The effect of direct observation of procedural skills/mini-clinical evaluation exercise on the satisfaction and clinical skills of nursing students in dialysis

Assessing Residents in the Department of Surgery at a Tertiary Care Centre Using Mini-Clinical Evaluation Exercise (Mini-CEX)

OBJECTIVE

This study aimed to introduce, sensitize, and train our postgraduate students and faculty of the department of general surgery with the use of mini-Clinical Evaluation Exercise (mini‑CEX) and to assess the perception of students and faculty towards it.

MATERIAL AND METHODS

A cross‑sectional observational study was conducted over a period of four months. Ten surgery residents in the department were asked to volunteer to participate and five professors conducted the session. Five sessions of mini‑CEX (nine points) were conducted for each resident in different settings of the out‑patient department (OPD) and in‑patient department (IPD). A total of five skills were tested. Feedback from faculty and residents regarding the perception of mini‑CEX was also taken.

RESULTS

A statistically significant difference in mean scores of all domains was observed comparing the first and last assessment (p<0.05). Hundred percent of the residents scored superior category (7-9) in the final assessment in all domains, whereas the maximum was in a satisfactory scoring grade in 1st assessment. The time taken for the assessment significantly reduced from 1st assessment to the last assessment in OPD and IPD settings (p=0.001). The mini-CEX assessment tool got 100% feedback from faculty in terms of skill improvement, method, attitude of residents, and ability to identify gaps in knowledge. However, one assessor thought that "time given for assessment" was inadequate and more effort was required than the usual traditional assessment methods. The most identified problem faced by residents was that the "time given during assessment" was less (50%); however, overall residents also found it valid, effective, and helpful in identifying knowledge gaps and improving clinical and communication skills.

CONCLUSION

Mini‑CEX improves the learning environment in residency and also leads to improvement in medical interviewing skills, physical examination skills, humanistic qualities/professionalism, and counseling skills. So, it can be used for residency training in clinical departments.

The Effect of Direct Observation of Procedural Skills on Learning and Satisfaction of Students in Community Dentistry Course

Introduction

Direct Observation of Practical Skills (DOPS) tests is a valuable method for clinical assessment. This study aimed to implement the DOPS test to assess the procedural skills of community dentistry courses and its effects on mastery learning and satisfaction of professors and students at Tabriz faculty of dentistry in 2021-2022.

Methods

In a quasi-experimental study, 60 dentistry students of a class were assigned into two study (n=30) and control (n=30) groups by Permuted block randomization. In the case group, the skills were related to Fluoride therapy, fissure sealant therapy, and health education evaluated by DOPS. In the control group, these skills were evaluated by traditional evaluation methods. Each test was repeated three times. Finally, the satisfaction of students in the case group was assessed by a questionnaire. The chi-square test was used to compare qualitative variables. Repeated measure ANOVA test was used to compare the mean scores in three stages and two groups. P value less than 0.05 was considered significant. Data were analyzed using SPSS 16 software.

Results

A significant difference in the mean score of Fluoride therapy, pit and fissure sealant therapy, and health education was seen between the case and control groups (P<0.001). Also a significant increase in these skills in the third stage of assessment in the case group was observed (P<0.001). The professors and students' satisfaction was considerably high on the DOPS test.

Conclusion

The DOPS method had more impact on Fluoride therapy, pit and fissure sealant therapy, and health education's learning process in dentistry students than the conventional evaluation. The professors and students' satisfaction level was high regarding DOPS. The advantages of the DOPS method are student-centeredness, objectivity, and appropriate feedback.

Application of direct observation of operational skills in nursing skill evaluation of pressure injury: A randomized clinical trial

This was a non-blinded, single-centre, randomized, controlled clinical trial that compared the effectiveness of direct observation of procedural skills (DOPSs)with traditional assessment methods in pressure injury (PI) care skills. The study population included 82 nursing professionals randomly assigned to the study group (n = 41) and the control group (n = 41). Both groups of nurses underwent a 6-month training in PI care skills and were subsequently evaluated. The main outcome variables were the PI skill operation scores and theoretical scores. Secondary outcome variables included satisfaction and critical thinking abilities. Independent sample t-tests and chi-square tests were used to assess differences between the two groups of nurses. The results showed no statistically significant difference in PI skill operation scores between the two groups of nurses (p > 0.05). When comparing the PI theoretical scores, the study group scored higher than the control group, and this difference was statistically significant (p < 0.05). In terms of satisfaction assessment, the study group and the control group showed differences in improving self-directed learning, enhancing communication skills with patients, improving learning outcomes and increasing flexibility in clinical application (p < 0.05). When comparing critical thinking abilities between the two groups of nurses, there was no statistically significant difference at the beginning of the training, but after 3 months following the training, there was a statistically significant difference between the two groups (p < 0.01).The results indicated that the DOPS was effective in improving PI theoretical scores, increasing nurse satisfaction with the training and enhancing critical thinking abilities among nurses.

Designing and implementing an OMMID midwifery professional competence mixed test: A multimethod, multiphasic study

The assessment of professional competence is essential to ensure the achievement of competence standards. The goal of this study is to design and implement a professional competence test model to make the test unified, comprehensive, and fair. This research was a multimethod, multiphasic study. The first qualitative phase of the nominal group technique was conducted to design the test model with specific guidelines. The second phase was a mixed-method parallel field trial conducted on 161 senior midwifery bachelor students in universities of Iran. The test was conducted following the traditional method in the control group and OMMID model in the intervention group. This model consists of three parts: the MCQs (multiple choice questions), OSCE (objective structured clinical examination), and clinically-oriented tests, which included Mini-CEX (mini-clinical evaluation exercise) and DOPS (direct observation of procedural skills). Data were collected using questionnaires and interviews, and the results were assessed qualitatively and quantitatively. The OMMID model and the associated guideline were designed. Qualitative data analysis resulted in six main themes, including organizing, structure, tension due to change, fairness, unification, and outcome. The OMMID model did not increase students' anxiety and stress and did not decrease their satisfaction. The merits of this model include having a centralized guideline, using multiple evaluation methods, comprehensive evaluation of necessary skills, promotion of fairness, and increased student satisfaction.

Validation of a form for assessing the professional performance of residents in cardiology by nurses

BACKGROUND

There is a strong need for transformation in our assessment systems from one that evaluates performance based on levels of training to another that focuses on professional competence to meet the expected requirements for the practice of the profession. The aim of this study is to validate for the first time a Spanish version of a new tool for assessing the professional performance of residents by nurses newly developed in the Ottawa Hospital (O-RON).

MATERIALS AND METHODS

After the author's written authorization, the original O-RON form was translated and cross-culturally adapted. Then we conducted a prospective observational study in two cardiology centers in the city of Buenos Aires. The validity of the tools was evaluated by the ability of the instrument to discriminate the level of experience of the residents according to their post-graduate year level. Data is expressed as percentages and frequencies of the qualifications obtained in the different questions. The chi-square test was used to assess the significance of the differences obtained. A generalizability test was used to evaluate reliability. Feasibility was defined as a minimum of 4 assessments per resident per evaluation round. Satisfaction of evaluators was assessed using a survey with a 10-point scale designed by the authors.

RESULTS

A total of 838 evaluations were performed. Regarding validity, the 15-item form could significantly discriminate the experience of the residents according to their postgraduate year level (P < 0,005). Thirty evaluations per resident are required to obtain reliable results. The tool is feasible to implement and an average of 4.55 assessment per resident per evaluation round were achieved throughout the entire experience. This value remained stable during the 8 rounds (1st: 4.65; 2nd: 4.34; 3^rd: 4.47; 4^th: 6.17; 5^th: 4.56; 6^th: 4.08; 7^th: 4.36; 8^th: 3.91). The levels of satisfaction among the evaluators were acceptable.

CONCLUSION

The Spanish version of the O-RON form can provide residents with a valuable source of feedback from the eyes of nurses on important aspects of their professional training. This tool, positively assessed by the raters, significantly discriminates residents' experience. Its implementation is feasible in our environment, and it is user-friendly, though it requires a considerable number of assessments to achieve high reliability.

Improvement of the clinical skills of nurse anesthesia students using mini-clinical evaluation exercises in Iran: a randomized controlled study

PURPOSE

The present study aimed to investigate the effect of a mini-clinical evaluation exercise (CEX) assessment on improving the clinical skills of nurse anesthesia students at Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

METHODS

This study started on November 1, 2022, and ended on December 1, 2022. It was conducted among 50 nurse anesthesia students divided into intervention and control groups. The intervention group’s clinical skills were evaluated 4 times using the mini-CEX method. In contrast, the same skills were evaluated in the control group based on the conventional method—that is, general supervision by the instructor during the internship and a summative evaluation based on a checklist at the end of the course. The intervention group students also filled out a questionnaire to measure their satisfaction with the miniCEX method.

RESULTS

The mean score of the students in both the control and intervention groups increased significantly on the post-test (P<0.0001), but the improvement in the scores of the intervention group was significantly greater compared with the control group (P<0.0001). The overall mean score for satisfaction in the intervention group was 76.3 out of a maximum of 95.

CONCLUSION

The findings of this study showed that using mini-CEX as a formative evaluation method to evaluate clinical skills had a significant effect on the improvement of nurse anesthesia students’ clinical skills, and they had a very favorable opinion about this evaluation method.

Mini clinical evaluation exercise (Mini-CEX): A tool for assessment of residents in department of surgery

BACKGROUND

The mini-clinical evaluation exercise (mini-CEX) is a formative assessment tool designed to provide feedback on skills essential to good medical care by observing an actual clinical encounter. However, the bigger advantage of mini-CEX is the structured feedback that it provides to the students as well as the faculty, thus helping them to make better decisions.

MATERIALS AND METHODS

This study was a cross-sectional observational study. Sixteen surgery residents volunteered for participation and five professors conducted sessions; hence, 80 mini-CEX encounters. Seven core clinical skill assessments were done, and the performance was rated on a 9-point scale (grouped into unsatisfactory, satisfactory, and superior). Immediate feedback to the residents was given by the faculty. Delayed feedback from faculty and residents regarding the perception of mini-CEX was taken. Statistical analysis was done using SPSS version 20 and analysis of variance (ANOVA) for inferential statistics.

RESULTS

As planned, 80 (100%) mini-CEX encounters were conducted. Surgery residents showed improvement that was statistically significant in the competencies of medical interviewing skills, physical examination skills, humanistic qualities/professionalism, and counseling skills. Most of the faculty (80%) were able to identify the gaps in the knowledge of students and areas of improvement for their teaching. However, 60% of the faculty felt that it required more effort than traditional methods. The mean time taken by the assessor for observation and feedback to residents was 12.51 min and 5.68 min, respectively. The mean scores of evaluator satisfaction and resident satisfaction with mini-CEX sessions were 6.04 and 7.49, respectively.

CONCLUSIONS

Mini-CEX improves the learning environment in residency and also leads to improvement in medical interviewing skills, physical examination skills, humanistic qualities/professionalism, and counseling skills. It is done in the actual patient encounter and hence prepares the resident better for dealing with patients in the future.

Effect of Rehabilitation Physical Training on Basketball Injury under Ultrasound Examination

In order to solve the problem of observing the effect of rehabilitation physical training on basketball player injury, a kind of observation study on the effect of rehabilitation physical training on basketball player injury based on memory ultrasound examination was proposed. This study makes a comprehensive analysis of physical fitness training factors such as physical fitness test plan, training arrangement, training method, training monitoring, and effect evaluation. Through the experiment, it is found that there are still gaps in physical training, diagnostic standards, training plans and requirements, load monitoring, standardization of operation, nutrition, and recovery in the training organization. There are only 23.81% of full-time physical coaches and 25.40% of professional team doctors at all levels of sports teams. There were only 23.81% of full-time physical fitness coaches and 25.40% of professional team doctors in all levels of sports teams. Basketball players in the basketball injury survey had 67 sports injuries throughout the year, with a rate of 3.35 injuries per person and 2.48 injuries per 1000 hours. The location of chronic injuries is usually the lower back, knee joint, and ankle. The main injuries are due to the physical component, with injuries occurring most frequently throughout the training season in July, August, and September. Experiments show that good and professional physical training can reduce the risk of injury to a greater extent than strengthening the specific skills of athletes.