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Kwan D, Leslie K, Dubins D, Guo A, Haddadi E, Steenhof N. Two for One: Merging Continuing Professional Development and Faculty Development in the CATE Curriculum for Pharmacy Preceptors. Can J Hosp Pharm 2024; 77:e3465. [PMID: 38601130 PMCID: PMC10984263 DOI: 10.4212/cjhp.3465] [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: 02/23/2023] [Accepted: 09/16/2023] [Indexed: 04/12/2024]
Abstract
Background Continuing professional development (CPD) and faculty development (FD) are not traditionally combined, although there is evidence that integrating them enhances knowledge acquisition. Objective To explore preceptors' perceptions and the effectiveness of CATE (Clinical And Teaching Education), an education model that blends clinical content with the application of that clinical knowledge through a specified teaching technique. Methods Thirty-five hospital and community pharmacy preceptors from the Leslie Dan Faculty of Pharmacy, University of Toronto, participated in CATE, which consisted of a 2-hour synchronous, online workshop integrating clinical content about depression with the "One-Minute Preceptor" (OMP) teaching skill. Qualitative and quantitative data were collected longitudinally using surveys and semistructured interviews. Participant and process outcomes were explored through descriptive and thematic analysis using a modified Kirkpatrick framework. Results Participants valued the incorporation of educational theory and opportunities to practise the OMP using scripted role plays based on the depression-related content. The combination of FD and CPD was appealing, although participants wanted more clarity about their integration. The CATE model positively influenced their approaches to serving as preceptors, and using the OMP helped to reveal learners' knowledge gaps. There was a desire to share the teaching technique with colleagues to provide a more cohesive approach to teaching. Conclusions Integrating CPD and FD in a synchronous, online environment was feasible and well received, and it helped to solidify preceptors' roles as educators. Combining CPD and FD represents an effective strategy to build the clinical and educational expertise of preceptors, which in turn has the potential to improve the quality of experiential learning for pharmacy students. This novel method of fostering the pedagogical growth of preceptors could be a model for other health professions.
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Affiliation(s)
- Debbie Kwan
- , BScPhm, MSc, ACPR, FCSHP, is an Assistant Professor, Teaching Stream, with the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
| | - Karen Leslie
- , MD, MEd, FRCPC, is a Professor in the Department of Paediatrics, University of Toronto and The Hospital for Sick Children, Toronto, Ontario
| | - David Dubins
- , PhD, BASc, is an Associate Professor, Teaching Stream, with the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
| | - Alice Guo
- , BA, MHSc, is a Speech-Language Pathologist with Toronto Western Hospital, University Health Network, Toronto, Ontario
| | - Elnaz Haddadi
- , BEd, BScPhm, PharmD, is an Advanced Practice Clinical Leader with the Pharmacy Department, Centre for Addiction and Mental Health, Toronto, Ontario
| | - Naomi Steenhof
- , BScPhm, MSc, PhD, is an Assistant Professor, Teaching Stream, with the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
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Schenarts PJ, Scarborough AJ, Abraham RJ, Philip G. Teaching Before, During, and After a Surgical Resuscitation. Surg Clin North Am 2024; 104:451-471. [PMID: 38453313 DOI: 10.1016/j.suc.2023.10.004] [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] [Indexed: 03/09/2024]
Abstract
Teaching during a surgical resuscitation can be difficult due to the infrequency of these events. Furthermore, when these events do occur, the trainee can experience cognitive overload and an overwhelming amount of stress, thereby impairing the learning process. The emergent nature of these scenarios can make it difficult for the surgical educator to adequately teach. Repeated exposure through simulation, role play, and "war games" are great adjuncts to teaching and preparation before crisis. However, surgical educators can further enhance the knowledge of their trainees during these scenarios by using tactics such as talking out loud, targeted teaching, and debriefing.
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Affiliation(s)
- Paul J Schenarts
- Department of Surgery, School of Medicine, Creighton University, Omaha, NE, USA.
| | - Alec J Scarborough
- Department of Surgery, School of Medicine, Creighton University, Omaha, NE, USA
| | - Ren J Abraham
- Department of Surgery, School of Medicine, Creighton University, Omaha, NE, USA
| | - George Philip
- Department of Surgery, School of Medicine, Creighton University, Omaha, NE, USA
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Hoebes RR, Ashipala DO. Exploring the barriers to Registered Nurses undertaking clinical teaching in clinical settings: A qualitative descriptive study. Nurs Open 2023; 10:7767-7779. [PMID: 37767733 PMCID: PMC10643839 DOI: 10.1002/nop2.2022] [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: 04/26/2022] [Revised: 08/29/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023] Open
Abstract
AIM The study aimed to explore and describe the barriers affecting Registered Nurses in undertaking clinical teaching in clinical settings. The exploration was based on the experiences of Registered Nurses at a selected teaching hospital in Namibia. The researcher intended to identify strategies that could be used to mitigate the negative effects of barriers to effective clinical teaching. DESIGN A qualitative explorative, descriptive and contextual research design was used. METHODS Purposive sampling was used to select 16 participants. Data were collected through in-depth, semi-structured interviews, which were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis. RESULTS Clinical teaching is negatively affected by several barriers that hamper clinical teaching and nursing students' learning outcomes. Seven main themes were identified: (1) participants' understanding of clinical teaching; (2) organizational barriers; (3) patient barriers; (4) Registered Nurse barriers; (5) student barriers; (6) training institution barriers; and (7) strategies to mitigate barriers to clinical teaching. CONCLUSION The findings revealed that several barriers negatively affect clinical nursing education and hamper the clinical teaching and learning of nursing students. PATIENT OR PUBLIC CONTRIBUTION This study may assist in the development of targeted interventions that address the barriers that hinder clinical teaching at teaching hospitals. Additionally, this study could assist in improving the health care that is provided by nursing students to patients. The findings may assist with improved quality by reducing nursing students' theory-practice gap and by promoting collaboration between Registered Nurses and nurse educators in clinical settings.
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Affiliation(s)
- Riana Rolinda Hoebes
- Department of General Nursing Science, School of Nursing and Public Health, Faculty of Health Sciences and Veterinary MedicineUniversity of Namibia (UNAM)RunduNamibia
| | - Daniel Opotamutale Ashipala
- Department of General Nursing Science, School of Nursing and Public Health, Faculty of Health Sciences and Veterinary MedicineUniversity of Namibia (UNAM)RunduNamibia
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Heilmann A, Pelletier J, Murray C, Croft A. Novel Academic Tabletop 2022 (NAT22): A Dynamic Dice-Based Emergency Medicine Education Tool. Cureus 2023; 15:e49498. [PMID: 38152781 PMCID: PMC10752340 DOI: 10.7759/cureus.49498] [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] [Accepted: 11/27/2023] [Indexed: 12/29/2023] Open
Abstract
Gamification is an effective teaching tool that improves engagement and knowledge retention. Tabletop role-playing games are dynamic games that use random chance and foster player/leader partnership. To date, there are no teaching tools that mimic dynamic or unpredictable patient presentations. This style of game may work well as a tool for medical education in a simulation-based modality. In this report, we document the rules, materials, and training required to reproduce a hybrid game created to combine facets of simulation and tabletop role-playing games (TRPGs) to create a dynamic medical education tool. After testing the game for flaws and fluidity of gameplay, we plan to collect data evaluating emergency medicine residents' enjoyability and knowledge retention. In this article, we describe a novel TRPG simulation hybrid game that we hypothesize will improve learner enjoyability/engagement and have similar educational benefits to standard medical education.
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Affiliation(s)
- Adam Heilmann
- Emergency Medicine, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, USA
| | - Jessica Pelletier
- Emergency Medicine, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, USA
| | - Collyn Murray
- Emergency Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, USA
| | - Alexander Croft
- Emergency Medicine, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, USA
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Perlman E, Sagalowsky S. Case Cards: A Novel Learner-Centered Initiative to Improve Resident Education in the Pediatric Emergency Room. Cureus 2023; 15:e36944. [PMID: 37131566 PMCID: PMC10148975 DOI: 10.7759/cureus.36944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 04/03/2023] Open
Abstract
INTRODUCTION The pediatric emergency department (PED) provides a wealth of learning opportunities for residents. However, delivering dedicated education can be a significant challenge due to considerable variability in day-to-day schedules, volume, cases, time, and resource availability. Case-based and learner-centered teaching models are well suited for ambulatory settings like the emergency department. Using the Kern model, we designed an educational intervention titled "Case Cards" to facilitate active learning conversations in pediatric emergency medicine (PEM). Our goal was to improve clinical teaching in the PED to demonstrate self-reported satisfaction, knowledge acquisition, confidence, and commitment among residents rotating in this fast-paced, challenging clinical environment. METHODS After general and targeted needs assessments, we developed a compendium of 30 high-yield case cards to facilitate case-based learning conversations between learners and preceptors. Case topics mirror the American Board of Pediatrics Content Outline of Emergent Conditions. The "Learner Card" presents a PEM case for the learner to read and hold, while the "Teacher Card" contains evidence-based teaching prompts following established learner-centered clinical teaching models to guide and facilitate the case. Post-implementation surveys queried Kirkpatrick New World educational outcomes in a retrospective format. RESULTS We collected data from 24 pediatric and emergency medicine residents between July 2021 and January 2022. All respondents agreed or strongly agreed that case cards are enjoyable, educational, applicable to clinical practice, enhanced confidence, and would be recommended to others. CONCLUSION Case cards for learner-centered teaching in the pediatric emergency setting are well-received and demonstrate resident self-reported satisfaction, knowledge, and confidence in core PEM conditions. Having established and readily available teaching topics, such as case cards, can enhance the clinical experience in the PED and other challenging settings and augment clinical exposure to core content. Educators may wish to expand and explore evolving technologies to facilitate learner-centered clinical teaching.
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Hashim MJ. Teaching Family Medicine and General Practice. Korean J Fam Med 2022; 43:93-100. [PMID: 35320894 PMCID: PMC8943240 DOI: 10.4082/kjfm.20.0223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022] Open
Abstract
The teaching of family medicine and general practice should aim to develop an appreciation of the unique nature and role of the specialty. Teachers should relate patient cases to the principles of family medicine. These principles include (1) compassionate care; (2) a generalist/holistic approach focusing on the whole person, family, and community; (3) continuity of relationship, i.e., building a patient-physician bond of trust; (4) reflective mindfulness; and (5) lifelong learning. The curriculum, instructional strategy, and assessment should be carefully aligned. Core competencies include patient-centered communication, physical examination skills, clinical procedures, palliative care, humanities in medicine, holistic care, shared decision-making, family therapy, home and community visits, chronic disease care, problem-based documentation, team-based care, data-driven improvement, information mastery, ethics and professionalism, and work-life balance. Family medicine/general practice is defined as the medical specialty that manages common and long-term illnesses, focusing on overall health and well-being. Hence, clerkship schedules should maximize clinical exposure and opportunities for self-reflection. A learner-centered approach should begin with a self-identified inventory of learning needs based on the curriculum; next, these needs should be chosen as topics for student presentations. Teaching methods should include mini-workshops: a combination of didactic lectures and small-group exercises. Individual face-to-face formative feedback should occur at midcourse and culminate in a group reflection on the learning experience. Clinical supervision should gradually decrease as each resident demonstrates safe patient care. Procedure skills training should be closely supervised, formally documented, and constitute about one-fourth of learning sessions.
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Affiliation(s)
- Muhammad Jawad Hashim
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
- Corresponding Author: Muhammad Jawad Hashim https://orcid.org/0000-0002-9280-9709 Tel: +971-3-713-7655, Fax: +971-3-767-2022, E-mail: ;
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Effective Veterinary Clinical Teaching in a Variety of Teaching Settings. Vet Sci 2022; 9:vetsci9010017. [PMID: 35051101 PMCID: PMC8779673 DOI: 10.3390/vetsci9010017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/29/2021] [Accepted: 01/03/2022] [Indexed: 12/04/2022] Open
Abstract
This review explores different modalities for clinical teaching of veterinary learners globally. Effective clinical teaching aims to prepare graduates for a successful career in clinical practice. Unfortunately, there is scant literature concerning clinical teaching in veterinary medicine. Our intent for this review is to stimulate and/or facilitate discussion and/or research in this important area. We discuss the different forms that veterinary clinical teaching can take, depending on their setting, which can be university-based clinical activities, work-based in commercial clinical practices, or in a traditional academic setting with little to no real-time exposure to clients and patients. We suggest that each of these modalities has a place in clinical teaching of veterinary learners at any point in the curriculum but that a mix of these approaches will likely provide an improved experience for the learner. Further, we discuss strategies to improve clinical teaching in these different settings. Potential strategies related to the teaching skills of clinical instructors could include training in delivery of clinical teaching in a variety of learning settings, and instructors’ official recognition, including opportunities for career progression. Potential strategies to improve clinical teaching in different teaching settings would vary with the learning settings. For example, in traditional academic settings, case-based learning with incorporation of simulation models is one proposed strategy. The involvement of learners in ‘teach-others’ is a strategy for both traditional academic and clinical settings. Finally, clearly addressing Day One competencies is required in any clinical teaching setting.
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ElHawary H, Salimi A, Gorgy A, Fesdekjian L, Seal A, Gilardino MS. Medical Student Mentorship in Surgery: Lessons Learnt and Future Directions. JOURNAL OF SURGICAL EDUCATION 2022; 79:129-138. [PMID: 34429277 DOI: 10.1016/j.jsurg.2021.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 07/12/2021] [Accepted: 07/18/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Mentorship is one of the cornerstones of surgical education, providing students with the tools to navigate the challenges of the transition from a trainee to a surgeon. OBJECTIVES Our study aims to describe the characteristics of successful mentorship of medical students who successfully matched into surgical fields, and to provide medical students practical information on how to successfully find and maintain successful mentoring relationships. METHODS In this multi-center cross-sectional observational study, 2 surveys; 1 for mentees, defined as junior surgical residents (medical students who matched into surgical specialties), and 1 for mentors, defined as staff surgeons, were used to collect data between August 1, 2020 to November 1, 2020. The study was retrospective in nature and did not directly assess survey participants while they were in medical school, but rather while they were residents, retrospectively answering regarding their experiences as medical students. The surveys contained 24 questions pertaining to demographics, the dynamics of mentor-mentee relationships, qualities sought in a mentee, and barriers/benefits to mentorship. RESULTS A total of 111 attending surgeons and 138 surgical residents completed the surveys. Seventy-eight percent of surgeons had mentored at least 1 medical student, while 74.6% of residents had at least 1 mentor during medical school. The top three mentee qualities reported by mentors were willingness to learn, being a hard worker, and curiosity. There was a significant disparity between mentors' and mentees' perceptions of the importance of scientific curiosity as a mentee trait (p < 0.05). Mentors and mentees have different perceived barriers to forming successful mentorships. CONCLUSIONS While the majority of students have experienced fruitful mentoring relationships, the differences in perception of mentors and mentees still represent barriers to be overcome to allow mentorship in surgery to flourish.
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Affiliation(s)
- Hassan ElHawary
- Division of Plastic and Reconstructive Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Ali Salimi
- Department of Ophthalmology, McGill University Health Center, Montreal, Quebec, Canada
| | - Andrew Gorgy
- Department of Surgery, McGill University, Montreal, Quebec, Canada
| | - Lara Fesdekjian
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Alexander Seal
- Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mirko S Gilardino
- Division of Plastic and Reconstructive Surgery, McGill University Health Center, Montreal, Quebec, Canada.
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Willers S, Jowsey T, Chen Y. How do nurses promote critical thinking in acute care? A scoping literature review. Nurse Educ Pract 2021; 53:103074. [PMID: 33992878 DOI: 10.1016/j.nepr.2021.103074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 10/21/2022]
Abstract
AIM Critical thinking is essential to quality health care and patient outcomes in the acute care setting. It is important for educators to understand and apply teaching and learning strategies to promote critical thinking of nursing students and junior nurses in acute care. DESIGN We followed Arksey and O'Malley's 2005 framework to undertake a scoping literature review to find out how critical thinking is promoted among nursing learners (i.e., nursing students and junior nurses) in acute care. METHODS Between September and October 2018, four databases were searched: MEDLINE, CINAHL, ERIC, and Google Scholar. Search terms included: rapid, teaching, methods, nursing, promote, critical thinking and acute setting. A descriptive thematic analysis was undertaken. RESULTS Twenty-three articles were included for review. Three main themes were identified from the analysis: learner-teacher relationship, reflection, and inquiry. Strong relationships promoted positive role modelling and effective feedback - both contributing to the teaching of critical thinking. Reflection strategies such as concept mapping and journaling were frequently used, while active student inquiry further promoted critical thinking in the acute setting. CONCLUSIONS The acute setting affords opportunities and challenges to promote critical thinking. Teachers/clinicians should incorporate learner-centred pedagogy and encourage reflective practice to embed critical thinking in teaching and clinical practice.
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Affiliation(s)
- Shona Willers
- Southern District Health Board, Dunedin, New Zealand
| | - Tanisha Jowsey
- Centre for Medical and Health Sciences Education, The University of Auckland, New Zealand
| | - Yan Chen
- Centre for Medical and Health Sciences Education, The University of Auckland, New Zealand.
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Raff AC. Great nephrologists begin with great teachers: update on the nephrology curriculum. Curr Opin Nephrol Hypertens 2021; 30:215-222. [PMID: 33229909 DOI: 10.1097/mnh.0000000000000676] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to highlight developments and opportunities in the nephrology curriculum from the basic science foundation years through teaching medical students, residents and fellows in the clinical realm. RECENT FINDINGS Teaching skills are a vital tool for nephrologists both to promote excellent patient care and attract talented learners to the field. Exposure to dynamic and inspiring nephrologists is one of the main factors given by students and residents for selecting a career in nephrology. Nephrology teaching, including case discussions, problem-based learning, team-based learning and flipped classrooms, provides motivating active learning for medical students and is equally effective for didactics in graduate medical education. Avenues for teaching in the clinical realm include the microskills framework, bedside teaching and grounding in evidence-based medicine. Areas of growth include blended nephrology/subspecialty fields as well as social media applications. SUMMARY Medical education is a satisfying and exciting area of growth in the field of nephrology. The recent literature provides a framework for best practices in active learning as well as providing numerous examples of educational interventions and innovations. In addition, this field is ripe for further development and scholarly activity.
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Affiliation(s)
- Amanda C Raff
- Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
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Natesan S, Bailitz J, King A, Krzyzaniak SM, Kennedy SK, Kim AJ, Byyny R, Gottlieb M. Clinical Teaching: An Evidence-based Guide to Best Practices from the Council of Emergency Medicine Residency Directors. West J Emerg Med 2020; 21:985-998. [PMID: 32726274 PMCID: PMC7390547 DOI: 10.5811/westjem.2020.4.46060] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/30/2020] [Accepted: 04/09/2020] [Indexed: 01/28/2023] Open
Abstract
Clinical teaching is the primary educational tool use to train learners from day one of medical school all the way to the completion of fellowship. However, concerns over time constraints and patient census have led to a decline in bedside teaching. This paper provides a critical review of the literature on clinical teaching with a focus on instructor teaching strategies, clinical teaching models, and suggestions for incorporating technology. Recommendations for instructor-related teaching factors include adequate preparation, awareness of effective teacher attributes, using evidence-based-knowledge dissemination strategies, ensuring good communication, and consideration of environmental factors. Proposed recommendations for potential teaching strategies include the Socratic method, the One-Minute Preceptor model, SNAPPS, ED STAT, teaching scripts, and bedside presentation rounds. Additionally, this article will suggest approaches to incorporating technology into clinical teaching, including just-in-time training, simulation, and telemedical teaching. This paper provides readers with strategies and techniques for improving clinical teaching effectiveness.
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Affiliation(s)
- Sreeja Natesan
- Duke University, Division of Emergency Medicine, Durham, North Carolina
| | - John Bailitz
- Northwestern University, Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois
| | - Andrew King
- The Ohio State University Wexner Medical Center, Department of Emergency Medicine, Columbus, Ohio
| | - Sara M. Krzyzaniak
- University of Illinois College of Medicine at Peoria/OSF Healthcare, Department of Emergency Medicine, Peoria, Illinois
| | - Sarah K. Kennedy
- Indiana University School of Medicine, Department of Emergency Medicine, Indianapolis, Indiana
| | - Albert J. Kim
- Washington University in Saint Louis School of Medicine, Department of Emergency Medicine, St. Louis, Missouri
| | - Richard Byyny
- Denver Health Medical Center, Department of Emergency Medicine, Denver, Colorado
| | - Michael Gottlieb
- Rush Medical Center, Department of Emergency medicine, Chicago, Illinois
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Pierce C, Corral J, Aagaard E, Harnke B, Irby DM, Stickrath C. A BEME realist synthesis review of the effectiveness of teaching strategies used in the clinical setting on the development of clinical skills among health professionals: BEME Guide No. 61. MEDICAL TEACHER 2020; 42:604-615. [PMID: 31961206 DOI: 10.1080/0142159x.2019.1708294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background: Literature describing the effectiveness of teaching strategies in the clinical setting is limited. This realist synthesis review focuses on understanding the effectiveness of teaching strategies used in the clinical setting.Methods: We searched ten databases for English language publications between 1 January 1970 and 31 May 2017 reporting effective teaching strategies, used in a clinical setting, of non-procedural skills. After screening, we used consensus to determine inclusion and employed a standardised instrument to capture study populations, methodology, and outcomes. We summarised what strategies worked, for whom, and in what settings.Results: The initial search netted 53,642 references after de-duplication; 2037 were retained after title and abstract review. Full text review was done on 82 references, with ultimate inclusion of 25 publications. Three specific teaching strategies demonstrated impact on educational outcomes: the One Minute Preceptor (OMP), SNAPPS, and concept mapping. Most of the literature involves physician trainees in an ambulatory environment. All three have been shown to improve skills in the domains of medical knowledge and clinical reasoning.Discussion/conclusions: Apart from the OMP, SNAPPS, and concept mapping, which target the formation of clinical knowledge and reasoning skills, the literature establishing effective teaching strategies in the clinical setting is sparse.
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Affiliation(s)
- Cason Pierce
- Department of Medicine, University of Colorado Anschutz, Aurora, CO, USA
| | - Janet Corral
- Department of Medicine, University of Colorado Anschutz, Aurora, CO, USA
| | - Eva Aagaard
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Ben Harnke
- Strauss Health Sciences Library, University of Colorado Anschutz, Aurora, CO, USA
| | - David M Irby
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Chad Stickrath
- Department of Medicine, University of Colorado Anschutz, Aurora, CO, USA
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Buckley C, Natesan S, Breslin A, Gottlieb M. Finessing Feedback: Recommendations for Effective Feedback in the Emergency Department. Ann Emerg Med 2020; 75:445-451. [DOI: 10.1016/j.annemergmed.2019.05.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Indexed: 01/11/2023]
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Chen L, Chen H, Xu D, Yang Y, Li H, Hua D. Peer assessment platform of clinical skills in undergraduate medical education. J Int Med Res 2019; 47:5526-5535. [PMID: 31530204 PMCID: PMC6862878 DOI: 10.1177/0300060519861025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective The study objective was to enhance clinical skills among undergraduate students majoring in clinical medicine in performing physical examination by establishing a novel platform for peer assessment of clinical skills. Methods A total 126 Year 2012 students majoring in medicine and receiving traditional training were assigned to the control group, and 126 Year 2013 students receiving instruction via the peer assessment platform of clinical skills were allocated to the study group. Scores of the physical examination, paper exam, and peer assessment were compared using a t-test, and we performed linear correlation analysis of the data. Results Scores of the physical examination and peer assessment among Year 2013 students (the study group) were significantly higher than those in the control group. Paper exam scores in the study group were also significantly higher than those in the controls. The three assessment scores did not differ significantly according to sex. Conclusions The peer assessment platform can not only improve medical students’ skills and capabilities in physical examination, it can also enhance their theoretical knowledge of basic clinical principles. We determined that sex was not related to the assessment scores obtained by medical students.
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Affiliation(s)
- Liling Chen
- Medical Simulation Center, Nanjing Medical University, Nanjing, China.,The First School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Hong Chen
- Medical Simulation Center, Nanjing Medical University, Nanjing, China
| | - Di Xu
- Medical Simulation Center, Nanjing Medical University, Nanjing, China.,Department Of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yan Yang
- Medical Simulation Center, Nanjing Medical University, Nanjing, China
| | - Huiming Li
- Medical Simulation Center, Nanjing Medical University, Nanjing, China
| | - Dong Hua
- Department of Mathematics and Computer Science, Nanjing Medical University, Nanjing, China
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Jain V, Rao S, Jinadani M. Effectiveness of SNAPPS for improving clinical reasoning in postgraduates: randomized controlled trial. BMC MEDICAL EDUCATION 2019; 19:224. [PMID: 31226996 PMCID: PMC6588865 DOI: 10.1186/s12909-019-1670-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 06/12/2019] [Indexed: 05/12/2023]
Abstract
BACKGROUND In-patient postgraduate teaching suffers with issues like long and unstructured presentations inclusive of a lot of historical information and time constraints due to increasing workload. A six-step pneumonic SNAPPS a learner-centered model modifies the learning encounter by condensing the reporting of facts while encouraging clinical reasoning. This study was planned with the aim to evaluate the effectiveness of SNAPPS as compared to traditional case presentation for facilitating clinical reasoning in inpatient setting. We also wanted to understand perceptions of postgraduates and teachers about this new method of case presentation. METHODS This open labeled randomized controlled trial was carried amongst the 18 residents of department of Medicine, MGIMS. The teachers and residents in the SNAPPS were sensitized to SNAPPS technique by using videos, role plays and handouts over 2 sessions of 30 min each. Twenty-seven case presentations (3/resident) were carried out in each group (total 54 case presentations). Data was recorded into validated data recording sheet after each presentation and feedback was taken from the teacher as well as residents regarding their perception. RESULTS The SNAPPS model heralds a change in the preceptor training, pairing faulty development and learner development as companions in education. Guided by the SNAPPS technique, students summarized patient findings concisely (7 vs. 2.7 vs. 5.22vs. 2.33, p = 0.0057) while maintaining the same degree of thoroughness as in traditional case presentations. The students in the SNAPPS group were clearer about their diagnostic hypothesis and compared and contrasted their different diagnosis well (2.56 vs. 1.74, p value =0.002). The students in the SNAPPS group initiated patient management discussion almost 20% more times as compared to the control group. CONCLUSION We conclude that SNAPPS a learner centered technique for case presentations facilitated the expression of clinical diagnostic reasoning and case based uncertainties in the inpatient setting without extending the unusual length of the student case presentations. It also paved way for enhanced self-directed learning.
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Affiliation(s)
- Vishakha Jain
- Department of Medicine, Mahatma Gandhi Institute of Medical sciences, Sewagram, Wardha, Maharashtra 442102 India
| | - Siddharth Rao
- Department of Surgery, Mahatma Gandhi Institute of Medical sciences, Sewagram, Wardha, Maharashtra 442102 India
| | - Mariya Jinadani
- Department of Physiotherapy, Seth GS medical college and KEM hospital, Mumbai, India
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Sidhu NS, Edwards M. Deliberate teaching tools for clinical teaching encounters: A critical scoping review and thematic analysis to establish definitional clarity. MEDICAL TEACHER 2019; 41:282-296. [PMID: 29703088 DOI: 10.1080/0142159x.2018.1463087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE AND METHOD We conducted a scoping review of tools designed to add structure to clinical teaching, with a thematic analysis to establish definitional clarity. RESULTS Six thousand and forty nine citations were screened, 434 reviewed for eligibility, and 230 identified as meeting study inclusion criteria. Eighty-nine names and 51 definitions were identified. Based on a post facto thematic analysis, we propose that these tools be named "deliberate teaching tools" (DTTs) and defined as "frameworks that enable clinicians to have a purposeful and considered approach to teaching encounters by incorporating elements identified with good teaching practice." We identified 46 DTTs in the literature, with 38 (82.6%) originally described for the medical setting. Forty justification articles consisted of 16 feedback surveys, 13 controlled trials, seven pre-post intervention studies with no control group, and four observation studies. Current evidence of efficacy is not entirely conclusive, and many studies contain methodology flaws. Forty-nine clarification articles comprised 12 systematic reviews and 37 narrative reviews. The most number of DTTs described by any review was four. A common design theme was identified in approximately three-quarters of DTTs. CONCLUSIONS Applicability of DTTs to specific alternate settings should be considered in context, and appropriately designed justification studies are warranted to demonstrate efficacy.
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Affiliation(s)
- Navdeep S Sidhu
- a Department of Anaesthesia and Perioperative Medicine , North Shore Hospital , Auckland , New Zealand
- b Department of Anaesthesiology , University of Auckland , Auckland , New Zealand
| | - Morgan Edwards
- a Department of Anaesthesia and Perioperative Medicine , North Shore Hospital , Auckland , New Zealand
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