Live lectures and videos do not differ in relation to learning outcomes of dental ergonomics

OBJECTIVES

This study aimed to compare the knowledge attained by third-year dental students in physical ergonomics altering live lectures and videos in teaching. The second aim was to investigate implementation of the theoretical knowledge on ergonomics into practice.

MATERIAL AND METHODS

Forty-five students divided into two groups attended a live lecture (45 min) or viewed videos (45 min). After the first teaching session, the groups changed parts. All students answered a questionnaire with 13 true or false-questions on ergonomics at baseline and immediately after both teaching sessions. Friedman's test and Wilcoxon signed rank test were used to compare questionnaire scores of the student groups. Additionally, we photographed 17 randomly selected students 3 months after baseline during a simulation workshop on endodontics. We analyzed the photographs for ergonomic postures using a specific 12-point checklist.

RESULTS

At baseline, no difference in the knowledge between the two groups was discovered, when both scored 72%. After the first teaching session, significant improvement in both groups (p < .05) was found; and there was no statistically significant difference in the scores between the groups (88% in the lecture-first and 82% in the video-first group). After the second teaching session, the scores were similar in both groups. Overall all improvement in both groups was significant (p < .001). The photograph analysis showed half of the postures being in accord with the ergonomic guidelines.

CONCLUSIONS

Both live lectures and videos showed similar outcomes in teaching ergonomics. Implementation of the knowledge on ergonomics is insufficient. Videos provide an easy-to-organize alternative to live lectures in teaching dental ergonomics. New means are needed to have dental students implement their knowledge on ergonomics into practice.

Effect of the Wingman-Connect Upstream Suicide Prevention Program for Air Force Personnel in Training: A Cluster Randomized Clinical Trial

IMPORTANCE

Suicide has been a leading manner of death for US Air Force personnel in recent years. Universal prevention programs that reduce suicidal thoughts and behaviors in military populations have not been identified.

OBJECTIVES

To determine whether the Wingman-Connect program for Airmen-in-training reduces suicidal ideation, depression, and occupational problems compared with a stress management program and to test the underlying network health model positing that cohesive, healthy units are protective against suicidal ideation.

DESIGN, SETTING, AND PARTICIPANTS

This cluster randomized clinical trial was conducted from October 2017 to October 2019 and compared classes of personnel followed up for 6 months. The setting was a US Air Force technical training school, with participants studied to their first base assignment, whether US or international. Participants in 216 classes were randomized, with an 84% retention rate. Data analysis was performed from November 2019 to May 2020.

INTERVENTIONS

The Wingman-Connect program used group skill building for cohesion, shared purpose, and managing career and personal stressors (3 blocks of 2 hours each). Stress management training covered cognitive and behavioral strategies (2 hours). Both conditions had a 1-hour booster session, plus text messages.

MAIN OUTCOMES AND MEASURES

The primary outcomes were scores on the suicidal ideation and depression scales of the Computerized Adaptive Test for Mental Health and self-reports of military occupational impairment. Class network protective factors hypothesized to mediate the effect of Wingman-Connect were assessed with 4 measures: cohesion assessed perceptions that classmates cooperate, work well together, and support each other; morale was measured with a single item used in other studies with military samples; healthy class norms assessed perceptions of behaviors supported by classmates; and bonds to classmates were assessed by asking each participant to name classmates whom they respect and would choose to spend time with.

RESULTS

A total of 215 classes including 1485 individuals (1222 men [82.3%]; mean [SD] age, 20.9 [3.1] years) participated; 748 individuals were enrolled in the Wingman-Connect program and 737 individuals were enrolled in the stress management program. At 1 month, the Wingman-Connect group reported lower suicidal ideation severity (effect size [ES], -0.23; 95% CI, -0.39 to -0.09; P = .001) and depression symptoms (ES, -0.24; 95% CI, -0.41 to -0.08; P = .002) and fewer occupational problems (ES, -0.14; 95% CI, -0.31 to -0.02; P = .02). At 6 months, the Wingman-Connect group reported lower depression symptoms (ES, -0.16; 95% CI, -0.34 to -0.02; P = .03), whereas the difference in suicidal ideation severity was not significant (ES, -0.13; 95% CI, -0.29 to 0.01; P = .06). The number needed to treat to produce 1 fewer participant with elevated depression at either follow-up point was 21. The benefits of the training on occupational problems did not extend past 1 month. The Wingman-Connect program strengthened cohesive, healthy class units, which helped reduce suicidal ideation severity (estimate, -0.035; 95% CI, -0.07 to -0.01; P = .02) and depression symptom scores (estimate, -0.039; 95% CI, -0.07 to -0.01; P = .02) at 1 month.

CONCLUSIONS AND RELEVANCE

Wingman-Connect is the first universal prevention program to reduce suicidal ideation and depression symptoms in a general Air Force population. Group training that builds cohesive, healthy military units is promising for upstream suicide prevention and may be essential for ecological validity. Extension of the program to the operational Air Force is recommended for maintaining continuity and testing the prevention impact on suicidal behavior.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04067401.

Assessment of HEADS UP online training as an educational intervention for sports officials/athletic trainers

BACKGROUND

Sports- and recreation-related concussions are a common injury among children. Sports officials (SOs) and athletic trainers (ATs) are integral to setting the stage for safe play and managing concussions when they occur, and significant numbers of both groups have completed the Centers for Disease Control and Prevention's HEADS UP online concussion training course. However, the utility of the course for these audiences has not been assessed. We hypothesized that sports officials' and athletic trainers' concussion-related knowledge, attitudes, and behavioral intentions will improve from pre- and post-test after completing CDC's HEADS UP online concussion training course.

METHOD

Respondents' concussion-related knowledge, attitudes, and behavioral intentions were assessed both before and after taking the training course. Differences between pre- and post-test scores were calculated based on the Wilcoxon Signed Rank Test Z-score or McNemar's test. Effect sizes were interpreted.

RESULTS

The SOs and ATs who participated in the HEADS UP online training had a high level of concussion knowledge before taking the course: 90% or more of respondents could identify the correct response for at least seven of the 13 knowledge questions in the pre-test. Still, the course was effective at improving the respondents' knowledge about return-to-play protocols and concussion reporting. Further, SOs and ATs demonstrated improvement in their concussion-related attitudes and behavioral intentions between the pre- and post-test.

CONCLUSION

SOs' and ATs' concussion knowledge, attitudes, and behavioral intentions improved immediately following completion of the CDC HEADS UP online training. Future research could also focus on the long-term retention of this type of training. Practical Applications: This study provides insight into how to better focus concussion-related educational programs to fit SOs' and ATs' needs.

Forensic peer specialists: Training, employment, and lived experience

OBJECTIVE

Despite calls for increased peer support services for individuals involved with the criminal justice system, little is known about the training, employment, and characteristics of forensic peer specialists (FPSs). Pennsylvania developed the nation's first FPS program and remains at the forefront of the field. This paper responds to three research questions regarding forensic peer support in Pennsylvania, assessing: (a) employment patterns and demographic characteristics; (b) work tasks and sites; and (c) challenges and benefits of working as an FPS.

METHOD

Data are drawn from a larger mixed-methods study of forensic peer support in Pennsylvania, including a detailed online survey of 117 FPS-trained workers, followed by 16 qualitative interviews with a subset of survey respondents.

RESULTS

While all survey respondents completed forensic peer support training, only 36% (n = 44) have been employed as FPSs. 96% of survey respondents report having used mental health services, compared to 55% reporting past incarceration. FPSs spend the majority of their work time providing individual support to peer clients and work in multiple settings. Additionally, FPSs report both benefits and challenges related to their work.

CONCLUSION AND IMPLICATIONS FOR PRACTICE

Study results suggest that FPS characteristics, practices, and work settings simultaneously align with and differ from nonspecialized peer support services. Program developers and advocates should focus attention on expanding employment opportunities, and FPSs with lived experience should be prioritized for these positions. Despite significant implementation barriers, FPSs are passionate about this work and promote the expansion of the field. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The "GIST" of the reading comprehension problem in grades 4 and 5

Main idea and summary are essential elements of reading comprehension. We report results from Grades 4 and 5 student performance on two years of state-mandated standardized reading testing which indicate that students perform statistically significantly lower on main idea and summary questions on the tests than any other question category. In this study, teacher competency was measured in a main idea task and teacher surveys were used to understand what instructional practices and materials they use to teach reading comprehension. Descriptive analyses indicate that teachers have a moderate competency for writing main ideas and many use instructional practices that are not supported by empirical evidence or reviewed by the What Works Clearinghouse. Thus, teacher knowledge and instructional practices may be malleable factors that contribute to student outcomes.

Professionals' experiences of using an improvement programme: applying quality improvement work in preschool contexts

BACKGROUND

Improvement work can be used in preschools to enrich outdoor environment for children's better health. Effective improvement work can facilitate the necessary changes, but little is known about professionals' experiences of participation in improvement interventions. The aim was to evaluate how preschool staff experience quality improvement work, using the Breakthrough Series Collaborative improvement programme, to enhance outdoor environments.

METHODS

An improvement intervention using a breakthrough collaborative was performed at 9 preschools in Sweden and examined with a longitudinal mixed method design. Staff completed questionnaires on 4 occasions (n=45 participants) and interviews took place after the intervention (n=16 participants).

RESULTS

The intervention was successful in the sense that the staff were content with the learning seminars, and they had triggered physical changes in the outdoor environment. They integrated the quality improvement work with their ordinary work and increasingly involved the children. The staff tested improvement tools but did not find them entirely appropriate for their work, because they preferred existing methods for reflection.

CONCLUSIONS

The challenges in quality improvement work seem to be similar across contexts. Using the Breakthrough Series Collaborative in a public health intervention is promising but needs to be integrated with preunderstandings, current reflections and quality tools and models.

Undergraduate medical education: a national survey of consultant radiologists

OBJECTIVE

Rising clinical demand and changes to Radiologists' job plans mean it is becoming ever more difficult for Radiologists to teach medical students.The aim of this study was to assess the current role of Radiologists in undergraduate medical education in Scotland.

METHODS

Consultant Radiologists working across all 14 Scottish Health Boards were invited by email to participate in an anonymous short online survey. The survey ran for 6 weeks from November 2019. One reminder email was sent a week before the survey closed.

RESULTS

102 responses were recorded, representing 34% of the total whole time equivalent Radiologists in Scotland. All agreed Radiology should be taught to medical students. Over 70% (n = 73) taught medical students, most often during supporting professional activity time. 76 percent of Radiologists who did not teach expressed a desire to do so. The most common barrier to teaching was not having enough time in their job plan. Scottish Radiologists delivered a median of 10 h (IQR 0-22) a year of teaching to medical students. Thematic analysis of free comments revealed staffing/time constraints severely limiting ability to teach.

CONCLUSION

This is the first national survey to assess the current role of Radiologists in teaching medical students. While most are teaching or want to teach, there is a large drop-off between current Scottish and previously reported UK median teaching hours. Engagement from Universities, Royal College of Radiologists and Health Boards is urgently needed to reverse this trend.

ADVANCES IN KNOWLEDGE

This is the first national survey into the current role of Radiologists in undergraduate medical education. There is a large drop-off between current Scottish and previously reported UK median teaching hours.

Longitudinal team training programme in a Norwegian surgical ward: a qualitative study of nurses' and physicians' experiences with teamwork skills

OBJECTIVES

Teamwork and interprofessional team training are fundamental to ensuring the continuity of care and high-quality outcomes for patients in a complex clinical environment. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based team training programme intended to facilitate healthcare professionals' teamwork skills. The aim of this study is to describe healthcare professionals' experiences with teamwork in a surgical ward before and during the implementation of a longitudinal interprofessional team training programme.

DESIGN

A qualitative descriptive study based on follow-up focus group interviews.

SETTING

A combined gastrointestinal surgery and urology ward at a hospital division in a Norwegian hospital trust.

PARTICIPANTS

A convenience sample of 11 healthcare professionals divided into three professionally based focus groups comprising physicians (n=4), registered nurses (n=4) and certified nursing assistants (n=3).

INTERVENTIONS

The TeamSTEPPS programme was implemented in the surgical ward from May 2016 to June 2017. The team training programme included the three phases: (1) assessment and planning, (2) training and implementation and (3) sustainment.

RESULTS

Before implementing the team training programme, healthcare professionals were essentially satisfied with the teamwork skills within the ward. During the implementation of the programme, they experienced that team training led to greater awareness and knowledge of their common teamwork skills. Improved teamwork skills were described in relation to a more systematic interprofessional information exchange, consciousness of leadership-balancing activities and resources, the use of situational monitoring tools and a shared understanding of accountability and transparency.

CONCLUSIONS

This study suggests that the team training programme provides healthcare professionals with a set of tools and terminology that promotes a common understanding of teamwork, hence affecting behaviour and communication in their daily clinical practice at the surgical ward.

TRIAL REGISTRATION NUMBER

ISRCTN13997367.

Pharmacy educators' views on graduate attributes and case-based learning in an undergraduate degree

BACKGROUND AND PURPOSE

The nature, form, and process of activating graduate attributes is an expanding research focus within the field of professional education. The focus on graduate capabilities has led to higher education institutions interrogating current curricula practices with a view to exploring innovative ways to transform curricula and pedagogy. This article explores pharmacy educators' views on which graduate attributes are important and investigates the role of case-based learning (CBL) in developing graduate attributes in a single university program.

EDUCATIONAL ACTIVITY AND SETTING

This qualitative study is based on data drawn from reflective interviews with pharmacy educators on graduate attributes and from document analysis. Data were analyzed against a framework of graduate attributes and grouped into three domains encompassing knowledge and action as well as construction of graduates' identities as members of a profession.

FINDINGS

The graduate attributes identified by pharmacy educators resonated with the extant literature, organizational policy documents, and the professional council's accreditation framework. The domains of knowledge (Domain 1) and possessing and displaying (Domain 2) are sufficiently addressed in the curriculum. However, engagement with identity construction and roles and responsibilities (Domain 3) appears to be relatively less-developed through CBL.

SUMMARY

While CBL in its current form exhibits limitations with regard to developing Domain 3, it has the potential to develop this through emotionally rich cases, role models, and greater integration of CBL and inter-professional education (IPE) as well as making graduate attributes more explicit within the curriculum.

The Current Landscape of College-Sponsored Postgraduate Teaching and Learning Curriculum Programs

Objective. To describe the landscape of teaching and learning curriculum (TLC) programs sponsored by US schools and colleges of pharmacy and evaluate their adoption of best practice recommendations. Methods. A 28-item electronic survey instrument was developed based on best practice recommendations published by the American Association of Colleges of Pharmacy (AACP), American Society of Health-System Pharmacists (ASHP), and American College of Clinical Pharmacy (ACCP) for the conduct of TLC programs. The survey instrument was electronically distributed to 137 accredited colleges and schools of pharmacy in the United States. Results. Eighty-eight institutions responded, resulting in a response rate of 64%. Sixty-one TLC programs were included in the final analysis. Seventy-five percent of TLC programs reported using best practice recommendations; however, 10% of respondents indicated they were not aware of the published recommendations. Inconsistencies among programs were noted in required teaching experiences, participant evaluation, and ongoing programmatic assessment. Conclusion. Most institutions offering TLC programs are aware of published best practice guidelines and have adopted a majority of the published best practices. However, considerable variability exists across the country. Development of a formal external validation process for TLC programs is necessary to ensure consistent quality.

Woman to Woman: Implementation of a Cervical Cancer Education Training Program for Grenadian Lay Health Advisors

The reduction in cervical cancer (CC) in developed countries, due mainly to Pap testing, has not filtered down to Caribbean countries including Grenada despite accessible screening. This is attributed to a lack of knowledge and low screening. Researchers in low resource settings successfully trained lay health advisors (LHAs), using theory-based, culturally relevant interventions to reverse this trend. The use of LHAs in Grenada was not documented in the literature; therefore, the purpose of this study was to implement and evaluate a culturally relevant curriculum in an effort to educate Grenadian LHAs on CC. Using convenience sampling, 8 Grenadian women were recruited from the parishes with the highest rates of CC. They participated in Woman to Woman (W2W), a 2-day CC, and human papilloma virus (HPV) prevention education program facilitated by local content experts. W2W was adapted from an evidence-based curriculum and tailored for the Grenadian context. Training consisted of modules on CC and HPV. Knowledge of LHAs was measured pre- and post-intervention. Summative evaluation was assessed using a focus group discussion. There was a significant increase in CC knowledge among LHA post-training (p < 0.05) and LHAs had positive opinions about the intervention. They had an enhanced sense of self-efficacy and valued feeling part of a team. The W2W results indicated that an evidence-based and culturally tailored educational intervention has the potential for significant gains in CC and HPV knowledge. Future research will evaluate the LHA-led CC and HPV educational intervention in the community setting.

Teaching motivational interviewing in a blended learning environment

BACKGROUND AND PURPOSE

To describe the implementation of blended learning in teaching motivational interviewing (MI) to third-year pharmacy students and evaluate changes in MI knowledge by assessing students' abilities to recognize and formulate responses using MI skills after the training and, for a subset of students, one year later.

EDUCATIONAL ACTIVITY AND SETTING

The comMIt e-learning program was integrated into a third-year pharmacy communication course. Skills learned in the program were applied and assessed using e-learning quizzes, three in-class practice sessions and a 5-minute final assessment video. In addition, students completed a 22-item pre- and post-survey addressing their abilities to recognize and formulate statements using MI skills. This survey was voluntarily completed again one year later.

FINDINGS

Sixty students completed the training and showed a statistically significant improvement between the pre- and post-surveys. Twenty-seven students voluntarily responded to the survey one year later. While overall performance dropped between the post-survey and the one-year follow-up, students sustained their ability to formulate appropriate MI responses to the open-response questions.

SUMMARY

This study demonstrates that students can successfully learn and retain MI skills using blended learning via the comMIt e-learning program and in-class practice activities.

Building Capacity for Caregiver Education in Yap, Micronesia

The US Affiliated Pacific Islands have an urgent need for family caregiver education to prevent caregiver burnout and strengthen the existing culture where seniors are cared for at home by their families. The Pacific Islands Geriatric Education Center conducted a 32-hour family caregiver train-thetrainer workshop in partnership with the Yap Department of Health Services and the Yap Area Health Education Center (AHEC) from October 16 - 20, 2017. Twenty-seven participants including community health workers, peer educators, health assistants, nurses, and physicians were trained as instructors. Confidence in caregiving increased following the training and feedback was extremely positive. Competence in geriatric syndromes was improved after attending the workshop (P < .001). Lessons from the field revealed an immense value of adding home visits to the training practicum as well as the need to translate caregiving handouts into the outer island languages. Yap AHEC is committed to offering this course as part of caregiver education at the hospital and in the community.

National Survey on Canadian Undergraduate Medical Programs: The Decline of the Anatomical Sciences in Canadian Medical Education

The anatomical sciences have always been regarded as an essential component of medical education. In Canada, the methodology and time dedicated to anatomy teaching are currently unknown. Two surveys were administered to course directors and discipline leaders to gain a comprehensive view of anatomical education in Canadian medical schools. Participants were queried about contact hours (classroom and laboratory), content delivery and assessment methods for gross anatomy, histology, and embryology. Twelve schools responded to both surveys, for an overall response rate of 64%. Overall, Canadian medical students spend 92.8 (± 45.4) hours (mean ± SD) studying gross anatomy, 25.2 (± 21.0) hours for histology, and 7.4 (± 4.3) hours for embryology. Gross anatomy contact hours statistically significantly exceeded those for histology and embryology. Results show that most content is delivered in the first year of medical school, as anatomy is a foundational building block for upper-year courses. Laboratory contact time for gross anatomy was 56.8 (± 30.7) hours, histology was 11.4 (± 16.2) hours, and embryology was 0.25 (± 0.6) hours. Additionally, 42% of programs predominantly used instructor/technician-made prosections, another 33% used a mix of dissection and prosections and 25% have their students complete cadaveric dissections. Teaching is either completely or partially integrated into all Canadian medical curricula. This integration trend in Canada parallels those of other medical schools around the world where programs have begun to decrease contact time in anatomy and increase integration of the anatomical sciences into other courses. Compared to published American data, Canadian schools offer less contact time. The reason for this gap is unknown. Further investigation is required to determine if the amount of anatomical science education within medical school affects students' performance in clerkship, residency and beyond.

Survey of Gross Anatomy Education in China: The Past and the Present

Medical education in mainland China has undergone massive expansion and reforms in the past decades. A nation-wide survey of the five-year clinical medicine programs aimed to examine the course hours, pedagogies, learning resources and teaching staff of anatomy both at present and over the past three decades (1990-1999, 2000-2009, and 2010-2018). The directors or senior teachers from 90 out of the 130 five-year clinical medicine programs were invited to fill out a factual questionnaire by email. Ultimately, sixty-five completed questionnaires were received from 65 different schools. It was found that the total number of gross anatomy course hours has decreased by 11% in the past 30 years and that systematic and regional anatomy have been increasingly taught separately among the surveyed medical schools. Problem-based learning has been adopted in thirty-five (54%) of the surveyed schools, and team-based learning is used in ten (15%) of the surveyed schools. The surveyed schools reported receiving more donated cadavers in recent years, with the average number increasing from 20.67 ± 20.29 in 2000-2009 to 36.10 ± 47.26 in 2010-2018. However, this has not resulted in a decrease in the number of students who needed to share one cadaver (11.85 ± 5.03 in 1990-1999 to 14.22 ± 5.0 in 2010-2018). A decreasing trend regarding the teacher-student ratio (1:25.5 in 2000-2009 to 1:33.2 in 2010-2018) was also reported. The survey demonstrated the historical changes in gross anatomy education in China over the past thirty years.

Medical students' ratings of the relevance and actual implementation of interprofessional education and preferences for teaching formats: comparison by gender and prior education

Objectives: Interprofessional education is becoming increasingly important for collaboration in patient care. In the national context, there are few empirical studies on the assessment of medical students as important stakeholders in their education. Method: Students (N=2,974) participated in a semester-wide online evaluation of the modular curriculum of medicine at the Charité Berlin. Socio-demographic data (including gender, completion of prior education/studies), assessments of the relevance and extent of interprofessional collaboration and preferences for interprofessional education in various teaching formats were collected. Results: In total, data from 1,019 students were included in the evaluation. The relevance of interprofessional collaboration was considered high by medical students. Female students rated the relevance higher than male students. The completion of pre-education (vocational training or study) had no additional influence. The actual implementation of interprofessional education was rated equally low by female and male students. Medical students rated patient-centred, interactive small group formats as particularly suitable for interprofessional education. There were no gender differences, but the effect was more pronounced among students with vocational training. Conclusion: The assessments of female and male students show a large difference between the perceived relevance and the actual implementation of interprofessional collaboration in the modular curriculum of medicine. This study provides an empirical basis for the actual implementation of interprofessional collaboration and students' views on suitable teaching formats for interprofessional education.

Protecting children across borders - child protection in an international context (Germany/Switzerland) as an interprofessional teaching unit

Introduction: Interprofessional collaboration (IPC) in everyday clinical practice is a prerequisite for good patient care but currently this is not sufficiently anchored in the education of health care professionals. Project description: A course on child protection in the interprofessional and international domain was established at the Medical School, University of Freiburg. In this course, students of medicine, nursing science and social work acquire skills for successful interprofessional cooperation. Its participants learn across professional and national borders, not only with but also from and about each other. In this way, they deepen their insights into international IPC through a key topic that is relevant to many disciplines. The course is run as a one-day campus day. This paper presents the course setup and evaluation results. Methods: The evaluation was carried out online and in writing in a before and after format using the Freiburg Questionnaire for Interprofessional Learning Evaluation (FILE) in addition to oral feedback. Learning objectives for IPC and child protection were formulated and the participants were asked about their subjective achievements. Results: From summer semester (SuSe) 2017 to SuSe 2018, 39 participants took part in the course. It was rated as m=1.5 (using German school grades where 1=very good, 6=unsatisfactory). In 18 of the 26 FILE items, participants report a self-assessed increase in knowledge or skills/abilities. This growth in learning coincides with the learning objectives set. Discussion & conclusion: From the perspective of the participants, the course teaches interprofessional competencies in an international setting and is seen as an informative course offer. The continuation or expansion of such courses as a supplement to purely single-country interprofessional courses is desirable.

Assessment of structured classroom debate to teach an antimicrobial stewardship elective course

BACKGROUND AND PURPOSE

The main aim of this study was to evaluate the effect of a structured classroom debate format on teaching antimicrobial stewardship.

EDUCATIONAL ACTIVITY AND SETTING

An active learning approach using a debate format was implemented to engage students in infectious diseases concepts to further develop critical thinking skills. This was a one-group, pre- and posttest design conducted in third year pharmacy students enrolled at the Philadelphia College of Osteopathic Medicine School of Pharmacy Georgia campus. A ten-item assessment survey was used prior to and after the course to evaluate student knowledge. Student perception of skill development was assessed by a survey using a five-point Likert scale. The skills assessed included critical thinking, communication, public speaking, research/drug information, and teamwork.

FINDINGS

Thirty-three students participated in the six debates over the course of the semester. There was a statistically significant increase in post-knowledge assessment mean score (75%) compared to pre-knowledge assessment mean score (45%). The post-course survey showed improved confidence in perception of skills in all of the areas assessed.

SUMMARY

The structured classroom debate format has a positive association with increasing students' knowledge level and perception of skills assessed.

The Decline in Community Preceptor Teaching Activity: Exploring the Perspectives of Pediatricians Who No Longer Teach Medical Students

PURPOSE

Difficulty in recruiting and retaining community preceptors for medical student education has been described in the literature. Yet little, if any, information is known about community outpatient preceptors who have stopped or decreased teaching time with students. This study aimed to examine these preceptors' perspectives about this phenomenon.

METHOD

Using a phenomenology framework, this multi-institutional qualitative study used semistructured interviews with community pediatric preceptors who had stopped or reduced teaching time with medical students. Interviews were conducted between October 2017 and January 2018 and transcribed verbatim. Interviews explored factors for engaging in teaching, or decreasing or ceasing teaching, that would enable future teaching. An initial code book was developed and refined as data were analyzed to generate themes.

RESULTS

Twenty-seven community pediatricians affiliated with 10 institutions participated. Thirty-seven codes resulted in 4 organizing themes: evolution of health care, personal barriers, educational system, and ideal situations to recruit and retain preceptors, each with subthemes.

CONCLUSIONS

From the viewpoints of physicians who had decreased or stopped teaching students, this study more deeply explores previously described reasons contributing to the decline of community preceptors, adds newly described barriers, and offers strategies to help counter this phenomenon based on preceptors' perceptions. These findings appear to be manifestations of deeper issues including the professional identify of clinical educators. Understanding the barriers and strategies and how they relate to preceptors themselves should better inform education leaders to more effectively halt the decline of community precepting and enhance the clinical precepting environment for medical students.

Does a novel teaching approach work? A Students' perspective

BACKGROUND

There is always a call for educational reform and further research to improve educational programs. The continuous development of new educational approaches is a work in progress. Educational strategies like team-based learning, flipped classroom, and lottery-based token economy, were used to develop a novel teaching approach.

AIM

This study had two major goals. The first goal was to introduce a novel teaching approach in professional healthcare academies. The second goal was to get an in-depth understanding, from the students' perspective, about the benefits and limitations of this new teaching approach.

METHOD

The study was conducted using a qualitative, phenomenological research design. Third and fourth-year nursing students completed reflective journals to describe their personal experience with the new teaching approach at the end of the semester. The students' responses were analyzed and coded using Kember's four-category coding schema for reflective writing, to extract themes using thematic analysis.

FINDINGS

Seventy-five students completed and returned their reflective journals. The analysis showed various challenges and facilitators/benefits of the students' experiences. The themes that emerged from the analysis were: lack of exposure vs. a sense of achievement; lack of teamwork skills vs. role fulfillment; working with new people vs. conflict resolution; variation vs. collaboration/creativity; time management vs. constructive competition; wasting resources vs. flexibility, and proactivity/active engagement. These themes summarized why the new teaching approach worked and what barriers students faced with the new assembly.

CONCLUSION

Results from the current study demonstrated the great potential of the new teaching approach. Recommendations for future research were also discussed.

Qualitative Analysis of the Impact of Changes to the Student Evaluation of Teaching Process

Objective. To determine how changes to the student evaluation of teaching (SET) survey instrument and process at a college of pharmacy contributed to improved student response rates and to understand how the process could be further refined. Methods. Pharmacy students from the class of 2018 who had participated in both the old and new SET process were recruited to participate in one of four focus group interviews. An inductive approach was used for data collection and analysis. A focus group guide was created based on two major domains: comparing changes between the old and new SET process and survey form, and determining how the new SET process could be further refined. Results. In South Jordan, UT, six students participated in one of the focus groups and seven students participated in the other focus group. In Henderson, NV, seven students participated in each of the two focus groups. Twenty-seven total students participated in the four focus groups across two campuses. Students stated that reducing the number of questions on each SET survey instrument and using a 5-point rather than a 10-point Likert scale were positive changes. The changes also motivated them to complete the surveys, which improved overall response rates. Although students reported that the monetary incentive (contributions toward the cost of the class banquet) that had been added to the new SET process was a strong motivator, the incentive itself would have likely been insufficient without the other changes. Several participants stated that receiving feedback from faculty members on changes made to teaching materials based upon previous student evaluations was also an important motivator for students to continue completing the surveys. Conclusion. Students identified several motivators for SET participation. Improving the process for survey completion is essential to improve response rates to more accurately represent the feedback of the entire student body. Additionally, the evaluation process must ensure that the data gathered are robust, accurate, and insightful, to be of good use of student and faculty time.

Feedback in medical education - a workshop report with practical examples and recommendations

Background: As a teaching method, feedback is an integral part of medical education. However, there is a lack of a uniform theoretical basis or generally recognized guidelines for its specific design. Against this background, the aim of this article is to discuss conceptual considerations and empirical findings regarding feedback using various practical examples. Procedure and conceptual considerations: Building on the results of a workshop of the Committee for Communicative and Social Competences of the Society for Medical Education (GMA), this article first explains central conceptual considerations and empirical results on the topic of feedback. A particular focus is on various variables that influence the effect of feedback. This includes the feedback source, the frequency of feedback, starting points of feedback, the connection between feedback and reflection as well as the motivation and meta-cognitive skills of the feedback recipient. Practical examples: The implementation of feedback in practice is illustrated using eight examples from the field of medical and dental education. They stem from various settings and the focus is on formative oral feedback. It will become evident that the focus is more on the givers of feedback than the recipients of feedback. Instructions for recipients of feedback on how to reflect on it is still the exception. Discussion: Many of the relevant aspects for the effect of feedback described in the literature are already taken into account in the practical examples discussed. In conclusion, seven recommendations are made for implementing feedback in practice.

What Makes the "Perfect" Inpatient Consultation? A Qualitative Analysis of Resident and Fellow Perspectives

PURPOSE

To characterize the methods of inpatient consult communication, given new communication modalities; to explore residents' and fellows' perspectives on the ideal consult and how this consult could affect their teaching, learning, and patient safety; and to identify barriers to and strategies for optimizing consultations.

METHOD

Using qualitative grounded theory, the authors conducted semistructured focus groups with pediatric residents and fellows at Lucile Packard Children's Hospital at Stanford University from October 2016 to September 2017, using questions developed by expert consensus to address study objectives. Sessions were audiorecorded and transcribed verbatim. Two authors independently coded the transcripts and reconciled codes to develop categories and themes using constant comparison. The third author validated the codes, categories, and themes. To ensure trustworthiness, participants edited the themes for accuracy.

RESULTS

Twenty-seven residents and 16 fellows participated in 7 focus groups (3 with residents, 4 with fellows). Four themes emerged: (1) Many forms of communication are successfully used for initial inpatient consult recommendations (in person, phone, text messages, notes in electronic medical records); (2) residents and fellows prefer in-person communication for consults, believing it leads to improved teaching, learning, and patient safety; (3) multiple strategies can optimize consults regardless of communication modality; and (4) how residents frame the initial consult affects the interaction and can increase fellow engagement, which leads to more fellow teaching, residents' improved understanding, and better patient care.

CONCLUSIONS

Residents and fellows believe that structured initial consults conducted in person improve teaching, learning, and patient care. Several strategies exist to optimize this process.

Implementing a Wearable Sensor for Lymphedema Garments: A Prospective Study of Training Effectiveness

Lymphedema garments apply therapeutic pressure to maintain minimum leg volume. Practitioners and patients apply these garments and seek to achieve appropriate compression pressure "by feel."

PURPOSE

A study was conducted to assess the feasibility of applying a sensor-feedback device to train staff to accurately apply garments.

METHODS

A convenience sample of wound care and rehabilitation staff volunteered for a prospective, randomized, unblinded, single-center pilot study. Participants were randomized to instruction+feedback (ie, receiving training on compression application and using the device to determine whether they achieved desired pressure) or instruction only groups (n = 6 each). Each volunteer applied hook-and-loop closures on the author's leg pre- and post-training with a target of 35 mm Hg, or |Ppre- 35|= |Ppost- 35|=0. (|P| is absolute value of P). The feedback group used a device to measure the applied compression; the device consists of a capacitive sensor of thin polyurethane foam between conductive fabric layers and a microcomputer/Bluetooth transmitter under a vacuum seal that fits into a fabric pocket of a lymphedema garment at the posterior ankle and pairs with a mobile device. A lymphology-certified therapist coordinated training. Data were collected with a pen/paper tool and analyzed with Student's t test.

RESULTS

The instruction+feedback group was closer to target after training (|Ppre - 35|= 10 ± 12 mm Hg; |Ppost - 35|=5 ± 4 mm Hg; P <.05; paired t test) than the instruction only group (|Ppre- 35|=19 ± 11 mm Hg; |Ppost - 35|=12 ±12 mm Hg; not significant).

CONCLUSION

This wearable mobile pressure sensor device assists practitioners in applying hook-and-loop lymphedema garments closer to target pressure. Larger studies with clinicians and research that involves patient application of compression are warranted.

Medication adherence teaching activity for first year pharmacy students in a Canadian university: Description and evaluation

BACKGROUND AND PURPOSE

Medication non-adherence is a significant health problem in Canada and pharmacists are ideally positioned to help patients adhere to their regimens. There is an urgent need for pharmacy schools to ensure graduates receive training in this area. In this paper, we describe a medication taking simulation activity for first year pharmacy students using a multi-method approach to evaluation.

EDUCATIONAL ACTIVITY AND SETTING

Students were provided with placebo capsules and instructed to take one capsule twice per day for two weeks, complete the Beliefs About Medications Questionnaire (BMQ) before the activity, and provide a pill count and reflection on their experiences afterwards. Quantitative analysis involved calculation of percent adherence from pill counts and establishing beliefs about medications from BMQ scores. Perceptions of the teaching activity were determined using qualitative inductive content analysis of a sub-set of student reflections.

FINDINGS

All 224 students participated and complete pill count and BMQ data was obtained from 190 students (85%). Applying a cut-off of 80% to categorize adherence status, 51.8% of students were adherent. BMQ analyses indicated collective student uncertainty in three BMQ sub-scales (specific-necessity, specific-concern, and general-overuse) and a significant difference between adherent and non-adherent students in the specific-necessity sub-scale. Qualitative analyses of a set of student reflections resulted in two major themes: (1) developing empathy and (2) learning about adherence.

SUMMARY

This activity provided opportunities for students to experience the challenges involved in medication-taking from the patient's perspective and to realize the pharmacist's role to facilitate medication adherence.