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1.
J Surg Educ ; 81(11): 1618-1622, 2024 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-39276706

RESUMO

BACKGROUND: Traditional surgical education often lacks targeted preparation for the interactive components of examinations, such as viva voce and objective structured clinical examination (OSCE) assessments. We present our approach and explore the efficacy of a near-peer tutoring program aimed at enhancing final-year students' readiness for such assessments. METHODS: Project SEPFYR (surgical exam prep for final year exam readiness) was conducted within a near-peer tutoring framework and comprised interactive discussions of selected case scenarios focusing on viva voce techniques and OSCE responses. Pre- and postprogram anonymized web-based surveys were employed to assess perceived self-efficacy among participants, while the Stanford Faculty Development Program-26 (SFDP-26) tool was used to evaluate the performance of tutors. RESULTS: Near-peer tutoring intervention resulted in improvements in perceived self-efficacy scores among final-year students. Additionally, tutors demonstrated high-quality facilitation skills as evaluated by the SFDP-26. CONCLUSIONS: Near-peer tutoring is a promising approach to enhance surgical examination readiness, particularly in addressing interactive assessment components. This model fosters a supportive learning environment while leveraging the expertise and relatability of near-peer tutors.

2.
JAMIA Open ; 7(3): ooae090, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39314672

RESUMO

Objectives: This article focuses on the role of the electronic health record (EHR) to generate meaningful formative feedback for medical students in the clinical setting. Despite the scores of clinical data housed within the EHR, medical educators have only just begun to tap into this data to enhance student learning. Literature to-date has focused almost exclusively on resident education. Materials and Methods: Development of EHR auto-logging and triggered notifications are discussed as specific use cases in providing enhanced feedback for medical students. Results: By incorporating predictive and prescriptive analytics into the EHR, there is an opportunity to create powerful educational tools which may also support general clinical activity. Discussion: This article explores the possibilities of EHR as an educational resource. This serves as a call to action for educators and technology developers to work together on creating health record user-centric tools, acknowledging the ongoing work done to improve student-level attribution to patients. Conclusion: EHR analytics and tools present a novel approach to enhancing clinical clerkship education for medical students.

3.
Am J Surg ; : 115956, 2024 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-39271429

RESUMO

BACKGROUND: Letters of recommendation (LOR) are vital to surgical residency applications. Our prior study demonstrated differences in letter content by applicant sex, including more frequent reference to leadership and awards for male applicants. This study evaluates if leadership activities and awards as documented by the applicant's curriculum vitae (CV) corroborate differences noted in corresponding recommendation letters. METHODS: LORs and CVs for 2016-2017 surgery resident applicants selected for interview at single academic institution were analyzed for documentation of leadership and awards and assessed for concordance. RESULTS: 89 applicant CVs (45 male, 44 female) and 332 LORs (165 male, 167 female) were reviewed for evidence of leadership and awards. While 94 â€‹% of CVs had evidence of leadership, leadership was referenced in LORs more often for men than women (45 â€‹% vs 30 â€‹%, p â€‹= â€‹0.004). References to leadership skills (38 â€‹% vs 21 â€‹%, p=<0.001), elected/appointed office (33 â€‹% vs 16 â€‹%, p â€‹< â€‹0.001), and volunteer/work-related leadership role (12 â€‹% vs 3 â€‹%, p â€‹= â€‹0.001) occurred more commonly for men. Similarly, awards were present in 74 â€‹% of CVs without difference by sex but referenced more commonly for men compared to women (64 â€‹% vs 46 â€‹%, p â€‹= â€‹0.001). CONCLUSION: References to leadership and awards in LORs were more common for men than women applicants, which is not reflective of CV content. Although LOR need not recapitulate CVs, fair appraisal of leadership abilities is encouraged.

4.
Am J Pharm Educ ; 88(10): 101267, 2024 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-39159836

RESUMO

OBJECTIVE: To explore stakeholder views on the structures and processes supporting planned and unplanned interprofessional education (IPE) during experiential learning (EL) placements for student pharmacists in Scotland. METHODS: Online semistructured group interviews were conducted with academic staff, practice educators, and EL facilitators (preceptors). Recordings were transcribed verbatim and analyzed thematically. Systems theory underpinned the study. Ethical approval was granted by the School of Pharmacy and Life Sciences Ethics Review Committee at Robert Gordon University. RESULTS: Three main themes were identified: current IPE delivery and context, factors affecting IPE delivery and student pharmacist learning, and rethinking current IPE provision. Stakeholder views provided valuable insights into presage factors relating to contextual elements (cultural, logistical, regulatory) and their influence on IPE delivery and interprofessional learning. EL facilitator and student pharmacist characteristics were also highlighted as influencing factors; process factors included examples of planned and unplanned IPE experiences on offer in community, hospital, primary care, and specialist areas of pharmacy practice; product factors highlighted the importance of IPE to support the development of collaborative competencies. Future developments need to focus on a continuum of IPE learning and a coordinated approach between higher education institutions and placement providers and interprofessional practice teams. CONCLUSION: Curricular development and implementation of new IPE is not without its challenges. This study has provided a strong foundation that will inform future developments to ensure new initiatives are conducive to supporting effective interprofessional learning during placements.

5.
Nurs Open ; 11(7): e2210, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38958174

RESUMO

AIM: To investigate nursing/midwifery students, Clinical Mentors, Link Teachers and Head Nurses experiences within "Dedicated Education Unit" model in 6 European clinical placements and analyse the necessary elements for a powerful clinical learning environment. DESIGN: A multi-country, phenomenological, qualitative study. METHODS: Focus group interviews were performed to identify the personal and organizational factors of importance for students and nurses/midwives. RESULTS: Data analysis produced 4 main themes (1) Clinical placement organization, (2) students' clinical knowledge and skill acquisition, (3) students, and nurses/midwives' experiences within the DEU model and (4) factors for creating an effective learning environment. CONCLUSIONS: A close educational-service collaboration, a realistic clinical placement planning, a focus on student learning process and an investment in professionals' education and development among others, are elements to set up a powerful clinical learning environment. IMPLICATIONS FOR THE PROFESSION: It is considered advisable and urgent to improve the working conditions of nurses/midwives and the learning environments of students as a strategy to alleviate the global shortage of nurses and respond to the increasingly demanding health needs of the population. IMPACT: Due to the close relationship between students' learning and features of the clinical environment nurse educators seek innovative models which allow students to manage patient care and their transition to professional practice. To implement new learning strategies, identifying students, nurses and midwives perceptions and suggestions is a powerful information to evaluate implementation process and outcomes. PUBLIC CONTRIBUTION: Our findings could help academic and clinical managers to meet the human and organizational requirements to create a successful learning environment in every student placement.


Assuntos
Grupos Focais , Pesquisa Qualitativa , Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/psicologia , Estudantes de Enfermagem/estatística & dados numéricos , Europa (Continente) , Tocologia/educação , Feminino , Competência Clínica/normas , Enfermeiras e Enfermeiros/psicologia , Adulto , Bacharelado em Enfermagem , Enfermeiros Obstétricos/educação , Enfermeiros Obstétricos/psicologia
6.
J Surg Educ ; 81(10): 1418-1427, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38971680

RESUMO

OBJECTIVE: Urological education has been declining in medical schools, leaving many students without adequate exposure to the fundamentals of the field. We aimed to create a virtual urology course for medical students preparing for subinternships. DESIGN: We created a 4-week curriculum of case-based urology modules with sections on hematuria, bladder cancer, kidney stones, vesicoureteral reflux, prostate cancer, urinary incontinence, and erectile dysfunction. Students completed precourse and postcourse surveys assessing confidence in content knowledge and 4 educational competencies. Faculty completed postcourse surveys. Confidence was scored on a 5-point Likert scale (0-4). SETTING: We offered the course in May 2022 and May 2023. The course was fully virtual and was offered at medical schools across the United States. PARTICIPANTS: The course included 157 medical students from 60 institutions and 44 faculty instructors from 30 institutions. All instructors were urologists representing a range of urological subspecialties. RESULTS: Surveys were completed by 61/157 students (39%) and 33/44 faculty (75%). Median student confidence in content knowledge increased across all disease processes: hematuria (3 vs. 2), bladder cancer (3 vs. 1), kidney stones (3 vs. 2), vesicoureteral reflux (3 vs. 1), prostate cancer (3 vs. 1), urinary incontinence (3 vs. 2), and erectile dysfunction (3 vs. 2) (all p < 0.001). Median confidence scores also increased across all 4 educational competencies: patient evaluation (3 vs. 2), pathophysiology (3 vs. 2), literature appraisal (3 vs. 2), and patient counseling (3 vs. 1) (all p < 0.001). Confidence increases in all areas were maintained at 7-month follow-up. Most students (85%) and faculty (91%) rated the course "excellent" or "very good." CONCLUSIONS: A multi-institutional virtual urology course for medical students led to a durable increase in confidence pertaining to content knowledge and various educational competencies.


Assuntos
Currículo , Educação de Graduação em Medicina , Urologia , Urologia/educação , Educação de Graduação em Medicina/métodos , Humanos , Estados Unidos , Masculino , Feminino , Competência Clínica , Avaliação de Programas e Projetos de Saúde , Educação a Distância , Desenvolvimento de Programas , Estudantes de Medicina/estatística & dados numéricos
7.
J Surg Educ ; 2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-38964960

RESUMO

INTRODUCTION: Digital education tools are a cornerstone in the evolution to CBME through EPAs. Successful implementation requires understanding the variable impacts of EHR-driven delivery of EPAs, flexible digital device access to EPAs, and user-behavior trends. METHODS: Through a HIPAA compliant, flexible-device accessible, surgical education platform, general surgery training programs at 21 institutions collected EPA from July 2023 to April 2024. At 5 EHR-integrated institutions (EHR+), EPA were created for clinical activities based on the OR schedule, automatically pushed to attendings and residents with built in completion reminders. At 16 institutions without EHR integration (EHR-), EPA were initiated manually. To improve user experience, care phases were bundled (cEPA). We compared the EHR+ and EHR- groups, computing descriptive statistics on the cEPAs completed and user behavior metrics. RESULTS: We collected 4187 cEPAs in total, with 82% at EHR+ institutions and 18% at EHR- institutions. Platform triggering dramatically drove cEPA completion for both faculty and residents, 88% and 81%, respectively. Only 3% were initiated by the faculty or resident. Faculty at EHR+ institutions strongly preferred the automated OR-triggered workflow to start their EPAs (Chi-squared test, p ≈ 0). Faculty completed all 3 care phases nearly 80% of the time. Time reminders specifically drive EPA completion for residents and faculty on weekdays and build habits on weekends. 71% of cEPAs completed were by computer, and 29% by phone. More comments were provided when computers were used. Residents reviewed feedback with a median lag of 1 hour and 29 min after results were available. CONCLUSIONS: EHR-driven delivery of EPA leads to a 4.6-fold increase in EPAs completed. EPA initiation is the most critical phase in the workflow and EHR-data driven alerts drive this action. These alerts are also effective drivers of habit formation. Flexible device access is important to increase EPAs completed and improve the usefulness through comments for residents.

8.
AANA J ; 92(4): 295-302, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39056499

RESUMO

Safely anesthetizing patients with left ventricular assist devices (LVADs) can be intimidating, particularly for novice anesthesia providers. Given the variety of complex issues anesthesia providers may encounter with patients, it would be impractical to expect expertise in every population. To combat the inevitable loss of knowledge, education experts recommend active learning techniques, including test-enhanced learning, active recall, and spaced repetition. To that end, this research team created an LVAD Assessment for Anesthesia, or LAmA tool, to be evaluated for content validity by eight experts. The LAmA tool and content validity assessment were distributed to two anesthesiologists and four nurse anesthetists in the cardiothoracic anesthesia department at a hospital in Northeast Ohio, as well as to two outside nursing research experts. Results were analyzed by the research team and the content validity index (CVI) was determined. A CVI of at least 0.875 was required for the tool to be valid, and final scores in the categories of relevance, clarity, and importance were all ≥ 0.9. The data from the validated tool were used to create a pocket reference on LVAD anesthetic management. Both educational assessments and pocket references have the potential to positively impact knowledge retention and patient outcomes, making them excellent clinical resources.


Assuntos
Coração Auxiliar , Enfermeiros Anestesistas , Humanos , Enfermeiros Anestesistas/educação , Anestesia/normas , Reprodutibilidade dos Testes , Competência Clínica/normas
10.
Int J Epidemiol ; 53(3)2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-38847781

RESUMO

Teaching epidemiological concepts in academic settings poses a challenge due to the intricate nature of the discipline as both a science and a practice. Whereas traditional classroom-based teaching methods are commonly employed, evidence suggests they may not be the most effective approach for fostering core competencies and skills required in real-life scientific work. In this article, we describe our process of transitioning from traditional classroom teaching of epidemiology towards practice-based coaching to convey epidemiological concepts to bachelor's and master's students in Biomedicine. We chose the framework of randomized controlled trials (RCT) since they offer a great opportunity to teach epidemiological concepts in a hands-on course. This practice-based course encompasses the entire life cycle of a study, allowing students to design and conduct a short-term experiment, analyse its data and prepare a scientific paper. We provide a comprehensive overview of the course structure, content, learning objectives and course evaluation, while also discussing the advantages and disadvantages of this innovative format. Our approach offers a promising alternative to classroom teaching by incorporating practical, hands-on experiences offering students a high level of independence and self-determination, as well as facilitation and coaching by faculty. It has the potential to be applied across diverse academic settings, providing students with valuable skills and competencies in epidemiology.


Assuntos
Epidemiologia , Tutoria , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Epidemiologia/educação , Tutoria/métodos , Currículo , Suíça , Competência Profissional , Ensino
11.
J Surg Educ ; 81(6): 823-840, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38679495

RESUMO

OBJECTIVE: Entrustable professional activities (EPAs) are a crucial component of contemporary postgraduate medical education with many surgery residency programs having implemented EPAs as a competency assessment framework to assess and provide feedback on the performance of their residents. Despite broad implementation of EPAs, there is a paucity of evidence regarding the impact of EPAs on the learners and learning environments. A first step in improving understanding of the use and impact of EPAs is by mapping the rising number of EPA-related publications from the field of surgery. The primary objective of this scoping review is to examine the nature, extent, and range of articles on the development, implementation, and assessment of EPAs. The second objective is to identify the experiences and factors that influence EPA implementation and use in practice in surgical specialties. DESIGN: Scoping review. Four electronic databases (Medline, Embase, Education Source, and ERIC) were searched on January 20, 2022, and then again on July 19, 2023. A quasi-statistical content analysis was employed to quantify and draw meaning from the information related to the development, implementation, assessment, validity, reliability, and experiences with EPAs in the workplace. PARTICIPANTS: A total of 42 empirical and nonempirical articles were included. RESULTS: Four thematic categories describe the topic areas in included articles related to: 1) the development and refinement of EPAs, including the multiple steps taken to develop and refine unique EPAs for surgery residency programs; 2) the methods for implementing EPAs; 3) outcomes of EPA use in practice; 4) barriers, facilitators, and areas for improvement for the implementation and use of EPAs in surgical education. CONCLUSIONS: This scoping review highlights the key trends and gaps from the rapidly increasing number of publications on EPAs in surgery residency, from development to their use in the workplace. Existing EPA studies lack a theoretical and/or conceptual basis; future development and implementation studies should adopt implementation science frameworks to better structure and operationalize EPAs within surgery residency programs.


Assuntos
Competência Clínica , Educação Baseada em Competências , Internato e Residência , Educação Baseada em Competências/métodos , Cirurgia Geral/educação , Humanos , Educação de Pós-Graduação em Medicina/métodos
12.
BMC Med Educ ; 24(1): 214, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38429781

RESUMO

BACKGROUND: In the context of standardized training for general practitioners, the emphasis is still primarily on clinical skills, which does not fully encompass the overall development of general practitioners. This study implemented a practice-based learning and improvement (PBLI) project among students and evaluated its effectiveness based on indicators such as learning outcomes, students' subjective experiences, and annual grades. This study offers recommendations for optimizing general practitioners' teaching and residential training programs. METHODS: 60 residents who participated in the regular training of general practitioners at the First Clinical College of Tongji Medical College of Huazhong University of Science and Technology from January 2019 to January 2022 were selected for this study. They were randomly divided into two groups, the PBLI group, and the control group, using a random number table method. Out of the 60 residents, 31 were assigned to the control group and 29 were assigned to the PBLI group. The participants in the PBLI group received additional PBLI training along with their daily residential training, while the participants in the control group only took part in the latter. The effectiveness of the PBLI program was analyzed by conducting a baseline survey, administering questionnaires, and evaluating examination results. RESULTS: After implementing the program, the PBLI group scored significantly higher than the control group (p < 0.05). Throughout the implementation process, students in the PBLI group expressed high satisfaction with the learning project, particularly with its content and alignment with the training objective. The teacher's evaluation of the PBLI group students surpassed that of the control group in various areas, including literature retrieval, self-study, courseware development, speech ability, and clinical thinking. CONCLUSIONS: The PBLI program aims to encourage resident-centered study in standardized residency training. This approach is beneficial because it motivates students to engage in active learning and self-reflection, ultimately enhancing the effectiveness of standardized residency training.


Assuntos
Clínicos Gerais , Internato e Residência , Humanos , Aprendizagem Baseada em Problemas , Currículo , Competência Clínica
13.
J Surg Educ ; 81(5): 671-679, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38556437

RESUMO

OBJECTIVE: Multiple elements in the clinical learning environment have been found to influence medical students' learning experiences. A rich area of research, many factors are already known to influence students' experiences of learning which go on to impact later training choices. However, there is a knowledge gap specifically related to undergraduate medical students' experiences of surgical placement. This study aims to explore the lived experiences of medical students in their surgery rotation(s). DESIGN: A phenomenological study using semistructured interviews was conducted. Transcribed interview recordings were thematically analyzed using an iterative approach. SETTING: Participants were studying in a large medical school in the north of England. PARTICIPANTS: Fitting with the method, 6 undergraduate medical students, with at least 1 surgery placement took part in the study. RESULTS: Participants described issues including knowing the details of clinical opportunities, the clinical environment, and the portfolio; having a sense of involvement and previous surgical experiences; teaching and assessments; observation; and interactions. These experiences were also found to influence later career aspirations. CONCLUSIONS: The findings suggest that undergraduate surgical learning experiences can be influenced by various themes: knowing the details of progression, the clinical environment, having a sense of involvement and previous experiences, constructive alignment of teaching and assessment, and professional identity formation. Future studies can explore methods such as personalized learning outcomes to enhance the overall learning experience of medical students.


Assuntos
Educação de Graduação em Medicina , Cirurgia Geral , Pesquisa Qualitativa , Estudantes de Medicina , Educação de Graduação em Medicina/métodos , Humanos , Feminino , Masculino , Cirurgia Geral/educação , Estudantes de Medicina/psicologia , Inglaterra , Adulto , Entrevistas como Assunto , Adulto Jovem
14.
Med Sci Educ ; 34(1): 181-191, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38510391

RESUMO

Medical school often has opportunities for students to engage in peer or near-peer teaching, however structured teacher training is rarely conducted. We present an Educational Fellowship for rising M2 students as teaching assistants for first year Physician Assistant students. In this near-peer interprofessional teaching model, the M2 students learn pedagogical theory and best practices for teaching and learning. The curriculum and experience may be used by any healthcare profession. Since many healthcare professions have classes during the summer, we present our program as a conceptual model for other institutions.

15.
Br J Nurs ; 33(4): 200-204, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38386526

RESUMO

BACKGROUND: Preregistration nursing students (trainee nursing associates and student nurses) may have a disability or impairment that requires reasonable adjustments while they are on clinical placement. At The Open University, practice tutors support nursing students on clinical placement, which includes overseeing the facilitation of any such reasonable adjustments. However, they may not feel prepared to provide this support. METHOD: A qualitative approach with a broad interpretivist paradigm was adopted. Data were collected from three focus groups that included a total of 10 nursing practice tutors. Audio data were transcribed and analysed using complete coding followed by thematic analysis. FINDINGS: Three main themes were identified - it's complex; impact of engagement; and a cohesive approach - along with associated subthemes. CONCLUSION: Despite their clear interest in helping nursing students who require reasonable adjustments for practice-based learning, practice tutors can be hindered by barriers resulting from a lack of both training and guidelines. The complexity of the practice tutor role and student issues can compound this. Consistency in practice tutor training is recommended, as well as regular access to peer support to address these difficulties and develop the skills and knowledge.


Assuntos
Estudantes de Enfermagem , Humanos , Grupos Focais
16.
JMIR Res Protoc ; 13: e53284, 2024 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-38329786

RESUMO

BACKGROUND: The learning process in clinical placements for health care students is a multifaceted endeavor that engages numerous actors and stakeholders, including students, clinical tutors, link teachers, and academic assessors. Successfully navigating this complex process requires the implementation of tasks and mentorships that are synchronized with educational and clinical processes, seamlessly embedded within their respective contexts. Given the escalating number of students and the rising demand for health care services from the general population, it becomes imperative to develop additional tools that support the learning process. These tools aim to simplify day-to-day clinical practice, allowing a concentrated focus on value-based activities. This paper introduces a project funded by the European Commission that involves 5 European countries. The project's objective is to comprehensively outline the entire process of development and ultimately implement mobile technology in practice placements. The project tackles the existing gap by constructing tailored mobile apps designed for students, teachers, tutors, and supervisors within each participating organization. This approach leverages practice-based learning, mobile technology, and technology adoption to enhance the overall educational experience. OBJECTIVE: This study aims to introduce mobile technology in clinical practice placements with the goal of facilitating and enhancing practice-based learning. The objective is to improve the overall effectiveness of the process for all stakeholders involved. METHODS: The "4D in the Digitalization of Learning in Practice Placement" (4D Project) will use a mixed methods research design, encompassing 3 distinct study phases: phase 1 (preliminary research), which incorporates focus groups and a scoping review, to define the problem, identify necessities, and analyze contextual factors; phase 2 (collaborative app development), which involves researchers and prospective users working together to cocreate and co-design tailored apps; and phase 3, which involves feasibility testing of these mobile apps within practice settings. RESULTS: The study's potential impact will primarily focus on improving communication and interaction processes, fostering connections among stakeholders in practice placements, and enhancing the assessment of training needs. The literature review and focus groups will play a crucial role in identifying barriers, facilitators, and factors supporting the integration of mobile technology in clinical education. The cocreation process of mobile learning apps will reveal the core values and needs of various stakeholders, including students, teachers, and health care professionals. This process also involves adapting and using mobile apps to meet the specific requirements of practice placements. A pilot study aimed at validating the app will test and assess mobile technology in practice placements. The study will determine results related to usability and design, learning outcomes, student engagement, communication among stakeholders, user behavior, potential issues, and compliance with regulations. CONCLUSIONS: Health care education, encompassing disciplines such as medicine, nursing, midwifery, and others, confronts evolving challenges in clinical training. Essential to addressing these challenges is bridging the gap between health care institutions and academic settings. The introduction of a new digital tool holds promise for empowering health students and mentors in effectively navigating the intricacies of the learning process. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/53284.

17.
Diagnosis (Berl) ; 11(2): 142-150, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38310520

RESUMO

OBJECTIVES: Practice-based learning and improvement (PBLI) is an ACGME (Accreditation Council for Graduate Medical Education) core competency. Learning and reflecting on patients through follow-up is one method to help achieve this competency. We therefore designed a study evaluating a structured patient follow-up intervention for senior internal medicine (IM) residents at the University of Colorado Hospital (UCH). METHODS: Trainees completed structured reflections after performing chart review of prior patients during protected educational time. Two-month follow-up surveys evaluated the exercise's potential influence on clinical and reflective practices. RESULTS: Forty out of 108 (37 %) eligible residents participated in the exercise. Despite 62.5 % of participants lacking specific questions about patient outcomes before chart review, 81.2 % found the exercise at least moderately helpful. 48.4 % of participants believed that the review would change their practice, and 60.9 % felt it reinforced their existing clinical practices. In our qualitative data, residents learned lessons related to challenging clinical decisions, improving transitions of care, the significance of early goals of care conversations, and diagnostic errors/strategies. CONCLUSIONS: Our results indicate that IM residents found a structured patient follow-up intervention educational, even when they lacked specific patient outcomes questions. Our results underscore the importance of structured self-reflection in the continuous learning process of trainees and suggest the benefit of dedicated educational time for this process.


Assuntos
Tomada de Decisão Clínica , Medicina Interna , Internato e Residência , Humanos , Medicina Interna/educação , Educação de Pós-Graduação em Medicina , Competência Clínica , Inquéritos e Questionários , Masculino , Seguimentos , Feminino
18.
Int J Nurs Educ Scholarsh ; 21(1)2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38167136

RESUMO

OBJECTIVES: To explore the values, practices, and behaviours that support nursing students' professional development in practice-based learning environments in Rwanda. METHODS: A focused ethnographic approach was used. Nursing students (n=12), nurses (n=11), clinical instructors (n=7) and nurse leaders (n=8) from three teaching hospitals and an educational program participated in the study. Data was collected trough individual interviews and participant observation. RESULTS: Participants embraced a culture of preparing nursing students for their professional roles as a professional responsibility, and a means of securing the nursing profession. Modeling the appropriate behaviours to students and respecting them as learners and humans constituted the caring attributes that sustain a positive learning environment for their professional growth. CONCLUSIONS: Nurturing and caring environments offer students opportunities to integrate caring attitudes into their interactions with patients and to develop professionally. IMPLICATIONS FOR INTERNATIONAL AUDIENCE: Findings underscore the need to enhance caring values within nursing curricula.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Humanos , Ruanda , Currículo , Aprendizagem
19.
J Surg Educ ; 81(1): 106-114, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38008642

RESUMO

BACKGROUND: A central tenet of competency-based medical education is the formative assessment of trainees. There are currently no assessments designed to examine resident competence on-call, despite the on-call period being a significant component of residency, characterized by less direct supervision compared to daytime. The purpose of this study was to design a formative on-call assessment tool and collect valid evidence on its application. METHODS: Nominal group technique was used to identify critical elements of surgical resident competence on-call to inform tool development. The tool was piloted over six months in the Division of Plastic & Reconstructive Surgery at our institution. Quantitative and qualitative evidence was collected to examine tool validity. RESULTS: A ten-item tool was developed based on the consensus group results. Sixty-three assessments were completed by seven staff members on ten residents during the pilot. The tool had a reliability coefficient of 0.67 based on a generalizability study and internal item consistency was 0.92. Scores were significantly associated with years of training. We found the tool improved the quantity and structure of feedback given and that the tool was considered feasible and acceptable by both residents and staff members. CONCLUSIONS: The Western University Call Assessment Tool (WUCAT) has multiple sources of evidence supporting its use in assessing resident competence on-call.


Assuntos
Internato e Residência , Humanos , Educação de Pós-Graduação em Medicina/métodos , Reprodutibilidade dos Testes , Universidades , Competência Clínica , Avaliação Educacional/métodos
20.
J Adv Nurs ; 80(6): 2415-2428, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38097514

RESUMO

AIM: The aim of the study was to evaluate a person-centred model of clinical supervision to enhance person-centredness. DESIGN: Experimental, quantitative. METHODS: One hundred and three New Graduates were supported to reflect through a person-centred lens (July-December 2020). Evaluation was undertaken at 6 months using: the Manchester Clinical Supervision Scale-26 (effectiveness of supervision) and the Person-centred Practice Inventory (measures attributes of the nurse/midwife, the care environment and person-centred processes). Due to participation difficulties, scores were calculated by attendance rates using descriptive and inferential statistics. RESULTS: Regular attendees scored higher on the supervision's effectiveness; however, this did not reach efficacy. 'Finding time' to attend contributed to low scores. Supervision scored well on its supportive function when attended. Many New Graduates perceived a decline in their care environment. Attendance aside, New Graduates averaged an increased in their person-centred attributes and processes. Greater participation was found in those who scored higher at baseline on their person-centred attributes and processes, and this higher scoring continued at 6 months than those who attended less. CONCLUSION: New Graduates who perceive themselves as person-centred and reflective at baseline are more likely to attend a person-centred clinical supervision and score higher at 6 months than those who attended less often. New Graduates found support within supervision during challenging times. IMPLICATIONS FOR PRACTICE FOR PROFESSIONAL AND/OR PATIENT CARE: For successful implementation of Person-centred Clinical Supervision, New Graduates need support to attend, as attendance supports them to begin seeing value in the process. IMPACT: This intervention kept person-centred practice at the forefront of New Graduates reflection, in a time of extreme change. The research has implications for nursing and midwifery management with the imperative to deliver person-centred care and create the person-centred cultures for staff to feel supported and empowered. REPORTING METHOD: Transparent Evaluation of Non-randomized Designs (TREND). PATIENT OF PUBLIC CONTRIBUTION: No patient or public contribution. CONTRIBUTION TO WIDER COMMUNITY: New Graduates grow their person-centredness over their transitioning year; however, this can be enhanced with regular clinical supervision underpinned by person-centred theory. Clinical supervisors can provide support to New Graduates when the environment is challenged.


Assuntos
COVID-19 , Assistência Centrada no Paciente , Humanos , Feminino , Adulto , Masculino , SARS-CoV-2 , Tocologia/educação , Competência Clínica , Enfermeiros Obstétricos/psicologia , Enfermeiros Obstétricos/educação , Supervisão de Enfermagem , Gravidez
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