The Future of Clinical Education: Opportunities and Challenges from Allied Health Deans' Perspective.

ISSUE: There is limited information and consensus on the future of clinical education and the key factors impacting allied health (AH) clinical training. AH deans identified both opportunities and challenges impacting clinical education based on a proposed educational model. METHODS: From July 2013 to March 2014, 61 deans whose institutions were 2013 members of the Association of Schools of Allied Health Professions (ASAHP) participated in a three-round Delphi survey. Agreement on the relative importance of and the ability to impact the key factors was analyzed. Impact was evaluated for three groups: individual, collective, and both individual and collective deans. AH deans' responses were summarized and refined; individual items were accepted or rerated until agreement was achieved or study conclusion. RESULTS: Based on the deans' ratings of importance and impact, 159 key factors within 13 clinical education categories emerged as important for the future of clinical education. Agreement was achieved on 107 opportunities and 52 challenges. CONCLUSIONS: The Delphi technique generated new information where little existed specific to AH deans' perspectives on AH clinical education. This research supports the Key Factors Impacting Allied Health Clinical Education conceptual model proposed earlier and provides a foundation for AH deans to evaluate opportunities and challenges impacting AH clinical education and to design action plans based on this research.

Construct Validity for a Cost-effective Arthroscopic Surgery Simulator for Resident Education.

INTRODUCTION: Arthroscopy is one of the most challenging surgical skills to assess and teach. Although basic psychomotor arthroscopic skills, such as triangulation and object manipulation, are incorporated into many simulation exercises, they are not always individually taught or objectively evaluated. In addition, arthroscopic instruments, arthroscopy cameras, and the cadaver or joint models necessary for practice are costly. METHODS: A low-cost arthroscopic simulator was created to practice triangulation, probing, horizon changes, suture management, and object manipulation. The simulator materials were purchased exclusively from national hardware stores with a total cost averaging $79. The universal serial bus (USB) camera is included in the total cost. Three residency programs accredited by the Accreditation Council for Graduate Medical Education were tested on the simulator. Replica boards were created at each institution. Participants included medical students (20), residents (46), and attending physicians (9). RESULTS: Construct validity-the ability to differentiate between novice, intermediate, and senior level participants-was obtained. On all tasks, junior residents scored at a statistically significant lower rate than senior residents and attending physicians. CONCLUSIONS: This cost-effective arthroscopic surgical simulator objectively demonstrated that attending physicians and senior residents performed at a higher level than junior residents and novice medical students. The results of this study demonstrate that this simulator could be an important training tool for resident education.

U.S. Dental School Deans' Perceptions of the Rising Cost of Dental Education and Borrowing Pressures on Dental Students: Report of Survey Results.

This report presents findings from a survey of U.S. dental school deans designed to capture their perceptions regarding the rising cost of dental education and its impact on borrowing by dental students to finance their education. The survey included questions about factors influencing the cost of dental education, concerns about dental student borrowing, and financial awareness resources for students. The survey was distributed to the deans of all 63 U.S. dental schools in January 2013; 42 deans responded, for a 67% response rate. The results indicate that, according to the responding deans, new clinical technologies, technology costs, and central university taxes are the main factors that contribute to the increasing cost of dental education. Coupled with reduced state appropriations at public dental schools and declines in private giving at all dental schools, dental school deans face a perplexing set of financial management challenges. Tuition and fees are a primary source of revenue for all dental schools; however, many deans do not have total control over the cost of attending their schools since tuition and fees are often tied to mandates and policies from the parent university and the state legislature. The findings of this study indicate that U.S. dental school deans are aware of and concerned about the impact of increases in tuition and fees on dental student debt and that they are using a variety of strategies to address the growth in dental student borrowing.

Validation of an effective, easy-to-make hemostasis simulator.

The purpose of this study is to describe the construction method of a cost-effective, easy-to-make hemostasis simulator and to compare its effectiveness as a training tool to cadaver training. The simulator is made of materials commonly found in hospitals and clinics. These include a column manometer, a 500-ml saline bag, two intravenous fluid lines, a three-way stopcock, and a 6-mm-diameter Penrose drain. The device was tested on 10 final-year veterinary students. All participants tied 40 knots on the simulator and 40 knots on equine jejunal arteries sourced from a local abattoir. They were then asked to fill out a questionnaire comparing both methods. Participants assigned an overall assessment median score of 8.5/10 to the simulator and of 6.2/10 to cadaver practice. The simulator provided reliable haptic feedback, giving trainees a lifelike feel very close to that experienced when actually closing a blood vessel. In addition, it was effective in objectively evaluating students' ability to place ligatures on vessels. After adequate training, students' skills had significantly improved, alongside their confidence in placing hemostatic sutures. This proves our model is also useful in teaching basic open-surgery skills. Finally, its low production cost makes it ideally suited for self-practice.

Introducing CAD/CAM into a predoctoral dental curriculum: a case study.

This article describes the decision making and implementation process used at Indiana University School of Dentistry to incorporate a CAD/CAM system into the predoctoral curriculum and presents data regarding the opinions of students and faculty members after one year. Using a non-validated survey instrument, D1 students rated their experience fabricating a CAD/CAM-generated crown. Eighty-eight of the 105 D1 students (84 percent response rate) responded to the four multiple-choice questions, and a varying number provided written responses. Eighty percent of the responding students rated the overall learning experience as good or excellent, and 43 percent judged that they were prepared to fabricate a crown independently. Students' comments about the experience were generally positive. The twelve supervising faculty members were also surveyed after the first year. When asked to evaluate the initial quality of the crowns at placement, they rated 89 to 98 percent of them good or excellent on the measures of marginal fit, axial contours, proximal contacts, and occlusal contacts. In their judgment, CAD/CAM-generated crowns were as good as or better than those received from commercial labs. After one year, the school's experience has been that the performance of these crowns is consistent with the literature and that they are a viable option. Also, the students are enthusiastic about this addition to the curriculum.

Ambiente virtual de aprendizagem sobre gerenciamento de custos de curativos em úlceras por pressão / Virtual learning environment for managing costs of dressings for pressure ulcers / Ambiente virtual de aprendizaje sobre gerenciamiento de costos de vendajes en úlceras por presión

Pesquisa descritiva e aplicada com objetivo de descrever a construção e avaliação de um ambiente virtual de aprendizagem na temática de gerenciamento de custos de curativos em úlceras por pressão, por meio da metodologia WebQuest. Nas etapas de planejamento e desenvolvimento, foram utilizados recursos tecnológicos simples e acessíveis, com ênfase nos aspectos pedagógicos. Na etapa de avaliação, quatro especialistas em informática, quatro enfermeiros docentes e quatro enfermeiros atuantes no gerenciamento de custos em enfermagem avaliaram os aspectos técnicos (Tempo de Resposta e Qualidade de Interface) e pedagógicos (Conteúdo, Atividade, Interação). Estes aspectos tiveram avaliação positiva (acima de 86% de características totalmente atendidas), exceto para o Tempo de Resposta (62% totalmente atendidas e 30% parcialmente atendidas). Os resultados evidenciaram a viabilidade da aplicação do ambiente virtual de aprendizagem para alunos de graduação em enfermagem visando à análise do impacto na aprendizagem sobre gerenciamento de custos de materiais em enfermagem.

A descriptive and applied study aimed at describing the construction and assessment of a virtual learning environment on the topic of cost management of pressure ulcer dressings, using WebQuest methodology. For the planning and development phases, we used simple and accessible technological resources, focused on educational aspects. During the assessment phase, four computer science specialists, four nursing professors and four nursing professionals who worked with cost management evaluated technical aspects (Response Time and Interface Quality) as well as educational ones (Content, Activity, Interaction). These aspects received positive evaluations (over 86% of criteria were fulfilled), except for Response Time (62% were totally fulfilled and 30% partially fulfilled). The results demonstrated that it is possible to make use of virtual learning environments with undergraduate nursing students in order to impact education regarding material cost management in nursing.

Investigación descriptiva, aplicada, objetivando describir la construcción y evaluación de un ambiente virtual de aprendizaje sobre temática de gerenciamiento de costos de vendajes en úlceras por presión, mediante la metodología WebQuest. En las etapas de planificación y desarrollo, fueron utilizados recursos tecnológicos simples y accesibles, enfatizándose los aspectos pedagógicos. En la etapa de evaluación, cuatro especialistas en informática, cuatro enfermeros docentes y cuatro enfermeros actuantes en gerenciamiento de costos en enfermería evaluaron los aspectos técnicos (Tiempo de Respuesta y Calidad de Interfaz) y pedagógicos (Contenido, Actividad, Interacción). Estos aspectos recibieron evaluación positiva (más del 86% de características totalmente atendidas), exceptuando al Tiempo de Respuesta (62% totalmente atendidas y 30% parcialmente atendidas). Los resultados evidenciaron la viabilidad de aplicación del ambiente virtual de aprendizaje para alumnos de grado en enfermería, apuntando al análisis del impacto en el aprendizaje sobre gerenciamiento de costo de materiales en Enfermería.

The awareness and attitudes of students of one indian dental school toward information technology and its use to improve patient care.

BACKGROUND: Many obstacles need to be overcome if digital and electronic technologies are to be fully integrated in the operation of dental clinics in some countries. These obstacles may be physical, technical, or psychosocial barriers in the form of perceptions and attitudes related to software incompatibilities, patient privacy, and interference with the patient-practitioner relationship. The objectives of the study are to assess the perceptions of Indian dental students of one school toward the usefulness of digital technologies in improving dental practice; their willingness to use digital and electronic technologies; the perceived obstacles to the use of digital and electronic technologies in dental care setups; and their attitudes toward Internet privacy issues. METHODS: The study population consisted of 186 final year undergraduate dental students from the A. B. Shetty Memorial institute of Dental Sciences, Rajiv Gandhi University of Health Sciences, Mangalore, India. Survey data were analyzed descriptively . RESULTS: Most students indicated that information technology enhances patient satisfaction, the quality of dental record, diagnosis, treatment planning, and doctor-doctor communication. Cost of equipment and need for technical training were regarded as major obstacles by substantial proportions of respondents. DISCUSSION: Most dental students at our school feel that the information technology will support their decision making in diagnoses and devising effective treatment plans, which in turn increase patient satisfaction and quality of care. Students also perceived that lack of technical knowledge and the high cost of implementation are major barriers to developing information technology in India.

Information and communication technology use among Victorian and South Australian oral health professions students.

The objective of this study was to determine and analyze the use of information and communication technology (ICT) by oral health professions students in Victoria and South Australia. Data were collected during the 2009 and 2010 academic years via electronic survey. Out of 1,138 students studying in Adelaide and Victorian dental schools, 740 students participated, for an overall response rate of 65 percent. The majority were dental students (n=609) with 131 seeking a Bachelor of Oral Health (B.O.H.) degree. The majority were female (62.0 percent), had home Internet access (91.7 percent), and no barriers to accessing the Internet (87.2 percent). Among those who mentioned barriers, difficult access and cost were the most common. The Internet was accessed at least once a week by the majority for general purposes (93.5 percent) and for study purposes (84.2 percent). Nonetheless, thirty-nine students (5.3 percent) were non-frequent ICT users. The probability of an oral health professions student being in the non-ICT users group was explored utilizing a logistic regression analysis. The final model contained three predictors: location of school, ethnic background, and place of Internet use (χ(2) [3]=117.7; p<0.0001). After controlling for other variables in the model, those studying in South Australia were significantly more likely (OR=2.32; 95 percent CI 1.05 to 5.11) to be in the non-users groups. In the same manner, students from an Asian background were three times more likely to be non-users (OR=3.06; 95 percent CI 1.16 to 8.08). Those who had access to the Internet at home (OR=0.02; 95 percent CI 0.01 to 0.05) were less likely to be a non-user. These results represent a preliminary evaluation of ICT use among oral health professions students in Australia. It seems that a digital divide exists among these students. The information can be utilized in planning dental education programs and incorporating the use of ICT suitable for oral health professions students and in the design and implementation of employment recruitment and retention programs.

GCAT-SEEKquence: genome consortium for active teaching of undergraduates through increased faculty access to next-generation sequencing data.

To transform undergraduate biology education, faculty need to provide opportunities for students to engage in the process of science. The rise of research approaches using next-generation (NextGen) sequencing has been impressive, but incorporation of such approaches into the undergraduate curriculum remains a major challenge. In this paper, we report proceedings of a National Science Foundation-funded workshop held July 11-14, 2011, at Juniata College. The purpose of the workshop was to develop a regional research coordination network for undergraduate biology education (RCN/UBE). The network is collaborating with a genome-sequencing core facility located at Pennsylvania State University (University Park) to enable undergraduate students and faculty at small colleges to access state-of-the-art sequencing technology. We aim to create a database of references, protocols, and raw data related to NextGen sequencing, and to find innovative ways to reduce costs related to sequencing and bioinformatics analysis. It was agreed that our regional network for NextGen sequencing could operate more effectively if it were partnered with the Genome Consortium for Active Teaching (GCAT) as a new arm of that consortium, entitled GCAT-SEEK(quence). This step would also permit the approach to be replicated elsewhere.

Teaching with technology: free Web resources for teaching and learning.

In this bimonthly series, the department editor examines how nurse educators can use Internet and Web-based computer technologies such as search, communication, collaborative writing tools; social networking, and social bookmarking sites; virtual worlds; and Web-based teaching and learning programs. In this article, the department editor and her coauthor describe free Web-based resources that can be used to support teaching and learning.

How we develop and sustain innovation in medical education technology: Keys to success.

The use of information technology to support the educational mission of academic medical centers is nearly universal; however, the scope and methods employed vary greatly (Souza et al. 2008 ). This article reviews the methods, processes, and specific techniques needed to conceive, develop, implement, and assess technology-based educational programs across healthcare disciplines. We discuss the core concepts, structure, and techniques that enable growth, productivity, and sustainability within an academic setting. Herein are specific keys to success with examples including project selection, theory-based design, the technology development process, implementation, and evaluation that can lead to broad participation and positive learning outcomes. Most importantly, this article shares methods to involve students, faculty, and stakeholders in technology design and the development process that fosters a sustainable culture of educational innovation.

The status of US multi-campus colleges and schools of pharmacy.

OBJECTIVE: To assess the current status of multi-campus colleges and schools of pharmacy within the United States. METHODS: Data on multi-campus programs, technology, communication, and opinions regarding benefits and challenges were collected from Web sites, e-mail, and phone interviews from all colleges and schools of pharmacy with students in class on more than 1 campus. RESULTS: Twenty schools and colleges of pharmacy (18 public and 2 private) had multi-campus programs; 16 ran parallel campuses and 4 ran sequential campuses. Most programs used synchronous delivery of classes. The most frequently reported reasons for establishing the multi-campus program were to have access to a hospital and/or medical campus and clinical resources located away from the main campus and to increase class size. Effectiveness of distance education technology was most often sited as a challenge. CONCLUSION: About 20% of colleges and schools of pharmacy have multi-campus programs most often to facilitate access to clinical resources and to increase class size. These programs expand learning opportunities and face challenges related to technology, resources, and communication.

Training and simulation for patient safety.

BACKGROUND: Simulation-based medical education enables knowledge, skills and attitudes to be acquired for all healthcare professionals in a safe, educationally orientated and efficient manner. Procedure-based skills, communication, leadership and team working can be learnt, be measured and have the potential to be used as a mode of certification to become an independent practitioner. RESULTS: Simulation-based training initially began with life-like manikins and now encompasses an entire range of systems, from synthetic models through to high fidelity simulation suites. These models can also be used for training in new technologies, for the application of existing technologies to new environments and in prototype testing. The level of simulation must be appropriate to the learners' needs and can range from focused tuition to mass trauma scenarios. The development of simulation centres is a global phenomenon which should be encouraged, although the facilities should be used within appropriate curricula that are methodologically sound and cost-effective. DISCUSSION: A review of current techniques reveals that simulation can successfully promote the competencies of medical expert, communicator and collaborator. Further work is required to develop the exact role of simulation as a training mechanism for scholarly skills, professionalism, management and health advocacy.

Using technology in resource limited countries for competency based education and training.

Competency based education and training (CBET) helps to prepare graduates of medical laboratory science programs for the specific needs of the workforce. This is especially important in resource-limited countries where shortage of laboratory personnel creates a large demand for skilled graduates. Internet and other technology can be useful to teach specific tasks in CBET. Even in resource-limited countries, technology can be used in the implementation of competency based education and training curricula in medical laboratory programs.

Learning in a virtual world: experience with using second life for medical education.

BACKGROUND: Virtual worlds are rapidly becoming part of the educational technology landscape. Second Life (SL) is one of the best known of these environments. Although the potential of SL has been noted for health professions education, a search of the world's literature and of the World Wide Web revealed a limited number of formal applications of SL for this purpose and minimal evaluation of educational outcomes. Similarly, the use of virtual worlds for continuing health professional development appears to be largely unreported. METHODS: We designed and delivered a pilot postgraduate medical education program in the virtual world, Second Life. Our objectives were to: (1) explore the potential of a virtual world for delivering continuing medical education (CME) designed for physicians; (2) determine possible instructional designs using SL for CME; (3) understand the limitations of SL for CME; (4) understand the barriers, solutions, and costs associated with using SL, including required training; and (5) measure participant learning outcomes and feedback. We trained and enrolled 14 primary care physicians in an hour-long, highly interactive event in SL on the topic of type 2 diabetes. Participants completed surveys to measure change in confidence and performance on test cases to assess learning. The post survey also assessed participants' attitudes toward the virtual learning environment. RESULTS: Of the 14 participant physicians, 12 rated the course experience, 10 completed the pre and post confidence surveys, and 10 completed both the pre and post case studies. On a seven-point Likert scale (1, strongly disagree to 7, strongly agree), participants' mean reported confidence increased from pre to post SL event with respect to: selecting insulin for patients with type 2 diabetes (pre = 4.9 to post = 6.5, P= .002); initiating insulin (pre = 5.0 to post = 6.2, P= .02); and adjusting insulin dosing (pre = 5.2 to post = 6.2, P= .02). On test cases, the percent of participants providing a correct insulin initiation plan increased from 60% (6 of 10) pre to 90% (9 of 10) post (P= .2), and the percent of participants providing correct initiation of mealtime insulin increased from 40% (4 of 10) pre to 80% (8 of 10) post (P= .09). All participants (12 of 12) agreed that this experience in SL was an effective method of medical education, that the virtual world approach to CME was superior to other methods of online CME, that they would enroll in another such event in SL, and that they would recommend that their colleagues participate in an SL CME course. Only 17% (2 of 12) disagreed with the statement that this potential Second Life method of CME is superior to face-to-face CME. CONCLUSIONS: The results of this pilot suggest that virtual worlds offer the potential of a new medical education pedagogy to enhance learning outcomes beyond that provided by more traditional online or face-to-face postgraduate professional development activities. Obvious potential exists for application of these methods at the medical school and residency levels as well.

Youth as content producers in a niche social network site.

Most U.S. teenagers participate in online social network sites, devoting hours to these networks, often at the expense of other leisure-time activities. This article describes young people's activities within one topic-focused niche network, outlining its unique features and the role of young people as content producers within and beyond the space. Links between youth's online contributions and their interest, self-expression, social connections, and civic involvement are discussed.

Using technology to teach technology.

As staff development professionals, our goal is to provide cost-effective learning opportunities that meet the objectives of the learner, the program, and the organization. The decision to use instructional technology is based on cost, time, and outcomes. This article describes one organization's use of an inexpensive and versatile software application to develop Web-based tutorials to educate and train clinical staff on a new clinical information system.