'Fostering transformative learning, self-reflexivity and medical citizenship through guided tours of disadvantaged neighborhoods'

Transformative Learning in an Online Doctor of Nursing Practice Population Health Course

BACKGROUND

Population health is a critical component of Doctor of Nursing Practice (DNP) education, providing the foundation for clinical prevention, health equity, responsible policy, and practice change. Many DNP learners enter population health courses focused on individual patient care in microsystems. Transformative learning broadens learners' perspectives about health determinants and implications for health system transformation.

METHOD

Transformative learning strategies were imbedded in a 10-week, online population health course. Students engaged with readings and multimedia content and wrote anonymous reflective analyses about population health determinants. Qualitative survey data were explored for transformative content using line-by-line content analysis. The stages of transformative learning were used as a priori codes.

RESULTS

Learners questioned their own beliefs and epistemologies and demonstrated all aspects of transformative learning, although not equally across course topics.

CONCLUSION

To achieve the promised outcomes of DNP education, population health content should be professionally transformative and integrated across the curriculum. [J Nurs Educ. 2019;58(8):481-484.].

Realist approach to evaluating an interprofessional education program for medical students in clinical practice at a community hospital

Introduction: We examined the interrelationships between context, mechanism, and outcome using a realist approach following the introduction of interprofessional education (IPE) to clinical practice for medical students in the community.Methods: Through participant observation and interviews, a working hypothesis was developed. To evaluate IPE in clinical practice, medical students' reports were thematically analyzed, and configuration on contexts, mechanisms, and outcomes were identified using a realist approach.Results: Influential contexts were medical students' experience of clinical practice and learning characteristics, the capacity of other professionals, interprofessional relationships, and characteristics of the community hospital. One key mechanism was observational learning. Others were self-regulated learning, legitimate peripheral participation, experiential learning, contact hypotheses, awareness of social structure, and cognitive empathy. As faculties supported these key mechanisms, medical students became aware of the legitimacy of community-oriented primary care, noting the roles of physicians who support patients' and/or their family's life in collaboration with other professionals, and reflecting the necessity of shifting from physician-centered perspectives. As a result, medical students deepened their empathic understanding for other professionals.Conclusion: Faculties should develop IPE programs in clinical practice based on the 'mechanism', 'context', 'outcome' pattern and 'context-mechanism-outcome' configuration in primary care settings.

Using poster presentation to assess large classes: a case study of a first-year undergraduate module at a South African university

BACKGROUND

The massification of higher education is often associated with poor student engagement, poor development of their critical thinking, inadequate feedback and poor student throughput. These factors necessitate the need to devise novel, innovative methods to teach, assess and provide feedback to learners to counter the restrictions imposed due to the large class learning environments. This study was conducted to ascertain the perceptions of 1st year medical students and staff at the Nelson Mandela School of Medicine regarding the value of poster presentations as a strategy to enhance learning, assessment and feedback.

METHODS

This was an exploratory observational, descriptive cross-sectional, case study. Data was collected through separate student and staff questionnaires that required participant responses on a five-point Likert scale. The data was extracted into Excel spreadsheets for quantitative analysis.

RESULTS

Two-hundred- and-thirty (92%) student questionnaires were returned (N = 250). Most students indicated that the design and presentation of the poster had helped them to select important material (92%), understand and describe disadvantage (86%) and to make a difference in the community (92%). The students agreed that the poster assessment was an efficient (81%) and fair method (75%) that provided opportunities for meaningful feedback. Ten staff members responded to the questionnaire. Most staff members (90%) indicated that the poster presentation had allowed students to demonstrate their engagement in a meaningful and appropriate way around issues of disadvantage and HIV and agreed that the poster presentations allowed for immediate and effective feedback.

CONCLUSION

Students' interactions in the tasks promoted active engagement with others and course material; the development of higher order thinking and skills which added to students' accounts of transformative learning experiences. They could describe and illustrate the difference that they had made in their chosen community. The poster presentations allowed for quick and efficient marking, immediate feedback and an opportunity to validate the students' participation. Poster presentations offered an innovative way to encourage deep meaningful engagement and learning amongst peers and facilitators. Poster presentations should be more widely considered as an innovative way of encouraging deeper engagement and learning in a large class setting.

Attitudes and Practices of Dental Students in Providing Oral Health-Care Services to Underserved Rural Patients Attending Dental Institutions of Telangana, India

Introduction:

Attitude is a relatively enduring organization of beliefs around an object, subject, or concept, which predisposes one to respond in some preferential manner. It decides one’s action. Dental students frequently come across underserved rural population and must have good attitudes toward them, so that the care delivered to them will be optimum.

Aim:

To assess the attitudes and practices of dental students in providing oral health-care services to underserved rural patients.

Materials and Methods:

A cross-sectional study was conducted among final-year Bachelor of Dental Surgery (BDS) students, interns, and postgraduate students who are involved in providing dental care in dental institutions of Telangana State, India. A 15-item, self-structured, pretested questionnaire was administered. Descriptive statistics were calculated using the Statistical Package for the Social Sciences (SPSS) software, version 20.0. Attitudes and practices of undergraduates and postgraduates were compared using paired t-test.

Results:

A total of 574 students participated in the study. Approximately 73.3% of the dental students agreed that they personally want to be involved in providing oral health care for the underserved and 27.1% students disagreed that underserved patients are subjects on whom they can train and expertise. Approximately 56.62% of dental students often asked patients about the expenses they bear for attending a single dental visit and 53.48% tried to minimize the number of appointments required for the patients. No significant difference was observed in attitudes between undergraduates and postgraduates.

Conclusion:

Dental students had moderate attitude toward underserved patients but this was not reflected in their practices.