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Objectives: Advising patients seeking medical guidance while communicating with them via telephone is a highly relevant skill in clinical daily life. However, telephone consultations differ from face-to-face interactions: clinical examination is nearly impossible and visual signals cannot be observed. Thus, telephone consultations require specific skills training. This article describes the development, implementation and evaluation of a course, "Telephone Consultation for Medical Emergencies", for 5th year medical students at the University of Bern, Switzerland. Methods: Following the evidence in the literature for telephone consultations, we developed guidelines for effective communication via telephone. After self-study of preparatory material, learners engaged in telephone consultations with simulated patients (SP) at the simulation center. They received multi-dimensional feedback regarding the encounter. Results: The course was successfully implemented in 2012. Evaluations showed the course to be well-received by students. In a survey, students agreed that they had learned many new skills and that they considered this learning as being important in their future employment. They felt that the SP feedback was helpful and that being observed by peer-students during the encounter or filling in a checklist while observing peer-students in other encounters added to their learning. During the debriefing of the simulation with a clinical expert, students judged the scenarios as realistic and relevant, praised the SP performances and identified that the most instructive aspect of the training was the opportunity to practice and to get feedback. Conclusion: Telephone consultations require specific skills that should be trained. The current Covid-19 pandemic and the recommendations of government institutions for patients to contact healthcare professionals primarily via telephone stress the importance of adequately training these skills. In this publication we describe a feasible and viable format for implementing this process.
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Comunicación , Educación de Pregrado en Medicina , Urgencias Médicas , Relaciones Médico-Paciente , Estudiantes de Medicina , Teléfono , Adulto , COVID-19/epidemiología , Competencia Clínica , Evaluación Educacional , Femenino , Humanos , Masculino , Pandemias , Simulación de Paciente , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , SARS-CoV-2 , Suiza/epidemiologíaRESUMEN
e-Learning: Basics of Sonography. Development of a Nationwide Entry-Level Module for Ultrasound Training in Switzerland Abstract. Teaching the rudiments of the theoretical and practical aspects of sonography is a challenge for many ultrasound course instructors, which is why the use of e-learning has come to the fore. An e-learning programme has already been implemented as part of a SGUM project: the "Fundamentals of Sonography" module. It has now been further developed in terms of teaching methods and content so that it can be offered as a "pre-course assignment" to participants in a variety of ultrasound courses. Based on theoretical knowledge and the evaluation of previous e-learning courses, the principles for the revision of the learning programme were developed and then implemented. After completing the four course sections, users should be able to operate an ultrasound device and understand the basic physical principles. This article describes the didactic concepts of the revision of the e-learning, the contents of the end product, and the implications for practice.
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Instrucción por Computador , Curriculum , Ultrasonografía , Examen Físico , SuizaRESUMEN
OBJECTIVES: Video-based worked examples enable medical students to successfully prepare for breaking-bad-news (BBN) encounters with simulated patients (SPs). This is especially true when examples include hints that signal important content. This paper investigates whether the beneficial effect of hints only applies to video-based worked examples or also text-based examples. METHODS: One-hundred-and-forty-seven fourth-year medical students attending a BBN training participated in either of two equally scaffolded, randomised field trials. Prior to encountering SPs, the students worked through an e-learning module introducing the SPIKES protocol for delivering bad news; it contained the same worked example presented to either of four groups as text or video, with or without additional hints denoting the SPIKES steps being implemented. RESULTS: Only a main effect of 'hints' was revealed, implying that students in the hints groups delivered the news to an SP significantly more appropriately than those in the without-hints groups. CONCLUSIONS: Independent of their presentation format, worked examples with hints best foster students' BBN skills learning. PRACTICE IMPLICATIONS: In addition to video, text-based worked examples can effectively prepare students for BBN simulations if hints are included. This offers an affordable alternative to video examples, as text examples can be generated with less effort.
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Competencia Clínica/normas , Comunicación , Educación de Pregrado en Medicina/métodos , Simulación de Paciente , Estudiantes de Medicina/psicología , Revelación de la Verdad , Adulto , Evaluación Educacional , Femenino , Humanos , Aprendizaje , Masculino , Relaciones Médico-Paciente , Médicos , Competencia Profesional , Estudiantes de Medicina/estadística & datos numéricos , Encuestas y Cuestionarios , Grabación en VideoRESUMEN
OBJECTIVES: Effective instructional approaches are needed to enable undergraduates to optimally prepare for the limited training time they receive with simulated patients (SPs). This study examines the learning effects of different presentation formats of a worked example on student SP communication. METHODS: Sixty-seven fourth-year medical students attending a mandatory communication course participated in this randomized field trial. Prior to the course, they worked through an e-learning module that introduced the SPIKES protocol for delivering bad news to patients. In this module, a single worked example was presented to one group of students in a text version, to a second group in a video version, and to a third group in a video version enriched with text hints denoting the SPIKES steps. RESULTS: The video-with-hints group broke bad news to SPs significantly more appropriately than either of the other groups. Although no further condition-related effects were revealed, students who learned from the text version most frequently (although non-significantly) ignored unpleasant emotions (standardised emotional cues and concerns) expressed by the SPs. CONCLUSIONS: The learning effect was strongest when the video-based worked example was accompanied by hints. PRACTICE IMPLICATIONS: Video-related learning approaches that embed attention-guiding hints can effectively prepare undergraduates for SP encounters.
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Educación de Pregrado en Medicina/métodos , Aprendizaje , Estudiantes de Medicina/psicología , Revelación de la Verdad , Competencia Clínica , Emociones , Femenino , Humanos , Masculino , Simulación de Paciente , Grabación en Video , Adulto JovenRESUMEN
Objectives: Interprofessional collaboration is becoming increasingly important in health care for various reasons. Interprofessional Education (IPE) can provide a basis for this. The aim of our study was to find out how medical (MS) and nursing students (NS) think about their own and other professions, what they know about each other, how strong their willingness to embrace IPE is, and what forms of IPE they deem useful. Methodology: Seven IPE experts rated the two measuring instruments, Readiness for Interprofessional Learning Scale RIPLS, and Interdisciplinary Education Perception Scale IEPS in terms of relevance of the items, and the quality of translation into German. Nine RIPLS items and 13 IEPS items were considered content-valid. All MS of the University of Bern and NS of the two Bernese educational institutions for nursing were invited to the online survey in the fall of 2014 by email. Results: 498 (254 MS, 244 NS) of the 2374 invited students completely filled in the questionnaire (21%). The results of the reduced RIPLS allowed no conclusive statements. When assessing their own occupational group in the IEPS, the MS attributed "competence and autonomy" to themselves significantly more frequently, while to the NS, the same was true for the item, "actual cooperation". MS know significantly less about the training of other health professionals. NS show a significantly higher willingness to embrace IPE. Teaching ethics, communication, team training, and clinical skills are deemed suitable for IPE by both groups. From the comments it appears that in both groups a majority welcomes IPE; however, the various arguments had different prevalence in both groups. Both groups fear that IPE leads to heightened stress during the study. A subgroup of MS fears a lowering of academic level. Conclusion: The results of this survey of Bernese MS and NS concerning IPE provide important information for the planning and implementation of IPE. Important steps in the introduction of IPE will be a clear justification and the definition of its objectives. These must be explicitly communicated to all students.
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Competencia Clínica , Relaciones Interprofesionales , Estudiantes de Enfermería , Actitud del Personal de Salud , Humanos , Estudios Interdisciplinarios , Estudiantes de MedicinaRESUMEN
INTRODUCTION: Various different learning methods are available for planning tuition regarding the introduction to surgical hand disinfection. These learning methods should help to organise and deal with this topic. The use of a video film is an alternative to conventional tuition due to the real presentation possibilities of practical demonstration. OBJECTIVE: This study examines by way of comparison which form of communication is more effective for learning and applying surgical hand disinfection for medical students in their first year of studies: video-based instruction or conventional tuition. METHODOLOGY: A total of 50 first-year medical students were randomly allocated either to the "Conventional Instruction" (CI) study group or to the "Video-based Instruction" (VI) study group. The conventional instruction was carried out by an experienced nurse preceptor/nurse educator for the operating theatre who taught the preparatory measures and the actual procedure in a two-minute lesson. The second group watched a two-minute video sequence with identical content. Afterwards, both groups demonstrated practically the knowledge they had acquired at an individual practical test station. The quality (a) of the preparation and (b) of the procedure as well as (c) the quality of the results was assessed by 6 blind experts using a check list. The acceptability of the respective teaching method was also asked about using a questionnaire. RESULTS: The group performance did not differ either in the preparation (t=-78, p<0.44) or in the quality (t=-99, p<0.34). With respect to performance, it was possible to demonstrate a strong treatment effect. In the practical (t=-3.33, p<0.002, d=0.943) and in the total score (t=-2.65, p<0.011, d=0.751), the group with video-based instruction achieved a significantly better result. In response to the question as to which of the two learning methods they would prefer, the significant majority (60.4%) of students stated video instruction. CONCLUSION: In this study, the use of the video-based instruction emerged as the more effective teaching method for learning surgical hand disinfection for medical students and is preferable to conventional instruction. The video instruction is associated with a higher learning effectiveness, efficiency and acceptability.
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Desinfección de las Manos , Estudiantes de Medicina , Grabación en Video , Adulto , Evaluación Educacional , Femenino , Humanos , Aprendizaje , Masculino , Encuestas y CuestionariosRESUMEN
Teamwork and the interprofessional collaboration of all health professions are a guarantee of patient safety and highly qualified treatment in patient care. In the daily clinical routine, physicians and nurses must work together, but the education of the different health professions occurs separately in various places, mostly without interrelated contact. Such training abets mutual misunderstanding and cements professional protectionism, which is why interprofessional education can play an important role in dismantling such barriers to future cooperation. In this article, a pilot project in interprofessional education involving both medical and nursing students is presented, and the concept and the course of training are described in detail. The report illustrates how nursing topics and anatomy lectures can be combined for interprofessional learning in an early phase of training. Evaluation of the course showed that the students were highly satisfied with the collaborative training and believed interprofessional education (IPE) to be an important experience for their future profession and understanding of other health professionals. The results show that the IPE teaching concept, which combines anatomy and nursing topics, provides an optimal setting for learning together and helps nurses and doctors in training to gain knowledge about other health professionals' roles, thus evolving mutual understanding.
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Anatomía/educación , Educación Médica , Educación en Enfermería , Relaciones Interprofesionales , Estudiantes de Medicina/psicología , Estudiantes de Enfermería/psicologíaRESUMEN
BACKGROUND: The established communication skills training (CST) curriculum consists of continuous education, frequent practice with real patients, supervision and feedback from medical teachers. The limitation of this curriculum is that students have to directly apply the theoretical basis they are provided with to real patients. To improve the existing CST curriculum a CST module involving simulated patients was introduced in order to develop more complex communication skills. METHODS: A new CST module using simulated patients was developed and evaluated. The students assessed the module from their own perspective using a questionnaire, and compared it with other courses. In addition, the communication competencies of the students were assessed with a self-report questionnaire before and after the training. RESULTS: The overall rating for the course was 5.4 on a six-point Swiss school grade scale, with six being the best possible score. The self-assessment showed positive changes after the intervention and subjective improvement in knowledge, to varying extents. DISCUSSION: For the acquisition of more complex communication skills students value being able to practise their skills with simulated patients first, before practising with real patients.
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Competencia Clínica/normas , Comunicación , Relaciones Médico-Paciente , Curriculum , Educación de Pregrado en Medicina , Humanos , Simulación de Paciente , Encuestas y Cuestionarios , SuizaRESUMEN
BACKGROUND: In the training of healthcare professionals, one of the advantages of communication training with simulated patients (SPs) is the SP's ability to provide direct feedback to students after a simulated clinical encounter. The quality of SP feedback must be monitored, especially because it is well known that feedback can have a profound effect on student performance. Due to the current lack of valid and reliable instruments to assess the quality of SP feedback, our study examined the validity and reliability of one potential instrument, the 'modified Quality of Simulated Patient Feedback Form' (mQSF). METHODS: Content validity of the mQSF was assessed by inviting experts in the area of simulated clinical encounters to rate the importance of the mQSF items. Moreover, generalizability theory was used to examine the reliability of the mQSF. Our data came from videotapes of clinical encounters between six simulated patients and six students and the ensuing feedback from the SPs to the students. Ten faculty members judged the SP feedback according to the items on the mQSF. Three weeks later, this procedure was repeated with the same faculty members and recordings. RESULTS: All but two items of the mQSF received importance ratings of > 2.5 on a four-point rating scale. A generalizability coefficient of 0.77 was established with two judges observing one encounter. CONCLUSIONS: The findings for content validity and reliability with two judges suggest that the mQSF is a valid and reliable instrument to assess the quality of feedback provided by simulated patients.
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Curriculum , Educación en Enfermería/métodos , Retroalimentación , Simulación de Paciente , Adulto , Comunicación , Evaluación Educacional , Femenino , Humanos , Masculino , Control de Calidad , Reproducibilidad de los Resultados , Estudiantes de Enfermería/estadística & datos numéricos , Encuestas y Cuestionarios , Suiza , Adulto JovenRESUMEN
This study investigated the effectiveness of modules involving standardized patients and role-plays on training communication skills. The first module involved standardized patients and an Objective Structured Clinical Examination (OSCE); the second module consisted of peer role-plays and a written examination. A randomized posttest-only control group design with first-year nursing students was used. The intervention group received one-to-one communication training with direct oral feedback from the standardized patient. The control group had training with peer role-playing and mutual feedback. The posttest involved students' rating their self-efficacy, and real patients and clinical supervisors evaluated their communication skills. No significant differences were found between self-efficacy and patient ratings. However, the clinical supervisors rated the intervention group's communication skills to be significantly (p < 0.0001) superior. Assessments by clinical supervisors indicate that communication training modules including standardized patients and an OSCE are superior to communication training modules with peer role-playing.