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1.
J Pak Med Assoc ; 74(6): 1119-1123, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38948983

RESUMEN

Objective: To compare the perception of dental students and faculty members regarding the attributes of effective clinical teachers. METHODS: This cross-sectional study was conducted at the Dow University of Health Sciences, Karachi, from August 2021 to November 2021, and comprised of third and final year dental students and associated clinical faculty members from three dental colleges in the city. Data was collected using the modified version of a pre-validated questionnaire. Data was analysed using SPSS 25. RESULTS: Of the 200 students approached, 169(84.5%) responded; 135(79.9%) females and 34(20.1%) males with mean age 21.78±1.099 years (range: 19-26 years). Of the 59 teachers approached, 49(83%) responded; 33(67.3%) females and 16(32.7%) males with mean age 31.59±5.041 years (range: 23-49 years). The students found record-keeping a tiresome task 69(42%), while teachers regarded it essential for clinical development. Unlike teachers, the students were unable to identify the relevance of clinical objectives and they also did not appreciate teachers' involvement in clinical procedures. For other domains regarding personal traits, teaching methods and clinical skills, both groups had similar responses. Conclusion: There was generally a similarity of opinions among students and teachers regarding the essential qualities of effective dental clinical teaching.


Asunto(s)
Docentes de Odontología , Estudiantes de Odontología , Humanos , Femenino , Masculino , Estudiantes de Odontología/psicología , Estudiantes de Odontología/estadística & datos numéricos , Estudios Transversales , Adulto , Adulto Joven , Pakistán , Educación en Odontología/métodos , Persona de Mediana Edad , Encuestas y Cuestionarios , Competencia Clínica , Enseñanza , Actitud del Personal de Salud
2.
J Pak Med Assoc ; 74(1): 123-125, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38219178

RESUMEN

The study was conducted to determine and compare the caring behaviours of nursing students in four-year BS Nursing (Bachelor of Science in nursing) and two-year Post- RN BSN (Registered nurse to Bachelor of Science in Nursing) programmes. A cross-sectional analytical study was conducted in the nursing institutes of KP from July to September 2022. The sample size was 383 calculated by using the Rao soft sample size calculator. through Caring Behaviour Inventory (CBI-24) having six point Likert scale. Descriptive and inferential statistics were calculated through SPSS 20.0. There were more males, i.e. 60.6%, as compared to female students (39.4%). The overall mean score of caring competencies of Post-RN BS Nursing (Registered nurse to Bachelor of Science in Nursing) was 27.17±2.17 which is higher than 23.19±4.1 for BSN students (Bachelor of Science in nursing). Caring behaviours of overall participants are correlated with gender (p=0.001), age (p=0.001), and semester (p=0.001). The caring competency of Post-RN BS nursing students' are higher than the BS Nursing programme students. That could be due to the clinical exposure of Post-Rn students after completing a three-year Diploma in General Nursing.


Asunto(s)
Bachillerato en Enfermería , Estudiantes de Enfermería , Masculino , Humanos , Femenino , Estudios Transversales
3.
Nurse Educ Today ; 133: 106047, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38039885

RESUMEN

OBJECTIVES: Historically, emphasis on task-completion and lack of intentional approaches that develop students' thinking skills have dominated clinical education. One contributing factor may be the limited literature about teaching to develop clinical reasoning and clinical judgment in the clinical environment. This integrative review accessed available literature to answer the question, What strategies are used to develop clinical judgment in the clinical education environment? DESIGN: The Whittemore and Knafl approach framed the integrative review. The framework includes the following steps 1) problem identification, 2) literature search, 3) data evaluation, 4) data analysis, and 5) presentation. DATASOURCES: The data bases CINAHL Plus with Full Text, OVID, and ProQuest were searched through the period of January 2000 through July of 2022. REVIEW METHODS: The PRISMA protocol informed review and screening of the literature. Authors assessed articles for eligibility via first screening by abstract review, followed by review of the full text. Both authors reviewed the articles, assessing qualification for inclusion and evaluating the content. Data from eligible articles were analyzed and synthesized to answer the research question. RESULTS: Of the initial 427 articles, a total of 20 articles met inclusion criteria for final analysis. Five general themes emerged for clinical judgment during clinical education. The findings identified the teaching strategies nurse educators use. Many of the teaching methods include deliberateness and intentionality in planning and implementing the strategies. In addition to evaluating clinical judgment, nurse educators guided and mentored student thinking. Finally, this review identified reported outcomes and results of the teaching strategies and methods. CONCLUSIONS: A limited number of articles describing teaching for clinical judgment in clinical environment were found. The articles analyzed found that nurse educators used a variety of teaching strategies for the purpose of developing students' clinical judgment. More research is needed to guide best-practices in clinical education. We must move the science forward to transform and leverage clinical education more deliberately to teach thinking in practice and decision-making about patient care.


Asunto(s)
Bachillerato en Enfermería , Estudiantes de Enfermería , Humanos , Juicio , Bachillerato en Enfermería/métodos , Pensamiento , Estudiantes , Razonamiento Clínico
4.
Front Surg ; 10: 1113267, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36860941

RESUMEN

Background: Despite the clerkship being crucial in the training of a future doctor, no widely accepted education model has been proposed. This study devised a new model for clinical clerkship rotations, titled "LEARN" for Lecture, English-video, Advisor, Real-case and Notion, and evaluated whether the LEARN model is appropriate for medical education in China. Methods: A cross-sectional study was performed among 101 fourth-year students from the Xiangya School of Medicine during an Orthopaedic Surgery clerkship rotation in the Third Xiangya Hospital. They were divided into seven groups and took clerkship based on the LEARN model. A questionnaire was collected at the conclusion to measure learning outcomes. Results: The LEARN model was highly accepted with the acceptance of five sessions being 95.92% (94/98), 93.88% (92/98), 96.98% (97/98), 100% (98/98) and 96.94% (95/98). The outcomes of two genders were comparable, whereas a difference was observed in the test score among groups (group 3 scored 93.93 ± 5.20, higher than others). Quantitative analysis showed that positive correlations existed in participation in the Notion (Notion means students' case discussion) section with leadership (r = 0.84, 95% CI: 0.72-0.94, p < 0.001), participation in the Real-case section with leadership (r = 0.66, 95% CI: 0.50-0.80, p < 0.001), participation in the Real-case section with mastery of inquiring skills (r = 0.57, 95% CI: 0.40-0.71, p < 0.001) and participation in the Notion section with mastery of physical examination skills (r = 0.56, 95% CI: 0.40-0.69, p < 0.001). Further qualitative analysis demonstrated that high-level participation in the English-video section indicated better outcomes in mastery of inquiring (p < 0.01), physical examination (p < 0.001), film reading (p < 0.01) and clinical reasoning (p < 0.01) skills. Conclusion: Our results support the LEARN model is a promising method for medical clerkship in China. Further research involving more participants and more meticulous design is planned to test its efficacy. For refinement, educators may try to promote students' participation in the English-video session.

5.
BMC Med Educ ; 23(1): 128, 2023 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-36823563

RESUMEN

BACKGROUND: Near-peer medical education serves as an important method of delivering education to junior students by senior students. Due to the reduced clinical exposure because of the COVID-19 pandemic, we developed a mentorship scheme to help medical students with their Integrated Structured Clinical Examinations (ISCEs) by providing a combination of near-peer mentorship together with lecture-based teaching on a weekly basis for a 12-week period. Students attended a specialty-focused lecture every Tuesday followed by a small group teaching session organised by their tutor. METHODS: A longitudinal evaluative interventional study was undertaken by the international student led medical education organisation, OSCEazy. The teaching programme was organised and conducted by third year medical students to a recruited cohort of second year medical students. Students' perceptions of ISCEs (confidence, anxiety, and overall performance) were evaluated using 5-point Likert scales while their knowledge of the specialty was assessed using 10 single best answer questions which were distributed via Google® forms at the start and end of each week. In addition, we assessed tutor perceptions of their teaching and learning experience. RESULTS: Seventy-two tutees were enrolled in the programme (mean age: 24.4, female: 77.8%). 88.9% of the participants had not attended any online ISCE teaching prior to this. They preferred in-person ISCE teaching as compared to virtual sessions [median 4.5 (IQR 4-5) vs 3 (IQR 3-4), p <  0.0001), respectively]. There was a significant overall increase in knowledge when comparing pre-session and post-session performance [mean 53.7% vs 70.7%, p <  0.0001)]. There was a significant increase in student confidence [Confidence: median 3 (IQR:3-4) vs 4 (IQR 3-4), p <  0.0001] while no change was seen in the anxiety and perception of their overall performance in an ISCE. [Anxiety: median 3 (IQR 2-4) vs 3 (IQR 3-4), p = 0.37, Performance: median 3 (IQR 3-4) vs median 3 (IQR 3-4), p <  0.0001]. The tutors reported an increase in their confidence in teaching ISCEs online [median 3 (IQR 2-3.25) vs median 4 (IQR 4-5), p <  0.0001)]. CONCLUSION: Online near-peer teaching increases the confidence of both tutees and tutors involved while enhancing the tutees' knowledge of the specialty. Thus, medical schools should incorporate near-peer teaching in their curriculum to enhance the student learning experience.


Asunto(s)
COVID-19 , Educación de Pregrado en Medicina , Estudiantes de Medicina , Humanos , Femenino , Adulto Joven , Adulto , Pandemias , Educación de Pregrado en Medicina/métodos , Aprendizaje , Curriculum , Grupo Paritario , Enseñanza
6.
HEC Forum ; 35(4): 325-335, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35092518

RESUMEN

Movies can serve valuable didactic purposes teaching clinical ethics to medical students. However, using film sequences as means to develop critical thinking is not a straightforward task. There is a significant gap in the literature regarding how to analyse the ethical content embedded in these clips systematically, in a way that facilitates the students' transition from anecdotal reflections to abstract thinking. This article offers a pedagogical proposal to approach the ethical analysis of film sequences in a systematic fashion. This structured stepwise method encourages students to identify the main ethical problem of a selected scene and to reflect on the theoretical principles involved, emphasizing the application of these norms and values in a contextually situated analysis. We believe this method in film studies both reinforces the students' comprehension of the theoretical framework of an ethical topic, and casts light on its pertinence and limitations under the circumstances of the scene, thus proving a constructive tool to strengthen the bridge between the theoretical teaching of clinical ethics and clinical practice.


Asunto(s)
Películas Cinematográficas , Estudiantes de Medicina , Humanos , Pensamiento , Análisis Ético , Ética Médica
7.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-972129

RESUMEN

@#Peer-assisted learning (PAL) is a potential approach for clinical education that can reduce the burden of clinical supervision and enhance learning. This study aims to identify opportunities for PAL through investigating how speech language therapy students perceive and already participate in PAL within a range of clinical practicum settings. The Speech Sciences students across all years at one institution were invited to participate in a cross-sectional survey that was adapted and revised from Tai et al. (2014). Speech Sciences students reported they applied PAL as part of their learning strategy in their clinical practicums, but still relied on supervisors as the main source of. PAL occurred more frequently in contexts where students already had some clinical experience and spent substantial amounts of time together. Students agreed that PAL enhanced their learning and emphasized a few advantages of PAL, such as having the opportunity to share their ideas, experiences, and knowledge, and providing a positive learning environment without pressure. Confidence to provide information or feedback to peers was cited as a shortcoming in PAL. PAL is a viable teaching approach that can be used in speech-language therapy clinical education program to reduce the supervisory burden. The findings from our study show that PAL is largely self-initiated among speech-language therapy students. However, PAL must be tailored to suit different clinical education year levels and clinical settings to benefit. Case discussion may be one area where scaffolded PAL activities could represent a feasible first step to increasing PAL.

9.
Phys Ther ; 102(7)2022 07 04.
Artículo en Inglés | MEDLINE | ID: mdl-35639979

RESUMEN

OBJECTIVE: Clinical instructors play a key role in physical therapist professional education but may serve with minimal preparation and without clearly defined expectations for their teaching performance. The objective of this study was to utilize a consensus-building process to establish core competencies of clinical teaching within physical therapist education. METHODS: A modified Delphi approach was used to identify core competencies of clinical teaching. An expert panel consisted of clinical instructors, site coordinators of clinical education, and directors of clinical education, representing multiple geographic regions in the United States. The panel assessed the relevance of 30 original competencies. Criteria for consensus included 75% of participants perceiving the competency as very or extremely relevant and a median score of 2 (very relevant) on a 5-point Likert scale. Consistent with a Modified Delphi approach, quantitative and qualitative data analysis were completed for each of the 3 rounds. Revised surveys were used in Rounds 2 and 3 based on the results from previous data analysis. RESULTS: Twenty-four competencies achieved final consensus. The competencies were categorized within 3 domains: learner-centered educator (n = 8), assessor/evaluator (n = 7), and professional role model (n = 9). CONCLUSION: The 24 competencies and 3 domains provide the foundation for a competency framework for clinical teaching in physical therapy. This framework provides clarity for the expected knowledge, skills, and attitudes of clinical instructors in physical therapist professional education. IMPACT: This is the first study, to our knowledge, to utilize a consensus-building strategy to clearly define competencies of clinical teaching in physical therapist professional education. Like efforts in nursing and medical education, adoption of these competencies could promote consistency in clinical instructor teaching behaviors and contribute to the creation of assessment and professional development mechanisms for clinical instructors, positively impacting the preparation of the next generation of excellent physical therapist clinicians.


Asunto(s)
Fisioterapeutas , Competencia Clínica , Consenso , Curriculum , Técnica Delphi , Humanos , Fisioterapeutas/educación , Estados Unidos
10.
Nurse Educ Today ; 115: 105409, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35636245

RESUMEN

BACKGROUND: Entrustable professional activities (EPAs), as new methods used to operationalize competency-based education, are gaining acceptance in medical professions. However, no EPA-based framework exists to evaluate emergency care nurse practitioners' competencies in clinical practice. OBJECTIVES: To develop, implement, and evaluate an EPA-based framework for emergency care nurse practitioners. DESIGN: Prospective observational study. SETTING: An accredited nurse practitioner training program in the emergency department of a University-affiliated Hospital. PARTICIPANTS: Eight novice nurse practitioners and eighteen clinical instructors. METHODS: A working group of academic educators, nurse practitioner leaders, and clinical instructors developed a set of EPAs using a participatory design method. We scheduled weekly ad hoc evaluations for the nurse practitioners in emergency care, and we collected several observations from multiple assessors for analysis. RESULTS: Four nested EPAs were developed that adopted a 1-5 supervision-entrustment scale to measure performance. The results of the 20-month assessments illustrated that the average scores of EPA1, which measured the assessment and management of patients with acute medical presentations in the emergency department, differed significantly but were not positively correlated with the nurse practitioners' increasing subspecialty and department seniority levels (Kruskal-Wallis test P = .011 and 0.006, respectively). In addition, the most time required for the nurse practitioners to achieve a stable level 5 entrustability score for all EPAs for at least 3 consecutive months was 18 months. Clinical instructors noted that recognizing limits is a skill that is essential for a nurse practitioner to earn clinical instructors' trust. CONCLUSIONS: Entrustability scores may not correlate with nurse practitioners' increasing seniority, and patient care requires the longest training time (18 months) for emergency care nurse practitioners to achieve autonomy. Program directors should adjust the supervision-entrustment level expected at various stages of training according to the complexity of individual EPAs. An EPA-based assessment framework in a nurse practitioner training program may assist in overseeing the development of competencies for emergency care nurse practitioners.


Asunto(s)
Servicios Médicos de Urgencia , Internado y Residencia , Enfermeras Practicantes , Competencia Clínica , Educación Basada en Competencias/métodos , Evaluación Educacional , Humanos , Enfermeras Practicantes/educación , Proyectos Piloto
11.
BMC Nurs ; 21(1): 94, 2022 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-35461292

RESUMEN

BACKGROUND: The COVID-19 lockdown in March 2020 had a significant consequence for nursing students worldwide including limited access to learning situations in clinical rotation. Therefore, this study aims to explore how an innovative redesign of a clinical course in a time of pandemic supported nursing students in learning the fundamentals of care in their first year. The redesign involved the transformation of a traditional hands-on clinical course into a technology-enhanced learning environment. DESIGN: This was an explorative convergent mixed-methods study using both quantitative and qualitative methods. METHODS: Twenty-four first-year nursing students responded to an online questionnaire with open-ended questions. Two nursing students and one faculty member participated in individual online interviews, and three faculty members participated in an online focus group interview. All the data were collected in June 2020. The quantitative data were analyzed using descriptive statistics and the qualitative data using content analysis. The GRAMMS guideline was applied. RESULTS: The students achieved the learning outcomes regarding fundamental care, basic physical assessment skills, and clinical reasoning with the help of academic assignments, multimedia learning resources, and virtual patients. Further, six central aspects of the facilitator role in the virtual simulation were identified. The aspect that was considered most valuable involved uncovering the "red thread" between different areas of knowledge in the first year of nursing education; this supported the students to better understand how to think and talk like a nurse. CONCLUSION: This study offers insight into how a technology-enhanced clinical course can foster the learning of fundamental nursing care, basic physical assessment skills, and clinical reasoning skills; enhancing students' preparedness for clinical hours. Virtual patients' scenarios contributed to integrating different types of knowledge and skills that are important when providing nursing care for patients in clinical practice. This study also highlighted a gap in pedagogical competence among faculty members with regards to facilitating learning in a technology-enhanced learning environment. Study findings suggest promising pedagogical strategies that should be further developed post-pandemic, in response to the call for a renewal of nursing education using more technologically supported learning designs.

13.
Phys Ther ; 101(12)2021 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-34459493

RESUMEN

OBJECTIVE: This explorative study investigates the moderating effect of sex and baseline pain characteristics on the effectiveness of preoperative pain neuroscience education (PNE) plus knee joint mobilization versus biomedical education plus knee joint mobilization in patients who have knee osteoarthritis and are scheduled to undergo total knee arthroplasty (TKA). METHODS: After baseline assessment of self-reported questionnaires (pain intensity, disability, symptoms of central sensitization and pain cognitions) and quantitative sensory testing, 44 participants with knee osteoarthritis were randomized into the PNE plus knee joint mobilization or biomedical education plus knee joint mobilization group. The questionnaires were retaken directly after and 1 month after 4 sessions of treatment and at 3 months after surgery. Based on baseline quantitative sensory testing results, the sample was subdivided into a high (showing high experimental pain levels and low pressure pain thresholds) and low pain cluster using principal components analysis and cluster analysis. Therapy effects over time were evaluated using 3-way analysis of variance, with time as the within factor and treatment, sex, and baseline pain cluster as between factors. RESULTS: Women benefited significantly more from the PNE intervention compared with the control intervention in terms of self-reported symptoms of central sensitization. For both pain clusters, differences in therapeutic effects concerning pain intensity and pain cognitions were found, with higher superiority of the PNE intervention in the high-pain cluster subgroup compared with the low-pain cluster. CONCLUSION: Based on these explorative analyses, it can be concluded that sex and preoperative pain measures may influence the effectiveness of preoperative PNE for some specific outcome measures in people scheduled to undergo TKA. IMPACT: Although further research on this topic is needed, the potential influence of sex and preoperative pain measures on the effectiveness of preoperative PNE should be considered when implementing this intervention in people undergoing TKA.


Asunto(s)
Artroplastia de Reemplazo de Rodilla/métodos , Manipulación Ortopédica/métodos , Neurociencias/educación , Osteoartritis de la Rodilla/psicología , Osteoartritis de la Rodilla/terapia , Dolor/psicología , Educación del Paciente como Asunto/métodos , Anciano , Evaluación de la Discapacidad , Femenino , Humanos , Masculino , Dimensión del Dolor , Factores Sexuales
14.
J Pak Med Assoc ; 71(5): 1458-1466, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-34091635

RESUMEN

OBJECTIVE: To identify nursing instructors' clinical education competencies. METHODS: The integrative review comprised research articles published between 2008 and 2018 on Medline, Scopus, Web of Science and Education Information Resource Centre databases searched through relevant key words. All the short listed papers were reviewed and quality assessment was done. Data was analysed using content analysis method. Nursing instructors' clinical education competencies were extracted from the original texts in the form of initial codes which were categorised into subcategories and categories based on comparisons of their similarities and differences. Finally, themes were extracted as expression of content hidden in the data to generate new insights. RESULTS: Of the 17 studies selected, 6(35.3%) were quantitative, 4(23.5%) qualitative, 3(17.6%) review studies and 4(23.5%) were mixed-methods studies. Three overarching themes identified were clinical teaching process competencies, students' supervision competencies in clinical settings and nursing instructors' professional ethics. CONCLUSIONS: The review provides insightful information on nursing instructors' clinical education competencies. Nursing educational institutions need to be encouraged to incorporate these concepts into educational curricula to empower nursing instructors and to enhance the quality of clinical education.


Asunto(s)
Bachillerato en Enfermería , Estudiantes de Enfermería , Competencia Clínica , Curriculum , Docentes de Enfermería , Humanos
15.
JMIR Mhealth Uhealth ; 9(1): e22633, 2021 01 07.
Artículo en Inglés | MEDLINE | ID: mdl-33410756

RESUMEN

BACKGROUND: As many students in higher education are skilled users of mobile technology, mobile learning (mLearning) can be a promising educational strategy to enhance their learning experience. mLearning might also be well suited for nursing students as they navigate between multiple learning contexts in their educational curriculum. As an educational strategy, mLearning may also reduce challenges caused by the theory-practice gap in nursing by supporting skills and knowledge transfer between the university and clinical settings. As the introduction of basic physical assessment skills (B-PASs) into Norwegian bachelor's degree education in nursing occurred quite recently, there is a lack of competence in supervision and teaching in both university and clinical settings. As such, mLearning appears to be a good strategy to support student B-PAS learning and knowledge transfer across learning contexts. OBJECTIVE: This study aims to explore and elicit the perspectives of students regarding the way in which a selection of digital learning resources supports B-PAS learning and application in clinical rotation, which of the selected digital learning resources are beneficial to include in a suite of mLearning tools, and how the selected digital learning resources could support the transfer of skills and knowledge from the academic to clinical context. METHODS: We used a longitudinal participatory design approach to co-design a suite of mLearning tools. The co-design processes took place in several workshops (WSs) over a period of 3 months: 2 WSs with first-year students (n=6), 3 WSs with second-year students (n=6), and 3 WSs with third-year students (n=8). The students evaluated several digital learning resources in both academic and clinical contexts. The digital learning resources included digital simulation with virtual patients, massive open online courses, and multimedia learning material. In the co-design WS, the potential and benefits of these digital learning resources for the learning and application of B-PASs were explored. RESULTS: The students reported that the digital learning resources stimulated learning in 7 different ways. They also emphasized the importance of including all selected and tested digital learning resources. Moreover, students supported the inclusion of additional learning material, such as multiple-choice tests and written assignments, aimed at providing feedback and contributing to knowledge development. CONCLUSIONS: The co-design processes and collaboration with the nursing students provided insight into how a suite of mLearning tools may support the learning and application of B-PASs and human bioscience knowledge in clinical rotation. From the students' perspective, one of the strengths of the suite of mLearning tools was the range of content, as this met a broader range of student learning preferences regarding learning B-PASs. The suite of mLearning tools contributes to and supports skills training and knowledge transfer between multiple learning contexts.


Asunto(s)
Educación en Enfermería/métodos , Evaluación Educacional/métodos , Aprendizaje , Estudiantes de Enfermería/psicología , Adulto , Femenino , Humanos , Masculino , Noruega
16.
BMC Nurs ; 19: 57, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32607059

RESUMEN

BACKGROUND: Nursing student numbers have risen in response to projected registered nurse shortfalls, increasing numbers of new graduates requiring transitional support and pressure on clinical placements. A Collaborative Clusters Education Model, in which Entry to Practice facilitators coach ward-based registered nurses to support students' and new graduates' learning, may address placement capacity. The research aim was to evaluate the acceptability of the Collaborative Clusters Education Model to stakeholders by examining their perceptions of the facilitators and barriers to the model in its implementation. METHODS: A convergent mixed methods evaluation approach was adopted. The study took place in a large Australian health service in south-east Queensland. Participants included Bachelor of Nursing students, Entry to Practice facilitators, ward-based registered nurses, academics and new graduates. A mixed methods design was used. Elements included an online survey of nursing students, and interviews with new graduates, Entry to Practice facilitators, ward-based registered nurses, and academics. Descriptive statistics were calculated on quantitative data. Thematic analysis was conducted on qualitative data. RESULTS: Participants included 134 (of 990) nursing students (response rate 13.5%), five new graduates, seven Entry to Practice facilitators, four registered nurses, and three nurse academics. Students rated facilitators' effectiveness highly (4.43/5 ± 0.75), although this finding is tempered by a low response rate (13.5%). For learners, the model provided access to learning experiences, although preferences for sources of support differed between students and new graduates, and further clarification of responsibilities was required. For other stakeholders, three themes emerged: students' and new graduates' integration into the workplace can promote learning; tensions arise in new ways to approach performance assessment; and aligning expectations requires high levels of communication. CONCLUSIONS: This evaluation found that acceptability was good but at risk from limited clarity around roles and responsibilities. Further research into this model is recommended.

17.
J Gen Intern Med ; 34(5): 662-668, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30993622

RESUMEN

BACKGROUND: Trust informs supervision decisions in medical training. Factors that influence trust differ depending on learners' and supervisors' level. Research has focused on resident trainees; questions exist about how medical students experience entrustment. OBJECTIVE: This study examines how clerkship students perceive supervisors' trust in them and its impact on their learning. DESIGN: Qualitative study using individual semi-structured interviews. PARTICIPANTS: Clerkship medical students at the University of California, San Francisco. APPROACH: We invited 30 core clerkship students to participate in interviews (October 2017 to February 2018) eliciting examples of appropriate, over-, and under-trust. We coded and analyzed transcripts using thematic analysis. KEY RESULTS: Sixteen (53%) students participated. Three major themes arose: trust as scaffolding for learning, effects of trust on the learning environment, and consequences of trust for patients. Appropriate trust usually involved coaching and close guidance, often with more junior supervisors (interns or residents). These situations fostered students' motivation to learn, sense of value on the team, and perceived benefits to patients. Over-trust was characterized by task assignment without clear instruction, supervision, or feedback. Over-trust prompted student anxiety and stress, and concerns for potential patient harm. Under-trust was characterized by lack of clarity about the student role, leading to frustration and discontent, with unclear impact on patients. Students attributed inappropriate trust to contextual and supervisor factors and did not feel empowered to intervene due to concerns about performance evaluations and hierarchy. CONCLUSIONS: As early learners in the clinical workplace, students frame trust as entailing high levels of support. It is important for medical educators to consider ways to train resident and faculty supervisors to enact trust and supervision for students differently than for residents. Structures that encourage students and supervisors to discuss trust and supervision in a transparent way can enhance learning.


Asunto(s)
Prácticas Clínicas/organización & administración , Educación de Pregrado en Medicina/organización & administración , Estudiantes de Medicina/psicología , Actitud del Personal de Salud , Humanos , Relaciones Interprofesionales , Investigación Cualitativa , Confianza
18.
Nurse Educ Today ; 73: 17-22, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30472405

RESUMEN

BACKGROUND: With the US facing an opioid epidemic, undergraduate nursing students are increasingly encountering patients with opioid use disorder in the clinical setting. Yet, nursing curriculums have not adapted to meet this need. Previous research indicates students are exposed to negative messages that might influence their views about patients with opioid use disorder. OBJECTIVES: The purpose of this study was to examine nursing students' experiences encountering patients with opioid use disorder in the clinical setting, their attitudes about their encounters, and their perceptions of their educational preparedness to care for this population. METHOD: Purposive sampling was used to identify participants. Semi-structured interviews were conducted until saturation. Krippendorff's method for qualitative content analysis was used to cluster units within the data to identify emergent themes. PARTICIPANTS: Eleven senior nursing students from a public university in New England participated. RESULTS: Analysis revealed six themes, including: navigating ethical dilemmas, gaining comfort with time and experience, avoiding the "elephant in the room," learning from real-world scenarios, witnessing discriminatory care, and recognizing bias and stigma. CONCLUSIONS: Students were most likely to experience bias and internal conflict in maternity clinical rotations. Education should include practical communication strategies to reduce avoidance behaviors among nursing students as well as techniques to manage difficult situations and reduce moral distress. Nurses must be mindful of their power to influence students and should model non-judgmental language and behavior. Students ultimately expressed a desire to provide informed and empathetic care.


Asunto(s)
Competencia Clínica , Conocimientos, Actitudes y Práctica en Salud , Trastornos Relacionados con Opioides/psicología , Estigma Social , Estudiantes de Enfermería/psicología , Bachillerato en Enfermería , Femenino , Humanos , Entrevistas como Asunto , New England , Investigación Cualitativa , Adulto Joven
19.
Rev. bras. med. fam. comunidade ; 13(40): 1-7, jan.-dez. 2018. ilus
Artículo en Portugués | LILACS, Coleciona SUS | ID: biblio-969186

RESUMEN

A formação do médico de família e comunidade tem nos serviços de Atenção Primária à Saúde o principal cenário de práticas. Além destes, outros estágios têm sido empregados para o aprimoramento de competências específicas. Objetivo: Descrever o perfil de estágios externos realizados pelos médicos residentes no programa de residência em Medicina de Família e Comunidade da Faculdade de Medicina da Universidade de São Paulo. Resultados: Os estágios externos acontecem durante 2 meses no segundo ano de residência e são divididos igualmente em estágio eletivo (em que é necessário vínculo com a instituição) e optativo (podem ser selecionados livremente). A maioria destes estágios ocorre no Brasil e através de vínculos informais, sem haver uma parceria ou arranjo oficial entre instituições e/ou serviços. Os principais estágios buscados são em medicina rural e no National Health Service (Reino Unido). Conclusão: Estágios externos enriquecem a formação do residente e possibilitam o aprimoramento do programa de residência. Grande parte dos estágios é solicitada por contato informal, o que aponta para o desafio de firmar vínculos entre pessoas, serviços e instituições, visando fortalecer cada vez mais a formação em Medicina de Família e Comunidade.


Introduction: The main field of training of the Family Doctor are Primary Health Care services as primary practice scenario. In addition to these, other stages are used to enhance the learning of specific competencies. Objective: To describe the profile of external internships performed by residents in the Residency Program in Family Medicine of the Medical School of the University of São Paulo. Results: External internships are held for 2 months in the second year of residency and are equally divided into elective internships (in which a bond with the institution is required) and optional (freely selectable). Most of these internships occur in Brazil and through informal ties, without a partnership or official arrangement between institutions and/or services. The main stages sought are in rural medicine and the National Health Service (UK). Conclusion: The external internships enriches the resident's training and enable the improvement of the residency program. Most of the internships are requested through informal contact, which points to the challenge of establishing links between people, services and institutions to strengthen training in Family and Comunnity Medicine.


Introducción: La formación del médico de familia y comunidad tiene en los servicios de Atención Primaria a la Salud el principal escenario de prácticas. Además de éstas, otras prácticas se emplean para perfeccionar competencias específicas. Objetivo: Describir el perfil de prácticas externas realizadas por los médicos residentes en el programa de residencia en Medicina de Familia y Comunidad de la Facultad de Medicina de la Universidade de São Paulo. Resultados: Las practicas externas ocurren durante 2 meses en el segundo año de residencia y se dividen igualmente en las prácticas electivas (en las que es necesario un vínculo con la institución) y optativas (se pueden seleccionar libremente). La mayoría de estas prácticas ocurre en Brasil y a través de vínculos informales, sin que haya una sociedad o arreglo oficial entre instituciones y/o servicios. Las principales etapas buscadas son en medicina rural y en el National Health Service (Reino Unido). Conclusión: Las prácticas externas enriquecen la formación del residente y posibilitan el perfeccionamiento del programa de residencia. Gran parte de las prácticas es seleccionada por contacto informal, lo que apunta el desafío de firmar vínculos entre personas, servicios e instituciones visando fortalecer cada vez más la formación en Medicina de Familia y Comunidad.


Asunto(s)
Atención Primaria de Salud , Prácticas Clínicas , Educación Médica , Medicina Familiar y Comunitaria , Internado y Residencia
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