Implementing Telemedicine into Clinical Training Through Pre-recorded Video Consultations.

Although the contribution of real patient encounters to medical education is well known, challenges such as a lack of suitable cases, patients not consenting to student involvement, physical space limitations that prevent every student from participating, the inability to replicate the same patient encounter, and reduced patient admissions to healthcare facilities during extraordinary periods are common obstacles that need to be addressed in clinical education. To overcome these challenges, video consultation (VC) recordings, which were made with the consent of patients having a telemedicine consultation, were collected as an archive of medical interview recordings covering a wide spectrum of pulmonary diseases. These recordings were watched by students in a classroom setting during clinical clerkships, with case discussions interspersed. This article, which also discusses the results of clinical clerkship evaluations, indicates that the use of pre-recorded VC sessions can be an effective tool for teaching good clinical practices through the ideal method of medical interviews, diagnostic approaches, evaluation of test results, communication skills with patients and their relatives, and addressing the socio-psychological aspects and social impacts of diseases. As an innovative attempt, sharing this process at an early stage of development may inspire enthusiasm for implementing this approach and open the field for further development.

Developing effective communication skills in audiology using anonymous patient feedback.

OBJECTIVE: To explore the value of anonymous patient feedback for audiology students, examining alignment between student and patient judgments on communication skills and assessing how students utilise the feedback. DESIGN: This study utilised a mixed methods design, employing a Likert survey to collect patient and student ratings on professionalism, compassion, and listening and talking skills in clinical encounters. Semi-structured interviews investigated the student perspective of receiving patient feedback. STUDY SAMPLE: 13 Audiology students and 31 patients who were placed at, or received care at an Audiology teaching clinic. RESULTS: Patients' ratings across all measures were higher on average when compared to students' self-ratings, only correlating significantly for the measure concerning students' talking skills. Five themes and one subtheme were identified: Emotional impacts, A worthwhile experience, Contrasting priorities, Patients retake centre stage, and Self-reflective learners (subtheme Self-doubt). CONCLUSIONS: This study reveals that patient feedback led student Audiologists to report heightened seriousness in their interactions and increased attention on skills vital for patient-centred care. The process boosted students' confidence and reinforced awareness of the patient's perspective. Further research is needed to gauge the extent of these effects and explore the feasibility of implementing a large-scale patient feedback program in audiology training settings.

Preparing internal medicine trainees for their intensive care rotations: What are we doing across the UK?

Internal medicine trainees (IMTs) comprise a significant portion of rotational junior doctors in intensive care units (ICUs) in the UK. Provision of formal training for this role is highly variable, delivered by only 67% of units responding to our UK-wide survey. Topics most often covered in formal training include renal medicine, airway management, pharmacology, ventilators, vascular access and assessing the critically unwell patient. The results of the survey have been used to design a follow-up national survey of IMTs to elicit their perceived training needs when undertaking their intensive care medicine rotation.

So You Are a Clinical Instructor-Now What?

Many nuclear medicine technologists find themselves in the role of clinical instructor, often without much in the way of educational background. This article provides a few recommendations on how to get started in this role. After distinguishing between the roles of affiliate education supervisor and clinical instructor, the article discusses 2 basic tools: the clinical course learning outcomes and the student handbook. Expectations for students are reviewed. An important aspect of clinical instruction is the attitude of the instructor. Clinical instructors can motivate students or demotivate them, with this choice having a significant impact on the student's development. Overall, the desire and determination to be pleasant and helpful to students make the greatest difference in their development into nuclear medicine technologists.

Photovoice and Health Perception in a Group of Early-Career Nurses.

Background. Nurses' perceptions of health are essential to decision making and communicating with clients. However, little is known about their own perceptions of this phenomenon. This study focuses on health-related beliefs among young nurses enrolled in a master's-level nursing program using a modified photovoice methodology. Methods. The study population was 87 nurses undergoing a master's degree in nursing at Jagiellonian University Medical College in Krakow, Poland, participating in an obligatory health psychology course. For the modified photovoice activity, the participants took three photos related to their perceptions of (1) health, (2) health protective factors, and (3) health risk factors. The data interpretation involved a thematic analysis of these photos and captions; a narrative analysis to distinguish between documentary and symbolic photos; and a descriptive analysis of the photo production. Results. Eighty-seven students completed the photography assignment. The mean age was 22.1 years (SD = 1.1). Most photos (91%) documented real-life health behaviours. Some photos (9%) used everyday objects such as sunflowers to create symbols related to health. A photo series showed a model of the human brain in different environments and activities. Conclusions. Student participation in the photovoice activity appeared to strengthen observation and interpretation skills, which are essential to client care. Students used this opportunity to reflect on their own lives and environments and show their perceptions of health, health protective factors, and health risks. The activity planted seeds for changes in students' health perceptions and critical thinking. Future research could explore whether participation in a modified photovoice activity as experiential learning in a required health psychology course contributes to changes in master's-level nursing students' personal health behaviours and client care.

Experiences of Using a Digital Guidance and Assessment Tool (the Technology-Optimized Practice Process in Nursing Application) During Clinical Practice in a Nursing Home: Focus Group Study Among Nursing Students.

BACKGROUND: Nursing students' learning during clinical practice is largely influenced by the quality of the guidance they receive from their nurse preceptors. Students that have attended placement in nursing home settings have called for more time with nurse preceptors and an opportunity for more help from the nurses for reflection and developing critical thinking skills. To strengthen students' guidance and assessment and enhance students' learning in the practice setting, it has also been recommended to improve the collaboration between faculties and nurse preceptors. OBJECTIVE: This study explores first-year nursing students' experiences of using the Technology-Optimized Practice Process in Nursing (TOPP-N) application in 4 nursing homes in Norway. TOPP-N was developed to support guidance and assessment in clinical practice in nursing education. METHODS: Four focus groups were conducted with 19 nursing students from 2 university campuses in Norway. The data collection and directed content analysis were based on DeLone and McLean's information system success model. RESULTS: Some participants had difficulties learning to use the TOPP-N tool, particularly those who had not attended the 1-hour digital course. Furthermore, participants remarked that the content of the TOPP-N guidance module could be better adjusted to the current clinical placement, level of education, and individual achievements to be more usable. Despite this, most participants liked the TOPP-N application's concept. Using the TOPP-N mobile app for guidance and assessment was found to be very flexible. The frequency and ways of using the application varied among the participants. Most participants perceived that the use of TOPP-N facilitated awareness of learning objectives and enabled continuous reflection and feedback from nurse preceptors. However, the findings indicate that the TOPP-N application's perceived usefulness was highly dependent on the preparedness and use of the app among nurse preceptors (or absence thereof). CONCLUSIONS: This study offers information about critical success factors perceived by nursing students related to the use of the TOPP-N application. To develop similar learning management systems that are usable and efficient, developers should focus on personalizing the content, clarifying procedures for use, and enhancing the training and motivation of users, that is, students, nurse preceptors, and educators.

Simulated medication administration for vulnerable populations using scanning technology: a quasi-experimental pilot study.

BACKGROUND: Medication errors may occur due to shortcuts and pressures on time and resources on nurses. Nursing students are enculturated into these environments where their perceptions of norms around reporting and responding to medication errors are formative, yet simulated medication administration experiences are rarely reflective of the real-world environment. such as the standard use of medication scanning technology. The purpose of the present study is to test a pilot intervention, Medication Quick Response (QR) code scanning, and evaluate its effect on medication errors during simulation when compared to traditional simulation medication administration practices and to assess the students' perceptions of the intervention. METHODS: We conducted a quasi-experimental, observational study involving Junior and Senior (3rd and 4th year) undergraduate, pre-licensure nursing students from Spring 2022 until Fall 2023. Seven simulations were conducted in pediatric and obstetric courses. The intervention group used non-patented, low cost QR scanning during medication administration. The control group used standard manual administration. Medication errors were measured based on the quantity, type of error, and degree of patient risk. A Qualtrics survey was used to assess the students' perceptions of the intervention following simulation participation. RESULTS: A total of 166 students participated in the study. In each course, 7 groups were assigned to the intervention and 8 were assigned to the control. More than half of the groups made at least one medication error (n = 17), one-third of groups (n = 10) made a high-risk medication error. There was no statistically meaningful difference in the rate, type, or potential patient risk of medication errors between the intervention and control groups. The majority of participants (n = 53) felt that QR scanning more closely mimicked medication administration in clinical settings. Half of the participants responded that it improved their safety practices (n = 37). CONCLUSIONS: The results of this pilot study indicate that while there is a high risk for error among pre-licensure nursing students, the use of QR scanning did not increase the risk of medication errors. The next study iteration will build upon these pilot findings to integrate the use of embedded medication errors, time management tasks, and a multi-site implementation.

Oral health needs of Wampanoag elders on Martha's Vineyard: A comprehensive assessment.

OBJECTIVES: Evaluate oral health care access and utilisation, while identifying the specific oral health needs of the Native American Elders within the Wampanoag Tribe of Gay Head (WTGH) on Martha's Vineyard Island. BACKGROUND: Elders, particularly the WTGH face notable issues in obtaining oral health care. This study addressed the oral health gaps within the WTGH Elders through a comprehensive community needs assessment. METHODS: Employing a mixed-methods approach, qualitative concept mapping interviews with stakeholders and tribe members, a quantitative survey was conducted, and deidentified billing codes were analysed. RESULTS: Concept mapping revealed limited availability of services, accessibility and transportation, insurance challenges, lack of a centralised database, tribal/national policy and health-related self-sufficiency. Quantitative data indicated that 65% of Elders faced challenges in accessing oral health care, and 48% reported experiencing an oral health issue in the last 12 months. Additionally, 23% did not receive oral health care during this period, with a significant portion having previously utilised services at the Martha's Vineyard Hospital Oral Health Clinic. CONCLUSION: Establishing a formal relationship between the WTGH and an academic institution for creating a portable oral health clinic supervised by faculty and developing a structured referral system is essential. This initiative aims to dismantle barriers to oral health care, improve access, and meet the oral health needs among Elders while offering valuable educational experiences for students regarding diverse patient populations and access-to-care factors.

Mental toughness and psychological performance skills in the operating room: Staff perceptions and implications for function and training.

The importance of psychological performance skills (mental toughness) is recognised in many mission-critical professions. Similar importance has been suggested for nursing. Survey data demonstrate that surgical staff believe that such skills exert significant influence on surgical excellence, surgical errors and on managing surgical emergencies. However, few surgical staff receive such training. It is suggested that models exist to easily meet this training need and opportunity.

Assessment during clinical education among nursing students using two different assessment instruments.

BACKGROUND: Assessment of undergraduate students using assessment instruments in the clinical setting is known to be complex. The aim of this study was therefore to examine whether two different assessment instruments, containing learning objectives (LO`s) with similar content, results in similar assessments by the clinical supervisors and to explore clinical supervisors' experiences of assessment regarding the two different assessment instruments. METHOD: A mixed-methods approach was used. Four simulated care encounter scenarios were evaluated by 50 supervisors using two different assessment instruments. 28 follow-up interviews were conducted. Descriptive statistics and logistic binary regression were used for quantitative data analysis, along with qualitative thematic analysis of interview data. RESULT: While significant differences were observed within the assessment instruments, the differences were consistent between the two instruments, indicating that the quality of the assessment instruments were considered equivalent. Supervisors noted that the relationship between the students and supervisors could introduce subjectivity in the assessments and that working in groups of supervisors could be advantageous. In terms of formative assessments, the Likert scale was considered a useful tool for evaluating learning objectives. However, supervisors had different views on grading scales and the need for clear definitions. The supervisors concluded that a complicated assessment instrument led to limited very-day usage and did not facilitate formative feedback. Furthermore, supervisors discussed how their experiences influenced the use of the assessment instruments, which resulted in different descriptions of the experience. These differences led to a discussion of the need of supervisor teams to enhance the validity of assessments. CONCLUSION: The findings showed that there were no significant differences in pass/fail gradings using the two different assessment instruments. The quantitative data suggests that supervisors struggled with subjectivity, phrasing, and definitions of the LO´s and the scales used in both instruments. This resulted in arbitrary assessments that were time-consuming and resulted in limited usage in the day-to-day assessment. To mitigate the subjectivity, supervisors suggested working in teams and conducting multiple assessments over time to increase assessment validity.