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Martínez-Gaitero C, Dennerlein SM, Dobrowolska B, Fessl A, Moreno-Martínez D, Herbstreit S, Peffer G, Cabrera E. Connecting Actors With the Introduction of Mobile Technology in Health Care Practice Placements (4D Project): Protocol for a Mixed Methods Study. JMIR Res Protoc 2024; 13:e53284. [PMID: 38329786 PMCID: PMC10884912 DOI: 10.2196/53284] [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: 10/02/2023] [Revised: 11/12/2023] [Accepted: 11/23/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND The learning process in clinical placements for health care students is a multifaceted endeavor that engages numerous actors and stakeholders, including students, clinical tutors, link teachers, and academic assessors. Successfully navigating this complex process requires the implementation of tasks and mentorships that are synchronized with educational and clinical processes, seamlessly embedded within their respective contexts. Given the escalating number of students and the rising demand for health care services from the general population, it becomes imperative to develop additional tools that support the learning process. These tools aim to simplify day-to-day clinical practice, allowing a concentrated focus on value-based activities. This paper introduces a project funded by the European Commission that involves 5 European countries. The project's objective is to comprehensively outline the entire process of development and ultimately implement mobile technology in practice placements. The project tackles the existing gap by constructing tailored mobile apps designed for students, teachers, tutors, and supervisors within each participating organization. This approach leverages practice-based learning, mobile technology, and technology adoption to enhance the overall educational experience. OBJECTIVE This study aims to introduce mobile technology in clinical practice placements with the goal of facilitating and enhancing practice-based learning. The objective is to improve the overall effectiveness of the process for all stakeholders involved. METHODS The "4D in the Digitalization of Learning in Practice Placement" (4D Project) will use a mixed methods research design, encompassing 3 distinct study phases: phase 1 (preliminary research), which incorporates focus groups and a scoping review, to define the problem, identify necessities, and analyze contextual factors; phase 2 (collaborative app development), which involves researchers and prospective users working together to cocreate and co-design tailored apps; and phase 3, which involves feasibility testing of these mobile apps within practice settings. RESULTS The study's potential impact will primarily focus on improving communication and interaction processes, fostering connections among stakeholders in practice placements, and enhancing the assessment of training needs. The literature review and focus groups will play a crucial role in identifying barriers, facilitators, and factors supporting the integration of mobile technology in clinical education. The cocreation process of mobile learning apps will reveal the core values and needs of various stakeholders, including students, teachers, and health care professionals. This process also involves adapting and using mobile apps to meet the specific requirements of practice placements. A pilot study aimed at validating the app will test and assess mobile technology in practice placements. The study will determine results related to usability and design, learning outcomes, student engagement, communication among stakeholders, user behavior, potential issues, and compliance with regulations. CONCLUSIONS Health care education, encompassing disciplines such as medicine, nursing, midwifery, and others, confronts evolving challenges in clinical training. Essential to addressing these challenges is bridging the gap between health care institutions and academic settings. The introduction of a new digital tool holds promise for empowering health students and mentors in effectively navigating the intricacies of the learning process. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53284.
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Affiliation(s)
| | | | - Beata Dobrowolska
- Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Angela Fessl
- Institute of Interactive Systems and Data Science, Graz University of Technology, Graz, Austria
- Know-Center GmbH, Graz, Austria
| | - Daniel Moreno-Martínez
- Germans Trias i Pujol Research Institute, Hospital Germans Trias i Pujol Institut Català de la Salut, Badalona, Spain
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Hepburn J. Diagnostic uncertainty and axial spondyloarthropathy: A case for cognitive debiasing through practice-based learning and improvement activity. Musculoskeletal Care 2023; 21:1463-1469. [PMID: 37776078 DOI: 10.1002/msc.1818] [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] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 08/29/2023] [Accepted: 09/03/2023] [Indexed: 10/01/2023]
Affiliation(s)
- Jordan Hepburn
- Musculoskeletal (MSK) GP Advanced Practice Physiotherapy Service, Edinburgh Health & Social Care Partnership, NHS Lothian, Edinburgh, UK
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Thaivalappil A, Coghlin R, Bell C, Dougherty B, Duench S, Janicki R, Papadopoulos A. A mixed-methods assessment of community-engaged learning in a Master of Public Health program. SAGE Open Med 2023; 11:20503121231176637. [PMID: 37275845 PMCID: PMC10233587 DOI: 10.1177/20503121231176637] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/02/2023] [Indexed: 06/07/2023] Open
Abstract
Objective Community-engaged learning is used in Master of Public Health programs to enhance student training, connect with communities, help solve societal issues, develop competencies, and build partnerships. However, it is unclear how much community-engaged learning components supplement existing Master of Public Health programs and prepare students in developing these competencies. Thus, the aim of this study was to apply an explanatory mixed-methods study design to evaluate a Canadian Master of Public Health program's community-engaged learning activities and propose recommendations to strengthen public health training and course delivery. Methods We conducted a questionnaire among Master of Public Health students (n = 25), focus group discussion with a subset of these students (n = 7), and one-on-one semi-structured telephone interviews with community partners who had previously hosted Master of Public Health students for practicum placements (n = 11). Results Community-engagement enhanced learning among Master of Public Health students, with the practicum placement, and program development capstone resulting in the largest self-reported development. Students in the focus group indicated community engagement provided skill and professional development, but also identified wanting additional curriculum coverage on various statistical software and qualitative research methods. Interviews with community partners revealed benefits of practicum placements such as mutual knowledge transfer, increased organizational capacity, and strengthened academic-community partnerships. Community partners also commented on challenges with recruitment, training, and aligning student-organization goals. Conclusion The findings from this study suggest that an update to the Master of Public Health program curriculum, its core competencies, a combination of community-engagement activities, and future evaluations will be needed to advance education delivery.
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Affiliation(s)
| | - Rachel Coghlin
- Health Promotion Team,
Wellington-Dufferin-Guelph Public Health, Guelph, ON, Canada
| | - Courtney Bell
- Infection Prevention and Control,
Fraser Health Authority, Surrey, BC, Canada
| | - Brendan Dougherty
- Department of Population Medicine,
University of Guelph, Guelph, ON, Canada
| | - Stephanie Duench
- Health Protection and Investigation
Division, Region of Waterloo Public Health and Emergency Services, Waterloo, ON,
Canada
| | - Rachelle Janicki
- Office of the Chief Science Officer,
Public Health Agency of Canada, Guelph, ON, Canada
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Khalaf A, Almutairi AB, Saeed R, Alotaibi N, Alhamad H, Ghadanfar L. The Supervisees' Perspectives Concerning the Clinical Supervision of Radiologic Sciences Students at Clinical Sites: Implications and Future Directions. Adv Med Educ Pract 2023; 14:305-312. [PMID: 37016623 PMCID: PMC10066897 DOI: 10.2147/amep.s397035] [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: 11/11/2022] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Clinical supervision (CS) is essential to practice-based learning in radiology. The assessment of the effectiveness of CS is essential to ensure the success of the process and to provide high-quality patient care. PURPOSE This study aimed to evaluate the CS of both Diagnostic Radiography (DR) and Nuclear Medicine (NM) technology students studying at Kuwait University. METHODS The Manchester Clinical Supervision Scale-26 (MCSS-26©) was distributed electronically to 90 third and fourth year students from Radiologic Sciences department. Ethical approval was obtained from the Health Sciences Centre (HSC) Ethical Committee and all the participants provided electronic informed consent. Data are presented as mean ± SD. RESULTS Seventy responses were collected from DR and NM (response rate 78%, DR: n= 51, NM: n=19). Overall, the mean CS score from the MCSS was 67.7±11.3, n=70. CS in NM scored more effective than that in DR with a p=0.037 (72.3±10.1, 66.0±11.3, respectively). CONCLUSION The effectiveness of CS has been evaluated in third and fourth year students across the two divisions of RS the department at Kuwait University. This study showed that students value the impact of CS in their professional role and 70% reported being satisfied with the overall CS experience. Limited studies are available that focuses on students' perceptions about clinical supervision; therefore, more studies are needed to evaluate the effectiveness of CS among RS students. Implications for interprofessional education are presented.
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Affiliation(s)
- Asseel Khalaf
- Radiologic Sciences Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Anwar B Almutairi
- Physical Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Raed Saeed
- Radiologic Sciences Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Naser Alotaibi
- Occupational Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Hamad Alhamad
- Occupational Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Layla Ghadanfar
- Radiologic Sciences Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
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Abstract
The American health care system has many great successes, but there continue to be opportunities for improving quality, access, and cost. The fee-for-service health care paradigm is shifting toward value-based care and will require accountability around quality assurance and cost reduction. As a result, many health care entities are rallying health care providers, administrators, regulators, and patients around a national imperative to create a culture of safety and develop systems of care to improve health care quality. However, the culture of patient safety and quality requires rigorous assessment of outcomes, and while numerous data collection and decision support tools are available to assist in quality assessment and performance improvement, the public reporting of this data can be confusing to patients and physicians alike and result in unintended negative consequences. This review explores the aims of health care reform, the national efforts to create a culture of quality and safety, the principles of quality improvement, and how these principles can be applied to patient care and medical practice.
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Affiliation(s)
- Thomas E MacGillivray
- HOUSTON METHODIST DEBAKEY HEART AND VASCULAR CENTER, HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS
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Oxford JT, Jorcyk CL. Students engage in primary literature in molecular biology techniques using an online journal club format. Biochem Mol Biol Educ 2020; 48:675-677. [PMID: 33080662 PMCID: PMC7722140 DOI: 10.1002/bmb.21472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/18/2020] [Accepted: 10/06/2020] [Indexed: 06/08/2023]
Abstract
Campus closures in Spring 2020 required rapid transition to online course delivery. Fall 2020 has similar needs and expectations. The Advanced Topics in Molecular Biology Techniques course, designed for upper division undergraduate and graduate students, uses a "journal club" format. The journal club format includes practice-based learning and provides student choice. Examples from graduate students effectively model the expectations using near-peer instruction. Teaching in the time of COVID-19 requires openness to new ideas and modifications to previous approaches. We were able to move the course online with little interruption.
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Affiliation(s)
- Julia Thom Oxford
- Department of Biological Sciences, Boise State University, Boise, Idaho, USA
| | - Cheryl L Jorcyk
- Department of Biological Sciences, Boise State University, Boise, Idaho, USA
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Grundy Q, Cussen C, Dale C. Constructing a problem and marketing solutions: A critical content analysis of the nature and function of industry-authored oral health educational materials. J Clin Nurs 2020; 29:4697-4707. [PMID: 32979871 DOI: 10.1111/jocn.15510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/26/2020] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To document the nature of industry-authored educational materials focused on oral health; and analyse how they construct the relationships between nurses and industry. BACKGROUND Nurses frequently rely on pharmaceutical and medical device companies for continuing education. However, industry-sponsored education is a key aspect of multi-faceted promotional campaigns and may introduce bias into clinical decision-making. DESIGN Critical qualitative content analysis reported according to the COREQ checklist. METHODS We purposively sampled educational documents from the websites of 4 major manufacturers of oral health products for acute care. Two researchers analysed each document using an open-ended coding form. We conducted an interpretive analysis using inductive coding methods. RESULTS We included 63 documents that emphasised the importance of education in the form of training, expert guidance, evidence syntheses and protocols to support oral care practices. Industry promoted its relationship with nursing as an oral health authority through three dominant messages: (1) Pneumonia is a source of morbidity, mortality and treatment costs, which informed nurses about a critical problem; (2) Comprehensive oral care reduces pneumonia risk, which instructed nurses about product-oriented solutions; and (3) Frequent oral care is important, which emphasised compliance to standardised protocols. These messages formed an accountability logic that prompted clinicians to address a problem for which the company's products served as a solution. In doing so, industry validated dominant administrative concerns including compliance, while promoting product uptake. CONCLUSIONS Industry-authored educational materials may promote industry interests, rather than nursing or patient agendas. Dependence on industry's information and product solutions may have unintended, negative consequences for nursing practice. RELEVANCE TO CLINICAL PRACTICE Though industry's educational materials present as convenient, helpful and evidence-based, they may serve to redirect care processes in ways that reinforce company goals rather than clinical priorities. Nurses should seek independent sources of continuing education where possible.
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Affiliation(s)
- Quinn Grundy
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Cliodna Cussen
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Craig Dale
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,Trauma, Emergency and Critical Care, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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van Woezik TE, Oosterman JP, Reuzel RP, van der Wilt GJ, Koksma JJ. Practice-based learning: an appropriate means to acquire the attitude and skills for evidence-based medicine. Int J Med Educ 2020; 11:140-145. [PMID: 32710724 PMCID: PMC7874920 DOI: 10.5116/ijme.5ee0.ab48] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 09/10/2019] [Accepted: 06/10/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To evaluate a practice-based, self-directed EBM-course in an undergraduate medical curriculum in terms of EBM attitude and motivation beliefs. METHODS This study was conducted in a 4-week course of the first-year undergraduate medical curriculum, which takes place twice in an academic year. One group of students (n=210) received a normal EBM-module in November. A practice-based EBM-module was implemented in January for another group of students (n=130). We approached all students following the courses for participation in our research project. In a quasi-experimental design, a validated survey was used to assess students' EBM task value and self-efficacy on a 7-point Likert-scale. In the experimental group, complementary qualitative data were gathered on attitude and motivation by open evaluative questions. RESULTS Overall response rate was 93,5%, resulting in 191 students in the control group and 127 students in the experimental group. We did not find differences between the groups in terms of EBM task value and self-efficacy. However, the experimental group showed a higher increased perception of the importance of EBM in decision making in clinical practice (60.0% vs 77.2%; χ2(1, N=318) = 8.432, p=0.004). These students obtained a better understanding of the complexities and time-consuming nature of EBM in medical practice. CONCLUSIONS The practice-based EBM-course helps students to reflect on practice and knowledge critically. Our findings indicate that integrating clinical practice in the undergraduate learning environment fosters attitude and motivation, suggesting that practice-based learning in EBM education may advance student development as a critically reflective practitioner.
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Affiliation(s)
| | | | - Rob P.B. Reuzel
- Radboud University Medical Centre, Nijmegen, the Netherlands
| | | | - Jur J. Koksma
- Radboud University Medical Centre, Nijmegen, the Netherlands
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Brewer ML, Flavell H. High and low functioning team-based pre-licensure interprofessional learning: an observational evaluation. J Interprof Care 2020; 35:538-545. [PMID: 32615830 DOI: 10.1080/13561820.2020.1778652] [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: 10/23/2022]
Abstract
Interprofessional education (IPE) is embedded in many health professional training programs, often with a focus on collaborative teamwork. Most studies into whether IPE delivers the desired collaborative teamwork capabilities has tended to rely on short term, self-assessed changes in learners' attitudes, knowledge and skills. This study adopted overt ethnographic observation to understand how a convenience sample of students behave in groups during interprofessional team-based clinical placements. Interprofessional student teams were observed by two independent observers on eight occasions (a total of 720 hours) across three sites. Thematic analysis of the observational data indicates that student teams fell into two categories: higher and lower functioning. Higher functioning teams were observed using humor to build rapport, reduce tension and express humility, and evidenced a greater emphasis on shared client goals. In contrast, lower functioning teams were more formal, with no evidence of humor and less interaction. The higher functioning teams, therefore, not only demonstrated greater interprofessional collaboration they also appeared to have higher levels of psychological safety. Participants in the higher functioning teams also demonstrated mutual trust and confidence and took more risks, often speaking up to provide suggestions, share knowledge and skills, and seek or offer feedback. The results suggest that further explicit training in, and assessment of, psychological safety in IPE needs to be undertaken.
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Affiliation(s)
- Margo L Brewer
- Pro-Vice Chancellor's Office, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Helen Flavell
- Pro-Vice Chancellor's Office, Faculty of Health Sciences, Curtin University, Perth, Australia
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Francis ER, Bernard S, Nowak ML, Daniel S, Bernard JA. Operating Room Virtual Reality Immersion Improves Self-Efficacy Amongst Preclinical Physician Assistant Students. J Surg Educ 2020; 77:947-952. [PMID: 32199861 DOI: 10.1016/j.jsurg.2020.02.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 11/12/2019] [Revised: 02/04/2020] [Accepted: 02/16/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To assess the impact on self-efficacy for preclinical physician assistant (PA) students through immersive virtual reality (VR) operating room simulation. DESIGN Randomized double-blinded controlled experiment measuring self-efficacy using Schwarzer and Jerusalem's general self-efficacy scale. An entirely novel operating room was created, casted, and filmed using VR software. Fifty-two preclinical PA students were randomly assigned to VR (n = 26) or traditional lecture (n = 26) and self-efficacy was measured in both conditions using a general self-efficacy scale given before and after the virtual experience. A mixed ANOVA, independent sample t tests, and paired samples t tests were performed. SETTING Shenandoah University Physician Assistant program, Winchester, Virginia. RESULTS Exposure to VR training after the traditional lecture improves self-efficacy amongst PA students (p < 0.05). Exposure to VR improved self-efficacy compared to traditional methods (p < 0.05). There was no difference in self-efficacy amongst PA students with the traditional model (p < 0.05). CONCLUSIONS The introduction of VR simulation improved preclinical PA student self-efficacy in the operating room setting.
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Affiliation(s)
- Erika R Francis
- University, School of Health Professions, Division of Physician Assistant Studies, Winchester, Virginia.
| | - Stephanie Bernard
- University, School of Health Professions, Division of Physician Assistant Studies, Winchester, Virginia
| | - Morgan L Nowak
- University, School of Health Professions, Division of Physician Assistant Studies, Winchester, Virginia
| | - Sarah Daniel
- Shenandoah University, School of Education and Leadership, Winchester, Virginia
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Shah DS, Panchal V, Devi S, Datar S, Kumari S, Ugalmugle A, Chincholkar D, Pal B, Yadav A, Patki G. A time-efficient model of spreading health awareness which also provides good experiential learning to medical students. Educ Health (Abingdon) 2019; 31:163-167. [PMID: 31134947 DOI: 10.4103/efh.efh_245_16] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Although alcohol and tobacco are leading causes of mortality and morbidity, their use continues to be common. We hypothesized that awareness about this issue can be spread in a time-efficient way if health talks are conducted within hospital premises itself. Furthermore, this could potentially provide good experiential learning to medical students. Methods In this longitudinal study, we implemented such an awareness activity and evaluated the outcome. Students who showed interest to volunteer were helped to develop an in-depth understanding of the issue, through detailed presentation and discussions. They conducted health talks near the wards, with patients and their relatives, after routine college hours. An iterative process was used to improve the health talk, based on self-reflection and formative feedback. A pre- and post-self-assessment of students regarding their knowledge and skills on this issue was obtained. A structured, anonymous questionnaire was administered to the audience before and after three of the educational talks. Results In 29 days, our team of 24 students gave 21 health talks reaching out to 1090 rural people. Pre-post analysis of audience showed improvement in their awareness level and many developed the motivation to quit their addictions. Self-rating of students across all knowledge domains increased by at least 2 points (scale of 1-7) and across all skill domains, it increased by 3 points (P < 0.0001). Conclusion This model of conducting health talks in hospital premises can enable us to spread health awareness effectively, in a time-efficient and cost-effective way. Furthermore, this model can prove to be a novel and effective academic tool for grooming medical students.
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Affiliation(s)
- Dharav Sunil Shah
- Department of Psychiatry, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Vidit Panchal
- Undergraduate Medical Students, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Savithri Devi
- Undergraduate Medical Students, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Shrinidhi Datar
- Undergraduate Medical Students, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Sonika Kumari
- Undergraduate Medical Students, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Anvita Ugalmugle
- Undergraduate Medical Students, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Darshani Chincholkar
- Undergraduate Medical Students, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Bhumika Pal
- Undergraduate Medical Students, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Akshay Yadav
- Undergraduate Medical Students, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Gauri Patki
- Undergraduate Medical Students, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
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Qutishat D, Muhaidat J, Mohammad M, Okasheh R, Al-Khlaifat L, Al-Yahya E. Exploring attitudes of physiotherapy students towards a community-based project used as a learning tool. Physiother Theory Pract 2019; 37:115-125. [PMID: 31131662 DOI: 10.1080/09593985.2019.1619209] [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: 10/26/2022]
Abstract
BACKGROUND Community-based projects are an experiential learning tool that provides students with an opportunity to work within a team, to apply their skills and to learn in real workplace settings. Promoting physical activity is an important component of physiotherapy education, but the best method for training students to promote physical activity is open for discussion. PURPOSE This study explored the attitudes and learning experiences of physiotherapy students who worked in groups to complete a community-based project involving the delivery of physical activity programs to a healthy population. METHODS Data were collected from a focus group of eight physiotherapy students each of whom had participated in a community-based project early in their studies. RESULTS Four themes emerged from the analysis of the data: 1) self-confidence and independence; 2) creativity and innovation; 3) effective communication; and 4) team dynamics. The students had positive attitudes toward community-based projects and reported that their experiences were a highly valued component of their early practice-based learning. The findings of this study are expected to encourage educators to use community-based projects early in undergraduate physiotherapy programs, as it helps students develop professional skills such as effective communication, creativity, and innovation. Students also learned to innovate to solve real-world problems in the workplace such as resource limitations. They also learned to appreciate the importance of team dynamics in a successful intervention. CONCLUSION The findings suggest early participation in community-based projects is an excellent way for physiotherapy students to develop the competencies required for clinical practice and for their role in promoting physical activity.
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Affiliation(s)
- Dania Qutishat
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan , Amman, Jordan
| | - Jennifer Muhaidat
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan , Amman, Jordan
| | - Maha Mohammad
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan , Amman, Jordan
| | - Rasha Okasheh
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan , Amman, Jordan
| | - Lara Al-Khlaifat
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan , Amman, Jordan
| | - Emad Al-Yahya
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan , Amman, Jordan.,Movement Science Group, Faculty of Health and Life Sciences, Oxford Brookes University , Oxford, UK
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Abstract
This article explores the role of embodied, sensible knowledge in practice-based learning. Despite recent efforts to conceptualize how practitioners become skillful through corporeal and sensible learning, it still seems under-theorized and hard to understand what this exactly entails. The aim of this article is to account for the inherently embodied and sensible nature of knowledge by drawing on a 2-year ethnographic study of train dispatchers in a railway control room. Embodied and sensible knowledge is developed through the work of Merleau-Ponty and Heidegger, as phenomenology is a way to theorize the body beyond being an object to, instead, account for embodiment as lived and experienced. The data show that such knowledge can be understood as a matter of ‘attunement’: dispatchers become progressively skillful in bringing their bodies and senses in tune with practical situations and perturbations in the environment. The article contributes to a richer understanding of embodiment, especially in the relation between knowledge and practices, in organization studies and management learning.
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Larsen DP, Naismith RT, Margolis M. High-Frequency Learning Goals: Using Self-Regulated Learning to Influence Day-to-Day Practice in Clinical Education. Teach Learn Med 2017; 29:93-100. [PMID: 27813672 DOI: 10.1080/10401334.2016.1230501] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 06/06/2023]
Abstract
PROBLEM Although self-regulated learning (SRL) is considered a fundamental skill that must be developed in physician training, many programs of SRL utilize learning goals that are generated only at the beginning of learning experiences or are widely spaced apart in time. These goals are often not formally shared with those actually working with the learner in the clinical setting. INTERVENTION We developed a program of written, student-generated weekly learning goals in which students focused on processes of becoming better doctors for their patients. These goals were shared at the beginning of each week with students' clinical teams for feedback and incorporation into the work. CONTEXT The weekly learning goals program was developed and implemented as part of a required 3rd-year neurology clerkship. At the end of each 4-week clerkship, students were asked to evaluate the program through an anonymous electronic survey utilizing quantitative and open-ended qualitative questions. OUTCOME Seventy-six of 82 students completed the evaluation survey (93% response rate). Eighty-six percent reported that the weekly learning goals increased their awareness of their thoughts and actions. Seventy-eight percent reported that the learning goals helped to improve their clinical performance to some degree, and 57% reported that the learning goals increased their focus on patient care. Students described a greater sense of focus on self-assessment and accountability from their goals. Students often commented that engagement from attendings and residents regarding their goals was a key element for successful learning from their goals. LESSONS LEARNED Student-generated weekly learning goals on a neurology clerkship appear to be an effective method to operationalize SRL. For most students, the frequency of the goals allowed for close self-monitoring, and the act of sharing goals with the team opened a new avenue for dialogue between students and their supervisors.
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Affiliation(s)
- Douglas P Larsen
- a Department of Neurology , Washington University in St. Louis School of Medicine , St. Louis , Missouri , USA
| | - Robert T Naismith
- a Department of Neurology , Washington University in St. Louis School of Medicine , St. Louis , Missouri , USA
| | - Mathew Margolis
- b Washington University in St. Louis School of Medicine , St. Louis , Missouri , USA
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Mcnaughton S, Barrow M, Bagg W, Frielick S. Capturing the Integration of Practice-Based Learning with Beliefs, Values, and Attitudes using Modified Concept Mapping. J Med Educ Curric Dev 2016; 3:10.4137_JMECD.S30079. [PMID: 29349311 PMCID: PMC5736271 DOI: 10.4137/jmecd.s30079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 02/01/2016] [Accepted: 02/02/2016] [Indexed: 05/16/2023]
Abstract
Practice-based learning integrates the cognitive, psychomotor, and affective domains and is influenced by students' beliefs, values, and attitudes. Concept mapping has been shown to effectively demonstrate students' changing concepts and knowledge structures. This article discusses how concept mapping was modified to capture students' perceptions of the connections between the domains of thinking and knowing, emotions, behavior, attitudes, values, and beliefs and the specific experiences related to these, over a period of eight months of practice-based clinical learning. The findings demonstrate that while some limitations exist, modified concept mapping is a manageable way to gather rich data about students' perceptions of their clinical practice experiences. These findings also highlight the strong integrating influence of beliefs and values on other areas of practice, suggesting that these need to be attended to as part of a student's educational program.
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Affiliation(s)
- Susan Mcnaughton
- University of Auckland, Auckland, New Zealand
- Auckland University of Technology, Auckland, New Zealand
| | - Mark Barrow
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Warwick Bagg
- Head of the Medical Programme, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Stanley Frielick
- Centre for Learning and Teaching, Auckland University of Technology, Auckland, New Zealand
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Maertens H, Aggarwal R, Desender L, Vermassen F, Van Herzeele I. Development of a PROficiency-Based StePwise Endovascular Curricular Training (PROSPECT) Program. J Surg Educ 2016; 73:51-60. [PMID: 26276301 DOI: 10.1016/j.jsurg.2015.07.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 05/18/2015] [Revised: 07/06/2015] [Accepted: 07/13/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Focus on patient safety, work-hour limitations, and cost-effective education is putting pressure to improve curricula to acquire minimally invasive techniques during surgical training. This study aimed to design a structured training program for endovascular skills and validate its assessment methods. DESIGN A PROficiency-based StePwise Endovascular Curricular Training (PROSPECT) program was developed, consisting of e-learning and hands-on simulation modules, focusing on iliac and superficial femoral artery atherosclerotic disease. Construct validity was investigated. Performances were assessed using multiple-choice questionnaires, valid simulation parameters, global rating scorings, and examiner checklists. Feasibility was assessed by passage of 2 final-year medical students through this PROSPECT program. SETTING Ghent University Hospital, a tertiary clinical care and academic center in Belgium with general surgery residency program. PARTICIPANTS Senior-year medical students were recruited at Ghent University Hospital. Vascular surgeons were invited to participate during conferences and meetings if they had performed at least 100 endovascular procedures as the primary operator during the last 2 years. RESULTS Overall, 29 medical students and 20 vascular surgeons participated. Vascular surgeons obtained higher multiple-choice questionnaire scores (median: 24.5-22.0 vs. 15.0-12.0; p < 0.001). Students took significantly longer to treat any iliac or femoral artery stenosis (3.3-14.8 vs. 5.8-30.1min; p = 0.001-0.04), whereas in more complex cases, fluoroscopy time was significantly higher in students (8.3 vs. 21.3min; p = 0.002; 7.3 vs. 13.1min; p = 0.03). In all cases, vascular surgeons scored higher on global rating scorings (51.0-42.0 vs. 29.5-18.0; p < 0.001) and examiner checklist (81.5-75.0 vs. 54.5-43.0; p < 0.001). Hence, proficiency levels based on median expert scores could be determined. There were 2 students who completed the program and passed for each step within a 3-month period during their internships. CONCLUSIONS A feasible and construct validated surgical program to train cognitive, technical, and nontechnical endovascular skills was developed. A structured, stepwise, proficiency-based valid endovascular program to train cognitive, technical, and human factor skills has been developed and proven to be feasible. A randomized controlled trial has been initiated to investigate its effect on performances in real life, patient outcomes, and cost-effectiveness.
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Affiliation(s)
- Heidi Maertens
- Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium.
| | - Rajesh Aggarwal
- Department of Surgery, McGill University, Montreal, Canada; Arnold & Blema Steinberg Medical Simulation Centre, McGill University, Montreal, Canada
| | - Liesbeth Desender
- Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium
| | - Frank Vermassen
- Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium
| | - Isabelle Van Herzeele
- Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium
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Hollon MF. Competency-based residency training and the web log: modeling practice-based learning and enhancing medical knowledge. J Community Hosp Intern Med Perspect 2015; 5:29713. [PMID: 26653701 PMCID: PMC4677591 DOI: 10.3402/jchimp.v5.29713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 10/08/2015] [Accepted: 10/16/2015] [Indexed: 12/02/2022] Open
Abstract
Background By using web-based tools in medical education, there are opportunities to innovatively teach important principles from the general competencies of graduate medical education. Objectives Postulating that faculty transparency in learning from uncertainties in clinical work could help residents to incorporate the principles of practice-based learning and improvement (PBLI) in their professional development, faculty in this community-based residency program modeled the steps of PBLI on a weekly basis through the use of a web log. Method The program confidentially surveyed residents before and after this project about actions consistent with PBLI and knowledge acquired through reading the web log. Results The frequency that residents encountered clinical situations where they felt uncertain declined over the course of the 24 weeks of the project from a mean frequency of uncertainty of 36% to 28% (Wilcoxon signed rank test, p=0.008); however, the frequency with which residents sought answers when faced with uncertainty did not change (Wilcoxon signed rank test, p=0.39), remaining high at approximately 80%. Residents answered a mean of 52% of knowledge questions correct when tested prior to faculty posts to the blog, rising to a mean of 65% of questions correct when tested at the end of the project (paired t-test, p=0.001). Conclusions Faculty role modeling of PBLI behaviors and posting clinical questions and answers to a web log led to modest improvements in medical knowledge but did not alter behavior that was already taking place frequently among residents.
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Affiliation(s)
- Matthew F Hollon
- Providence Internal Medicine Residency, Spokane, WA, USA.,Department of Medicine, University of Washington School of Medicine, Spokane, WA, USA;
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Roberts C, Kumar K. Student learning in interprofessional practice-based environments: what does theory say? BMC Med Educ 2015; 15:211. [PMID: 26611786 PMCID: PMC4662027 DOI: 10.1186/s12909-015-0492-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 08/29/2015] [Accepted: 11/20/2015] [Indexed: 05/30/2023]
Abstract
Student learning in interprofessional practice-based environments has garnered significant attention in the last decade, and is reflected in a corresponding increase in published literature on the topic. We review the current empirical literature with specific attention to the theoretical frameworks that have been used to illustrate how and why student learning occurs in interprofessional practice-based environments. Our findings show there are relatively few theoretical-based studies available to guide educators and researchers alike. We recommend a more considered and consistent use of theory and suggest that professional identity and socio-cultural frameworks offer promising avenues for advancing understandings of student learning and professional identity development within interprofessional practice-based environments.
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Affiliation(s)
- Chris Roberts
- Sydney Medical School, Sydney University, Sydney, Australia.
| | - Koshila Kumar
- Flinders University Rural Clinical School, Adelaide, Australia.
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Susarla SM, Lopez J, Mundinger GS, Lifchez SD, Redett RJ. Abstract presentations by residents at an intramural research day: what factors affect publication? J Surg Educ 2015; 72:566-571. [PMID: 26073474 DOI: 10.1016/j.jsurg.2015.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 11/03/2014] [Revised: 12/23/2014] [Accepted: 01/04/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To assess the rate of conversion of scientific abstracts presented at an intramural resident research day to published articles and identify the factors associated with successful conversion. DESIGN Retrospective cohort study. SETTING Johns Hopkins Hospital, Department of Plastic Surgery. PARTICIPANTS Evaluation of 78 abstracts presented by plastic surgery residents as part of an intramural research day over a 5-year period. RESULTS A total of 78 abstracts were presented by residents over the study period. Most abstracts (49, 63%) were presented by senior residents (postgraduate year ≥4). Fifty-six abstracts (72%) were clinical studies. The majority (54, 69%) of primary investigators had an academic rank of associate professor or professor. Fifty abstracts (64%) were subsequently published in a peer-reviewed journal. The mean time to publication was 15.6 ± 13.6 months. In a logistic regression model, abstract conversion was inversely associated with increasing postgraduate year (odds ratio = 0.56, 95% CI: 0.36-0.85, p = 0.007) and directly associated with primary investigator academic rank (odds ratio = 3.3, 95% CI: 1.1-10.5, p = 0.047). CONCLUSIONS The conversion rate of abstracts to published articles from an intramural resident research day is >50% and is associated with increased time until graduation and primary investigator academic rank. These results suggest that research exposure early in surgical training and experienced mentorship are key elements to successful education in surgical research.
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Affiliation(s)
- Srinivas M Susarla
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland.
| | - Joseph Lopez
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - Gerhard S Mundinger
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - Scott D Lifchez
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - Richard J Redett
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland
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Snelgrove H, Kuybida Y, Fleet M, McAnulty G. "That's your patient. There's your ventilator": exploring induction to work experiences in a group of non-UK EEA trained anaesthetists in a London hospital: a qualitative study. BMC Med Educ 2015; 15:50. [PMID: 25890264 PMCID: PMC4367902 DOI: 10.1186/s12909-015-0331-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 08/02/2014] [Accepted: 02/27/2015] [Indexed: 05/05/2023]
Abstract
BACKGROUND European health systems depend increasingly on the services of health professionals who obtained their primary medical qualification from other countries. There has been a significant increase recently in fully qualified specialist doctors arriving from the European Union to provide short term or longer-term solutions to health human resources needs in the UK National Health System. These doctors often take up senior consultant positions. As a result, the NHS has had to learn to deal with both expatriation and repatriation of EU doctors as a constant dynamic characteristic of its own ability to deliver services. We conducted a qualitative study to explore the acclimatisation experience of EU doctors with qualifications in anaesthesia arriving in the United Kingdom to take up clinical employment in the NHS. The question we ask is: how do specialty registered anaesthetists who trained in other European countries experience the process of acclimatisation to practice in the United Kingdom in a large hospital in London? METHODS We did individual interviews with non-UK, EU-qualified doctors with Certification of Completion of specialty Training who were registered with the General Medical Council in the UK and could practice in the NHS as specialist anaesthetists. The doctors were all interviewed whilst working in a large NHS teaching hospital in London, UK. We analysed qualitative data from interview transcripts to identity themes and patterns regarding senior doctor's acclimatisation to the British system. RESULTS Acclimatisation conceived of as transfer of clinical expertise was problematic for doctors who felt they lacked the right kind of support. Doctors sought different opportunities to share wider perspectives on care deriving from their previous experience. CONCLUSIONS Hospital conceptions of acclimatisation as a highly individual process can offer an idealized view of clinical work and learning in the new system. Socio-cultural theories suggest we create regular learning opportunities for international staff to critically reflect on practice with local staff to acclimatise more effectively.
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Affiliation(s)
- Huon Snelgrove
- Education Training and Development, St Georges's Healthcare NHS Trust, Blackshaw Road, Tooting London, SW17 0QT, UK.
| | - Yuriy Kuybida
- Clinical fellow in Anaesthesia, Frimley Park Hospital NHS Foundation Trust, Frimley Camberley, Surrey, UK.
| | - Mark Fleet
- Anaesthetic Registrar, St George's Healthcare NHS Trust, Blackshaw Road, SW17 0QT, London, UK.
| | - Greg McAnulty
- Consultant in Intensive Care and Anaesthesia, St George's Healthcare NHS Trust, Blackshaw Road, SW17 0QT, Tooting London, UK.
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Novick RJ, Lingard L, Cristancho SM. The call, the save, and the threat: understanding expert help-seeking behavior during nonroutine operative scenarios. J Surg Educ 2015; 72:302-9. [PMID: 25451719 PMCID: PMC5578753 DOI: 10.1016/j.jsurg.2014.09.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 09/17/2014] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Asking for help in the operating room occurs within a surgical culture that has traditionally valued independence, decisiveness, and confidence. A tension exists between these deeply ingrained character traits and the new culture of team-based practice that emphasizes maximizing patient safety. The objective of this study is to explore surgeon-to-surgeon help-seeking behaviors during complex and unanticipated operative scenarios. STUDY DESIGN Semistructured interviews were conducted with a purposeful sample of 14 consultant surgeons from multiple specialties. We used constructivist grounded theory to explore help-seeking experiences. Analysis occurred alongside and informed data collection. Themes were identified iteratively using constant comparisons. SETTING The setting included 3 separate hospital sites in a Canadian academic health sciences center. PARTICIPANTS A total of 14 consultant surgeons from 3 separate departments and 7 divisions were included. RESULTS We developed the "Call-Save-Threat" framework to conceptualize the help-seeking phenomenon. Respondents highlighted both explicit and tacit reasons for calling for help; the former included technical assistance and help with decision making, and the latter included the need for moral support, "saving face," and "political cover." "The Save" included the provision of enhanced technical expertise, a broader intraoperative perspective, emotional support, and a learning experience. "The Threat" included potential downsides to calling, which may result in near-term or delayed negative consequences. These included giving up autonomy as primary surgeon, threats to a surgeon's image as a competent practitioner, and a failure to progress with respect to independent judgment and surgical abilities. CONCLUSIONS Our "Call-Save-Threat" framework suggests that surgeons recurrently negotiate when and how to seek help in the interests of patient safety, while attending to the traditional cultural values of autonomy and decisive action. This has important implications for surgical postgraduate education and also throughout a surgeon's career trajectory.
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Affiliation(s)
- Richard J Novick
- Department of Surgery, Schulich School of Medicine and the Centre for Education Research and Innovation, Western University, London, Ontario, Canada; Department of Medicine, Schulich School of Medicine and the Centre for Education Research and Innovation, Western University, London, Ontario, Canada.
| | - Lorelei Lingard
- Department of Medicine, Schulich School of Medicine and the Centre for Education Research and Innovation, Western University, London, Ontario, Canada
| | - Sayra M Cristancho
- Department of Surgery, Schulich School of Medicine and the Centre for Education Research and Innovation, Western University, London, Ontario, Canada
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Affiliation(s)
- Steven Y Lin
- Center for Education and Research in Family and Community Medicine, Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, 211 Quarry Road, Suite 405, MC 5985, 94304, Palo Alto, CA, USA,
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Ahrweiler F, Scheffer C, Roling G, Goldblatt H, Hahn EG, Neumann M. Clinical practice and self-awareness as determinants of empathy in undergraduate education: a qualitative short survey at three medical schools in Germany. GMS Z Med Ausbild 2014; 31:Doc46. [PMID: 25489346 PMCID: PMC4259065 DOI: 10.3205/zma000938] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 07/15/2014] [Accepted: 07/18/2014] [Indexed: 12/19/2022]
Abstract
STUDY AIM Physician empathy constitutes an outcome-relevant aim of medical education. Yet, the factors promoting and inhibiting physician empathy have not yet been extensively researched, especially in Germany. In this study, we explored German medical students' views of the factors promoting and inhibiting their empathy and how their experiences were related to their curricula. METHODS A qualitative short survey was conducted at three medical schools: Bochum University, the University of Cologne and Witten/Herdecke University. Students were invited to complete an anonymous written questionnaire comprised of open-ended questions inquiring about the educational content of and situations during their medical education that positively or negatively impacted their empathy. Data were analyzed through qualitative content analysis according to the methods of Green and Thorogood. RESULTS A total of 115 students participated in the survey. Respondents reported that practice-based education involving patient contact and teaching with reference to clinical practice and the patient's perspective improved their empathy, while a lack of these inhibited it. Students' internal reactions to patients, such as liking or disliking a patient, prejudice and other attitudes, were also considered to influence their empathy. Although each of the three schools takes a different approach to teaching interpersonal skills, no relevant differences were found in their students' responses concerning the possible determinants of empathy. CONCLUSION Providing more training in practice and more contact with patients may be effective ways of promoting student empathy. Students need support in establishing therapeutic relationships with patients and in dealing with their own feelings and attitudes. Such support could be provided in the form of reflective practice training in order to promote self-awareness. More research is needed to evaluate these hypothetical conclusions.
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Affiliation(s)
- Florian Ahrweiler
- Witten/Herdecke University, Faculty of Health, School of Medicine, Institute for Integrative Medicine, Integrated Curriculum for Anthroposophic Medicine, Witten, Germany
- Augusta-Kranken-Anstalt, Medizinische Kliniken, Bochum, Germany
| | - Christian Scheffer
- Witten/Herdecke University, Faculty of Health, School of Medicine, Institute for Integrative Medicine, Integrated Curriculum for Anthroposophic Medicine, Witten, Germany
- Gemeinschaftskrankenhaus Herdecke, Department of Internal Medicine, Clinical Education Ward for Integrative Medicine, Herdecke, Germany
| | - Gudrun Roling
- Witten/Herdecke University, Faculty of Health, School of Medicine, Institute for Integrative Medicine, Integrated Curriculum for Anthroposophic Medicine, Witten, Germany
| | - Hadass Goldblatt
- University of Haifa, Faculty of Social Welfare & Health Sciences, Department of Nursing, Haifa, Isarael
| | - Eckhart G. Hahn
- Universitätsklinikum Erlangen, Gesellschaft für Berufliche Fortbildung, Forschung und Entwicklung e.V. an der Medizinischen Klinik 1, Erlangen, Germany
| | - Melanie Neumann
- Witten/Herdecke University, Faculty of Health, Witten, Germany
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Bucklen KA, Carlson DW, Shah N, Pruitt C. Development of a pediatric hospitalist curriculum to promote faculty development, teaching excellence, and evidence-based care. Hosp Pediatr 2014; 4:387-92. [PMID: 25362082 DOI: 10.1542/hpeds.2013-0108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 11/24/2022]
Abstract
OBJECTIVE The Pediatric Hospital Medicine Core Competencies (PHMCC), published in 2010, serve as the foundation for development of pediatric hospital medicine curricula to standardize and improve inpatient pediatric training and practice. Here the authors describe development of a PHMCC-based curriculum for faculty development, improved teaching, and evidence-based care, and as the basis for scholarly projects. METHODS A 2-year repeating curriculum of 51 topics based on the PHMCC was designed, presented by hospitalists for division members at weekly division conferences, and recorded for asynchronous learning. Fourteen of those topics were created for online viewing only. Topic development included use of pertinent medical research, guidelines, and local experts. Presentations followed a standardized format and were reviewed by senior division members before delivery. Attendees evaluated all presentations. RESULTS Twenty live topics were presented. All talks received ratings of 4.3 or higher (on a scale of 1 to 5) on evaluation by attendees, and 70% of presentations were reported as likely to change practice by 80% or more of attendees. Opportunities for increased mentorship were realized. The division was recognized for its work through an invitation to present topics 4 times annually at a community-wide continuing medical education program and regional pediatric meetings, and proposals have been submitted for national meetings. CONCLUSIONS The PHMCC-based curriculum has led to increased opportunities for education, mentorship, and improvement in the quality of care by attendees. Other academic divisions may benefit from a curriculum to enhance professional development and standardize clinical care and teaching.
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Affiliation(s)
- Kathryn A Bucklen
- Department of Pediatrics, Washington School of Medicine, Saint Louis, Missouri; and
| | - Doug W Carlson
- Department of Pediatrics, Washington School of Medicine, Saint Louis, Missouri; and
| | - Neha Shah
- Department of Pediatrics, George Washington University School of Medicine & Health Sciences, Washington, DC
| | - Cassandra Pruitt
- Department of Pediatrics, Washington School of Medicine, Saint Louis, Missouri; and
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Webb TP, Merkley TR, Wade TJ, Simpson D, Yudkowsky R, Harris I. Assessing competency in practice-based learning: a foundation for milestones in learning portfolio entries. J Surg Educ 2014; 71:472-479. [PMID: 24776864 DOI: 10.1016/j.jsurg.2014.01.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 07/19/2012] [Revised: 01/08/2014] [Accepted: 01/30/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Graduate medical education is undergoing a dramatic shift toward competency-based assessment of learners. Competency assessment requires clear definitions of competency and validated assessment methods. The purpose of this study is to identify criteria used by surgical educators to judge competence in Practice-Based Learning and Improvement (PBL&I) as demonstrated in learning portfolios. METHODS A total of 6 surgical learning and instructional portfolio entries served as documents to be assessed by 3 senior surgical educators. These faculty members were asked to rate and then identify criteria used to assess PBL&I competency. Individual interviews and group discussions were conducted, recorded, and transcribed to serve as the study dataset. Analysis was performed using qualitative methodology to identify themes for the purpose of defining competence in PBL&I. The assessment themes derived are presented with narrative examples to describe the progression of competency. RESULTS The collaborative coding process resulted in identification of 7 themes associated with competency in PBL&I related to surgical learning and instructional portfolio entries: (1) self-awareness regarding effect of actions; (2) identification and thorough description of learning goals; (3) cases used as catalyst for reflection; (4) reconceptualization with appropriate use and critique of cited literature; (5) communication skills/completeness of entry template; (6) description of future behavioral change; and (7) engagement in process--identifies as personally relevant. CONCLUSIONS The identified themes are consistent with and complement other criteria emerging from reflective practice literature and experiential learning theory. This study provides a foundation for further development of a tool for assessing learner portfolios consistent with the Accreditation Council for Graduate Medical Education's Next Accreditation System requirements.
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Affiliation(s)
| | | | | | | | | | - Ilene Harris
- University of Illinois-Chicago, Chicago, Illinois
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Carlsen CG, Lindorff-Larsen K, Funch-Jensen P, Lund L, Morcke AM, Ipsen M, Charles P. Is current surgical training efficient? A national survey. J Surg Educ 2014; 71:367-374. [PMID: 24797853 DOI: 10.1016/j.jsurg.2013.10.002] [Citation(s) in RCA: 10] [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] [Received: 06/24/2013] [Revised: 09/03/2013] [Accepted: 10/05/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Evaluation of surgical training in Denmark is competency based with no requirement for a specific number of procedures. This may affect monitoring of surgical progress adversely and cause an underestimation of the time needed to acquire surgical competencies. We investigated the number of common surgical procedures performed by trainees. Trainees' and consultants' expectations from the training program were also investigated. DESIGN AND PARTICIPANTS A questionnaire was sent to all 115 surgical trainees in Denmark. We asked how many common surgical procedures the trainees had performed during their postgraduate training, whether self-reported procedural confidence was achieved during their training, and whether their training expectations were met. Another questionnaire dealt with the consultants' expectations of the surgical training. RESULTS The total number of common surgical procedures (Lichtenstein hernia repair, appendectomy, laparoscopic appendectomy, and laparoscopic cholecystectomy) that were performed varied between trainees. One group performed few common procedures during training. A low number in 1 procedure correlated with a similar pattern in other procedures. Approximately one-third did not perform common elective procedures independently until their fifth year. Consultants and trainees viewed training differently. CONCLUSIONS Our study reveals no common trend in the numbers and types of procedures performed during training. The number of procedures seems to reflect the individual trainee and a local tradition rather than the particular training program. An informal competency-based assessment system with lack of quantitative requirements evidently involves a risk of skewness in training.
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Affiliation(s)
| | - Karen Lindorff-Larsen
- NordSim, Center for Skills Training and Simulation, Aalborg University Hospital, Center for Science and Innovation, Aalborg, Denmark
| | - Peter Funch-Jensen
- Clinical Institute, Aarhus University, Skejby Hospital, Aarhus N, Denmark
| | - Lars Lund
- Department of Urology, Odense University Hospital, Odense, Denmark
| | - Anne Mette Morcke
- Centre of Medical Education, Aarhus University, Incuba Science Park, Aarhus N, Denmark
| | | | - Peder Charles
- Centre of Medical Education, Aarhus University, Incuba Science Park, Aarhus N, Denmark
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Waits SA, Reames BN, Krell RW, Bryner B, Shih T, Obi AT, Henke PK, Minter RM, Englesbe MJ, Wong SL. Development of Team Action Projects in Surgery (TAPS): a multilevel team-based approach to teaching quality improvement. J Surg Educ 2014; 71:166-168. [PMID: 24602703 PMCID: PMC4550103 DOI: 10.1016/j.jsurg.2014.01.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 11/28/2013] [Accepted: 01/23/2014] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To meet the Accreditation Council for Graduate Medical Education core competency in Practice-Based Learning and Improvement, educational curricula need to address training in quality improvement (QI). We sought to establish a program to train residents in the principles of QI and to provide practical experiences in developing and implementing improvement projects. DESIGN We present a novel approach for engaging students, residents, and faculty in QI efforts-Team Action Projects in Surgery (TAPS). SETTING Large academic medical center and health system. PARTICIPANTS Multiple teams consisting of undergraduate students, medical students, surgery residents, and surgery faculty were assembled and QI projects developed. Using "managing to learn" Lean principles, these multilevel groups approached each project with robust data collection, development of an A3, and implementation of QI activities. RESULTS A total of 5 resident led QI projects were developed during the TAPS pilot phase. These included a living kidney donor enhanced recovery protocol, consult improvement process, venous thromboembolism prophylaxis optimization, Clostridium difficile treatment standardization, and understanding variation in operative duration of laparoscopic cholecystectomy. Qualitative and quantitative assessment showed significant value for both the learner and stakeholders of QI related projects. CONCLUSION Through the development of TAPS, we demonstrate a novel approach to addressing the increasing focus on QI within graduate medical education. Efforts to expand this multilevel team based approach would have value for teachers and learners alike.
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Affiliation(s)
- Seth A Waits
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Bradley N Reames
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Robert W Krell
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Benjamin Bryner
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Terry Shih
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Andrea T Obi
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Peter K Henke
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Rebecca M Minter
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | | | - Sandra L Wong
- Department of Surgery, University of Michigan, Ann Arbor, Michigan.
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Gupta M, Ringer S, Tess A, Hansen A, Zupancic J. Developing a quality and safety curriculum for fellows: lessons learned from a neonatology fellowship program. Acad Pediatr 2014; 14:47-53. [PMID: 24126046 DOI: 10.1016/j.acap.2013.06.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 06/22/2013] [Accepted: 06/29/2013] [Indexed: 11/27/2022]
Abstract
Formal training in health care quality and safety has become an important component of medical education at all levels, and quality and safety are core concepts within the practice-based learning and system-based practice medical education competencies. Residency and fellowship programs are rapidly attempting to incorporate quality and safety curriculum into their training programs but have encountered numerous challenges and barriers. Many program directors have questioned the feasibility and utility of quality and safety education during this stage of training. In 2010, we adopted a quality and safety educational module in our neonatal fellowship program that sought to provide a robust and practical introduction to quality improvement and patient safety through a combination of didactic and experiential activities. Our module has been successfully integrated into the fellowship program's curriculum and has been beneficial to trainees, faculty, and our clinical services, and our experience suggests that fellowship may be particularly well suited to incorporation of quality and safety training. We describe our module and share tools and lessons learned during our experience; we believe these resources will be useful to other fellowship programs seeking to improve the quality and safety education of their trainees.
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Affiliation(s)
- Munish Gupta
- Harvard Combined Fellowship Program in Neonatal-Perinatal Medicine, Boston, Mass; Beth Israel Deaconess Medical Center, Boston, Mass.
| | - Steve Ringer
- Harvard Combined Fellowship Program in Neonatal-Perinatal Medicine, Boston, Mass; Brigham and Women's Hospital, Boston, Mass
| | - Anjala Tess
- Beth Israel Deaconess Medical Center, Boston, Mass
| | - Anne Hansen
- Harvard Combined Fellowship Program in Neonatal-Perinatal Medicine, Boston, Mass; Boston Children's Hospital, Boston, Mass
| | - John Zupancic
- Harvard Combined Fellowship Program in Neonatal-Perinatal Medicine, Boston, Mass; Beth Israel Deaconess Medical Center, Boston, Mass
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29
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Affiliation(s)
- Delphine S Tuot
- Division of Nephrology, University of California, San Francisco, USA.
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Mladenovic J, Shea JA, Duffy FD, Lynn LA, Holmboe ES, Lipner RS. Variation in internal medicine residency clinic practices: assessing practice environments and quality of care. J Gen Intern Med 2008; 23:914-20. [PMID: 18612717 PMCID: PMC2517925 DOI: 10.1007/s11606-008-0511-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [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] [Indexed: 10/21/2022]
Abstract
BACKGROUND Few studies have systematically and rigorously examined the quality of care provided in educational practice sites. OBJECTIVE The objectives of this study were to (1) describe the patient population cared for by trainees in internal medicine residency clinics; (2) assess the quality of preventive cardiology care provided to these patients; (3) characterize the practice-based systems that currently exist in internal medicine residency clinics; and (4) examine the relationships between quality, practice-based systems, and features of the program: size, type of program, and presence of an electronic medical record. DESIGN This is a cross-sectional observational study. SETTING This study was conducted in 15 Internal Medicine residency programs (23 sites) throughout the USA. PARTICIPANTS The participants included site champions at residency programs and 709 residents. MEASUREMENTS Abstracted charts provided data about patient demographics, coronary heart disease risk factors, processes of care, and clinical outcomes. Patients completed surveys regarding satisfaction. Site teams completed a practice systems survey. RESULTS Chart abstraction of 4,783 patients showed substantial variability across sites. On average, patients had between 3 and 4 of the 9 potential risk factors for coronary heart disease, and approximately 21% had at least 1 important barrier of care. Patients received an average of 57% (range, 30-77%) of the appropriate interventions. Reported satisfaction with care was high. Sites with an electronic medical record showed better overall information management (81% vs 27%) and better modes of communication (79% vs 43%). CONCLUSIONS This study has provided insight into the current state of practice in residency sites including aspects of the practice environment and quality of preventive cardiology care delivered. Substantial heterogeneity among the training sites exists. Continuous measurement of the quality of care provided and a better understanding of the training environment in which this care is delivered are important goals for delivering high quality patient care.
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Affiliation(s)
| | - Judy A. Shea
- University of Pennsylvania, Philadelphia, PA USA
| | | | - Lorna A. Lynn
- American Board of Internal Medicine, Philadelphia, PA USA
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Lavoinne A, Jeannot E, Claeyssens S, Fessard C, Matray F. [Creatine kinase and isoenzymes in full-term newborn and premature infants]. Ann Biol Clin (Paris) 1985; 43:875-7. [PMID: 3832978 PMCID: PMC10884912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/12/2023] [Accepted: 11/23/2023] [Indexed: 01/07/2023]
Abstract
Serum creatine kinase activity was measured during the first post-natal days in healthy full-term and premature infants. The CK isoenzymes (CK-MM, MB and BB) were separated using ion-exchange column chromatography. Total CK activity is lower for premature infants than for full-term infants at the same time-periods. However the separation of the CK isoenzymes shows that the same normal values for the CK-BB (expressed as U/l) may be used for the two groups of infants.
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