Post Graduate Students' Experiences with Research Ethics: A South African Perspective

The strict adherence to ethical principles (namely respect for persons, beneficence/non-maleficence and justice) when conducting research involving human participants is the bedrock of research. There has been little research on students' experiences with the research ethics process and how these students incorporate ethical standards into their research work, despite previous research looking into teaching methodologies, curricula, and the educational environment for postgraduate students. The purpose of the study was to investigate postgraduate students' experiences with research ethics during their research project. A sample of 11 participants was used. Through online interviews, this qualitative study, underpinned by the interpretivist paradigm, collected data from postgraduate students from different disciplines and universities in South Africa between June and August 2021. The findings showed different perspectives on the training received in research ethics, and on support and guidance received from supervisors, and the application of research ethics principles in their research projects. Most participants indicated gaps in the teaching and support they received and had not read their university research ethics policies. By focusing on students' experiences in a developing country and different disciplines, the study contributes to the body of knowledge on postgraduate student experiences. Furthermore, the findings suggest that there is need for more research ethics training amongst postgraduate students in South Africa.

Learning and assessment strategies to develop specific and transversal competencies for a humanized medical education

Introduction: Medical education should promote the development of skills and abilities that can be applied to real-world work performance. The aim of this study is to evaluate technical and methodological knowledge, as well as physician-patient communication skills, as one of the most important transversal competencies that a good physician should acquire; all this in a reliable, accurate and objective way. Methods: We present a rubric specifically designed and implemented for the evaluation of specific and transversal competencies in the physiology practical sessions, during the second year of the medical degree. The assessment consists in two evaluation tests: 1) a theoretical test that consists of multiple-choice questions. Students must demonstrate that they have acquired adequate theoretical knowledge (specific competency "to know"); 2) a practical test, in which students are evaluated by the rubric through the simulation of a medical consultation. Thus, demonstrating their ability to execute/apply what they have learned in class (specific competency "to know how to do"). They are also evaluated on the transversal competencies that we call "communication with the patient" (transversal competency "to know how to be there") and "dealing with the patient" (transversal competency "to know how to be"). Results: We evaluated whether there were differences in the grades obtained by students when the transversal competencies were not assessed (academic years 2017-2018 and 2018-2019; n = 289), and when the transversal competencies were assessed by applying the rubric in the academic years 2019-2020, 2021-2022, and 2022-2023 (n = 526). Furthermore, we present a student perception that supports the use of clinical simulation and our rubric as a good method within the competency learning process. Discussion: The acquisition of these competencies, starting from the first courses of undergraduate education, helps to raise the students' awareness in the development of a more humanized medicine, allowing a better response to the patients' needs. Our rubric, which clearly indicate the performance criteria, have become an excellent method to carry out the assessment of competencies, both for students and teachers, since they allow to obtain clear evidence of the level of acquisition and application of knowledge.

An exploration of instructors' and students' perspectives on remote delivery of courses during the COVID-19 pandemic

The world-wide pivot to remote learning due to the exogenous shocks of COVID-19 across educational institutions has presented unique challenges and opportunities. This study documents the lived experiences of instructors and students and recommends emerging pathways for teaching and learning strategies post-pandemic. Seventy-one instructors and 122 students completed online surveys containing closed and open-ended questions. Quantitative and qualitative analyses were conducted, including frequencies, chi-square tests, Welch Two-Samples t-tests, and thematic analyses. The results demonstrated that with effective online tools, remote learning could replicate key components of content delivery, activities, assessments, and virtual proctored exams. However, instructors and students did not want in-person learning to disappear and recommended flexibility by combining learning opportunities in in-person, online, and asynchronous course deliveries according to personal preferences. The paper concludes with future directions and how the findings influenced our planning for Fall 2021 delivery. The video abstract for this article is available at https://www.youtube.com/watch?v=F48KBg_d8AE.

Identifying Factors That Influence Student Perceptions of Stress in Biology Courses with Online Learning Modalities

Students in higher education encounter many factors both inside (academic) and outside (nonacademic) classrooms that can influence their perceptions of stress in their biology courses. These can include course learning modalities, coursework, grades, as well as time management outside of class. It is unknown what stressors are perceived by students enrolled in biology courses-especially in online learning modalities. Therefore, our mixed method study aims to investigate the extent to which online course modalities influence students' perception of stress, as well as identify academic and nonacademic factors that influence students' perceptions of stress in biology courses. Student survey data (n = 240) was collected in the Fall 2020 semester while many courses were held online due to the COVID-19 pandemic. Our qualitative and quantitative analyses indicated three major findings: First, 70% of students specifically indicated that online-learning modalities increased their stress levels. Our second major finding is that 70% of students indicated the size of class workloads-work both in and out of class-is too much, which especially impacts students with caretaking and work responsibilities. Finally, over 85% of students indicated that exams were a major source of stress, specifically, a third of the students reported the time to complete the exam and exam material as sources of stress. This work is the first to identify stressors in online biology courses, and these analyses will inform future pedagogy, curriculum, and policies to mitigate students' stress as instructors continue to explore online learning pedagogy.

Physiotherapy Students' Experiences about Ethical Situations Encountered in Clinical Practices

(1) Background: It is important to explore the ethical situations that physiotherapy students encountered in their clinical practices. (2) Methods: Qualitative, explorative, descriptive study. The participants included third-year physiotherapy students. They had to write five narratives about ethical situations encountered in their clinical practices. Krippendorff’s method for qualitative content analysis was used to cluster units within the data to identify emergent themes. The study protocol was approved by the authors’ University Ethic Committee of Human Research (H1515588244257). (3) Result: 280 narratives were reported by 64 students (23.34 ± 4.20 years, 59% women). Eight categories were identified from the qualitative analysis of the data: (a) professional responsibility, (b) professional competence, (c), beneficence, (d) equality and justice, (e) autonomy, (f) confidentiality, (g) respect for privacy, and (h) sincerity. All participants were informed and provided written informed consent. (4) Conclusions: Ethical principles were frequently violated in physiotherapy. Experiences of physiotherapy students must be examined to tailor educational interventions prior to their initiation into practice. Ethics education is needed in workplaces and should be increased in basic education. Facilitating the ethical awareness of future physiotherapists is a challenge for university teachers who provide ethical competence training.

Peer learning and collaborative placement models in health care: a systematic review and qualitative synthesis of the literature

AIMS

To summarise the international empirical literature to provide a comprehensive overview of peer learning and collaborative practice placement models in health care and to synthesise their benefits and challenges.

BACKGROUND

Practical placements for students are in high demand due to the need for an increased nursing, midwifery and health professional workforce, thus collaborative placement models are an attractive solution to potentially increase placement capacity and enhance the student learning experience.

DESIGN

A systematic search of the literature and qualitative data synthesis using the PRISMA checklist and ENTREQ guidelines.

REVIEW METHODS

MEDLINE and CINAHL searched in March 2020. Quality appraisal of studies conducted. Collaborative models and empirical findings summarised. Reported benefits, challenges and implementation recommendations synthesised. Two tables developed for data representation.

RESULTS

172 studies were identified by the search strategy. Of these, 47 articles were included for appraisal and synthesis. 30 articles employed qualitative, seven quantitative and ten mixed-methods approaches. Research took place in eight countries. The majority of studies employed focus groups, interviews as well as questionnaire design. The total participant sample was 3462 consisting of students and educators.

CONCLUSIONS

This review confirmed that any peer learning is beneficial in supporting students' confidence and team working skills. It is especially helpful when pairing first year with third-year students. The latter can demonstrate their clinical skills and prepare for working in practice. Simultaneously, expert-led learning is important for role modelling and for the recognition of acquired skills. Evidence on the optimal placement experience is inconclusive; however, it can be concluded that any form of collaborative placement model requires careful planning and continuous preparation for staff and students.

RELEVANCE TO CLINICAL PRACTICE

Decision makers should consider implementing at least some form of peer learning to assist students with peer support, and ideally work towards a collaborative learning environment.

Student's Experiences on Learning Therapeutic Relationship: A Narrative Inquiry

Despite the importance of the therapeutic relationship on nursing practice, the literature regarding teaching and learning therapeutic relationship is limited. This paper discussed how an undergraduate nursing student learned therapeutic relationship in an acute care setting. Narrative inquiry was applied as a research methodology. The student's reflection served as the narrative in this paper. Collaboratively, researchers conducted data analysis, common themes were drawn, and a summative narrative was presented. Based on the student's narrative, a three-dimensional model, including practical knowledge, theory, and reflection, has been created as our summative narrative. This model suggests that, to facilitate a learning process on creating therapeutic nurse-patient relationship, practical knowledge is the foundation, theory is a leading guide, and constant reflection is a learning tool which transforms learning into a reflective and meaningful experience. To promote learning on therapeutic relationship, nurse educators should emphasize the importance of both practical knowledge and theory. Constant reflection as a learning tool should be encouraged and embedded in nursing curriculum. Diverse approaches of reflection should be promoted.

Learning experiences of final-year student midwives in labor wards: A qualitative exploratory study

INTRODUCTION

Clinical placements are an integral part of midwifery education and are crucial for achieving professional competencies. Although students' experiences on placements have been shown to play a meaningful role in their learning, they have received scant attention in the literature. The aim of this paper is to describe the learning experiences of final-year student midwives in labor wards within the Brussels metropolitan region, Belgium.

METHODS

A qualitative exploratory study was conducted using two focus groups (N=20). Data analysis included: transcription of audio recordings, thematic content analysis with coding into recurrent and common themes, and broader categories. Discussions among researchers were incorporated in all phases of the analysis for integrity and data fit.

RESULTS

Data analysis identified the following categories as determining student learning experiences in labor wards: 1) managing opportunities, 2) being supported, and 3) dealing with the environment. Overall, respondents were positive and enthusiastic about their learning experiences, although some felt tense and unprepared. Students expressed concerns about differences in learning opportunities between placements and found it challenging to achieve all competencies. Student learning experiences were enhanced when they had placements for longer periods with the same supportive mentors.

CONCLUSIONS

Factors related to students' functioning, the healthcare professional, midwifery education and hospital environment affected their learning in labor wards. The combination of a more persevered preparation of students and mentors, together with a student-centered organization of placements, is crucial to create a positive learning experience for midwifery students in labor wards.

A Comprehensive Reflective Journal-Writing Framework for Pharmacy Students to Increase Self-Awareness and Develop Actionable Goals

Objective. To develop and evaluate the effectiveness of a structured model for reflective journal writing (RJW) and a grading rubric as part of a student portfolio designed to help Doctor of Pharmacy (PharmD) students create actionable goals. Methods. A structured, eight-domain format was developed to engage students in prioritization, identification, exploration, recollection, evaluation, and challenging/solidifying their own knowledge, while assembling an action plan for development (abbreviated using the acronym PIE-RECAP). After completing RJW using this model, students self-identified domains established by the Center for the Advancement of Pharmacy Education (CAPE) that corresponded to their entries. A grading rubric was designed and normalized to require minimal training for use. RJW and other elements of student portfolios were implemented simultaneously across three cohorts (N=296). Twenty-one faculty and staff graders each evaluated 10 to 15 student journal entries. Results. Of 771 journal entries, 648 (84%) met expectations, while 123 (16%) needed to be rewritten. Students identified experiences that were meaningful to them and shared in their RJW entry the knowledge and/or information that they did not know prior to the experience. Common themes identified in the students' RJWs included: curricular experiences (12.7%), cocurricular experiences (18.4%), and experiential training (68.6%). Conclusion. The PIE-RECAP method can be used to guide students in RJW and identify CAPE domains in their personal and professional experiences in pharmacy school. The associated grading rubric can be used to evaluate students' RJW entries and assess their growth in curricular, cocurricular and affective domains relative to their progression.

Oral Health and Dental Students' Perceptions of Their Clinical Learning Environment: A Focus Group Study

Creating an optimal clinical learning environment poses a challenge to health professions educators. To evaluate and improve the clinical learning environment, it is necessary to understand students' experiences of their environment and the factors they perceive as having an impact on their learning. The aim of this explorative qualitative study was to examine University of Otago Faculty of Dentistry students' perceptions of their clinical learning environment to gain insights into how learning outcomes could be enhanced. In 2015, all approximately 600 students at all levels of the Bachelor of Oral Health and Bachelor of Dental Surgery degrees at the University of Otago, Dunedin, New Zealand, were invited to participate in focus groups. Focus groups facilitated by the faculty education research fellow and another researcher employed for the project were conducted during the second half of the academic year. Transcribed data were analyzed using a general inductive approach. Twenty-one students from all levels of the two programs attended one of six confidential focus groups. Three broad themes were evident in the results from all groups: feedback processes, assessments and grading, and tutor interactions. In the focus groups, students expressed dissatisfaction regarding current feedback practices, types of feedback to benefit learning, consistency in the grading system, and impact of different educators' teaching styles on learning. These results indicated a need for further research and curricular efforts to promote good student-teacher relationships in the clinical learning environment, which are paramount for creating an optimal teaching and learning environment and enhancing student outcomes.

Radiation Therapy Students as Partners in the Development of Alternative Approaches to Assessing Treatment Planning Skills

AIM

The involvement of undergraduate students in assessment design is not a new concept. However, there is a paucity of evidence on radiation therapy students' participation in the design of teaching and learning activities. This article reports the development and initial evaluation of alternative approaches to assessing treatment planning skills and knowledge in undergraduate radiation therapy education.

METHODS

A group of undergraduate radiation therapy students participated in a series of semistructured focus group meetings. The students nominated a practical examination and an oral plan critique assessment approach. The lecturers embedded two formative tasks to test the approaches in a second-year treatment planning subject. Two surveys assessed the experiences of the students, authenticity, engagement, and the practicality of the tasks in the treatment planning subject.

RESULTS

The responses show that 92% of participants perceived the practical treatment planning examination as an authentic or real-world assessment approach. Moreover, 96% of the participants supported the notion of incorporating the tasks into the treatment planning subject. Most students (96%) perceived an oral critique of a treatment plan as an authentic approach and also supported the notion of incorporating oral critiques as an assessment task. Student engagement was high in both the practical and oral critique tasks, suggesting that lecturers could also include such tasks as formative activities to enhance learning.

CONCLUSION

Involving student voices in pedagogic assessment design positively influenced the development of new assessments for the treatment planning subject. The oral critiques and practical-based approaches nominated are likely to enhance authenticity to students' learning experiences and provide opportunities for students to develop desirable professional capabilities.

Dental students' and staff perceptions of the impact of learning environment disruption on their learning and teaching experiences

INTRODUCTION

This project is a qualitative investigation into student and staff experiences of the effect of a major building redevelopment on their Dental School learning and teaching environments. Currently, there is little research exploring the impact of disruptions to the learning environment on students' learning and staff teaching experiences.

METHOD

Data were collected in 2016 using an online survey, semi-structured interviews and focus groups with students and staff. Data were analysed using a general inductive approach.

RESULTS

Four broad themes emerged as follows: (i) students valued having a space for personal and collaborative work within the Dental School; (ii) both staff and students positioned staff contributions to learning experiences above the role of the physical learning environment; (iii) the majority of staff and students not feel that the physical environment limited their clinical training; and (iv) staff and students were able to adapt to the impact of building redevelopment through resilience and organisation.

DISCUSSION

Results of this research have informed the provision of collegial spaces at the School, both as the building redevelopment continues, and in planning for the completed building.

How do medical and nursing students experience emotional challenges during clinical placements?

OBJECTIVES

To investigate which kinds of situations medical and nursing students found emotionally challenging during their undergraduate education, and how they managed their experiences.

METHODS

This study used an exploratory research design. We gathered qualitative data using an open-ended questionnaire distributed to students in the middle and at the end of their education. In total, 49 nursing and 65 medical students participated. Also, five students were interviewed individually to acquire richer data. Data were analysed using narrative thematic analysis.

RESULTS

Medical and nursing students experienced a range of situations during their undergraduate education that they found emotionally challenging, mainly during clinical placements. The students' narratives concerned confronting patients' illness and death, unprofessional behaviour among healthcare professionals, dilemmas regarding patient treatment, students relating to patients as individuals and not diagnoses, and using patients for their own learning. The narratives concerned both the formal and the hidden curriculum, i.e., what is included in the profession (confronting illness and death), and what is not (unprofessional behaviour among healthcare professionals). Students managed their experiences by talking to trusted peers or supervisors, and by getting used to these situations.

CONCLUSIONS

Despite the different knowledge, experiences, and conditions for medical and nursing students, our findings suggest that their experiences of emotional challenges are similar. Support and opportunities to talk about these experiences are important. Teachers, supervisors, and students need to be aware that students might experience emotionally difficult situations, and that the students need time for reflection and support.

Student Experiences of High-stakes Testing for Progression in One Undergraduate Nursing Program

Each year, thousands of students throughout the world are required to complete one or more high-stakes tests as a measure of competency in undergraduate nursing education. Currently, the trend in nursing education is to use high-stakes tests to establish program progression policies. However, use of these tests to block student progression is of serious concern. This article describes findings of a pilot study that used a phenomenographic approach to understand senior nursing students' experiences of completing multiple high-stakes tests for successful progression within one undergraduate nursing program. Eighteen graduating senior nursing students participated in the study via individual interviews. Students described a multitude of experiences, organized into five main categories of descriptions: high-stakes tests as a value; high-stakes tests as a stressor; high-stakes tests as a high expectation; high-stakes tests as various inconsistencies; and high-stakes tests affecting the transfer of learning. Student perspectives with high-stakes testing contributed valuable insight lacking in the current nursing education literature. Findings suggested if high-stakes tests are to be used for program progression, it is imperative for nurse educators to convene and explore strategies to support student preparation and success with testing, and develop well-defined structures of teaching and learning for the delivery of course content.