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Ovitsh RK, Gupta S, Kusnoor A, Jackson JM, Roussel D, Mooney CJ, Pinto-Powell R, Appel JL, Mhaskar R, Gold J. Minding the gap: towards a shared clinical reasoning lexicon across the pre-clerkship/clerkship transition. Med Educ Online 2024; 29:2307715. [PMID: 38320116 PMCID: PMC10848998 DOI: 10.1080/10872981.2024.2307715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/16/2024] [Indexed: 02/08/2024]
Abstract
Teaching and learning of clinical reasoning are core principles of medical education. However, little guidance exists for faculty leaders to navigate curricular transitions between pre-clerkship and clerkship curricular phases. This study compares how educational leaders in these two phases understand clinical reasoning instruction. Previously reported cross-sectional surveys of pre-clerkship clinical skills course directors, and clerkship leaders were compared. Comparisons focused on perceived importance of a number of core clinical reasoning concepts, barriers to clinical reasoning instruction, level of familiarity across the undergraduate medical curriculum, and inclusion of clinical reasoning instruction in each area of the curriculum. Analyses were performed using the Mann Whitney U test. Both sets of leaders rated lack of curricular time as the largest barrier to teaching clinical reasoning. Clerkship leaders also noted a lack of faculty with skills to teach clinical reasoning concepts as a significant barrier (p < 0.02), while pre-clerkship leaders were more likely to perceive that these concepts were too advanced for their students (p < 0.001). Pre-clerkship leaders reported a higher level of familiarity with the clerkship curriculum than clerkship leaders reported of the pre-clerkship curriculum (p < 0.001). As faculty transition students from the pre-clerkship to the clerkship phase, a shared understanding of what is taught and when, accompanied by successful faculty development, may aid the development of longitudinal, milestone-based clinical reasoning instruction.
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Affiliation(s)
- Robin K. Ovitsh
- Department of Pediatrics, Downstate Health Sciences University College of Medicine, Brooklyn, NY, USA
| | - Shanu Gupta
- Department of Internal Medicine, University of South Florida, Tampa, FL, USA
| | - Anita Kusnoor
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jennifer M. Jackson
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Danielle Roussel
- Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Christopher J. Mooney
- Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Roshini Pinto-Powell
- Department of Medicine and Medical Education, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Joel L. Appel
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI, USA
| | - Rahul Mhaskar
- Department of Internal Medicine, University of South Florida College of Medicine, Tampa, FL, USA
| | - Jonathan Gold
- Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, East Lansing, MI, USA
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Çetinkaya L, Keser İ, Yildirim S, Keser H. The effect of case-based mobile virtual patient application on students' academic achievement in clinical reasoning skills. Med Educ Online 2024; 29:2322223. [PMID: 38445566 PMCID: PMC10919315 DOI: 10.1080/10872981.2024.2322223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/19/2024] [Indexed: 03/07/2024]
Abstract
This mixed-method study aims to determine the effect of the use of mobile virtual patient application with narrated case-based virtual patients as an assistive technology on students' clinical reasoning skills. It makes a notable contribution by exploring the impact of mobile virtual patient applications on healthcare students' clinical skills and their preparation for real-world patient care. In addition, the accuracy of the analysis results regarding the effect on student achievement was analyzed with a second dataset tool, and thus, aiming to increase reliability by verifying the same research question with a different quantitative analysis technique. In the qualitative part of the study, students' views on the implementation were collected through an open-ended questionnaire and the data were subjected to content analysis. An achievement test was also developed to determine the development of students' clinical reasoning skills, which revealed that each of the learning environments had different outcomes regarding students' achievement and that supporting the traditional environment with the mobile virtual patient application yielded better results for increasing students' achievement. Students' opinions about the mobile virtual patient application and the process also support the increase in academic achievement aimed at measuring clinical reasoning skills. The content analysis showed that the students, who generally reported multiple positive factors related to the application, thought that the stories and cases presented created a perception of reality, and they especially highlighted the contribution of the application to learning the story organization. Based on all these results, it can be said that the application supports clinical reasoning, provides practical experience, improves academic achievement, and contributes positively to motivation.
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Affiliation(s)
- Levent Çetinkaya
- Department of Computer Education and Instructional Technology, Canakkale Onsekiz Universty, Canakkale, Türkiye
| | - İ̇lke Keser
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Türkiye
| | - Serkan Yildirim
- Department of Computer Education and Instructional Technology, Ankara University, Ankara, Türkiye
| | - Hafize Keser
- Faculty of Educational Sciences, Department of Computer Education and Instructional Technology, Ankara University, Ankara, Türkiye
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3
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Woolfe Loftus N, Navales V, Bowden T. Using the NEWS2 and ABCDE assessment to identify early signs of clinical deterioration. Nurs Stand 2024:e12188. [PMID: 38523526 DOI: 10.7748/ns.2024.e12188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2023] [Indexed: 03/26/2024]
Abstract
Nurses may encounter deteriorating patients in their clinical practice, so they require an understanding of the early physiological signs of deterioration and a structured approach to patient assessment. This enables appropriate management and a timely response to the most life-threatening issues identified, such as a compromised airway. This article describes how nurses can use early warning scores and a structured patient assessment, using the ABCDE (airway, breathing, circulation, disability, exposure) framework, to identify early signs of deterioration and facilitate the timely escalation of patient care where necessary.
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Affiliation(s)
- Nicholas Woolfe Loftus
- Adult Critical Care Unit, St Bartholomew's Hospital, London, and NIHR predoctoral clinical academic fellow, City, University of London, London, England
| | - Vanna Navales
- Adult Critical Care Unit, St Bartholomew's Hospital, London, England
| | - Tracey Bowden
- School of Health and Psychosocial Sciences, City, University of London, London, England
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4
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Baker E, Battle C, Lee G. Blunt mechanism chest wall injury: initial patient assessment and acute care priorities. Emerg Nurse 2024:e2181. [PMID: 38468549 DOI: 10.7748/en.2024.e2181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 03/13/2024]
Abstract
Blunt mechanism chest wall injury (CWI) is commonly seen in the emergency department (ED), since it is present in around 15% of trauma patients. The thoracic cage protects the heart, lungs and trachea, thereby supporting respiration and circulation, so injury to the thorax can induce potentially life-threatening complications. Systematic care pathways have been shown to improve outcomes for patients presenting with blunt mechanism CWI, but care is not consistent across the UK. Emergency nurses have a crucial role in assessing and treating patients who present to the ED with blunt mechanism CWI. This article discusses the initial assessment and acute care priorities for this patient group. It also presents a prognostic model for predicting the probability of in-hospital complications following blunt mechanism CWI.
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Affiliation(s)
- Edward Baker
- King's College Hospital NHS Foundation Trust, London, England
| | - Ceri Battle
- Swansea Bay University Health Board, Swansea, Wales
| | - Geraldine Lee
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, England
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5
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Bernardo M. Analysing arterial blood gas results using the RoMe technique. Nurs Stand 2024; 39:40-43. [PMID: 38312004 DOI: 10.7748/ns.2024.e12193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 02/06/2024]
Abstract
Arterial blood gas (ABG) analysis is a fundamental skill in healthcare practice, particularly when caring for acutely unwell or deteriorating patients. It can be useful in the assessment of patients' acid-base balance and gas exchange, thereby informing appropriate care and management. However, many nurses find interpreting ABG results challenging. This article outlines a simplified approach to ABG analysis using three main values - pH, partial pressure of carbon dioxide and bicarbonate - and applying the RoMe ('Respiratory opposite, Metabolic equal') technique. It also provides brief descriptions of selected acid-base imbalances and explains how to identify whether these are uncompensated, partially compensated or fully compensated.
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Affiliation(s)
- Marlon Bernardo
- Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, England
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Maybury C, Williams MA, Challenger K, Fassas E, Galvan S, Gelmann D, Jung KS, Lu AY, Wang J, Stines E, Baur C. How health literacy is taught and evaluated in dentistry, medicine, nursing, law, pharmacy, public health, and social work: a narrative review. J Commun Healthc 2024; 17:51-67. [PMID: 37707288 DOI: 10.1080/17538068.2023.2258315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
BACKGROUND This narrative review examined the published peer-reviewed literature on how health literacy is taught and evaluated in seven health professional and adjacent disciplines: dentistry, medicine, nursing, law, pharmacy, public health, and social work. The study objectives were to assess how students are educated about health literacy and how their health literacy education and skills are evaluated. METHODS Study selection followed guidelines outlined in PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We searched PubMed, CINAHL, SocINDEX (EBSCOhost), Lexis Advance and Public Health (ProQuest) for English-language publications of health literacy education studies across seven disciplines at U.S.-based institutions. Inclusion criteria included: 1) methods describing a primary health literacy educational intervention, 2) professional education in one or more of the seven disciplines, 3) educational institutions in the United States, and 4) articles published in peer-reviewed journals between 2000 and 2020. RESULTS The searches yielded 44 articles. Health literacy education is evident in six of the seven studied disciplines, and varies widely in the quality, quantity, timing and mode of education and evaluation. Despite the presence of health literacy accreditation requirements, none of the seven disciplines has developed and implemented a standard, rigorous health literacy education program for students. CONCLUSIONS Graduating institutions and professional accreditation organizations that set the standards for education must lead the way by implementing upstream changes in health literacy professional education. Teaching health literacy to students in health professions is one strategy to help close gaps in patient/client professional communication for graduates and those they serve.
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Affiliation(s)
- Catherine Maybury
- School of Public Health, Horowitz Center for Health Literacy, University of University of Maryland, College Park, USA
| | - Mary Ann Williams
- Health Sciences and Human Services Library, University of Maryland Baltimore, USA
| | | | | | - Sonia Galvan
- School of Nursing, University of Maryland Baltimore, USA
| | | | - Karen S Jung
- School of Dentistry, University of Maryland Baltimore, USA
| | | | - Jocelyn Wang
- Francis King Kerry School of Law, University of Maryland Baltimore, Baltimore, USA
| | - Elsie Stines
- University of Maryland Baltimore Medical Center and University of Maryland Baltimore, Baltimore, USA
| | - Cynthia Baur
- School of Public Health, Horowitz Center for Health Literacy, University of University of Maryland, College Park, USA
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7
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Knight C, Smith SR. Developing and evaluating a major trauma course and coaching programme for ward nurses. Emerg Nurse 2024:e2184. [PMID: 38374764 DOI: 10.7748/en.2024.e2184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 02/21/2024]
Abstract
Nurses working with major trauma patients in ward environments in the UK are expected to evidence their knowledge and skills in a set of national competencies. This article describes a bespoke major trauma course and a coaching and portfolio development programme designed to enhance ward nurses' knowledge and skills, help them evidence their competence and support their professional development. Evaluation of the course showed an overall improvement in nurses' self-rated competence and confidence in a range of relevant major trauma topics and clinical skills. Evaluation of the coaching and portfolio development programme showed that nurses believed their knowledge and skills had improved after taking part and that they valued the opportunity for professional development.
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Affiliation(s)
- Chris Knight
- Manchester University NHS Foundation Trust, Manchester, England
| | - Stella Ruth Smith
- major trauma clinical lead, Manchester University NHS Foundation Trust, Manchester, England
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8
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Panagiotidou E, Lillis T, Fotopoulos I, Kalyvas D, Dabarakis N. Evaluation of Self-Perceived Confidence and Competence in Oral Surgery among Final Year Undergraduate Students in Greece. Eur J Dent 2024; 18:360-367. [PMID: 38158210 PMCID: PMC10959612 DOI: 10.1055/s-0043-1771330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES Oral surgery is an integral part of dentistry that deals with the diagnosis and management of pathology of the mouth and jaws that requires surgical intervention. The aim of undergraduate studies in oral surgery is, upon graduation, to be confident and competent to treat without assistance surgical cases in the spectrum of general dentistry. This study evaluates the senior Greek dental students' self-confidence and self-perceived competence to undertake cases within the scope of oral surgery. Evaluation of clinical experience gathered during training and self-perceived confidence and competence in generic oral surgery skills is included. MATERIALS AND METHODS The present study was a questionnaire survey conducted during the academic year 2018-2019. The questionnaire comprised three sections. Section 1 included demographic data and four closed-ended questions concerning numerical data about procedures that they had already performed or observed, section 2 included four questions concerning their self-perceived competence to perform basic surgical techniques, and section 3 included 10 clinical case scenarios. RESULTS One hundred and twenty-seven students participated in the study. Among the basic surgical skills, students were most confident with suturing, and they were least confident with bone removal. Students from the Aristotle University of Thessaloniki (AUTH) tend to show higher level of confidence compared with students from the National and Kapodistrian University of Athens (NKUA) in most questions. CONCLUSION Greek graduate dental students report moderate levels of self-confidence in oral surgery. A realistic approach in increasing self-confidence and competence in oral surgery would be the focus on preclinical training in generic elementary surgical skills, in combination with increased observational sessions of oral surgery procedures or outreach training.
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Affiliation(s)
- Eliza Panagiotidou
- Department of Dentoalveolar Surgery, Implantology and Dental Anesthesiology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodoros Lillis
- Department of Dentoalveolar Surgery, Implantology and Dental Anesthesiology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Fotopoulos
- Department of Dentoalveolar Surgery, Implantology and Dental Anesthesiology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Demos Kalyvas
- Department of Oral Surgery and Dental Anesthesia, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Dabarakis
- Department of Dentoalveolar Surgery, Implantology and Dental Anesthesiology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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9
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Reuben JS, Hashmani K, Perez M, Gyurko R, Kang M, Cooke MR. Accommodations for disabilities in dental education: A focus on technical standards and clinical skills. J Dent Educ 2024. [PMID: 38279641 DOI: 10.1002/jdd.13443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/24/2023] [Accepted: 12/03/2023] [Indexed: 01/28/2024]
Abstract
Providing disability-based accommodations is a multifaceted process that must balance the needs of dental students and their institutions. Reasonable accommodations must not compromise patient safety or cause an undue burden on the student or institution. Therefore, more creative approaches must be considered as the number of individuals and the types of learning disabilities have increased in recent years. In the clinical setting, providing accommodations also requires detailed advanced planning and collaboration to maintain program quality. However, current technical standards (TS) may serve as a barrier to entry into the health professions for people with disabilities. These individuals remain substantially underrepresented in dentistry despite bringing unique perspectives and experiences that can contribute to a diverse workforce of culturally proficient practitioners. In response, many schools have adopted a "functional" approach to TS that emphasizes a student's abilities rather than their limitations. In addition, innovative assistive technologies coupled with the application of critical pedagogy and universal design learning practices that engage people with the widest possible range of capabilities allows equitable approaches for learning and assessment while maintaining professional standards.
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Affiliation(s)
- Jayne S Reuben
- Department of Biomedical Sciences, Texas A&M University School of Dentistry, Dallas, Texas, USA
| | - Khairunisa Hashmani
- Department of Periodontics and Dental Hygiene, University of Texas School of Dentistry, Houston, Texas, USA
| | - Mitzy Perez
- Academic Affairs, University of Puerto Rico, San Juan, Puerto Rico
| | - Robert Gyurko
- Department of Periodontics, Tufts University, Boston, Massachusetts, USA
| | - Mary Kang
- Department of Periodontology and Implant Dentistry, New York University, New York City, New York, USA
| | - Matthew R Cooke
- Departments of Dental Aneisthesiology and Pediatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Setnikar A, Lecordier D. Using nursing knowledge in the acute phase of stroke: An exploratory qualitative descriptive study. Rech Soins Infirm 2024; 154:55-69. [PMID: 38182541 DOI: 10.3917/rsi.154.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Introduction Strokes represent a major public health issue in which nurses are involved, both in care and in research. The literature reveals a description of their activities in treating the disease and the altered functions in which it results, as well as in managing the experience of the sufferer. The aim of this work was to describe the knowledge upon which nurses draw when caring for patients in the acute phase of stroke. Methods This exploratory qualitative descriptive multicentric survey was carried out via non-directive interviews with nurses working in neurovascular units. Thematic qualitative analysis was used to describe their activities and to highlight the knowledge and skills used. Results The results show that the nurses express themselves with ease when discussing their medical knowledge, and with more difficulty concerning knowledge from the human, social, and nursing sciences. However, they often combine this knowledge in a nursing perspective. Discussion This work opens up prospects with regard to supporting the nursing knowledge already leveraged and developing the nursing knowledge (concepts and theory of care) relevant to the particular context of strokes. The results also encourage a reflective analysis of nurses’ experience.
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Affiliation(s)
- Alexandra Setnikar
- Infirmière en pratique avancée, M.Sc, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - Didier Lecordier
- Infirmier cadre de santé, Ph.D en sociologie, Douarnenez, France
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Savant SV, Chadha N, Fredrick D, Reddy HS. A Novel Video-Based Skills Curriculum for Incoming Ophthalmology Residents. Semin Ophthalmol 2024; 39:83-88. [PMID: 37496206 DOI: 10.1080/08820538.2023.2239332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/27/2023] [Accepted: 07/02/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Given limited pre-residency ophthalmology exposure, skill training for PGY-2 ophthalmology residents is essential. However, orientation experiences vary, and skills acquisition is often not measured. OBJECTIVE A novel video-based orientation curriculum was developed and implemented to standardize and effectively teach ophthalmic examination skills to incoming ophthalmology residents. METHODS An instructional video library (VL) on ophthalmic exam skills was created in 2020. Prior to any instruction, PGY2s were recorded performing basic ophthalmic exams (BOE) using slit-lamp recording smartphone adapters. After a 2-week orientation involving live teaching, practice, and self-directed library review, ophthalmic exams were again recorded. A 36-point ophthalmic exam skills checklist expanding upon the Ophthalmic Clinical Evaluation Exercise (OCEX) was developed for scoring videos. Residents also completed pre- and post- surveys assessing their comfort with the ophthalmic exam. RESULT 7 of 11 incoming PGY-2 residents (63.7%) ophthalmology residents participated. Average recorded OCEX score improved from 16.5 ± 5.8 to (p = .0002) to 30.9 ± 2.7. Surveyed resident comfort with the exam increased from 2.4 ± 0.6 to 4.2 ± 0.5 on a 5-point Likert scale (p < .0001). CONCLUSION Our video library orientation curriculum was effective in rapidly increasing resident comfort and BOE skills. With the launch of the integrated internship model, the VL curriculum may be effective for training ophthalmology PGY1s, medical students and non-ophthalmology providers.
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Affiliation(s)
- Shravan V Savant
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA
| | - Nisha Chadha
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA
| | - Douglas Fredrick
- Department of Ophthalmology, Casey Eye Institute, Portland, OR, USA
| | - Harsha S Reddy
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA
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12
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Donroe JH, Egger E, Soares S, Sofair AN. Clinical Reasoning: Perspectives of Expert Clinicians on Reasoning Through Complex Clinical Cases. Cureus 2024; 16:e51696. [PMID: 38313894 PMCID: PMC10838525 DOI: 10.7759/cureus.51696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 02/06/2024] Open
Abstract
Introduction Clinical reasoning is a core skill for physicians; most doctors do not attain the level of expertise associated with that of an expert clinician (EC). The purpose of this study is to identify the clinical reasoning strategies ECs prioritize when reasoning through complex cases. Methods We interviewed 14 ECs and performed a thematic analysis to identify strategies ECs prioritize when reasoning through complex clinical cases. The authors chose ECs based on the recognition of clinical and teaching expertise by trainees and other faculty members (ECs within our institution) and institutional recognition of high achievement in medicine and medical education (ECs outside our institution). We used a semi-structured guide to interview each EC, then reviewed and coded the interview transcriptions. We developed themes based on agreements between all transcript reviewers. Results We interviewed 11 male and three female ECs, one from outside the study institution. Two (14%) ECs were primary care physicians, and the remaining were sub-specialists. The authors organized strategies for clinical reasoning through complex cases around four themes, which were as follows: (1) connecting clinical reasoning to patient context; (2) embracing uncertainty, then reducing it; (3) returning to the patient's bedside; and (4) remaining humble to limit diagnostic errors. Conclusion Clinical reasoning is a core clinical skill of physicians, and this article describes clinical reasoning strategies prioritized by ECs for complex clinical cases. Recognition and integration of these strategies into medical training and clinical educator practice may facilitate the evolution of clinical reasoning skills and reduce diagnostic errors.
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Affiliation(s)
- Joseph H Donroe
- General Internal Medicine, Yale School of Medicine, New Haven, USA
| | - Emilie Egger
- Social and Behavioral Sciences, Yale School of Public Health, New Haven, USA
| | - Sarita Soares
- General Internal Medicine, Yale School of Medicine, New Haven, USA
| | - Andre N Sofair
- General Internal Medicine, Yale School of Medicine, New Haven, USA
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Stevens N. Thinking of Learning Communities? Here Are Some of the Ways They May Benefit Your Medical Students. J Med Educ Curric Dev 2024; 11:23821205231223303. [PMID: 38204975 PMCID: PMC10775716 DOI: 10.1177/23821205231223303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/07/2023] [Indexed: 01/12/2024]
Abstract
Learning communities are designed to bring together students, faculty, and potentially other healthcare professionals, to learn with and from each other formally in teaching activities but also in the social domain. In recent years, learning communities have gained some recognition as an effective educational strategy but their use is still not widely seen in all medical schools. Numerous benefits of learning communities have been reported and these include improved academic performance, enhanced critical thinking and problem-solving abilities, increased student confidence, and improved communication skills. Learning communities also provide opportunities for personal growth, mentorship, and self-reflection, all of which contribute to a students' professional development.
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Affiliation(s)
- Niall Stevens
- Department of Clinical Microbiology, RCSI Education & Research Centre, Beaumont Hospital, Dublin, Ireland
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14
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Bradley F, Nelson PA, Cutts C, Hodgson D. Negotiating new roles in general practice: a qualitative study of clinical pharmacists. Br J Gen Pract 2024; 74:e27-e33. [PMID: 38154936 PMCID: PMC10755993 DOI: 10.3399/bjgp.2023.0145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/10/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND To address general practice workforce shortages, policy in England has supported the recruitment of 'non-medical' roles through reimbursement funding. As one of the first to receive funding, the clinical pharmacist role offers insight into the process of new role negotiation at general practice level. AIM To identify factors influencing clinical pharmacist role negotiation at practice level, comparing the process under two different funding and employment models. DESIGN AND SETTING Qualitative interview study with staff involved in the following schemes: 1) the national NHS England (NHSE) Clinical Pharmacists in General Practice scheme; and 2) a local clinical commissioning group-funded scheme, providing clinical pharmacist support to general practices in one area of Greater Manchester in the UK. METHOD Semi-structured interviews with purposive and snowball sampling of pharmacists, GPs, and practice staff took place. The interviews were analysed using template analysis. RESULTS In total, 41 interviews were conducted. The following four factors were found to influence role negotiation: role ambiguity; competing demands and priorities; potential for (in)appropriate utilisation of clinical skills; and level of general practice control over the role. Key differences between the two funding and employment models were the level of influence GPs had in shaping the role and how adaptable pharmacists could be to practice needs. The potential for inappropriate utilisation was reported under both schemes, but most apparent under the role reimbursement, direct employment model of the NHSE scheme. CONCLUSION This study has highlighted lessons applicable for the introduction of non-medical roles more widely in general practice. It has provided insight into the factors that can influence role negotiation at practice level and how different funding and/or employment models can impact on this process.
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Affiliation(s)
- Fay Bradley
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester
| | - Pauline A Nelson
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester; Sheffield University Management School, University of Sheffield, Sheffield
| | - Chris Cutts
- Centre for Pharmacy Postgraduate Education, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester; NHS England North West, Manchester
| | - Damian Hodgson
- Alliance Manchester Business School, University of Manchester, Manchester; Sheffield University Management School, University of Sheffield, Sheffield
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Ekelund K, Tolsgaard MG, Jacobsen RVB, Østergaard D, Bader-Larsen K. Learning strategies for the advanced trainee in specialist training. Med Teach 2023:1-8. [PMID: 38145618 DOI: 10.1080/0142159x.2023.2289845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/28/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND A significant factor of clinicians' learning is based on their ability to effectively transfer acquired knowledge, skills, and attitudes from specialty-specific clinical courses to their working environment. MATERIAL AND METHOD We conducted semi-structured interviews with 20 anaesthesiologist trainees (i.e. residents) in four group and five individual interviews using SRL principles as sensitizing concepts. Data were collected and analyzed iteratively using thematic analysis. RESULTS Advanced trainees are highly motivated to explore what they have learned in specialty-specific courses, but they often face several barriers in implementing their learning in the workplace environment. Four themes emerged from the interview data: 'Be ready to learn', "Take the 'take-home-messages' home', "Be ready to create your own opportunities', and "Face it, it's not entirely up to you'. Understanding the challenges regarding transferring knowledge from courses to the working environment is an important lesson for assisting trainees set their learning goals, monitor their progress, and re-evaluate their SRL processes. CONCLUSION Even for advanced trainees, successfully transferring knowledge from specialty-specific courses often requires adequate commitment and support. Medical supervisors and other relevant stakeholders must be aware of their shared responsibility for creating individual environments that support opportunities for trainees to self-regulate their learning.
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Affiliation(s)
- Kim Ekelund
- Copenhagen Academy for Medical Education and Simulation (CAMES), Herlev Hospital, University Hospital of Copenhagen, Herlev, Denmark
- The University of Copenhagen, Copenhagen, Denmark
- Department of Anaesthesiology, Juliane Marie Centre, Rigshospitalet University Hospital of Copenhagen, Copenhagen, Denmark
| | - Martin Grønnebæk Tolsgaard
- The University of Copenhagen, Copenhagen, Denmark
- Copenhagen Academy for Medical Education and Simulation (CAMES), Rigshospitalet University Hospital of Copenhagen, Copenhagen, Denmark
- Department of Obstetrics, Juliane Marie Centre, Rigshospitalet University Hospital of Copenhagen, Copenhagen, Denmark
| | - Rikke Vita Borre Jacobsen
- Copenhagen Academy for Medical Education and Simulation (CAMES), Herlev Hospital, University Hospital of Copenhagen, Herlev, Denmark
- The University of Copenhagen, Copenhagen, Denmark
- Department of Anaesthesiology, Centre of Head and Orthopaedics, Rigshospitalet University Hospital of Copenhagen, Copenhagen, Denmark
| | - Doris Østergaard
- Copenhagen Academy for Medical Education and Simulation (CAMES), Herlev Hospital, University Hospital of Copenhagen, Herlev, Denmark
- The University of Copenhagen, Copenhagen, Denmark
| | - Karlen Bader-Larsen
- Copenhagen Academy for Medical Education and Simulation (CAMES), Rigshospitalet University Hospital of Copenhagen, Copenhagen, Denmark
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16
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Brocker A, Scafide KN. Systematic review: Self-efficacy and skill performance. Int Nurs Rev 2023. [PMID: 38135913 DOI: 10.1111/inr.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/11/2023] [Indexed: 12/24/2023]
Abstract
AIM The aim of this systematic review was to investigate the relationship between self-efficacy and skill performance in undergraduate student nurses. BACKGROUND Across higher education, self-efficacy is an important predictor of student success in skill-based learning. Nursing students are required to demonstrate skills prior to caring for hospitalized patients. Understanding the relationship between self-efficacy and nursing student skill performance may support patient safety. METHODS Following the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), a systematic search was conducted of four databases: CINAHL, Medline, Psychinfo, and Web of Science. Quantitative, peer-reviewed studies published in English were included with no limitation on year. Hands-on skill performance had to be performed in laboratory or simulation settings and evaluated by an expert. Identified studies were assessed for methodological rigor using Joanna Briggs Institute's Critical Appraisal Tools. FINDINGS A total of 2,450 items were identified by database search and screened, resulting in 20 eligible studies. Most of the studies included novice first- or second-year students. Self-efficacy was operationalized as either a general or skill-specific measure, while the type of skill and associated instrumentation varied widely. Sixteen (80%) of the included study reports showed weak to no correlation between self-efficacy and skill performance. The remaining 4 reports noted a moderate-to-strong relationship. CONCLUSION Our findings conflict with existing research in other higher education disciplines where self-efficacy is a significant predictor of performance success. Explanations for this contradiction likely center around how self-efficacy was operationalized and rigor of the included studies. IMPLICATIONS FOR NURSING Larger studies controlling for confounding variables are needed to understand this relationship with a goal of developing more consistent approaches to teaching and learning skills within prelicensure curriculums.
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Affiliation(s)
- Angela Brocker
- School of Nursing, George Mason University, Fairfax, Virginia, USA
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17
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Blaschke AL, Hapfelmeier A, Rubisch HPK, Berberat PO, Gartmeier M. Structure and quality of bedside teaching: A videographic analysis. Med Teach 2023:1-9. [PMID: 38110186 DOI: 10.1080/0142159x.2023.2289860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 11/28/2023] [Indexed: 12/20/2023]
Abstract
Bedside teaching (BST) is a core element of medical education. In light of a reported decrease in BST, evidence on how to use BST time most efficiently should be developed. Given that little research into the tangible quality characteristics of good BST has been reported, we investigated the influence of various teacher and structural characteristics on the perceived quality of BST. We filmed and coded 36 BSTs involving 24 lecturers and 259 students. Structural characteristics of interest were: number of students and patients, overall duration, and the proportion of clinical examination. Lecturer questionnaires provided insight into teaching experience and intrinsic motivation, and student evaluations assessed the quality of BSTs in three dimensions. Correlations are reported using the Pearson r and a linear mixed model (LMM). The intrinsic motivation of lecturers was significantly positively correlated with perceived quality, but their experience was only weakly so correlated. In the LMM, a significant association was observed for the quality dimension of clinical teaching with the number of patients and the proportion of time spent on clinical examination. Based on our findings, we recommend including multiple patients in BSTs, and providing substantial opportunities for clinical examination. Regarding lecturers, motivation matters more than experience.
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Affiliation(s)
- Anna-Lena Blaschke
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Alexander Hapfelmeier
- Institute of AI and Informatics in Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- Institute of General Practice and Health Services Research, School of Medicine, Technical University of Munich, Munich, Germany
| | - Hannah P K Rubisch
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Pascal O Berberat
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Martin Gartmeier
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
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18
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Muehlberg J, Tipold A, Heppelmann M, Wissing S. Simulator-Assisted Training of Abomasal Surgery-A Pilot Study Using Blended Learning and Face-to-Face Teaching. Animals (Basel) 2023; 13:3822. [PMID: 38136859 PMCID: PMC10740769 DOI: 10.3390/ani13243822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Two stimulators were developed, one simplified and one realistic, in the present study for learning abomasal surgery for veterinary students. The simulators were tested in a pilot study: The upcoming blended learning format was compared with traditional face-to-face teaching. A total of 21 5th-year students participated in the study. While one group learned the surgical technique in traditional face-to-face simulator training, the second group completed interactive video training asynchronously. Afterwards, skills were examined in person. The results showed that the different groups did not lead to different performance results. Participation in the study increased self-assessment of skills by an average of about 7 of 36 points, as well as the learning success and motivation of students in both groups. The simulators developed were well liked by the students and rated as appropriate by 12 practicing bovine veterinarians. The pilot study indicates that blended learning could be a suitable alternative to traditional face-to-face teaching. This should be followed by further research to support the use of blended learning in the veterinary education of clinical skills.
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Affiliation(s)
- Julia Muehlberg
- Clinical Skills Lab, Centre for E-Learning, Didactics and Training Research, University of Veterinary Medicine Hannover, 30173 Hannover, Germany;
| | - Andrea Tipold
- Clinic for Small Animals, Neurology, University of Veterinary Medicine Hannover, 30559 Hannover, Germany;
| | - Maike Heppelmann
- Clinic for Cattle, University of Veterinary Medicine Hannover, 30173 Hannover, Germany;
| | - Sandra Wissing
- Clinical Skills Lab, Centre for E-Learning, Didactics and Training Research, University of Veterinary Medicine Hannover, 30173 Hannover, Germany;
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19
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Abstract
PURPOSE This qualitative study describes nurses' experiences and perceptions of how they develop the clinical gaze. METHODS This qualitative study used an inductive approach and content analysis to assess the experiences of newly graduated nurses, nurse managers, and nursing teachers. Nineteen interviews were conducted. To achieve credibility, the study followed the guidelines of the Consolidated Criteria for Reporting Qualitative research (COREQ). RESULTS Two themes emerged: nurses' personal abilities and the learning culture. Learning culture was considered the foundation of the development of the clinical gaze. The clinical gaze was found to be developed in relationships with patients and when learning together with colleagues, in which the opportunities for reflection are central. To develop the clinical gaze, structures for learning activities, such as reflection, communication exercises, and simulation, are needed so that they become a natural part of daily work. This can also be achieved through supervision and skills training both at university and in a care context. CONCLUSIONS Prerequisites for the development of the clinical gaze include physical presence with the patient combined with learning activities such as conscious reflection with others in a safe learning culture.
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Affiliation(s)
- Marie-Louise Södersved Källestedt
- Källestedt Clinical Skills Center, Region Västmanland, Västerås, Sweden,School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden,CONTACT Marie-Louise Södersved Källestedt School of Health, Care and Social Welfare, Mälardalen University, VästeråsSE-721 23, Sweden
| | - Margareta Asp
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Anna Letterstål
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden,Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Margareta Widarsson
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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20
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Klig JE, Stenson BA, Kivlehan SM, Jackson A, Berwick JR, Kosowsky JM. Twelve tips for practical clinical skills coaching. Med Teach 2023; 45:1357-1363. [PMID: 37318542 DOI: 10.1080/0142159x.2023.2220895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Coaching is rapidly evolving in clinical medicine, including for clinical skills (CS) learning. Yet a schema is needed for how to coach students in the many CS that are pivotal to the practice of medicine. These twelve tips aim to provide practical strategies for teachers and educators to coach students for CS learning. The tips cover many important aspects of CS coaching, including establishing a safe space, ways to prepare to coach, setting goals, guiding a coaching relationship, fostering coaching conversations, and in-person or virtual approaches. Together, the tips align as seven key steps of an overall coaching process. The twelve tips apply equally to coaching struggling students and all students seeking to improve CS and offer a guide for coaching at an individual or program level.
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Affiliation(s)
- Jean E Klig
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
- Office of Medical Education, Harvard Medical School, Boston, MA, USA
| | - Bryan A Stenson
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Sean M Kivlehan
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Agnieszka Jackson
- Office of Medical Education, Harvard Medical School, Boston, MA, USA
| | - Jessica R Berwick
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Joshua M Kosowsky
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
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21
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Parry A. Understanding the use of oxygen delivery devices. Nurs Stand 2023:e12175. [PMID: 37982146 DOI: 10.7748/ns.2023.e12175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2023] [Indexed: 11/21/2023]
Abstract
Many nurses will care for a patient who requires oxygen therapy, either to treat an acute respiratory condition, such as a lung infection, or a chronic condition, such as chronic obstructive pulmonary disease. This article discusses the physiology of gaseous exchange and provides an overview of some of the main respiratory conditions that may result in the need for oxygen therapy. The author also describes the oxygen delivery devices commonly used in clinical practice, such as simple face masks and nasal cannulas, to assist nurses in selecting the most appropriate device.
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Affiliation(s)
- Andrew Parry
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, Wales
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22
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Gorick H. How to triage patients in the emergency department. Emerg Nurse 2023:e2186. [PMID: 37971254 DOI: 10.7748/en.2023.e2186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 11/19/2023]
Abstract
Triaging patients can be a complicated process, with multiple modes of assessment taking place simultaneously, and nurses need to be confident and competent in their assessment skills. This article explains the necessary preparation for triage and outlines the steps that nurses need to take when triaging a patient in the emergency department. • Triage requires a targeted patient assessment, using both clinical judgement and triage tools to determine appropriate acuity categories.• Different scales and algorithms are used in triage, so it is essential to clearly communicate the acuity categories assigned to patients.• A structured approach to patient assessment can guide decision-making and identify issues.• Various diagnostic tests can be used to facilitate the triage process, but care needs to be taken to ensure the process is not prolonged by their use. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when assessing the acuity of patients in triage.• How you could use this information to educate nursing students or your colleagues on the appropriate technique and evidence base regarding the triaging of patients in the emergency department.
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Affiliation(s)
- Hugh Gorick
- School of Health Sciences, University of East Anglia, Norwich, England
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23
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Reyes Alardo LV, Palmer LB, Beach A, García-Godoy F. Perceptions of dental students, dental faculty, practicing dentists and industry dental professionals on the acquisition of dental competencies and clinical skills in the Dominican Republic. Eur J Dent Educ 2023; 27:974-984. [PMID: 36539992 DOI: 10.1111/eje.12889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 11/06/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION This study gathered perceptions from four stakeholder groups in the Dominican Republic (DR) regarding acquiring professional dental competencies and clinical skills. MATERIALS AND METHODS Researcher-created surveys covering core dental competencies and clinical skills were distributed to stakeholder groups associated with nine different DR dental programs. Respondents included 153 undergraduate dental students, 153 dental faculty members, 108 practicing dentists (who had graduated in the past 5 years) and 42 industry professionals (who hire and supervise dentists). Data were examined using descriptive statistics, univariate ANOVA and multiple linear regressions. RESULTS Dental school students and recent graduates now practicing dentists in the DR reflected moderate to solid confidence that they had learned most of the dental skills and competencies covered in the survey. Industry professionals were a bit less confident overall, while dental faculty offered the lowest scores, although those were often still in the moderately confident range. ANOVAs revealed significant differences when broken down by individual university dental programs. Regressions also revealed that individual university dental programs significantly predict confidence that dental skills and competencies were achieved. CONCLUSION Data show that DR's dental stakeholder groups generally felt optimistic about the learning occurring. However, the lower mean scores and higher standard deviations from faculty responses raise concern, as do the significant differences between individual dental programs and the dental program itself a significant predictor. Further review of programs is needed, and a national set of dental competencies should be considered in this country.
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Affiliation(s)
| | - Louann Bierlein Palmer
- Department of Educational Leadership, Research and Technology, Western Michigan University, Kalamazoo, Michigan, USA
| | - Andrea Beach
- Department of Educational Leadership, Research and Technology, Western Michigan University, Kalamazoo, Michigan, USA
| | - Franklin García-Godoy
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA
- Adjunct Faculty, The Forsyth Institute, Cambridge, Massachusetts, USA
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24
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Manohar S, Moniz T, Haidet P, Chisolm MS, Balhara KS. Applying the Prism Model to design arts and humanities medical curricula. Int Rev Psychiatry 2023; 35:576-582. [PMID: 38461395 DOI: 10.1080/09540261.2023.2254384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/29/2023] [Indexed: 03/11/2024]
Abstract
The arts and humanities (A&H) play a fundamental role in medical education by supporting medical learners' development of core competencies. Like all medical curricula, those integrating the A&H are more likely to achieve the desired outcomes when the learning domains, goals, objectives, activities, and evaluation strategies are well-aligned. Few faculty development programs focus on helping medical educators design A&H curricula in a scholarly manner. The Prism Model, an evidence-based tool, supports educators developing A&H medical curricula in a rigorous way for maximum impact. The model posits that the A&H can serve four pedagogical functions for medical learners: 1) skill mastery, 2) perspective taking, 3) personal insight, and 4) social advocacy. Although this model has been described in the literature, no practical guidance exists for medical educators seeking to apply it to the development of a specific curriculum. This paper provides a step-by-step demonstration of how to use the Prism Model to design an A&H curriculum. Beginning with the first step of selecting a learning domain through the final step of curriculum evaluation, this paper helps medical educators apply the Prism Model to develop A&H curricula with intentionality and rigour to achieve the desired learning outcomes.
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Affiliation(s)
| | - Tracy Moniz
- Department of Communication Studies, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Paul Haidet
- Woodward Center for Excellence in Health Sciences Education, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | | | - Kamna S Balhara
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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25
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Zayapragassarazan Z, Sumathy MK, Wyawahare M, Pai D. A protocol to evaluate the effectiveness of competency-based simulation training modules on the educational outcomes among MBBS students - A mixed method study. J Educ Health Promot 2023; 12:375. [PMID: 38144029 PMCID: PMC10743914 DOI: 10.4103/jehp.jehp_338_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/08/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND The growing recognition of the importance of simulation-based training has been a present focus of medical education curriculum planners. This study aims to design, develop, implement, and evaluate the educational outcomes of training modules for a list of essential skills that MBBS students in a tertiary care teaching hospital in South India need to learn as part of their competency-based MBBS curriculum. MATERIALS AND METHODS This sequential transformative mixed method study will be implemented in three phases: i) identification of essential skills for simulation-based training following the modified Delphi method, ii) development of skill training modules using ADDIE model of instructional design, implementation of the modules and collection of data on the educational outcomes and iii) a qualitative study involving in-depth interview and focus group discussion on understanding the potential for incorporating the modules into the present MBBS curriculum. Data on educational outcomes relevant to the study objectives will be collected using appropriate tools and analyzed using descriptive statistics and qualitative analytic methods. RESULTS Phase one will tabulate the list of five essential skills and phase two educational outcomes will contain descriptive statistics on knowledge and skill acquisition, perception of simulation-based teaching and learning, and higher-order thinking skills. Phase three qualitative analysis will highlight the enabling and barrier aspects for incorporating this approach of simulation-based skill training within the current MBBS curriculum. CONCLUSIONS The study outcomes will provide curriculum planners and educators insights into designing and implementing simulation-based skill training for undergraduate medical students. It will also help policymakers develop policies in medical education technologies to provide quality medical education and fulfill the objective of quality healthcare for all.
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Affiliation(s)
| | - Masanam Kasi Sumathy
- Department of Medical Education, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Mukta Wyawahare
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dinker Pai
- Department of Surgery and Medical Simulation Centre, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
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26
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Price N, Wood AF. Acute kidney injury in the critical care setting. Nurs Stand 2023; 38:45-50. [PMID: 37458070 DOI: 10.7748/ns.2023.e12063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 07/18/2023]
Abstract
Acute kidney injury is a sudden reduction in renal function which impairs the kidneys' ability to maintain fluid, electrolyte and acid-base balance. The syndrome often develops secondary to severe illness and is associated with a significant increase in morbidity and mortality rate in critically ill patients. This article gives an overview of the pathophysiology and aetiology of acute kidney injury, as well as the associated complications and clinical diagnostic signs. The authors also describe some common causes of the syndrome in critically ill patients, specifically sepsis, liver failure and cardiac failure, and discuss patient management in the critical care setting, with a focus on haemodynamic support and continuous renal replacement therapy.
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Affiliation(s)
- Natasha Price
- division of nursing and paramedic science, school of health sciences, Queen Margaret University, Edinburgh, Scotland
| | - Alison Fiona Wood
- programme lead for independent prescribing, division of nursing and paramedic science, school of health sciences, Queen Margaret University, Edinburgh, Scotland
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27
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Rosengarten L. Administration of intravenous fluids and medicines in children and young people. Nurs Child Young People 2023:e1481. [PMID: 37661751 DOI: 10.7748/ncyp.2023.e1481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2023] [Indexed: 09/05/2023]
Abstract
Managing intravenous (IV) access is a standard proficiency for UK nurses, enabling them to administer IV injections and IV infusions and to manage injection equipment and infusion pumps and devices. In this article the author describes various types of venous access devices that are commonly seen in practice and details the preparation, checking and administration of IV fluids and medicines, including some complications that may arise. The author also discusses the calculation of fluid requirements, types of IV fluids, displacement values and ongoing care of venous access devices.
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Affiliation(s)
- Leah Rosengarten
- health and life sciences, Northumbria University, Newcastle Upon Tyne, England
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28
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Berendes S, Schaper E, Tipold A, Wissing S. Evaluation of the eOSCE for testing clinical skills. Front Vet Sci 2023; 10:1196311. [PMID: 37662984 PMCID: PMC10472136 DOI: 10.3389/fvets.2023.1196311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
The OSCE is a proven instrument for testing practical skills of students, not only in the (veterinary) medical field. At the University of Veterinary Medicine Hannover, Foundation (TiHo), students must complete a 10-week rotation in one of the university’s own clinics during the practical year in the 9th and 10th semesters in addition to other practical training. Within this framework, the first training for acquiring clinical practical skills with a formative examination (OSCE; Objective Structured Clinical Examination) was developed in the Clinical Skills Lab (CSL) in 2014. Since 2018, the TiHo has been the first veterinary medical training institution in Germany to conduct electronic OSCEs (eOSCEs). In the future, eOSCEs will also be introduced as a summative examination at the TiHo. For this reason, students in the practical year of the winter semester 2021/2022 and summer semester 2022 as well as former and current examiners were surveyed regarding their satisfaction with the eOSCE examination format as part of this study. The 175 analyzed questionnaires from students and 27 analyzed questionnaires from examiners showed a high level of satisfaction with the eOSCE overall, but at the same time indicated problems that should be ironed out before it is introduced as a summative examination in the state examination. In addition to its standardization and objectivity, the examination format also convinced with its quality-assurance review procedure and the direct feedback possibility with regard to the students’ performance.
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Affiliation(s)
- Svenja Berendes
- Centre for E-Learning, Didactics and Educational Research (ZELDA), Clinical Skills Lab, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Elisabeth Schaper
- Centre for E-Learning, Didactics and Educational Research (ZELDA), E-Learning Consulting, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Andrea Tipold
- Clinic for Small Animals, Neurology, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Sandra Wissing
- Centre for E-Learning, Didactics and Educational Research (ZELDA), Clinical Skills Lab, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
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29
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Zhong Z. A comparison of two different remote OSCEs during the COVID-19 pandemic: A candidate's perspective. Med Teach 2023:1-2. [PMID: 37566744 DOI: 10.1080/0142159x.2023.2244660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
The Membership of the Royal College of Obstetricians and Gynaecologists (MRCOG) and the European Fellowship in Obstetrics and Gynaecology (EBCOG) exams are both well-renowned specialty qualifications that assess the competency of obstetricians and gynaecologists. In this article, an exam candidate shares his perspective on the changes made during the COVID-19 pandemic. Despite changing to an online format to allow candidates to take the exam remotely, the MRCOG Part 3 exam maintained its main exam structures: (1) simulated patient task to evaluate the candidates' interactions with well-trained patients in a tele-interview: (2) structure discussion with the clinical examiners based on some certain topics. In contrast, the EBCOG has created a brand new structure to suit the online model to assess the candidates' core clinical skills in broader aspects. Although it is unclear whether online exam will exist in future, this has been a unique experience for candidates during pandemic.
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Affiliation(s)
- Zixing Zhong
- Center for Reproductive Medicine, Department of Obstetrics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
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Liu A, Duffy M, Tse S, Zucker M, McMillan H, Weldon P, Quet J, Long M. Concurrent versus terminal feedback: The effect of feedback delivery on lumbar puncture skills in simulation training. Med Teach 2023; 45:906-912. [PMID: 36931315 DOI: 10.1080/0142159x.2023.2189540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Simulation-based medical education (SBME) is widely used to teach bedside procedural skills. Feedback is crucial to SBME but research on optimal timing to support novice learners' skill development has produced conflicting results. METHODS We randomly assigned 32 novice medical students to receive feedback either during (concurrent) or after (terminal) trialing lumbar puncture (LP). Participants completed pre- and post-acquisition tests, as well as retention and transfer tests, graded on a LP checklist by two blinded expert raters. Cognitive load and anxiety were also assessed, as well as learners' perceptions of feedback. RESULTS Participants who received concurrent feedback demonstrated significantly higher LP checklist scores (M = 91.54, SE = 1.90) after controlling for baseline levels, than those who received terminal feedback (M = 85.64, SE = 1.90), collapsed across post, retention, and transfer tests. There was no difference in cognitive load and anxiety between groups. In open-ended responses, participants who received concurrent feedback more often expressed satisfaction with their learning experience compared to those who received terminal feedback. DISCUSSION AND CONCLUSIONS Concurrent may be superior to terminal feedback when teaching novice learners complex procedures and has the potential to improve learning if incorporated into SBME and clinical teaching. Further research is needed to elucidate underlying cognitive processes to explain this finding.
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Affiliation(s)
- Anna Liu
- School of Medicine and Dentistry, University of Western Ontario, London, Canada
| | - Melissa Duffy
- Department of Educational Studies, University of South Carolina, Columbia, SC, USA
| | - Sandy Tse
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
- Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Marc Zucker
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
- Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Hugh McMillan
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
- Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Patrick Weldon
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
- Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Julie Quet
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
- Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Michelle Long
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
- Children's Hospital of Eastern Ontario, Ottawa, Canada
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Klig JE, Kettyle WM, Kosowsky JM, Phillips, Jr. WR, Farrell SE, Hundert EM, Dalrymple JL, Goldhamer MEJ. A pilot clinical skills coaching program to reimagine remediation: a cohort study. MedEdPublish (2016) 2023; 13:29. [PMID: 37674590 PMCID: PMC10477753 DOI: 10.12688/mep.19621.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
Abstract
Background New approaches are needed to improve and destigmatize remediation in undergraduate medical education (UME). The COVID-19 pandemic magnified the need to support struggling learners to ensure competency and readiness for graduate medical education (GME). Clinical skills (CS) coaching is an underutilized approach that may mitigate the stigma of remedial learning. Methods A six-month CS coaching pilot was conducted at Harvard Medical School (HMS) as a destigmatized remedial learning environment for clerkship and post-clerkship students identified as 'at risk' based on objective structured clinical examinations (OSCE). The pilot entailed individual and group coaching with five faculty, direct bedside observation of CS, and standardized patient encounters with video review. Strengths-based coaching principles and appreciative inquiry were emphasized. Results Twenty-three students participated in the pilot: 14 clerkship students (cohort 1) and 9 post-clerkship students (cohort 2). All clerkship students (cohort 1) demonstrated sustained improvement in CS across three OSCEs compared to baseline: at pilot close, at 6-months post pilot, and at 21-24 months post-pilot all currently graduating students (10/10, 100%) passed the summative OSCE, an HMS graduation requirement. All post-clerkship students (cohort 2) passed the HMS graduation OSCE (9/9,100%). Feedback survey results included clerkship students (9/14; 64%) and post-clerkship students (7/9; 78%); all respondents unanimously agreed that individual coaching was "impactful to my clinical learning and practice". Faculty and leadership fully supported the pilot as a destigmatized and effective approach to remediation. Conclusion Remediation has an essential and growing role in medical schools. CS coaching for remedial learning can reduce stigma, foster a growth mindset, and support sustained progress for 'at risk' early clerkship through final year students. An "implementation template" with suggested tools and timelines can be locally adapted to guide CS coaching for UME remediation. The CS coaching pilot model is feasible and can be generalized to many UME programs.
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Affiliation(s)
- Jean E. Klig
- Massachusetts General Hospital, Boston, Massachusetts, 02114, USA
- Harvard Medical School, Boston, Massachusetts, 02115, USA
| | | | - Joshua M. Kosowsky
- Harvard Medical School, Boston, Massachusetts, 02115, USA
- Brigham and Women’s Hospital, Boston, Massachusetts, 02115, USA
| | - William R. Phillips, Jr.
- Harvard Medical School, Boston, Massachusetts, 02115, USA
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, 02115, USA
| | - Susan E. Farrell
- Harvard Medical School, Boston, Massachusetts, 02115, USA
- Brigham and Women’s Hospital, Boston, Massachusetts, 02115, USA
| | | | - John L. Dalrymple
- Harvard Medical School, Boston, Massachusetts, 02115, USA
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, 02115, USA
| | - Mary Ellen J. Goldhamer
- Massachusetts General Hospital, Boston, Massachusetts, 02114, USA
- Harvard Medical School, Boston, Massachusetts, 02115, USA
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Ogston-Tuck S. Intramuscular injection: exploring the evidence on effective administration. Nurs Stand 2023; 38:71-76. [PMID: 37357532 DOI: 10.7748/ns.2023.e12161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/27/2023]
Abstract
Administering medicines by intramuscular (IM) injection is a familiar, though not necessarily common, nursing procedure. To ensure effective administration of IM injections it is important that nurses are up to date with the evidence on factors such as selection of injection site, use of appropriate equipment and injection technique. This article explores the evidence on effective administration of IM injections with the aim of enhancing nurses' decision-making and technique when undertaking this procedure.
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Affiliation(s)
- Sherri Ogston-Tuck
- Institute of Health & Society, University of Worcester, Worcester, England
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Saeed S, Afzal A, Khalid F, Jehan F. Student experiences of simulation-based learning and its impact on their performance in Objective Structured Clinical Examination in Pediatrics - A mixed method study. Pak J Med Sci 2023; 39:978-982. [PMID: 37492306 PMCID: PMC10364247 DOI: 10.12669/pjms.39.4.7287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/26/2022] [Accepted: 04/08/2023] [Indexed: 07/27/2023] Open
Abstract
Objective This study aims to assess the effectiveness of integrating simulation for teaching pediatric clinical examination skills to undergraduate, MBBS Year-IV medical students at The Aga Khan University, Karachi, Pakistan. Methods In this mixed method study, the Objective Structured Clinical Examination (OSCE) scores of the students who were taught using simulation (batch 2017-2018) were compared with the batch of the academic year 2016 -2017 (taught via traditional methods). In order to explore the experiences of the intervention group, a questionnaire with four open-ended questions was administered at the end of the clerkship. Results Students who were taught by simulation, scored significantly higher on the clinical skills stations in Objective Structured Clinical Examination, than in the pre-intervention group (p-value <0.01). The students quoted safety of the learning environment, opportunities for deliberate practice, debriefing and facilitation skills maximized quoted that their experience of learning through simulation, however, some challenges were identified for future improvement. Conclusion The result of the study suggested simulation as a useful instructional strategy for teaching examination skills to students in their early years. The student gained confidence through deliberate practice and feedback without compromising patient safety, which translated into improved performance in the high-stakes OSCE examination at the end of the clerkship.
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Affiliation(s)
- Sana Saeed
- Sana Saeed, FCPS Assistant Professor, Department of Pediatrics & Department for Educational Development. The Aga Khan University Karachi, Karachi, Pakistan
| | - Azam Afzal
- Azam Afzal, MHPE Senior Manager, Department of Community Medicine & Department for Educational Development. The Aga Khan University Karachi, Karachi, Pakistan
| | - Farah Khalid
- Farah Khalid, MSc Instructor, Department of Pediatrics, The Aga Khan University Karachi, Karachi, Pakistan
| | - Fyezah Jehan
- Fyezah Jehan, FCPS Associate Professor, Chair, Department of Pediatrics. The Aga Khan University Karachi, Karachi, Pakistan
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Bayazit A, Ilgaz H, Gönüllü İ, Erden Ş. Profiling students via clustering in a flipped clinical skills course using learning analytics. Med Teach 2023; 45:724-731. [PMID: 36448794 DOI: 10.1080/0142159x.2022.2152663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Flipped classrooms have become popular as a student-centered approach in medical education because they allow students to improve higher-order thinking skills and problem-solving applications during in-class activities. However, students are expected to study videos and other class materials before class begins. Learning analytics and unsupervised machine learning algorithms (clustering) can be used to examine the pre-class activities of these students to identify inadequate student preparation before the in-class stage and make appropriate interventions. Furthermore, the students' profiles, which provide their interaction strategies towards online materials, can be used to design appropriate interventions. This study investigates student profiles in a flipped classroom. The learning management system interactions of 375 medical students are collected and preprocessed. The k-means clustering algorithms examined in this study show a two-cluster structure: 'high interaction' and 'low-interaction.' These results can be used to help identify low-engaged students and give appropriate feedback.
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Affiliation(s)
- Alper Bayazit
- Medical Education, and Informatics, Ankara University, Ankara, Turkey
| | - Hale Ilgaz
- The Faculty of Open and Distance Education, Ankara University, Ankara, Turkey
| | - İpek Gönüllü
- Medical Education, and Informatics, Ankara University, Ankara, Turkey
| | - Şengül Erden
- Medical Education, and Informatics, Ankara University, Ankara, Turkey
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Kowero E, Burengelo D, Philbert D, Sirili N. "…with the third eye we can detect mistakes and correct them…'' Supportive supervision and the management of Clubfoot by Ponseti method: Qualitative experiences from Mwanza, Tanzania. Medicine (Baltimore) 2023; 102:e34116. [PMID: 37352044 PMCID: PMC10289721 DOI: 10.1097/md.0000000000034116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/25/2023] Open
Abstract
Supportive supervision is the key to health programs in the provision of quality care. Clubfoot or Congenital Talipes Equinovarus remains among the prevalent congenital musculoskeletal birth defects in Tanzania. In 2015, Tanzania introduced supportive supervision guidelines for clubfoot treatment. However, little is known about how supportive supervision helps maintain the skills of providers. To analyze the supportive supervision in maintaining the clinical skills of healthcare workers in clubfoot management in Mwanza, Tanzania. An exploratory qualitative case study employing in-depth interviews (IDIs) with healthcare providers, supervisors, and parents of children with clubfoot was conducted in Mwanza, Tanzania. Data were collected from 3 purposefully selected hospitals and 32 IDI were conducted with the selected participants between April and May 2021. A semi-structured interview guide was used to conduct the IDIs. Qualitative content analysis was used to analyze the data. Two categories were identified in this study. First "the contribution of supportive supervision" attributed by its purpose and the success brought by the supportive supervision. Second, "the maintenance of healthcare workers' skills was attributed to their willingness to learn and actively engage in supportive supervision, cooperation with clinics and clubfoot programmes, and material support. The findings of this study underscore the contribution of supportive supervision to maintaining skills in the management of clubfoot in Tanzania. The findings of this study highlight the importance of joint efforts to maintain quality service skills.
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Affiliation(s)
- Emmanuel Kowero
- Department of Development Studies, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es salaam, United Republic of Tanzania
| | - Dorica Burengelo
- Department of Development Studies, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es salaam, United Republic of Tanzania
| | - Doreen Philbert
- Department of Development Studies, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es salaam, United Republic of Tanzania
| | - Nathanael Sirili
- Department of Development Studies, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es salaam, United Republic of Tanzania
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Kaifi R, Subahi A, Alqarni S, Jaddawi A, Alghamdi A, Alshamrani KM. The Impact of COVID-19 on Radiological Science Students and Interns at King Saud bin Abdulaziz University for Health Sciences: Cross-Sectional Study. Adv Med Educ Pract 2023; 14:563-571. [PMID: 37305167 PMCID: PMC10257397 DOI: 10.2147/amep.s407289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 05/23/2023] [Indexed: 06/13/2023]
Abstract
Introduction The impact of the coronavirus disease (COVID-19) outbreak on many parts of our lives cannot be overstated. This study aimed to identify the psychological, physical activity, and educational effects of COVID-19 on radiological sciences students and interns at the three campuses of King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Jeddah, and Alahsa. Methods A cross-sectional study was conducted between November and December 2021 among Saudi-108 radiological sciences students and interns using non-probability convenient sampling at King Saud bin Abdul-Aziz University for Health Science (KSAU-HS), Riyadh, Jeddah, and Alahsa using a validated questionnaire. Statistical analyses were conducted using Excel and JMP statistical software. Results 102 out of 108 completed the questionnaire resulting in a 94.44% response rate. The percentage of the overall negative psychological impact was 62%. For the physical activity effects of COVID-19 among students and interns, 96% reported a decline in their physical activities. 77% of participants reported a fair impression that the students were able to achieve some of their academic goals and acquired new skills during the pandemic, and 20% reported a good impression. They achieved all their goals and developed new skills, whereas 3% reported bad impressions and needed to achieve their goals or improve their skills. Conclusion COVID-19 had a negative psychological and physical activity impact on RADs students and interns at the three KSAU-HS campuses in the Kingdom of Saudi Arabia. Despite technical difficulties, students and interns reported positive academic outcomes from COVID-19.
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Affiliation(s)
- Reham Kaifi
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah City, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah City, Saudi Arabia
- Medical Imaging Department, Ministry of the National Guard - Health Affairs, Jeddah City, Saudi Arabia
| | - Ahmed Subahi
- King Abdullah International Medical Research Center, Jeddah City, Saudi Arabia
- Department of Basic Sciences, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, National Guard, Jeddah City, Saudi Arabia
| | - Salem Alqarni
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah City, Saudi Arabia
| | - Ahmed Jaddawi
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah City, Saudi Arabia
| | - Ahmed Alghamdi
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah City, Saudi Arabia
| | - Khalid M Alshamrani
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah City, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah City, Saudi Arabia
- Medical Imaging Department, Ministry of the National Guard - Health Affairs, Jeddah City, Saudi Arabia
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Kelly K, Wilder L, Bastin J, Lane-Cordova A, Cai B, Cook J. Utility of Gynecological Teaching Associates. Cureus 2023; 15:e40601. [PMID: 37469809 PMCID: PMC10353857 DOI: 10.7759/cureus.40601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 07/21/2023] Open
Abstract
Introduction Gynecological teaching associates (GTAs) are trained to teach the pelvic exam using themselves as models, and it has been hypothesized that their use can improve learners' confidence and interpersonal skills. This study aims to gain greater insight into whether the use of GTAs is associated with increased medical students' confidence when performing the pelvic exam during clinical rotations. Methods An email survey was distributed to medical students in two different classes at a single United States Medical Licensing Examination (USMLE)-accredited medical school: one that learned the pelvic exam using GTAs and one that did not. A Fisher's exact test was performed to determine associations between the use of GTAs and confidence in performing the pelvic exam, with a p-value of <0.01. Results Out of the 85 survey participants, 68 had performed a pelvic exam in the clinical setting and thus rated their confidence level. Of the 38 students who learned using a GTA, 66% (p<0.0024) reported a confidence level of four or five (out of five) compared to 50% of the 30 students who were not able to practice using a GTA. There was a statistically significant difference in the confidence levels of students who practiced on GTAs compared to those who did not. Discussion Our findings demonstrated that students who were able to learn the pelvic exam using GTAs reported higher confidence levels when subsequently performing a pelvic exam in a clinical setting. Conclusion Our findings support investment in GTA programming for teaching the pelvic exam in medical school curricula.
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Affiliation(s)
- Katherine Kelly
- Department of Obstetrics and Gynecology, Prisma Health Richland Hospital, Columbia, USA
| | - Lauren Wilder
- Department of Obstetrics and Gynecology, Prisma Health Richland Hospital, Columbia, USA
| | - Jessica Bastin
- Department of Obstetrics and Gynecology, Prisma Health Richland Hospital, Columbia, USA
| | - Abbi Lane-Cordova
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Bo Cai
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - James Cook
- Department of Obstetrics and Gynecology, Prisma Health Richland Hospital, Columbia, USA
- Department of Medical Education and Academic Affairs, School of Medicine, University of South Carolina, Columbia, USA
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Hall L, Binks S, Heal C. The effect of COVID-19 on medical student clinical skill practice and self-perceived proficiency. MedEdPublish (2016) 2023; 13:10. [PMID: 37435137 PMCID: PMC10331848 DOI: 10.12688/mep.19478.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 07/13/2023] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic significantly impacted medical education. This study aimed to determine how COVID-19 affected students' opportunity to practice core clinical skills across specialty rotations and their self-perceived proficiency at performing these. Methods: Routinely administered surveys of fifth year medical student' experiences and perceptions of medical training from 2016 to 2021 were analysed. Number of times core clinical skills were performed and self-perceived proficiency of each skill were compared pre- (years 2016-2019) and during-COVID (years 2020-2021). Results: Data from 219 surveys showed a reduction in the opportunity to perform "a cervical screen test" (p<0.001), "a mental health assessment" (p=0.006), "assess the risk of suicide" (p=0.004) and "bladder catheterisation" (p=0.007) during-COVID. Self-reported skill proficiency was also less during-COVID for performance of: "a mental health assessment" (p=0.026) and "an ECG" (p=0.035). Conclusions: The impact of COVID-19 on mental health skills was greatest, potentially due to a shift toward telehealth services and consequent reduced ability for students to engage in consultations. In a time of potential long-term change in the healthcare landscape, it is imperative to ensure adequate opportunity to practice all core clinical skills during medical training. Inclusion of telehealth earlier into the curriculum may benefit student confidence.
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Affiliation(s)
- Leanne Hall
- College of Medicine and Dentistry, James Cook University, Mackay, Queensland, 4740, Australia
| | - Sophie Binks
- College of Medicine and Dentistry, James Cook University, Mackay, Queensland, 4740, Australia
| | - Clare Heal
- College of Medicine and Dentistry, James Cook University, Mackay, Queensland, 4740, Australia
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Hunter Buskey R, Gideon R, Thomas T, Brown-Stephenson ME, Lyons M, Hassan D, Dunwoody M, Patel TB, Beasley C, Hinkley J, Garrett C, Brown D, Everett P, Gielski ML, Hamilton G. Use of a National Clinical Skills Assessment Program Improves the Clinical Competency for Correctional Nurses and Advanced Practice Providers. J Correct Health Care 2023. [PMID: 37098167 DOI: 10.1089/jchc.21.11.0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
The Federal Bureau of Prisons clinical skills training development (CSTD) team accomplished the planning, creation, and execution of a first-ever national clinical skills assessment program (CSAP) for nurses and advanced practice providers (APPs). Clinical skills assessment is a part of nurse and APP credentialing and privileging and must be completed for new hires along with continued biennial recredentialing accreditation standards. A training resource manual, discipline-specific skills checklist, pre-/postprogram written examination, and standard operating procedures were created. The CSTD team used commercially available manikins, food items, and easily obtainable office supplies for simulated experiential skills assessments. The CSAP provided a consistent, reproducible, and scalable approach for the orientation, assessment, and, if indicated, remediation for correctional nurses and APPs.
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Affiliation(s)
| | - Ruby Gideon
- Federal Bureau of Prisons, Rees Spring, Missouri, USA
| | | | | | - Maude Lyons
- Federal Bureau of Prisons, Durham, North Carolina, USA
| | | | | | | | - Cubie Beasley
- Federal Bureau of Prisons, Wake Forest, North Carolina, USA
| | | | - Chad Garrett
- Federal Bureau of Prisons, Monument, Colorado, USA
| | - Darlene Brown
- Federal Bureau of Prisons, Durham, North Carolina, USA
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Pfeil SA, Shellhaas CS. Using simulation to train clinical providers in the effective use of telehealth. Nutr Clin Pract 2023; 38:520-530. [PMID: 37017930 DOI: 10.1002/ncp.10977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/13/2023] [Accepted: 02/09/2023] [Indexed: 04/06/2023] Open
Abstract
With the onset of the COVID-19 pandemic, telehealth became a widely used method to provide patient care. Providers had to quickly learn how to adapt traditional clinical care to the virtual environment. The existing literature focuses on the technological aspects of telehealth with only a few publications addressing optimization of communication, with even fewer looking at the use of simulation to fill the knowledge gap in this area. Simulation training is one such avenue that can be used to practice virtual encounters. This review outlines how to effectively use simulation as an educational method to teach clinical skills needed for effective telehealth communication. The experiential nature of simulation provides learners with an opportunity to adapt their clinical skills to a telehealth encounter, and an opportunity to practice challenges unique to a telehealth environment, such as patient privacy, patient safety, technology disruption, and performance of an examination virtually. The goal of this review is to discuss how simulation may be used to train providers for best practices in telehealth.
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Affiliation(s)
- Sheryl A Pfeil
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Cynthia S Shellhaas
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, USA
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Imm MR, Agarwal G, Zhang C, Deshpande AR, Issenberg B, Chandran L. EPMO: A novel medical student assessment tool that integrates entrustable professional activities, prime, and the modified Ottawa coactivity scale. Med Teach 2023; 45:419-425. [PMID: 36288734 DOI: 10.1080/0142159x.2022.2137012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE Alignment of workplace-based assessments (WPBA) with core entrustable professional activities (EPAs) for entering residency may provide opportunities to monitor student progress across the continuum of undergraduate medical education. Core EPAs, however, reflect tasks of varying degrees of difficulty and faculty assessors are not accustomed to rating students based on entrustability. Expectations of student progress should vary depending on the complexity of the tasks associated with the EPAs. An assessment tool that orients evaluators to the developmental progression of specific EPA tasks will be critical to fairly evaluate learners. METHODS The authors developed an EPA assessment tool combining the frameworks of Professionalism, Reporter, Interpreter, Manager, Educator (PRIME), and Modified Ottawa coactivity scales. Only those EPAs that could be repeatedly observed and assessed across clinical clerkships were included. From July 2019 to March 2020, third-year medical students across multiple clerkships were assessed using this tool. The authors hypothesized that if the tool was applied correctly, ratings of learner independence would be lower with higher complexity tasks and that such ratings would increase over the course of year with ongoing clinical learning. RESULTS Assessment data for 247 medical students were similar across clerkships suggesting that evaluators in diverse clinical contexts were able to use this tool to assign scores reflective of developing entrustability in the workplace. Faculty rated student entrustability highest in skills emphasized in the pre-clerkship curriculum (professionalism and reporter) and progressively lower in more advanced skills (interpreter and manager). Students' ratings increased over time with more clinical exposure. CONCLUSIONS The authors developed a composite WBPA tool that combines the frameworks of EPAs, PRIME, and Modified Ottawa Co- Activity and demonstrated the usability of applying it for learner assessments in clinical settings. Further multicenter studies with cohorts of pre- and post-clerkship students may provide additional validity evidence for the tool.
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Affiliation(s)
- Matthew R Imm
- Department of Medicine, The University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Gauri Agarwal
- Department of Medicine, The University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Chi Zhang
- Department of Medical Education, The University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Amar R Deshpande
- Department of Medicine, The University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Barry Issenberg
- Department of Medical Education, The University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Latha Chandran
- Department of Medical Education, The University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
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Kelley B, Littman J, Anandarajah G. Physicians' Concordant and Discordant Views on Primary Versus Specialty Palliative Care Skills: An Exploratory Study. J Pain Symptom Manage 2023; 65:e391-e395. [PMID: 36521767 DOI: 10.1016/j.jpainsymman.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/01/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Brendan Kelley
- Warren Alpert Medical School (B.K., J.L., G.A.), Brown University, Providence, RI
| | - Jake Littman
- Warren Alpert Medical School (B.K., J.L., G.A.), Brown University, Providence, RI
| | - Gowri Anandarajah
- Warren Alpert Medical School (B.K., J.L., G.A.), Brown University, Providence, RI; Hope Hospice and Palliative Care Rhode Island (G.A.), Providence, RI.
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Sabirov A, Chludzinski M, Eminof E, Eddy A, Gallagher J, Jung I. Learning abnormal physical examination signs: an introductory course. J Osteopath Med 2023; 123:295-299. [PMID: 36998103 DOI: 10.1515/jom-2022-0163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 03/07/2023] [Indexed: 04/01/2023]
Abstract
CONTEXT The acquisition of clinical skills is an essential part of the osteopathic medical school curriculum. Preclinical medical students, especially at osteopathic medical schools, have limited exposure to abnormal physical examination (PE) findings that are not typically seen in a student's peers or in a standardized patient (SP). The early exposure of first-year medical students (MS1s) to normal and abnormal findings in the simulation settings better equips them to identify abnormalities when they encounter them in a clinical setting. OBJECTIVES The aim of this project was to develop and implement the introductory course on learning abnormal PE signs and pathophysiology of abnormal clinical findings to address the educational needs of MS1s. METHODS The didactic part of the course consisted of PowerPoint presentations and lecture on the topics related to the simulation. The practical skill session was 60 min, during which time students first practiced PE signs and then were assessed on their ability to accurately identify abnormal PE signs on a high-fidelity (HF) mannequin. Faculty instructors guided students through clinical cases and challenged them with probing questions in clinically relevant content. Before- and after-simulation evaluations were created to assess students' skills and confidence. Student satisfaction levels after the training course were also assessed. RESULTS This study demonstrated significant improvements in five PE skills (p<0.0001) after the introductory course of abnormal PE clinical signs. The average score for five clinical skills increased from 63.1 to 88.74% (before to after simulation). The confidence of students in performing clinical skills and their understanding of the pathophysiology of abnormal clinical findings also increased significantly (p<0.0001) after simulation activity and educational instruction. The average confidence score increased from 3.3 to 4.5% (before to after simulation) on a 5-point Likert scale. Survey results demonstrated high satisfaction with the course among learners with mean satisfaction score 4.7 ± 0.4 on 5-point Likert scale. The introductory course was well received by MS1s and they left positive feedback. CONCLUSIONS This introductory course offered MS1s with novice PE skills the ability to learn a variety of abnormal PE signs, including heart murmurs and rhythms, lung sounds, measurement of blood pressure (BP), and palpation of the femoral pulse. This course also allowed abnormal PE findings to be taught in a time-efficient and faculty-resource-efficient manner.
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Affiliation(s)
- Albert Sabirov
- Department of Basic Science, Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | | | - Emin Eminof
- Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | - Alexis Eddy
- Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | - John Gallagher
- Department of Internal Medicine, Millcreek Community Hospital, Erie, PA, USA
| | - Ichabod Jung
- Department of Basic Science, Lake Erie College of Osteopathic Medicine, Erie, PA, USA
- Urology Residency Research Director, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
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Dawson BC. Assessment and management of lower urinary tract symptoms in men. Nurs Stand 2023; 38:e11996. [PMID: 36970750 DOI: 10.7748/ns.2023.e11996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 06/18/2023]
Abstract
Lower urinary tract symptoms (LUTS) is a broad term that covers a range of urinary issues, which are often categorised as storage and voiding symptoms. Storage symptoms include increased frequency, nocturia, urgency and urge incontinence, while voiding symptoms include hesitancy, suboptimal flow, dribbling and incomplete emptying. In men, the most common causes of LUTS are benign prostatic hyperplasia (prostate enlargement) and overactive bladder. This article provides an overview of the anatomy of the prostate and outlines the assessment process for men presenting with LUTS. It also explains the recommended lifestyle modifications, medicines and surgical interventions available to male patients who are experiencing these symptoms.
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Rainey H. Chronic kidney disease: understanding its association with other long-term conditions. Nurs Stand 2023:e12081. [PMID: 36950902 DOI: 10.7748/ns.2023.e12081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 03/24/2023]
Abstract
Chronic kidney disease (CKD) is a common long-term condition and is associated with increased mortality and a reduction in healthy years of life. Early identification and appropriate treatment of CKD can reduce these risks. The inclusion of CKD in any discussions with people about other long-term health conditions such as cardiovascular disease and diabetes mellitus is also essential. All nurses need to understand the risks associated with CKD so that they can develop the confidence to routinely discuss the condition with patients and support them to improve their health.
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Affiliation(s)
- Helen Rainey
- chronic kidney disease, Barts Health NHS Trust, London, England
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Zhou D, Davitadze M, Ooi E, Ng CY, Allison I, Thomas L, Hanania T, Blaggan P, Evans N, Chen W, Melson E, Boelaert K, Karavitaki N, Kempegowda P. Sustained clinical knowledge improvements from simulation experiences with Simulation via Instant Messaging-Birmingham Advance. Postgrad Med J 2023; 99:25-31. [PMID: 36947426 DOI: 10.1093/postmj/qgac008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 11/03/2022] [Accepted: 11/13/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Simulation via Instant Messaging-Birmingham Advance (SIMBA) delivers simulation-based learning through WhatsApp and Zoom, helping to sustain continuing medical education (CME) for postgraduate healthcare professionals otherwise disrupted by the coronavirus (COVID-19) pandemic. This study aimed to assess whether SIMBA helped to improve clinical knowledge and if this improvement in knowledge was sustained over time. METHODS Two SIMBA sessions-thyroid and pituitary-were conducted in July-August 2020. Each session included simulation of various real-life cases and interactive discussion. Participants' self-reported confidence, acceptance, and knowledge were measured using surveys and multiple-choice questions pre- and post-simulation and in a 6- to 12-week follow-up period. The evaluation surveys were designed using Moore's 7 Levels of CME Outcomes Framework. RESULTS A total of 116 participants were included in the analysis. Significant improvement was observed in participants' self-reported confidence in approach to simulated cases (thyroid, n = 37, P < .0001; pituitary, n = 79, P < .0001). Significant improvement in clinical knowledge was observed following simulation (thyroid, n = 37, P < .0001; pituitary, n = 79, P < .0001). For both sessions, retention of confidence and knowledge was seen at 6-12 weeks' follow-up. CONCLUSIONS SIMBA increased participants' clinical knowledge on simulated cases and this improvement was retained up to 6-12 weeks after the session. Further studies are required to explore long-term retention and whether it translates to improved real-world clinical practice.
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Affiliation(s)
- Dengyi Zhou
- College of Medical and Dental Sciences, University of Birmingham, Birmingham B4 6BN, United Kingdom
| | - Meri Davitadze
- Endocrinology, Georgian-American Family Medicine Clinic 'Medical House', Tbilisi 0171, Georgia
| | - Emma Ooi
- The faculty of Medicine and Health Sciences, Royal College of Surgeons in Ireland and University College Dublin (RCSI & UCD) Malaysia Campus, Pulau Pinang 10450, Malaysia
| | - Cai Ying Ng
- Royal Glamorgan Hospital, Cwm Taf Morgannwg University Health Board, Rhondda Cynon Taf, Talbot Green CF72 8XR, United Kingdom
| | - Isabel Allison
- College of Medical and Dental Sciences, University of Birmingham, Birmingham B4 6BN, United Kingdom
| | - Lucretia Thomas
- College of Medical and Dental Sciences, University of Birmingham, Birmingham B4 6BN, United Kingdom
| | - Thia Hanania
- College of Medical and Dental Sciences, University of Birmingham, Birmingham B4 6BN, United Kingdom
| | - Parisha Blaggan
- College of Medical and Dental Sciences, University of Birmingham, Birmingham B4 6BN, United Kingdom
| | - Nia Evans
- Royal Glamorgan Hospital, Cwm Taf Morgannwg University Health Board, Rhondda Cynon Taf, Talbot Green CF72 8XR, United Kingdom
| | - Wentin Chen
- College of Medical and Dental Sciences, University of Birmingham, Birmingham B4 6BN, United Kingdom
| | - Eka Melson
- Ninewells Hospital, NHS Tayside, Dundee DD2 1UB, United Kingdom
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TH, United Kingdom
| | - Kristien Boelaert
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, United Kingdom
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - Niki Karavitaki
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TH, United Kingdom
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, United Kingdom
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham B15 2TT, United Kingdom
| | - Punith Kempegowda
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TH, United Kingdom
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, United Kingdom
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Bestwick C, Yates C, Carter V. Developing an oral healthcare assessment strategy to enhance patient care. Nurs Stand 2023; 38:41-47. [PMID: 36872892 DOI: 10.7748/ns.2023.e12000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 03/07/2023]
Abstract
The promotion of oral healthcare is an integral part of nursing care. However, research has shown that staff in hospitals and community care settings often lack oral healthcare skills. This article details a quality improvement project in which a scoping exercise was undertaken in one NHS trust to assess whether ward-based oral healthcare provision was adequate. The scoping exercise identified that there was a need to address the lack of oral healthcare provision in the trust. Subsequently, a multidisciplinary working group developed an oral healthcare assessment tool and rolled this out across the trust. The authors also provided online training for nurses in the trust to assist them in using the new tool. At the same time, an audit of the oral healthcare products used in the trust, and their appropriateness, was undertaken.
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Affiliation(s)
| | - Caroline Yates
- The Royal Wolverhampton NHS Trust, Wolverhampton, England
| | - Vanda Carter
- The Royal Wolverhampton NHS Trust, Wolverhampton, England
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Paul T, Hoque MA, Dey T, Sutradhar BC, Mannan A, Sarker D, Mohsin MAS, Baillie S. Establishing the Most Important Clinical Skills for New Graduate Veterinarians by Comparing Published Lists with Regional Stakeholder Expectations: A Bangladesh Experience. J Vet Med Educ 2023:e20220114. [PMID: 36867664 DOI: 10.3138/jvme-2022-0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Veterinary clinical skills training is evolving rapidly around the world and there is increasing interest in Bangladesh in opening clinical skills laboratories and using models in teaching. The first clinical skills laboratory was opened at Chattogram Veterinary and Animal Sciences University in 2019. The current study aimed to identify the most important clinical skills for veterinarians in Bangladesh to inform the further development of clinical skills laboratories and ensure resources are deployed effectively and efficiently. Lists of clinical skills were collated from the literature, national and international accreditation standards, and regional syllabi. The list was refined through local consultation, focused on farm and pet animals, and was disseminated via an online survey to veterinarians and final-year students who were asked to rate the level of importance of each skill for a new graduate. The survey was completed by 215 veterinarians and 115 students. A ranked list was generated with injection techniques, animal handling, clinical examination, and basic surgical skills among the most important. Some techniques requiring specific equipment and some advanced surgical procedures were considered less important. As a result of the study, the most important clinical skills for a new graduate in Bangladesh have been identified for the first time. The results will inform the development of models, the use of clinical skills laboratories, and the design of clinical skills courses for veterinary training. Our approach of drawing upon existing lists followed by local stakeholders consultation is recommended to others to ensure clinical skills teaching is regionally relevant.
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Affiliation(s)
- Thomby Paul
- Department of Medicine and Surgery, Chattogram Veterinary and Animal Sciences University, Zakir Hossain Road, Khulshi, Chattogram 4225, Bangladesh
| | - Md Ahasanul Hoque
- Department of Medicine and Surgery, Chattogram Veterinary and Animal Sciences University, Zakir Hossain Road, Khulshi, Chattogram 4225, Bangladesh
| | - Tuli Dey
- Department of Medicine and Surgery, Chattogram Veterinary and Animal Sciences University, Zakir Hossain Road, Khulshi, Chattogram 4225, Bangladesh
| | - Bibek Chandra Sutradhar
- Department of Medicine and Surgery, Chattogram Veterinary and Animal Sciences University, Zakir Hossain Road, Khulshi, Chattogram 4225, Bangladesh
| | - Abdul Mannan
- Teaching and Training Pet Hospital and Research Center, Chattogram Veterinary and Animal Sciences University, Purbachal New Town, Road # 114, Dhaka, Bangladesh
| | - Debashish Sarker
- Department of Medicine and Surgery, Chattogram Veterinary and Animal Sciences University; Khulshi 4225, Chattogram, Bangladesh
| | - Md Abu Shoieb Mohsin
- Department of Medicine and Surgery, Chattogram Veterinary and Animal Sciences University, Zakir Hossain Road, Khulshi, Chattogram 4225, Bangladesh
| | - Sarah Baillie
- Bristol Veterinary School, University of Bristol, Langford House, Langford, Bristol BS40 5DU UK
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Baillie S, Dilly M, Ciappesoni JL, Read E. The Rapid and International Expansion of Veterinary Clinical Skills Laboratories: A Survey to Establish Recent Developments. J Vet Med Educ 2023:e20220113. [PMID: 36795498 DOI: 10.3138/jvme-2022-0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Veterinary clinical skills laboratories are used for teaching a wide range of practical, clinical, and surgical skills on models and simulators. A survey conducted in 2015 identified the role of such facilities in veterinary education in North America and Europe. The current study aimed to capture recent changes using a similar survey with three sections to collect data about the structure of the facility, its uses in teaching and assessment, and the staffing. The survey consisted of multiple choice and free text questions, was administered online using Qualtrics and was disseminated in 2021 via clinical skills networks and Associate Deans. Responses were received from 91 veterinary colleges in 34 countries; 68 had an existing clinical skills laboratory and 23 were planning to open one within 1-2 years. Collated information from the quantitative data described the facility, teaching, assessment and staffing. Major themes emerged from the qualitative data relating to aspects of the layout, location, integration in the curriculum, contributions to student learning, and the team managing and supporting the facility. Challenges were associated with budgeting, the ongoing need for expansion and leadership of the program. In summary, veterinary clinical skills laboratories are increasingly common around the world and the contributions to student learning and animal welfare were well recognized. The information about existing and planned laboratories and the tips from those managing the facilities provides valuable guidance for anyone intending to open or expand an existing clinical skills laboratory.
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Affiliation(s)
- Sarah Baillie
- Bristol Veterinary School, University of Bristol, Langford House, Langford, Bristol BS40 5DU UK
| | - Marc Dilly
- Dina-Weißmann-Allee 6, 68519 Viernheim, Germany
| | - José Luis Ciappesoni
- University of Buenos Aires (UBA), Chorroarín 280 C1427CWO, Autonomous City of Buenos Aires, Argentina
| | - Emma Read
- The Ohio State University College of Veterinary Medicine, Columbus, OH 43210 USA
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Chen X, Gong MF, Wu S, He J. "LEARN", a novel teaching method for Chinese clinical clerkship: A cross-sectional study. Front Surg 2023; 10:1113267. [PMID: 36860941 PMCID: PMC9968847 DOI: 10.3389/fsurg.2023.1113267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/20/2023] [Indexed: 02/16/2023] Open
Abstract
Background Despite the clerkship being crucial in the training of a future doctor, no widely accepted education model has been proposed. This study devised a new model for clinical clerkship rotations, titled "LEARN" for Lecture, English-video, Advisor, Real-case and Notion, and evaluated whether the LEARN model is appropriate for medical education in China. Methods A cross-sectional study was performed among 101 fourth-year students from the Xiangya School of Medicine during an Orthopaedic Surgery clerkship rotation in the Third Xiangya Hospital. They were divided into seven groups and took clerkship based on the LEARN model. A questionnaire was collected at the conclusion to measure learning outcomes. Results The LEARN model was highly accepted with the acceptance of five sessions being 95.92% (94/98), 93.88% (92/98), 96.98% (97/98), 100% (98/98) and 96.94% (95/98). The outcomes of two genders were comparable, whereas a difference was observed in the test score among groups (group 3 scored 93.93 ± 5.20, higher than others). Quantitative analysis showed that positive correlations existed in participation in the Notion (Notion means students' case discussion) section with leadership (r = 0.84, 95% CI: 0.72-0.94, p < 0.001), participation in the Real-case section with leadership (r = 0.66, 95% CI: 0.50-0.80, p < 0.001), participation in the Real-case section with mastery of inquiring skills (r = 0.57, 95% CI: 0.40-0.71, p < 0.001) and participation in the Notion section with mastery of physical examination skills (r = 0.56, 95% CI: 0.40-0.69, p < 0.001). Further qualitative analysis demonstrated that high-level participation in the English-video section indicated better outcomes in mastery of inquiring (p < 0.01), physical examination (p < 0.001), film reading (p < 0.01) and clinical reasoning (p < 0.01) skills. Conclusion Our results support the LEARN model is a promising method for medical clerkship in China. Further research involving more participants and more meticulous design is planned to test its efficacy. For refinement, educators may try to promote students' participation in the English-video session.
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Affiliation(s)
- Xiangyu Chen
- Department of Orthopaedic Surgery, Central South University Third Xiangya Hospital, Changsha, China,Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Matthew F. Gong
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Song Wu
- Department of Orthopaedic Surgery, Central South University Third Xiangya Hospital, Changsha, China
| | - Jinshen He
- Department of Orthopaedic Surgery, Central South University Third Xiangya Hospital, Changsha, China,Correspondence: Jinshen He
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