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Samaraweera BP, Pillay M, Muttiah N, Moodley L. Exploring clinical reasoning in child language assessment through decoloniality. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-16. [PMID: 38425227 DOI: 10.1080/17549507.2023.2296864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
PURPOSE Clinical reasoning has been taught, practised, and researched under Western epistemologies, which have been fallible in addressing the complexity of clinical reasoning within Indigenous cultures and societies. We explored how speech-language pathologists in Sri Lanka negotiate and value Indigenous and Western perspectives in clinical reasoning within a decolonial framework. METHOD This study used participatory research methodology within the decolonised qualitative research paradigm to produce data collaboratively with eight Sri Lankan speech-language pathologists. Oral history narratives and object-based textual reflections generated the necessary data for the study. Systematic visual-textual analysis and reflexive thematic analysis were carried out iteratively, and the data analysis and interpretation were undertaken collaboratively with the participants. RESULT We generated four key themes about professional education, individuality in practice, holistic thinking, and balancing interests and priorities. The results demonstrate that social, political, and economic forces impact practitioners' clinical reasoning. CONCLUSION Practising science in its original form within Indigenous contexts is challenging. Colonial roots and imperialism impact the delivery of appropriate services in socially and politically marginalised communities. Practitioners' self-awareness about authentic identities and practical wisdom can develop culturally relevant knowledge for equitable practice.
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Affiliation(s)
- Buddhima P Samaraweera
- Discipline of Speech-Language Therapy, University of KwaZulu-Natal, Durban, South Africa
| | - Mershen Pillay
- Discipline of Speech-Language Therapy, University of KwaZulu-Natal, Durban, South Africa
- Speech-Language Therapy, Massey University, New Zealand
| | - Nimisha Muttiah
- Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Sri Lanka
- Communication Disorders and Sciences, State University of New York, Cortland, NY, USA
| | - Legini Moodley
- Discipline of Speech-Language Therapy, University of KwaZulu-Natal, Durban, South Africa
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Soemantri D, Nurokhmanti H, Qomariyah N, Claramita M. The Practice of Feedback in Health Professions Education in the Hierarchical and Collectivistic Culture: a Scoping Review. MEDICAL SCIENCE EDUCATOR 2022; 32:1219-1229. [PMID: 36276778 PMCID: PMC9583993 DOI: 10.1007/s40670-022-01597-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 06/16/2023]
Abstract
The global trend in student assessment is moving towards outcome-based assessment that requires multiple systematic data points and continuous feedback. However, in hierarchical and collectivistic cultures, one-way communication is practised more often, leading to less dialogical feedback. This scoping review explored feedback practice in Asian educational setting. Based on the 17 articles selected, the findings were categorised into four themes, i.e. inhibiting or facilitating factors of feedback, influences of cultural factors on feedback, discrepancies between students' and teachers' perceptions of feedback and impact of feedback. Hierarchical and collectivist cultural aspects, such as preference for group feedback, are pertinent to feedback practice, which likely influence the readiness for programmatic assessment.
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Affiliation(s)
- Diantha Soemantri
- Department of Medical Education, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Hikmawati Nurokhmanti
- Department of Medical, Health Professions Education, and Bioethics, Faculty of Medicine-Public Health-and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Nurul Qomariyah
- Department of Community Medicine, Faculty of Medicine, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
| | - Mora Claramita
- Department of Medical, Health Professions Education, and Bioethics, Faculty of Medicine-Public Health-and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Ota T, Tan C, Ishii A, Shiotani H. Do differences in chronotypes affect sleep and health-related quality of life of nursing students? A cross-sectional study. Chronobiol Int 2022; 39:1435-1443. [PMID: 36043479 DOI: 10.1080/07420528.2022.2117049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Nursing students experience higher levels of stress and more sleep-related problems than other students; however, the relationship of chronotype to nursing students' sleep status and health-related quality of life (HRQOL) is unclear. This cross-sectional, observational study investigated whether chronotype affected Japanese nursing college students' sleep and HRQOL. Nursing students completed the Attribute Questionnaire about Subject Background, Japanese Version Morningness‒Eveningness Questionnaire (MEQ), Munich Chrono-Type Questionnaire‒Japanese Version (MCTQ), Japanese Version of the Pittsburgh Sleep Quality Index (PSQI), SF-12v2 Standard, Japanese Version 2.0 (SF-12), Japanese Translation of Profile of Mood States 2nd Edition‒Adult Short (POMS2). Of the 241 students (mean age 20.16 ± 1.80 years; 80.9% female), 80 (33.2%) had evening, 142 (58.9%) had intermediate, and 19 (7.9%) had morning chronotype. The overall total PSQI score was 6.86 ± 2.97. Additionally, 141 students (64.1%) scored ≥ 6, suggesting disturbed sleep. Approximately 80% of the evening chronotype students had a total PSQI score of 8.34 ± 3.11, clearly indicating disturbed sleep. Sleep-related parameters (total PSQI score, bedtime, sleep latency, wake-up time, sleep duration, social jetlag) were worse in evening than in other chronotypes. SF-12 and POMS2 did not differ among chronotypes. Thus, evening chronotype nursing students require sleep-related support from early on.
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Affiliation(s)
- Tomomi Ota
- Graduate School of Health Sciences, Nursing, Kobe University, Kobe, Japan
| | - Chieko Tan
- School of Health Sciences, Nursing, Kobe Tokiwa University, Kobe, Japan
| | - Atsue Ishii
- Graduate School of Health Sciences, Nursing, Kobe University, Kobe, Japan
| | - Hideyuki Shiotani
- School of Health Sciences, Nursing, Kobe Tokiwa University, Kobe, Japan
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Yao X, Jia X, Shi X, Liu G, Li Y, Zhang X, Du S, Li J, Yin Z. Exploring the experiences and expectations of pharmacist interns in large general hospitals in China: from the perspective of interns. BMC MEDICAL EDUCATION 2022; 22:528. [PMID: 35799164 PMCID: PMC9264576 DOI: 10.1186/s12909-022-03591-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/21/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Hospital-based pharmacy internship (HBPI) is critical for the transition from "pharmacy students" to "professional pharmacists". This study explores the pharmacist interns' experiences and expectations for HBPI from their personal experiences intending to provide references for future hospital pharmacy education reform and policy development. METHODS This is a multicenter qualitative study applying focus group discussions. Pharmacist interns were invited as participants from large teaching hospitals in Henan, China. A thematic analysis was conducted to qualitatively analyze this data. Nvivo 12 was utilized for data management and processing. RESULTS Three focus group discussions were conducted, involving 16 interns as participants. Three themes were summarized regarding interns' expectations and experiences: (1) positive experiences of the HBPI; (2) negative experiences of the HBPI; (3) expectations and suggestions for the HBPI. CONCLUSION This study finds that the HBPI improves the professional knowledge, professional skills, and core competencies of interns. Therefore, the HBPI is an important preparation and transition stage for pharmacy students. However, the current pharmacy internship in China still has imperfections such as the insufficient ability of clinical teachers, unreasonable internship models, and unscientific internship content.
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Affiliation(s)
- Xiali Yao
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xuedong Jia
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiangfen Shi
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Gang Liu
- Department of Pharmacology, School of Basic Medical Sciences, Guizhou Medical University, Guiyang, Guizhou, China
| | - Yuwei Li
- College of Pharmacy, Jiangsu Food and Pharmaceutical Science College, Jiangsu, Huaian, China
| | - Xiaojian Zhang
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Shuzhang Du
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jun Li
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
| | - Zhao Yin
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
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Nomura O, Itoh T, Mori T, Ihara T, Tsuji S, Inoue N, Carrière B. Creating Clinical Reasoning Assessment Tools in Different Languages: Adaptation of the Pediatric Emergency Medicine Script Concordance Test to Japanese. Front Med (Lausanne) 2021; 8:765489. [PMID: 34950681 PMCID: PMC8688734 DOI: 10.3389/fmed.2021.765489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/12/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Clinical reasoning is a crucial skill in the practice of pediatric emergency medicine and a vital element of the various competencies achieved during the clinical training of resident doctors. Pediatric emergency physicians are often required to stabilize patients and make correct diagnoses with limited clinical information, time and resources. The Pediatric Emergency Medicine Script Concordance Test (PEM-SCT) has been developed specifically for assessing physician's reasoning skills in the context of the uncertainties in pediatric emergency practice. In this study, we developed the Japanese version of the PEM-SCT (Jpem-SCT) and confirmed its validity by collecting relevant evidence. Methods: The Jpem-SCT was developed by translating the PEM-SCT into Japanese using the Translation, Review, Adjudication, Pretest, Documentation team translation model, which follows cross-cultural survey guidelines for proper translation and cross-cultural and linguistic equivalences between the English and Japanese version of the survey. First, 15 experienced pediatricians participated in the pre-test session, serving as a reference panel for modifying the test descriptions, incorporating Japanese context, and establishing the basis for the scoring process. Then, a 1-h test containing 60 questions was administered to 75 trainees from three academic institutions. Following data collection, we calculated the item-total correlations of the scores to optimize selection of the best items in the final version of the Jpem-SCT. The reliability of the finalized Jpem-SCT was calculated using Cronbach's α coefficient for ensuring generalizability of the evidence. We also conducted multiple regression analysis of the test score to collect evidence on validity of the extrapolation. Results: The final version of the test, based on item-total correlation data analysis, contained 45 questions. The participant's specialties were as follows: Transitional interns 12.0%, pediatric residents 56.0%, emergency medicine residents 25.3%, and PEM fellows 6.7%. The mean score of the final version of the Jpem-SCT was 68.6 (SD 9.8). The reliability of the optimized test (Cronbach's α) was 0.70. Multiple regression analysis showed that being a transitional intern was a negative predictor of test scores, indicating that clinical experience relates to performance on the Jpem-SCT. Conclusion: This pediatric emergency medicine Script Concordance Test was reliable and valid for assessing the development of clinical reasoning by trainee doctors during residency training.
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Affiliation(s)
- Osamu Nomura
- Department of Emergency and Disaster Medicine, Hirosaki University, Hirosaki, Aomori, Japan
| | - Taichi Itoh
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States.,Department of Medical Education, University of Illinois at Chicago, Chicago, IL, United States
| | - Takaaki Mori
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Division of Pediatric Emergency Medicine, Tokyo Children's Medical Center, Fuchu, Tokyo, Japan
| | - Takateru Ihara
- Division of Pediatric Emergency Medicine, Tokyo Children's Medical Center, Fuchu, Tokyo, Japan
| | - Satoshi Tsuji
- National Center for Child Health and Development, Setagaya, Tokyo, Japan
| | - Nobuaki Inoue
- Department of Human Resources Development, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Shinjuku, Tokyo, Japan
| | - Benoit Carrière
- Department of Pediatrics, Section of Pediatric Emergency Medicine, Centre Hospitalier Universitaire Sainte-Justine, Montréal, QC, Canada
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Altalhi F, Altalhi A, Magliah Z, Abushal Z, Althaqafi A, Falemban A, Cheema E, Dehele I, Ali M. Development and evaluation of clinical reasoning using 'think aloud' approach in pharmacy undergraduates - A mixed-methods study. Saudi Pharm J 2021; 29:1250-1257. [PMID: 34819786 PMCID: PMC8596158 DOI: 10.1016/j.jsps.2021.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/09/2021] [Indexed: 10/26/2022] Open
Abstract
Introduction Given the widespread use of clinical reasoning (CR) in the healthcare practice, it is essential to inculcate the CR practice in undergraduate pharmacy education which can not only facilitate their clinical education and clinical rotations but can also help them become better clinical pharmacists. There is very limited CR employed in the pharmacy curriculum and practice in the Middle East countries. This study aimed to develop and evaluate CR practice in pharmacy undergraduates in one college of pharmacy in Saudi Arabia. Methods We employed a mixed-methods methodology that included two phases. In Phase I, students were introduced to CR practice ('think aloud' method) and given geriatric clinical cases which they used in two sessions together with a tutor. This was followed by the writing of SOAP notes using the tutor feedback and completion of a survey that included a self-reflection about their experience of using the CR method. Phase II included face-to-face semi-structured interviews involving selected students that were recruited via convenience sampling to further explore the issues identified in Phase I of the study. Results Of the 155 students who completed the survey (response rate 94%), the majority of them agreed that CR using the 'think aloud' method was useful in gathering (92%) and interpreting (95%) relevant patient information, identifying medication-related problems (95%), exploring therapeutic options for the problem(s) (93%) and formulating a treatment plan for the patient (90%). Qualitative data analysis of the 12 interviews was consistent with these findings. Furthermore, it provided an insight into the challenges faced by the students in applying this CR method. Conclusions Students found the practice of CR using the 'think aloud' method helpful in working through given cases and taking clinical decisions. This method can be widely employed in pharmacy education and practice.
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Affiliation(s)
- Faisal Altalhi
- College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Ziad Magliah
- College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Zaid Abushal
- College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Anas Althaqafi
- College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Azzam Falemban
- College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ejaz Cheema
- School of Pharmacy, University of Management and Technology, Lahore, Pakistan
| | - Inderpal Dehele
- School of Pharmacy, University of Birmingham, Birmingham, United Kingdom
| | - Majid Ali
- School of Life and Medical Sciences, University of Hertfordshire (hosted by Global Academic Foundation), New Administrative Capital, Cairo. Egypt
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