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Oto T, Matsumoto Y, Iwashita Y, Yoshida R, Taguchi N. A Qualitative Study on the Development of Professionalism Among Japanese Dental Students. Cureus 2024; 16:e51762. [PMID: 38187020 PMCID: PMC10771338 DOI: 10.7759/cureus.51762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2024] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Professionalism is believed to vary depending on factors such as era and culture. Therefore, clarifying the meaning of professionalism in each country, region, and workplace is essential. However, how professionalism is cultivated among dental students in Japanese schools has yet to be fully elucidated. Therefore, this study examined whether professionalism among Japanese dental students changes by year. This research will contribute to effective professional education. PARTICIPANTS AND METHODS The participants included six fourth-year dental students and nine fifth-year dental students. Semi-structured interviews were conducted from November 2018 to January 2019, and verbatim transcripts were created from the recorded data. Based on these verbatim transcripts, thematic analysis was utilized to examine and identify professionalism components for each academic year. RESULTS Three themes based on 14 constituent concepts were obtained for fourth-year students. Three themes based on 20 constituent concepts were obtained for fifth-year students. Fourth-year students primarily focused on technical aspects. In contrast, fifth-year students placed greater emphasis on attitude and communication skills. CONCLUSION From fourth-year students, who primarily focus on classroom learning and practical training, to fifth-year students who gain clinical experience, the constituent elements of professionalism became more complex. However, this study did not examine other aspects of healthcare professionalism, such as interprofessional collaboration. A comprehensive education program tailored to the clinical setting is necessary for cultivating professionalism.
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Affiliation(s)
- Takayuki Oto
- Department of General Dental Practices, Kagoshima University Hospital, Kagoshima-shi, JPN
| | - Yuko Matsumoto
- Department of General Dental Practices, Kagoshima University Hospital, Kagoshima-shi, JPN
| | - Yoichiro Iwashita
- Department of Dental Education, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima-shi, JPN
| | - Reiko Yoshida
- Department of General Dental Practices, Kagoshima University Hospital, Kagoshima-shi, JPN
| | - Norihiro Taguchi
- Department of Dental Education, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima-shi, JPN
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Chesterton P, Deane F, Moore D. Implementing An External Student Placement Strategy Into an Undergraduate Chiropractic Curriculum in the United Kingdom: An Education Descriptive Report. JOURNAL OF CHIROPRACTIC HUMANITIES 2023; 30:1-8. [PMID: 37304040 PMCID: PMC10247877 DOI: 10.1016/j.echu.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 06/13/2023]
Abstract
Objective The aim of this descriptive report is to describe the development and implementation of a placement strategy into an entry-level chiropractic course within the United Kingdom. Methods Placements are educational experiences during which students can observe or apply theory in real practice situations. For this study, the placement strategy was developed for the chiropractic program at Teesside University through an initial working group that generated its aims, objectives, and philosophy. Evaluation surveys were completed for each module containing placement hours. The median and interquartile range (IQR) were calculated for combined responses using a Likert scale (1 = strongly agree; 5 = strongly disagree). Students were allowed to provide comments. Results A total of 42 students participated. Placement hours were divided across all taught years (Academic Year 1: 11%; Year 2: 11%; Year 3: 26%; Year 4: 52%). Data were evaluated 2 years post-launch, with 40 students reporting to be satisfied overall with Year 1 (median 1, IQR 1-2) and Year 2 (1, IQR 1-2) placement modules. Participants perceived that placement experiences were applicable to the workplace and their future careers across modules in both Year 1 (1, IQR 1-2) and Year 2 (1, IQR 1-1.5) and that continuous feedback improved their clinical learning (Year 1 [1, IQR 1-2]; Year 2 [1, IQR 1-2]). Conclusion This report describes the strategy and student evaluation findings over its 2-year inception, exploring the principles of interprofessional learning, reflective practice, and authentic assessment. The strategy was implemented successfully following placement acquisition and auditing processes. Student feedback reported overall satisfaction with the strategy, which was associated with graduate-ready skills.
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Affiliation(s)
- Paul Chesterton
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Faye Deane
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Daniel Moore
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
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Nisbet G, Thompson T, McAllister S, Brady B, Christie L, Jennings M, Kenny B, Penman M. From burden to benefit: a multi-site study of the impact of allied health work-based learning placements on patient care quality. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022:10.1007/s10459-022-10185-9. [PMID: 36401661 DOI: 10.1007/s10459-022-10185-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
Allied health clinical placements take place within an increasingly overstretched health care system where demand for services often exceeds availability of resources. Within this environment, student placements are often perceived as an additional burden to an already overwhelmed workforce. This study explored whether the quality of patient care was enhanced when services were re-designed using a collaborative partnership approach to more purposefully integrate students into delivery of care. Using an embedded multiple case study design, data were collected through focus groups and interviews, patient experience surveys, and secondary administrative data sources. Cases were across physiotherapy and occupational therapy in six different hospital settings. Perception of care provided by students was viewed positively by all stakeholders, including patients. Perceived health outcomes of faster improvement of health condition, improved mobility and function identified through our qualitative findings were supported by quantitative service delivery markers such as increased therapy sessions, more patients being discharged home instead of to other care facilities and reduced length of stay. Health care providers and students alike perceived improvements in service efficiencies whilst maintaining high quality care. This study has provided preliminary evidence towards improved patient care when a partnering approach is adopted whereby students are intentionally integrated into services that otherwise might not have been delivered. Furthermore, it has shifted the associated narrative from students as additional burden to students as benefit.
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Affiliation(s)
- Gillian Nisbet
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Tanya Thompson
- South Western Sydney Local Health District, Sydney, Australia
| | - Sue McAllister
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Bernadette Brady
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- South Western Sydney Local Health District, Sydney, Australia
| | - Lauren Christie
- South Western Sydney Local Health District, Sydney, Australia
- St Vincent's Health Network Sydney, Sydney, Australia
| | | | - Belinda Kenny
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- School of Health Sciences, Western Sydney University, Sydney, Australia
| | - Merrolee Penman
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
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O'Brien BC, Zapata J, Chang A, Pierluissi E. Bridging medical education goals and health system outcomes: An instrumental case study of pre-clerkship students' improvement projects. PERSPECTIVES ON MEDICAL EDUCATION 2022; 11:179-186. [PMID: 35394613 PMCID: PMC9391531 DOI: 10.1007/s40037-022-00711-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Many medical schools engage students in health system improvement (HSI) efforts. Evaluation of these efforts often focuses on students' learning outcomes and rarely considers the impact on health systems, despite the significant commitment health systems make to these efforts. Our study identified and evaluated system-level outcomes of pre-clerkship medical students' engagement in HSI efforts. METHODS We used an instrumental case study approach to examine the effects of pre-clerkship medical students' engagement in HSI projects as part of a 15-month experiential curriculum. We extracted data from 53 project summaries and posters completed during the 2017-18 academic year and follow-up survey data collected in May 2019 from physician coaches and health system professionals who mentored students, contributed to these projects, and worked in the clinical microsystems where the projects occurred. RESULTS We identified three categories and ten indicators of health system outcomes relevant to medical student engagement in HSI. Using these indicators, our evaluation found multiple benefits to the microsystems in which projects occurred. These included achievement of project aims, perceived immediate and sustained project impact on the health system, and development and implementation of projects with aims that aligned with national and health system priorities. CONCLUSION Evaluation of HSI curricula needs to include effects on health systems so that program design can optimize the experience for all involved. Our study offers a framework others can use to evaluate system-level effects of project-based HSI curricula and shows several ways in which students' engagement can add value to health systems.
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Affiliation(s)
- Bridget C O'Brien
- Department of Medicine and Education Scientist, Center for Faculty Educators, University of California San Francisco, San Francisco, CA, USA.
| | - Josué Zapata
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Anna Chang
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Edgar Pierluissi
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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Adapt and Fear Less. JOURNAL OF ACUTE CARE PHYSICAL THERAPY 2022. [DOI: 10.1097/jat.0000000000000189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bourne E, Short K, Kenny B, McAllister L. Clinical educators can supervise students without increased stress: a study of interacting factors using insights from complexity theory. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022; 27:125-145. [PMID: 34591229 DOI: 10.1007/s10459-021-10075-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 09/19/2021] [Indexed: 06/13/2023]
Abstract
Supervising students in healthcare settings is complex and can be stressful for clinical educators. However, it is unclear how to design student placements without clinical educator stress. Using complexity theory as a lens, fuzzy set Qualitative Comparative Analysis (fsQCA) was used to explore factors associated with no increased stress for clinical educators during speech pathology (SP) placements. Factor selection was informed by the Demand- Control- Support model and existing literature. No single factor was necessary for clinical educators to experience no increased stress. Varied combinations of all factors were found in 10 paths to no increased stress. These combinations often had passing student(s); however, multiple paths included other factors that could be adjusted by clinical educators prior to placement. For example, having more than one workday per week without students was a factor in four paths to no increased stress despite other potential challenges such as a higher caseload throughput. More experienced educators, who had other supporting factors (e.g. lower caseload throughput or workplace engagement such as support from colleagues and managers), also perceived no increased stress in four paths. Student placements without increased stress for clinical educators require consideration of multiple interacting factors. Principles of complexity theory provide insight into how clinical educators uniquely respond to their individual circumstances, resulting in different experiences of student placement impact even within similar workplaces. FsQCA has highlighted practical ways clinical educators supervise students without increased stress. However, any changes for an individual clinical educator need to be considered in combination with other factors given the complexity of clinical education and healthcare settings.
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Affiliation(s)
- Elizabeth Bourne
- Work Integrated Learning, Sydney School of Health Sciences, University of Sydney, Susan Wakil Health Building D18, Western Avenue, Camperdown, NSW, 2600, Australia.
| | - Kate Short
- Liverpool Hospital and Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - Belinda Kenny
- School of Health Sciences, Western Sydney University, Campbelltown, Australia
| | - Lindy McAllister
- University of Sydney, Sydney School of Health Sciences, Sydney, Australia
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Myhre D, Ornstein J, Whalen-Browne M, Malhi RL. The impact of urban-based family medicine postgraduate rotations on rural preceptors/teachers. CANADIAN MEDICAL EDUCATION JOURNAL 2021; 12:6-17. [PMID: 34804283 PMCID: PMC8603882 DOI: 10.36834/cmej.71304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND The use of rural rotations within urban-based postgraduate programs is the predominant response of medical education to the health needs of underserved rural populations. The broader impact on rural physicians who teach has not been reported. METHODS This study examined the personal, professional, and financial impact of a rural rotations for urban-based family medicine (UBFM) residents on Canadian rural teaching physicians. A survey was created and reviewed by community and academic rural physicians and a cohort of Canadian rural family physicians teaching UBFM residents was sampled. Survey data and free-text responses were assessed using quantitative and qualitative analyses. RESULTS Participants with rural residency backgrounds perceived a negative impact of teaching UBFM (p = 0.02 personal and professional) and those in a primary rural environment (as defined below) perceived impact as positive (p < 0.001). Rural preceptors often held contrasting attitudes towards learners with negative judgements counter-balanced by positive thoughts. Duration in practice and of teaching experience did not have a significant impact on ratings. CONCLUSION Being a rural preceptor of UBFM residents is rewarding but also stressful. The preceptor location of training and scope of practice appears to influence the impact of UBFM residents.
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Affiliation(s)
- Douglas Myhre
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Jodie Ornstein
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Molly Whalen-Browne
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Rebecca L Malhi
- Distributed Learning and Rural Initiatives, Cumming School of Medicine, University of Calgary, Alberta, Canada
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Kemp C, van Herwerden L, Molloy E, Kleve S, Brimblecombe J, Reidlinger D, Palermo C. How do students offer value to organisations through work integrated learning? A qualitative study using Social Exchange Theory. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:1075-1093. [PMID: 33641049 DOI: 10.1007/s10459-021-10038-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 02/16/2021] [Indexed: 06/12/2023]
Abstract
Learning through work is a common feature of preparing health professionals for practice. Current understandings of work-integrated learning or a 'work-based placement', focus on students being consumers of experiences rather than providing a reciprocal benefit to the organisation in which they are placed. More nuanced understanding of the ways that students can offer value to organisations may provide new opportunities and increased capacity for workplace learning. This study drew on Social Exchange Theory to explore the perceived value and benefits of work-integrated learning experiences to the organisations in which students are placed. The focus was on population health placements undertaken by dietetics students at a large Australian university. An interpretive approach was employed with interviews with placement educators and document analysis of student-generated products from their placement. Seventeen of 20 eligible placement educators were interviewed, with interview data coded using thematic framework analysis. These data were supported with document analysis of student scientific posters completed as part of assessment to develop themes which were interpreted with social exchange theory. Three themes were identified: (1) students add to the organisation's capacity, (2) benefits outweigh time cost of planning and supervising and (3) explicitly valuing students for their contributions may build trust and further potentiate bi-directional benefits. Results suggest that student placements can add value to organisations. This reciprocity of benefits should be communicated to all stakeholders involved in the university-community collaboration, including students. Social exchange theory sensitised researchers to nuanced findings that may support the translation of these study findings to other student work-integrated learning settings.
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Affiliation(s)
- Caitlin Kemp
- Monash Centre for Scholarship in Health Education, Monash University, Level 3, 27 Rainforest Walk, Clayton Campus Wellington Road, Clayton, VIC, 3800, Australia
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia
| | - Louise van Herwerden
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia
| | - Elizabeth Molloy
- Department of Medical Education, The University of Melbourne, Melbourne, Australia
| | - Sue Kleve
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia
| | - Julie Brimblecombe
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia
| | - Dianne Reidlinger
- Nutrition and Dietetics, Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Claire Palermo
- Monash Centre for Scholarship in Health Education, Monash University, Level 3, 27 Rainforest Walk, Clayton Campus Wellington Road, Clayton, VIC, 3800, Australia.
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia.
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Tay YX, Cai S, Chow HC, Lai C. The needs and concerns of clinical educators in radiography education in the face of COVID-19 pandemic. J Med Imaging Radiat Sci 2021; 52:3-8. [PMID: 33139232 PMCID: PMC7572088 DOI: 10.1016/j.jmir.2020.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 01/03/2023]
Affiliation(s)
- Yi Xiang Tay
- Division of Radiological Sciences, Radiography Department, Singapore General Hospital, Singapore, Singapore
| | - Sihui Cai
- Division of Radiological Sciences, Radiography Department, Singapore General Hospital, Singapore, Singapore
| | - Hwei Chuin Chow
- Division of Radiological Sciences, Radiography Department, Singapore General Hospital, Singapore, Singapore
| | - Christopher Lai
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore.
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Sevenhuysen SL, Kent F, Wright C, Williams C, Bowles KA, Matthews K, Ayton D, Maloney S. "Why have you done it that way?" Educator perceptions of student-initiated conversations about perceived deviations from evidence-based clinical practice. NURSE EDUCATION TODAY 2021; 98:104768. [PMID: 33485160 DOI: 10.1016/j.nedt.2021.104768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 12/17/2020] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
Students on clinical placement may encounter practice that deviates from what they perceive to be evidence-based. However, queries by students about the evidence-base of their clinical educators decision-making and practice can be a challenging conversation to initiate. It is unclear how these conversations occur, and what impact engaging in these challenging conversations may have on practice, the learning experience, and the relationship with the educator. This study sought to explore clinical educators' experiences of student-initiated discussions that question the evidence-base of their clinical practice. And to identify their preferred approaches for students to initiate these conversations. Individual interviews were conducted with 23 clinical educators from five professions at three different hospitals in Victoria, Australia. Semi-structured interviewing techniques were employed to identify participants' context and experiences. Participants described student-initiated conversations about deviations from evidence-based practice as challenging encounters with potential for positive or negative impact on clinical educators, students and patients. They noted that the perceived appropriateness of the discussion could be influenced by the method utilised by students to initiate the conversation. Elements identified by clinical educators as barriers or enablers to support students to appropriately initiate conversations about clinical practice may be utilised by education and health providers to enhance opportunities for learning conversations to occur.
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Affiliation(s)
- Samantha L Sevenhuysen
- Department of Physiotherapy, Monash University, McMahons Road, Frankston, Victoria, Australia.
| | - Fiona Kent
- Faculty Medicine, Nursing Health Sciences at Monash University, Clayton, Victoria, Australia
| | - Caroline Wright
- Department of Medical Imaging and Radiation Sciences, Monash University, Wellington Road, Clayton, Victoria, Australia; School of Primary and Allied Health Care, Monash University, Wellington Road, Clayton, Victoria, Australia
| | - Cylie Williams
- Department of Physiotherapy, Monash University, McMahons Road, Frankston, Victoria, Australia; Peninsula Health, Hastings Road, Frankston, Victoria, Australia
| | - Kelly-Ann Bowles
- Department of Paramedicine, Monash University, McMahons Road, Frankston, Victoria, Australia
| | - Kristie Matthews
- Department of Medical Imaging and Radiation Sciences, Monash University, Wellington Road, Clayton, Victoria, Australia; Peter MacCallum Cancer Centre, Australia
| | - Darshini Ayton
- School of Primary and Allied Health Care, Monash University, Wellington Road, Clayton, Victoria, Australia
| | - Stephen Maloney
- School of Primary and Allied Health Care, Monash University, Wellington Road, Clayton, Victoria, Australia
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Reine E, Aase K, Raeder J, Thorud A, Aarsnes RM, Rustøen T. Exploring postoperative handover quality in relation to patient condition: A mixed methods study. J Clin Nurs 2021; 30:1046-1059. [PMID: 33434381 DOI: 10.1111/jocn.15650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 12/03/2020] [Accepted: 12/31/2020] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To describe postoperative handover reporting and tasks in relation to patient condition and situational circumstances, in order to identify facilitators for best practices. BACKGROUND High-quality handovers in postoperative settings are important for patient safety and continuity of care. There is a need to explore handover quality in relation to patient condition and other affecting factors. DESIGN Observational mixed methods convergent design. METHODS Postoperative patient handovers were observed collecting quantitative (n = 109) and qualitative data (n = 48). Quantitative data were collected using the postoperative handover assessment tool (PoHAT), and a scoring system assessing patient condition. Qualitative data were collected using free-text field notes and an observational guide. The study adheres to the GRAMMS guideline for reporting mixed methods research. RESULTS Information omissions in the handovers observed ranged from 1-13 (median 7). Handovers of vitally stable and comfortable patients were associated with more information omissions in the report. A total of 50 handovers (46%) were subjected to interruptions, and checklist compliance was low (13%, n = 14). Thematic analysis of the qualitative data identified three themes: "adaptation of handover," "strategies for information transfer" and "contextual and individual factors." Factors facilitating best practices were related to adaptation of the handover to patient condition and situational circumstances, structured verbal reporting, providing patient assessments and dialogue within the handover team. CONCLUSIONS The variations in items reported and tasks performed during the handovers observed were related to patient conditions, situational circumstances and low checklist compliance. Adaptation of the handover to patient condition and situation, structured reporting, dialogue within the team and patient assessments contributed to quality. RELEVANCE TO CLINICAL PRACTICE It is important to acknowledge that handover quality is related to more than transfer of information. The present study has described how factors related to the patient and situation affect handover quality.
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Affiliation(s)
- Elizabeth Reine
- Department of Nurse Anaesthesia, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Karina Aase
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Johan Raeder
- Department of Anaesthesia, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne Thorud
- Department of Nurse Anaesthesia, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Reidunn M Aarsnes
- Department of Nurse Anaesthesia, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Tone Rustøen
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
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Cornett M, Palermo C, Wallace MJ, Diug B, Ward B. A realist review of scholarly experiences in medical education. MEDICAL EDUCATION 2021; 55:159-166. [PMID: 32888210 DOI: 10.1111/medu.14362] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/20/2020] [Accepted: 08/25/2020] [Indexed: 06/11/2023]
Abstract
CONTEXT Scholarly experiences have been increasingly employed to support the development of scholarly skills for medical students. How the characteristics of the various scholarly experiences contributes to scholarly outcomes or the complexities of how the experiences build skills warrants further exploration. OBJECTIVES To identify how medical students' scholarly experiences lead to scholarly outcomes under what circumstances. METHODS A realist review was conducted with a search of Ovid MEDLINE, CINAHL, Scopus and ERIC databases using the terms "medical student" and "scholarly experience" and related synonyms. Studies involving the engagement of medical students in a range of compulsory scholarly experiences including quality improvement projects, literature reviews and research projects were included. Key data were extracted from studies, and realist analysis was used to identify how contexts and mechanisms led to different outcomes. RESULTS From an initial 4590 titles, 28 studies of 22 scholarly experiences were identified. All were primarily focused on research-related scholarly experiences. Organisational research culture that valued research, dedicated time, autonomy and choice of experience were found to be key contexts. Adequately supported and structured experiences where students can see the value of research and quality supervision that builds student's self-efficacy were identified as mechanisms leading to outcomes. Outcomes included increased research skills and attitudes, scholarly outputs (eg publications) and future interest in research or other scholarly endeavours. CONCLUSIONS The design of scholarly experiences for medical students needs to ensure protected time, adequate supervision and autonomy, to achieve scholarly outcomes. Much of the focus is on research and traditional outcomes with little known about the role or outcomes associated with other scholarly work.
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Affiliation(s)
- Marian Cornett
- Monash Centre for Scholarship in Health Education, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Claire Palermo
- Monash Centre for Scholarship in Health Education, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Megan J Wallace
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Basia Diug
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Bernadette Ward
- School of Rural Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Bendigo, VIC, Australia
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Nisbet G, McAllister S, Morris C, Jennings M. Moving beyond solutionism: Re-imagining placements through an activity systems lens. MEDICAL EDUCATION 2021; 55:45-54. [PMID: 32777085 DOI: 10.1111/medu.14345] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Clinical placements are central to the process of preparing future health professionals for practice. Health care environments are increasingly complex and demanding with clinical placements often being perceived as a burden on busy health professionals giving rise to a service-education tension. This tension creates a situation ripe for simplistic solutionist approaches. For example, characterising the problem of clinical placements as students negatively impacting on service productivity results in a reductionist solution such as universities compensating health services for student education. Challenges faced by placement seekers and placement providers are multifaceted and complex requiring a more sophisticated understanding and response to the challenges of involving students in the workplace to prepare them for the future workforce. RE-CONCEPTUALISATION We argue that the health and education systems have become de-coupled. Learning and working are seen as distinct activities that are at odds with one another. Re-imagining the purposes and practices of clinical placements for the mutual benefit of patients, health services and students may fruitfully address this disconnect. WORKED EXAMPLE We present a worked example using the conceptual and analytical tools of cultural-historical activity theory to articulate what we have learnt about this health-education disconnect. Our worked example draws on research involving a series of clinical education case studies within acute care contexts. CONCLUSION Through the lens of cultural-historical activity theory, we highlight that solutionist approaches are entrenched in a de-coupling of health from education where the shared object of preparing the future workforce is fragmented. Successful re-coupling requires a partnership that is founded on a shared commitment to preparing the future workforce; recognises that learning and practice are inseparable; and understands that both activity systems are fluid and that collaboration to stay focused on the shared object of preparing the future workforce is complex, challenging and ongoing work.
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Affiliation(s)
- Gillian Nisbet
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Sue McAllister
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Clare Morris
- Barts and The London School of Medicine, Queen Mary University of London, London, UK
| | - Matthew Jennings
- Liverpool Hospital, Southwest Sydney Local Health District, Liverpool, NSW, Australia
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14
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Couch D, O'Sullivan B, Russell D, McGrail M, Wallace G, Bentley M. An exploration of the experiences of GP registrar supervisors in small rural communities: a qualitative study. BMC Health Serv Res 2020; 20:834. [PMID: 32891144 PMCID: PMC7487663 DOI: 10.1186/s12913-020-05697-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 08/31/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Australia registrar training to become a general practitioner (GP) involves three to four years of supervised learning with at least 50% of GP registrars training wholly in rural areas. In particular rural over regional GP placements are important for developing future GPs with broader skills because the rural scope of practice is wider. Having enough GP supervisors in smaller rural communities is essential such training. We aimed to explore what makes rural GPs' based outside of major regional centres, participate in supervising or not, their experiences of supervising, and impact of their practice context. METHODS Semi-structured interviews were undertaken with 25 GPs based in rural Tasmania (outside of major regions - Hobart and Launceston), in towns of < 25,000 population, to explore the GPs' professional backgrounds, their experiences of supervising GP registrars, their practice context and their decisions about supervising GP registrars or not. Thematic analysis was undertaken; key ideas, concepts and experiences were identified and then reviewed and further refined to core themes. RESULTS Supervising was perceived to positively impact on quality of clinical care, reduce busy-ness and improve patient access to primary care. It was energising for GPs working in rural contexts. Rural GPs noted business factors impacted the decision to participate in supervision and the experience of participating: including uncertainty and discontinuity of registrar supply (rotational training systems), registrar competence and generating income. CONCLUSIONS Supervising is strongly positive for rural GPs and related to job satisfaction but increasing supervision capacity in rural areas may depend on better policies to assure continuity of rural registrars as well as policies and systems that enable viable supervision models tailored to the context.
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Affiliation(s)
- Danielle Couch
- School of Rural Health, Monash University, 26 Mercy St, Bendigo, VIC, 3550, Australia.
| | - Belinda O'Sullivan
- School of Rural Health, Monash University, 26 Mercy St, Bendigo, VIC, 3550, Australia.,Rural Clinical School, The University of Queensland, Toowoomba, Australia
| | - Deborah Russell
- School of Rural Health, Monash University, 26 Mercy St, Bendigo, VIC, 3550, Australia.,Menzies School of Health Research, Alice Springs, Northern Territory, Australia
| | - Matthew McGrail
- School of Rural Health, Monash University, 26 Mercy St, Bendigo, VIC, 3550, Australia.,Rural Clinical School, The University of Queensland, Toowoomba, Australia
| | - Glen Wallace
- General Practice Supervisors Australia, Bendigo, Australia
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15
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Barrett EM, Belton A, Alpine LM. Supervision models in physiotherapy practice education: student and practice educator evaluations. Physiother Theory Pract 2019; 37:1185-1198. [PMID: 31782324 DOI: 10.1080/09593985.2019.1692393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: To establish the supervision models used during physiotherapy practice placements and to determine student and practice educators' evaluations of the quality of these placements.Design: Cross-sectional study set in clinical sites providing placements for physiotherapy students in Ireland.Participants: Practice educators and students completing placements in 2015/16.Outcome Measure: Questionnaire which measured 18 indicators linked to quality assured placements. Eight additional indicators in the practice educator questionnaire addressed the overall feasibility of the supervision model. Two open-ended questions captured comments on the benefits and challenges of each model.Results: The overall response rate was 72% (112/155). The majority (75%, n = 84) of participants reported a 1:1 (one student: one educator) model of supervision. Fourteen percent (n = 16) reported a 1.2 (one student: two educators) model and 9% (n = 10) a 2.1 (two students: one educator) model. There was generally positive agreement with the questionnaire indicating that all placements, irrespective of supervision model were positively evaluated by participants. Students, however, indicated a more negative evaluation of the placement than practice educators in indictors related to communication, the provision of feedback, establishing an effective relationship with their educator and diversity of available learning opportunities. Indicators relating to productivity and the placement representing an efficient use of resources and personnel received more negative or equivocal ratings by educators.Conclusions: While the 1.1 model remains the most widely used supervision model in physiotherapy practice education, other models also score positively, offering choice to placement providers when determining the model that best suits their service.
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Affiliation(s)
- Emer M Barrett
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, University of Dublin, St James's Hospital, Dublin, Ireland
| | - Anne Belton
- Physiotherapy Department, Tallaght University Hospital, Dublin, Ireland
| | - Lucy M Alpine
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, University of Dublin, St James's Hospital, Dublin, Ireland
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16
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Morgan K, Campbell KL, Sargeant S, Reidlinger DP. Preparing our future workforce: a qualitative exploration of dietetics practice educators’ experiences. J Hum Nutr Diet 2019; 32:247-258. [DOI: 10.1111/jhn.12620] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K. Morgan
- Faculty of Health Sciences and Medicine; Bond University; Gold Coast QLD Australia
| | - K. L. Campbell
- Faculty of Health Sciences and Medicine; Bond University; Gold Coast QLD Australia
| | - S. Sargeant
- School of Health and Human Sciences; Southern Cross University; Coolangatta QLD Australia
| | - D. P. Reidlinger
- Faculty of Health Sciences and Medicine; Bond University; Gold Coast QLD Australia
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