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Huon JF, Nizet P, Tollec S, Vene E, Fronteau C, Leichnam A, Tching-Sin M, Michelet-Barbotin V, Foucault-Fruchard L, Nativel F. A systematic review of the impact of simulation on students' confidence in performing clinical pharmacy activities. Int J Clin Pharm 2024; 46:795-810. [PMID: 38632204 DOI: 10.1007/s11096-024-01715-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/13/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Although confidence does not automatically imply competence, it does provide pharmacy students with a sense of empowerment to manage a pharmacotherapeutic problem independently. Among the methods used in higher education, there is growing interest in simulation. AIM To evaluate the impact of simulation on pharmacy students' confidence in performing clinical pharmacy activities. METHOD Articles that reported the use of simulation among pharmacy students with fully described outcomes about confidence were included. Studies for which it was impossible to extract data specific to pharmacy students or simulation were excluded. The search was carried out in Medline, Embase, Lissa and PsycInfo from inception to August the 31th, 2022. The results were synthesized into 4 parts: confidence in collecting information, being an expert in a procedure/pathology, counselling and communicating, and other results. The quality assessment of included studies was conducted using the Mixed Methods Appraisal Tool "MMAT" tool. RESULTS Among the 39 included articles, the majority were published in the last 5 years and conducted in the United States. The majority included pharmacy students in years 1 through 3 (69.2%). The most common study design was the pre-post uncontrolled design (66.7%). Studies measuring the effects of human and/or virtual simulation were mainly focused on confidence to counsel and/or communicate with patients and colleagues (n = 20). Evaluations of the effects of these types of simulation on confidence in information gathering by health professionals were also well represented (n = 16). CONCLUSION Simulation-based training generally yielded positive impact on improving pharmacy students' confidence in performing clinical pharmacy activities. Rigorous assessment methods and validated confidence questionnaires should be developed for future studies.
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Affiliation(s)
- Jean-François Huon
- Nantes Université, CHU Nantes, Pharmacie, 5 allée de l'île Gloriette, 44000, Nantes, France.
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France.
| | - Pierre Nizet
- Nantes Université, CHU Nantes, Pharmacie, 5 allée de l'île Gloriette, 44000, Nantes, France
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
| | - Sophie Tollec
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
- CHU Orléans, Orléans, France
| | - Elise Vene
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
- CHU Rennes, Rennes, France
| | - Clémentine Fronteau
- Nantes Université, CHU Nantes, Pharmacie, 5 allée de l'île Gloriette, 44000, Nantes, France
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
| | - Alison Leichnam
- Nantes Université, CHU Nantes, Pharmacie, 5 allée de l'île Gloriette, 44000, Nantes, France
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
| | - Martine Tching-Sin
- Nantes Université, CHU Nantes, Pharmacie, 5 allée de l'île Gloriette, 44000, Nantes, France
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
| | - Vanessa Michelet-Barbotin
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
- CHU Rennes, Rennes, France
| | - Laura Foucault-Fruchard
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
- CHU Tours, Service Pharmacie, Tours, France
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Fabien Nativel
- Nantes Université, Oniris, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, 44000, Nantes, France
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Álvarez-Montero S, Crespí P, Gómez-Salgado J, Ramírez-Durán MV, Rodríguez-Gabriel MDP, Coronado-Vázquez V. Assessment of a medical student mentoring programme to improve attitudes related to grief and coping with death. Heliyon 2023; 9:e20959. [PMID: 37916093 PMCID: PMC10616318 DOI: 10.1016/j.heliyon.2023.e20959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/28/2023] [Accepted: 10/12/2023] [Indexed: 11/03/2023] Open
Abstract
Objectives To evaluate the impact of a mentoring programme for medical students doing a palliative care rotation, aimed at improving coping with death and attitudes towards the suffering produced by illness. Methods A quasi-experimental study without a control group was carried out on second-year medical students. Five 1-h group sessions were conducted. Attitudes towards grief and coping with death were assessed before the mentoring programme began and afterwards, using the Brief Humanizar Scale and the Bugen's Coping with Death Scale, respectively. Results In terms of the sense of grieving as measured by the Brief Humanizar Scale, the mean score for the 'Burden' factor was 7 points and for the 'Change' factor it was 28.6, indicating that suffering makes more sense as a lever for positive change than as a burden. Regarding Bugen's Coping with Death Scale, the mean score was 127.8 points before the mentoring programme and 139.2 afterwards. Hence, the score after the mentoring programme increased by 11.4 points, improving strategies to cope with death. Conclusion Medical professionals must cope with death and end-of-life patients. In addition to scientific knowledge, students need to acquire competencies for better coping with the death of patients, with mentoring programmes helping to enhance this process of learning.
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Affiliation(s)
| | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health. Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Program. Universidad Espíritu Santo, Guayaquil, Ecuador
| | | | | | - Valle Coronado-Vázquez
- Universidad Francisco de Vitoria, Madrid, Spain
- B21-20R Group, Instituto Aragonés de Investigaciones Sanitarias, University of Zaragoza, Zaragoza, Spain
- Las Cortes Health Centre, Madrid Health Service, Madrid, Spain
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Turi ER, McMenamin A, Wolk CB, Poghosyan L. Primary care provider confidence in addressing opioid use disorder: A concept analysis. Res Nurs Health 2023; 46:263-273. [PMID: 36611290 PMCID: PMC10033432 DOI: 10.1002/nur.22294] [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: 09/29/2022] [Revised: 12/08/2022] [Accepted: 12/14/2022] [Indexed: 01/09/2023]
Abstract
Primary care providers (PCPs) are well-positioned to provide care for opioid use disorder (OUD), yet very few address OUD regularly. One contributing factor may be PCPs' lack of confidence in their ability to effectively treat OUD. Evidence demonstrates that clinician confidence in home care and hospital settings is associated with improved care delivery and patient outcomes. However, a conceptual definition of PCP confidence in addressing OUD has yet to be established. The aim of this concept analysis is to enhance conceptual understanding of PCP confidence in addressing OUD and inform future measurement strategies. Following Walker and Avant's method of concept analysis, PubMed, PsycINFO, and Google Scholar were searched in October 2021. Manuscripts were included if they referenced confidence in relation to PCPs who provide care to adult patients with OUD. Studies conducted outside the US and not published in English were excluded. The search resulted in 18 studies which were synthesized to conceptualize PCP confidence in addressing OUD. Defining attributes include self-efficacy, experience, and readiness to address OUD. These attributes may be influenced by organizational culture, training, support, and resources. Consequences of PCP confidence addressing OUD may include improved patient outcomes, improved delivery of and access to OUD care, and PCP attitude changes. This concept analysis-which grounds the concept of PCP confidence in addressing OUD in the theoretical and empirical literature-lays the framework for future measurement of the concept. This represents a critical first step towards developing strategies to enhance PCP confidence in addressing OUD.
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Affiliation(s)
- Eleanor R Turi
- Columbia University School of Nursing, New York, New York, USA
| | - Amy McMenamin
- Columbia University School of Nursing, New York, New York, USA
| | | | - Lusine Poghosyan
- Columbia University School of Nursing, New York, New York, USA
- Columbia University Mailman School of Public Health, New York, New York, USA
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Molinengo G, Loera B, Miniotti M, Leombruni P. Shortening the Frommelt Attitude Toward the Care Of the Dying Scale (FATCOD-B): a Brief 9-Item Version for Medical Education and Practice. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1736-1742. [PMID: 34046819 PMCID: PMC9681677 DOI: 10.1007/s13187-021-02020-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/25/2021] [Indexed: 06/12/2023]
Abstract
End-of-life care training has gaps in helping students to develop attitudes toward caring for the dying. Valid and reliable assessment tools are essential in building effective educational programmes. The Frommelt Attitude Toward the Care Of the Dying scale (FATCOD-B) is widely used to measure the level of comfort/discomfort in caring for the dying and to test the effectiveness of end-of-life care training. However, its psychometric properties have been questioned and different proposals for refinement and shortening have been put forward. The aim of this study is to get to a definitive reduction of the FATCOD-B through a valid and parsimonious synthesis of the previous attempts at scale revision. Data were gathered from a sample of 220 medical students. The item response theory approach was used in this study. Of the 14 items selected from two previous proposals for scale revision, 3 had a weak correlation with the whole scale and were deleted. The resulting 11-item version had good fit indices and withstood a more general and parsimonious specification (rating scale model). This solution was further shortened to 9 items by deleting 2 of 3 items at the same level of difficulty. The final 9-item version was invariant for gender, level of religiosity and amount of experience with dying persons, free from redundant items and able to scale and discriminate the respondents.
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Affiliation(s)
| | - Barbara Loera
- Department of Psychology, University of Turin, Turin, Italy
| | - Marco Miniotti
- 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy.
- Clinical Psychology Unit, AOU 'Città Della Salute e della Scienza', Turin, Italy.
| | - Paolo Leombruni
- 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy
- Clinical Psychology Unit, AOU 'Città Della Salute e della Scienza', Turin, Italy
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Wells G, Llewellyn C, Hiersche A, Minton O, Barclay D, Wright J. Care of the dying - medical student confidence and preparedness: mixed-methods simulation study. BMJ Support Palliat Care 2022:bmjspcare-2022-003698. [PMID: 35850959 DOI: 10.1136/spcare-2022-003698] [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: 04/08/2022] [Accepted: 06/24/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Of all doctors, Foundation Year 1 trainees spend the most time caring for dying patients yet report poor preparation and low confidence in providing this care. Despite documented effectiveness of simulation in teaching end-of-life care to undergraduate nurses, undergraduate medicine continues to teach this subject using a more theoretical, classroom-based approach. By increasing undergraduate exposure to interactive dying patient scenarios, simulation has the potential to improve confidence and preparedness of medical students to care for dying patients. The main study objective was to explore whether simulated experience of caring for a dying patient and their family can improve the confidence and preparedness of medical students to provide such care. METHODS A mixed-methods interventional study simulating the care of a dying patient was undertaken with serial measures of confidence using the Self Efficacy in Palliative Care (SEPC) tool. Significance testing of SEPC scores was undertaken using paired t-tests and analysis of variance. Post-simulation focus groups gathered qualitative data on student preparedness. Data were transcribed using NVivo software and interpreted using Thematic Analysis. RESULTS Thirty-eight 4th-year students participated. A statistically significant post-simulation increase in confidence was seen for all SEPC domains, with sustained confidence observed at 6 months. Focus group data identified six major themes: current preparedness, simulated learning environment, learning complex skills, patient centredness, future preparation and curriculum change. CONCLUSION Using simulation to teach medical students how to care for a dying patient and their family increases student confidence and preparedness to provide such care.
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Affiliation(s)
- Geoffrey Wells
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Carrie Llewellyn
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Andreas Hiersche
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Ollie Minton
- Sussex Cancer Centre, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | | | - Juliet Wright
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, UK
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