The influence of sociodemographic and health-related factors, clinical education status, and sleep quality on work-related quality of life among dental students

INTRODUCTION

With the premise that the demanding educational process and associated factors could influence the work-related quality of life (WRQoL) of dental students, this study aimed to investigate the influence of diverse sociodemographic and health-related factors, clinical education status, and sleep quality on the WRQoL of dental students.

MATERIALS AND METHODS

A three-part questionnaire was administered to a group of preclinical and clinical dental students studying in different classes. The first part of the questionnaire included various sociodemographic and health-related questions. In the second part, the multidimensional 23-item WRQoL scale, with established validity and reliability, was applied to evaluate the WRQoL of the students. The last part of the questionnaire included the Pittsburgh Sleep Quality Index, comprising 19 items. General linear models were created to predict subscale scores using sociodemographic and health-related characteristics, as well as univariate significant independent variables.

RESULTS

It was observed that the majority of the participants (78.2%) had poor sleep quality. Being clinical dental students had a significant and positive effect on the stress at work domain of WRQoL (p = .006), while it had a significant and negative effect on the home-work interface domain (p < .001). The decrease in sleep quality had a significant and negative effect on all domains of WRQoL (p < .05) except for the stress at work domain.

CONCLUSIONS

Clinical education status, regular smoking, and sleep quality significantly affect different domains of dental students' WRQoL. Changes in these factors should be considered in approaches to increasing students' WRQoL.

Bridging the gap: Innovating undergraduate public health nursing education through a service-learning health fair project

Amidst a critical shortage of registered nurses, nursing schools are aiming to expand enrollment while working with ongoing resource constraints. Service-learning clinical activities can enhance nursing education by improving clinical quality, addressing faculty and clinical site shortages, and meeting increasing enrollment demands. This paper describes a health fair experience that served as a service-learning clinical experience within an undergraduate public health nursing course. The experience bridged theoretical knowledge with real-world application, fostering competency-based learning and addressing community health needs, resulting in a positive impact on students, faculty, and the community.

Evaluative judgement in practice education: How does the ability to judge the quality of work impact placement performance?

INTRODUCTION

Occupational therapy students need to be ready to work autonomously in a range of environments as soon as they complete their degree. Practice education experiences are considered key to students developing the competencies that autonomous work requires. To function autonomously in practice environments, it is argued that practitioners need to be able to judge the quality of their own work and the work of others. This is referred to as evaluative judgement. However, there is limited empirical literature relating to evaluative judgement and even less exploring the concept within occupational therapy.

METHODS

This study used qualitative methods, seeking to understand the evaluative judgements of clinical practice made by third- and fourth-year occupational therapy students during practice education.

RESULTS

Twenty-one interviews were conducted with third- (n = 10) and fourth-year occupational therapy students (n = 1), university support staff supporting practice education (n = 4), and practice education supervisors (n = 5) at one Australian university. Practice education grades and documentation were also used as data. Data were analysed thematically, and two themes, each with three sub-themes, were identified: students coming to understand expected standards, with the following sub-themes: students attuning to cues, cues that inform supervisors about students' meeting the standards, and barriers and frustrations to understanding standards; and practising and developing evaluative judgement, with the following sub-themes: making comparisons, acting on feedback, and reflective practice.

CONCLUSIONS

Practice education experiences provide many context-specific opportunities for students to develop their evaluative judgement. Students may be supported to come to know what quality work looks like by offering scaffolded opportunities to develop evaluative judgement in university and practice education settings.

Online versus in-person surgical near-peer teaching in undergraduate medical education during the COVID-19 pandemic: A mixed-methods study

Background and Aims

The coronavirus disease 2019 (COVID-19) pandemic stimulated a paradigm shift in medical and surgical education from in-person teaching to online teaching. It is unclear whether an in-person or online approach to surgical teaching for medical students is superior. We aim to compare the outcomes of in-person versus online surgical teaching in generating interest in and improving knowledge of surgery in medical students. We also aim the quantify the impact of a peer-run surgical teaching course.

Methods

A six-session course was developed by medical students and covered various introductory surgical topics. The first iteration was offered online to 70 UK medical students in March 2021, and the second iteration was in-person for 20 students in November 2021. Objective and subjective knowledge was assessed through questionnaires before and after each session, and also for the entire course. Data were analyzed from this mixed-methods study to compare the impact of online versus in-person teaching on surgical knowledge and engagement.

Results

Students in both iterations showed significant improvement of 33%-282% across the six sessions in knowledge and confidence after completing the course (p < 0.001). There was no significant difference in the level of objective knowledge, enjoyment, or organization of the course between online and in-person groups, although the in-person course was rated as more engaging (mean Likert score 9.1 vs. 9.7, p = 0.033).

Discussion

Similar objective and subjective surgical teaching outcomes were achieved in both iterations, including in "hands-on" topics such as suturing, gowning, and gloving. Students who completed the online course did not have any lower knowledge or confidence in their surgical skills; however, the in-person course was reported to be more engaging. Surgical teaching online and in-person may be similarly effective and can be delivered according to what is most convenient for the circumstances, such as in COVID-19.

Virtual reality-based surgical planning simulator for tumorous resection in FreeForm Modeling: an illustrative case of clinical teaching

The importance of virtual reality (VR) has been emphasized by many medical studies, yet it has been relatively under-applied to surgical operation. This study characterized how VR has been applied in clinical education and evaluated its tutorial utility by designing a surgical model of tumorous resection as a simulator for preoperative planning and medical tutorial. A 36-year-old male patient with a femoral tumor who was admitted to the Affiliated Jiangmen Traditional Chinese Medicine Hospital was randomly selected and scanned by computed tomography (CT). The data in digital imaging and communications in medicine (*.DICOM) format were imported into Mimics to reconstruct a femoral model, and were generated to the format of *.stl executing in the computer-aided design (CAD) software SenSable FreeForm Modeling (SFM). A bony tumor was simulated by adding clay to the femur, the procedure of tumorous resection was virtually performed with a toolkit called Phantom, and its bony defect was filled with virtual cement. A 3D workspace was created to enable the individual multimodality manipulation, and a virtual operation of tumorous excision was successfully carried out with indefinitely repeated running. The precise delineation of surgical margins was shown to be achieved with expert proficiency and inexperienced hands among 43 of 50 participants. This simulative educator presented an imitation of high definition, those trained by VR models achieved a higher success rate of 86% than the rate of 74% achieved by those trained by conventional methods. This tumorous resection was repeatably handled by SFM, including the establishment of surgical strategy, whereby participants felt that respondent force feedback was beneficial to surgical teaching programs, enabling engagement of learning experiences by immersive events which mimic real-world circumstances to reinforce didactic and clinical concepts.

Mental Health First Aid Training for Allied Health Clinical Educators: A Pre- and Post-Evaluation

Purpose

Health profession students may experience mental health issues during training, and clinical educators report that they don't feel confident in supporting students with these issues. This study explored whether a customized Mental Health First Aid (MHFA) training programme changed the knowledge, perceptions, intentions, and confidence of clinical educators in supporting students with mental health issues in the workplace.

Method

Twenty-four allied health clinical educators from a tertiary health service attended a two-day customized MHFA course. The educators completed assessments before (n = 21) and after (n = 23) the course. Quantitative data was analyzed using independent t-tests. Qualitative data was thematically analyzed using content analysis.

Results

Knowledge improved significantly (p = <0.001). The confidence to manage students with mental health issues increased significantly (p < 0.001). A significant change in perception was only found with respect to a character in a scenario being dangerous or unpredictable. Intentions to assist co-workers and students with mental health issues improved for all items but not necessarily significantly.

Conclusions

This programme improved educators' knowledge of mental health, perceptions of people with mental health issues, intentions of providing help, and confidence to support people with mental health issues.

Improving Accessibility of Continuing Professional Development for Oncology Health Professionals Through the EviQ Education App

Oncology clinicians must participate in continuing professional development (CPD) to stay up to date with best practice. The Cancer Institute NSW eviQ Education program produces evidence-based, peer-reviewed eLearning resources for oncology professionals. In response to user feedback, eviQ Education trialled a mobile app, EdApp, to improve accessibility of self-directed CPD materials. Following a pilot, users indicated that the EdApp improved CPD accessibility and user experience. EdApp will continue to be used to support evidence-based practice.

User-Led Learning Preferences to Inform Rapid Learning Online Education Supporting Evidence-Based Best Practice in Oncology

Effective eLearning design takes into account the learning needs and styles of users. eviQ Education, a program of the Cancer Institute NSW, considered evidence from user data to develop a range of clinical education resources in formats informed by user preferences, including mini-modules, videos and webinars. Through the website and mobile app, content is available on-demand, supporting health professionals to learn anytime, anywhere, on any device.

Efficacy of online communication partner training package for student healthcare professionals

BACKGROUND

People with aphasia are vulnerable recipients of healthcare. The nature of the communicative environment and the communication disability can adversely impact access to timely and quality healthcare. Student healthcare professionals are often underprepared to interact successfully with people with aphasia and may benefit from communication partner training (CPT).

AIMS

To investigate the potential effectiveness and acceptability of a brief, two-part introductory Supported Conversation for Adults with Aphasia (SCA™)-based CPT package, delivered to a sample of students across a diverse range of healthcare disciplines.

METHODS & PROCEDURES

A pre-post-within group experimental design was used to investigate the potential effectiveness and acceptability of an online CPT package (50 minute module + 1 hour workshop) for healthcare students. The Aphasia Attitudes, Strategies and Knowledge (AASK) survey measured participants' knowledge of aphasia, facilitative communication strategies and attitudes towards people with aphasia. Data were collected pre-training, following the training module and following the workshop, and 6 weeks post-training. Statistical analysis was conducted on the AASK data. In addition, participant feedback (ratings and open text responses) was collected after the workshop. Ratings were analysed descriptively, and thematic content analysis was used for open text responses.

OUTCOMES & RESULTS

236 participants completed the pre-training AASK and 106 completed the AASK at subsequent time points. Statistically significant gains were demonstrated from pre- to post-module completion. Between the end of the module and the end of the workshop, some gains were maintained and others showed further statistically significantly improvements. While all gains were not maintained at the 6-week follow-up, statistically significantly improvements from pre-training scores remained evident. Student feedback was predominantly positive, with suggested improvements for training content and length.

CONCLUSIONS & IMPLICATIONS

The results provide preliminary evidence that a brief, online CPT package can support student healthcare professionals' knowledge and attitudes towards aphasia and communicating with people with aphasia. Online training was acceptable to students and feasible as an embedded or optional component of curriculum. Ongoing training (e.g., in the form of refresher sessions) and inclusion of a skills-based component are recommended to maximize communication skill development.

WHAT THIS PAPER ADDS

What is already known on the subject Student healthcare professionals recognize the need to develop knowledge and skills to successfully support people with communication disability, such as aphasia, to participate effectively in their healthcare. Evidence in favour of online communication partner training for student healthcare professionals is currently limited. What this study adds to the existing knowledge This study demonstrates that a brief introductory online communication partner training program can be efficacious for improving knowledge and attitudes regarding communicating with people who have aphasia. What are the potential or actual clinical implications of this work? Students will likely need further ongoing refresher training with inclusion of practical components to develop and maintain the knowledge and skills required to be proficient communication partners with people with aphasia.

Pediatric Intersession: An Upfront Flipped-Classroom Curriculum to Promote Pediatric Clerkship Readiness

OBJECTIVES

Best practices for content selection, mode of delivery, and timing of pediatric clerkship readiness curricula for medical students have, by and large, not been established. Capitalizing on changes in structure of the clinical clerkships during the COVID-19 pandemic, we created an upfront clerkship readiness curriculum, termed Pediatric Intersession (PI), to replace the existing weekly lecture-based clerkship didactics.

METHODS

Our goal was to develop an interactive curriculum with innovative instructional design methodology intended to promote broad foundational pediatric knowledge and clerkship preparedness using case-based learning. We first conducted a needs assessment and crafted curriculum content using guiding principles from the 2019 Council on Medical Student Education in Pediatrics (COMSEP) curriculum. We then organized material into four daily modules prior to the start of the clerkship and employed flipped classroom (FC) methodology.

RESULTS

Sixty-six percent of students completed course evaluations, and >90% of the 100 respondents reported that the PI enhanced their clinical learning. Pre-/post-testing demonstrated some knowledge gain following the small-group sessions and there was no change on the National Board of Medical Examiners (NBME) Subject Exam mean scores compared to prior cohorts of students.

CONCLUSIONS

The global pandemic provided an opportunity to re-envision our pediatric clerkship didactics content, while also incorporating instructional design methodology preferred by students. Our curriculum promotes a small group-based, interactive approach to clerkship readiness that fosters learning in the clinical environment that can be adapted for various settings. Our evaluation suggests that the transition to a FC readiness curriculum can be done successfully while effectively preparing students for their pediatric clerkship.

The development of items for a physiotherapy clinical programme evaluation tool

Background

Evaluating a physiotherapy clinical education programme is challenging, given its complex and multidimensional nature, resulting in a paucity of research on the topic.

Objectives

The objective of our study, which was part of a larger study, was to identify items that could be included in a tool to evaluate a physiotherapy clinical education programme in South Africa.

Method

A qualitative study utilising focused group discussions including academics, clinical educators and clinicians was undertaken. A broad script that delved into clinical education experience was used. An inductive thematic content analysis using MaxQda version 2018.2 was undertaken; the data were coded, and similar foci were categorised and subcategorised. This process led to the identification of themes. Both triangulation of the data (member checks, field note comparison, observer reflection and verification of the data) and assuring the data's trustworthiness (credibility, dependability and confirmability) were undertaken.

Results

Fourteen focus group discussions were held countrywide. Three themes emerged from the data. A macro theme included all governance issues, a meso theme included all structural issues and a micro theme included all aspects related to clinical experience.

Conclusion

The complex nature of clinical physiotherapy education and its diversity can be seen in these emerging themes. All the categories and subcategories making up these themes must now be considered in the next step of developing this tool.

Clinical implications

Quality assurance and minimal training standards may be ensured.

ChatGPT Interactive Medical Simulations for Early Clinical Education: Case Study

BACKGROUND

The transition to clinical clerkships can be difficult for medical students, as it requires the synthesis and application of preclinical information into diagnostic and therapeutic decisions. ChatGPT-a generative language model with many medical applications due to its creativity, memory, and accuracy-can help students in this transition.

OBJECTIVE

This paper models ChatGPT 3.5's ability to perform interactive clinical simulations and shows this tool's benefit to medical education.

METHODS

Simulation starting prompts were refined using ChatGPT 3.5 in Google Chrome. Starting prompts were selected based on assessment format, stepwise progression of simulation events and questions, free-response question type, responsiveness to user inputs, postscenario feedback, and medical accuracy of the feedback. The chosen scenarios were advanced cardiac life support and medical intensive care (for sepsis and pneumonia).

RESULTS

Two starting prompts were chosen. Prompt 1 was developed through 3 test simulations and used successfully in 2 simulations. Prompt 2 was developed through 10 additional test simulations and used successfully in 1 simulation.

CONCLUSIONS

ChatGPT is capable of creating simulations for early clinical education. These simulations let students practice novel parts of the clinical curriculum, such as forming independent diagnostic and therapeutic impressions over an entire patient encounter. Furthermore, the simulations can adapt to user inputs in a way that replicates real life more accurately than premade question bank clinical vignettes. Finally, ChatGPT can create potentially unlimited free simulations with specific feedback, which increases access for medical students with lower socioeconomic status and underresourced medical schools. However, no tool is perfect, and ChatGPT is no exception; there are concerns about simulation accuracy and replicability that need to be addressed to further optimize ChatGPT's performance as an educational resource.

Principles of Effective Simulation-Based Teaching Sessions in Medical Education: A Narrative Review

A challenge for medical educators is to provide learning opportunities that allow students to develop technical and non-technical skills as set by the clearly defined learning objectives within their relevant institutions. This is particularly relevant in clinical education, which encompasses a vast majority of medical education. Specifically, clinical education is highly variable, with numerous distractions, interruptions and variability in learning experience and quality of clinical educators which often result in underprepared medical students by the time they transition into clinical practice. Simulation-based teaching (SBT) has been a key pedagogical approach that has been implemented into curriculum design to assist with addressing some of these educational challenges. However, their implementation is highly variable, and research into evidence-based best practice considerations in SBT design and implementation is fundamental to their success in medical student development. A narrative review was performed following a computer-assisted search on electronic databases Medline, Embase and Google Scholar. Relevant papers that explored the role of SBT in medical education were considered for this review. SBT is an important pedagogical approach to support the education of medical students. Their use has the benefit of providing a standardised and safe environment that mimics 'real life' as a means of allowing students to hone key skills with respect to clearly defined learning outcomes. The role of debriefing and feedback is crucial to the development of efficacious SBT programs, and therefore the upskilling and training of educators is a key aspect of evidence-based SBT design. Despite this, medical educators must be cognisant of the limitations of SBT. These include the cost and resources required to develop and implement SBT sessions, the effort and conceptualisation required to standardise and ensure these programs reflect real-life situations as well as the degree of training for facilitators to ensure they can best deliver and achieve learning outcomes and provide effective debriefing and feedback for students. Understanding the educational frameworks and the evidence-based best practice principles for SBT design and implementation is highly necessary for medical educators given the resource demands of SBT programs.

Clinical experience of undergraduate dental students in paediatric dentistry: A 5-year cross-sectional study

INTRODUCTION

The clinical experience of undergraduate dental students in Paediatric Dentistry has a profound influence on their future confidence. The purpose of this study was to evaluate the clinical experience of undergraduate students in Paediatric Dentistry over five consecutive years and to determine whether changes in teaching practices are reflected in the clinic.

MATERIALS AND METHODS

In total, 196 records submitted at the end of the Paediatric Dentistry training from the last 5 years (2016-2020) were evaluated. The variables analysed included the number of patients treated per student, the year, and the numbers and types of procedures performed individually across the years. The data were grouped into two categories; pre and post implementation of an electronic portfolio and a change in teaching practices (2016-2017 and 2018-2020 respectively). Data were analysed using Student's t-test or Mann-Whitney for two group comparison, depending on data distribution (α = 5%).

RESULTS

There was a significant reduction in the number of radiographs exposed (p = .013) between the two groups. The number of fissure sealants had increased in recent years (p < .001). Although the number of stainless steel crowns performed remained unchanged (p = .98), there was an increase in the number of crowns placed using the Hall technique (p < .001) and a concurrent decrease in the number of conventional crowns placed (p < .001).

CONCLUSION

The clinical experience of undergraduate students has changed in line with evolving teaching practices. The use of objective measures such as patient numbers and range of procedures can be used as a method of evaluating student clinical experience. Other assessment tools are still required to evaluate additional aspects of clinical learning in paediatric dentistry.

Development of competencies to strengthen support for caregivers and enhance their capacity to provide care

Nearly 53 million family caregivers in the United States provide care to older adults, performing tasks ranging from meal preparation and grocery shopping, to wound care and medication management. While caregivers are critical to the health care system, they are not adequately supported to serve in this role. Successfully integrating family caregivers into the health care team and supporting their health and well-being is a public health priority and should be a focus for clinical education programs. To address this gap, the Family Caregiving Institute at the Betty Irene Moore School of Nursing at UC Davis developed the Interprofessional Family Caregiving Competencies as a framework to guide the development of curricula to enhance health care providers' skills, knowledge, and abilities in family caregiving. Twenty-one competencies are categorized within the following four domains: the nature of family caregiving; family caregiving identification and assessment; providing family-centered care; and the context of family caregiving.

Motivational Interviewing Education in North American Family Medicine Clerkships: A CERA Study

BACKGROUND AND OBJECTIVES

Many health conditions are preventable or modifiable through behavioral changes. Motivational interviewing (MI) is an evidence-based communication technique that explores a patient's reasons for behavioral changes. This study assesses the current landscape of MI training in North American Family Medicine (FM) clerkships.

METHODS

We analyzed data gathered as part of the 2022 Council of Academic Family Medicine's Educational Research Alliance (CERA) survey of FM clerkship directors (CDs). The survey was distributed via email invitation to 159 US and Canadian FM CDs in June 2022.

RESULTS

Of the 94 responses received, 61% indicated that MI training is provided in their FM clerkship. Medical school type, class size, and location were associated with MI training priority, offerings, and duration in the clerkship, respectively. CD experience correlated with MI training duration; student MI skill training level was associated with MI training duration and priority; the rigor of student MI skills evaluation was correlated with MI teaching methods and training duration; self-reported student MI competency was associated with the length of time students spent with FM community preceptors as well as MI training priority and teaching methods; and several items emerged as predictors of student, CD, and FM faculty MI training expansion.

CONCLUSIONS

Opportunities exist to enhance the volume, content, and rigor of MI training in North American FM clerkships as well as to improve self-reported student MI competency within those clerkships.

Effectiveness of Online Faculty Calibration Activities

Purpose Dental hygiene faculty members must be able to provide evidence of skill calibration for clinical evaluation of students. The purpose of this study was to evaluate the effectiveness of online instructional videos compared to in-person sessions for faculty calibration.Methods A randomized crossover pretest/posttest research design was used to evaluate online and in-person faculty calibration activities. Fifteen faculty members from a baccalaureate dental hygiene program were randomly assigned to an AB or BA sequence for calibration sessions on two different instruments. Following a 2-week washout period, the groups switched activity modalities. A pretest, posttest, and retention test, administered 10 weeks following the activity, were administered to determine learning levels and the new and retained knowledge. A 7-point Likert scale questionnaire evaluated the reaction to and impact of the calibration activities. Descriptive statistics analyzed demographic and Likert scale data. Paired samples t-tests were used to analyze the research questions (p≤0.05).Results Online calibration activities yielded higher posttest scores than in-person activities (p=0.01). Findings related to feelings of confidence revealed a greater percentage of participants agreed that online calibration activities increased their ability to evaluate student performance. Findings related to feelings of preparedness supported equal percentages of participants who agreed the online and in-person activities increased their ability to teach dental hygiene instrumentation. There was no significant difference between in-person and online retention test scores (p=0.235).Conclusion Faculty members agreed that both online and in-person calibration activities were an effective use of their time and contributed to greater feelings of confidence and preparedness. However, the online calibration activities seemed to be more effective at increasing calibration on instrumentation. More research is needed to determine additional effective strategies for online calibration of clinical faculty.

Suitable, fit, competent and safe to practice nursing? Assessing nursing students' personal qualities in clinical placement-An integrative review

AIMS AND OBJECTIVES

This study aims to explore, describe, and synthesize the personal requirements student nurses are assessed in their clinical placement to be suitable, fit, competent, and safe for the nursing profession.

BACKGROUND

There are different terms and concepts used when describing what nursing students are assessed by regarding personal requirements needed to be eligible to enter the nursing profession. This is regulated and enforced mainly by different standards and guidelines.

DESIGN

An integrative review using Whittmore and Knafl's (2005) methodology.

METHODS

Searches were systematically conducted in CINAHL, Education Source, ERIC, Academic Source Elite, MEDLINE and EMBASE, NORART, SveMed+, and Bibliotek.dk. The PRISMA checklist for systematic reviews was used.

RESULTS

Eighteen studies were included in the review. The results present various factors student nurses are assessed by in clinical placements, which were categorized into three themes: attitude and personal characteristics, behavior, and basic knowledge. Assessing students is a complex and subjective endeavor, and decisions are based on a holistic assessment of several different aspects of the student's performance and behavior CONCLUSIONS: The personal requirements to be deemed suited for det nursing profession are complex and composed of several different components. Assessments are often based more on assessors' subjective standards and intuition than on the provided guidelines and standards. There is no universal understanding of which characteristics or qualities are considered necessary for a student to be deemed suited for the nursing profession.

RELEVANCE TO CLINICAL PRACTICE

This study points at challenges with the assessment of nursing students today as there are no clear standards or understanding of the requirements needed.

Reimagining Preparedness of Health Professional Graduates Through Stewardship

Issue: Preparing health professional students for practice matters and is an important objective of health professional education. But although health professional courses grow in number and continue to graduate entry-level practitioners annually, there are signs that health professional education is not quite hitting the "purpose" mark. Preparedness is a term encountered often in health professional education, but it is besieged with challenges. Those challenges relate to whether graduates are prepared for their future careers and how preparedness for practice is understood; understandings of preparedness influence what curriculum, teaching, and learning prepares graduates about and for. Evidence: There is a wealth of the literature that suggests that graduates are not prepared for practice or believe they are not. This literature tends to grow rather than diminish, with arguments about preparedness materializing time and again. Preparedness means different things to students, academics, and practitioners and this creates misunderstanding as well as lessening the construct's value to research, education, and practice. What it means to be prepared is in fact not a static construct but changes in response to the needs of individuals and communities and broader societal context. When preparedness is defined as competence in skills or knowledge, graduates will be ill equipped to operate in the chaotic, ambiguous times we now face as competencies tend to oversimplify and reduce the demands of practice. Implications: Preparedness is only one purpose that could be attached to the educational formation of university graduates. It is time we expand our thinking about what is valuable and necessary to learn in order to become health professionals equipped to address the health and social care problems now and to come. Furthermore, continuing to address the challenges of preparedness for practice in the same ways as we have done for decades will not result in change; new and different educational approaches are required to meaningfully reimagine health professional education. We need to value education as a scholarly field in its own right, as much as we do evidence-based healthcare. A concept that prompts us to think and act in these reinvigorated ways is stewardship, which I offer as an expansive way to think about the purposes and desired outcomes of health professional education. Stewardship is an idea that sustains and cares for the professions, and therefore is highly relevant to the preparation of healthcare practitioners.

A qualitative analysis investigating competence assessment of undergraduate nursing students

BACKGROUND

This study reports on the process of competence assessment in undergraduate nursing programmes in New Zealand.

AIM

To identify current competence assessment practice and determine how competence assessment is constructed in order to reflect student development.

DESIGN

This research utilised a qualitative exploratory-descriptive design.

PARTICIPANTS

Nurse educators from nine tertiary institutions opted to participate in the research.

METHODS

Semi-structured interviews were conducted and data were analysed using a thematic analysis approach.

RESULTS

Three themes are reported in this article; clinical assessment pedagogy, measure of competence, and relational assessment practice. There was significant variation between and within institutions in conducting competence assessment while scaffolding competence assessment throughout the degree programme was highlighted as a challenge.

CONCLUSIONS

This study highlights the need for an assessment process that allows for the developing competence of nursing students and competencies that are designed to adequately assess students in each year of the nursing programme.

Didactic dissonance-embracing the tension between classroom and clinical education

The United States is undergoing a transformation in the way pain is viewed and treated. This transformation affects pain education, as some degree of disconnect will be expected between what is taught in classroom settings and what learners observe in clinical settings. We term this disconnect "didactic dissonance" and propose a novel process to harness it as a learning tool to further pain education. Based on principles of transformative learning theory, we describe a structured, three-step process beginning with (1) priming learners to recognize didactic dissonance and identify specific examples from their education, followed by (2) encouraging learners to search the primary literature to resolve observed dissonance and reflect on the system factors that created and perpetuated the disconnect, and then (3) providing an opportunity for learner reflection and planning for how they will address similar situations in future practice and teaching environments. Fostering an environment conducive to learning-through modeling the intellectual virtues of curiosity, humility, and creativity-is a critical task for educators when implementing this process. Recognizing challenges faced by educators in both classroom and clinical settings, it may be a more feasible first step to integrate the concept of didactic dissonance into existing curricular elements. For programs able to implement the full three-step process, a discussion guide along with an example of a facilitated discussion have been provided. While proposed in the context of pain education, this transformational approach can be utilized across all topics in medical education to foster autonomous lifelong learning.

Development, Implementation and Evaluation of an Acute Care Physical Therapy 'Float' Placement during the COVID-19 Pandemic: A Case Report

Clinical education is a mandatory component of physical therapy curricula globally. COVID-19 disrupted clinical education, jeopardizing students' abilities to meet graduation requirements. The objective of this case report is to outline the development, implementation and evaluation of a multiple clinical instructor (CI), multiple unit, acute care float clinical placement for a final year, entry-level physical therapy student and offer implementation recommendations. This placement included an eight-week, multiple CI (one primary, four supporting), multiple (five) unit clinical placement which was developed between St. Joseph's Healthcare and the McMaster University Masters of Science (Physiotherapy) Program between 10 August and 2 October 2020. Student evaluations and reflections by the student and CIs were collected and analyzed using interpretive description. Analysis from the reflections revealed six themes: (1) CI and student attributes; (2) increased feasibility; (3) varied exposure; (4) central communication and resources; (5) organization; and (6) managing expectations. An acute care clinical experience is required for students in Canadian entry-to-practice physical therapy programs. Due to COVID-19, placement opportunities were limited. The float placement allowed clinicians to offer supervision despite staff re-deployment and increased organizational and work-life pressures during the pandemic. This model provides an approach to extenuating circumstances and may also increase acute care placements during non-pandemic times for physical therapy and other similarly structured healthcare professions.

While allied health students prefer face-to-face clinical placement, telehealth can support competency development: results from a mixed-methods study

Introduction

Student clinical placements are a mandatory requirement within most accredited health programs. During the COVID-19 pandemic, many health settings that had traditionally provided placements cancelled their offerings. Telehealth services however, increased and emerged as an alternative placement setting.

Aim

To compare the learning experiences for allied health students provided by telehealth and face-to-face accredited health placements.

Methods

Health students, from a university clinic between March to December 2020, delivering both face-to-face and telehealth consultations, were invited to complete a telephone survey with 3 demographic questions; and 10-items comparing their telehealth and face-to-face learning experiences. Pearson's chi-squared/Fisher's exact test was used to examine the association between each item and consultation setting. Qualitative survey data was thematically analysed using a descriptive approach.

Results

49 students from 2 universities and 5 disciplines completed the survey. Students rated their face-to-face experiences significantly higher than their telehealth experiences across all items (all p-values <0.01). Across 9 items students reported positive learning experiences in both settings. Students had greater opportunities to work in a multidisciplinary team in a face-to-face setting. Four themes were generated: (1) placements can vary in quality regardless of setting; (2) telehealth can provide valuable learning experiences and support competency development; (3) enablers for telehealth placements and (4) barriers for telehealth placements.

Conclusion

While telehealth can support student learning and competency development, in this study students preferred face-to-face experiences. To optimise telehealth placements consideration needs to be given to barriers and enablers such as technological issues and university curricula preparation.

Nursing Students' Spiritual/Religious Coping Strategies Dealing With First Experience of Witnessing Death During Clinical Practices

This study aims at determining spiritual/religious coping strategies of nursing students dealing with the first experience of witnessing death during clinical practices. One of the qualitative research approaches, a descriptive phenomenological study was designed. The study was carried out with 14 nursing students studying at a state university in Turkey. The students' first experiences of witnessing death were examined by the personal in-depth interviewing method. Data were analyzed using the thematic analysis method. The following five main themes were identified by the analysis: Perception of death; Witnessing death for the first time; Coping with death experience; Needs and recommendations; Impact of spirituality and religion. The obtained findings were presented according to the COREQ criteria. The findings showed that witnessing death for the first time is a difficult experience that affects students in various ways and students prayed and performed their prayers frequently to cope with the death experience.

The impact of rural nursing and midwifery clinical placements from the perspective of health service staff

OBJECTIVE

To explore the impact of providing nursing and midwifery student placements from the perspective of regional, rural and remote health service staff involved in hosting students.

SETTING

Hospital and health services across regional, rural and remote southern Queensland.

PARTICIPANTS

Thirty-six nursing and midwifery staff working in clinical and/or management roles who were direct clinical supervisors of students or in leadership positions with responsibility for overseeing and supporting clinical placements.

DESIGN

Semi-structured interviews exploring the experiences and perspectives of nursing and midwifery health service staff who support student placements. Data were subject to thematic analysis.

RESULTS

Five key themes were identified as follows: (a) bringing new ideas and perspectives, (b) opportunities for development, (c) supporting the future rural workforce (d) impacts on workload and productivity and (e) strategies for balancing supervision.

CONCLUSION

The results indicate that there are a range of perceived benefits and challenges of providing nursing and midwifery student placements within regional, rural and remote settings. The findings also indicate that there are opportunities to further support rural health services to optimise the positive impacts and mitigate the challenges of providing placements. To do so requires collaboration between health services and education providers to allocate students appropriately to health services and support health service staff.

Effectiveness of an online program using telesimulation for academic-clinical collaboration in preparing nurse preceptors' roles

AIM

To evaluate the effectiveness of an online program on nurse preceptors' knowledge and self-efficacy in their roles to support students' clinical education, and to examine their online experience.

BACKGROUND

Professional development of nurse preceptors is paramount to fostering work readiness of future graduate nurses on entering the workforce. The support from academic institutions in developing preceptors' roles in clinical teaching and assessment is pivotal.

DESIGN

This study employed a mixed-methods design.

METHOD

A total of 59 nurse preceptors from six healthcare institutions participated in an online preceptor program by collaborating with academic educators in facilitating student clinical learning and assessment through telesimulation following web-based instruction. Pre-test and post-tests were administered to evaluate the preceptors' knowledge and self-efficacy in their roles. Survey questionnaires and focus group discussions were conducted to evaluate their online experience. SQUIRE 2.0 guidelines were applied.

RESULTS

The preceptors demonstrated significant improvements (p < .001) in knowledge and levels of self-efficacy in their preceptor roles immediately and 1 month after the program. The following four themes emerged from their learning experiences: 'interactive learning approach', 'academic-practice collaboration', 'better understanding of clinical assessment tool' and 'application of teaching strategies'. The preceptors reported positively on their motivation to learn using the web-based instruction and on their telesimulation experience.

CONCLUSION

The study findings demonstrated effectiveness and feasibility of an online preceptor program to enhance preceptors' roles in supporting nursing students' transition to clinical practice, using a mix of web-based technologies to provide preceptors with self-directed and experiential learning approaches.

RELEVANCE TO CLINICAL PRACTICE

This study contributed to the development of an innovative online preceptor program that provided opportunity for academic-clinical collaboration and has broad applicability. The telesimulation created robust remote simulation experiences for preceptors, allowing them to collaborate with academic educators in facilitating students' clinical practice amid the COVID-19 pandemic.

Clinical teaching in dentistry: Evaluating a clinical oral pathology rotation while looking to the future of dental education

PURPOSE/OBJECTIVES

Clinical teaching in dentistry has cycled through specialty-based "departmental" teaching to group practice scenarios. The aims of this study were to ascertain third-year dental students' perceptions of a specialty-based rotation supplemented by online educational tools and to compare their Objective Structured Clinical Exam (OSCE) scores to those of the students in the previous year.

METHODS

This retrospective research design included the analysis of OSCE scores, and student responses to survey questions regarding their perceptions of the clinical oral pathology (COP) rotation. This study was completed in 2022. It included data from 2020 to 2021 and 2021 to 2022 corresponding to input from the Classes of 2022 and 2023, respectively. The response rate was 100%.

RESULTS

The students evaluated the focused COP rotation and the online teaching modules as a positive experience. The results of the OSCE were similar to those of the previous class and showed a high average score.

CONCLUSIONS

This study shows that students had a positive perception to specialty-based learning with online educational tools and that it enhanced the education they received in the comprehensive care clinic. The OSCE scores were similar to those of the previous class. These findings suggest a method of maintaining high-quality dental education through challenges as it continues evolving.

Exploration of the contribution of physiotherapy students to the delivery of health services: a qualitative study

OBJECTIVE

To understand the perspectives of physiotherapists on the contribution of students to the delivery of health services during clinical placements.

METHODS

Focus groups with a semi-structured interview guide were completed separately with new graduate physiotherapists reflecting on their student experience and experienced physiotherapists from five Queensland public health-sector hospitals. Interviews were transcribed verbatim in preparation for thematic analysis. Interview manuscripts were read independently and initially coding completed. Codes were compared and further refinement of themes occurred. Themes were reviewed by two investigators.

RESULTS

There were 38 new graduate participants across nine focus groups and 35 experienced physiotherapists across six focus groups who participated in this study. Students participate in a range of activities during clinical placements some of which contribute to delivery of health services and others which support student learning. Three major themes were identified: 1) tangible student contribution; 2) non-tangible student contribution; and 3) factors that influence the student contribution.

CONCLUSIONS

Overwhelmingly, both new graduate and experienced physiotherapists felt that students do contribute to the delivery of health services however careful consideration of a variety of factors is necessary to maximize the student contribution.

The Impact of COVID-19 on the Laboratory Professionals' Clinical Education: a Qualitative Study

A 48-question survey was developed and disseminated to laboratory professionals. This survey sought the perspective of clinical educators on a variety of topics, including two open-ended questions on the impact COVID-19 had on student clinical rotations and the ensuing policy changes. Of 207 clinical sites that participated in the survey., Some terminated student clinical rotations without offering any other training alternative. Others employed a number of strategies such as shortening the length of clinical rotations, taking fewer students, transitioning to an online learning platform, or delaying training until a future date. Some mandated regular illness checks, symptom checks, and COVID-19 testing when available. Clinical educators expressed concern over the lack of continuity of student clinical training, policy changes related to COVID-19 and student training that were deemed to diminish the quality of the students' clinical education. With terminated, delayed or shortened clinical rotations at many sites, in combination with staff and supply shortages, clinical educators were concerned about the overall quality of clinical education the students were receiving. In addition to these concerns, the reduction of student graduates during the pandemic decreased the number of applicants for job vacancies exasperating a pre-pandemic problem.

A Review, Update, and Commentary for the Cough without a Cause: Facts and Factoids of the Habit Cough

BACKGROUND

A habitual cough, persisting after the cause is gone, was described in a 1694 medical book. Successful treatment of this disorder known as habit cough was reported in 1966 by the "art of suggestion". The purpose of this article is to provide the current basis for diagnosis and treatment of the Habit Cough Syndrome.

METHOD

The epidemiology and clinical course of habit cough were reviewed; original data were obtained from three sources.

RESULTS

Unique clinical presentation was the basis for diagnosis of habit cough. Diagnosis was made 140 times with increasing frequency over 20 years at the University of Iowa clinic and 55 times over 6 years at a London clinic. Suggestion therapy provided more frequent cessation of cough than just reassurance. A Mayo Clinic archive of chronic involuntary cough found 16 of 60 still coughing 5.9 years after initial evaluation. Ninety-one parents of children with habit cough and 20 adults reported cessation of coughing from viewing a publicly available video of successful suggestion therapy.

CONCLUSIONS

Habit cough is recognizable from the clinical presentation. It is effectively treated in most children by suggestion therapy in clinics, by remote video conferencing, and by proxy from viewing a video of effective suggestion therapy.

Watch vs do: A randomized crossover design evaluating modified simulated patients and video learning for novice speech-language therapy students

BACKGROUND

Simulated learning activities are an effective tool for reducing speech-language therapy (SLT) students' anxiety and improving their confidence for clinical placements. Such activities include interacting with patients who are actors, clinical educators or peers and are known to decrease anxiety and increase confidence in SLT students. Screen-simulated patients using video are another alternative, which has not yet been fully evaluated in the education of SLT students.

AIMS

To compare the effectiveness of (1) modified simulated patient and (2) video simulated learning for increasing self-reported (a) confidence and (b) preparedness and (c) decreasing self-reported anxiety.

METHODS & PROCEDURES

This study used a randomized crossover design with 127 first-year graduate-entry master's SLT student participants. Students participated in two activities related to a clinical interaction with a paediatric client's carer: (1) a 1-hr modified simulated patient experience with clinical staff as the simulated patient; and (2) a video-learning task, with two videos of a clinician-carer interaction and an accompanying worksheet. Students were randomly allocated to a group of four students and the groups randomly allocated to receive modified simulated patient or video-learning first. Students were not blinded to the activities. The students completed a 19-item questionnaire at three time points: before either activity, after the first activity and after the second activity, to evaluate their self-reported confidence, clinical preparedness and anxiety.

OUTCOMES & RESULTS

A total of 62 students completed modified simulated patient first and 63 completed video-learning first. After either single activity the students had significantly increased confidence and preparedness scores, while only the modified simulated patient significantly reduced student anxiety scores. As a second activity, modified simulated patient resulted in further significant improvements in confidence, preparedness and anxiety; however, adding video learning as a second activity resulted in no significant benefit.

CONCLUSIONS & IMPLICATIONS

This study demonstrates the effectiveness of two low-resource clinical-learning activities for novice SLT students that can be applied in a range of settings. Of the two activities, modified simulated patient had greater effectiveness, as it was the only activity to decrease anxiety. An investigation of the pedagogical principles within the activities revealed that modified simulated patient activity had more opportunities for peer learning, supervisor feedback and verbal reflection in comparison with video learning that may explain the increased benefits.

WHAT THIS PAPER ADDS

What is already known on the subject Simulated learning activities are an effective teaching tool for SLT students, increasing confidence and decreasing anxiety in preparation for placement. Simulated patients require more resources than video simulation. Both simulated patients and video simulation provide a safe learning environment, where students can learn without risk to clients. What this paper adds to existing knowledge This study is among the first to investigate a modified version of simulated patients; our modification involves a clinical educator performing the role of both the simulated patient and simulation facilitator. It is the first to evaluate simulation via video learning for SLT students. The paper demonstrates the effectiveness of these two activities, and the slight advantage of modified simulated patient, for increasing novice students' confidence and preparedness and decreasing their anxiety about clinic. It also unpacks the pedagogical principles used in each activity to explain the reasons that modified simulated patient had greater effectiveness. What are the potential or actual clinical implications of this work? The two educational activities required no specialist equipment and can be applied in a range of pre-clinical and clinical settings by university staff and/or community clinical educators. Increasing confidence and preparedness, and decreasing anxiety will help ensure that student learning on scarce clinical placements is maximized.

Comparison of 3D printing model to 3D virtual reconstruction and 2D imaging for the clinical education of interns in hepatocellular carcinoma: a randomized controlled study

Background

The clinical education of interns on hepatocellular carcinoma (HCC) is both crucial and difficult in China, even if the education reform has advanced constantly over the years. The value of specific 3D printing model (3DPM) in clinical education of HCC is uncertain, and relevant literatures are very few. This study aimed to explore the effects of a patient-specific 3D printing liver model on the clinical education of HCC.

Methods

Three laparoscopic hepatectomies were collected. For each case, a 3D virtual reconstruction (3DVR) and 3DPM were created using multi-detector computed tomography (MDCT) data, respectively. A total of 62 interns were randomly assigned to each group (3DPM, 3DVR, and MDCT groups) through a table of random numbers for random grouping. Following lecture-based HCC education, interns in each group selected a corresponding model of HCC. All interns were tested on the hepatic tumor locations, the vessels adjacent to them, surgical planning, and test time using the centesimal system score within 90 min. A questionnaire investigation on the degree of satisfaction, interest, and helpfulness for improving the comprehension ability of liver anatomy and 3D spatial structures was also recorded. The 3DPM group were compared with both 3DVR and MDCT group by theoretical examination scores and questionnaire survey satisfaction to evaluate the effects of 3DPM on the interns' clinical education in HCC.

Results

All the interns completed the test and questionnaire. The 3DPM group gained significantly higher scores on the following test contents: indicating the correct tumor location (3DPM vs. 3DVR, MDCT: 36.7±4.8 vs. 33.2±5.8, 26.8±10.0, P=0.03, P<0.01, respectively), accurately identifying the relationship between the tumor and vessels (3DPM vs. 3DVR, MDCT: 37.1±4.6 vs. 31.6±3.7, 30.0±5.8, P<0.01, P<0.01, respectively), and designing appropriate surgical plans (3DPM vs. 3DVR, MDCT: 8±2.7 vs. 4.9±2.7, 5.9±3.8, P<0.01, P=0.04, respectively). The 3DPM group showed a higher degree of satisfaction (86.2%), interest (92.1%), and helpfulness (80.5%) for improving the comprehension ability of liver anatomy and 3D spatial structures.

Conclusions

The clinical teaching by utilizing 3DPM can significantly improve the professional theoretical level, strengthen clinical thinking and comprehensive ability, and improve the teaching effects of HCC for medical interns.

Predictors of clinical experience performance in occupational therapy and physiotherapy: A scoping review

INTRODUCTION

Successful completion of clinical education experiences is a graduation requirement for students in occupational therapy and physical therapy programmes. A scoping review was conducted to determine what is known about possible clinical experience performance predictors and to find associated research gaps.

METHODS

The search included one hand-searched journal and seven databases, which were used to identify related relevant studies: CINAHL, Education Database, Education Source, Education Resources Information Center (ERIC), PubMed, REHABDATA, and Web of Science. A research librarian guided the search process, and the review's reporting is structured by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Studies were included if they contained predictors of clinical experience success indicated by validated performance evaluation tools that were scored by clinical instructors. A multidisciplinary team reviewed the title, abstract, and full text for inclusion and conducted thematic data synthesis to categorise findings.

FINDINGS

Twenty-six articles met the inclusion criteria. The majority of articles were of correlational design and included single institutions. Seventeen articles included occupational therapy, eight included physical therapy, with only one article including both programmes. Four categories of predictors of clinical experience success were identified: pre-admission variables, academic preparation, learner characteristics, and demographics. Each of the main categories included three to six subcategories. Key findings included the following: (a) The most common cited predictors in clinical experiences are academic preparation and learner characteristics, (b) more experimental design studies are needed to determine the causal relationship between predictors and clinical experience success, and (c) future research is needed on ethnic disparities and clinical experience success.

CONCLUSION

Findings from this review show that possible predictors of clinical experience success include a wide range of factors when correlating success with a standardised tool. Academic preparation and learner characteristics were the most investigated predictors. There were only a small number of studies that found a correlation with pre-admission variables. The findings of this study suggest that students' academic achievement may be a critical element of clinical experience preparation. Future research using experimental designs and across institutions is needed to determine the main predictors for student success.

Impact of the COVID-19 pandemic on student supervision and education in health care settings: A state-wide survey of health care workers

OBJECTIVE

To investigate student supervisor experiences of supervising students on clinical placements since the onset of the COVID-19 pandemic.

BACKGROUND

Studies on the impact of COVID-19 on student clinical placements have focused largely on student reports and have been specific to individual professions or topic areas. There is a need to investigate student supervisor experiences. This study was conducted in Queensland (Australia) in four regional and rural public health services and four corresponding primary health networks.

METHODS

The anonymous, mixed methods online survey, consisting of 35 questions, was administered to student supervisors from allied health, medicine, nursing and midwifery between May and August 2021. Numerical data were analysed descriptively using chi-square tests. Free-text comments were analysed using content analysis.

RESULTS

Complete datasets were available for 167 respondents. Overall trends indicated perceived significant disruptions to student learning and support, plus mental health and well-being concerns for both students and supervisors. Extensive mask wearing was noted to be a barrier to building rapport, learning and teaching. Some positive impacts of the pandemic on student learning were also noted.

CONCLUSIONS

This study has highlighted the perceived impact of the pandemic on supervisors' mental health, and on the mental health, learning and work readiness of students. This study provides evidence of the pandemic impacts on student clinical placements from a supervisor point of view. Findings can assist in future-proofing clinical education and ensuring that students continue to receive learning experiences of benefit to them, meeting curriculum requirements, in the event of another pandemic.

Clinical education-related stressors and emotional states during clinical education among physical therapy students

BACKGROUND

While clinical education-related stressors in other healthcare professions have been reported, clinical education stressors in physical therapy students are not yet clear.

PURPOSE

This study aimed to identify clusters of stressors associated with clinical education among Japanese physical therapy students and determine the association between these clusters and emotional states.

METHODS

Participants were physical therapy students who had completed five weeks of clinical education. In addition to demographic data, the survey included the Brief Job Stress Questionnaire (BJSQ) and the Stress Reaction Scale (SRS-18). Exploratory factor analysis was used to extract latent variables for sub-items of the BJSQ. Spearman's correlation coefficients between the extracted latent variables and the subscales of the SRS-18 were calculated.

RESULTS

Data from 114 individuals (median age 21 years, 68 men and 46 women) were analyzed. The variables identified as clusters of stressors were: 1) "adaptation to clinical education"; 2) "task burden"; and 3) "appropriate work environment." These three clusters of stressors were significantly but only weakly correlated with the subscales of the SRS-18 (|rs| ≤ |-.39|).

CONCLUSION

The stressors associated with physical therapy clinical education need to be understood in terms of the students' active attitude toward clinical education, the burden of practice tasks, and the physical environment during practice.

Perspective: Acknowledging a Hierarchy of Social Needs in Diabetes Clinical Care and Prevention

The evidence of suboptimal social determinants of health (SDoH) on poor health outcomes has resulted in widespread calls for research to identify ways to measure and address social needs to improve health outcomes and reduce disparities. While assessing SDoH has become increasingly important in diabetes care and prevention research, little guidance has been offered on how to address suboptimal determinants in diabetes-related clinical care, prevention efforts, medical education and research. Not surprisingly, many patients experience multiple social needs - some that are more urgent (housing) than others (transportation/resources), therefore the order in which these needs are addressed needs to be considered in the context of diabetes care/outcomes. Here we discuss how conceptualizing diabetes related health through the lens of Maslow's hierarchy of needs has potential to help prioritize individual social needs that should be addressed to improve outcomes in the context of population-level determinants in the communities where people live.

End-of-Life Dreams and Visions: Initial Guidelines and Recommendations to Support Dreams and Visions at the End of Life

Background: End-of-life dreams and visions (ELDVs) are a common phenomenon in which dying patients experience dreams/visions often of deceased loved ones before death. Past research has highlighted the need for education and awareness to improve clinical engagement at the bedside in response to ELDVs. Objectives: To explore the perspectives of multidisciplinary hospice care providers who are ELDV subject matter experts. Design/Methods: Semi-structured interviews with 13 multidisciplinary hospice providers were conducted and analyzed using thematic qualitative analysis. Results: Analysis revealed six themes: Normalization, Rapport Building, Active Listening, Individualized Meaning Making, Barriers, and Education. A secondary thematic analysis focused on defining/describing ELDVs and resulted in two themes: Natural Part of Dying and ELDV Properties. Conclusions: Findings identified facilitators and barriers encountered when caring for a patient with ELDVs. Based on this, an initial set of recommendations for meaningful clinical engagement regarding ELDVs and initial operationalized definition has been proposed.

Lessons learned from clinical course design in the pandemic: Pedagogical implications from a qualitative analysis

AIMS

The purpose of this study was to examine clinical pedagogy based on experiences of changes and adaptations to clinical courses that occurred in nursing education during the pandemic. Beyond learning how to manage nursing education during a pandemic or other crisis, we uncover the lessons to be learned for overall improvement of nursing education.

DESIGN

Qualitative descriptive analysis using semi-structured interview data with baccalaureate nursing students.

METHODS

Data were collected in the spring of 2021 using semi-structured interview with 15 participants. Transcribed text was analysed using thematic content analysis. The COREQ checklist was used to guide our reporting.

RESULTS

Three themes were identified related to course design in clinical courses for nursing students: the role and limitations of simulation, competency evaluations and career implications. Students expressed some concern over not 'finishing hours', loss of in-person clinical experiences and their reduced exposure to different clinical settings.

CONCLUSION

To prepare work-ready nurses, educators need to keep in mind the trends, issues and demands of future healthcare systems. Simulation may have been a temporary measure to achieve clinical competence during the pandemic but needs to be of high-quality and cannot meet all the expected learning outcomes of clinical courses. Exposure to different patients, families and communities will ensure that the future nursing workforce has experience, socialization, competence, and desire to work in various clinical settings. Competency evaluation similarly needs to be robust and objective and consider the role and perception of hours completed.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution. Participants were nursing students.

Realistic simulation in nursing education: Testing two scenario-based models

AIM

To evaluate students' self-perceived pedagogical outcomes when using a digital scenario-based tool compared to traditional scenarios printed on paper.

DESIGN

This study used a within-subjects experiment.

METHOD

A digital platform for scenario development was developed, focusing on patients' regaining independence and returning home after an acute event. Students participated in two simulation activities, differing only in the type of scenario used and completed a questionnaire to evaluate their learning experience.

RESULTS

Students considered that the new scenario template provided a clearer understanding of the situation under analysis, allowing them to recognize the focuses of attention to be prioritized when formulating the intervention plan. No Patient or Public Contribution: A digital platform for a standardized process of scenario writing to help realistic simulation in nursing education is a novelty in this study and will likely contribute to substantial learning gains.

Measuring educational neglect using the Q method: A model based on the burden of disseminated tungiasis

Background

A paramount factor in the control of neglected tropical diseases from both medical and social aspects is education. New strategies must be constantly pursued to test and provide educational information related to diseases affecting vulnerable populations. We applied the Q method as a model to measure educational neglect based on the burden of disseminated tungiasis.

Methods

Using a saturation method for sample size calculation, we recruited students and healthcare professionals to evaluate and classify 27 statements related to the prevention, control and treatment of tungiasis. After quantitative analysis, the Q method was applied based on the paired use of the centroid method and Varimax rotation, and 4 factors were extracted representing the main sets of viewpoints among the participants.

Results

We included 119 healthcare professionals with different academic degrees. Statements classified by specialists with a + agreement were also classified as a + agreement by most of the participants. However, we detected 5 important disagreements related to the topical treatment of tungiasis and control of the disease in the environment and animals. The Q method showed that almost no consensus was detected for four statements. The classification of each statement was not related to the participants' academic degree.

Conclusions

There is significant educational neglect related to tungiasis prevention and treatment in healthcare sciences in Brazil. We conclude that the Q method may be an interesting strategy alone or associated with quantitative strategies for detecting educational limitations related to neglected diseases. In countries where neglected diseases are endemic, a detailed study evaluating the quality of education related to these diseases must be prioritized.

Written reflective practice abilities of SLT students across the degree programme

BACKGROUND

Written reflective practice (WRP) is a teaching tool used across speech-language therapy (SLT) clinical education programmes. The process aims to support the development of reflective skills required for the workplace (e.g., problem-solving and self-evaluation).

AIMS

This cross-sectional and repeated-measures study design investigated students' demonstration of breadth of WRP across the clinical education programme.

METHODS & PROCEDURES

The participants were 77 undergraduate SLT students in their first, second or final professional year of the clinical programme. Participants wrote critical reflections following an interaction with a client/s as part of their clinical education experiences. Formative feedback was provided after each written reflection (WR). In total four WRs per participant were coded for breadth of WRP using a modification of Plack et al.'s coding schema from 2005. This was completed for each of the four time points across the academic year for each professional year.

OUTCOMES & RESULTS

There was a statistically significant association between time (i.e., professional year of the programme) and likelihood of demonstration of breadth of reflection for the lower level reflective element of 'attend' and higher level reflective element of 're-evaluate'. A positive trend between time and likelihood of demonstration of breadth of reflection was seen for the lower level element of 'reflection-for-action'. Final-professional-year students exhibited significant enhancements in the higher level elements (e.g., 'premise') compared with first- and second-professional-year students.

CONCLUSIONS & IMPLICATIONS

This group of SLT students exhibited significant change in breadth of WRP across the degree programme. This finding has positive implications for facilitating WRP with students and using the current coding framework in clinical programmes.

WHAT THIS PAPER ADDS

What is already known on this subject WRP is one form of reflective practice (RP) used in SLT, allied health, medical and nursing clinical education programmes. Researchers have suggested that RP skills develop over time for students. Previously, studies examining WRP have focused on one off assessment of skill or over a timeframe of 6-10 weeks. Here, we examine SLT students' WRP skills across the degree programme. What this paper adds to existing knowledge SLT students exhibited significant positive change in breadth of WRP across the degree programme as their clinical experience increased. Our results provide quantitative information in support of using RP as a learning tool throughout clinical education programmes for SLT. What are the potential or actual clinical implications of this work? This study offers support for educators of SLT students; for example, how educators can assess WRP, and how educators can foster SLT student skill development with formative feedback and reflective questioning. This study also offers support for student SLT, for example, describing how WRP can be part of their individualized learning approach and provide a purposeful examination of self and clinical skill development.

Investigation of academic motivation in medical students and its association with clinical education quality, academic achievement, and academic burnout

BACKGROUND

Improving the quality of clinical education requires continuous review of the current situation, identifying strengths, and correcting weaknesses. This study aimed to investigate the association between academic motivation with quality of clinical education, academic achievement, and burnout.

MATERIALS AND METHODS

This cross-sectional study was done in 2020 on all of the 140 internship students of Shahrekord University of Medical Sciences, using the consensus method. The data collection tools included standard questionnaires such as Herman's Academic Motivation, Clinical Education Quality, Maslach Modified Academic Burnout, Pham and Taylor Academic Achievement, Satisfaction of Educational Welfare Facilities. Data were analyzed using SPSS (ver. 22) software and descriptive statistics (mean, standard deviation, frequency and percentage of frequency), Spearman rank, correlation coefficient and Mann-Whitney and Kruskal-Wallis statistical tests. P < 0.05 is considered statistically significant.

FINDINGS

The mean ± SD of age was 25.68±2.03. 86 (61.4%) of the internship were female and 87 (62.1%) were single. Mean± SD of academic motivation and quality of clinical education were 81.51± 8.73 and 28/99± 11/52 respectively. Also, the Mean± SD of academic achievement and academic burnouts were 147/61± 14/94 and 42/37± 10/42 respectively.

RESULTS

Academic motivation had a meaningful and positive relationship with academic achievement and satisfaction of welfare facilities but a negative correlation with academic burnout. Also, academic achievement and academic burnout had a negative correlation but a positive correlation was seen between the quality of clinical education and satisfaction of welfare facilities.

CONCLUSION

Considered the results, recommended improving welfare education facilities by using up-to-date training aids, upgrading educational infrastructure, and employ young staff in the education office. For improving the quality of clinical education, appropriate educational methods, conducting developmental assessments continuously, using simulated environments, and improving students' motivation.

Iranian nursing students' experiences of workplace violence: a qualitative study

BACKGROUND

Workplace violence against nursing students is a common phenomenon. This study aimed to investigate Iranian nursing students' experiences of workplace violence, including their reaction to violence and the consequences and the effects of such violence on the students.

METHODS

The study participants were undergraduate nursing students. The data were collected using semi-structured, in-depth face-to-face interviews. Data analysis was carried out with qualitative approach using conventional content analysis.

RESULTS

Four categories were extracted from the analysis of the interview transcriptions: vertical violence, horizontal violence, reaction to violence and consequences of violence. Nurses were the major imposers of violence against students and psychological and verbal violations were the most of used forms of violence. The students reacted to violence in the forms of counteracting, reporting, disregarding and considering as commonplace.

CONCLUSIONS

Workplace violence is a common phenomenon experienced by nursing students in this study, which causes devastating individual, educational, and professional impacts. Action plans including providing safe environment and appropriate support from nurses and educators should be developed in clinical settings to intervene and to prevent workplace violence.

Students' Perception of Learning Through Targeted Practice and Effective Feedback

PURPOSE

To examine how second-year radiologic technology students perceived their ability to learn based on targeted practice and effective feedback provided by clinical instructors and staff radiographers.

METHODS

This study used qualitative methods with a descriptive design. Data were collected from second-year radiologic technology students in New Jersey and New York through a questionnaire and a follow-up, semistructured interview about their perceptions of the clinical learning environment.

RESULTS

Two themes were identified from this study: students perceive targeted practice and effective feedback as very effectual to the clinical education process and students' desire additional opportunities for targeted practice that can be performed independently with no interference from the clinical instructor or staff radiographer, followed by effective feedback. Unexpected findings included that some clinical instructors did not provide targeted practice or effective feedback and some clinical instructors and technologists did not allow or permit enough independent practice for students to complete a self-assessment of their clinical skills.

DISCUSSION

This study demonstrated that positive learning for students occurs when the clinical instructors and staff radiographers allow students to work closely with them by providing opportunities for assisted and independent practice opportunities and through a willingness to provide feedback.

CONCLUSION

Additional professional development opportunities are needed for clinical instructors and staff radiographers. For clinical instructors, more education is needed to understand students' need for feedback. For staff radiographers, professional development is needed to incorporate teaching skills and to help them realize the valuable effects they have on the students' clinical education.

Where Are We Now? A Follow-up Survey on Regulation of Simulation Use in United States Prelicensure Nursing Programs

Background

Approval of simulation in substitution of traditional clinical hours increased in nursing programs during the COVID-19 pandemic, yet these temporary and inconsistent between states. Variability and a return to "pre-pandemic" limits on simulation use amplify questions about consistency of learner outcomes.

Methods

Boards of Nursing (BONs) of the United States and District of Columbia (DC) were queried to verify accuracy of simulation regulations posted on the International Nursing Association for Clinical Simulation and Learning (INACSL) regulatory map and to identify factors contributing to regulatory changes.

Results

Approximately half of respondents indicated information posted on the INACSL regulatory map is accurate for their state. Almost 30% of respondents indicated information is not accurate. Some states could not confirm accuracy of simulation regulations posted.

Conclusions

Many nursing programs expanded the use of simulation during the COVID-19 pandemic. Reverting to "prepandemic" limited simulation use presents a missed opportunity to advance nursing education and align simulation regulation with the growing body of evidence supporting its outcomes.

Use of a Simulated-Virtual Training Module to Improve Dental Hygiene Students' Self-Reported Knowledge, Attitudes, and Confidence in Providing Care to Children with Autism Spectrum Disorder: A pilot study

Purpose: Autism spectrum disorder (ASD) is a developmental disorder affecting an individual's ability to communicate, interact, behave, and learn. The purpose of this study was to determine knowledge, attitudes, and confidence of dental hygiene students in providing care to children with ASD as a mechanism for evaluating dental hygiene curricula for patients with special needs.Methods: A simulated-virtual training (SVT) intervention was developed as an interactive approach for educating dental hygiene students on providing care to a child patient with ASD. The SVT intervention consisted of a scenario in which the clinician "interacted" with a child with ASD who was having difficulty in the dental environment. Pre- and post-test surveys measured students' knowledge, attitudes, and perceived confidence related to providing dental hygiene services to children with ASD prior to and following the intervention. The Wilcoxon Signed Rank was used to determine statistical significance at the p=.05 level.Results: Thirty-three second year dental hygiene students completed the pre- and post-test surveys for a response rate of 97%. Statistically significant differences were observed for self-reported confidence to provide care to patients with ASD upon graduation, assessment of the unique needs of children with ASD, and an understanding of the dental needs for children with ASD (p<0.05). Participants' confidence with performing dental hygiene services on children with ASD greatly increased, with statistically significant difference found for almost all services (i.e., oral exam, oral hygiene instruction, oral photos, radiographs, scaling, fluoride treatment; p<0.05) except selective polishing. Most (90%) agreed that there is a need for additional/elective resources to help increase comfort in providing care to children with ASD.Conclusion: Results indicate the SVT intervention increased students' knowledge, attitudes, self-perceived confidence, and comfort. Dental and dental hygiene curricula could include technologies and intervention methods to advance access to dental care by children with ASD.

Postgraduate medical education in obstetrics and gynaecology: Where are we now and what do we need for the future? A study on postgraduate training in obstetrics and gynaecology in Germany, Austria and Switzerland

Objective: In this study, we aim to assess the current situation of postgraduate medical education in obstetrics and gynaecology in Germany, Austria and Switzerland. In addition, we aim to determine transferable advantages amongst the countries. Study design: We performed a survey through a digital questionnaire with a total of 40 questions. The survey was advertised via communication channels of the German, Austrian and Swiss gynaecological societies; the participants were enrolled anonymously. Results: A total of 422 trainees took part in the survey. Differences within the three countries where found regarding the workload and the training of sub-specialties. Generally, the participants described to spend the majority of their daily working hours on documentation. Concerning assessment of current training regulations, more than half of trainees stated that they were actually faced with notable difficulties to fulfil the required obligatory numbers of self-performed interventions being documented. When asked for their intrinsic feeling of safety, around two-third of trainees felt "confident to very confident" during standard interventions. These numbers were up to 12% higher in the group of trainees who experienced simulation training during their education. Conclusion: With the help of this survey, weak points can be identified such as workload and implementation of current training regulations. Projects and ideas as EBCOG PACT, EPAs, the reduction of bureaucracy through digitization and deepening skills through simulation make a valuable contribution to compensate for these deficits and to adapt to future requirements.