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Knutsen JS, Bondevik GT, Hunskaar S. To be or not to be supervisors for medical students in general practice clinical placements: a questionnaire study from Norway. Scand J Prim Health Care 2024; 42:442-449. [PMID: 38602196 DOI: 10.1080/02813432.2024.2337063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 03/26/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVE Many countries experience challenges in recruiting and retaining general practitioners (GPs) as supervisors for medical students in clinical placements. We aimed to investigate the opportunities, capacities and limitations of Norwegian GPs to become supervisors. DESIGN Web-based cross-sectional questionnaire study. SETTING Norwegian general practice. SUBJECTS All GPs in Norway, including locums and those on leave, both active supervisors, and GPs who are not presently supervising medical students. MAIN OUTCOME MEASURES GPs' terms of salary, office facilities, limiting factors, capacity and needs for becoming or continuing as supervisors. RESULTS Among 5145 GPs, 1466 responded (29%), of whom 498 (34%) were active supervisors. Lack of a dedicated student office was the most reported limitation for both active supervisors (75%) and other GPs (81%). A high proportion (67%) of active supervisors reported that they could host more students per year, given financial support for equipped offices and higher salaries. With this kind of support, 48% (n = 461) of the GPs who were not supervisors for medical students were positive about a future supervisor role. By adjusted regression analysis, female GPs had lower likelihood of being supervisors, OR (95% CI) 0.75 (0.59-0.95) than male colleagues. GPs in the North, Mid and West regions had higher odds (OR 3.89, 3.10 and 2.42, respectively) than those in the South-East region. Teaching experience also increased the odds (2.31 (1.74-3.05). CONCLUSIONS There seems to be capacity among both active and potential supervisors if increased salaries and financial support for office facilities are made available.
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Affiliation(s)
- Julie Solberg Knutsen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Gunnar Tschudi Bondevik
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
| | - Steinar Hunskaar
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
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Garavelis K, Hayes N, Maloney M, Liddle K, Moritz K, Gullo MJ, Rose T, Gullo H, McMah R, Heussler H, Reid N. Student experiences in a novel interprofessional neurodevelopmental clinic: a qualitative study. BMC MEDICAL EDUCATION 2024; 24:874. [PMID: 39138469 PMCID: PMC11323686 DOI: 10.1186/s12909-024-05756-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/09/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND Student-led clinics can provide low-cost speciality care and practical interprofessional education (IPE) opportunities. In Australia, there are currently limited speciality services available that provide neurodevelopmental assessments that consider fetal alcohol spectrum disorder (FASD) as one possible outcome. The aim of the current study was to understand student experiences in a novel interprofessional student-led clinic for children and adolescents with suspected or confirmed prenatal alcohol exposure. METHOD Seventeen allied health university students (11 occupational therapy; 6 psychology) participated in individual semi-structured interviews following completion of a 10-week clinic placement. Reflexive thematic analysis was undertaken using NVivo12. RESULTS Four main themes were generated: (1) Interprofessional practice a key for students' development as future healthcare professionals; (2) Meaningful relationships and students' belief they made a difference; (3) Novel challenges tested students' capabilities on placement; and (4) Supervisor attitude and approach to learning supported student development. CONCLUSIONS The current study demonstrated that the interprofessional student-led neurodevelopmental clinic provided a valuable IPE opportunity for students.
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Affiliation(s)
- Khari Garavelis
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
- Child Health Research Centre, The University of Queensland, 62 Graham Street South Brisbane, Brisbane, QLD, 4121, Australia
| | - Nicole Hayes
- Child Health Research Centre, The University of Queensland, 62 Graham Street South Brisbane, Brisbane, QLD, 4121, Australia
| | - Maree Maloney
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Karen Liddle
- Child Health Research Centre, The University of Queensland, 62 Graham Street South Brisbane, Brisbane, QLD, 4121, Australia
- Children's Health Queensland, Queensland, Brisbane, Australia
| | - Karen Moritz
- Child Health Research Centre, The University of Queensland, 62 Graham Street South Brisbane, Brisbane, QLD, 4121, Australia
| | - Matthew J Gullo
- School of Applied Psychology, Griffith University, Griffith, Australia
- Centre for Mental Health, Griffith University, Griffith, Australia
| | - Tanya Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Hannah Gullo
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Rebecca McMah
- Child Health Research Centre, The University of Queensland, 62 Graham Street South Brisbane, Brisbane, QLD, 4121, Australia
| | - Helen Heussler
- Child Health Research Centre, The University of Queensland, 62 Graham Street South Brisbane, Brisbane, QLD, 4121, Australia
- Children's Health Queensland, Queensland, Brisbane, Australia
| | - Natasha Reid
- Child Health Research Centre, The University of Queensland, 62 Graham Street South Brisbane, Brisbane, QLD, 4121, Australia.
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Channa S, Topping A, Willis C, Melody T, Pearce R. Clinical learning experiences of healthcare professional students in a student-led clinical learning environment (SLCLE) - A mixed methods evaluation. Nurse Educ Pract 2024; 79:104035. [PMID: 38972251 DOI: 10.1016/j.nepr.2024.104035] [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: 01/29/2024] [Revised: 06/07/2024] [Accepted: 06/15/2024] [Indexed: 07/09/2024]
Abstract
AIM To evaluate healthcare professional (HCP) students clinical learning experiences' whilst undertaking placements in a student-led clinical learning environment (SLCLE) and any changes in self-reported ratings of confidence. BACKGROUND The English NHS Long Term Workforce Plan (2023) highlights the need to expand domestic education of HCPs to meet workforce shortages. The demand for quality clinical placements to support the preparation of HCP students remains a challenge globally. A creative solution has been the development of student-led learning clinical environments in healthcare settings. SLCLEs provide high-quality learning experience, increase clinical placement capacity whilst maintaining patient care standards. A multisite NHS Trust adopted this model as evidence suggests HCP students will be better prepared on qualification to adopt registered practitioner professional responsibilities. This model has been integrated across three hospital sites within a large teaching hospital, providing care for a diverse population and designed to accommodate students from a range of HCP disciplines and higher educational institutions. DESIGN A mixed methods convergent design. METHODS An online survey was administered to SLCLE allocated nursing and allied health profession (AHP) undergraduate and graduate-entry first, second and third-year students (n=132). Face to face focus groups/individual interviews were undertaken with a purposive sample of student participants (n=80) to evaluate their experiences of clinical learning in SLCLEs. Survey data were analysed using descriptive statistics and paired t-tests, interviews using framework method. RESULTS Undergraduate and graduate-entry students from four UK universities completed the survey (n=132), 103 students (78 %) responded. Most were year 2 students (n=43/42 %), pursuing nursing programmes (n=82/80 %). Most considered the SLCLE met their expectations (n=76/74 %), reported increased confidence post-placement (n=84/82 %), felt supported by staff (n=80/78 %), peers (n=93/90 %) and clinical educators (n=93/90 %). Self-reported confidence scores post-SLCLE were significantly higher than pre-SLCLE. On-line pre-placement information was infrequently accessed yet identified as an omission. Four themes were identified: (i) preconceptions and initial anxiety; (ii) empowerment, growth and a unique learning experience; (iii) collaborative inter-professional learning and support; and (iv) insights and anticipations. CONCLUSIONS The SLCLE allocation enhanced students' confidence and knowledge. Support from clinical educators, ward staff and doctors was perceived as invaluable for creating a positive learning culture. Peer support and opportunities to lead care delivery contributed to students' professional development. The format and method for providing pre-placement information needs review as do strategies for avoiding delays in completing assessment documentation. Overall, the SLCLE experience offers much potential as a nurturing and effective learning environment for HCP students.
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Affiliation(s)
- Sunita Channa
- University Hospitals Birmingham NHS Foundation Trust, School of Nursing, AHPs and Midwifery, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, United Kingdom.
| | - Annie Topping
- School of Nursing and Midwifery, College of Medicine and Health, University of Birmingham, United Kingdom; School of Nursing, AHPs and Midwifery, Integrated Clinical Academic Office, University Hospitals Birmingham NHS Foundation Trust, United Kingdom
| | - Carol Willis
- University Hospitals Birmingham NHS Foundation Trust, School of Nursing, AHPs and Midwifery, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, United Kingdom
| | - Teresa Melody
- University Hospitals Birmingham NHS Foundation Trust, School of Nursing, AHPs and Midwifery, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, United Kingdom
| | - Ruth Pearce
- University Hospitals Birmingham NHS Foundation Trust, School of Nursing, AHPs and Midwifery, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, United Kingdom
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Prestes Vargas J, Smith M, Chipchase L, Morris ME. Impact of interprofessional student led health clinics for patients, students and educators: a scoping review. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024:10.1007/s10459-024-10342-2. [PMID: 38842784 DOI: 10.1007/s10459-024-10342-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 05/12/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Although interprofessional student led health clinics have been implemented worldwide, the impact of this model await confirmation. OBJECTIVES To conduct a critical analysis of the literature on interprofessional student led clinics, and the views of stakeholders on feasibility and the barriers and facilitators to implementation. DESIGN A scoping review, evidence synthesis and quality appraisal were conducted using PRISMA Scr. Eight databases were searched from 2003 to 2023: Medline (Ovid), Embase (Ovid), CINAHL (EBSCO), Cochrane, Scopus, ERIC, Web of Science and Informit Health Collection. A qualitative descriptive approach was used to analyse data from patients, students and educators and inductive thematic analysis identified emergent themes. RESULTS Forty-six studies were included from a yield of 3140 publications. A key theme to emerge was that patients perceived improvements in their health and wellbeing and valued gaining health information from student led clinics. Student experiences were mostly positive although some found it challenging to work in interprofessional teams and roles were not always clear. The clinics enabled students to improve communication skills and autonomy. Clinical educators reported that students benefited from experiential learning within an interprofessional context. The clinics were feasible, provided that sufficient funding, infrastructure, staff and resources were available. Barriers to implementation included lack of funding, excessive waiting times and non-aligned student timetables. Pre-clinic orientation and support from on-site clinical educators facilitated implementation. CONCLUSIONS Despite some challenges with implementing interprofessional student led clinics, they can have a positive impact on student learning and patient experiences.
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Affiliation(s)
- Janine Prestes Vargas
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Moira Smith
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, 3086, Australia
- College of Healthcare Sciences, Department of Physiotherapy, James Cook University, Townsville, QLD, 4814, Australia
| | - Lucy Chipchase
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, 5042, Australia
| | - Meg E Morris
- Victorian Rehabilitation Centre, Glen Waverley, and ARCH and CERI La Trobe University, Bundoora, VIC, 3086, Australia.
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Scala JJ, Cha H, Shamardani K, Rashes ER, Acosta-Alvarez L, Mediratta RP. Training the next generation of community-engaged physicians: a mixed-methods evaluation of a novel course for medical service learning in the COVID-19 era. BMC MEDICAL EDUCATION 2024; 24:426. [PMID: 38649984 PMCID: PMC11034080 DOI: 10.1186/s12909-024-05372-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 03/29/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Medical school curricula strive to train community-engaged and culturally competent physicians, and many use service learning to instill these values in students. The current standards for medical service learning frameworks have opportunities for improvement, such as encouraging students to have more sustainable and reciprocal impact and to ingrain service learning as a value to carry throughout their careers rather than a one-time experience. PEDS 220: A COVID-19 Elective is a Stanford University course on the frontlines of this shift; it provides timely education on the COVID-19 pandemic, integrating community-oriented public health work to help mitigate its impact. METHODS To analyze our medical service learning curriculum, we combined qualitative and quantitative methods to understand our students' experiences. Participants completed the Course Experience Questionnaire via Qualtrics, and were invited to complete an additional interview via Zoom. Interview transcripts were analyzed using an interactive, inductive, and team-based codebook development process, where recurring themes were identified across participant interviews. RESULTS We demonstrate through self-determination theory that our novel curriculum gives students valuable leadership and project management experience, awards strong academic and community-based connections, and motivates them to pursue future community-engaged work. CONCLUSIONS This educational framework, revolving around students, communities, and diversity, can be used beyond the COVID-19 pandemic at other educational institutions to teach students how to solve other emergent global health problems. Using proven strategies that empower future physicians to view interdisciplinary, community-engaged work as a core pillar of their responsibility to their patients and communities ensures long-term, sustainable positive impact. TRIAL REGISTRATION N/A.
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Affiliation(s)
- Jack J Scala
- Department of Biology, BS Candidate, Stanford University, Palo Alto, CA, USA
| | - Hannah Cha
- Department of Symbolic Systems, BS Candidate, Stanford University, Palo Alto, CA, USA.
| | | | - Emma R Rashes
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Rishi P Mediratta
- Department of Pediatrics, Division of Pediatric Hospital Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
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Maple M, O'Neill K, Gartshore S, Clark J, White J, Pearce T. School-based multidisciplinary student-led clinics in health and Australian accreditation standards: A scoping review. Aust J Rural Health 2023; 31:1168-1183. [PMID: 37888895 DOI: 10.1111/ajr.13051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 08/02/2023] [Accepted: 09/30/2023] [Indexed: 10/28/2023] Open
Abstract
INTRODUCTION Student-led clinics can provide health services to marginalised groups where service offerings are sparse or difficult to access, such as rural areas. Offering these services to children and young people can promote health and well-being by addressing the individual challenges and the social determinants of health. There is uncertainty, however, as to whether student-led clinics can meet Australian accreditation standards for health professionals completing degree programs. OBJECTIVE This study aims to determine the capacity for health student placements in school-based student-led clinics to meet accreditation standards. DESIGN A systematic scoping review was conducted based on Arksey and O'Malley's framework and the PRISMA-ScR statement. SETTING Several databases were examined, including Ebsco (Academic Source and CINAHL), ProQuest (PsycINFO, ERIC) and grey literature sources along with a desktop review of accreditation standards across seven health disciplines. Two independent reviewers screened eligible studies. FINDINGS The search retrieved 1037 records with 65 full-text papers assessed for eligibility. Eleven papers met the inclusion criteria. Based on the evidence, both nursing and exercise and sports science accreditation standards were best suited to student-led clinics. DISCUSSION Although broad categories of work-integrated learning activities were applied, it appears feasible to expect accreditation standards for health disciplines at an Australian university to be a good fit for health student-led school-based clinics. CONCLUSION Increasing health student placement opportunities within student-led clinics can improve the health and well-being of children and young people in regional, rural and remote (RRR) areas of Australia who may otherwise have limited access to allied health services.
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Affiliation(s)
- Myfanwy Maple
- School of Health, University of New England, Armidale, New South Wales, Australia
| | - Kristy O'Neill
- School of Education, University of New England, Armidale, New South Wales, Australia
| | - Scott Gartshore
- School of Health, University of New England, Armidale, New South Wales, Australia
| | - Jane Clark
- School of Health, University of New England, Armidale, New South Wales, Australia
| | - James White
- School of Education, University of New England, Armidale, New South Wales, Australia
| | - Tania Pearce
- School of Health, University of New England, Armidale, New South Wales, Australia
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Simmons L, Barker R, Barnett F. Evaluating Allied Health Clinical Placement Performance: Protocol for a Modified Delphi Study. JMIR Res Protoc 2023; 12:e44020. [PMID: 37651163 PMCID: PMC10502602 DOI: 10.2196/44020] [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: 11/03/2022] [Revised: 06/27/2023] [Accepted: 07/21/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND University-affiliated student-led health care services have emerged in response to the challenges faced by universities in securing quality clinical placements for health care students. Evidence of the health care benefits and challenges of student-led health care services is growing, while evidence of clinical placement performance remains variable and not generalizable. Though there have been previous attempts to develop a framework for evaluation of clinical placement performance, concerns have been raised about the applicability of these frameworks across the various placement settings. Additionally, the perspectives of all key stakeholders on the critical areas of clinical placement performance have yet to be considered. OBJECTIVE This study's objective is to gather information on areas of measurement related to student learning outcomes, experience of placement, and costs of placement and then develop consensus on which of those areas need to be included in a framework for evaluation of clinical placement performance within the context of student-led health care services. The aim of this paper is to outline a protocol for a modified Delphi study designed to gain consensus on what is important to measure when evaluating an allied health clinical placement. METHODS We will recruit up to 30 experts to a heterogeneous expert panel in a modified Delphi study. Experts will consist of those with firsthand experience either coordinating, supervising, or undertaking clinical placement. Purposive sampling will be used to ensure maximum variation in expert panel member characteristics. Experts' opinions will be sought on measuring student learning outcomes, student experience, and cost of clinical placement, and other areas of clinical placement performance that are considered important. Three rounds will be conducted to establish consensus on what is important to measure when evaluating clinical placement. Each round is anticipated to yield both quantitative data (eg, percentage of agreement) and qualitative data (eg, free-text responses). In each round, quantitative data will be analyzed descriptively and used to determine consensus, which will be defined as ≥70% agreement. Qualitative responses will be analyzed thematically and used to inform the subsequent round. Findings of each round will be presented, both consensus data and qualitative responses in each subsequent round, to inform expert panel members and to elicit further rankings on areas of measurement yet to achieve consensus. RESULTS Data analysis is currently underway, with a planned publication in 2024. CONCLUSIONS The modified Delphi approach, supported by existing research and its ability to gain consensus through multiround expert engagement, provides an appropriate methodology to inform the development of a framework for the evaluation of clinical placement performance in allied health service. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44020.
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Affiliation(s)
- Lisa Simmons
- James Cook University, Townsville, Queensland, Australia
| | - Ruth Barker
- James Cook University, Townsville, Queensland, Australia
| | - Fiona Barnett
- James Cook University, Townsville, Queensland, Australia
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Brownie S, Blanchard D, Amankwaa I, Broman P, Haggie M, Logan C, Pearce A, Sampath K, Yan AR, Andersen P. Tools for faculty assessment of interdisciplinary competencies of healthcare students: an integrative review. Front Med (Lausanne) 2023; 10:1124264. [PMID: 37396887 PMCID: PMC10314362 DOI: 10.3389/fmed.2023.1124264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/25/2023] [Indexed: 07/04/2023] Open
Abstract
Increasingly, interprofessional teamwork is required for the effective delivery of public health services in primary healthcare settings. Interprofessional competencies should therefore be incorporated within all health and social service education programs. Educational innovation in the development of student-led clinics (SLC) provides a unique opportunity to assess and develop such competencies. However, a suitable assessment tool is needed to appropriately assess student progression and the successful acquisition of competencies. This study adopts an integrative review methodology to locate and review existing tools utilized by teaching faculty in the assessment of interprofessional competencies in pre-licensure healthcare students. A limited number of suitable assessment tools have been reported in the literature, as highlighted by the small number of studies included. Findings identify use of existing scales such as the Interprofessional Socialization and Valuing Scale (ISVS) and the McMaster Ottawa Scale with Team Observed Structured Clinical Encounter (TOSCE) tools plus a range of other approaches, including qualitative interviews and escape rooms. Further research and consensus are needed for the development of teaching and assessment tools appropriate for healthcare students. This is particularly important in the context of interprofessional, community-partnered public health and primary healthcare SLC learning but will be of relevance to health students in a broad range of clinical learning contexts.
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Affiliation(s)
- Sharon Brownie
- School of Health Sciences, Swinburne University, Hawthorn, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
- Centre for Health and Social Practice and Centre for Sports Science and Human Performance, Waikato Institute of Technology – Te Pukenga, Hamilton, New Zealand
| | - Denise Blanchard
- School of Nursing, Eastern Institute of Technology – Te Pukenga, Hawkes Bay, New Zealand
- School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, Bathurst, NSW, Australia
- School of Nursing and Midwifery, The University of Newcastle Central Coast Clinical School, Ourimbah, NSW, Australia
| | - Isaac Amankwaa
- Centre for Health and Social Practice and Centre for Sports Science and Human Performance, Waikato Institute of Technology – Te Pukenga, Hamilton, New Zealand
- Faculty of Health, University of Canberra, Canberra, NSW, Australia
| | - Patrick Broman
- Centre for Health and Social Practice and Centre for Sports Science and Human Performance, Waikato Institute of Technology – Te Pukenga, Hamilton, New Zealand
| | - Marrin Haggie
- Centre for Health and Social Practice and Centre for Sports Science and Human Performance, Waikato Institute of Technology – Te Pukenga, Hamilton, New Zealand
| | - Carlee Logan
- Centre for Health and Social Practice and Centre for Sports Science and Human Performance, Waikato Institute of Technology – Te Pukenga, Hamilton, New Zealand
| | - Amy Pearce
- Centre for Health and Social Practice and Centre for Sports Science and Human Performance, Waikato Institute of Technology – Te Pukenga, Hamilton, New Zealand
| | - Kesava Sampath
- Centre for Health and Social Practice and Centre for Sports Science and Human Performance, Waikato Institute of Technology – Te Pukenga, Hamilton, New Zealand
| | - Ann-Rong Yan
- Faculty of Health, University of Canberra, Canberra, NSW, Australia
| | - Patrea Andersen
- Centre for Health and Social Practice and Centre for Sports Science and Human Performance, Waikato Institute of Technology – Te Pukenga, Hamilton, New Zealand
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, QLD, Australia
- School of Nursing, Midwifery and Social Science, Central Queensland University, Sippy Downs, QLD, Australia
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Wilson OWA, Broman P, Tokolahi E, Andersen P, Brownie S. Learning Outcomes from Participation in Student-Run Health Clinics: A Systematic Review. J Multidiscip Healthc 2023; 16:143-157. [PMID: 36700175 PMCID: PMC9869697 DOI: 10.2147/jmdh.s385709] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/06/2022] [Indexed: 01/19/2023] Open
Abstract
Student-run clinics (SRCs) offer unique opportunities for students to engage in healthcare delivery, but the student learning outcomes of such clinics have not yet been systematically examined in a comprehensive manner. The purpose of this review was to appraise and synthesize existing literature pertaining to student learning outcomes associated with participation in SRCs. A systematic review was undertaken using PubMed, CINAHL, and Web of Science databases. The quality of articles that met inclusion criteria articles was appraised using the Mixed Methods Appraisal Tool (MMAT). Study details, such as learning outcomes, were also extracted. Ninety-two studies met inclusion criteria. Most studies were conducted in North America (n = 73, 79.3%), and related to clinics involving solely medical students (n = 35, 38.0%) or multi-professional clinics (n = 34, 37.0%). Demonstrated learning outcomes of SRC participation include clinical skills, interprofessional skills, empathy/compassion for underserved patients, and leadership. SRC participation had little apparent impact on students' future career directions. Quality appraisal via the MMAT found mixed levels of research quality amongst reviewed studies. In summary, while SRC participation appears to offer benefits for student learning, improved study design and research outside of North American contexts would further advance knowledge.
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Affiliation(s)
- Oliver W A Wilson
- Centre for Health and Social Practice, Waikato Institute of Technology Te Pūkenga, Hamilton, New Zealand,Department of Kinesiology, Pennsylvania State University, University Park, PA, USA,Te Hau Kori, Victoria University of Wellington, Wellington, New Zealand
| | - Patrick Broman
- Centre for Health and Social Practice, Waikato Institute of Technology Te Pūkenga, Hamilton, New Zealand
| | - Ema Tokolahi
- Centre for Health and Social Practice, Waikato Institute of Technology Te Pūkenga, Hamilton, New Zealand,School of Occupational Therapy, Otago Polytechnic Te Pūkenga, Dunedin, New Zealand
| | - Patrea Andersen
- Centre for Health and Social Practice, Waikato Institute of Technology Te Pūkenga, Hamilton, New Zealand,School of Nursing, Midwifery and Social Science, CQUniversity, Rockhampton, QLD, Australia,School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy DownsQLD, Australia
| | - Sharon Brownie
- Centre for Health and Social Practice, Waikato Institute of Technology Te Pūkenga, Hamilton, New Zealand,School of Health Sciences, Swinburne University, Hawthorne, VIC, Australia,School of Medicine & Dentistry, Griffith University, BrisbaneQLD, Australia,Correspondence: Sharon Brownie, School of Health Sciences, Swinburne University, Hawthorne, VIC, Australia, Email
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Zhu X, Rask M, Xu H. First year nursing students' reflections about developing their verbal nursing skills during their nursing education in China: a qualitative study. Front Public Health 2023; 11:1149512. [PMID: 37213655 PMCID: PMC10196177 DOI: 10.3389/fpubh.2023.1149512] [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: 01/22/2023] [Accepted: 04/07/2023] [Indexed: 05/23/2023] Open
Abstract
Objective The aim of the study is to explore the expectations of a group of first-year nursing students in China about developing their verbal and social interactional skills during their nursing education. Background Nursing students' communication skills were not fully developed in China. Students have many challenges to face regarding developing their nursing skills, especially interaction skills, when they start their education. Design A qualitative design was used in this research. Method Twelve second-semester undergraduate nursing students were interviewed on the basis of purposive sampling, and qualitative content analysis was employed. Results The main theme was 'facilitating a caring nurse-patient relationship' and 'using a knowledge base for performing nursing care'. The first theme comprises two sub-themes, 'caring approach' and 'helping and involving the patient in care', with three and two categories, respectively. The second theme comprises the two sub-themes, 'knowledge needed to be able to understand the patient' and 'health and treatment information', with three and two categories, respectively. Conclusion A synthesis of both knowledge and practice is needed to improve the nursing students' interaction and professional skills during their nursing education.
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Affiliation(s)
- Xiaoling Zhu
- Wenzhou Medical University, School of Nursing, Wenzhou, Zhejiang, China
| | - Mikael Rask
- Linnaeus University, School of Health and Caring Sciences, Växjö, Sweden
| | - Hongbo Xu
- Wenzhou Medical University, School of Nursing, Wenzhou, Zhejiang, China
- *Correspondence: Hongbo Xu,
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Abrey C, De Silva N, Godwin J, Jacotine T, Raab D, Urquhart K, Mumford K, McLaughlin P, Vaughan B. Does the student-led osteopathy clinical learning environment prepare students for practice? BMC MEDICAL EDUCATION 2022; 22:603. [PMID: 35927729 PMCID: PMC9354297 DOI: 10.1186/s12909-022-03658-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND For many allied health disciplines, pre-professional clinical education takes place in student-led, on-campus clinic environments. In these environments, pre-professional students undertake patient care under the supervision of qualified health professionals. Literature exploring the benefits of the student-led clinical learning environment is limited and little is known about the role student-led clinics play in preparing pre-professional osteopathy students for professional practice. AIM To explore the perceptions of osteopathy clinical educators about the role of the student-led clinic at Victoria University (VU) in preparing pre-professional students for professional practice. METHODS A qualitative collective case study methodology was utilised to explore clinical educator perceptions. Individual interviews were conducted with clinical educators employed in the university osteopathy clinic. Interview questions were framed around the Capabilities for Osteopathic Practice which set the Australian osteopathy practice standards. Data were assessed by two of the authors using thematic analysis. RESULTS Nine clinical educators out of 31 employed at the university clinic (29%) agreed to participate. Qualitative analysis generated three themes: perceptions of the student-led clinic (SLC) as a learning environment; clinical educator perception of their role in the SLC; and, challenges to and of the SLC environment. CONCLUSIONS Clinical educators perceived that the student-led osteopathy clinical learning environment develops pre-professional learners to meet some, but not all, of the capabilities for professional practice as an osteopath in Australia. The environment may be improved through faculty development, fostering a proactive learning approach, addressing system-based issues, and providing opportunities to interact with other health professions.
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Affiliation(s)
- Conor Abrey
- College of Health & Biomedicine, Victoria University, Melbourne, Australia
| | - Niraj De Silva
- College of Health & Biomedicine, Victoria University, Melbourne, Australia
| | - Jake Godwin
- College of Health & Biomedicine, Victoria University, Melbourne, Australia
| | - Thomas Jacotine
- College of Health & Biomedicine, Victoria University, Melbourne, Australia
| | - Daniel Raab
- College of Health & Biomedicine, Victoria University, Melbourne, Australia
| | - Kieran Urquhart
- College of Health & Biomedicine, Victoria University, Melbourne, Australia
| | - Kelley Mumford
- College of Health & Biomedicine, Victoria University, Melbourne, Australia
| | - Patrick McLaughlin
- College of Health & Biomedicine, Victoria University, Melbourne, Australia.
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
| | - Brett Vaughan
- Department of Medical Education, University of Melbourne, Melbourne, Australia
- Faculty of Health, Southern Cross University, Lismore, Australia
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Hams A, Bell N, Jones T. Evaluating the Impact of a Regional Student-Led Physiotherapy Clinic Model to Improve Self-Reported Function in Community-Dwelling Adults With Neurological Diagnoses. J Neurol Phys Ther 2022; 46:206-212. [PMID: 35412496 DOI: 10.1097/npt.0000000000000399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Neurological conditions are a major cause of health morbidity that negatively impacts function and quality of life (QoL). Despite this burden, community services are disproportionally scarce. Student-led physiotherapy services (SLSs) are a model that can increase community access to health care while providing authentic clinical experiences for students. SLSs consistently demonstrate high client satisfaction; however, limited evaluation of the impact of this model on the client's clinical outcomes exists. Therefore the aim of this project was to evaluate the impact of a physiotherapy student-led community-based rehabilitation service. METHODS The SLS operated 4 days a week over a 15-week period. Forty-two community-dwelling clients (mean age 74 years) with a neurological diagnosis were included. During initial consultation, participants completed basic demographics, up to 3 Patient-Specific Functional Scales (PSFSs) and a QoL questionnaire (World Health Organization Quality of Life-Brief Questionnaire [WHOQOL-BREF]). At discharge, participants completed the WHOQOL-BREF, PSFS, and a patient experience survey. Risk event data were also collected. RESULTS Over half of the PSFS items targeted mobility (55%). There was a significant improvement (P < 0.05) in median change (quartiles) for pre-/post-PSFS scores for clients whose primary condition was balance 1.0 (0.0-3.0), cerebrovascular accident 1.0 (2.0-3.0) or multiple Sclerosis 1.0 (1.0-2.0), and mean (SD) WHOQOL-BREF scores for Physical Health (12.2 ± 1.5 to 13.1 ± 1.3) and Social Relationships (12.7 ± 2.7 to 16.6 ± 3.3). Patient experience survey results indicated that clients had confidence and trust in students. No adverse events were reported. DISCUSSION AND CONCLUSIONS The SLS model provides a strategy to increase access to health care and clinical placement capacity. Findings demonstrated improved self-rated function, QoL, and positive patient experience for community-dwelling clients with nonacute neurological diagnoses.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A380).
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Affiliation(s)
- Andrea Hams
- Griffith University, Gold Coast, Australia (A.H., T.J.); Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia (A.H.); and Physique Health, Tamborine Mountain, Australia (N.B.)
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King RM, Chua J, Nunnery D, Sastre LR. Opportunities and Lessons Learned to Support Didactic Experiential Learning through a Nutrition Education and Counseling Pilot at an FQHC. J Acad Nutr Diet 2022; 122:1425-1432.e5. [DOI: 10.1016/j.jand.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 05/01/2022] [Accepted: 05/02/2022] [Indexed: 10/18/2022]
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Doucet JR, Fournier TA, Bishop CM, Gaudet DJ, Nagel DA. Pilot of a community-based interprofessional "student-infused" pulmonary rehabilitation program in Saint John, New Brunswick. CANADIAN JOURNAL OF RESPIRATORY THERAPY : CJRT = REVUE CANADIENNE DE LA THERAPIE RESPIRATOIRE : RCTR 2022; 57:26-31. [PMID: 35295955 PMCID: PMC8919708 DOI: 10.29390/cjrt-2020-053] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background With the increasing prevalence of chronic pulmonary conditions in New Brunswick and Canada it is necessary to consider innovative interventions to improve access to rehabilitation and supportive care for affected clients. In Fall 2018 we piloted a pulmonary rehabilitation (PR) program for persons with moderate to severe chronic obstructive pulmonary disease (COPD) to demonstrate a novel approach of bridging interprofessional education of students in health care fields with provision of care in a community setting. Methods An 8-week PR program was implemented and evaluated using a quasi-experimental design with pre- and post-testing to measure the effects of the program’s exercise and educational interventions on persons with COPD. Participants were assessed using the 6-Minute Walk Test (6MWT), the St. George’s Respiratory Questionnaire (SGRQ), and a custom questionnaire that rated the participants’ activities of daily living and the PR program. Results Seven participants completed our PR program. Following the intervention, participants’ self-reported health demonstrated a statistically significant improvement. Even though changes on the 6MWT and SGRQ were not shown to be statistically significant, there was evidence of clinically meaningful improvements in those measures. On average, participants walked 25 m further postintervention and showed clinically meaningful improvements on the SGRQ. Conclusions This pilot project demonstrated that a community-based PR program with active involvement of students from multiple health care programs can have positive outcomes for clients with COPD. It also illustrated how educational programs can provide an innovative means for increasing access to rehabilitation and supportive care for clients in the community.
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Affiliation(s)
- John R Doucet
- Allied Health Department, School of Health, New Brunswick Community College, Saint John, Canada
| | - Tammie A Fournier
- Allied Health Department, School of Health, New Brunswick Community College, Saint John, Canada
| | - Christy M Bishop
- Allied Health Department, School of Health, New Brunswick Community College, Saint John, Canada
| | - Derek J Gaudet
- Department of Psychology, University of New Brunswick, Saint John, Canada
| | - Daniel A Nagel
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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Ahern C, O'Donnell M. Are physiotherapy student-led services a suitable model of clinical education? - perceptions & experiences of physiotherapists, students & patients, a qualitative meta-synthesis. Physiother Theory Pract 2022; 39:963-978. [PMID: 35072598 DOI: 10.1080/09593985.2022.2031362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Physiotherapy student-led services (SLS) are becoming increasingly prevalent in clinical education (CE) practice within physiotherapy curricula. This innovative model differs from traditional styles adopted by many, as its primary focus is on increased student responsibility and replicating the reality of practice. However, limited literature is currently available on its suitability as a CE model and on the perceptions of such a model. PURPOSE This qualitative study aims to evaluate the suitability of physiotherapy SLS as a model of CE, as perceived by all involved stakeholders. METHODS A qualitative meta-synthesis of literature sourced from popular healthcare databases was conducted. Studies incorporating any stakeholder perspectives on physiotherapy SLS, or that focused on it as a method of CE were included. Quality appraisal and thematic analysis were conducted on nine included studies. RESULTS All included studies were deemed to be of high-quality following appraisal. Five key themes were developed, showcasing the added benefits and challenges of SLS. These included: 1) Development of Desirable Professional Skills and Attributes; 2) Need for Optimal Supervision; 3) Peer Learning Experience; 4) High-Quality Care; and 5) Student Autonomy. CONCLUSION Physiotherapy SLS offers attractive opportunities for students conducting CE. Involved stakeholders believe that this model does not negatively impact the quality of care and safety provided to patients who attend.
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Affiliation(s)
- Chloe Ahern
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, V94 T9PX, Co. Limerick, Ireland
| | - Marie O'Donnell
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, V94 T9PX, Co. Limerick, Ireland
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Manninen K, Karlstedt M, Sandelin A, von Vogelsang AC, Pettersson S. First and second cycle nursing students' perceptions of the clinical learning environment in acute care settings - A comparative crossectional study using the CLES+T scale. NURSE EDUCATION TODAY 2022; 108:105211. [PMID: 34784564 DOI: 10.1016/j.nedt.2021.105211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/08/2021] [Accepted: 11/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Research has shown that the clinical learning environment can both facilitate and hinder students' learning. Students' perceptions need to be evaluated, preferably using nationally and internationally validated instruments. In Sweden, there is a lack of research about students' evaluation in acute care settings and from the perspectives of different levels of students. OBJECTIVES The aim was to explore and compare perceptions of the clinical learning environment of first- and second-cycle nursing students in an acute care setting using the Clinical Learning Environment, Supervision and Nurse Teacher scale (CLES+T). DESIGN The design involves cross-sectional data collection with comparisons between groups. SETTING AND PARTICIPANTS Data were collected from a convenience sample of first- and second-cycle students at the end of their clinical placements in an acute care setting at a university hospital. METHODS A paper version and a web version of the culturally adapted version of CLES+T was filled out by the students. An independent t-test was used to explore the differences between CLES+T scores and distribution methods and educational level. Internal consistency was evaluated using Cronbach's alpha. RESULTS Overall, the students (N = 179) were satisfied with the clinical learning environment. There was no significant difference in the total score (m = 4.31, SD = 0.63) between first- and second-cycle students except for the subscale of "Premises of nursing on the ward" and the individual items "The ward's nursing philosophy was clearly defined" and "Patients received individual nursing care", showing that the first-cycle students were more satisfied compared to the second-cycle students. The scale demonstrated high internal consistency (α = 0.97 vs. 0.96) for the paper survey and the web survey, respectively. CONCLUSIONS Our findings provide initial support for the CLES+T as a useful instrument to evaluate the clinical learning environment at different levels of education and in different contexts regardless of distribution method.
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Affiliation(s)
- Katri Manninen
- Department of Infectious Diseases, Karolinska University Hospital, 141 86 Stockholm, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Sweden; The Swedish Red Cross University College, Stockholm, Sweden.
| | - Michaela Karlstedt
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Neurosurgery, Heart, Vascular and Neuro Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Annika Sandelin
- Research, Development, and Educational Unit Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Ann-Christin von Vogelsang
- Department of Neurosurgery, Heart, Vascular and Neuro Theme, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Susanne Pettersson
- Department of Rheumatology, Inflammation and Ageing, Theme, Karolinska University Hospital, Stockholm, Sweden
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Cervera-Gasch A, González-Chordá VM, Ortiz-Mallasen V, Andreu-Pejo L, Mena-Tudela D, Valero-Chilleron MJ. Student satisfaction level, clinical learning environment, and tutor participation in primary care clinical placements: An observational study. NURSE EDUCATION TODAY 2022; 108:105156. [PMID: 34637989 DOI: 10.1016/j.nedt.2021.105156] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 09/12/2021] [Accepted: 09/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Competence evaluations in the clinical setting represent approximately 50% of the nurse training process. Factors, such as perceived learning environment and clinical nurse participation, may influence nursing student satisfaction during clinical placements. OBJECTIVE To evaluate the relationship between the levels of nursing student satisfaction with clinical placements, the clinical learning environment, and the level of nurse tutor participation. DESIGN A cross-sectional study. SETTING AND PARTICIPANTS We included 61 nursing students and 45 clinical nurses from 35 primary care centres assigned to the Universitat Jaume I. VARIABLES AND DATA COLLECTION We assessed the overall level of student satisfaction with clinical placements, students' perception of the learning environment, tutors' level of participation, and socio-demographic variables. DATA ANALYSIS We performed a descriptive analysis of the study sample, as well as correlation and simple linear regression analyses. Questionnaire results were analysed depending on the nature of the variables. RESULTS The students' perception of the learning environment was 4.39 ± 0.48 points out of 5. The overall satisfaction level was 8.89 ± 1.22 points out of 10. Tutor participation level in students learning was 3.91 ± 0.58 points out of 5. CONCLUSIONS Both student perception of the learning environment in the clinical setting and their overall level of satisfaction with clinical placements in the primary care centres were considered high. Tutors were participative, but poorly satisfied.
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Affiliation(s)
- Agueda Cervera-Gasch
- Nursing Department, Univesitat Jaume I, Avda Sos Baynat s/n, 12071 Castellón, Spain.
| | | | - Víctor Ortiz-Mallasen
- Nursing Department, Univesitat Jaume I, Avda Sos Baynat s/n, 12071 Castellón, Spain; Departamento de Salut de La Plana, Conselleria de Sanitat Universal i Salut Pública, Vila-real, Castellón, Spain
| | - Laura Andreu-Pejo
- Nursing Department, Univesitat Jaume I, Avda Sos Baynat s/n, 12071 Castellón, Spain.
| | - Desiree Mena-Tudela
- Nursing Department, Univesitat Jaume I, Avda Sos Baynat s/n, 12071 Castellón, Spain.
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Zulu BM, du Plessis E, Koen MP. Experiences of nursing students regarding clinical placement and support in primary healthcare clinics: Strengthening resilience. Health SA 2021; 26:1615. [PMID: 34858643 PMCID: PMC8603057 DOI: 10.4102/hsag.v26i0.1615] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 08/13/2021] [Indexed: 11/16/2022] Open
Abstract
Background This research addressed the need to have a deeper understanding of nursing students’ experiences of clinical placement and support in primary healthcare (PHC) settings. Aim To explore and describe the experiences of nursing students’ clinical placement in PHC settings. Setting The study was conducted at PHC clinics in a specific province in South Africa. Method A qualitative, exploratory, descriptive and contextual research design was used. The population comprised fourth-year nursing students selected using purposive sampling. Five semi-structured focus group interviews were conducted. Data saturation determined the sample size which comprised 25 nursing students. Thematic data analysis produced four main themes. Results The main themes were (1) the meaning of placement, (2) experiences of clinical placement, (3) needs for support, and (4) resilience of nursing students. Conclusions Nursing students encountered negative and positive experiences. Both experiences confirmed that PHC settings can be valuable learning opportunities for nursing students. Nursing students appreciated the supervision of professional nurses who created an atmosphere conducive for teaching and learning by welcoming and encouraging nursing students’ independence. Recommendations include: appointing a professional nurse specifically for supervision of nursing students, tutor support before summative examinations, improvement of services, including the availability of resources. Contribution This article contributes to awareness of how nursing students manage to stay resilient irrespective of negative experiences during clinical placement and how tutors and professional nurses can support them. The study’s recommendations can guide professional nurses, nurse educators, nurse managers and other healthcare PHC workers to support nursing students.
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Affiliation(s)
- Beauty M Zulu
- Department of Nursing, Faculty of Health Sciences, Ann Latsky Nursing College, Johannesburg, South Africa
| | - Emmerentia du Plessis
- NuMIQ Research Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Magdalena P Koen
- NuMIQ Research Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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Wynne D, Cooper K. Student-led rehabilitation groups and clinics in entry-level health education: a scoping review. JBI Evid Synth 2021; 19:2958-2992. [PMID: 34474440 DOI: 10.11124/jbies-20-00340] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The purpose of this review was to identify, map, and describe the characteristics of student-led physical rehabilitation groups and clinics in entry-level health education. INTRODUCTION Student-led groups and clinics for physical rehabilitation are an emergent phenomenon in entry-level health professional education. Data gathered in this scoping review aimed to provide an understanding of the range and scope of student-led groups and clinics within a physical rehabilitation context, and establish the evaluation undertaken to date from a student, service user, and stakeholder perspective. It also aimed to identify other important factors in the design, execution, and feasibility of the concept. Finally, it aimed to identify gaps in the literature that can be addressed by further research. INCLUSION CRITERIA This scoping review considered studies and sources that identify student-led methods for carrying out physical rehabilitation for service users in either an exercise group or clinic environment. Students and groups/clinics on entry-level qualifying courses were considered. The review considered primary and secondary research in any paradigm as well as text and opinion articles. METHODS The JBI methodology for conducting scoping reviews was employed. The following databases were searched: MEDLINE, CINAHL, AMED, ERIC, Scopus, and SPORTDiscus. Searches were limited from January 1, 1998, to the date of the search (November 1, 2019). Non-English articles were excluded. To supplement the review, searches for gray literature were also undertaken. Data extraction was performed by two reviewers using a pre-determined data extraction form developed by the authors. The results of the review are presented in narrative form and supported by tables and figures. RESULTS This review identified 523 sources of information of which 111 were screened at full-text stage and 48 sources were eligible to be included in the final scoping review. A wide range of student-led groups and clinics that provide physical rehabilitation exist globally. Drivers for the clinics and groups vary; key aims included providing a learning environment for student skill development, serving as clinical placements, and providing a social enterprise. Evaluations focused on student experience, service user experience, and cost-benefit analyses. CONCLUSIONS Student-led groups and clinics are at different stages of development and use within entry-level curricula. The objectives and drivers for groups and clinics vary worldwide; therefore, the evolution of groups and clinics has driven a wide range and number of models globally.
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Affiliation(s)
- Donna Wynne
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Kay Cooper
- School of Health Sciences, Robert Gordon University, Aberdeen, UK.,The Scottish Centre for Evidence-based, Multi-professional Practice: A JBI Centre of Excellence, Aberdeen, UK
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Cant R, Ryan C, Cooper S. Nursing students' evaluation of clinical practice placements using the Clinical Learning Environment, Supervision and Nurse Teacher scale - A systematic review. NURSE EDUCATION TODAY 2021; 104:104983. [PMID: 34229233 DOI: 10.1016/j.nedt.2021.104983] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/31/2021] [Accepted: 05/17/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To review undergraduate nursing students' perceptions of the quality of their clinical placement experiences by means of surveys conducted using the Clinical Learning Environment Supervision and Nurse Teacher questionnaire. DESIGN Systematic review of English language studies published between 2014 and 2020, in any clinical setting, utilising data collected in the decade 2010 to 2020. DATA SOURCES Structured searches were conducted in CinahlPlus, Ovid Medline, Scopus, PubMed and Google Scholar. REVIEW METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses framed the review. RESULTS A total of 111 records were screened, after which 21 studies met criteria for inclusion. Studies were centred on students in Sweden and in 15 other countries. Students' ratings of 'Experience' were positive across five scale subdimensions with means 3.0-3.95 of a possible 5 (overall mean 75.4%). 'Satisfaction' across seven studies was rated highly (mean 4.16 of 5) 83.2% agreement. The highest rated subdimension was Supervisory relationship, with the Role of the Nurse Teacher rated lower and inconsistently. The underlying elements are discussed. CONCLUSION Although students' Experience and Satisfaction were rated highly averaging over 75%, there is still room for improvement. Further research is needed to examine how students perceive various components of 'satisfaction' within clinical learning environments because this can be seen as the primary measure of program quality. Research using experimental and observational study designs is needed to compare ways of preparing clinical teachers and reporting measurable learning outcomes for models of supervision that are applicable in varied clinical learning environments.
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Affiliation(s)
- Robyn Cant
- School of Health, Federation University Australia, Berwick, VIC 3806, Australia.
| | - Colleen Ryan
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Noosaville, QLD 4567, Australia.
| | - Simon Cooper
- School of Health, Federation University Australia, Berwick, VIC 3806, Australia.
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Adel FW, Berggren RE, Esterl RM, Ratelle JT. Student-run free clinic volunteers: who they are and what we can learn from them. BMC MEDICAL EDUCATION 2021; 21:356. [PMID: 34174871 PMCID: PMC8236183 DOI: 10.1186/s12909-021-02793-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/08/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Initiatives employing medical students' volunteerism and idealism, such as the Student-Run Free Clinics (SRFC) program, are prevalent in US medical schools. Many studies evaluated various aspects of volunteering, sometimes resulting in conflicting evidence. This study simultaneously sought to identify the characteristics of volunteers vs. non-volunteers, and to characterize the volunteers' perception of the SRFC. METHODS We administered a survey to the Long School of Medicine (LSOM) Class of 2018 before their third year of medical school. The authors compared and contrasted the findings of the SRFC volunteers with their non-volunteering counterparts by analyzing their demographics, volunteering history, academic performance, and clinical skills. The volunteers were also asked about their SRFC experiences. RESULTS While most volunteers were female (62 %) and non-traditional students (67 %), the difference was not statistically significant (p = 0.15 and p = 0.38, respectively). Additionally, there were no statistically significant differences between the two groups in measures of academic performance (p = 0.25). Most of the volunteers learned about the SRFC program prior to starting medical school. Further, while SRFC volunteers were more likely to engage in additional local volunteering initiatives, the difference was not statistically significant (p = 0.03, prespecified α= 0.006). Importantly, volunteers agreed/strongly agreed that SRFC volunteering emphasized aspects that were missing or underemphasized in the formal medical school curriculum. CONCLUSIONS Medical students' age, gender, undergraduate major, and non-traditional status were not statistically different between volunteers vs. non-volunteers. However, there may be tendencies for volunteers to be female, non-traditional, and locally engaged. Further, the timing of knowledge of the SRFC program may not affect student involvement in the SRFC, either. Most importantly, however, while volunteering does not affect the students' academic performance, it may provide improvements in clinical competencies.
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Affiliation(s)
- Fadi W Adel
- Department of Internal Medicine, Mayo Clinic, 200 1st St SW, Minnesota, 55905, Rochester, United States of America.
| | - Ruth E Berggren
- The Center for Medical Humanities and Ethics, The Joe R. and Teresa Lozano Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
| | - Robert M Esterl
- The Center for Medical Humanities and Ethics, The Joe R. and Teresa Lozano Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
| | - John T Ratelle
- Division of Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
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Suikkala A, Timonen L, Leino-Kilpi H, Katajisto J, Strandell-Laine C. Healthcare student-patient relationship and the quality of the clinical learning environment - a cross-sectional study. BMC MEDICAL EDUCATION 2021; 21:230. [PMID: 33888103 PMCID: PMC8061060 DOI: 10.1186/s12909-021-02676-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/14/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Relationships with patients are seen as the core component of establishing the quality of patient-centred care and promoting patients' autonomy and relevant use of services. A clinical learning environment that emphasizes relationship-based healthcare is essential for encouraging future healthcare professionals to work in partnership with patients. There is also broad agreement that the insight of patients should be used actively in healthcare students' clinical learning. The aim of this study was to describe healthcare students' perceptions of their relationship with patients and the quality of the clinical learning environment and to identify factors associated with both of these. METHODS A cross-sectional survey using an electronic questionnaire was applied to collect data from 1644 Finnish healthcare students, mostly nursing students, between January 2018 and May 2018. The data were analysed statistically using descriptive statistics, Spearman's correlation coefficients, and multifactor analysis of variance. RESULTS Students perceived the level of the student-patient relationship and the role of the teacher as good while pedagogical atmosphere, premises of care, premises of learning, and supervisory relationship were perceived to be at very good level. The correlations between the student-patient relationship and all clinical learning environment dimensions were perceived as moderate. Furthermore, a number of student-related factors associated with the student-patient relationship and the quality of the clinical learning environment were detected. CONCLUSIONS In this study, the rarely explored perspective of the student-patient relationship within the context of the clinical learning environment was included. The student-patient relationship and the quality of the clinical learning environment were perceived as good by the students, with a number of determining factors affecting these perceptions. Giving the student-patient relationship a role in clinical education may be conducive to students' learning with the patient in focus, and may thus promote the competence needed in the rapidly evolving healthcare environment and the changing scope of clinical practice.
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Affiliation(s)
- Arja Suikkala
- Diaconia University of Applied Sciences, Kyläsaarenkuja 2, FI- 00580, Helsinki, Finland.
- Department of Nursing Science, University of Turku, Turku, Finland.
| | | | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
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Bala M, Arora V, Chawla B, Gautam N. Developing health promotional skills among medical undergraduates for tuberculosis patients: An innovative way to benefit students as well as patients. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:100. [PMID: 34084847 PMCID: PMC8150077 DOI: 10.4103/jehp.jehp_670_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/04/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Involving medical undergraduate students in patients' health education will not only help in improving students' learning as well as professional and communication skills but also plays an important role in achieving better health outcome of patients. The aim of the study was to assess the impact of students led educational intervention regarding tuberculosis (TB) on their learning and on the patients' knowledge and attitude towards the disease. MATERIALS AND METHODS One hundred medical undergraduates were included in the study. An integrated lecture on TB was given to all participants followed by preintervention test on TB. One group was then subjected to interactive traditional lecture. Whereas the videos reflecting the experiences of TB patients were shown to the other group and was given an assignment to prepare educational leaflets for TB patients followed by postintervention test for both groups. The patients' satisfaction level with the information given via educational leaflet and the overall perceived benefits of this activity by the students were assessed. Data analysis done using SPSS version 23.0. Independent and paired t-test were used to calculate difference of means for quantitative variables. RESULTS Two groups were comparable preintervention however postintervention there was significant improvement in knowledge in the study group (P0.000). Overall 74.2% of the patients were satisfied with the information provided through leaflets. Students' feedback highlighted that majority of the them felt benefitted from this activity. CONCLUSION It can be concluded that such type of educational interventions have dual benefits, i.e., learning for the students as well as providing health education to patients which in turn will improve their clinical outcome.
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Affiliation(s)
- Manju Bala
- Department of Microbiology, Dr. Y S Parmar Government Medical College, Nahan, Himachal Pradesh, India
| | - Vikramjeet Arora
- Department of Anaesthesia, Dr. Y S Parmar Government Medical College, Nahan, Himachal Pradesh, India
| | - Bharti Chawla
- Department of Community Medicine, Pt. J L Nehru Government Medical College, Chamba, Himachal Pradesh, India
| | - Neha Gautam
- Department of Microbiology, Dr. Y S Parmar Government Medical College, Nahan, Himachal Pradesh, India
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Rockey NG, Weiskittel TM, Linder KE, Ridgeway JL, Wieland ML. A mixed methods study to evaluate the impact of a student-run clinic on undergraduate medical education. BMC MEDICAL EDUCATION 2021; 21:182. [PMID: 33766015 PMCID: PMC7992336 DOI: 10.1186/s12909-021-02621-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 03/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The purpose of this study was to evaluate the extent to which a longitudinal student-run clinic (SRC) is meeting its stated learning objectives, including providing critical community services and developing physicians who more fully appreciate the social factors affecting their patients' health. METHODS This was a mixed methods program evaluation of an SRC at Mayo Clinic Alix School of Medicine (MCASOM). A survey was conducted of medical students who had participated in the clinic and seven interviews and three focus groups were conducted with SRC patients, students, faculty, staff, and board members. Transcripts were coded for systematic themes and sub-themes. Major themes were reported. Survey and interview data were integrated by comparing findings and discussing areas of convergence or divergence in order to more fully understand program success and potential areas for improvement. RESULTS Greater than 85% of student survey respondents (N = 90) agreed or strongly agreed that the SRC met each of its objectives: to provide a vital community service, to explore social determinants of health (SDH), to understand barriers to healthcare access and to practice patience-centered examination. Qualitative data revealed that the SRC contextualized authentic patient care experiences early in students' medical school careers, but the depth of learning was variable between students. Furthermore, exposure to SDH through the program did not necessarily translate to student understanding of the impact of these social factors on patient's health nor did it clearly influence students' future practice goals. CONCLUSIONS The MCASOM SRC experience met core learning objectives, but opportunities to improve long-term impact on students were identified. Participation in the SRC enabled students to engage in patient care early in training that is representative of future practices. SRCs are an avenue by which students can gain exposure to real-world applications of SDH and barriers to healthcare access, but additional focus on faculty development and intentional reflection may be needed to translate this exposure to actionable student understanding of social factors that impact patient care.
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Affiliation(s)
- Nathan G. Rockey
- Mayo Clinic Alix School of Medicine, 200 First Street SW, Rochester, MN 55905 USA
| | - Taylor M. Weiskittel
- Mayo Clinic Graduate School of Biomedical Sciences, 200 First Street SW, Rochester, MN 55905 USA
| | - Katharine E. Linder
- Mayo Clinic Alix School of Medicine, 200 First Street SW, Rochester, MN 55905 USA
| | - Jennifer L. Ridgeway
- Center for the Science of Healthcare Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA
| | - Mark L. Wieland
- Division of Community Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA
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Suikkala A, Koskinen S, Katajisto J, Leino-Kilpi H. Congruence between nursing students' and patients' views of student-patient relationships. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:79-115. [PMID: 32436071 PMCID: PMC7900057 DOI: 10.1007/s10459-020-09972-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 04/27/2020] [Indexed: 06/11/2023]
Abstract
The growing emphasis on learning with and from patients has shifted the focus from education and healthcare professionals to the student-patient relationship. The relationship between student and patient, with a supportive preceptor as a resource, can influence the progression and development of an authentic person-centred approach to care among students. The purpose of this study was to analyse the congruence between nursing students' and patients' views of their relationship during students' clinical placement. The study compared data from cross-sectional matched cohort pairs of nursing students (n = 187) and patients (n = 187) in Finland. The data were collected between March 2015 and May 2016 using corresponding questionnaires and procedures in both cases. Both students' and patients' views were moderately or weakly congruent in terms of facilitative relationship, characterised as a mutually enriching relationship for both students and patients through dialogue. Patients, however, tended to see the relationship significantly more often as mechanistic, focusing on students learning practical skills, compared to students who saw the relationship more often as facilitative. Patients' age and the reasons for care were the only background variables that predicted the congruence between students' and patients' views of their relationships. These findings suggest ways in which student-patient relationships can be made more meaningful in supporting learning in clinical education.
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Affiliation(s)
- Arja Suikkala
- Department of Nursing Science, University of Turku, Turku, Finland.
- Department of Nursing Science, University of Turku, FI-20014, Turku, Finland.
| | - Sanna Koskinen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku and Turku University Hospital, Turku, Finland
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Abstract
Aim: To evaluate person-centred home visits as an interprofessional learning (IPL) activity for undergraduate students during clinical placements in primary healthcare. Background: Interprofessional collaboration is known to improve patient safety, increase job satisfaction, and reduce stress among healthcare professionals. Students should already during their basic training experience interprofessional collaboration. Methods: Students from six different educational programmes and supervisors and adjunct clinical lecturers from different professions participated in the learning activity. The students read a description of the patient history before the visit together with a supervisor. During the home visit, the students were responsible for history-taking and for performing relevant examinations. Afterwards, the students made a joint care plan for the patient. Students, supervisors, and adjunct clinical lecturers discussed the outcomes in a seminar and reflected on each other’s professional roles. The students and the patients answered a questionnaire about the activity, and the supervisors and the adjunct clinical lecturers were interviewed in focus groups. Findings: Thirty interprofessional home visits were conducted, involving 109 students from six different healthcare professions. The students reported that they had gained insights into how different professions could collaborate and an increased understanding of teamwork. All patients were satisfied with the visits and felt that they had been listened to. The interview analysis showed one overarching theme: ‘Interprofessional home visits in primary healthcare were an appreciated and effective pedagogical learning activity with a sustainability dependent on organisational factors’. Conclusions: The students felt that participation in the activity increased their understanding of collaboration and of other professions’ skills. The supervisors found the home visits to be an appreciated and effective learning activity. The results indicate that this learning activity can be used in primary healthcare settings to promote students’ IPL, but organisational factors need to be considered in order to support sustainability.
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Drexler R, Fröschle F, Predel C, Sturm B, Ustorf K, Lehner L, Janzen J, Valentin L, Scheer T, Lehnert F, Tadzic R, Oldhafer KJ, Meyer TN. Establishing a student-run free clinic in a major city in Northern Europe: a 1-year experience from Hamburg, Germany. J Public Health (Oxf) 2020; 42:793-798. [PMID: 31840742 PMCID: PMC7685854 DOI: 10.1093/pubmed/fdz165] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Student-Run Free Clinics (SRFCs) have been an integral part of US medical schools since the 1960s and provide health care to underserved populations. In 2018, we established an SRFC in Hamburg, Germany, a major city in Northern Europe. The aim of this study was to describe the central problems and to investigate the usefulness of an SRFC in a country with free access to medical care, such as Germany. METHODS All consecutive patients treated at the SRFC Hamburg between February 2018 and March 2019 that consented to this study were analyzed regarding clinical characteristics, diagnosis, readmission rate and country of origin. RESULTS Between February 2018 and March 2019, 229 patients were treated at the SRFC in Hamburg. The patients came from 33 different countries with a majority (n = 206, 90%) from countries inside the European Union. The most common reasons for visiting the SRFC were infections (23.2%), acute or chronic wounds (13.5%) and fractures (6.3%). CONCLUSION Our multicultural patients suffer mainly from infections and traumatological and dermatological diseases. We find similarities to published Canadian SRFC patient cohorts but differences in diseases and treatment modalities compared to US SRFCs. Importantly, we demonstrate the relevance and necessity of the SRFC in a major city in Northern Europe.
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Affiliation(s)
- Richard Drexler
- Asklepios Campus Hamburg, Semmelweis University Budapest, Hamburg, Germany
- Student-Run Free Clinic Hamburg, Hamburg, Germany
| | - Felix Fröschle
- Asklepios Campus Hamburg, Semmelweis University Budapest, Hamburg, Germany
- Student-Run Free Clinic Hamburg, Hamburg, Germany
| | - Christopher Predel
- Asklepios Campus Hamburg, Semmelweis University Budapest, Hamburg, Germany
- Student-Run Free Clinic Hamburg, Hamburg, Germany
| | - Berit Sturm
- Asklepios Campus Hamburg, Semmelweis University Budapest, Hamburg, Germany
- Student-Run Free Clinic Hamburg, Hamburg, Germany
| | - Klara Ustorf
- Asklepios Campus Hamburg, Semmelweis University Budapest, Hamburg, Germany
- Student-Run Free Clinic Hamburg, Hamburg, Germany
| | - Louisa Lehner
- Asklepios Campus Hamburg, Semmelweis University Budapest, Hamburg, Germany
- Student-Run Free Clinic Hamburg, Hamburg, Germany
| | - Jara Janzen
- Asklepios Campus Hamburg, Semmelweis University Budapest, Hamburg, Germany
- Student-Run Free Clinic Hamburg, Hamburg, Germany
| | - Lisa Valentin
- Asklepios Campus Hamburg, Semmelweis University Budapest, Hamburg, Germany
- Student-Run Free Clinic Hamburg, Hamburg, Germany
| | - Tristan Scheer
- Asklepios Campus Hamburg, Semmelweis University Budapest, Hamburg, Germany
- Student-Run Free Clinic Hamburg, Hamburg, Germany
| | - Franziska Lehnert
- Asklepios Campus Hamburg, Semmelweis University Budapest, Hamburg, Germany
- Student-Run Free Clinic Hamburg, Hamburg, Germany
| | - Refmir Tadzic
- Student-Run Free Clinic Hamburg, Hamburg, Germany
- Gesundheitszentrum Dr. Tadzic und Kollegen, Hamburg, Germany
| | - Karl Jürgen Oldhafer
- Asklepios Campus Hamburg, Semmelweis University Budapest, Hamburg, Germany
- Student-Run Free Clinic Hamburg, Hamburg, Germany
- Department of General and Visceral Surgery, Asklepios Hospital Barmbek, Hamburg, Germany
| | - Tobias N Meyer
- Asklepios Campus Hamburg, Semmelweis University Budapest, Hamburg, Germany
- Student-Run Free Clinic Hamburg, Hamburg, Germany
- Department of Nephrology, Asklepios Hospital Barmbek, Hamburg, Germany
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Suikkala A, Leino-Kilpi H, Katajisto J. Nursing student-patient relationship - a 10-year comparison study in Finland. Int J Nurs Educ Scholarsh 2020; 17:/j/ijnes.2020.17.issue-1/ijnes-2019-0125/ijnes-2019-0125.xml. [PMID: 33151176 DOI: 10.1515/ijnes-2019-0125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 10/13/2020] [Indexed: 12/11/2022]
Abstract
Objective This study aimed to describe and compare the group-level findings from 2005-2006 and 2015-2016 regarding students' and patients' views of the nursing student-patient relationship and associated factors. Methods The data were in both cases collected using Student-Patient Relationship Scales. The data were analysed statistically. Results In both student cohorts, authoritative and facilitative student-patient relationships were reported by the students more frequently than mechanistic relationships. Authoritative relationships were most common in both patient cohorts, whereas facilitative relationships had become more frequent than mechanistic relationships. A positive change of views in the student and patient cohorts was found in factors associated with the relationship. Conclusion In order to strengthen a clinical learning culture that reflects a facilitative student-patient relationship, further research is needed on the processes and outcomes of that relationship.
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Affiliation(s)
- Arja Suikkala
- University of Turku, Department of Nursing Science, University of Turku, Turku, Finland and Diaconia University of Applied Sciences, Helsinki, Finland
| | - Helena Leino-Kilpi
- University of Turku, Department of Nursing Science, University of Turku, Turku, Finland, andTurku University Hospital, Turku, Finland
| | - Jouko Katajisto
- University of Turku, Department of Mathematics and Statistics, Turku, Finland
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Suikkala A, Leino-Kilpi H, Katajisto J, Koskinen S. Nursing student-patient relationship and related factors-A self-assessment by nursing students. J Clin Nurs 2020; 29:4030-4044. [PMID: 32696592 DOI: 10.1111/jocn.15426] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/13/2020] [Accepted: 07/10/2020] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To describe the nursing student-patient relationship in terms of three types of relationships-mechanistic, authoritative and facilitative-and analyse the factors related to the type of relationship. BACKGROUND As future professionals, nursing students have a central role in facilitating patient autonomy while working in partnership with patients. Supporting student-patient relationship throughout the nursing education may result in positive outcomes for both students and patients. DESIGN A cross-sectional study. METHODS The data were collected from a convenience sample of Finnish nursing students using a structured web survey. Statistical data analysis was performed using chi-square test, two-sample t test, one-way analysis of variance and multinomial logistic regression. The STROBE Statement - Checklist for cross-sectional studies was used (Appendix S1). RESULTS Students most often assessed their relationship with the patients as facilitative, followed by authoritative and mechanistic relationships. The results revealed three predictors for facilitative relationship: students' older age, long enough contact time with the patient and higher competence in ensuring quality. In authoritative and facilitative relationships, students had significantly more positive perceptions of the contextual factors and consequences of the relationship and higher ratings of self-assessed competence levels than students in a mechanistic relationship. CONCLUSIONS It seems that the facilitative student-patient relationship is connected to the professional competence of nursing students, especially in the area of ensuring the quality of patient care. Therefore, sustaining clinical learning environments and pedagogical approaches that value and support facilitative relationships in students' clinical learning should be enhanced. RELEVANCE TO CLINICAL PRACTICE Efforts aimed at contributing to facilitative student-patient relationships have a crucial role in shaping students' competency and in promoting high-quality patient care. Thus, supervision of students organised around establishing mutual student-patient relationships with the preceptors acting as facilitators will benefit both students and patients.
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Affiliation(s)
- Arja Suikkala
- Department of Nursing Science, University of Turku, Turku, Finland.,Diaconia University of Applied Sciences, Helsinki, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Sanna Koskinen
- Department of Nursing Science, University of Turku, Turku, Finland
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Suen J, Attrill S, Thomas JM, Smale M, Delaney CL, Miller MD. Effect of student-led health interventions on patient outcomes for those with cardiovascular disease or cardiovascular disease risk factors: a systematic review. BMC Cardiovasc Disord 2020; 20:332. [PMID: 32652933 PMCID: PMC7353670 DOI: 10.1186/s12872-020-01602-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 06/26/2020] [Indexed: 11/10/2022] Open
Abstract
Background As the need for health care services rise, alternative service delivery models such as student-led health interventions become attractive alternatives to alleviate the burden on healthcare. Predominantly, student-led health interventions were free clinics servicing socially disadvantaged communities in the USA. A 2015 systematic review identified that students value these student-run clinics and reported skill and knowledge attainment from participating. Previous research has reported on patient satisfaction outcomes, but less frequently about the clinical outcomes patients accrue from these student-delivered services. As cardiovascular disease is the leading cause of death worldwide, this review aimed to explore the effectiveness of student-led health interventions through examining their impact on objective clinical outcomes, using the case of patients at risk of, or with, cardiovascular disease. Methods A systematic literature search was conducted in eight electronic databases to identify student-led health interventions conducted on adults with a cardiovascular disease risk factor or established cardiovascular disease, and a clinical outcome of interest. Through double-blinded screening and data extraction, sixteen studies were identified for synthesis. Results The majority of student-led health interventions for patients at risk of cardiovascular disease demonstrated a positive impact on patient health. Statistically significant changes amongst patients at risk of cardiovascular disease appeared to be associated with student-led individualised intervention or group-based interventions amongst patients with diabetes or those who are overweight or obese. The evidence was of moderate quality, as included studies lacked a control group for comparison and detail to enable the intervention to be replicated. Conclusions Future research applying a student-led health intervention through a randomised control trial, with rigorous reporting of both student and patient interventions and outcomes, are required to further understand the effectiveness of this alternative service delivery model.
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Affiliation(s)
- Jenni Suen
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Stacie Attrill
- Speech Pathology, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Jolene M Thomas
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Matilda Smale
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Christopher L Delaney
- Vascular Surgery Unit, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia, 5042, Australia
| | - Michelle D Miller
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
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Jakobsen F, Glassou EN, Kirkeby L, Hansen TB. Patients' experiences of being treated by an interprofessional student team compared with uniprofessional treatment by residents supported by nurses: a case study. J Interprof Care 2020; 35:546-551. [PMID: 32552172 DOI: 10.1080/13561820.2020.1763276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Clinical experience, preferably interprofessional, is an important part of health professionals' undergraduate training. In recent years, more and more patient treatment has been moving to outpatient clinics with research suggesting hat this shift is not compromising students' learning outcomes. The purpose of this study was to explore orthopedic outpatients' perceived experiences of being treated by an interprofessional student team consisting of one medical and one nursing student versus being treated by a resident doctor supported by nurses in a uniprofessional setup. We performed an exploratory single case study with two embedded units: 1) a quantitative part with a survey (n = 89) including seven questions and 2) a qualitative part with interviews (n = 46). In the questionnaire, three of the seven questions revealed a significant difference in favor of the student teams. However, the qualitative part of the study did not indicate any differences between the groups. In this study, patients' experiences in an orthopedic outpatient clinic were not influenced by being treated by interprofessional student teams compared to normal patient pathway with registrars and nurses working uniprofessionally. This information is important in designing and implementing student curriculums with clinical training in outpatient clinics. Furthermore, the interprofessional student team can undertake unassisted consultations with selected patients with indirect supervision from the supervisors, making the clinical setting realistic for the students. However, in this teaching model, feedback to the students relies only on the students' written patient records; even if patient satisfaction is high, structured observation of student performance may be necessary as a supplementary teaching tool. This may be incorporated in future studies of patient-student relations in clinical training in an outpatient setting.
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Affiliation(s)
- Flemming Jakobsen
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Herning, Denmark
| | - Eva Natalia Glassou
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Herning, Denmark.,Department of Quality, Regional Hospital West Jutland, Herning, Denmark
| | - Lone Kirkeby
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Herning, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Torben Bæk Hansen
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Herning, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Johnston D, McInerney P, Miot J. Volunteering, health and the homeless - the cost of establishing a student-run primary healthcare clinic serving the inner-city homeless in South Africa. BMC Health Serv Res 2020; 20:202. [PMID: 32164694 PMCID: PMC7069018 DOI: 10.1186/s12913-020-5061-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 02/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Those who are homeless are more prone to communicable, respiratory and cardiovascular diseases and are less likely to access healthcare services. In South Africa there are no specific public healthcare services tailored to the needs of these communities, particularly if they are immigrants. Trinity Health Services is a student-run inner-city clinic providing free healthcare to the homeless of Johannesburg, South Africa. The clinic operates two nights per month and provides treatment for mainly acute conditions. The purpose of this study was to determine the costs of establishing and operating a student-run clinic for an indigent population. METHODS This costing analysis used a mixed-methods approach combining an ingredients-based and top-down methodology. The costs, capital and recurrent, pertaining to the establishment and operating of the clinic as well as the cost of treatment per patient were identified and quantified from 1st January 2016 - 31st December 2017. RESULTS The capital costs incurred in establishing the clinic were calculated to be £10,968.57 (ZAR 214157.08) and included building alterations, equipment purchased, installations, furniture, application for a pharmacy license, consumables and medications. The recurrent costs per annum were estimated at £17,730.72 (ZAR 346185.54) and comprised of overheads and maintenance, rental, personnel, pharmacy license, consumables and medication. The cost of treatment per patient, included medication dispensed and consumables used in the consultation, was estimated at £3.54 (ZAR 69.05) per visit. CONCLUSIONS This study summarised the costs of establishing and operating a student-run clinic providing pertinent information essential to the sustainability of the service. It also provides a model for costs associated with free clinics in faith-based and university settings.
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Affiliation(s)
- Deanne Johnston
- Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Patricia McInerney
- Centre for Health Science Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jacqui Miot
- Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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Timm JR, Schnepper LL. A mixed-methods evaluation of an interprofessional clinical education model serving students, faculty, and the community. J Interprof Care 2020; 35:92-100. [PMID: 32013630 DOI: 10.1080/13561820.2019.1710117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The clinical learning environment significantly affects students' preparedness to enter practice. Nursing programs may struggle securing relevant clinical sites necessary for student learning and meeting accreditation standards. Programs must be creative in developing community-based experiences that facilitate students' learning. However, authentic interprofessional practice is often missing. We evaluated how an interprofessional clinical education model provided preventive health services through a faculty-student-led clinic and delivered an effective avenue to educate health profession students while serving the community. The model was implemented as a pilot project over the course of one semester. We used mixed-methods to analyze data from pre/post-instruments and focus groups to gain a comprehensive understanding of the effect of the model on students, faculty, and the community. Student growth in interprofessional competencies, measured with the Interprofessional Education Collaborative Self-Assessment Tool and the Interprofessional Socialization and Valuing Scale, indicates significant difference pre/post-participation. Four themes were identified from the focus groups highlighting the impact of the clinical education model: interprofessional teamwork, an unorthodox learning environment, delivery of primary and secondary prevention in the community, and reaching underserved populations. This clinical education model has promising utility in providing an interprofessional clinical learning environment while serving the community.
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Affiliation(s)
- Jennifer R Timm
- Department of Nursing, Winona State University , Winona, MN, USA
| | - Lisa L Schnepper
- Department of Nursing, Winona State University , Winona, MN, USA
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Dyar A, Lachmann H, Stenfors T, Kiessling A. The learning environment on a student ward: an observational study. PERSPECTIVES ON MEDICAL EDUCATION 2019; 8:276-283. [PMID: 31595430 PMCID: PMC6820594 DOI: 10.1007/s40037-019-00538-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Worldwide, a growing number of healthcare students require clinical environments for learning. Some wards have become adapted 'student wards' to meet this demand. Benefits have been reported from the students', supervisors' and patients' perspectives. There is no definition of a student ward, and little research on what the term means. A deeper understanding of the characteristics of student wards is needed to support their use. The aim of this study is to describe what characterises the learning environment on one student ward. METHODS An ethnographic approach was used for an observational study on a student ward in a hospital in Sweden. Student nurses, supervisors and others on the ward were observed. Field notes were thematically analysed. RESULTS Four themes were identified: 'Student-led learning' described students learning by actively performing clinical tasks and taking responsibility for patients and for their own learning. 'Learning together' described peer learning and supervision. 'Staff's approach to learning' described personalised relationships between the students and staff and the build-up of trust, the unified inter-professional approach to teaching, and the supervisors' motivation for teaching and for their own learning. 'Student-dedicated space' described the effect of the student room on the learning environment. DISCUSSION AND CONCLUSIONS This study describes the characteristics of a student ward that centred around a community of practice that shared a view of learning as a priority, allowing staff to provide clinical care without compromising students' learning. This qualitative study at a single centre lays the groundwork for future research into other student wards.
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Affiliation(s)
- Anna Dyar
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
| | - Hanna Lachmann
- Department of Learning, Informatics and Ethics, Karolinska Institutet, Stockholm, Sweden
- The Swedish Red Cross University College, Stockholm, Sweden
| | - Terese Stenfors
- Department of Learning, Informatics and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Anna Kiessling
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
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Al-Anazi NA, Alosaimi D, Pandaan I, Anthony D, Dyson S. Evaluating clinical placements in Saudi Arabia with the CLES+T scale. Nurse Educ Pract 2019; 39:11-16. [DOI: 10.1016/j.nepr.2019.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 05/30/2019] [Accepted: 07/08/2019] [Indexed: 10/26/2022]
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Forbes R. Service dissatisfaction and non-attendance in physiotherapy student-led clinics: a qualitative study. Physiother Theory Pract 2019; 36:1390-1398. [PMID: 30676151 DOI: 10.1080/09593985.2019.1570576] [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: 01/31/2023]
Abstract
Background and Purpose: Student-led physiotherapy clinics are a valuable means for providing education opportunities and cost-effective services to the public. Service dissatisfaction is an important construct in understanding how student-led services can maximize patient care and minimize non-attendance while maintaining effective learning environments. Design: A qualitative interview design was used with semi-structured interviews. Results: Eighteen patients from three different university student-led physiotherapy clinics were interviewed. Five themes emerged that were associated with negative perceptions of service provision: (1) inadequate communication, (2) insufficient supervision, (3) loss of autonomy, (4) time commitment, and (5) continuity of care. Conclusion: The results of this study highlight factors that service providers should consider to mitigate negative patient experiences and relevant implications of dissatisfaction including non-attendance. Ensuring transparency of patient expectations of services and enhancing patient continuity of care between physiotherapists and students are important in minimizing the potentially negative factors associated with student-led health services.
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Affiliation(s)
- Roma Forbes
- School of Health and Rehabilitation Sciences, University of Queensland , St Lucia, Brisbane, QLD, Australia
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