Assessing the training needs of medical students in patient information gathering

Challenges and solutions in developing an objective and structured clinical examination for complementary and integrative medicine: A mixed-method approach

This study explores the challenges encountered by developers when creating objective and structured clinical examination (OSCE) modules specifically for Korean medicine (KM). The complexity of developing pattern identification (PI) items, due to the lack of standardized materials and ambiguity in KM, was a primary focus. A mixed-method approach was utilized, including a survey, importance-performance analysis, and focus group interviews. Seven developers participated, creating a total of 21 OSCE modules. The main difficulties identified were in developing PI items, selecting appropriate cases, crafting realistic examination situations, determining scoring criteria, setting up checklists, and writing scenarios. Challenges were categorized into "case," "examination situation," "postexamination notes," "checklist," "scenario," "format," and "PI." The importance-performance analysis revealed improvements in module development capabilities with each iteration. For the future development of efficient OSCE modules, standardization of KM diagnostic methods and PI is essential. The study highlights the need for social and academic efforts, as well as support from the KM education community and schools, to address these challenges and enhance the development process.

The role of mentoring, supervision, coaching, teaching and instruction on professional identity formation: a systematic scoping review

BACKGROUND

Mentoring's pivotal role in nurturing professional identity formation (PIF) owes much to its combined use with supervision, coaching, tutoring, instruction, and teaching. However the effects of this combination called the 'mentoring umbrella' remains poorly understood. This systematic scoping review thus aims to map current understanding.

METHODS

A Systematic Evidence-Based Approach guided systematic scoping review seeks to map current understanding of the 'mentoring umbrella' and its effects on PIF on medical students and physicians in training. It is hoped that insights provided will guide structuring, support and oversight of the 'mentoring umbrella' in nurturing PIF. Articles published between 2000 and 2021 in PubMed, Scopus, ERIC and the Cochrane databases were scrutinised. The included articles were concurrently summarised and tabulated and concurrently analysed using content and thematic analysis and tabulated. The themes and categories identified were compared with the summaries of the included articles to create accountable and reproducible domains that guide the discussion.

RESULTS

A total of 12201 abstracts were reviewed, 657 full text articles evaluated, and 207 articles included. The three domains identified were definitions; impact on PIF; and enablers and barriers. The mentoring umbrella shapes PIF in 3 stages and builds a cognitive base of essential knowledge, skills and professional attitudes. The cognitive base informs thinking, conduct and opinions in early supervised clinical exposure in Communities of practice (COP). The COPs' individualised approach to the inculcation of desired professional characteristics, goals, values, principles and beliefs reshapes the individual's identity whilst the socialisation process sees to their integration into current identities.

CONCLUSION

The mentoring umbrella's provides personalised longitudinal support in the COP and socialisation process. Understanding it is key to addressing difficulties faced and ensuring holistic and timely support.

Developing communication curricula in healthcare education: An evidence-based guide

OBJECTIVE

To present a guide for communication curriculum development in healthcare professions for educators and curriculum planners.

METHODS

We collated a selection of theories, frameworks and approaches to communication curriculum development to provide a roadmap of the main factors to consider when developing or enhancing communication skills curricula.

RESULTS

We present an evidence-based guide for developing and enhancing communication curriculum that can be applied to undergraduate and postgraduate healthcare education. Recommended steps to consider during the communication curricula development process include thoughtful examination of current communication education, needs assessment, focused learning goals and objectives, incorporation of experiential educational strategies allowing for skills practice and feedback and use of formative and summative assessment methods. A longitudinal, developmental and helical implementation approach contributes to reinforcement and sustainment of learners' knowledge and skills.

CONCLUSION AND PRACTICE IMPLICATIONS

Drawing on best practices in developing communication curricula can be helpful in ensuring successful approaches to communication skills training for any level of learner or healthcare profession. This position paper provides a guide and identifies resources for new and established communication curriculum developers to reflect on strengths and opportunities in their own approaches to addressing the communication education needs of their learners.

"We're All Time Poor": Experienced Clinicians' and Students' Perceptions of Challenges Related to Patient Communication

PHENOMENON

Communication is a complex and essential element of clinical practice. It is widely accepted that communication skills can be taught and learned, but challenges remain for clinicians in achieving effective communication with patients. This study explored the patient-communication challenges faced by both medical students and experienced clinicians.

APPROACH

Semi-structured interviews were conducted with twenty medical students and nineteen experienced clinicians from a range of medical disciplines. Interviews were recorded and transcribed, and transcriptions subjected to thematic analysis and coding to quantify the challenges discussed.

FINDINGS

There was remarkable consistency in the challenges described by both groups of participants, with eight predominant challenges identified: time constraints and chaotic environments, rapport building, patient characteristics, reluctance, omissions, assumptions, decision-making, and keeping conversations focused.

INSIGHTS

Medical curricula often focus on communication challenges associated with complex or sensitive clinical situations, but many of the challenges identified occur in routine consultations. Both pre-service and post-graduate medical training should adopt strategies to help build students' and clinicians' skills in managing these challenges from the outset of training.

Deepening the teaching and learning of clinical communication

Aims: clinical communication (CC) relates to health professionals’ interaction with patients/families. CC is fundamental for the physicians’ role. This paper aims to contribute to the discussion about reflection and feedback for meaningful teaching and learning of CC.Methods: the authors provided a short review and conceptual discussion of the history and nature of CC teaching, followed by exploring the role of reflection and feedback in teaching CC.Results: communicating well can be challenging as it requires medical students and professionals to adapt their communication to each patient/family while obtaining all the needed information, conveying trustworthiness, care, and compassion. The teaching of CC to medical students involves deepening the doctor-patient relationship’s technical, relational, and emotional elements. CC requires teaching that is flexible and tailored to the participants’ needs. Therefore, teaching CC must go beyond asking the appropriate question or applying specific checklist-based behaviours. In teaching CC, it is crucial to give medical students support to discuss personal and institutional barriers and attitudes and explore how to transfer their learning to clinical practice. To that end, reflection should be encouraged to allow students to express difficulties and feelings and enhance their understanding of themselves and others. Within this process, feedback is essential to moving beyond skill-based teaching to reflection-based learning.Conclusion: the move from skills-based learning requires using reflective processes and feedback to allow students to learn about their communication tendencies and needs to become more flexible and attuned to different patient’s needs in clinical encounters.

Effectiveness of simulated patients in geriatric education: A scoping review

BACKGROUND

Global healthcare systems are adapting to meet the demands of an aging population. It is essential to prepare our healthcare workers on complex and unique issues in the treatment of older adults. Past studies have shown that simulated patients are a valuable teaching tool in training current and prospective healthcare professionals. Few studies have examined its use in the geriatric context.

OBJECTIVES

This scoping review presents the effectiveness of simulated patients in healthcare education for geriatric care and eldercare purposes among current and prospective healthcare professionals.

DATA SOURCES

Search on CINAHL, Cochrane, ScienceDirect and Medline were completed on studies published between January 2009 to January 2020. A manual hand searching of reference lists for relevant articles was also conducted.

REVIEW METHODS

This scoping review follows the methods of Arksey and O-Malley to synthesize the literature on simulated patients in the teaching of geriatric care to current and prospective healthcare professionals. Inclusion criteria were, primary studies, with full-text articles, and in English.

RESULTS

Fifteen articles were included in this review. These articles were of wide variation by study design, settings, populations. Four broad themes were identified from existing literature: (i) improvement in geriatric knowledge, (ii) improvement in technical and non-technical skills, (iii) greater confidence in clinical and non-clinical skills, and (iv) learners' perception towards simulation as a learning pedagogy.

CONCLUSION

Simulated patients may have potential in improving geriatric education. Students generally enjoyed the learning methodology, finding it engaging and easy to learn by practising. Future studies could consider engaging simulated patients in the teaching pedagogy of geriatric teaching for current or prospective healthcare professionals.

Which teaching method is more effective in a communication course - role-playing versus simulated patients, taught by tutors or faculty staff? A randomized trial

Aim: Communicative skills can be taught and trained as part of medical training. In these courses, lecturers or tutors serve as instructors, and students perform interviews with simulated patients (SP) or role-play (RP) with fellow students. The present study was conducted to identify the combination of applied teaching methods that is most effective. Method: n=144 third-year (5th semester) medical students attended a medical history-taking course that consisted of three separate sessions (90 minutes each). Students were randomized into three groups. Groups 1 and 2 received training with SP in sessions one and two, followed by RP training in session three; (teaching by lecturer = SP-Lecturer group vs. teaching by tutor = SP-Tutor group). Group 3 received two sessions of RP training and a SP-based training in session three (teaching by tutor = RP-Tutor group). After completing the course, students had to rate their learning success using a short questionnaire, pass an SP-OSCE station and were supposed to answer exam questions. Results: The OSCE performance of both the SP-Lecturer group (n=28) and the RP-Tutor group (n=44) was significantly better than that of the SP-Tutor group (n=26; p=.018 and p=.041, respectively). All groups reported an increase in self-rated history-taking skills (p<.001). There was no difference between groups in the results achieved on the final exam. Conclusions: Students receiving SP-based teaching benefit more from a lecturer-taught course, while students instructed by tutors benefit more from RP-based teaching. The significant learning progress highlights the great advantage of taking the course as part of medical studies. Further research should aim to determine at which time each teaching method improves learning progress most effectively.