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Dewi SP, Wilson A, Duvivier R, Kelly B, Gilligan C. Do the teaching, practice and assessment of clinical communication skills align? BMC MEDICAL EDUCATION 2024; 24:609. [PMID: 38824578 PMCID: PMC11144343 DOI: 10.1186/s12909-024-05596-8] [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: 01/18/2024] [Accepted: 05/23/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Evidence indicates that communication skills teaching learnt in the classroom are not often readily transferable to the assessment methods that are applied nor to the clinical environment. An observational study was conducted to objectively evaluate students' communication skills in different learning environments. The study sought to investigate the extent to which the communication skills demonstrated by students in classroom, clinical, and assessment settings align. METHOD A mixed methods study was conducted to observe and evaluate students during the fourth year of a five-year medical program. Participants were videorecorded during structured classroom 'interactional skills' sessions, as well as clinical encounters with real patients and an OSCE station calling upon communication skills. The Calgary Cambridge Observational Guides was used to evaluate students at different settings. RESULT This study observed 28 students and findings revealed that while in the classroom students were able to practise a broad range of communication skills, in contrast in the clinical environment, information-gathering and relationship-building with patients became the focus of their encounters with patients. In the OSCEs, limited time and high-pressure scenarios caused the students to rush to complete the task which focussed solely on information-gathering and/or explanation, diminishing opportunity for rapport-building with the patient. CONCLUSION These findings indicate a poor alignment that can develop between the skills practiced across learning environments. Further research is needed to investigate the development and application of students' skills over the long term to understand supports for and barriers to effective teaching and learning of communication skills in different learning environments.
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Affiliation(s)
- Sari Puspa Dewi
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jatinangor Km. 21 Sumedang West Java, Bandung, Indonesia.
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales , Australia.
- School of Medicine and Psychology, Australian National University, Canberra, Australia.
| | - Amanda Wilson
- School of Nursing and Midwifery, The University of Technology Sydney, Ultimo, Australia
| | - Robbert Duvivier
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales , Australia
- Parnassia Psychiatric Institute, The Hague, The Netherlands
- Center for Education Development and Research in Health Professions (CEDAR), Faculty of Medical Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Brian Kelly
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales , Australia
| | - Conor Gilligan
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales , Australia
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia
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Somerville SG, Harrison NM, Lewis SA. Twelve tips for the pre-brief to promote psychological safety in simulation-based education. MEDICAL TEACHER 2023; 45:1349-1356. [PMID: 37210674 DOI: 10.1080/0142159x.2023.2214305] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
It is recognised that simulation-based education can be stressful, and this can impact negatively on learning. A fundamental aspect of facilitating simulation is creating a safe educational environment. Edmondson's seminal work on creating psychological safety among interpersonal teams has been embraced by the healthcare simulation community. Psychological safety is an underpinning philosophy for creating simulation experiences in which learners can develop within a stimulating and challenging yet supportive social atmosphere. Through careful design and thoughtful delivery, the introductory phase of simulation, the pre-briefing, can effectively prepare learners for simulation, reduce learner anxiety, and promote psychological safety, to enhance learning experiences. These twelve tips provide guidance for conducting a pre-brief and promoting a psychologically safe environment for simulation-based education.
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Affiliation(s)
| | - Neil Malcolm Harrison
- Clinical Skills Centre, Dundee Institute for Healthcare Simulation, School of Medicine, University of Dundee, Dundee, Scotland
| | - Steven Anthony Lewis
- Clinical Skills Centre, Dundee Institute for Healthcare Simulation, School of Medicine, University of Dundee, Dundee, Scotland
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Dewi SP, Wilson A, Duvivier R, Kelly B, Gilligan C. Perceptions of medical students and their facilitators on clinical communication skills teaching, learning, and assessment. Front Public Health 2023; 11:1168332. [PMID: 37435523 PMCID: PMC10332845 DOI: 10.3389/fpubh.2023.1168332] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/05/2023] [Indexed: 07/13/2023] Open
Abstract
Introduction Despite various efforts to develop communication skills (CS) in the classroom, the transfer of these skills into clinical practice is not guaranteed. This study aimed to identify barriers and facilitators of transferring CS from the classroom to clinical environments. Methods A qualitative study was conducted at one Australian medical school to explore the experiences and perceptions of facilitators and students in relation to teaching and learning clinical CS. Thematic analysis was used to analyze data. Results Twelve facilitators and sixteen medical students participated in semi-structured interviews and focus-group discussions, respectively. Primary themes included the value of teaching and learning, alignment between approaches to teaching and actual clinical practices and students' perceptions of practice, and challenges in different learning environments. Discussion This study reinforces the value of teaching and learning CS by facilitators and students. Classroom learning provides students with a structure to use in communicating with real patients, which can be modified to suit various situations. Students have limited opportunities, however, to be observed and receive feedback on their real-patient encounters. Classroom session that discussed CS experiences during clinical rotation is recommended to strengthen learning both the content and process of CS as well as transitioning to the clinical environment.
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Affiliation(s)
- Sari Puspa Dewi
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Amanda Wilson
- School of Nursing and Midwifery, The University of Technology Sydney, Sydney, NSW, Australia
| | - Robbert Duvivier
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Parnassia Psychiatric Institute, The Hague, Netherlands
- Centre for Education Development and Research in Health Professions (CEDAR), Faculty of Medical Sciences, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Brian Kelly
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Conor Gilligan
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
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Grau Canét-Wittkampf C, Diemers A, Van den Bogerd K, Schönrock-Adema J, Damoiseaux R, Zwart D, Jaarsma D, Mol S, Bombeke K, de Groot E. Learning patient-centredness with simulated/standardized patients: A realist review: BEME Guide No. 68. MEDICAL TEACHER 2023; 45:347-359. [PMID: 35917585 DOI: 10.1080/0142159x.2022.2093176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Given the positive outcomes of patient-centred care on health outcomes, future doctors should learn how to deliver patient-centred care. The literature describes a wide variety of educational interventions with standardized patients (SPs) that focus on learning patient-centredness. However, it is unclear which mechanisms are responsible for learning patient-centredness when applying educational interventions with SPs. OBJECTIVE This study aims to clarify how healthcare learners and professionals learn patient-centredness through interventions involving SPs in different healthcare educational contexts. METHODS A realist approach was used to focus on what works, for whom, in what circumstances, in what respect and why. Databases were searched through 2019. Nineteen papers were included for analysis. Through inductive and deductive coding, CIC'MO configurations were identified to build partial program theories. These CIC'MOs describe how Interventions with SPs change the Context (C→C') such that Mechanisms (M) are triggered that are expected to foster patient-centredness as Outcome. RESULTS Interventions with SPs create three contexts which are 'a safe learning environment,' 'reflective practice,' and 'enabling people to learn together.' These contexts trigger the following seven mechanisms: feeling confident, feeling a sense of comfort, feeling safe, self-reflection, awareness, comparing & contrasting perspectives, combining and broadening perspectives. A tentative final program theory with mechanisms belonging to three main learning components (cognitive, regulative metacognitive and affective) is proposed: Interventions with SPs create a safe learning environment (C') in which learners gain feelings of confidence, comfort and safety (affective M). This safe learning environment enables two other mutual related contexts in which learners learn together (C'), through comparing & contrasting, combining and broadening their perspectives (cognitive M) and in which reflective practice (C') facilitates self-reflection and awareness (metacognitive M) in order to learn patient-centeredness. CONCLUSION These insights offer educators ways to deliberately use interventions with SPs that trigger the described mechanisms for learning patient-centredness.
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Affiliation(s)
| | - Agnes Diemers
- Department of General Practice and Elderly Care, and Center for Education Development and Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Kristin Van den Bogerd
- Department of Primary and Interdisciplinary Care, Skills Lab, University of Antwerp, Antwerpen, België
| | - Johanna Schönrock-Adema
- Centre for Education Development and Research in Health Professions (CEDAR) and LEARN, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Roger Damoiseaux
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Dorien Zwart
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Debbie Jaarsma
- Center for Education Development and Research in Health Professions (CEDAR) and LEARN, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands and Faculty of Veterinary Medicine, Utrecht, The Netherlands
| | - Saskia Mol
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Katrien Bombeke
- Department of Primary and Interdisciplinary Care, Skills Lab, University of Antwerp, Antwerpen, België
| | - Esther de Groot
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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He Q, Li Y, Wu Z, Su J. Explicating the Cognitive Process of a Physician's Trust in Patients: A Moderated Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14446. [PMID: 36361323 PMCID: PMC9656963 DOI: 10.3390/ijerph192114446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/30/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
Trust is considered a critical factor in the physician-patient relationship. However, little is known about the development and impact of physicians trusting their patients. A model that is premised on the integrated model of organizational trust was proposed in this article to reveal the cognitive processes involved in physicians' trust, with perceived integrity and the ability of the patient as antecedents and the physicians' communication efficacy as the outcome. A cross-sectional survey of 348 physicians in Zhejiang province, China, revealed that a physician's trust in a patient mediated the relationship between the physicians' perception of the integrity and ability of the patient, and the physician's communication efficacy. The physicians' educational backgrounds and work experience were also found to moderate an indirect effect: a lower level of education and longer work experience intensified the impact of the perceived integrity and ability of the patient on the physician's trust, while shorter work experience made the association between the physician's trust and communication efficacy more salient. This paper provided implications for both physician and patient sides.
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Affiliation(s)
- Qijun He
- School of Journalism and Communication, Shanghai University, Shanghai 200072, China
| | - Yungeng Li
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Zhiyao Wu
- School of Journalism and Communication, Shanghai University, Shanghai 200072, China
| | - Jingjing Su
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Underman K, Kochunilathil M, McLean L, Vinson AH. Online student culture as site for negotiating assessment in medical education. Soc Sci Med 2022; 310:115270. [PMID: 36030626 DOI: 10.1016/j.socscimed.2022.115270] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 08/01/2022] [Accepted: 08/04/2022] [Indexed: 11/30/2022]
Abstract
Classic studies of medical education have examined how professional socialization reproduces the prevailing professional culture, as well as how students actively negotiate their place in educational processes. However, sociological research has not re-examined student culture in light of structural transformations in medical education, such as the introduction of new assessment types and their use as modes of commensuration. In this paper, we examine data from two studies of online forums where medical trainees and applicants to medical school discuss their experiences preparing for tests of professional skills, including judgment, empathy, and communication. Examining how medical students talk about these tests on such forums allows us to understand the meaning-making processes at work as students negotiate the commensuration processes such tests enable. We examine how these negotiations take place in online forums, where participants confront common challenges, form common perspectives, and share common solutions, all hallmarks of student culture. Through qualitative analysis, we find that online communities are spaces where students grapple with these new forms of commensuration, interrogate the standards and quantifications that underlie them, and collectively negotiate how to approach these assessments. Using the case of online forum communities, our findings advance past work on student culture in medical sociology by theorizing student culture as an extra-organizational phenomenon that spans multiple career stages. In so doing, we highlight the importance of online forum data for studying social processes.
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Affiliation(s)
| | | | - Lauren McLean
- Central Michigan University College of Medicine, USA
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Møller JE, Kjaer LB, Helledie E, Nielsen LF, Malling BV. Transfer of communication teaching skills from university to the clinical workplace - does it happen? A mixed methods study. BMC MEDICAL EDUCATION 2021; 21:433. [PMID: 34404388 PMCID: PMC8369612 DOI: 10.1186/s12909-021-02834-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/15/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND Communication skills learned in the classroom do not transfer easily into clinical practice because they are not reinforced by teachers in the workplace setting and because lack of faculty training restricts the transfer of communication skills in real patient encounters. Trained university-based communication skills teachers often work simultaneously as doctors in clinics. This study explored if and how the skills of these teachers play a role in communication skills training in the clinical workplace. METHODS We used an exploratory sequential design: a mixed method approach that combined a survey with communication skills teachers, and qualitative individual interviews with these teachers and their educational leaders in clinical departments. The questionnaire was analysed using descriptive statistics. The interviews were analysed using content analysis. RESULTS The response rate was 34 %. A majority (93 %) used their communication skills when communicating with patients and relatives. Less than half taught communication in clinical departments. Approximately half of the respondents stated that encouragement from their leaders or colleagues would inspire them to use their teaching skills in the workplace. However, only 20 % had told their leaders about their competencies in teaching communication. One third thought that they needed further teacher training to teach in the clinical workplace. Qualitative analysis showed that teaching opportunities existed but mainly consisted of random, one-off sessions that came about through the initiative of the communication skills teachers themselves. The teachers described several barriers, such as the challenge of teaching colleagues, as communication relates to identity and hierarchical structures, as well as a lack of requests from colleagues or management, and department culture prioritizing topics relating to medical expertise. None of the educational leaders made use of the teachers' specific communication skills in a structured way: some saw it as unimportant, while others saw it as a potential resource. CONCLUSION Transfer of the teaching skills of communication skills teachers trained for university-based clinical communication training happened, but to a limited degree. Although both opportunities and barriers for transferring communication skills existed, barriers seemed to dominate, and opportunities for communication skills training in the workplace setting were not used to their full potential.
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Affiliation(s)
- Jane Ege Møller
- Department of Clinical Medicine, Aarhus University, INCUBA Skejby, Palle Juul- Jensens Boulevard 82, 8200 Aarhus N, Denmark
| | - Louise Binow Kjaer
- Centre for Health Sciences Education, Aarhus University, INCUBA Skejby, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark
| | - Emma Helledie
- Palliative Care Unit, Department of Oncology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Lone Folmer Nielsen
- Department of Clinical Medicine, Aarhus University, INCUBA Skejby, Palle Juul- Jensens Boulevard 82, 8200 Aarhus N, Denmark
| | - Bente Vigh Malling
- Department of Clinical Medicine, Aarhus University, INCUBA Skejby, Palle Juul- Jensens Boulevard 82, 8200 Aarhus N, Denmark
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Jacklin S, Maskrey N, Chapman S. Shared Decision-Making With a Virtual Patient in Medical Education: Mixed Methods Evaluation Study. JMIR MEDICAL EDUCATION 2021; 7:e22745. [PMID: 34110299 PMCID: PMC8235293 DOI: 10.2196/22745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 02/11/2021] [Accepted: 04/17/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Shared decision-making (SDM) is a process in which clinicians and patients work together to select tests, treatments, management, or support packages based on clinical evidence and the patient's informed preferences. Similar to any skill, SDM requires practice to improve. Virtual patients (VPs) are simulations that allow one to practice a variety of clinical skills, including communication. VPs can be used to help professionals and students practice communication skills required to engage in SDM; however, this specific focus has not received much attention within the literature. A multiple-choice VP was developed to allow students the opportunity to practice SDM. To interact with the VP, users chose what they wanted to say to the VP by choosing from multiple predefined options, rather than typing in what they wanted to say. OBJECTIVE This study aims to evaluate a VP workshop for medical students aimed at developing the communication skills required for SDM. METHODS Preintervention and postintervention questionnaires were administered, followed by semistructured interviews. The questionnaires provided cohort-level data on the participants' views of the VP and helped to inform the interview guide; the interviews were used to explore some of the data from the questionnaire in more depth, including the participants' experience of using the VP. RESULTS The interviews and questionnaires suggested that the VP was enjoyable and easy to use. When the participants were asked to rank their priorities in both pre- and post-VP consultations, there was a change in the rank position of respecting patient choices, with the median rank changing from second to first. Owing to the small sample size, this was not analyzed for statistical significance. The VP allowed the participants to explore a consultation in a way that they could not with simulated or real patients, which may be part of the reason that the VP was suggested as a useful intervention for bridging from the early, theory-focused years of the curriculum to the more patient-focused ones later. CONCLUSIONS The VP was well accepted by the participants. The multiple-choice system of interaction was reported to be both useful and restrictive. Future work should look at further developing the mode of interaction and explore whether the VP results in any changes in observed behavior or practice.
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Affiliation(s)
- Simon Jacklin
- School of Pharmacy and Bioengineering, Keele University, Keele, United Kingdom
| | - Neal Maskrey
- School of Pharmacy and Bioengineering, Keele University, Keele, United Kingdom
| | - Stephen Chapman
- School of Pharmacy and Bioengineering, Keele University, Keele, United Kingdom
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Nedungadi A, Ming C, Woodward F, Lasoye T, Birns J. Supporting the transition to becoming a medical registrar. Future Healthc J 2021; 8:e160-e163. [PMID: 33791499 DOI: 10.7861/fhj.2020-0177] [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: 11/27/2022]
Abstract
Introduction Physician training is seeing increasing numbers of doctors adopting the role of medical registrar. Non-clinical as well as clinical responsibilities are a source of great anxiety prior to trainees assuming this role. Methods A standardised, blended, 1-day course to address the needs of doctors transitioning to become a medical registrar was designed and delivered across four hospitals. A mixed methods evaluation approach was employed to assess the effect of the course. Results Thirty-four trainees approaching the transition to becoming a medical registrar participated. Quantitative and qualitative analysis of participants' written feedback showed a significant pre- to post-course increase in candidates' self-reported confidence in undertaking the medical registrar role along with learning in non-technical skills. Discussion This course was shown to be effective in helping to improve the confidence of trainees approaching the medical registrar role. The carefully designed standardised format may facilitate wider expansion of such training.
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Affiliation(s)
| | | | | | - Tunji Lasoye
- consultant and honorary senior lecturer in emergency medicine, King's College Hospital, London, UK
| | - Jonathan Birns
- geriatrics and general medicine, Guy's and St Thomas' NHS Foundation Trust, and deputy head, London School of Medicine for Health Education England, London, UK
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Hallewell R, Bryant C, Deaner A, Ruggles R, Birns J. Training educational supervisors to support physician trainees returning to practice. Future Healthc J 2020; 7:120-124. [PMID: 32550279 DOI: 10.7861/fhj.2019-0043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Physicians take time out of training for a variety of reasons and, on their return, they often lack confidence and feel 'out of touch'. These trainees require enhanced support and concerns have been raised about trainers' lack of skills and knowledge in this area. A standardised workshop was developed and delivered to address this with a mixed-methods evaluation approach used to analyse data from participants before and after training. Quantitative analysis showed significant pre- to post-course improvements in trainers' ability to understand, explain and manage issues pertaining to trainees taking time out of training. Qualitative analysis yielded three 'learning' themes surrounding knowledge, understanding and awareness of support needed for returning trainees and three 'action' themes surrounding disseminating information, providing resources and actively supporting returning trainees. Framework analysis of follow-up interviews demonstrated not only retention of topics learned but also positive changes in behaviour.
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Affiliation(s)
| | | | | | | | - Jonathan Birns
- Health Education England, London, UK and consultant in stroke medicine, geriatrics and general medicine, St Thomas' Hospital, London, UK
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Birns J, Mullender C, Balch I, Bryant C, Deaner A. Evaluation of training programmes mapped to the new internal medicine curriculum. Future Healthc J 2020; 7:116-119. [PMID: 32550278 DOI: 10.7861/fhj.2019-0060] [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: 11/27/2022]
Abstract
In preparation for the internal medicine training (IMT) programme introduced in 2019, the core medical training (CMT) programme in London was made 'IMT-ready' in 2018 by creating new rotations that reflected the compulsory requirements of the first 2 years of the IMT curriculum, including provision of the requisite number of critical care placements. Core medical trainees completed posts within the 'IMT-ready' programme between August 2018 and August 2019, during which time the trainee experience was evaluated. A total of 497 responses were received. Of these, 96% of trainees were on an 'acute unselected take' on-call rota, 79% were able to attend outpatient clinics, 80% had the opportunity to practise procedural skills and 88% had the opportunity to apply palliative care skills. Clear areas for improvement were identified that predominantly focused on the need to optimise trainee attendance of outpatient clinics and the number of patients seen during an acute take. With respect to future career intentions, only 63% of trainees planned on applying to a group 1 (with general medicine) higher medical specialty. Thematic analysis of trainees in critical care placements highlighted an appreciation of the level of senior support, feeling well integrated into the team, a positive experience of induction and excellent opportunities for performing procedures.
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Affiliation(s)
- Jonathan Birns
- Health Education England, London, UK and consultant in stroke medicine, geriatrics and general medicine, St Thomas' Hospital, London, UK
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Ntlokonkulu ZB, Rala NM, Goon DT. An Exploration of Student Midwives’ Lived Experiences Regarding Confidence and Satisfaction in Medium-Fidelity Simulation. Open Nurs J 2018. [DOI: 10.2174/1874434601812010272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Newly qualified midwives are expected to exhibit some level of confidence in practice when they enter the clinical environment.
Objective
To explore the lived experiences of student midwives after exposure to medium-fidelity simulation concerning confidence and satisfaction.
Methods
This qualitative, interpretive, phenomenological analysis study was conducted on a purposive sample of five, fourth-year Baccalaureate of Nursing Science student midwives at the University of Fort Hare. In-depth semi-structured interviews were conducted. Data analysis applied the interpretative phenomenological analysis approach.
Results
Superordinate theme sense of fulfilment elicited six sub-ordinate themes namely 1) Transferability of skills 2) Knowledgeable 3) Equipment used during simulation 4) Realism of simulation 4) Sense of accomplishment 5) Sure/unsure of performance. The use of a standardised patient during the simulation instead of a mannequin prepared participants for the real clinical environment. After being involved in the simulation, participants became more inquisitive regarding the management of the simulated condition. Satisfaction with simulation depended on whether the simulation activity met the student’s expectations, and if the simulation equipment resembled real clinical equipment. Post-partum haemorrhage simulation bridged the gap between theory and practice.
Conclusion
Confidence and satisfaction of student midwives during simulation is depended on the realism of the simulated activity. Exposure to simulated activity increases student knowledge. The student acknowledged that simulation can bridge the gap between theory and practice.
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Berney A, Carrard V, Schmid Mast M, Bonvin R, Stiefel F, Bourquin C. Individual training at the undergraduate level to promote competence in breaking bad news in oncology. Psychooncology 2017; 26:2232-2237. [DOI: 10.1002/pon.4452] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 04/28/2017] [Accepted: 04/29/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Alexandre Berney
- Psychiatric Liaison Service; Lausanne University Hospital; Lausanne Switzerland
| | - Valérie Carrard
- Faculty of Business and Economics; Lausanne University; Lausanne Switzerland
| | | | - Raphael Bonvin
- Medical Education Unit, Faculty of Biology and Medicine; Lausanne University; Lausanne Switzerland
| | - Friedrich Stiefel
- Psychiatric Liaison Service; Lausanne University Hospital; Lausanne Switzerland
| | - Céline Bourquin
- Psychiatric Liaison Service; Lausanne University Hospital; Lausanne Switzerland
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Cox CD, Cheon J, Crooks SM, Lee J, Curtis JD. Use of Entertainment Elements in an Online Video Mini-Series to Train Pharmacy Preceptors. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2017; 81:12. [PMID: 28289302 PMCID: PMC5339579 DOI: 10.5688/ajpe81112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 06/13/2016] [Indexed: 05/24/2023]
Abstract
Objective. To create an entertaining approach to training pharmacy preceptors. Design. A training program was developed to provide an innovative, entertaining, and flexible continuing education program for pharmacy preceptors. Three instructional design principles - providing an authentic context, offering a diversity of content, and engaging and maintaining attention - were foundational to this concept. The mini-series consisted of 12 online video episodes. Participants completed three reflective questions and one evaluation after watching each episode. Three months following completion of the training, a survey was distributed to analyze the long-term impact of the mini-series on precepting skills. Assessment. Two hundred two participants completed all 12 episodes. After completing the training series, the participants' confidence level in their knowledge pertaining to the objectives was significantly greater than before they started. Among the 32% of participants who responded to the three-month follow-up survey, the mean score for precepting confidence was 6.8 on a scale of 1 to 10 on which 1=no increase to 10=big increase. Also, 99% of participants indicated they would complete a similar training program and recommend to others. Conclusions. Feedback from the mini-series provides evidence of the effectiveness of its delivery format and use as a preceptor learning tool.
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Affiliation(s)
- Craig D. Cox
- Texas Tech University Health Sciences Center School of Pharmacy, Lubbock, Texas
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Contextual Influences on Feedback Practices: An Ecological Perspective. THE ENABLING POWER OF ASSESSMENT 2017. [DOI: 10.1007/978-981-10-3045-1_9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Dalgaty F, Guthrie G, Walker H, Stirling K. The value of mentorship in medical education. CLINICAL TEACHER 2016; 14:124-128. [DOI: 10.1111/tct.12510] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cushing AM. Learning patient-centred communication: The journey and the territory. PATIENT EDUCATION AND COUNSELING 2015; 98:1236-42. [PMID: 26297198 DOI: 10.1016/j.pec.2015.07.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 07/21/2015] [Accepted: 07/22/2015] [Indexed: 05/25/2023]
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Bittner A, Jonietz A, Bittner J, Beickert L, Harendza S. Translating medical documents into plain language enhances communication skills in medical students--A pilot study. PATIENT EDUCATION AND COUNSELING 2015; 98:1137-41. [PMID: 26095344 DOI: 10.1016/j.pec.2015.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 05/26/2015] [Accepted: 05/30/2015] [Indexed: 05/16/2023]
Abstract
OBJECTIVE To train and assess undergraduate medical students' written communication skills by exercises in translating medical reports into plain language for real patients. METHODS 27 medical students participated in a newly developed communication course. They attended a 3-h seminar including a briefing on patient-centered communication and an introduction to working with the internet platform http://washabich.de. In the following ten weeks, participants "translated" one medical report every fortnight on this platform receiving feedback by a near-peer supervisor. A pre- and post-course assignment consisted of a self-assessment questionnaire on communication skills, analysis of a medical text with respect to medical jargon, and the translation of a medical report into plain language. RESULTS In the self-assessment, students rated themselves in most aspects of patient-centered communication significantly higher after attending the course. After the course they marked significantly more medical jargon terms correctly than before (p<0.001). In a written plain language translation of a medical report they scored significantly higher with respect to communicative aspects (p<0.05) and medical correctness (p<0.001). CONCLUSION Translating medical reports into plain language under near-peer supervision is associated with improved communication skills and medical knowledge in undergraduate medical students. PRACTICE IMPLICATIONS To include translation exercises in the undergraduate medical curriculum.
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Affiliation(s)
| | | | | | | | - Sigrid Harendza
- III Medical Clinic, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
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Braude P, Reedy G, Dasgupta D, Dimmock V, Jaye P, Birns J. Evaluation of a simulation training programme for geriatric medicine. Age Ageing 2015; 44:677-82. [PMID: 25953500 DOI: 10.1093/ageing/afv049] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 01/14/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND geriatrics encompasses diverse medical, social and ethical challenges requiring a multidimensional, interdisciplinary approach. Recent reports have highlighted failings in the care of older people. It is therefore vital that trainees in geriatrics are afforded opportunities to develop skills in managing this complex population. Simulation has been adopted as a teaching tool in medicine; however, evidence for its use in geriatrics has been limited to small, single-site studies primarily involving role-play or discrete clinical skills training. METHODS a standardised, two centre, multimodal, interprofessional, geriatrics simulation training programme was developed using curriculum-mapped scenarios in which the patient perspective was central. Simulation techniques used included high-fidelity patient manikins, actors with integrated clinical skills using part-task trainers and role-play exercises. A mixed-methods evaluation was used to analyse data from participants before and after training. RESULTS eighty-nine candidates attended 12 similar courses over 2 years. Thematic analysis of candidate feedback was supportive of simulation as a useful tool, with benefits for both technical and non-technical skills. Candidates commented that simulation was a valuable training modality addressing curriculum areas rarely taught formally including continence assessment, end-of-life decisions and multidisciplinary situations. Quantitative analysis of pre- and post-course questionnaires revealed a significant improvement of self-reported confidence in managing geriatric scenarios (mean improvement 11.5%; P < 0.001). DISCUSSION this study demonstrated the feasibility of a standardised simulation training programme across two sites in geriatrics. Simulation training affords situational learning without compromising patient safety and is an exciting and novel method of delivering teaching for geriatrics that could be integrated into national training curricula.
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Affiliation(s)
- Philip Braude
- Department of Ageing and Health, Guy's and St Thomas' Hospital, Westminster Bridge Road, London, UK
| | - Gabriel Reedy
- Simulation and Interactive Learning Centre, Guy's and St Thomas' Hospital, London, UK
| | - Deblina Dasgupta
- Department of Elderly Care Medicine, Homerton University Hospital, London, UK
| | - Valerie Dimmock
- Homerton Simulation Centre, Homerton University Hospital, London, UK
| | - Peter Jaye
- Simulation and Interactive Learning Centre, Guy's and St Thomas' Hospital, London, UK
| | - Jonathan Birns
- Department of Ageing and Health, Guy's and St Thomas' Hospital, Westminster Bridge Road, London, UK
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Lefroy J, Yardley S. Embracing complexity theory can clarify best practice frameworks for simulation education. MEDICAL EDUCATION 2015; 49:344-6. [PMID: 25800289 DOI: 10.1111/medu.12662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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Wass V. Medical ethics and law: a practical guide to the assessment of the core content of learning. JOURNAL OF MEDICAL ETHICS 2014; 40:721-722. [PMID: 24861041 DOI: 10.1136/medethics-2013-101330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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