"We know what they're struggling with": student peer mentors' embodied perceptions of teaching in a health professional education mentorship program

Experiences of nursing students in A peer mentoring program during their clinical practices. A qualitative study

BACKGROUND

Clinical placements allow nursing students to develop the skills and attitudes necessary to provide care. Peer mentoring programmes seem to facilitate these achievements, but there are very few studies on the effects of peer mentoring on clinical placements and what it can bring to both mentors and mentees.

AIM

To describe the perspectives of nursing students on a peer mentoring programme during their clinical placements.

DESIGN

A qualitative descriptive and exploratory study.

SETTINGS AND PARTICIPANTS

First year and third year nursing students were included.

METHODS

Focus groups were conducted with students after they participated in a peer mentoring programme during their clinical practice rotation.

RESULTS

The support received from the student mentors was very important both academically and personally. Mentors also acknowledged having improved their teaching and leadership skills.

CONCLUSIONS

Our results can be applied to future studies to inform peer mentoring programmes as a complementary teaching tool in clinical placements to improve leadership and empowerment in nursing students.

Twelve tips for supporting medical learners through high-stakes assessment challenges

Learners across the medical education continuum will encounter numerous high-stakes exams and assessments. Effectively preparing for and performing well on these types of assessments can be challenging for learners for a wide variety of reasons. It is imperative that medical educators provide appropriate support for learners who experience challenges with high-stakes exams, particularly given the complexity of factors like life circumstances of individual learners and the significance of these assessments for career advancement/progression. Grouped into areas including educator mindset, information-gathering, and developing and executing a study plan, the following 12 tips will help medical educators be better prepared to meaningfully support learners in need of assessment remediation and guidance.

'We're like Spider-Man; with great power comes great responsibility': Coaches' experiences supporting struggling medical students

BACKGROUND

Medical students can experience a range of academic and non-academic struggles. Coaching is a valuable strategy to support learners, but coaches describe working with struggling learners as taxing. Transformative learning theory (TLT) provides insights into how educators grow from challenging experiences to build resilience. This study explores how coaches evolve as educators through supporting struggling students.

METHODS

This qualitative study grounded in an interpretivist paradigm used interviews of longitudinal medical student coaches at two academic institutions. Interviews, using TLT as a sensitizing concept, explored coaches' experience coaching struggling learners. We performed thematic analysis.

RESULTS

We interviewed 15 coaches. Coaches described supporting students through multi-faceted struggles which often surprised the coach. Three themes characterized coaches' experiences: personal responsibility, emotional response, and personal learning. Coaches shouldered high personal responsibility for learners' success. For some, this burden felt emotional, raised parental instincts and questions about maintaining boundaries with learners. Coaches evolved their coaching approach, challenged biases, and built skills. Coaches learned to better appreciate the learner point of view and employ resources to support students.

DISCUSSION

Through navigating learner struggles, educators can gain self-efficacy, learn to understand learners' perspectives, and evolve their coaching approach to lessen their personal emotional burden through time.

Striking fear into students' hearts: Unforeseen consequences of prescribing education

PURPOSE

Undergraduate medical education (UGME) has to prepare students to do safety-critical work (notably, to prescribe) immediately after qualifying. Despite hospitals depending on them, medical graduates consistently report feeling unprepared to prescribe and they sometimes harm patients. Research clarifying how to prepare students better could improve healthcare safety. Our aim was to explore how students experienced preparing for one of their commonest prescribing tasks: intravenous fluid therapy (IVFT).

METHODS

Complexity assumptions guided the research, which used a qualitative methodology oriented towards hermeneutic phenomenology. The study design was an uncontrolled and unplanned complex intervention: judicial review of the iatrogenic death of five children due to hyponatraemia in our region had resulted in the recommendation that students' education in 'the implementation of important clinical guidelines' relevant to fluid and electrolyte balance should be intensified. An opportunity sample of 40 final-year medical students drew and gave audio-recorded commentaries on rich pictures. We completed two template analyses: one of participants' transcribed commentaries on the pictures and one using a novel heuristic to analyse the pictures themselves. We then reconciled the two analyses into a single template.

RESULTS

There were four themes: affects, teaching and learning, contradictions, and the curriculum as a journey. To explore interconnections between themes, we chose the picture best exemplifying each of the four themes and interpreted the curriculum journey depicted in each of them. These interpretations were grounded in each participant's picture, verbal account of the picture, and the aggregate findings of the template analysis. Participants' experiences were influenced by the situated complexity of IVFT. Layered on top of that, contradictions, overlaps, and gaps within the curriculum introduced extraneous complexity. Confusion and apprehension resulted.

CONCLUSIONS

After spending five years preparing to prescribe IVFT, participants felt unprepared to do so. We conclude that intensive teaching had not achieved its avowed goal of improving students' preparedness for safe practice. Merton's seminal work on the 'unanticipated consequences of purposive social action' suggests that intensive teaching may even have contributed to their unpreparedness.

Trust, but verify

In this editorial, the editor considers issues of trust, accountability, and verification in the work of scholars, institutions, and journals, and challenges readers to examine the interdependencies of trust, accountability, and verification in shaping the field of health professions education.

Understanding students' participation in physiotherapy and nursing work settings

Students' health profession education includes learning at the workplace through placements. For students, participating in daily work activities in interaction with supervisors, co-workers and peers is a valuable practice to learn the expertise that is needed to become a health care professional. To contribute to the understanding of HPE-students' workplace learning, the focus of this study is to identify affordances and characterise student's participation during placements. We applied a research design based on observations. Three student-physiotherapists and four student-nurses were shadowed during two of their placement days. A categorisation of affordances is provided, in terms of students' participation in activities, direct interactions and indirect interactions. Students' daily participation in placements is discussed through unique combinations and sequences of the identified affordances reflecting changing patterns over time, and differences in the degree of presence or absence of supervisors, co-workers and peers.

Medical students' crisis-induced stress and the association with social support

BACKGROUND

Medical schools are challenged to guard student wellbeing given the potential negative impact of the COVID-19 outbreak combined with an already high prevalence of mental distress. Although social support is generally associated with less crisis-induced stress, it is unknown whether this applies to medical students during the COVID-19 outbreak.

OBJECTIVES

The impact of the COVID-19 outbreak on perceived stress of medical students was assessed by comparing their perceived stress levels during the outbreak to both their own baseline and the previous cohort's pre-COVID-19 stress levels. Then, the association between social support and stress during the COVID-19 outbreak was assessed.

METHODS

Dutch Year-1 medical students of cohort 2019 (n = 99) completed the 14-item Perceived Stress Scale (PSS-14) at two time points: baseline (pre-COVID-19) and final measurement (COVID-19). Social support-emotional-informational support and club membership-was assessed during the final measurement. PSS and social support scores were compared to similar measurements of cohort 2018 (n = 196). Students' baseline stress levels, gender, and study performance were controlled for when comparing final stress levels.

RESULTS

In cohort 2018 (pre-COVID-19), students' perceived stress levels did not differ significantly between the baseline and final measurements. Additionally, baseline stress levels of the two cohorts (2018 and 2019) were not found to be significantly different. Cohort 2019's final stress levels (COVID-19) were significantly higher compared to their baseline stress levels (paired t-test: t = 6.07, p < .001) and cohort 2018's final stress levels (linear regression: B = 4.186, p < .001). Only during the COVID-19 outbreak higher social support levels-i.e., emotional-informational support (B = -0.75, p < .001) and club membership (B = -3.68, p < .01)-were associated with lower stress levels.

CONCLUSIONS

During the COVID-19 outbreak, medical students' perceived stress levels were higher-especially for students with lower social support levels. Our results suggest that medical schools should optimize social support to minimize crisis-induced stress.

The lived experience of being an undergraduate midwifery student in the neonatal unit

OBJECTIVE

The objective of this study is to examine the experience of undergraduate student midwives in the neonatal unit.

BACKGROUND

Clinical experience is an essential component of education for the development of competent midwives. Literature has highlighted the pivotal effects of precepting and how it contributes to student experience. Although there is a plethora of research examining undergraduate student midwives' experience, to our knowledge this is the first study exploring their experience in the neonatal unit.

DESIGN

Based in phenomenology, eight semi-structured interviews were conducted producing rich data.

METHODS

Following informed consent and ethical approval, post transcription, the data were coded using Colaizzi's (1978) framework.

RESULTS

Significant themes and sub-themes emerged such as course design, environmental experience, sources of stress and preceptor experience. The student experience very much depends on the preceptor, how busy the environment is and if appropriately staffed.

CONCLUSIONS

Based on these findings there are suggested recommendations including adjusting the timing and length of the placement and how to improve the environment based on the preceptor-student relationship. Also, suggestions on how consistency and communication can be improved are proposed.