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1.
J Physician Assist Educ ; 32(1): 20-25, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33605685

RESUMO

ABSTRACT: Standardized entrance exams are used in many health professions as one way to objectively measure knowledge and facilitate comparisons across student groups. The physician assistant (PA) profession has historically not employed a profession-specific entrance exam, and the idea was never seriously explored until the Physician Assistant College Admissions Test was developed recently by a commercial assessment publisher, with field testing in some volunteer programs in 2018 and the exam's first administration in May of 2020. The 2020 Physician Assistant Education Association Presidents Commission chose to investigate the issues raised by a consensus-derived, PA-specific entrance exam to stimulate more informed discussion on the efficacy of such an exam. While it may have the potential to enhance efficiency in PA admissions and reduce variability in admissions requirements, a PA entrance exam would also likely introduce new challenges, including increased costs, impact on the diversity of the applicant pool, and incongruence with an increasingly holistic admissions process. The biggest barrier would likely be the lack of current consensus on the knowledge, skills, and attributes that matriculants need to be successful in the program and in clinical practice. Development of a consensus-derived PA entrance exam would be a complex, expensive, and time-consuming endeavor, requiring considerable attention to technical issues of psychometric quality, process transparency, and legal defensibility. Changes being made to health professions admissions practices due to the COVID-19 pandemic, including the dropping of test scores as a requirement by some institutions, may make some of the issues raised in this paper more timely than ever.


Assuntos
Avaliação Educacional/estatística & dados numéricos , Assistentes Médicos/educação , Critérios de Admissão Escolar/tendências , Escolas para Profissionais de Saúde/tendências , /epidemiologia , Humanos , Estados Unidos
2.
Andrologia ; 53(3): e13961, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33491204

RESUMO

In 2020, the COVID-19 pandemic led to the suspension of the annual Summer Internship at the American Center for Reproductive Medicine (ACRM). To transit it into an online format, an inaugural 6-week 2020 ACRM Online Mentorship Program was developed focusing on five core pillars of andrology research: scientific writing, scientific methodology, plagiarism understanding, soft skills development and mentee basic andrology knowledge. This study aims to determine mentee developmental outcomes based on student surveys and discuss these within the context of the relevant teaching and learning methodology. The mentorship was structured around scientific writing projects established by the team using a student-centred approach, with one-on-one expert mentorship through weekly formative assessments. Furthermore, weekly online meetings were conducted, including expert lectures, formative assessments and social engagement. Data were collected through final assessments and mentee surveys on mentorship outcomes. Results show that mentees (n = 28) reported a significant (p < .0001) improvement in all criteria related to the five core pillars. These results illustrate that the aims of the online mentorship program were achieved through a unique and adaptive online educational model and that our model has demonstrated its effectiveness as an innovative structured educational experience through the COVID-19 crisis.


Assuntos
Andrologia/educação , Educação a Distância/organização & administração , Escrita Médica , Modelos Educacionais , /epidemiologia , /transmissão , Avaliação Educacional/estatística & dados numéricos , Feminino , Humanos , Masculino , Mentores , Pandemias/prevenção & controle , Plágio , Estudantes/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Comunicação por Videoconferência/organização & administração
3.
Acad Med ; 96(1): 108-112, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33394662

RESUMO

PURPOSE: Combined baccalaureate-MD programs exist to fulfill a variety of educational missions, including to promote the development of physician-scientists, increase workforce diversity, promote primary care careers, and meet the needs of underserved patients. The authors sought to determine the demographics of combined program graduates, as well as their intention to practice in primary care (IPPC) and intention to work with the medically underserved (IWMU), as compared with graduates of traditional MD programs. METHOD: Data from the 2010-2017 Association of American Medical Colleges Graduation Questionnaire, a national survey of graduating medical students, were recategorized (e.g., as combined program or traditional program) before analysis. Logistic regression models on the 2 primary outcomes (IPPC and IWMU) were conducted to estimate odds ratios for the effects of covariates and predictors (e.g., gender, underrepresented in medicine [URM] group member, type of medical degree program). RESULTS: Data from a total of 109,028 respondents were included (3,182 from combined and 105,846 from traditional programs). Compared with students in traditional programs, those in combined programs were more likely to be younger (age at graduation ≤ 29: 3,143, 98.8% vs 89,688, 84.7%) and female (1,813, 57.0% vs 52,013, 49.1%) but less likely to identify as a URM group member (276, 8.7% vs 14,757, 13.9%). In an adjusted logistic regression model, graduating from a combined program, identifying as female, and IWMU predicted significantly greater odds of IPPC, while identifying as a URM, identifying as female, and having debt predicted significantly greater odds of IWMU. Graduating medical students who indicated family medicine as a career specialty were more likely to indicate an IWMU. CONCLUSIONS: Medical students graduating from combined programs were more likely to indicate an IPPC but were no more likely to indicate an IWMU than traditional program graduates.


Assuntos
Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Educação de Pós-Graduação em Medicina/tendências , Educação de Graduação em Medicina/estatística & dados numéricos , Educação de Graduação em Medicina/tendências , Avaliação Educacional/estatística & dados numéricos , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Adulto , Escolha da Profissão , Feminino , Humanos , Modelos Logísticos , Masculino , Razão de Chances , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
5.
Acad Med ; 96(2): 186-192, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33492834

RESUMO

Clerkship grades (like money) are a social construct that function as the currency through which value exchanges in medical education are negotiated between the system's various stakeholders. They provide a widely recognizable and efficient medium through which learner development can be assessed, tracked, compared, and demonstrated and are commonly used to make decisions regarding progression, distinction, and selection for residency. However, substantial literature has demonstrated how grades imprecisely and unreliably reflect the value of learners. In this article, the authors suggest that challenges with clerkship grades are fundamentally tied to their role as currency in the medical education system. Associations are drawn between clerkship grades and the history of the U.S. economy; 2 major concepts are highlighted: regulation and stock prices. The authors describe the history of these economic concepts and how they relate to challenges in clerkship grading. Using lessons learned from the history of the U.S. economy, the authors then propose a 2-step solution to improve upon grading for future generations of medical students: (1) transition from grades to a federally regulated competency-based assessment model and (2) development of a departmental competency letter that incorporates competency-based assessments rather than letter grades and meets the needs of program directors.


Assuntos
Estágio Clínico/normas , Economia/história , Educação Médica/legislação & jurisprudência , Avaliação Educacional/métodos , Internato e Residência/ética , Estágio Clínico/estatística & dados numéricos , Competência Clínica/normas , Avaliação Educacional/estatística & dados numéricos , Feminino , História do Século XX , Humanos , Internato e Residência/estatística & dados numéricos , Masculino , Faculdades de Medicina/organização & administração , Estudantes de Medicina/estatística & dados numéricos , Estados Unidos/epidemiologia
6.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 23(6): 325-330, dic. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-198788

RESUMO

OBJETIVOS: Identificar y analizar las estrategias de enseñanza implementadas durante las clases de trabajos prácticos de la asignatura de biología correspondiente a la carrera de medicina de la Facultad de Medicina de la Universidad Nacional de Tucumán con sede en la Facultad de Ciencias de la Salud de la Universidad Nacional de Salta, y reflexionar críticamente acerca de las estrategias de enseñanza a partir de la lectura que realizaron los estudiantes que cursan la asignatura. SUJETOS Y MÉTODOS: La investigación combinó los enfoques cuantitativos y cualitativos. La obtención de datos se realizó a partir del análisis documental (plan de estudio y programa de la asignatura, material didáctico, guías de trabajos prácticos y observaciones) y mediante la aplicación de encuestas semiestructuradas dirigidas a estudiantes que cursaron la asignatura. RESULTADOS: Según las percepciones y apreciaciones de los estudiantes implicados en esta investigación, las estrategias de enseñanza implementadas permitieron en gran medida la apropiación significativa de los conocimientos específicos de la asignatura, favoreciendo la construcción de saberes que se desarrollan en asignaturas posteriores de la carrera. CONCLUSIONES: Según la percepción crítica de los estudiantes, las estrategias de enseñanza desarrolladas durante los trabajos prácticos estarían enmarcadas dentro de la corriente constructivista. Asimismo, se advirtió que estarían estrechamente vinculadas con los objetivos del perfil profesional de la carrera, al propiciar el desarrollo de competencias que se consideran fundamentales para la formación del futuro médico


AIMS: To identify and to analyze the teaching strategies implemented during the practical work classes of the Biology subject corresponding to medical school of Facultad de Medicina of Universidad Nacional de Tucumán with headquarters in Facultad de Ciencias de la Salud of Universidad Nacional de Salta, and to reflect critically on teaching strategies, based on the reading made by the students taking the subject. SUBJECTS AND METHODS: The research combined quantitative and qualitative approaches. The data was obtained from the documentary analysis (study plan and program of the subject, teaching material, practical work guides and observations) and through the application of semi-structured surveys aimed at students who attended the subject. RESULTS: According to the perceptions and appreciations of the students involved in this research, the teaching strategies implemented allowed, to a large extent, the significant appropriation of the specific knowledge of the subject, favoring the construction of knowledge developed in subsequent subjects of the career. CONCLUSION: According to the critical perception of the students, the teaching strategies developed during the practical works can be framed within the constructivist approach. It was also noted that they are closely linked to the objectives of the professional profile of the career, by promoting the development of skills that are considered essential for the training of the future doctor


Assuntos
Humanos , Estratégias , Ensino , Biologia/educação , Estudantes de Medicina/estatística & dados numéricos , Educação Médica/métodos , Percepção , Argentina , Inquéritos e Questionários , Avaliação Educacional/estatística & dados numéricos
7.
Front Public Health ; 8: 609599, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33330345

RESUMO

In the wake of COVID-19, there is an urgent need for a diverse public health work force to address problems presented or exacerbated by the global pandemic. Educational programs that create our work force both train and shape the makeup of access through graduate applications. The Graduate Record Exam has a number of standing issues, with additional barriers created by the pandemic. We trace the GRE waiver movement over several years, focusing on the gradual adoption in CEPH accredited programs and the rapid expansion of temporary waivers as a response to testing access. Going forward, we need to consider gaps in waivers during the pandemic and how this data can be used to shape our future use of the GRE.


Assuntos
Educação Médica/estatística & dados numéricos , Educação Médica/normas , Avaliação Educacional/estatística & dados numéricos , Avaliação Educacional/normas , Saúde Pública/educação , Critérios de Admissão Escolar/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Estudantes de Medicina , Estados Unidos , Adulto Jovem
8.
GMS J Med Educ ; 37(7): Doc87, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33364366

RESUMO

Objective: Primary outcome of this retrospective study was the comparison of state examination results under simulated treatment conditions in times of Covid-19 versus patient treatment under non-pandemic conditions. Additionally, correlation analysis was performed between students' self- and examiners' assessment of the treatment results. Methods: Within 4 hours, 22 examinees each had to place a multi-surface adhesive anterior and posterior restoration, performed an endodontic treatment on a maxillary premolar and a periodontal debridement of one quadrant. All treatments were performed on a model fixed in a phantom head. Compliance with the prescribed hygiene and social distancing guidelines and self-assessment of the practical performance was part of the practical examination as well. One examiner per examination part evaluated anonymously the final results. The historical control was based on the exam results of a cohort from 2019. Mean values (standard deviation), non-parametric correlations (Spearman's Rho) and group comparisons (Mann-Whitney) were calculated for statistical analysis. Results: Examination results under simulated treatment conditions were significantly worse (p<0.05) than in the cohort that took their state exam in patients, with exception of the endodontic partial exam. The overall scores in restorative dentistry and periodontology of both groups, which include a structured theoretical examination, did not differ. The majority of the candidates rated their performance worse than the examiners, and there was no correlation between self- and third-party assessment. Conclusion: In the comparison of two years, a simulated practical examination without patients in restorative dentistry, endodontics and periodontology resulted in matchable results compared with an examination on patients. Equal conditions for the candidates resulting in better comparability and avoidance of ethical dilemmas of patient treatment under examination conditions could also be arguments towards a state examination under phantom conditions in the future.


Assuntos
/epidemiologia , Educação em Odontologia/organização & administração , Educação a Distância/organização & administração , Avaliação Educacional/estatística & dados numéricos , Odontólogos/educação , Educação em Odontologia/normas , Educação a Distância/normas , Avaliação Educacional/normas , Endodontia/educação , Humanos , Modelos Anatômicos , Pandemias , Autoavaliação , Estudantes de Odontologia
9.
PLoS One ; 15(10): e0239490, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33035228

RESUMO

This study analyzes the effects of COVID-19 confinement on the autonomous learning performance of students in higher education. Using a field experiment with 458 students from three different subjects at Universidad Autónoma de Madrid (Spain), we study the differences in assessments by dividing students into two groups. The first group (control) corresponds to academic years 2017/2018 and 2018/2019. The second group (experimental) corresponds to students from 2019/2020, which is the group of students that had their face-to-face activities interrupted because of the confinement. The results show that there is a significant positive effect of the COVID-19 confinement on students' performance. This effect is also significant in activities that did not change their format when performed after the confinement. We find that this effect is significant both in subjects that increased the number of assessment activities and subjects that did not change the student workload. Additionally, an analysis of students' learning strategies before confinement shows that students did not study on a continuous basis. Based on these results, we conclude that COVID-19 confinement changed students' learning strategies to a more continuous habit, improving their efficiency. For these reasons, better scores in students' assessment are expected due to COVID-19 confinement that can be explained by an improvement in their learning performance.


Assuntos
Infecções por Coronavirus/patologia , Educação a Distância , Avaliação Educacional/estatística & dados numéricos , Pneumonia Viral/patologia , Adulto , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/virologia , Feminino , Humanos , Masculino , Modelos Teóricos , Pandemias , Pneumonia Viral/virologia , Espanha , Estudantes de Medicina/estatística & dados numéricos , Adulto Jovem
11.
Ann Epidemiol ; 47: 8-12, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32713507

RESUMO

PURPOSE: The aim of the study was to determine if epidemiology instruction for high school students can improve science literacy skills compared with other science, technology, engineering, and math courses. METHODS: The Test of Scientific Literacy Skills (TOSLS), a validated measure of scientific inquiry and interpretation, was used to assess the change in students' (n = 116; 63% female, 36% Asian, 30% Hispanic, 54% 12th grade, 48% mid poverty, and 24% high poverty) science literacy skills based on pre-post performance. RESULTS: Multilevel models adjusted for individual-level student gender, race-ethnicity, grade level, age, semester, and poverty status showed similar TOSLS performance for physics (ß = 0.58; 95% confidence interval [CI], -0.44 to 1.61), biology (ß = 0.09; 95% CI, -0.82 to 1.00), and statistics (ß = -0.76; 95% CI, -1.84 to 0.32), and lower for chemistry (ß = -1.09; 95% CI, -2.26 to 0.08) and geology (ß = -1.04; 95% CI, -2.06 to -0.02) relative to the reference group, epidemiology. Models testing the interaction of course subject and sociodemographic factors did not show gender differences in TOSLS performance for epidemiology, in contrast with physics (lower in females) and biology (higher in females). CONCLUSIONS: Study findings suggest that epidemiology may be an appropriate method for supporting high school students' development of science literacy skills, although larger and more nuanced studies are needed.


Assuntos
Avaliação Educacional/métodos , Epidemiologia/educação , Aprendizagem , Saúde Pública/educação , Ciência/educação , Estudantes/estatística & dados numéricos , Adolescente , Avaliação Educacional/estatística & dados numéricos , Docentes , Feminino , Humanos , Masculino , Ensino
12.
Acad Med ; 95(7): 1050-1056, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32576763

RESUMO

PURPOSE: It is challenging to add rigorous, competency-based communication skills training to existing clerkship structures. The authors embedded a simulation-based mastery learning (SBML) curriculum into a medicine subinternship to demonstrate feasibility and determine the impact on the foundational skill of breaking bad news (BBN). METHOD: All fourth-year students enrolled in a medicine subinternship at Northwestern University Feinberg School of Medicine from September 2017 through August 2018 were expected to complete a BBN SBML curriculum. First, students completed a pretest with a standardized patient using a previously developed BBN assessment tool. Learners then participated in a 4-hour BBN skills workshop with didactic instruction, focused feedback, and deliberate practice with simulated patients. Students were required to meet or exceed a predetermined minimum passing standard (MPS) at posttest. The authors compared pretest and posttest scores to evaluate the effect of the intervention. Participant demographic characteristics and course evaluations were also collected. RESULTS: Eighty-five students were eligible for the study, and 79 (93%) completed all components. Although 55/79 (70%) reported having personally delivered serious news to actual patients, baseline performance was poor. Students' overall checklist performance significantly improved from a mean of 65.0% (SD = 16.2%) items correct to 94.2% (SD = 5.9%; P < .001) correct. There was also statistically significant improvement in scaled items assessing quality of communication, and all students achieved the MPS at mastery posttest. All students stated they would recommend the workshop to colleagues. CONCLUSIONS: It is feasible to embed SBML into a required clerkship. In the context of this study, rigorous SBML resulted in uniformly high levels of skill acquisition, documented competency, and was positively received by learners.


Assuntos
Variação Contingente Negativa/fisiologia , Avaliação Educacional/métodos , Internato e Residência/métodos , Aprendizagem/fisiologia , Treinamento por Simulação/métodos , Adulto , Lista de Checagem , Chicago/epidemiologia , Competência Clínica/estatística & dados numéricos , Comunicação , Currículo , Avaliação Educacional/estatística & dados numéricos , Estudos de Viabilidade , Feminino , Humanos , Masculino , Medicina/métodos , Estudantes de Medicina , Universidades/estatística & dados numéricos
13.
Gynecol Obstet Invest ; 85(3): 284-289, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32396916

RESUMO

INTRODUCTION: Narrow-band imaging (NBI) hysteroscopy by experienced hysteroscopists (EH) is useful for diagnosing endometrial neoplasms. OBJECTIVE: We investigated whether the diagnostic reliability of NBI could be improved by specific professional training. METHODS: Three levels of trainees who were Surgeons at our hospital were selected. Level I: 6 trainees had no prior hysteroscopic experience; level II: 6 trainees had experience with <100 cases; and level III: 6 trainees had <500 cases. The two-hour training program for white light hysteroscopy (WLH) and NBI included information on the classifications of diseases of the uterine cavity and on the features of diagnostic images. Images from 529 patients were evaluated independently by trainees with 3 levels of before and after training, and by EH. Trainees and EHs had to analyze and arrive at a hysteroscopic diagnosis for each image that was compared to the pathological diagnosis for diagnostic accuracy. RESULTS: After training, all levels achieved higher diagnostic accuracy with NBI than was seen with WLH. Level III trainees achieved diagnostic accuracy and kappa values for NBI that were equivalent to those of EH. CONCLUSIONS: Training can increase the diagnostic skill of all trainees using NBI, especially for trainees with prior hysteroscopic experience.


Assuntos
Competência Clínica/estatística & dados numéricos , Educação Médica Continuada/estatística & dados numéricos , Neoplasias do Endométrio/diagnóstico , Histeroscopia/educação , Imagem de Banda Estreita/métodos , Adulto , Educação Médica Continuada/métodos , Avaliação Educacional/estatística & dados numéricos , Feminino , Humanos , Histeroscopia/métodos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes
14.
J Grad Med Educ ; 12(2): 145-149, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32322345

RESUMO

Background: Two criteria that have been investigated for evaluating orthopedic surgery residency candidates are achieving an "honors" grade during a surgery clerkship and the total number of honors grades received in all clerkships. Unfortunately, the rate of honors grades given and the criteria for earning an honors grade differ between medical schools, making comparison of applicants from different medical schools difficult. Objective: We measured the rate of honors grades in clerkships at different medical schools in the United States to examine the utility of clerkship grades in evaluating orthopedic surgery residency applicants. Methods: Adequate data via the Electronic Residency Application Service were available for 86 of 142 Association of American Medical Colleges medical schools from the 2017 Match cycle. Descriptive statistics and Wilcoxon rank sum tests were performed to identify differences in grade distributions within each clerkship and in school ranking for research by U.S. News & World Report. Results: For the surgery clerkship, the median rate of honors grades given was 32.5% (range 5%-67%). There was a high rate of interinstitutional variability in all clerkships. We were unable to demonstrate a statistically significant relationship between research ranking and percentage honors grades given for individual clerkships. Conclusions: A standardized method for grading medical students during clinical clerkships does not exist, resulting in a high degree of interinstitutional variability. Surgery clerkship grades are an unreliable measure for comparing orthopedic surgery residency applicants from different medical schools. Standardized measures of applicant evaluation might be helpful in the future.


Assuntos
Estágio Clínico/normas , Educação de Graduação em Medicina/normas , Avaliação Educacional/estatística & dados numéricos , Estágio Clínico/estatística & dados numéricos , Educação de Graduação em Medicina/métodos , Avaliação Educacional/métodos , Avaliação Educacional/normas , Humanos , Internato e Residência/normas , Cirurgiões Ortopédicos/educação , Faculdades de Medicina/normas , Faculdades de Medicina/estatística & dados numéricos , Estudantes de Medicina , Estados Unidos
15.
GMS J Med Educ ; 37(1): Doc6, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32270020

RESUMO

Background: Since 2013 a competency-oriented student progress test (SKPT) has been administered at a number of German medical schools. The questions are generated on the basis of a two-dimensional blueprint, on which one axis contains the five competency domains - communicative competence (CO), practical clinical competence (CP), theoretical clinical competence (CT), scientific competence (SC), and professional decision-making competence (PR) - that form part of the competency model of the National Competency-based Catalogue of Learning Objectives for Undergraduate Medicine (NKLM). The feedback for students is structured in part according to these domains. The aim of our study is to examine if the results differentiated by competency domain show adequate measurement accuracy and if the results for the different domains also contain different information. Methods: The SKPTs for the years 2013 to 2017, taken by a total of 3,027 students, were examined. The measurement accuracy was determined using the coefficient glb (greatest bound to reliability) and the standard error of measurement; discriminant analysis of the principal components was carried out to demonstrate differentiation between the competency domains. Results: The reliability of the competency domains was above 0.8 for all SKPTs; exceptions to this were seen in two of the tests for CO and PR that had a reliability of 0.7-0.8. The results for all of the individual competency domains differed in their informational content compared to the overall of the other domains; the same applies for all pairwise comparisons, with the exceptions of CP and CT. Discussion: The SKPT feedback for students that is differentiated by competency domains basically fulfills the requirements for measurement reliability and distinctness. An improvement of the measurement quality for CO and PR and a better differentiation between CP and CT is desirable.


Assuntos
Competência Clínica/normas , Avaliação Educacional/normas , Estudantes de Medicina/estatística & dados numéricos , Competência Clínica/estatística & dados numéricos , Educação Baseada em Competências/métodos , Educação de Graduação em Medicina/métodos , Avaliação Educacional/métodos , Avaliação Educacional/estatística & dados numéricos , Retroalimentação , Humanos , Reprodutibilidade dos Testes
16.
J Surg Res ; 252: 57-62, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32234569

RESUMO

BACKGROUND: Airway management is an essential element of surgical training, but with fewer procedures performed during residency, simulation is crucial to fill educational gaps. We evaluated the effect of a multidisciplinary airway simulation on the comfort of general surgery residents in managing airways. MATERIALS AND METHODS: All residents PGY 2-5 at a large academic general surgery residency program participated in a multidisciplinary airway management simulation. Precourse surveys evaluated self-perception of skills in three areas of airway management: surgical airway, basic ventilator strategies, and endotracheal intubation. Simulation consisted of didactic and procedural components and used high- and low-fidelity models including silicon airways, ventilators, porcine trachea, and airway adjuncts. Instruction was provided by anesthesia and otolaryngology faculty. Postcourse assessment was performed with a four-level Likert questionnaire. Results were analyzed using paired t-tests. RESULTS: Of the 19 residents surveyed, 37% of residents had 1-5 h and 32% had 5-10 h of prior airway instruction. Significant increases in mean comfort were observed across all three studied areas. Residents reported increased comfort performing a surgical airway (1.16 versus 1.95), P < 0.0001, and troubleshooting ventilator issues (1.59 versus 2.16), P < 0.0001. Comfort regarding overall airway management including endotracheal intubation demonstrated similar improvement (1.84 versus 2.32), P = 0.02. Subgroup analysis by PGY level showed the greatest impact on comfort level in junior residents. CONCLUSIONS: Multidisciplinary airway simulation can be effectively implemented in a general surgery training program and positively affect trainee comfort with these techniques, particularly among junior residents.


Assuntos
Manuseio das Vias Aéreas , Cirurgia Geral/educação , Internato e Residência/métodos , Equipe de Assistência ao Paciente , Treinamento por Simulação/métodos , Animais , Competência Clínica/estatística & dados numéricos , Currículo , Avaliação Educacional/estatística & dados numéricos , Humanos , Internato e Residência/estatística & dados numéricos , Modelos Anatômicos , Avaliação de Programas e Projetos de Saúde , Suínos
17.
Plast Reconstr Surg ; 145(6): 1455-1463, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32195858

RESUMO

BACKGROUND: Surgical videos are increasingly common, although their role in residency curricula remains unclear. The aim of this study was to evaluate the impact of an educational surgical video on resident performance of an open carpal tunnel release through an Objective Structured Assessment of Technical Skills and serial questionnaires. METHODS: Twenty-two residents representing six postgraduate years were randomized to receive text-based materials with or without a surgical video before performing a carpal tunnel release on human cadavers. Procedures were video recorded, anonymized, and independently evaluated by three hand surgeons using the Objective Structured Assessment of Technical Skills global rating scale, a procedure-specific technical rating scale, a record of operative errors, and pass/fail designation. Residents completed questionnaires before and after the procedure to track confidence in their technical skills. RESULTS: Residents in their first and second postgraduate years (n = 10) who watched the surgical video committed fewer operative errors (median, 4 versus 1.3; p = 0.043) and were more confident in their abilities following the procedure (median, 75 versus 32; p = 0.043) than those receiving text resources alone. There were no significant differences in Objective Structured Assessment of Technical Skills performance or questionnaire responses among more senior residents (n = 12). The technical rating scale was internally consistent (Cronbach α = 0.95; 95 percent CI, 0.91 to 0.98), reliable (intraclass correlation coefficient, 0.73; 95 percent CI, 0.40 to 0.88), and correlated with surgical experience (Spearman ρ = 0.57; p = 0.006). CONCLUSION: Watching an educational surgical video to prepare for a cadaveric procedure significantly reduced operative errors and improved confidence among junior trainees performing a carpal tunnel release.


Assuntos
Síndrome do Túnel Carpal/cirurgia , Competência Clínica/estatística & dados numéricos , Internato e Residência/métodos , Cirurgiões/educação , Gravação em Vídeo , Adulto , Recursos Audiovisuais , Cadáver , Currículo , Avaliação Educacional/estatística & dados numéricos , Feminino , Humanos , Internato e Residência/estatística & dados numéricos , Masculino , Projetos Piloto , Estudos Prospectivos , Reprodutibilidade dos Testes , Treinamento por Simulação/métodos , Cirurgiões/estatística & dados numéricos
18.
J Prof Nurs ; 36(2): 77-82, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32204865

RESUMO

This paper highlights questions about Canadian nurse regulators' adoption of the U.S.-based NCLEX-RN examination, effective 2015, as the only route to initial registered nurse licensure in all jurisdictions, excluding Quebec. The decision for this change was made by the Canadian Council of Registered Nurses Regulators (CCRNR), an umbrella association of CEO's of provincial regulatory bodies in collaboration with the National Council of State Boards of Nursing (NCSBN). Adoption and implementation of this new policy was accomplished by the Council of each provincial regulatory body. This change, representing the first international adoption of NCLEX-RN, was deemed successful by CCRNR and NCSBN. However, the Canadian Association of Schools of Nursing (CASN) described the decision as unilateral and unwise, questioning the applicability of NCLEX-RN in the Canadian context, citing significant French language translation issues and unacceptable pass rates. Both authors have had extensive academic nursing experience in U.S. and Canada. Both had many conversations with Canadian colleagues who described the impact on nursing education as disastrous. Most of our American colleagues knew nothing about this change, but once informed, expressed some concerns similar to those of their Canadian counterparts. We suggest that international adoption of a US-based examination for initial licensure merits wider discussion by nursing faculty here and abroad.


Assuntos
Avaliação Educacional/estatística & dados numéricos , Docentes de Enfermagem/psicologia , Licenciamento em Enfermagem/normas , Enfermeiras e Enfermeiros/normas , Canadá , Comunicação , Bacharelado em Enfermagem , Avaliação Educacional/normas , Humanos , Estados Unidos
19.
Nurse Educ Today ; 87: 104346, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32058882

RESUMO

Nursing clinical placements provide a unique opportunity for students to develop and hone the skills and knowledge that will be used upon graduation in their future professional practice. There is an on-going inquiry into elements that may facilitate better leaning outcomes in a variety of teaching and learning settings, including clinical experiences. Using a Self-Determination Theory approach, this study examined whether undergraduate nursing students would benefit from immersion in an autonomy-supportive clinical setting. Using a two-group pre and post-test design, students were classified into either an autonomy-supportive or comparison clinical placement cohort and measured on their learning using the Mental Health Clinical Placement Survey. Results of a repeated measures multivariate analysis of variance indicated a significant difference on some of the measures of learning housed within the Mental Health Clinical Placement Survey with students in the autonomy-supportive group reporting higher scores at the post-test time point. Findings support the value that teaching and learning in an autonomy-supportive setting has, on the skills and educational development of students.


Assuntos
Estágio Clínico , Avaliação Educacional/estatística & dados numéricos , Serviços de Saúde Mental , Autonomia Pessoal , Autonomia Profissional , Estudantes de Enfermagem/psicologia , Competência Clínica/normas , Estudos de Coortes , Bacharelado em Enfermagem , Humanos , Teoria Psicológica
20.
Nurse Educ Today ; 87: 104356, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32058884

RESUMO

BACKGROUND: Cultural diversity is significant in aged care facilities. Registered nurses play a leading role in the care setting. Nurse-led education interventions to improve the cultural competence of aged care workers are in high demand. AIM: The aims of the study were to evaluate the effect of a nurse-led cross-cultural care program on cultural competence of Australian and overseas-born care workers. DESIGN: A pre- and post-evaluation design and a sub-group analysis. SETTINGS AND PARTICIPANTS: This study was undertaken in four large-sized aged care facilities in Australia. Direct care workers were invited to participate in the study. METHODS: The intervention lasted 12 months. Data were collected at baseline, 6 months and 12 months using the Clinical Cultural Competency Questionnaire and site champion reports. One-way ANOVA was applied to determine the changes of outcomes over time for the whole group. A mixed effect linear regression model was applied in the sub-group analyses to compare the differences of outcomes between the Australian-born and overseas-born groups. RESULTS: One hundred and thirteen staff participated in the study including Australian-born (n = 62) and overseas-born (n = 51). Registered nurses were trained as site champions to lead the program. The results showed a statistically significant increase in participants' scores in Knowledge (p = .000), Skills (p = .000), Comfort Level (p = .000), Importance of awareness (p = .01) and Self-Awareness (p = .000) in a 12-month follow-up. The increased scores in the Skills (p = .02) and Comfort Level (p = .001) were higher in the Australian-born group compared to the overseas-born group. The results also showed a statistically significant increase in participants' overall satisfaction scores with the program at 12 months (p = .009). The overseas-born group demonstrated a higher score in Desire to Learn More (p = .016) and Impact of the Program on Practice (p = .014) compared to the Australian-born group. CONCLUSION: A nurse-led cross-cultural care program can improve aged care workers' cultural competence.


Assuntos
Competência Cultural/educação , Assistência à Saúde Culturalmente Competente , Pessoal de Saúde/educação , Papel do Profissional de Enfermagem , Enfermeiras Internacionais/estatística & dados numéricos , Adulto , Idoso , Austrália , Competência Clínica/normas , Avaliação Educacional/estatística & dados numéricos , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Inquéritos e Questionários
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