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Alexander M, Behrend R, Franz A, Peters H. Feeling the responsibility: Exploring the emotional experiences of final-year medical students when carrying out clinical tasks. MEDICAL TEACHER 2024:1-8. [PMID: 38771960 DOI: 10.1080/0142159x.2024.2351137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/30/2024] [Indexed: 05/23/2024]
Abstract
PURPOSE The concept of Entrustable Professional Activities (EPA) is increasingly used to operationalize learning in the clinical workplace, yet little is known about the emotions of learners feeling the responsibility when carrying out professional tasks. METHODS We explored the emotional experiences of medical students in their final clerkship year when performing clinical tasks. We used an online reflective diary. Text entries were analysed using inductive-deductive content analysis with reference to the EPA framework and the control-value theory of achievement emotions. RESULTS Students described a wide range of emotions related to carrying out various clinical tasks. They reported positive-activating emotions, ranging from enjoyment to relaxation, and negative-deactivating emotions, ranging from anxiety to boredom. Emotions varied across individual students and were related to the characteristics of a task, an increasing level of autonomy, the students' perceived ability to perform a task and the level of supervision provided. DISCUSSION Emotions are widely present and impact on the workplace learning of medical students which is related to key elements of the EPA framework. Supervisors play a key role in eliciting positive-activating emotions and the motivation to learn by providing a level of supervision and guidance appropriate to the students' perceived ability to perform the task.
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Affiliation(s)
- Miriam Alexander
- Dieter Scheffner Center for Medical Education and Educational Research, Dean's Office of Study Affairs, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ronja Behrend
- Dieter Scheffner Center for Medical Education and Educational Research, Dean's Office of Study Affairs, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Anne Franz
- Dieter Scheffner Center for Medical Education and Educational Research, Dean's Office of Study Affairs, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Harm Peters
- Dieter Scheffner Center for Medical Education and Educational Research, Dean's Office of Study Affairs, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Nagel DA, Penner JL, Halas G, Philip MT, Cooke CA. Exploring experiential learning within interprofessional practice education initiatives for pre-licensure healthcare students: a scoping review. BMC MEDICAL EDUCATION 2024; 24:139. [PMID: 38350938 PMCID: PMC10863283 DOI: 10.1186/s12909-024-05114-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: 10/30/2023] [Accepted: 01/30/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Interprofessional collaborative team-based approaches to care in health service delivery has been identified as important to health care reform around the world. Many academic institutions have integrated interprofessional education (IPE) into curricula for pre-licensure students in healthcare disciplines, but few provide formal initiatives for interprofessional practice (IPP). It is recognized that experiential learning (EL) can play a significant role supporting IPP education initiatives; however, little is known of how EL is used within education for IPP in healthcare settings. METHODS We conducted a scoping review to map peer-reviewed literature describing IPP education initiatives involving EL for pre-licensure students in healthcare disciplines. A literature search was executed in MEDLINE, CINAHL, EMBASE, ERIC, PsycINFO, Scopus, and Social Services Abstracts. After deduplication, two independent reviewers screened titles and abstracts of 5664 records and then 252 full-text articles that yielded 100 articles for data extraction. Data was extracted using an Excel template, and results synthesized for presentation in narrative and tabular formats. RESULTS The 100 included articles represented 12 countries and IPP education initiatives were described in three main typologies of literature - primary research, program descriptions, and program evaluations. Forty-three articles used a theory, framework, or model for design of their initiatives with only eight specific to EL. A variety of teaching and learning strategies were employed, such as small interprofessional groups of students, team huddles, direct provision of care, and reflective activities, but few initiatives utilized a full EL cycle. A range of perspectives and outcomes were evaluated such as student learning outcomes, including competencies associated with IPP, impacts and perceptions of the IPP initiatives, and others such as client satisfaction. CONCLUSION Few educational frameworks specific to EL have been used to inform EL teaching and learning strategies to consolidate IPE learning and prepare students for IPP in healthcare settings. Further development and evaluation of existing EL frameworks and models would be beneficial in supporting robust IPP educational initiatives for students in healthcare disciplines. Intentional, thoughtful, and comprehensive use of EL informed by theory can contribute important advances in IPP educational approaches and the preparation of a future health care workforce.
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Affiliation(s)
- Daniel A Nagel
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - Jamie L Penner
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Gayle Halas
- Rady Chair in Interprofessional Collaborative Practice, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Mark T Philip
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Carol A Cooke
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, Canada
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Straub C, Bode SFN, Willems J, Farin-Glattacker E, Friedrich S. Challenges and opportunities of evaluating work based interprofessional learning: insights from a pediatric interprofessional training ward. Front Med (Lausanne) 2023; 10:1244681. [PMID: 38116035 PMCID: PMC10729382 DOI: 10.3389/fmed.2023.1244681] [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: 06/22/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023] Open
Abstract
Introduction Interprofessional collaboration among healthcare professionals is fostered through interprofessional education (IPE). Work-based IPE has demonstrated effectiveness within interprofessional training wards. We developed the Interprofessional Training Ward in Pediatrics (IPAPED) and employ a combination of established assessment tools and a newly created IPAPED questionnaire, directed at to assess both students' learning experiences and program structure. This paper presents the development and analysis of the psychometric properties of the IPAPED questionnaire. Methods Nursing trainees and medical students participated in IPAPED. The IPAPED questionnaire was developed to complement established instruments, based on IPE frameworks. Interprofessional collaboration and communication were represented in subscales in part 1 of the questionnaire. Part 2 focused on the IPAPED program itself. Statistical analyses included calculation of internal consistency for part 1 and exploratory factor analyses for part 2. Results All IPAPED participants between November 2017 and November 2022 completed the questionnaire (n = 105). 94 of 105 questionnaires were analyzed. Internal consistency for part 1 was low (Cronbach's α <0.58). Exploratory factor analyses revealed three distinct factors: teaching and learning material, interprofessional learning facilitation and professional guidance by nurses on the ward. Discussion Our results illustrate the challenge of performing high quality, theory based evaluation in a work-based setting. However, exploratory factor analyses highlighted the opportunity of focusing on both learning facilitators and staff on the wards to ensure a maximum learning output for participants. Developing program-specific questionnaires to gain insight into local structures has the potential to improve work-based IPE formats.
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Affiliation(s)
- Christine Straub
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Neuropediatrics and Muscle Disorders, Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian F. N. Bode
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Jana Willems
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Erik Farin-Glattacker
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Sebastian Friedrich
- Department of Neuropediatrics and Muscle Disorders, Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Leon CGRMPD, Mano LY, Fernandes DDS, Paula RAP, Brasil GDC, Ribeiro LM. Artificial intelligence in the analysis of emotions of nursing students undergoing clinical simulation. Rev Bras Enferm 2023; 76Suppl 4:e20210909. [PMID: 37075358 PMCID: PMC10103640 DOI: 10.1590/0034-7167-2021-0909] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 09/10/2022] [Indexed: 04/21/2023] Open
Abstract
OBJECTIVE to assess nursing students' emotions undergoing maternal-child clinical simulation. METHODS an observational study, carried out between June and July 2019. The Focus Group technique was used, with 28 nursing students, randomly distributed into three groups, with qualitative (Bardin technique) and quantitative data (Artificial Intelligence) analysis, to analyze emotions through facial expressions, tone of voice and description of speeches. RESULTS we defined two categories: "It was not easy, it was very stressful"; and "Very valuable experience". In Artificial Intelligence, emotional distribution between face, voice and speech revealed a prevalence of negative valence, medium-high degree of passivity, medium power to control the situation and medium-high degree of obstruction in task accomplishment. FINAL CONSIDERATIONS this study revealed an oscillation between positive and negative emotions, and shows to the importance of recognizing them in the teaching-learning process in mother-child simulation.
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Affiliation(s)
| | - Leandro Yukio Mano
- Universidade Estadual do Rio de Janeiro. Rio de Janeiro, Rio de Janeiro, Brazil
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Muis KR, Sinatra GM, Pekrun R, Kendeou P, Mason L, Jacobson NG, Van Tilburg WAP, Orcutt E, Zaccoletti S, Losenno KM. Flattening the COVID-19 curve: Emotions mediate the effects of a persuasive message on preventive action. Front Psychol 2022; 13:1047241. [PMID: 36533067 PMCID: PMC9751357 DOI: 10.3389/fpsyg.2022.1047241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/07/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Across four countries (Canada, USA, UK, and Italy), we explored the effects of persuasive messages on intended and actual preventive actions related to COVID-19, and the role of emotions as a potential mechanism for explaining these effects. Methods One thousand seventy-eight participants first reported their level of concern and emotions about COVID-19 and then received a positive persuasive text, negative persuasive text, or no text. After reading, participants reported their emotions about the pandemic and their willingness to take preventive action. One week following, the same participants reported the frequency with which they engaged in preventive action and behaviors that increased the risk of contracting COVID-19. Results Results revealed that the positive persuasive text significantly increased individuals' willingness to and actual engagement in preventive action and reduced risky behaviors 1 week following the intervention compared to the control condition. Moreover, significant differences were found between the positive persuasive text condition and negative persuasive text condition whereby individuals who read the positive text were more willing and actually engaged in more preventive action compared to those who read the negative text. No differences were found, however, at the 1-week follow-up for social distancing and isolation behaviors. Results also revealed that specific discrete emotions mediated relations between the effects of the texts and preventive action (both willing and actual). Discussion This research highlights the power of educational interventions to prompt behavioral change and has implications for pandemic-related interventions, government policy on health promotion messages, and future research.
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Affiliation(s)
- Krista Renee Muis
- Department of Educational and Counselling Psychology, Faculty of Education, McGill University, Montreal, QC, Canada
| | - Gale M. Sinatra
- Rossier School of Education, University of Southern California, Los Angeles, CA, United States
| | - Reinhard Pekrun
- Department of Psychology, University of Essex, Colchester, United Kingdom
| | - Panayiota Kendeou
- Department of Educational Psychology, College of Education and Human Development, University of Minnesota Twin Cities, St. Paul, MN, United States
| | - Lucia Mason
- Department of Developmental Psychology and Socialisation, University of Padua, Padua, Italy
| | - Neil G. Jacobson
- Rossier School of Education, University of Southern California, Los Angeles, CA, United States
| | | | - Ellen Orcutt
- Department of Educational Psychology, College of Education and Human Development, University of Minnesota Twin Cities, St. Paul, MN, United States
| | - Sonia Zaccoletti
- Department of Developmental Psychology and Socialisation, University of Padua, Padua, Italy
| | - Kelsey M. Losenno
- Department of Educational and Counselling Psychology, Faculty of Education, McGill University, Montreal, QC, Canada
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Monahan L, Zhao M, Monahan M, Acker K, Sandrik M. Physician Residents Shadowing a Certified WOC Nurse to Develop Interprofessional Competencies: A Quality Improvement Project. J Wound Ostomy Continence Nurs 2022; 49:29-33. [PMID: 35040813 DOI: 10.1097/won.0000000000000836] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this quality improvement (QI) project was to assess a shadowing experience with a certified WOC nurse (CWOCN) on 4 interprofessional collaborative practice domains: interprofessional communication, role awareness and responsibilities, teams and teamwork, and values and ethics for interprofessional practice. PARTICIPANTS AND SETTING Forty-nine physician residents in Family and Internal Medicine participated in this project set at a health system in Chicago, Illinois. APPROACH Residents spent 16 hours shadowing a CWOCN and completed the Interprofessional Education Collaborative Competency Self-Assessment Tool (IPESAT) pre- and postshadowing that measured 4 interprofessional education (IPE) domains: interprofessional communication, role awareness and responsibilities, teams and teamwork, and values and ethics for interprofessional practice. Paired t tests were performed to determine differences in IPESAT scores before and after the shadowing experience. OUTCOMES Residents demonstrated significant improvement in their overall knowledge of IPE (P = .000) as well as knowledge within each of the 4 domains (P = .000). After the shadowing experience, the overall ranking improved by 7.5%; the greatest gain (10.8%) occurred in the teamwork domain. IMPLICATIONS FOR PRACTICE We found that even a comparatively brief shadowing experience with a CWOCN improved knowledge in IPE competencies. The shadowing experience is now permanently part of the Internal Medicine Residency program, and based on these IPE outcomes, other residency programs in our setting, such as the Rehabilitation and Family Medicine program, have increased their requests to shadow with the CWOCN.
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Affiliation(s)
- Laura Monahan
- Laura Monahan, OFS, DNP, MBA, RN, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Meng Zhao, PhD, RN, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Michael Monahan, JD, MBA, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Katelijne Acker, PhD, RN, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Mary Sandrik, MSN, RN, CWOCN, Sinai Health System, Chicago, Illinois
| | - Meng Zhao
- Laura Monahan, OFS, DNP, MBA, RN, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Meng Zhao, PhD, RN, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Michael Monahan, JD, MBA, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Katelijne Acker, PhD, RN, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Mary Sandrik, MSN, RN, CWOCN, Sinai Health System, Chicago, Illinois
| | - Michael Monahan
- Laura Monahan, OFS, DNP, MBA, RN, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Meng Zhao, PhD, RN, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Michael Monahan, JD, MBA, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Katelijne Acker, PhD, RN, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Mary Sandrik, MSN, RN, CWOCN, Sinai Health System, Chicago, Illinois
| | - Katelijne Acker
- Laura Monahan, OFS, DNP, MBA, RN, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Meng Zhao, PhD, RN, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Michael Monahan, JD, MBA, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Katelijne Acker, PhD, RN, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Mary Sandrik, MSN, RN, CWOCN, Sinai Health System, Chicago, Illinois
| | - Mary Sandrik
- Laura Monahan, OFS, DNP, MBA, RN, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Meng Zhao, PhD, RN, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Michael Monahan, JD, MBA, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Katelijne Acker, PhD, RN, College of Nursing and Health Sciences, Texas A&M University-Corpus Christi
- Mary Sandrik, MSN, RN, CWOCN, Sinai Health System, Chicago, Illinois
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Byerly LK, Floren LC, Yukawa M, O'Brien BC. Getting outside the box: exploring role fluidity in interprofessional student groups through the lens of activity theory. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:253-275. [PMID: 32705403 DOI: 10.1007/s10459-020-09983-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 07/13/2020] [Indexed: 05/15/2023]
Abstract
Health professionals' roles and scopes often overlap, creating a need for role clarity in interprofessional teamwork. Yet, such clarity does not mean roles are fixed within teams and some literature suggests role flexibility can enhance team functioning. Interprofessional practice competencies and learning activities often emphasize knowledge and definition of roles, but rarely attend to the dynamic nature of roles and influential contextual factors. This study explores role fluidity in interprofessional student groups using an activity theory framework. Using a collective instrumental case study approach, the authors examine the fluidity of one physical therapy (PT) student's role within 3 different interprofessional (medical, pharmacy, PT) student groups completing nursing home patient care plans. Field notes, group debriefing interviews, and care plans were collected and coded from all care planning sessions. Codes mapped to group-specific activity systems that compared role-influencing interactions and tensions. The PT student's role fluidity varied in each group's activity system, influenced primarily by system tensions from implicit rules (e.g., encouraging questions), division of labor (e.g., rigid profession-based task assignment), and tool use (e.g., computers). Attention to modifiable system elements, such as tool use and explicit rules of inclusivity, could foster role fluidity and improve interprofessional teamwork and learning environments.
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Affiliation(s)
- Laura K Byerly
- Division of General Internal Medicine and Geriatrics, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, L-475, Portland, OR, 97239, USA.
| | - Leslie C Floren
- School of Pharmacy, University of California San Francisco, San Francisco, CA, USA
| | - Michi Yukawa
- Division of Geriatrics, University of California San Francisco, San Francisco, CA, USA
| | - Bridget C O'Brien
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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Hansen TB, Pape B, Thiesen PS, Jakobsen F. Interprofessional versus uniprofessional dyad learning for medical students in a clinical setting. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2020; 11:191-200. [PMID: 32986616 PMCID: PMC7882129 DOI: 10.5116/ijme.5f50.bc76] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/03/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES The aim of the present study was to explore and compare medical students' perceived learning outcomes when treating patients under supervision in two different learning settings: a uniprofessional or an interprofessional dyad. METHODS The design of the study is a qualitative interview study. Data were collected from October 2016 to June 2017 via semi-structured group interviews performed at the end of the clinical placement in an orthopaedic outpatient clinic for medical students in the last semester of the curriculum. In the placement, the students worked by turns in either a uniprofessional dyad with two medical students or an interprofessional dyad with a nursing student. The data from the interviews were analysed using Systematic Text Analysis. RESULTS Overall, 21 students were interviewed. The students appreciated the authenticity of dealing with real patient problems. Both dyads provided the possibility of working as a professional, but the interprofessional dyad had a more authentic setting. In both dyads, the students' interdependence and mutual support promoted the acquisition of knowledge and skills. Working in the interprofessional dyad facilitated relationships between the professions, and the medical students became aware of some of their own profession's strengths and weaknesses. The interprofessional collaboration contributed to different perspectives on the patients' course of treatment and led to a more holistic understanding of the treatment. CONCLUSIONS Interprofessional dyads have the potential to improve learning outcomes in the clinical training of medical students. Further studies are needed to explore the benefits across medical specialities and settings.
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Affiliation(s)
- Torben Bæk Hansen
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Denmark
| | - Britta Pape
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Denmark
| | - Pernille Staal Thiesen
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Denmark
| | - Flemming Jakobsen
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Denmark
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Horner P, Hunukumbure D, Fox J, Leedham-Green K. Outpatient learning perspectives at a UK hospital. CLINICAL TEACHER 2020; 17:680-687. [PMID: 32578389 DOI: 10.1111/tct.13189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Undergraduate students spend much of their training in the clinical workplace, increasingly in hospital outpatient settings; however, they report that this does not always yield the educational value that they expect. This study investigates ways in which outpatient learning can be enhanced from the perspectives of students and teachers, exploring which approaches may be most appropriate in different circumstances. METHODS We conducted 14 semi-structured interviews with medical students from one UK medical school and consultants (specialists) at a single teaching hospital. We explored their experiences and perceptions of clinical teaching and learning in this outpatient setting. Transcripts were analysed through a consensual qualitative research approach. An evaluation of established frameworks for outpatient teaching was conducted and strategies were matched to stakeholder needs. FINDINGS A total of 24 core ideas were identified, which were categorised into: individual factors (student, doctor and patient), interpersonal factors, team factors and organisational factors. Teaching strategies that address stakeholder needs included: student-led clinics, case-based discussions, one-minute preceptor, the SNAPPS tool (summarize, narrow differential, analyse, probe preceptor, plan and select issues for self-learning), advanced organisers and supplementing. DISCUSSION There is a complex interplay between personal, interpersonal, team and organisational factors that contribute to the effectiveness of the outpatient setting as a learning environment. Strategies at the personal and interpersonal levels are unlikely to be successful or sustained without organisational resourcing and support. Further research is needed to implement and evaluate these suggested strategies.
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Affiliation(s)
| | | | - Jonathan Fox
- Kingston Hospital NHS Foundation Trust, London, UK
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Andreassen P, Christensen MK, Møller JE. Focused ethnography as an approach in medical education research. MEDICAL EDUCATION 2020; 54:296-302. [PMID: 31850537 DOI: 10.1111/medu.14045] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 12/06/2019] [Accepted: 12/11/2019] [Indexed: 06/10/2023]
Abstract
CONTEXT Over recent decades, the use of qualitative methodologies has increased in medical education research. These include ethnographic approaches, which have been used to explore complex cultural norms and phenomena by way of long-term engagement in the field of research. Often, however, medical education consists of short-term episodes that are not bound to single sites, but take place in a myriad of locations and contexts such as classrooms, examination stations, clinical settings and online. This calls for methodologies that allow us to grasp what is at stake in an increasingly multifaceted and diverse field. METHODS In this article, we direct attention to focused ethnography, which has emerged as a useful, suitable and feasible applied qualitative research approach, and which uses adapted classic ethnographic methods, such as direct observation, to gain new insights and nuanced understandings of distinct phenomena, themes and interactions in specific settings in medical education (eg the learning potential of ward rounds, or how hierarchical positions affect learning situations). We introduce methodological key features of focused ethnography to give insights into how the approach can be used, and we offer examples of how the method has been used in medical education research to show how it has contributed in different ways to the field of medical education research. Furthermore, we address and discuss some of the main challenges and limitations of the approach. CONCLUSIONS Focused ethnography offers a methodological approach that sheds light over limited and well-defined social episodes and interactions. Precisely because the field of medical education consists to a large degree of such fragmented interactions, focused ethnography can be seen as a methodology tailored to these characteristics and should become an integrated part of the toolkit of medical education research.
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Affiliation(s)
- Pernille Andreassen
- Centre for Health Sciences Education, Aarhus University, INCUBA Skejby, Aarhus, Denmark
| | - Mette K Christensen
- Centre for Health Sciences Education, Aarhus University, INCUBA Skejby, Aarhus, Denmark
| | - Jane E Møller
- Centre for Health Sciences Education, Aarhus University, INCUBA Skejby, Aarhus, Denmark
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