Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 5.691
Filtrar
4.
Enferm. clín. (Ed. impr.) ; 29(5): 264-270, sept.-oct. 2019. tab
Artículo en Español | IBECS | ID: ibc-184150

RESUMEN

Objetivo: Explorar la percepción de los estudiantes de cuarto curso del Grado en Enfermería sobre el entorno asistencial donde tiene lugar su proceso formativo en prácticas clínicas. Método: Estudio cualitativo fenomenológico basado en la filosofía hermenéutica de Gádamer que contó con el desarrollo de grupos focales y entrevistas semiestructuradas en estudiantes de cuarto curso del Grado de Enfermería de la Universidad de Almería. El periodo de recogida fue en febrero de 2016. La información obtenida se transcribió y analizó mediante estrategias inductivas en busca de categorías emergentes. Resultados: El análisis reveló dos categorías principales: (1) influencia del entorno clínico en el desempeño asistencial y docente de las enfermeras y en el aprendizaje de los estudiantes y (2) formación y perspectivas laborales para los futuros profesionales. Cada una de ellas mostró dos subcategorías con sus correspondientes códigos. La información recogida reflejó las experiencias y percepciones de los estudiantes de Enfermería sobre el entorno asistencial donde tiene lugar su proceso formativo en prácticas clínicas. Conclusiones: Este estudio permitió conocer la percepción de los estudiantes de cuarto curso del Grado de Enfermería sobre el entorno donde tiene lugar su proceso formativo en prácticas clínicas. Conocer dicho fenómeno ayuda a identificar déficits en el aprendizaje clínico de los estudiantes y a adaptar los planes de estudios de las universidades a sus necesidades formativas a fin de garantizar su éxito como profesionales ante las futuras demandas del contexto clínico-laboral


Aim: To explore the perception of fourth-year nursing students of the healthcare environment where their training process in clinical practices takes place. Methods: Phenomenological qualitative study based on the hermeneutical philosophy of Gádamer that included the development of focus groups and semi-structured interviews in a sample of fourth-year nursing students from the University of Almería. The collection period was in February 2016. The information obtained was transcribed and analyzed by inductive strategies in search of emerging categories. Results: The analysis revealed two main categories: (1) influence of the clinical environment on the healthcare and teaching performance of nurses and on student learning and (2) training and job prospects for the future professionals. Each of them showed two subcategories with their corresponding codes. The information collected showed the experiences and perceptions of Nursing students regarding the healthcare environment where their training process in clinical practices takes place. Conclusions: This study enabled us to discover the perception of fourth-year nursing students of the environment where their training process in clinical practices takes place. Knowledge of this phenomenon helps to identify deficits in students' clinical learning and to adapt university curricula to their training needs in order to guarantee their success as professionals facing future clinical-labour demands


Asunto(s)
Humanos , Percepción , Estudiantes de Enfermería/psicología , Estudiantes de Enfermería/estadística & datos numéricos , Prácticas Clínicas/métodos , Prácticas Clínicas/normas , Enfermería Práctica , Análisis Cualitativo , Educación en Enfermería , Aprendizaje
5.
Enferm. clín. (Ed. impr.) ; 29(5): 271-279, sept.-oct. 2019. tab
Artículo en Español | IBECS | ID: ibc-184151

RESUMEN

Objetivo: Conocer las opiniones de los tutores y de los estudiantes del Grado en Enfermería sobre las prácticas clínicas e identificar estrategias y propuestas de mejora para el desempeño de la labor docente. Método: Estudio cualitativo con perspectiva fenomenológica mediante grupos focales con enfermeros tutores de prácticas clínicas y estudiantes de Enfermería. Los participantes se segmentaron en 3 grupos: estudiantes, tutores del área médica y tutores del área quirúrgica. El número de grupos lo determinó la saturación de la información. Se transcribieron los discursos y se realizó un análisis manual sintáctico y semántico de los discursos para extraer las variables de análisis. Se obtuvieron los permisos del Comité de Ética de la Investigación Provincial y del centro correspondiente. Resultados: Tanto los tutores como los estudiantes destacan la necesidad de capacitar a los tutores en las habilidades formativas y proporcionarles herramientas que faciliten su labor, así como el reconocimiento formal de su función docente. En sus discursos, ambos colectivos proponen un cambio de visión y, sobre todo, de actitudes en el desarrollo de la enseñanza-aprendizaje. Y, por último, se manifiesta la necesidad de un cambio en el modelo de relaciones entre la Universidad y los servicios sanitarios. Conclusiones: Con base en lo anteriormente expuesto, se identifica la necesidad de incentivar y formar a los profesionales clínicos para la función tutorial y de plantear un cambio de modelo que propicie un acercamiento entre la Universidad y el sistema sanitario


Objective: To discover the opinions of the tutors and students of the Degree in Nursing on clinical practices and identify strategies and improvement proposals for teacher performance. Method: A qualitative study with a phenomenological perspective through focus groups with clinical nurse tutors and nursing students. The participants were divided into 3 groups: students, tutors from the medical area and tutors from the surgical area. The number of groups was determined by saturation of the information. The discourse was transcribed and a syntactic and semantic manual analysis of the discourse was made to extract the analysis variables. Permission was obtained from the Provincial Research Ethics Committee and the corresponding centre. Results: Both the tutors and the students emphasized the need to train tutors in teaching skills and provide them with tools that facilitate their work, as well as the need for formal recognition of their teaching function. In their discourse, both groups proposed a change of vision, and above all of attitudes, in the development of teaching-learning. Finally, there is a need for a change in the model of relations between the University and health services. Conclusions: Based on the above, the need to encourage and train clinical professionals as tutors is identified and a change of model proposed to bring the University and the health system closer together


Asunto(s)
Humanos , Prácticas Clínicas/organización & administración , Pautas de la Práctica en Enfermería/organización & administración , Pautas de la Práctica en Enfermería/normas , Mejoramiento de la Calidad , Mentores , Análisis Cualitativo , Estudiantes de Enfermería/estadística & datos numéricos , Educación en Enfermería/organización & administración
6.
Fam Med ; 51(8): 687-690, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31509220

RESUMEN

BACKGROUND AND OBJECTIVES: Many medical schools assess student clinical knowledge using the National Board of Medical Examiners (NBME) subject examinations. The Family Medicine Clinical Science Mastery Series (CSMS) self-assessments, which are made up of former Family Medicine NBME examination questions, became available in September 2017. They provide students with realistic practice questions and immediate performance feedback. To further assess the utility of various study tools available to our students, this study investigated the impact of the CSMS self-assessments for family medicine on the NBME family medicine subject examination performance. METHODS: Data analysis was conducted to compare student performance on the end-of-rotation NBME Family Medicine Clinical Subject Examination before and after the introduction of the CSMS family medicine self-assessments. The effect size was measured using a Cohen d analysis. We conducted an independent t-test analysis to determine the effect the NBME Family Medicine CSMS self-assessments had on end-of-rotation clinical subject examination scores. RESULTS: The analysis revealed statistically significant improvement in students' clinical subject examination scores after the release of the CSMS in September 2017 (n=90) compared to the students' scores prior to the availability of the CSMS (n=95). CONCLUSIONS: Student scores improved with the introduction of the NBME CSMS family medicine self-assessment. These results support recommending student use of the CSMS as a study tool for their end-of-clerkship NBME subject examinations.


Asunto(s)
Prácticas Clínicas , Evaluación Educacional/estadística & datos numéricos , Medicina Familiar y Comunitaria , Autoevaluación , Estudiantes de Medicina/estadística & datos numéricos , Competencia Clínica , Educación de Pregrado en Medicina , Humanos
9.
Cuad. bioét ; 30(99): 149-156, mayo-ago. 2019.
Artículo en Español | IBECS | ID: ibc-185231

RESUMEN

Se analiza en primer lugar, la mutua interioridad que existe en toda acción humana entre su dimensión ética y técnica y más en concreto en la práctica sanitaria. Se establece que sólo con los hábitos técnicos o éticos o aplicando unas determinadas pautas deliberativas no se puede realizar un discernimiento sobre la bondad o no de una determinada acción. Para ello, se requiere adoptar una perspectiva personal, tanto para uno mismo como cuando se enjuician acciones de otros. Para ello en segundo lugar, es imprescindible la virtud de la prudencia para captar en el contexto concreto el bien a elegir. Esta cualidad ética está muy influida por el carácter ético global de la persona como por la capacidad deliberativa y el conocimiento de los principios éticos. Con respecto a lo segundo es necesario ejercitarse siguiendo las vías habituales por las que la persona toma decisiones y considera una acción determinada como buena o mala. Por ello, no se puede pretender que con métodos técnicos de decisión los profesionales sanitarios deliberen y tomen decisiones éticas. En conclusión es necesario que la prudencia de éstos, se apoye tanto en el carácter ético personal, como en el análisis de casos éticos en consonancia con el propio modo natural de actuar de la razón humana


First, the mutual interiority that exists in every human action between its ethical and technical dimen-sion is analyzed, more specifically in relation to health practice. It is established that by means of technical or ethical habits, or applying certain deliberative guidelines, alone it is not possible to discern between the goodness or not of a certain action. For this to be possible, it is necessary to adopt a personal perspective, both as regards oneself and when judging the actions of others. Secondly, then, the virtue of prudence is essential to choose the most best path in a specific context. This ethical habit is greatly influenced by the overall ethical character of the person and by their deliberative capacity and knowledge of ethical principles. With regard to the second, it is necessary to follow the usual ways by which the person makes decisions and considers a certain action as good or bad. Therefore, it cannot be pretend using technical decision-making methods health professionals will deliberate and make ethical decisions. In conclusion, it is necessary that the prudence of professionals be based both on the personal ethical character and on an analysis of ethical cases in consonance with the natural way in which human reason acts


Asunto(s)
Humanos , Toma de Decisiones/ética , Personal de Salud/ética , Desarrollo Moral , Refuerzo Biomédico/ética , Justicia Social , Obligaciones Morales , Moral , Prácticas Clínicas/ética
10.
BMC Med Educ ; 19(1): 269, 2019 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-31319895

RESUMEN

BACKGROUND: The relationship between large-group classroom attendance by students and test achievement in problem-based learning (PBL) curricula is unclear. This study examined the correlation between attendance at resource sessions (hybrid lectures in the PBL curriculum) and test scores achieved in pharmacology and determined whether the score achieved was related to student gender. METHODS: A cross-sectional observational study over one academic year of 1404 pre-clerkship medical students was performed. Class attendance during pharmacology resource sessions and MCQ test scores achieved in pharmacology were analysed. RESULTS: The percentage of students' attendance in resource sessions declined over three years of the programme, from 78.7 ± 27.5 in unit I to 22.1 ± 35.6 (mean ± SD) in unit IX. A significant but weakly positive correlation was evident between attendance and achievement in pharmacology (r = 0.280; p < 0.0001). The mean score of the students who attended > 50% of the resource sessions was significantly higher (p < 0.0001). Students who attended ≤50% were more likely to achieve lower tertile scores. The mean score achieved and the number of higher tertile scorers were higher among students who attended > 50% of the resource sessions. Although female students' attendance was significantly higher, no significant gender-related differences in either mean scores or top grades achieved were found. CONCLUSIONS: In a PBL curriculum, the classroom attendance of students in pharmacology declined during the pre-clerkship phase. A weak positive correlation was found between attendance and academic achievement, as measured by MCQ test scores. Factors other than motivation and attendance may confound gender-based academic performance and merit further research.


Asunto(s)
Rendimiento Académico , Curriculum , Educación de Pregrado en Medicina/métodos , Farmacología/educación , Aprendizaje Basado en Problemas/métodos , Prácticas Clínicas , Estudios Transversales , Femenino , Humanos , Masculino , Factores de Riesgo , Factores Sexuales , Estudiantes de Medicina/estadística & datos numéricos , Análisis y Desempeño de Tareas , Adulto Joven
12.
BMC Med Educ ; 19(1): 247, 2019 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-31277625

RESUMEN

BACKGROUND: In Australia, the number of medical graduates per year has increased at a greater rate than the increase in the number of specialist training places. Consequently, competition for training positions is intensifying. There is anecdotal evidence to suggest that medical graduates are acquiring additional qualifications to compete with their peers Stevenson 2017 ( https://insightplus.mja.com.au/2017/36/specialty-training-places-the-other-looming-crisis/ ). Our study investigates this phenomenon of additional credentialing and demonstrates the number and type of postgraduate and research qualifications obtained by specialists in training in Australia. This is the first study to assess the number and type of credentials acquired by registrars in each specialty and to provide insight into differences between specialities. METHODS: Information on specialists in training was obtained through the Medicine in Australia: Balancing Employment and Life (MABEL) survey conducted between 2008 and 2014. The number of any additional qualifications and specific PhD, Master's degree, postgraduate diploma/certificate and research degrees from medical school were assessed for each specialist training scheme in the database. RESULTS: Overall, 995 registrars representing 13 specialties were included. Just under a third (30.4%) completed a research-based degree during their medical degree and almost half (46.7%) of specialist registrars obtained further qualifications after completing medicine. A significantly higher proportion of ophthalmology (78.6%) and paediatric (67.5%) registrars, and a lower percentage of emergency medicine (36.7%) registrars, held postgraduate qualifications. Overall, 2.4% of registrars held a PhD and 10.1% held a Master's degree. A higher percentage of either PhD or Master's was held by ophthalmology (64.3%) and surgical (30.6%) trainees and a lower percentage by anaesthetics (6.3%) and physician trainees (7.9%). Postgraduate diplomas or certificates were most common among paediatric (41.2%) and obstetrics and gynaecology (25.6%) registrars. CONCLUSION: This is the first study to investigate the additional qualifications of specialists in training in Australia. Almost half of specialists in training surveyed (46.7%) have completed some form of additional study, whether it is a PhD, Master's, postgraduate diploma/certificate or research degree from medical school. Trainees of specialist training schemes are more qualified than specialists who trained in the past Aust Fam Physician 32:92-4, 2003.


Asunto(s)
Educación de Postgrado en Medicina/estadística & datos numéricos , Determinación de la Elegibilidad , Especialización , Australia , Prácticas Clínicas , Educación de Postgrado en Medicina/normas , Evaluación Educacional , Humanos , Internado y Residencia , Estudios Longitudinales , Modelos Educacionales , Especialización/estadística & datos numéricos
13.
BMC Med Educ ; 19(1): 287, 2019 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-31357970

RESUMEN

BACKGROUND: Professional identities are influenced by experiences in the clinical workplace including socialisation processes that may be hidden from academic faculty and potentially divergent from formal curricula. With the current educational emphasis on complexity, preparedness for practice, patient safety and team-working it is necessary to evaluate and respond to what students are learning about collaborative practices during their clinical placements. METHODS: 394 second year medical students at a London medical school were invited to submit a short formative essay as part of their coursework describing, evaluating and reflecting on their experiences of how healthcare professionals work together. Their experiences were derived from having spent two days each week for 25 weeks in clinical contexts across primary and secondary care. We consented 311 participants and used a Consensual Qualitative Research approach to analyse these essays, creating a 'students-eye view' of intra- and interprofessional practices in the workplace. RESULTS: We identified four overarching themes in students' essays:Theme 1: analyses of contextual factors driving team tensions including staff shortages, shifting teams, and infrastructural issues;Theme 2: observations of hierarchical and paternalistic attitudes and behaviours;Theme 3: respect for team members' ability to manage and mitigate tensions and attitudes; andTheme 4: take-forward learning including enthusiasm for quality improvement and system change. CONCLUSIONS: Students are being socialised into a complex, hierarchical, pressurised clinical workplace and experience wide variations in professional behaviours and practices. They articulate a need to find constructive ways forward in the interests of staff wellbeing and patient care. We present educational recommendations including providing safe reflective spaces, using students' lived experience as raw material for systems thinking and quality improvement, and closing the feedback loop with placement sites on behalf of students.


Asunto(s)
Prácticas Clínicas , Relaciones Interprofesionales , Estudiantes de Medicina/psicología , Lugar de Trabajo , Conducta Cooperativa , Humanos , Entrevistas como Asunto , Londres , Investigación Cualitativa
14.
Fam Med ; 51(6): 483-499, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31184761

RESUMEN

BACKGROUND AND OBJECTIVES: New standards announced in 2017 could increase the failure rate for Step 2 Clinical Skills (CS). The purpose of this study was to identify student performance metrics associated with risk of failing. METHODS: Data for 1,041 graduates of one medical school from 2014 through 2017 were analyzed, including 30 (2.9%) failures. Metrics included Medical College Admission Test, United States Medical Licensing Examination Step 1, and clerkship National Board of Medical Examiners (NBME) Subject Examination scores; faculty ratings in six clerkships; and scores on an objective structured clinical examination (OSCE). Bivariate statistics and regression were used to estimate risk of failing. RESULTS: Those failing had lower Step 1 scores, NBME scores, faculty ratings, and OSCE scores (P<.02). Students with four or more low ratings were more likely to fail compared to those with fewer low ratings (relative risk [RR], 12.76, P<.0001). Logistic regression revealed other risks: low surgery NBME scores (RR 3.75, P=.02), low pediatrics NBME scores (RR 3.67, P=.02), low ratings in internal medicine (RR 3.42, P=.004), and low OSCE Communication/Interpersonal Skills (RR 2.55, P=.02). CONCLUSIONS: Certain medical student performance metrics are associated with risk of failing Step 2 CS. It is important to clarify these and advise students accordingly.


Asunto(s)
Prácticas Clínicas/normas , Competencia Clínica/normas , Evaluación Educacional , Licencia Médica/normas , Estudiantes de Medicina/estadística & datos numéricos , Educación de Pregrado en Medicina/normas , Evaluación Educacional/normas , Evaluación Educacional/estadística & datos numéricos , Humanos , Criterios de Admisión Escolar , Estados Unidos
15.
BMC Med Educ ; 19(1): 207, 2019 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-31196063

RESUMEN

BACKGROUND: While literature on the theoretical value of entrustable professional activities (EPAs) for assessment is rapidly expanding, little experience exists on its application. The aims of this study are to develop and explore the utility of an EPA-based assessment tool for capturing the workplace performance of final-year medical students based on a full set of end-of-training EPAs. METHODS: The tool was developed in a systematic iterative process. Twelve 12 end-of-undergraduate medical training EPAs were nested into 72 smaller EPAs and cross-mapped onto a 6-point supervision level scale, both adjusted to the context of final-year clerkships. One version was created for students' self-assessment of their ability to carry out tasks and their history of carrying out tasks, and another version was created for supervisors' assessment of students' ability to carry out tasks. The tool was administered to final-year clerkship students and their clinical supervisors to explore its utility as an assessment approach. The results were analysed using descriptive and interferential statistics. RESULTS: We enrolled a total of 60 final-year medical students. For 33 students, ratings were provided from one supervisor and for 27 students from two supervisors. With regard to the reliability and validity of the tool, students' and supervisors' ratings showed an overall good internal consistency as well as variability between and within the EPAs. Over the full EPA range, students rated their ability to perform a task slightly higher than their task performance history and slightly lower than the supervisors' ratings. Students' self-ratings of their ability to perform a task correlated with their history in performing the task. Supervisors' ratings correlated among supervisors and not with students' ratings. Concerning educational outcomes, supervisors' average rating of students' ability to perform the EPAs without direct supervision was 64%, and key findings being double-checked. CONCLUSIONS: This study introduces a tool that is adjusted to the final-year clerkship context and can assess the workplace performance of trainees based on a full set of end-of-training EPAs. Its utility characteristics suggest that the tool may be employed as a formative and outcome-aligned approach to the assessment of final-year students before entering into residency.


Asunto(s)
Competencia Clínica , Evaluación Educacional , Internado y Residencia , Prácticas Clínicas , Educación Basada en Competencias , Educación de Pregrado en Medicina , Femenino , Humanos , Masculino , Autoevaluación , Estudiantes de Medicina , Lugar de Trabajo
16.
BMC Med Educ ; 19(1): 219, 2019 Jun 18.
Artículo en Inglés | MEDLINE | ID: mdl-31215430

RESUMEN

BACKGROUND: Little is known regarding the psychometric properties of computerized long-menu formats in comparison to classic formats. We compared single-best-answer (Type A) and long-menu formats using identical question stems during the computer-based, summative, intermediate clinical-clerkship exams for nine disciplines. METHODS: In this randomised sequential trial, we assigned the examinees for every summative exam to either the Type A or long-menu format (four different experimental questions, otherwise identical). The primary outcome was the power of discrimination. The study was carried out at the Faculty of Medicine, University of Geneva, Switzerland, and included all the students enrolled for the exams that were part of the study. Examinees were surveyed about the long-menu format at the end of the trial. RESULTS: The trial was stopped for futility (p = 0.7948) after 22 exams including 88 experimental items. The long-menu format had a similar discriminatory power but was more difficult than the Type A format (71.45% vs 77.80%; p = 0.0001). Over half of the options (54.4%) chosen by the examinees in long-menu formats were not proposed as distractors in the Type A formats. Most examinees agreed that their reasoning strategy was different. CONCLUSIONS: In a non-selected population of examinees taking summative exams, long-menu questions have the same discriminatory power as classic Type A questions, but they are slightly more difficult. They are perceived to be closer to real practice, which could have a positive educational impact. We would recommend their use in the final years of the curriculum, within realistic key-feature problems, to assess clinical reasoning and patient management skills.


Asunto(s)
Conducta de Elección , Prácticas Clínicas/estadística & datos numéricos , Computadores , Educación de Pregrado en Medicina/estadística & datos numéricos , Evaluación Educacional/métodos , Estudiantes de Medicina , Humanos , Evaluación de Programas y Proyectos de Salud , Estudios Prospectivos , Psicometría , Reproducibilidad de los Resultados , Estudiantes de Medicina/psicología , Estudiantes de Medicina/estadística & datos numéricos , Suiza
17.
GMS J Med Educ ; 36(3): Doc30, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31211225

RESUMEN

Background: During clinical clerkships students experience complex and challenging clinical situations related to problems beyond the domain of the "Medical Expert". Workplace routine may leave little opportunity to reflect on these situations. The University of Zurich introduced a mandatory course directly after the clinical clerkship year (CCY) to work up these situations. Prior to the course each student submitted a vignette on a case he or she had perceived challenging during the CCY and which was not related to the domain of the "Medical Expert" role. In this paper we want to characterize these cases in respect to most prominent themes and related CanMEDS roles. The goal was to inform clinical supervisors about potential teaching demands during the CCY. Methods: All case vignettes submitted by a years' cohort were analysed by three researchers in two ways: for the clinical characteristics and the main theme of the underlying problem and the most prominent CanMEDS roles involved. Themes of the underlying problem were aggregated to overarching topics and subsequently to main categories by pragmatic thematic analysis. Results: 254 case vignettes covered the whole spectrum of clinical disciplines. A wide range of underlying themes could be assigned to five main categories: "communication within team" (23.2%), "communication with patients and relatives" (24.8%), "patient behavior and attitudes" (18.5%), "clinical decision making" (24.0%), and "social and legal issues" (9.4%). Most frequent CanMEDS roles were "Communicator" (26.9%) and "Professional" (23.5%). Conclusions: Cases students perceived as challenging beyond the "Medical Expert" were reported from all clinical disciplines. These were mainly related to communicational and professional issues, mirrored by the CanMEDS roles "Communicator" and "Professional". Therefore, supervisors in clinical clerkships should put an additional teaching focus on communication and professionalism.


Asunto(s)
Prácticas Clínicas/normas , Curriculum/normas , Estudiantes de Medicina/psicología , Adulto , Actitud del Personal de Salud , Prácticas Clínicas/métodos , Competencia Clínica/normas , Curriculum/estadística & datos numéricos , Grupos Diagnósticos Relacionados/normas , Educación de Pregrado en Medicina/métodos , Educación de Pregrado en Medicina/normas , Femenino , Humanos , Masculino , Entrenamiento Simulado/métodos , Entrenamiento Simulado/normas
18.
BMC Med Educ ; 19(1): 224, 2019 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-31226996

RESUMEN

BACKGROUND: In-patient postgraduate teaching suffers with issues like long and unstructured presentations inclusive of a lot of historical information and time constraints due to increasing workload. A six-step pneumonic SNAPPS a learner-centered model modifies the learning encounter by condensing the reporting of facts while encouraging clinical reasoning. This study was planned with the aim to evaluate the effectiveness of SNAPPS as compared to traditional case presentation for facilitating clinical reasoning in inpatient setting. We also wanted to understand perceptions of postgraduates and teachers about this new method of case presentation. METHODS: This open labeled randomized controlled trial was carried amongst the 18 residents of department of Medicine, MGIMS. The teachers and residents in the SNAPPS were sensitized to SNAPPS technique by using videos, role plays and handouts over 2 sessions of 30 min each. Twenty-seven case presentations (3/resident) were carried out in each group (total 54 case presentations). Data was recorded into validated data recording sheet after each presentation and feedback was taken from the teacher as well as residents regarding their perception. RESULTS: The SNAPPS model heralds a change in the preceptor training, pairing faulty development and learner development as companions in education. Guided by the SNAPPS technique, students summarized patient findings concisely (7 vs. 2.7 vs. 5.22vs. 2.33, p = 0.0057) while maintaining the same degree of thoroughness as in traditional case presentations. The students in the SNAPPS group were clearer about their diagnostic hypothesis and compared and contrasted their different diagnosis well (2.56 vs. 1.74, p value =0.002). The students in the SNAPPS group initiated patient management discussion almost 20% more times as compared to the control group. CONCLUSION: We conclude that SNAPPS a learner centered technique for case presentations facilitated the expression of clinical diagnostic reasoning and case based uncertainties in the inpatient setting without extending the unusual length of the student case presentations. It also paved way for enhanced self-directed learning.


Asunto(s)
Prácticas Clínicas/normas , Competencia Clínica/normas , Estudios Cruzados , Humanos , Modelos Educacionales , Preceptoría , Solución de Problemas
19.
BMC Med Educ ; 19(1): 231, 2019 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-31238920

RESUMEN

BACKGROUND: An important barrier to smoking-cessation counseling for physicians is a lack of education at the undergraduate level. Interactive methods such as peer role-play (RP) or modules utilizing standardized patients (SPs) may be effective for medical students to enhance their performance on tobacco cessation counseling. This study compared the effectiveness of a module using SPs to that of a RP module for undergraduate medical students on tobacco cessation counseling. METHODS: This study was conducted over a single week of the family medicine clerkship. One hundred and thirteen fourth-year medical students were randomized into either the SP group or the RP group. A RP module involved a ten-minute encounter between the student doctor and the student patient followed by five minutes of feedback from the observer student using a group developed checklist. In a SP module, each student was asked to interview a SP portraying a smoker with willingness to quit. After the encounter, the SP provided five minutes of direct oral feedback to the student. In both modules, the total intervention lasted three-and-half hours and was supervised by faculty staff. Students' objective structured clinical examination (OSCE) scores were evaluated to determine their tobacco cessation counseling skills. Four evaluation periods were conducted at baseline, postintervention, post-clerkship, and before receiving the Korean medical licensing examination (KMLE). Students' smoking knowledge test scores and counseling self-confidence levels at pre- and post-intervention were also compared. RESULTS: In both groups, post-intervention OSCE scores increased significantly compared to baseline (Cohen's d 0.87, p < 0.001 in SP group; d 0.77, p < 0.001 in RP group). However, there were no differences between the two groups. Students achieved the highest OSCE score for smoking-cessation counseling before the KMLE. After training, student self-confidence and smoking-knowledge test scores increased significantly, regardless of the type of module. Self-confidence was higher in the SP group compared with the RP group (d 0.37, p = 0.01). CONCLUSIONS: Peer role-play may be equivalent to the SP method with regard to knowledge and skills reported during smoking-cessation counseling and SP method may be better in self-confidence. Cost and student self-confidence may be important factors when choosing among the teaching methods for smoking-cessation counseling.


Asunto(s)
Prácticas Clínicas , Consejo/educación , Educación de Pregrado en Medicina , Simulación de Paciente , Desempeño de Papel , Cese del Hábito de Fumar , Competencia Clínica , Educación de Pregrado en Medicina/métodos , Medicina Familiar y Comunitaria/educación , Humanos , República de Corea , Estudiantes de Medicina
20.
Korean J Med Educ ; 31(2): 125-133, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31230435

RESUMEN

PURPOSE: Medical students construct their identity as a student physician through clinical clerkship. However, there is a lack of research on the effect of clinical clerkship on professional self-concept formation. The aim of this study is to analyze and ascertain the relationship between medical students' satisfaction with clinical clerkship and professional self-concept. METHODS: This investigation studied 84 third- and fourth-year medical students enrolled in the Ajou University School of Medicine and Graduate School of Medicine. Study measures tools included satisfaction with clinical clerkship and professional self-concept measurement. For data analyses, a descriptive analysis of the research variable characteristics was applied, gender differences in variables by years of medical school were analyzed with t-tests, and correlation analysis was used to check for relationships between variables. RESULTS: We found no statistically significant differences between satisfaction with clinical clerkship with respect to medical school year and gender. While professional self-concept did not show significant differences by year of medical school, we observed statistically significant differences by gender with respect to the subscales of professional practice and communication factor. In addition, satisfaction with clinical clerkship and professional self-concept demonstrated statistically significant positive correlation. The present research was able to confirm that there exists a correlation between medical students' clinical clerkship experience and professional self-concept formation. CONCLUSION: Our study outcomes shows that provision of positive assistance as a measure to enhance satisfaction with clinical clerkship via the curriculum and environmental improvement is envisaged to lead to medical students' professional self-concept formation.


Asunto(s)
Actitud , Prácticas Clínicas , Competencia Clínica , Educación de Pregrado en Medicina , Satisfacción Personal , Autoimagen , Estudiantes de Medicina , Adulto , Comportamiento del Consumidor , Curriculum , Evaluación Educacional , Femenino , Humanos , Masculino , República de Corea , Facultades de Medicina , Autoeficacia , Factores Sexuales , Encuestas y Cuestionarios , Universidades , Adulto Joven
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA