Using medical reality television as a technology-enhanced learning strategy to provide authentic patient care experiences during clinical placements: a case study research investigation.

BACKGROUND: Over the last decade, the use of technology-enhanced learning (TEL) has rapidly expanded and diversified. Since the COVID-19 pandemic, there is a growing demand for distance and online learning strategies to support and even replace learning experiences previously afforded by clinical placements and clerkships. An intriguing but under-researched modality is the use of medical reality television to provide authentic experiences of patient care. This strategy does not feature in published medical educational literature, though promising research is emerging from other disciplines. METHODOLOGY: A programme of learning using medical reality television clips to facilitate case-based learning was developed according to the principles of 'anchored instruction', a technology-based educational theory. Clips were taken from the UK television show '24 hours in A&E'. Medical students' learning experiences were investigated using a qualitative approach addressing the following research questions: - What is the perceived emotional experience of medical students when watching reality television in an educational context? - How do medical students relate their experience of watching reality television in a formal educational setting to their perceived learning needs in the clinical environment? A case study research methodology was adopted within the interpretivist paradigm. Data were triangulated from semi-structured interviews with students and non-participant observation of the teaching session. Field notes and transcripts were analysed through an inductive thematic analysis. RESULTS: In response to the medical reality television, a diverse range of emotions were expressed including: excitement, amusement, concern, nervousness, sadness and joy. Students identified gaps in their clinical knowledge such as interpreting results, practical aspects of prescribing and end of life care. Key themes were increased student engagement and a promotion of holistic care practices. DISCUSSION: Students perceived reality television as a highly realistic and relatable medium and an enjoyable, memorable way to contextualise learning from the classroom to real life, a finding mirrored in previous studies in other fields. The high degree of emotion expressed may explain the improved subjective memorability of the cases. CONCLUSION: Medical reality television offers a unique means of engaging students by providing authentic experiences of patient care and should be valued alongside other technology-enhanced learning strategies.

Whole Person Health: Using Experiential Learning and the ICF Model as a Tool for Introductory Interprofessional Collaborative Practice.

BACKGROUND: The International Classification of Func¬tioning (ICF) model is recommended for interprofessional use to define, measure, and create health and disability policy. Our goal was to expand a uniprofessional student learning experience into an interprofessional experiential clinical learning experience focused on the ICF model. METHODS: An experiential interprofessional education program was developed for Physical Therapy (PT), Physician Assistant (PA), and Pharmacy students. Student teams interviewed a community mentor from a senior living community outside of class to explore their mentor's health journey, assess quality of life, and perform an environmental safety assessment. In this pilot study, students completed an anonymous, unique-identifier electronic survey with open response items pre- and post-experience. Data were coded using inductive thematic analysis. RESULTS: Four themes emerged: learning about other professions (scope of practice), mentor's experiences with health care, treating the whole person, and improving team effectiveness. All four Interprofessional Education Collaborative (IPEC) competencies mapped to the data broadly indicating this learning experience meets interprofessional educational requirements. CONCLUSIONS: Student teams deepened their understanding of their community mentor's health and valued the interprofessional knowledge gained. Using the common lens of the ICF, students' understanding and appreciation of other disciplines emerged and students began to see their mentors from a more holistic perspective.

Impact of an International Service Learning Experience in India for DPT Students: Short- and Long-Term Benefits.

PURPOSE: Awareness of global issues and cultural competence are essential for health professions students. Educational programs utilize International Service Learning (ISL) to address global issues and diverse cultures. This study describes short- and long-term benefits of ISL on Doctor of Physical Therapy (DPT) students. PROCEDURES: The ISL included study of Ayurveda, clinical service, collaborative learning, and cultural activities. A mixed-methods design included the Cross Cultural Adaptability Index (CCAI) administered to 14 students pre- and post-ISL and qualitative analysis of reflective papers. Interviews of participants were completed 2 to 3 years later. FINDINGS: Overall CCAI scores showed a statistically significant difference of 0.001 (p<0.01) pre and post ISL. Three subscales also showed a statistically significant difference (p<0.01). Qualitative analysis of reflective papers revealed three categories of impact: environmental connectedness, personal growth, and professional growth. Interviews conducted years following the ISL indicate that participants attribute several aspects of their professional and personal way of being to the ISL, including the importance of whole person care. CONCLUSIONS: Studies have shown benefits to health professions students immediately following an ISL. This study demonstrates that benefits persist years later. The long-term impact strengthens the rationale for including ISL during professional education.

Innovative Use of Service-Learning to Enhance Baccalaureate Nursing Education.

BACKGROUND: Service-learning is an established pedagogical approach to nursing education found primarily in community nursing. With changing health care landscapes, the expansion of service-learning projects throughout the nursing program provides opportunities to enrich assessment and critical thinking and amplify exposure to determinants of health. METHOD: Implementing service-learning in foundational nursing courses allows students to be challenged with the application of complex care management within a context of caring, cultural competence, social responsibility, and self-care initiatives. RESULTS: Integrating service-learning throughout the nursing curriculum has the potential to make positive, sustainable changes within a community, while simultaneously preparing students to view clients holistically, think critically, and develop cultural competence. CONCLUSION: Enhancing nursing curriculum by integrating service-learning opportunities can strengthen the learning experience and foster concepts of caring, social responsibility, cultural competence, and self-care. Working with community leaders from diverse groups can lead to sustainable projects that simultaneously benefit the community and nursing education. [J Nurs Educ. 2017;56(9):560-563.].

Qualitative evaluation of general university requirements in a new 4-year university curriculum: findings based on experiences of students.

Following the North American model, the length of undergraduate program in Hong Kong has been extended from 3 to 4 years since 2012. To maximize the impact of the additional year, The Hong Kong Polytechnic University (PolyU) has implemented a new general education framework entitled "General University Requirements (GUR)" aiming to cultivate students in a holistic manner. This study explored students' impressions of the GUR subjects using a survey collecting primarily qualitative data. Results from 163 students of eight faculties showed that students perceived the GUR subjects favorably. Having opportunities to make new friends from other departments and the teaching and learning methods, particularly experiential learning stimulated students' interest and enriched their learning experiences which were reportedly are unforgettable. Some of the obstacles encountered by students in several subjects were identified. The beneficial effects of the GUR subjects in different domains were voiced by the students.

An evaluation study on a university general education subject in Hong Kong.

This study evaluated a university general education subject on leadership and intrapersonal development ("Tomorrow's Leaders", TL) offered at The Hong Kong Polytechnic University (PolyU) based on an online survey using the Student Feedback Questionnaire (SFQ). At the end of the first semester of the 2013/2014 academic year, 725 Year-1 students completed the online questionnaire. Results showed that the students generally had positive ratings on both the subject attributes and the qualities of teachers. The majority of the participants perceived the subject as beneficial to their holistic development and leadership competencies. Students from the Faculty of Health and Social Sciences (FHSS) and the Faculty of Applied Science and Textiles (FAST) had more favorable evaluation of the subject than students from the Faculty of Construction and Environment (FCE). Students' perceived benefit of the subject was significantly predicted by the subject attributes and teacher attributes. Implications of the findings are discussed.

Policy-Focused Service-Learning as a Capstone: Teaching Essentials of Baccalaureate Nursing Education.

BACKGROUND: The advancing accountability of nurses and nurse educators requires students to develop knowledge, skills, and judgment on a continuum of focus from individual patients to the broader context of care. METHOD: A dynamic capstone policy course was developed by applying the American Association of Colleges of Nursing's Essentials of Baccalaureate Education for Professional Nursing Practice and capitalizing on related benefits of service-learning pedagogy. It shifts the approach from an intangible didactic lecture on policy and institutional structures to hands-on experiences in actual policy environment and patient health intersections. Acting as nurse consultants, students help clients address a system-based problem. Reflective assignments reinforce student learning as they take cumulative inventory of baccalaureate accomplishments. RESULTS: Competencies in professionalism, teamwork and collaboration, communication, problem solving, and quality assurance are assessed. Students have engaged at sophisticated levels of practice and advocacy. CONCLUSION: Situating capstone service-learning in a nursing policy course appears to sensitize students to perspectives of all ecological levels and desensitizes their discomfort in the policy arena. Implications for research include identifying and implementing measures of success in program outcomes. [J Nurs Educ. 2016;55(10):583-586.].

Development of Formative Capstone Simulations to Prepare Novice Students for Initial Clinical Practicum.

BACKGROUND: Nursing students often describe initial clinical experiences as extremely anxiety producing. Anxiety can decrease performance ability and, consequently, increase the risk for patient harm. Strategies to decrease this anxiety related to clinical experiences are limited within the nursing education literature. METHOD: Faculty in a 4-year baccalaureate nursing program developed and implemented formative capstone simulation scenarios with standardized patients, integrating therapeutic communication, essential patient care skills, and clinical reasoning for novice nursing students prior to their entry into their first clinical practicum. This article discusses the rationale, development, and implementation of these formative capstone simulation scenarios. RESULTS: Anecdotal student and faculty comments related to the formative capstone simulation scenarios were positive. CONCLUSIONS: Formative capstone simulation scenarios offer a method to prepare novice students for initial clinical practicum that is well received. Research is needed to formally examine the relationship between formative capstone simulation scenarios and student anxiety related to initial clinical practicum. [J Nurs Educ. 2016;55(10):587-589.].

Activated learning; providing structure in global health education at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA)- a pilot study.

BACKGROUND: Global health rotations are increasingly popular amongst medical students. The training abroad is highly variable and there is a recognized need for global health curriculum development. We sought to create and evaluate a curriculum, applicable to any global health rotation, that requires students to take an active role in their education and promotes engagement. METHODS: Prospective, observational, mixed method study of 4th year medical students enrolled in global health courses at UCLA in 2011-12. Course directors identified 4 topics common to all rotations (traditional medicine, health systems, limited resources, pathology) and developed activities for students to complete abroad: observation, interview and reflection on resources, pathology, medical practices; and compare/contrast their experience with the US healthcare system. Students posted responses on a discussion board moderated by US faculty. After the rotation, students completed an anonymous internet-based evaluative survey. Responses were tabulated. Qualitative data from discussion board postings and free response survey items were analyzed using the framework method. RESULTS: 14 (100 %) students completed the Activated Learning assignment. 12 submitted the post rotation survey (85.7 %). Activated Learning enhanced GH education for 67 % and facilitated engagement in the local medical culture for 67 %. Qualitative analysis of discussion board posting demonstrated multiple areas of knowledge gain and analysis of free response survey items revealed 5 major themes supporting Activated Learning: guided learning, stimulation of discussion, shared interactions, cultural understanding, and knowledge of global healthcare systems. Increased interactivity emerged as the major theme for future improvement. CONCLUSION: The results of this study suggest that an Activated Learning program may enhance education, standardize curricular objectives across multiple sites and promote engagement in local medical culture, pathology and delivery systems. Increased interaction between students and faculty may augment the impact of such a program.

Research capacity building in midwifery: Case study of an Australian Graduate Midwifery Research Intern Programme.

BACKGROUND: Having the research capacity to identify problems, create new knowledge and most importantly translate this knowledge into practice is essential within health care. Midwifery, as well as other health professions in Australia, is challenged in building its research capacity to contribute evidence to inform clinical practice. AIM: The aim of this project was to evaluate an innovative Graduate Midwifery Research Intern Programme offered at a tertiary obstetric hospital in Western Australia, to determine what was working well and how the programme could be improved. METHOD: A case study approach was used to gain feedback from graduate midwives within a Graduate Research Intern (GRI) Programme. In addition outcomes were compiled of all projects the GRI midwives contributed to. Six GRI midwives participated in a survey comprising of four open ended questions to provide feedback about the programme. RESULTS: Findings confirm that the GRI programme increased the graduates understanding of how research works, its capacity to define a problem, generate new knowledge and inform clinical practice. The GRI midwives' feedback suggested the programme opened their thinking to future study and gave them enhanced insight into women's experiences around childbirth. CONCLUSION: To grow our knowledge as a professional group, midwives must develop and promote programmes to build our pool of research capable midwives. By sharing our programme evaluation we hope to entice other clinical settings to consider the value in replicating such a programme within their context.

Assisting students to prepare for a clinical practice placement.

All students undertaking a nursing programme are required to complete clinical practice placements. These placement hours are an essential component of the training necessary to join the Nursing and Midwifery Council register and to practise as a nurse. Clinical practice placements can be stressful for students, and this can compromise their learning. Thorough preparation by the student and an understanding of the change in learning environment that accompanies a placement can reduce anxiety and improve the learning experience. This article describes the preparations a student can make to ensure a successful and educational clinical practice placement.

Giving you every reason to SMiLE.

This article outlines the plans to develop a student midwife integrated learning environment (SMILE) which will focus upon the delivery of postnatal (PN) care to women and families whilst also creating an innovative clinical learning environment for students. The SMiLE PN hub (facilitated by student midwives, supervised by a qualified midwife/sign-off mentor) has been designed to fuse seamlessly with current PN provision and provide an alternative environment for women to access a wide range of PN services. This service proposal not only increases the amount of PN learning opportunities and experience of students but also provides a much needed hub of PN activity for women and their families. It provides drop-in breastfeeding support, signposting to additional support networks and scheduled daily parenting workshops, such as baby bathing and safe sleeping advice.

Problem-based learning: where are we now? Guide supplement 36.3--Practical Application.

BACKGROUND: Problem-based learning (PBL) is a well used educational strategy, more frequently used in the pre-clinical phase rather than the clinical phase of medical student learning. This practical application explores its use in a Family Medicine undergraduate clerkship. METHOD: The PBL application is described during a 10- week rotation in Family Medicine for final year medical students. 217 students were asked to rank 24 statements describing their PBL experience on a five-point Likert scale. The grading was supplemented by one qualitative question. The clinical tutors were asked to write an evaluation statement on their experience. EVALUATION: The educational process was rated highly by students and faculty as a valuable learning methodology that enhanced their knowledge and understanding of patient problems, providing them with a more holistic approach to care. CONCLUSIONS: It would appear that PBL is infrequently used during clinical learning and specifically not in a Family Medicine clerkship. This small study supports its value to both student and faculty.

Experiential learning of empathy in a care-ethics lab.

To generate empathy in the care of vulnerable older persons requires care providers to reflect critically on their care practices. Ethics education and training must provide them with tools to accomplish such critical reflection. It must also create a pedagogical context in which good care can be taught and cultivated. The care-ethics lab 'sTimul' originated in 2008 in Flanders with the stimulation of ethical reflection in care providers and care providers in training as its main goal. Also in 2008, sTimul commenced the organization of empathy sessions as an attempt to achieve this goal by simulation. The empathy session is a practical and fairly straightforward way of working to provoke care providers and care providers in training to engage in ethical reflection. Characteristic of the empathy session in the care-ethics lab is the emphasis on experience as a basis for ethical reflection.

Use of multiple patient simulators to enhance prioritizing and delegating skills for senior nursing students.

The student clinical experience is rich, yet challenges arise in providing experiences where leadership skills can be developed and used in nursing practice. To increase student confidence and enhance student ability to safely and effectively prioritize, delegate, and implement care for numerous patients, a simulation-based learning (SBL) experience was developed. The SBL experience involves multiple patient simulators, case study analysis, and a debriefing session. Ninety-seven senior nursing students participated in this program. Students reported through Likert surveys to either "agree" or "strongly agree" that the SBL was well organized (87%, n = 84), prompted realistic expectations (59%, n = 57), the scenarios were believable (73%, n = 71), case studies increased understanding (66%, n = 64), and that the SBL experience increased understanding of prioritizing and delegating care (69%, n = 67). Seventy-eight percent (n = 76) reported "more confidence in ability to work as a team" and 55% (n = 52) reported "more confidence in prioritizing and delegating care."

Creating opportunities for successful international student service-learning experiences.

Healthcare and educational expeditions to developing countries are a life-altering experience for both faculty and students. The benefits gained personally and professionally from foreign travel are invaluable. Providing healthcare to people in developing countries gives a new dimension to holistic care. Proper trip preparation with consideration of safety, legal liabilities, and educational goals is a necessity to ensure positive outcomes for patients, students, faculty, and the university or college. This article extracts lessons learned from an actual trip and dissects them from a safety, legal, and educational standpoint. The information presented is a "must read" for any faculty member considering embarking on a healthcare expedition with students to a developing country.

Rich-narrative case study for online PBL in medical education.

Case studies are the basis of a well-known medical education pedagogy called problem-based learning (PBL). Traditional case studies are paper based and contain brief medical facts about a patient's illness. The authors of this article argue for a rich-narrative PBL design, and they report on a pilot project that incorporated such a design. The term "rich narrative" in this article covers two attributes. The first is the development of case studies that are rich in narrative information (often called "thick narrative"). The second component of rich narrative is the presentation of these thick narrative case studies in a media-rich format-that is, video rather than the traditional paper-based cases. Rich-narrative case studies may provide a more robust context for learning than traditional case studies because the rich cases more accurately reflect the complex reality of patient presentation and interaction. They also may help to lay the foundation for the development of a more holistic and patient-centered awareness during the training of health professionals. The use of video as a case presentation tool adds to this robust depiction of the patient as a complete human being rather than a collection of written symptoms. The authors discuss the power of narrative in learning, the significance of rich-narrative in medical education, the steps they took to develop a video-based, rich-narrative case study for online PBL tutorials at Simon Fraser University, and the evaluation of their prototype used in 2008.