study is a single-group pre-test and post-test experimental study on learning clinical procedures using IVR in the home setting. The study took place from September to November 2021. Focus group discussions were conducted and analysed verbatim using thematic analysis. RESULTS The students demonstrated significant improvement of knowledge for subcutaneous insulin, but overall, the increase in combined scores for both intravenous therapy and subcutaneous insulin were not statistically significant. Three overarching themes included: 1) Learning and practice, 2) Challenges and barriers, and 3) Personal attributes. Most of the participants found the experiences to be engaging, relevant, and satisfying. Some reported experiencing giddiness, headache, and lack of familiarity with technologies. CONCLUSIONS IVR simulation can potentially be used as a supplementary learning tool to improve knowledge of clinical procedures in mid-career switch students.
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Affiliation(s)
- Siew Tiang Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, 117597, Singapore.
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Wen Liang Loh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Laura Tham Schmidt
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - John Yap
- Application Architecture and Technology, National University of Singapore, Singapore.
| | - Fui Ping Lim
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Emily Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Chiew Jiat
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rosalind Siah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Simpson K, Midgley K. Learning through fun: board games cafes for undergraduate nursing students. Br J Nurs 2023; 32:384-389. [PMID: 37083378 DOI: 10.12968/bjon.2023.32.8.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
This article discusses the development, implementation and evaluation of clinical board games cafes in an undergraduate nurse education programme. Drawing on previous relevant literature about gaming approaches in education, the benefits and impact on student learning is presented. Thematic analysis of student feedback suggests that participation provided an opportunity to safely practise clinical scenarios and imbed concepts, as well as time to socialise to build support networks. Students also reported gaining confidence for their upcoming clinical placements. The benefits of a social opportunity timetabled during course teaching time was welcomed by students with commitments outside of the programme. The light-hearted cafe style environment can deliver a positive student experience and complement traditional teaching methods. Suggestions for future development include interdisciplinary sessions, development of games more specific to the mental health field and enabling students to get games out of the library for self-directed learning. Further evaluation of the impact of longer term learning through games is required.
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Affiliation(s)
- Kate Simpson
- Assistant Professor, School of Health Sciences, University of Nottingham
| | - Katherine Midgley
- Assistant Professor, School of Health Sciences, University of Nottingham
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26
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Villagrán I, Rammsy F, Del Valle J, Gregorio de Las Heras S, Pozo L, García P, Torres G, Varas J, Mandrusiak A, Corvetto M, Fuentes-Cimma J. Remote, asynchronous training and feedback enables development of neurodynamic skills in physiotherapy students. BMC Med Educ 2023; 23:267. [PMID: 37081551 PMCID: PMC10116106 DOI: 10.1186/s12909-023-04229-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, face-to-face teaching and learning of physiotherapy practical skills was limited. Asynchronous, remote training has been effective in development of clinical skills in some health professions. This study aimed to determine the effect of remote, asynchronous training and feedback on development of neurodynamic skills in physiotherapy students. METHODS Longitudinal repeated measurements study, across four training sessions. Participants engaged in a remote training program for development of upper limb neurodynamic techniques. In this sequential training, participants viewed the online tutorial, practiced independently, and uploaded a video of their performance for formative assessment and feedback from a trained instructor via a checklist and rubric. RESULTS Intra-subject analyses of 60 third-year physiotherapy students showed that the target standard of performance, with no further significant change in scores, was attained following session 2 for the checklist and session 3 for the rubric. This shows that two sessions are required to learn the procedures, and three sessions yield further improvements in performance quality. CONCLUSION The remote, asynchronous training and feedback model proved to be an effective strategy for students' development of neurodynamic testing skills and forms a viable alternative to in-person training. This study contributes to the future of acquiring physiotherapy clinical competencies when distance or hybrid practice is required.
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Affiliation(s)
- Ignacio Villagrán
- Carrera de Kinesiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Santiago, Chile
| | - Francisca Rammsy
- Carrera de Kinesiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Santiago, Chile
| | - Javiera Del Valle
- Carrera de Kinesiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Santiago, Chile
| | - Sofía Gregorio de Las Heras
- Carrera de Kinesiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Santiago, Chile
| | - Liliana Pozo
- Carrera de Kinesiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Santiago, Chile
| | - Patricio García
- Carrera de Kinesiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Santiago, Chile
| | - Gustavo Torres
- Carrera de Kinesiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Santiago, Chile
| | - Julián Varas
- Centro de Simulación y Cirugía experimental, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Allison Mandrusiak
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Marcia Corvetto
- Centro de Simulación y Cirugía experimental, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javiera Fuentes-Cimma
- Carrera de Kinesiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Santiago, Chile.
- School of Health Professions Education (SHE), Maastricht University, Maastricht, the Netherlands.
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Swallow MA, Wride AM, Donroe JH. Peer-Assisted Learning in a Longitudinal Hybrid Physical Exam Course. Med Sci Educ 2023; 33:359-362. [PMID: 36846080 PMCID: PMC9936932 DOI: 10.1007/s40670-023-01755-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 05/31/2023]
Abstract
Peer-assisted learning (PAL) improves teaching skills and self-confidence for instructors and creates a supportive learning climate for learners. We developed a PAL hybrid teaching structure for our physical exam course by partnering upper-level peer instructors with faculty co-instructors and evaluated its impact on upper-level student peer instructors and first-year student learners using quantitative and qualitative methods. The PAL component of the hybrid teaching structure was perceived to have important benefits for all and salient limitations for student learners. The hybrid nature of the course provided a unique vantage point for evaluation of PAL and we theorize that faculty co-instructors may balance some of the perceived limitations of PAL.
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Affiliation(s)
- Madisen A. Swallow
- Yale University School of Medicine, 1450 Chapel Street, Office MOB 211, New Haven, CT 06511 USA
| | - A. Mitchel Wride
- Yale University School of Medicine, 1450 Chapel Street, Office MOB 211, New Haven, CT 06511 USA
| | - Joseph H. Donroe
- Yale University School of Medicine, 1450 Chapel Street, Office MOB 211, New Haven, CT 06511 USA
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Meyer EG, Cozza KL, West JC, Hamaoka D. The Effectiveness of Online Experiential Learning in a Psychiatry Clerkship. Acad Psychiatry 2023; 47:181-186. [PMID: 36808570 PMCID: PMC9937738 DOI: 10.1007/s40596-023-01755-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The Uniformed Services University of the Health Sciences 5-week psychiatry clerkship educates about 180 students a year at sites around the USA. In 2017, weekly in-person experiential learning sessions were implemented for local students and resulted in improved performance in several end-of-clerkship Objective Structured Clinical Examination (OSCE) skills as compared to distant learners who did not receive these sessions. The difference in performance (~ 10%) highlighted a need to provide comparable training for distant learners. Providing in-person, repeated simulated experiential training at multiple distant sites was not practical, requiring development of a novel online approach. METHODS Students at all four distant sites over 2 years (n = 180) participated in five weekly synchronous online experiential learning sessions, while local students (n = 180) received five weekly in-person experiential learning sessions. Tele-simulation used the same curriculum, centralized faculty, and standardized patients as the in-person iterations. Overall end-of-clerkship OSCE performance was compared for learners receiving online versus in-person experiential learning for non-inferiority. Specific skills were compared to receiving no experiential learning. RESULTS Overall OSCE performance was non-inferior for students who received synchronous online as compared to in-person experiential learning. Performance on each skill other than communication improved significantly when comparing students who received online versus no experiential learning (p < 0.05). CONCLUSIONS The use of weekly online experiential learning to enhance clinical skills is comparable to in-person efforts. Virtual, simulated, synchronous experiential learning provides a feasible and scalable platform for training complex clinical skills to clerkship students, a critical capability given the impact the pandemic has had on clinical training.
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Affiliation(s)
- Eric G Meyer
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - Kelly L Cozza
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - James C West
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Derrick Hamaoka
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Hasan Ibrahim AS, Barry HE, Girvin B, Hughes CM. Development of a core set of clinical skills for pharmacist prescribers working in general practice: A Delphi study. Res Social Adm Pharm 2023; 19:628-33. [PMID: 36641297 DOI: 10.1016/j.sapharm.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/21/2022] [Accepted: 01/01/2023] [Indexed: 01/04/2023]
Abstract
BACKGROUND With increasing numbers of pharmacists working in general practices and undertaking patient-facing roles, it has been recognised that they must have the necessary clinical skills. However, previous studies have highlighted that practice-based pharmacists (PBPs) do not feel confident regarding their clinical skills, and it is unclear what skills are needed. OBJECTIVE To develop a core set of clinical skills (CSs) required for pharmacists who intend to practise as independent prescribers working in general practice/family medicine. METHODS Based on a previous study, 18 CSs were selected for inclusion in a three-round Delphi consensus questionnaire. These skills were rated by a Delphi panel on a 9-point Likert scale (ranging from 1 = limited importance to 9 = critical). The Delphi panel comprised designated leads of pharmacist independent prescribing programmes in each United Kingdom educational provider listed on the General Pharmaceutical Council website. A CS was included in the core set if 80% or more of participants scored between 7 and 9, and 15% or less scored between 1 and 3. RESULTS Following Round 1, seven CSs met the criteria for inclusion: 'Measuring heart rate (radial pulse)', 'Assessing respiratory rate', 'Measuring blood pressure (manual, e.g. with aneroid sphygmomanometer)', 'Measuring blood pressure (automated, i.e. electronic blood pressure monitor)', 'Measuring peripheral oxygen saturation (using pulse oximeter)', 'Measuring temperature', 'Measuring Peak Expiratory Flow Rate'. After two further rounds, a further four CSs were included consisting of 'Undertaking a urinalysis', 'Respiratory examination (includes inspection, palpation, percussion and listening to breath sounds)', 'Screening for/assessment of depression and anxiety using a validated questionnaire (e.g. Patient Health Questionnaire-9 [PHQ-9] scoring)', and 'Patient assessment via National Early Warning Score (NEWS)'. No consensus was reached on nine CSs. CONCLUSION This study has produced a core set of CSs for prescribing pharmacists. This study may contribute to standardisation of training and assessment for pharmacist prescribers working in general practice/family medicine.
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John JT, Gowda D, Schlair S, Hojsak J, Milan F, Auerbach L. After the Discontinuation of Step 2 CS: A Collaborative Statement from the Directors of Clinical Skills Education (DOCS). Teach Learn Med 2023; 35:218-223. [PMID: 35287502 DOI: 10.1080/10401334.2022.2039154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Issue: The United States Medical Licensing Exam (USMLE) Step 2 Clinical Skills Examination (Step 2 CS), the only clinical skills competency testing required for licensure in the United States, has been discontinued. Evidence: This exam, though controversial, propelled a movement emphasizing the value of clinical skills instruction and assessment in undergraduate medical education. While disappointed by the loss of this national driver that facilitated standardization of clinical skills education, the Directors of Clinical Skills Education (DOCS) see prospects for educational innovation and growth. DOCS is a national organization and inclusive community of clinical skills education leaders. This statement from DOCS regarding the discontinuation of USMLE Step 2 CS has been informed by DOCS meetings, listserv discussions, an internal survey, and a review of recent literature. Implications: Rigorous clinical skills assessment remains central to effective and patient-centered healthcare. DOCS shares specific concerns as well as potential solutions. Now free from the external pressure to prepare students for success on Step 2 CS, clinical skills educators can reprioritize content and restructure clinical skills programs to best meet the needs of learners and the ever-evolving healthcare landscape. DOCS, as an organization of clinical skills leaders, makes the following recommendations: 1) Collaboration amongst institutions must be prioritized; clinical skills assessment consortia should be expanded. 2) Governing, accrediting, and licensing organizations should leverage their influence to support and require high quality clinical skills assessments. 3) UME clinical skills leaders should develop ways to identify students who perform with exceptional, borderline, and poor clinical skills at their local institutions. 4) UME leadership should fully commit resources and curricular time to graduate students with excellent clinical skills.
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Affiliation(s)
- Janice Thomas John
- Science Education and Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Deepthiman Gowda
- Medical Education and Medicine, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA
| | - Sheira Schlair
- Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Joanne Hojsak
- Pediatrics and Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Felise Milan
- Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
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Girvin B, Sims L, Haughey S. Empowering future pharmacists - Embedding prescribing in the United Kingdom pharmacy undergraduate degree. Curr Pharm Teach Learn 2023; 15:334-339. [PMID: 37105795 DOI: 10.1016/j.cptl.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 02/14/2023] [Accepted: 04/17/2023] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Pharmacy education within the United Kingdom (UK) is on the cusp of a major change with the integration of pharmacist independent prescribing into the undergraduate Master of Pharmacy (MPharm) degree and foundation year. This presents an opportunity for schools of pharmacy to completely review and redesign the MPharm degree in order to embed prescribing. This commentary details what needs to change within the MPharm degree and how these changes can be enacted. COMMENTARY The learning outcomes for the new degree place greater emphasis on diagnostic and consultation skills, risk management, professional judgement, and leadership. Course content needs to be sequenced so that complexity builds throughout the programme and clinical skills are taught and practised within the context of prescribing. There will be more emphasis on higher-order cognitive skills, such as collaborative clinical decision-making, considering potential risks and benefits. Teaching will need to align with learning on placements and time needs built into the curriculum for preparation and debrief sessions following placements and simulation scenarios. The increased responsibility that comes with prescribing rights will require review of how professional identity is formed and professionalism skills are taught and assessed. IMPLICATIONS Pharmacists' expertise in medicines means that they are well-placed to be prescribers, which will help meet health service demands. Long-term funding will be required for placements in community, general practice, and hospital settings, including the provision of training and support to pharmacists mentoring students on placements. In spite of the challenges of curriculum redesign, this opportunity is wholeheartedly welcomed.
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Affiliation(s)
- Briegeen Girvin
- School of Pharmacy, Queen's University Belfast, United Kingdom.
| | - Laura Sims
- University of Exeter Medical School, United Kingdom.
| | - Sharon Haughey
- School of Pharmacy, Queen's University Belfast, United Kingdom.
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Donroe JH, Soares S, Sofair AN. Strategies to Improve Teaching Point-of-Care Ultrasound at the Bedside. Med Sci Educ 2023; 33:577-581. [PMID: 37261030 PMCID: PMC10226959 DOI: 10.1007/s40670-023-01772-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 06/02/2023]
Abstract
Point-of care-ultrasound (POCUS) is becoming a core clinical skill in many medical specialties. Teaching POCUS at the bedside allows for observation of learners during actual patient encounters, provides a medium for role modeling skills and behaviors, and incorporates all core POCUS competencies. Nonetheless, bedside teaching can be time consuming and intimidating for learners and teachers, and the full benefits of teaching at the bedside can be difficult to attain. We provide strategies for improving bedside POCUS teaching based on our collective experience as medical educators and POCUS instructors at both the undergraduate and graduate levels in medical education.
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Affiliation(s)
- Joseph H. Donroe
- Department of Internal Medicine, Yale School of Medicine, Office MOB 210, 1450 Chapel Street, New Haven, CT 06511 USA
| | - Sarita Soares
- Department of Internal Medicine, Yale School of Medicine, Office MOB 210, 1450 Chapel Street, New Haven, CT 06511 USA
| | - André N. Sofair
- Department of Internal Medicine, Yale School of Medicine, Office MOB 210, 1450 Chapel Street, New Haven, CT 06511 USA
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Weinstein A, MacPherson P, Schmidt S, Van Opstal E, Chou E, Pogemiller M, Gibbs K, Held M. Needs assessment for enhancing pediatric clerkship readiness. BMC Med Educ 2023; 23:188. [PMID: 36978085 PMCID: PMC10044806 DOI: 10.1186/s12909-023-04167-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Many students report feeling inadequately prepared for their clinical experiences in pediatrics. There is striking variability on how pediatric clinical skills are taught in pre-clerkship curricula. METHODS We asked students who completed their clerkships in pediatrics, family medicine, surgery, obstetrics-gynecology and internal medicine to rate their pre-clinical training in preparing them for each clerkship, specifically asking about medical knowledge, communication, and physical exam skills. Based on these results, we surveyed pediatric clerkship and clinical skills course directors at North American medical schools to describe the competence students should have in the pediatric physical exam prior to their pediatric clerkship. RESULTS Close to 1/3 of students reported not feeling adequately prepared for their pediatrics, obstetrics-gynecology, or surgery clerkship. Students felt less prepared to perform pediatric physical exam skills compared to physical exam skills in all other clerkships. Pediatric clerkship directors and clinical skills course directors felt students should have knowledge of and some ability to perform a wide spectrum of physical exam skills on children. There were no differences between the two groups except that clinical skills educators identified a slightly higher expected competence for development assessment skills compared to pediatric clerkship directors. CONCLUSIONS As medical schools undergo cycles of curricular reform, it may be beneficial to integrate more pre-clerkship exposure to pediatric topics and skills. Further exploration and collaboration establishing how and when to incorporate this learning could serve as a starting point for curricular improvements, with evaluation of effects on student experience and performance. A challenge is identifying infants and children for physical exam skills practice.
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Affiliation(s)
- Adam Weinstein
- Frank H. Netter MD School of Medicine, North Haven, CT, USA.
| | | | - Suzanne Schmidt
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Erica Chou
- Medical College of Wisconsin, Milwaukee, WI, USA
| | | | | | - Melissa Held
- University of Connecticut School of Medicine, Farmington, CT, USA
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Morishita M, Iida J, Nishigori H. Reconstructing the concept of empathy: an analysis of Japanese doctors' narratives of their experiences with illness. Adv Health Sci Educ Theory Pract 2023; 28:87-106. [PMID: 35951128 DOI: 10.1007/s10459-022-10143-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
The ability of doctors to empathise with patients is a crucial concern in establishing humanistic medicine. Therefore, the cultivation of this ability has been discussed extensively in medical education. One theory suggests that the experience of patienthood can increase empathy among doctors. This theory is supported by previous research that published doctors' illness narratives. However, the concept of empathy has been ambiguously defined in academic fields, including medicine; therefore, analysing how doctors experience 'empathy' in their interactions with patients is difficult. Our research question is how doctors who became patients describe the relationship between their illness experiences and the interactions with patients after their illness. To this end, this paper initially tracks the debates on 'empathy' in medicine and other disciplines, to develop a lens for analysing doctors' illness narratives. Next, we conduct a narrative analysis of illness stories from 18 Japanese medical doctors who became patients. Our analysis supports the traditional idea that an illness can enable a doctor to become more empathetic. However, this is overly simplistic; how doctors experience and subsequently process their illness is more complex. Moreover, this notion can disregard doctors' suffering in these circumstances, and fail to represent the often-lengthy process of mastering 'empathy' based on their experiences. Therefore, our analysis deconstructed the concept of 'empathy', showing that it can appear in various ways. Further research is required to elucidate how empathy is cultivated during the process of transformation of doctors' illnesses, focusing on their communities and practices.
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Affiliation(s)
- Mariko Morishita
- Medical Education Center, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - Junko Iida
- Faculty of Health and Welfare, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Hiroshi Nishigori
- Medical Education Center, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
- Center for Medical Education, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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Macfarlane E, Stitely M, Paterson H. What skills do New Zealand clinicians have to provide first trimester abortion in primary care and are they willing? Sex Reprod Healthc 2023; 35:100810. [PMID: 36706712 DOI: 10.1016/j.srhc.2022.100810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/15/2022] [Accepted: 12/21/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To determine the skills and intentions of health practitioners in New Zealand to provide first trimester abortion care.New Zealand achieved abortion law reform in 2020, changing how abortion could be delivered and experienced by pregnant people. However, little has changed in the way abortion care is provided. STUDY DESIGN This survey, which was deployed to a range of health practitioners via regulatory bodies and professional groups, used an online free text and tick box survey. Questions included demographics, scope of practice, abortion care experience, philosophical perspective on abortion, and skills transferable to abortion care. Data was analysed using descriptive statistics and deductive and inductive thematic analysis. RESULTS 128 respondents included doctors, nurses, midwives, counsellors, and social workers from a range of practice settings, the majority from primary health (51%). Most respondents indicated competency or proficiency in clinical skills relevant to provision of early medical abortion. However, practitioners were more likely to indicate "I do not have this skill" or "support required" for: calculating gestational age by bimanual examination (42%), LARC (implant and IUC) insertion (36%), undertake a pregnancy related consultation using tikanga best practice guidelines (19%).Analysis of qualitative data showed three main themes; (1) support for abortion access and for abortion provision in primary care (2) levels of intention to provide abortion (3) critical components for an action plan for abortion in primary care. CONCLUSION Abortion care in the community has support from health practitioners. They identified needs including development of clinical skills, funding, and wider sector support.
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Affiliation(s)
- E Macfarlane
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin 9054, Dunedin, New Zealand.
| | - M Stitely
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, New Zealand
| | - H Paterson
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, New Zealand
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Grundgeiger T, Ertle F, Diethei D, Mengelkamp C, Held V. Improving procedural skills acquisition of students during medical device training: experiments on e-Learning vs. e-Learning with hands-on. Adv Health Sci Educ Theory Pract 2023; 28:127-146. [PMID: 36068368 PMCID: PMC9992047 DOI: 10.1007/s10459-022-10148-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 07/23/2022] [Indexed: 06/15/2023]
Abstract
In the context of medical device training, e-Learning can address problems like unstandardized content and different learning paces. However, staff and students value hands-on activities during medical device training. In a blended learning approach, we examined whether using a syringe pump while conducting an e-Learning program improves the procedural skills needed to operate the pump compared to using the e-Learning program only. In two experiments, the e-Learning only group learned using only the e-Learning program. The e-Learning + hands-on group was instructed to use a syringe pump during the e-Learning to repeat the presented content (section "Experiment 1") or to alternate between learning on the e-Learning program and applying the learned content using the pump (section "Experiment 2"). We conducted a skills test, a knowledge test, and assessed confidence in using the pump immediately after learning and two weeks later. Simply repeating the content (section "Experiment 1") did not improve performance of e-Learning + hands-on compared with e-Learning only. The instructed learning process (section "Experiment 1") resulted in significantly better skills test performance for e-Learning + hands-on compared to the e-Learning only. Only a structured learning process based on multi-media learning principles and memory research improved procedural skills in relation to operating a medical device.
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Affiliation(s)
- Tobias Grundgeiger
- Institute Human-Computer-Media, Julius-Maximilians-Universität Würzburg, Oswald-Külpe-Weg 82, 97074, Würzburg, Germany.
| | - Franz Ertle
- Institute Human-Computer-Media, Julius-Maximilians-Universität Würzburg, Oswald-Külpe-Weg 82, 97074, Würzburg, Germany
| | - Daniel Diethei
- Institute Human-Computer-Media, Julius-Maximilians-Universität Würzburg, Oswald-Külpe-Weg 82, 97074, Würzburg, Germany
- Human-Computer Interaction, Universität Bremen, Bibliothekstraße 5, 28359, Bremen, Germany
| | - Christoph Mengelkamp
- Institute Human-Computer-Media, Julius-Maximilians-Universität Würzburg, Oswald-Külpe-Weg 82, 97074, Würzburg, Germany
| | - Volker Held
- Medical Device Management and Training, Schindeller 11, 97218, Gerbrunn, Germany
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Grimaldi G. [Simulations in continuing education for more patient safety : Do simulation and skills training influence patient safety in Germany?]. Unfallchirurgie (Heidelb) 2023. [PMID: 36856838 DOI: 10.1007/s00113-022-01272-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 03/02/2023]
Abstract
The secure mastering of manual skills and their regular training lead to a reduction of errors and to an improvement of patient safety. Due to increasing economic pressure and bureaucratization, there is less exposure and insufficient time in the clinical routine to communicate all the contents of continuing education. This is why surgical simulation has become increasingly relevant to improve surgical performance in residents. Nowadays, many forms of simulation training are offered in Germany; however, such training on a model is costly and personnel-intensive. In order to justify the effort, objective measurements are becoming more important to qualify the effectiveness of simulation-based training in Germany.
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Waldbillig F, von Rohr L, Nientiedt M, Neuberger M, Wessels F, V Hardenberg J, Westhoff N, Wuhrer A, Pechlivanidou I, Miernik A, Michel MS, Kriegmair MC, Gruene B. Prospective, Randomized Comparative Evaluation of a Novel Hands-On Endourology Training Curriculum. Urol Int 2023; 107:179-185. [PMID: 36481539 DOI: 10.1159/000527746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 10/10/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The aim of this randomised prospective trial was to evaluate a novel hands-on endourological training programme (HTP) and compare it to the standard endourological colloquium (SC). METHODS A new HTP was created based on a sequence of theoretical, video-based, and practical elements emphasising contemporary teaching methods. An existing SC in which live endourological operations were attended served as a comparison. Medical students were enrolled in a ratio of 1:2 (SC:HTP). Objective knowledge questionnaires (5 questions, open answers) and subjective Likert-type questionnaires (rating 1-3 vs. 4-5) were used for evaluation. Primary endpoint was urological knowledge transfer; secondary endpoints were learning effects, progression, and urological interest. RESULTS 167 students (SC n = 52, HTP n = 115) were included. The knowledge assessment showed a significant increase in knowledge transfer benefitting the HTP on all 5 surveyed items (mean: n = 4/5/4/3/2 vs. n = 2/3/1/1, p < 0.0001). Interest and duration of the course were rated significantly more positively by HTP students (100.0/95.0% vs. 85.0/70.0%, p < 0.0001). The HTP students were significantly more confident in performing a cystoscopy independently (HTP 43.5% vs. SC 11.5%, p < 0.0001) and significantly claimed more often to have gained interdisciplinary and urological skills during the course (HTP 90.0/96.5% vs. SC 23.1/82.7%, p < 0.0001/p = 0.003). HTP students were also more likely to take the course again (HTP 98.2% vs. SC 59.6%, p < 0.0001). CONCLUSION Modifying endourological teaching towards hands-on teaching resulted in stronger course interest, greater confidence regarding endourologic procedures, and significantly increased urologic knowledge transfer.
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Affiliation(s)
- Frank Waldbillig
- Department of Urology and Urosurgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.,RaVeNNA 4pi - Consortium of the German Federal Ministry of Education and Research (BMBF), Bonn, Germany
| | - Lennard von Rohr
- Department of Urology and Urosurgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Malin Nientiedt
- Department of Urology and Urosurgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Manuel Neuberger
- Department of Urology and Urosurgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Frederik Wessels
- Department of Urology and Urosurgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jost V Hardenberg
- Department of Urology and Urosurgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Niklas Westhoff
- Department of Urology and Urosurgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Anne Wuhrer
- Department of Studies and Teaching Development, Learning Hospital TheSiMA, Student Laparoscopy Initiative, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.,Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Ioanna Pechlivanidou
- Department of Studies and Teaching Development, Learning Hospital TheSiMA, Student Laparoscopy Initiative, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Arkadiusz Miernik
- RaVeNNA 4pi - Consortium of the German Federal Ministry of Education and Research (BMBF), Bonn, Germany.,Department of Urology, Faculty of Medicine, University of Freiburg - Medical Centre, Freiburg, Germany
| | - Maurice Stephan Michel
- Department of Urology and Urosurgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Maximilian C Kriegmair
- Department of Urology and Urosurgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.,RaVeNNA 4pi - Consortium of the German Federal Ministry of Education and Research (BMBF), Bonn, Germany
| | - Britta Gruene
- Department of Urology and Urosurgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.,RaVeNNA 4pi - Consortium of the German Federal Ministry of Education and Research (BMBF), Bonn, Germany
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Egilsdottir HÖ, Heyn LG, Falk RS, Brembo EA, Byermoen KR, Moen A, Eide H. Factors associated with changes in students' self-reported nursing competence after clinical rotations: a quantitative cohort study. BMC Med Educ 2023; 23:107. [PMID: 36774493 PMCID: PMC9922443 DOI: 10.1186/s12909-023-04078-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The quality of nursing care in different healthcare contexts can be associated with the level of available nursing competence. Physical assessment skills are vital in nurses' assessment of patient care needs. However, in nursing education, using physical assessment skills is challenging for nursing students who struggle to apply these skills comprehensively in a clinical rotation. Therefore, this study explores changes in nursing competence, factors associated with changes after clinical rotations, and whether a Suite of Mobile Learning Tools supports changes in confident use of basic physical assessment skills. METHODS A quantitative cohort study with an explorative pre-and post-test design. During autumn 2019 and spring 2020, 72 s-year nursing students and 99 third-year students participated in the study. The Nurse Professional Competence scale short form was used to investigate students' self-reported changes in nursing competence, and a study-specific questionnaire was used to investigate students' confidence concerning performing physical assessments. The students voluntarily used the Suite of Mobile Learning Tools for the learning of physical assessment. Linear regression analysis was used to identify factors associated with changes in nursing competence after clinical rotation. The STROBE guidelines for cohort studies were followed for study reporting. RESULTS After the clinical rotation, both student groups reported changes in nursing competence and confidence in performing physical assessment skills, with statistically significant moderate or large changes in all areas. The Suite of Mobile Learning Tools was evaluated as being useful for learning physical assessment. The regression analysis showed that confidence in performing physical assessment skills, the usefulness of the Suite of Mobile Learning Tools, and a higher nursing competence at the start of clinical rotation were positively associated with overall nursing competence. CONCLUSION Basic physical assessment skills are an important component of nursing competence and can be considered one of the pillars of person-centered care, as proposed by the Fundamentals of Care framework. Spaced repetition and access to digital resources are suggested pedagogical approaches to enhance student confidence in the use of assessment skills within academic and clinical contexts.
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Affiliation(s)
- H Ösp Egilsdottir
- Centre for Health and Technology, Faculty of Health and Social Sciences, Institute for Nursing and Health Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway.
| | - Lena Günterberg Heyn
- Centre for Health and Technology, Faculty of Health and Social Sciences, Institute for Nursing and Health Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - Ragnhild Sørum Falk
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
- Faculty of Health and Social Sciences, Institute for Nursing and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - Espen Andreas Brembo
- Centre for Health and Technology, Faculty of Health and Social Sciences, Institute for Nursing and Health Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - Kirsten Røland Byermoen
- Centre for Health and Technology, Faculty of Health and Social Sciences, Institute for Nursing and Health Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - Anne Moen
- Institute for Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 2B, 0371, Oslo, Norway
| | - Hilde Eide
- Centre for Health and Technology, Faculty of Health and Social Sciences, Institute for Nursing and Health Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
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Lebdai S, Bouvard B, Martin L, Annweiler C, Lerolle N, Rineau E. Objective structured clinical examination versus traditional written examinations: a prospective observational study. BMC Med Educ 2023; 23:69. [PMID: 36707797 PMCID: PMC9883896 DOI: 10.1186/s12909-023-04050-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Recently, Objective Structured Clinical Examinations (OSCE) became an official evaluation modality for 6-year medical students in France. Before, standard examination modalities were: written progressive clinical cases (PCC), written critical reading of scientific articles (CRA), and internship evaluation (IE). The aim of this study was to assess the performances of 6-year medical students in their final faculty tests by comparing OSCE-exams with standard examination modalities. METHODS This was a prospective observational study. We included all 6-year medical students in our university from 2020 to 2021. The endpoints were the scores obtained at the following final faculty tests during the 6th year of medical studies: OSCE-training, OSCE-exams, written PCC, written CRA, and IE. All scores were compared in a paired-analysis. RESULTS A total of 400 students were included in the study. No student was excluded in the final analysis. The mean scores obtained at the OSCE-exams were significantly different from those obtained at OSCE-training, PCC, CRA, and IE (12.6 ± 1.7, 11.7 ± 1.7, 13.4 ± 1.4, 13.2 ± 1.5, 14.7 ± 0.9, respectively; p < 0.001). OSCE-exams scores were moderately and significantly correlated with OSCE-training and PCC (Spearman rho coefficient = 0.4, p < 0.001); OSCE examination scores were lowly but significantly correlated with CRA and IE (Spearman rho coefficient = 0.3, p < 0.001). OSCE-scores significantly increased after an OSCE training session. CONCLUSION In our faculty, 6-year medical students obtained lower scores at OSCE exams compared to other standard evaluation modalities. The correlation was weak to moderate but significant. These results suggest that OSCE are not redundant with the other evaluation modalities. Interestingly, a single OSCE training session led to an improvement in OSCE scores underlining the importance of a specific training.
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Affiliation(s)
- Souhil Lebdai
- Urology Department, University Hospital of Angers, 49933 Angers cedex 9, Angers, France.
- Health Faculty, University of Angers, Angers, France.
- All'Sims Center for Simulation in Healthcare, University Hospital of Angers, Angers, France.
| | | | - Ludovic Martin
- Health Faculty, University of Angers, Angers, France
- All'Sims Center for Simulation in Healthcare, University Hospital of Angers, Angers, France
| | | | | | - Emmanuel Rineau
- Health Faculty, University of Angers, Angers, France
- All'Sims Center for Simulation in Healthcare, University Hospital of Angers, Angers, France
- Department of Anesthesia and Critical Care, University Hospital of Angers, Angers, France
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Lazarus ME, Hernandez EA, Kahn DG, Vigallon S, Cooper CB. A case study of a unique advanced clinical skills elective at the David Geffen School of Medicine at UCLA. MedEdPublish (2016) 2023; 13:1. [PMID: 36819947 PMCID: PMC9926504 DOI: 10.12688/mep.19397.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2022] [Indexed: 01/05/2023] Open
Abstract
Proficiency in clinical examination skills upon graduation from medical school is a core competency. Over the last few decades, the ability and confidence in this fundamental and crucial skill set has declined. The motivation and interest in meticulous physical examination by recently graduated residents has also eroded. In this case study, we describe a comprehensive, innovative, and immersive advanced clinical skills elective taken during the second half of the final year of medical school for students at the David Geffen School of Medicine. The course utilizes novel approaches to inspire, refresh and consolidate essential bedside observation skills and examination techniques. This approach gives senior students the confidence and fundamental understanding of how dedication to the patient exam can improve the doctor-patient relationship, core clinical reasoning and the practice of cost-effective and evidence-based care through their careers. We describe how the integration of fine art appreciation and introductory biding techniques are used to help students hone their visual diagnostic skills. We show how this is solidified through a longitudinal series of clinical image review sessions with diagnostic reasoning principles to formulate a clear differential. Point of care ultrasound, EKG analysis, advanced cardiac auscultation and diagnostic imaging skills are integrated in a comprehensive and memorable fashion. We present this case study to inspire clinical skills teachers everywhere to replicate our methods in resurrecting the importance of physical exams for their learners. Opening their trainees' eyes to new methods of honing their visual intelligence and developing healthy habits for stress and burnout reduction will aid the rest of their professional careers.
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Affiliation(s)
- Michael E. Lazarus
- Medicine, David Greffen School of Medicine, Los Angeles, California, 90095, USA,
| | | | - Daniel G. Kahn
- Medicine, David Greffen School of Medicine, Los Angeles, California, 90095, USA
| | - Stacey Vigallon
- Los Angeles Audubon Society, Los Angeles, California, 90066, USA
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Balante J, Candelaria D, Perez D, Koo F. Nursing students' experiences of using flipcharts as a learning tool during the COVID-19 pandemic. Nurse Educ Today 2023; 120:105650. [PMID: 36423406 PMCID: PMC9671641 DOI: 10.1016/j.nedt.2022.105650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 11/04/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Building mastery of clinical skills is essential for nursing students to ensure readiness for clinical placements. During the coronavirus disease (COVID-19) pandemic, limited face-to-face teaching and student access to campus facilities, along with the rapid adoption of online methods, increased the need to develop innovative teaching tools to support students. OBJECTIVE This study aimed to explore nursing student perceptions and experiences of using Flipcharts for learning clinical nursing skills during the COVID-19 pandemic. DESIGN This study used a qualitative descriptive design. METHODS Second-year nursing students were invited to participate at the end of the semester to share their experiences of using Flipcharts in their clinical simulation laboratory. A total of 12 nursing students participated in individual semi-structured interviews conducted between December 2020 and February 2021. Data were analysed using Braun and Clarke's six-step method of thematic analysis. RESULTS The findings of the study demonstrated that students considered Flipcharts to be beneficial in developing their clinical skills and were additionally valuable in supporting students with English as a second language. Three major themes were identified: the perceived value of Flipcharts during limited face-to-face teaching, the role of Flipcharts in supporting skills acquisition across learning domains, and the practicality and accessibility of this learning resource across different mediums. CONCLUSION Students perceived the use of Flipcharts to be valuable in achieving mastery of clinical skills during COVID-19. The students' experience of using Flipcharts was positive overall and found the learning tool practical and accessible in supplementing learning.
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Affiliation(s)
- Jay Balante
- Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Medicine and Health, D18 Susan Wakil Health Building, The University of Sydney, Sydney, Australia.
| | - Dion Candelaria
- Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Medicine and Health, D18 Susan Wakil Health Building, The University of Sydney, Sydney, Australia.
| | - Dawn Perez
- Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Medicine and Health, D18 Susan Wakil Health Building, The University of Sydney, Sydney, Australia.
| | - Fung Koo
- Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Medicine and Health, D18 Susan Wakil Health Building, The University of Sydney, Sydney, Australia; School of Nursing and Midwifery, Hawkesbury Campus Building G10, Western Sydney University, Sydney, Australia.
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Pérez Baena AV, Sendra Portero F. The objective structured clinical examination (OSCE): Main aspects and the role of imaging. Radiologia (Engl Ed) 2023; 65:55-65. [PMID: 36842786 DOI: 10.1016/j.rxeng.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 09/28/2022] [Indexed: 02/28/2023]
Abstract
The objective structured clinical examination (OSCE) is a format of examination that enables students to be evaluated in a uniform, standardized, reliable, and objective way. It is carried out in different clinical stations that simulate real clinical situations and scenarios. Numerous universities in Spain and other countries employ this approach for the final examination for medical school students. This update describes the organization, design, and fundamentals for the OSCE, proposing that radiology should form part of multidisciplinary OSCEs to the extent that it forms part of clinical practice. Moreover, it is interesting and opportune to introduce the OSCE in undergraduate and postgraduate training in radiology. Online platforms enable bidimensional OSCEs that are cost-effective in terms of staff, resources, and physical space, although this approach has certain limitations. Virtual world technologies make it possible to reproduce OSCE stations in three-dimensional scenarios; recent experiences in radiology have shown that this approach interests and motivates students and is widely accepted by them.
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Affiliation(s)
- A V Pérez Baena
- Servicio de Radiodiagnóstico, Hospital Comarcal de Antequera, Antequera, Spain.
| | - F Sendra Portero
- Departamento de Radiología y Medicina Física, Facultad de Medicina, Málaga, Spain
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Alfazari AS, Naim Ali HA, Alessa A, Magzoub ME. Assessing relational coordination and its impact on perceived mental health of students, teachers and staff in a clinical skills program during the COVID-19 pandemic. BMC Med Educ 2022; 22:773. [PMID: 36357937 PMCID: PMC9647241 DOI: 10.1186/s12909-022-03828-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The global spread of the COVID-19 virus caused unprecedented interruptions in medical education. This paper evaluates Relational Coordination (RC): communicating and relating for task integration; between the distinct stakeholders responsible for scheduling,delivering and receiving clinical teaching in the wake of the pandemic. METHODOLOGY Using a cross-sectional design, the level of Relational Coordination was assessed between twelve groups within a Clinical Skills Program at a Medical School in the United Arab Emirates. It also measures three relevant mental health factors: namely, Job satisfaction, Work Engagement, and Burnout. RESULTS Overall, RC scores were moderate (3.65 out of 5.00). Controlling for participants' position, RC was found to positively and significantly increase both job satisfaction (β = 1.10, p < 0.001) and work engagement (β = 0.78, p < 0.01)., Additionally, RC was significantly associated with lower burnout (β = -0.56, p = 0.05). Fifty percent of participants experienced high job satisfaction, with a mean score of 5.0 out of 7.0, while 73% reported being enthusiastic about their job, with a mean score of 6.0 out of 7.0. About a third of participants (27%) reported feeling burnout. CONCLUSIONS During times of disruption and crisis, medical education can benefit from higher levels of relational coordination. Our study shows the significant impact of relational coordination on mental health measures like job satisfaction and work engagement. To achieve the full potential and benefits of excellent levels of relational coordination in this program, we recommend six interventions focusing on improving communication, work processes, regular meetings, education innovations, capacity building, and the establishment of coaching and counseling programs for students and faculty.
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Affiliation(s)
- Ali S. Alfazari
- Medical Simulation Center, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Hebatallah A. Naim Ali
- The Heller School for Social Policy and Management, Brandeis University, Waltham Massachusetts, USA
| | - Awad Alessa
- Department of Medical Education, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mohi Eldin Magzoub
- Department of Medical Education, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Enoch LC, Abraham RM, Singaram VS. A comparative analysis of the impact of online, blended, and face-to-face learning on medical students' clinical competency in the affective, cognitive, and psychomotor domains. BMC Med Educ 2022; 22:753. [PMID: 36320031 PMCID: PMC9628081 DOI: 10.1186/s12909-022-03777-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/08/2022] [Accepted: 09/29/2022] [Indexed: 05/30/2023]
Abstract
BACKGROUND The Coronavirus Disease-2019 (COVID-19) pandemic in South Africa compelled medical schools to switch to a purely online curriculum. The innovative changes transformed the standard clinical skills curriculum to increase learning transfer to bridge the theory-practice gap. The efficacy of this intervention remains unknown. This study aims to measure medical students' clinical competency in the affective, cognitive, and psychomotor domains by assessing clinical skills knowledge retention and transfer from the online platform compared to face-to-face and blended learning. METHODS A non-random cross-sectional quasi-experimental study assessed third-year medical students' knowledge retention and learning transfer in three domains of clinical skills competence. Data were obtained using a score sheet during a directly observed formative and a trial online summative assessment. One hundred and one third-year medical students volunteered for the formative onsite assessment that tested the psychomotor domain. Two hundred and thirty-nine students were evaluated on the affective and cognitive domains in the summative online trial mini-objective structured clinical examination (tm-OSCE). The OSCE scores were analysed using descriptive statistics. The significance of the findings was evaluated by comparing OSCE scores with the pre-pandemic 2019 third-year medical students. RESULTS Statistically significant differences were found between the two cohorts of medical students from both years (p < 0.05). The 2021 blended group's (n = 101) medians were 90%, 95%CI [86, 92], 82%, 95%CI [80, 85], and 87%, 95% CI [84, 90] for the psychomotor, affective, and cognitive skills, respectively. The e-learning group's affective and cognitive skills medians were 78%, 95%CI [73, 79] and 76%, 95%CI [71, 78], respectively. The 2019 face-to-face cohort (n = 249) achieved medians of 70%, 95% CI [69, 72] and 84%, 95%CI [82, 86] for the affective and psychomotor skills, respectively. CONCLUSION Medical students demonstrated near and far transfer bridging the theory-practice gap in three clinical skills domains. The blended group performed significantly better than the e-learning and face-to-face groups. Medical schools and educators play a vital role in overcoming learning challenges and achieving higher transfer levels by adopting multiple student-centered teaching delivery approaches and arranging immediate application opportunities. This study offers medical educators suggestions that encourage the transfer of online learning to face-to-face practice, decentralising medical education with a revised blended learning strategy.
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Affiliation(s)
- L. C. Enoch
- School of Clinical Medicine, Clinical and Professional Practice, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - R. M. Abraham
- School of Clinical Medicine, Clinical and Professional Practice, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - V. S. Singaram
- School of Clinical Medicine, Clinical and Professional Practice, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Eliezer S, Efron M, Mendlovic S, Gal G, Lurie I. Mental health professionals' awareness of the parental functioning of persons with severe mental disorders: a retrospective chart study. Isr J Health Policy Res 2022; 11:37. [PMID: 36271385 DOI: 10.1186/s13584-022-00547-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 11/30/2022] Open
Abstract
Background: The proportion of persons with severe mental illness (SMI) who are parents has increased in recent decades. Children of parents with SMI are at increased risk for medical, behavioral, emotional, developmental, academic, and social problems. They also have an increased risk for injuries, accidents, and mortality, addictions, and various psychiatric disorders compared to children of parents with no such diagnoses. We aimed to examine the extent to which mental health professionals (MHPs) who treat adult patients with SMI in ambulatory settings are aware of these individuals’ functioning in three parenting domains: parental functioning, familial support system and children’s conditions. We also compared psychiatrists’ awareness with that of psychologists and social workers. Methods: In this retrospective practice-oriented study, we reviewed 80 clinical files of individuals diagnosed with schizophrenia, affective disorder or personality disorder treated in a mental health outpatient clinic, using the Awareness of Family’s Mental Health Checklist (AFMHC) developed for this study. Thus, awareness was determined on the basis of what was recorded in the patient file. Results: Almost half of the MHPs were unaware to their patients’ parental functioning as only 44% of files contained records relating to this issue. Awareness to other domains was even lower: 24% of files contained information on patient’s support system and 12% had information about their children’s mental and/or physical health. No statistically significant differences between psychiatrists and other MHPs were found with regards to awareness to the various domains. Positive correlations were found among MHP’s for awareness in the three domains. Conclusion: Lack of awareness among MHPs to their patients’ parental functioning is not specific to a certain profession and may be attributed to patients (e.g., reluctance to disclose relevant information) or to MHPs (e.g., lack of training). Awareness of family and parental functioning by MHPs working with persons with SMI should be part of a standard procedure, integrated into policy and training. Supplementary Information The online version contains supplementary material available at 10.1186/s13584-022-00547-4.
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Kavanaugh R, Pape Z, LaTourette B, Lehmier S. Who killed Mr. Brown? A hospital murder mystery in a pharmacy skills course. Med Teach 2022; 44:1151-1157. [PMID: 35531595 DOI: 10.1080/0142159x.2022.2071690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE To improve critical thinking skills and enhance team dynamics, a pilot study for inclusion of a murder mystery activity within the pharmacy practice skills laboratory was designed for student pharmacists. METHODS In groups, students participated in a murder mystery activity and were assessed via rubrics to critically evaluate potential reasons for a patient's death and find solutions for process improvements. Through an optional survey, students were asked about their group's ability to work as part of a healthcare team, which included identification of conflict management techniques. Faculty used an inductive coding process on student feedback to identify strengths and opportunities for growth. RESULTS All groups successfully completed the patient's cause of death and root cause analysis. Overall, students agreed their teams worked well together in solving this mystery. Communication was found to be both a strength and a weakness among group members and many students were able to self-identify conflict management strategies that were utilized during the activities. CONCLUSION Use of a murder mystery activity in a pharmacy skills laboratory is a unique approach to foster development of critical thinking skills and highlights the complexity with which a healthcare team must operate together to provide patient care.
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Affiliation(s)
- Rachel Kavanaugh
- School of Pharmacy, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Zachary Pape
- School of Pharmacy, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Bonnie LaTourette
- School of Pharmacy, Medical College of Wisconsin, Milwaukee, WI, USA
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Landau-Taylor J, Cassidy B, Claus LA, Prasad M, Shi J, Barrett J, Shaffer K, Wisco JJ. Integration of Clinical Skills into Preclinical Medical Curriculum Via a Low-Cost Femoral Triangle Ultrasound Model. Med Sci Educ 2022; 32:937-939. [PMID: 36276768 PMCID: PMC9583990 DOI: 10.1007/s40670-022-01629-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
We created a low-cost femoral triangle model that allows first year medical students to practice ultrasound-guided procedures while reinforcing their knowledge of femoral triangle anatomy. Use of this model also increased opportunities for informal near-peer teaching and student involvement in the creation of instructional materials.
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Affiliation(s)
- Jessica Landau-Taylor
- Department of Anatomy and Neurobiology, Boston University School of Medicine, 72 E. Concord St., L-1004 Boston, MA 02118 USA
- Boston University School of Medicine, Boston University, 72 E. Concord St., Boston, MA 02118 USA
| | - Brett Cassidy
- Boston University School of Medicine, Boston University, 72 E. Concord St., Boston, MA 02118 USA
| | - Lindsey A. Claus
- Boston University School of Medicine, Boston University, 72 E. Concord St., Boston, MA 02118 USA
| | - Minali Prasad
- Boston University School of Medicine, Boston University, 72 E. Concord St., Boston, MA 02118 USA
| | - Jessica Shi
- Boston University School of Medicine, Boston University, 72 E. Concord St., Boston, MA 02118 USA
| | - Jake Barrett
- Boston University School of Medicine, Boston University, 72 E. Concord St., Boston, MA 02118 USA
| | - Kitt Shaffer
- Department of Radiology, Boston University School of Medicine, 72 E. Concord St., Boston, MA 02118 USA
| | - Jonathan J. Wisco
- Department of Anatomy and Neurobiology, Boston University School of Medicine, 72 E. Concord St., L-1004 Boston, MA 02118 USA
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Solomon DA, Larrabee S, Ellis J, Erfani P, Johnson SF, Rich KM, Sandoval RS, Osman NY. A student-led interprofessional virtual outreach program for people with HIV during the Covid-19 pandemic: a pilot program at an academic medical center in Boston. BMC Med Educ 2022; 22:657. [PMID: 36056337 PMCID: PMC9438880 DOI: 10.1186/s12909-022-03716-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The Coronavirus disease 2019 (Covid-19) pandemic caused an abrupt disruption in clinical care and medical education, putting patients at increased risk for social stressors and displacing medical students from traditional clerkships. The pandemic also exposed the need for virtual tools to supplement clinical care and an opportunity to create meaningful roles for learners. METHODS An interdisciplinary group designed a student-led virtual outreach program for patients with HIV whose care was limited by the pandemic. Patients were identified by clinicians and social workers using a clinic-based registry. Students called patients to conduct needs assessments, provide Covid-19 education, and to facilitate connection to services. Students participated in case-based didactics and workshops on motivational interviewing and patient engagement using virtual tools. Facilitated team meetings were held weekly during which themes of calls were identified. RESULTS During a three-month period, five students participated in the outreach program. Two hundred sixteen patients were identified for outreach calls, of which 174 (75.9%) were successfully reached by telephone. Rate of completed phone call did not differ by age or gender. Sixty patients had a preferred language other than English of which 95.6% were reached in their preferred language. CONCLUSIONS Virtual proactive outreach can be used as a tool to support patients and engage students in clinical care when access to in-person care is limited. This model of care could be adapted to other ambulatory practices and integrated into pre-clerkship curriculum as an introduction to the social history and structural drivers of health (SDOH) (245/350).
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Affiliation(s)
- Daniel A Solomon
- Division of Infectious Diseases, Brigham and Women's Hospital, 75 Francis Street PBB-4A, Boston, MA, 02115, USA.
- Harvard Medical School, Boston, MA, USA.
- Department of Medicine, Brigham and Women's Hospital, 75 Francis Street PBB-4A, Boston, MA, 02115, USA.
| | - Susan Larrabee
- Division of Infectious Diseases, Brigham and Women's Hospital, 75 Francis Street PBB-4A, Boston, MA, 02115, USA
| | | | | | | | | | | | - Nora Y Osman
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Brigham and Women's Hospital, 75 Francis Street PBB-4A, Boston, MA, 02115, USA
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Bang G, Kwon OY. Real-time online point-of-view filming education for teaching clinical skills to medical students. Korean J Med Educ 2022; 34:231-237. [PMID: 36070993 PMCID: PMC9452373 DOI: 10.3946/kjme.2022.233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/29/2022] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE This study aimed to measure the educational satisfaction with and effectiveness of real-time online point-of-view filming (POVF) clinical skills education in medical students. METHODS Medical students participated in a 120-minute clinical skills education session. The session consisted of emergency procedures, wound management, and vascular access. The authors provided real-time online POVF using a smartphone. A questionnaire survey was issued to the students after the class, and their satisfaction with education, educational environment, and effectiveness were analyzed. RESULTS Responses about satisfaction with POVF education were very positive in all grades. However, approximately half of the students were satisfied with the smoothness of listening to a lecture and the video quality. More than half of the students responded positively to the question about educational effectiveness. CONCLUSION In these times of non-classroom teaching brought on by the coronavirus disease 2019 (COVID-19) pandemic, POVF clinical skills education is likely to be a very useful educational tool. If disadvantages such as insufficient feedback or environmental problems can be addressed, it could serve as an alternative method of clinical skills education even after the COVID-19 pandemic.
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Affiliation(s)
- Gwanwook Bang
- Department of Medical Education and Medical Humanities, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Oh Young Kwon
- Department of Medical Education and Medical Humanities, College of Medicine, Kyung Hee University, Seoul, Korea
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