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1.
Med Educ Online ; 29(1): 2295049, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38320114

RESUMO

Patient interviewing pedagogy in medical education has not evolved to comprehensively capture the biopsychosocial model of healthcare delivery. While gathering a patient's social history targets important aspects of social context it does not adequately capture and account for the real-time reassessment required to understand evolving factors that influence exposure to drivers of health inequities, social determinants of health, and access to supports that promote health. The authors offer a patient interviewing approach called the Contextual Interview (CI) that specifically targets dynamic and ever-changing social context information. To substantiate the use of the CI in medical education, the authors conducted a qualitative review of the Accreditation Council for Graduate Medical Education Milestones for primary care specialties (Family Medicine, Internal Medicine, and Pediatrics). Milestones were coded to the extent to which they reflected the learner's need to acknowledge, assess, synthesize and/or apply patient contextual data in real-time patient encounters. Approximately 1 in 5 milestones met the context-related and patient-facing criteria. This milestone review further highlights the need for more intentional training in eliciting meaningful social context data during patient interviewing. The CI as a cross-cutting, practical, time-conscious, and semi-structured patient interviewing approach that deliberately elicits information to improve the clinician's sense and understanding of a patient's social context. The authors reviewed future directions in researching adapted versions of the CI for undergraduate and graduate medical education.


Assuntos
Promoção da Saúde , Internato e Residência , Humanos , Criança , Educação de Pós-Graduação em Medicina , Medicina Interna/educação , Meio Social , Atenção à Saúde , Competência Clínica
2.
BMC Med Educ ; 24(1): 116, 2024 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-38321407

RESUMO

BACKGROUND: Dermatology teaching is fundamental for the promotion of young colleagues in our specialty. However, traditional teaching methods are being scrutinized by students of the 'Generation Y and Z', which can pose new challenges for teaching institutions. We therefore aimed to assess the motivational impact and reception of a newly created four-week curriculum containing modernized teaching methods integrated into clinical routine. METHODS: In this single-center study, 67 medical students completed this curriculum composed of weekly learning objectives including knowledge of morphological terms, 10 common dermatoses, communication and presentation skills. The participants provided information on their level of interest in dermatology each week as well as positive and negative aspects of the curriculum. RESULTS: During the curriculum a significant median increase in interest in dermatology was reported with no differences between the genders. Low initial interest could be improved, high initial interest maintained. Participants with an interest in scientific work (20.9%) were more motivated during the curriculum. The variety, quality of teaching and structure were the main aspects rated positively. Suggestions for improvement included the need for more teaching by senior doctors, transfer of responsibility, and a working environment updated to the latest technology standards. CONCLUSION: The presented curriculum was well received by the participants and allowed to better define learning preferences of new generations which can be helpful to modernize traditional teaching methods. Interest in scientific work could be a factor to identify students with a particularly strong interest in dermatology.


Assuntos
Dermatologia , Educação de Graduação em Medicina , Estudantes de Medicina , Humanos , Masculino , Feminino , Dermatologia/educação , Educação de Graduação em Medicina/métodos , Currículo , Aprendizagem , Ensino
3.
Med Educ Online ; 29(1): 2312713, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38324669

RESUMO

PURPOSE: Effective communication is critical in patient care. Multilingual medical providers, including Physician Assistants (PAs) can contribute to improved health care among patients with limited English proficiency; however, this is contingent upon matriculating multilingual providers. In this study, the association between prospective applicants' self-reported English as second language (ESL) status and their likelihood of matriculation into a PA program was investigated. METHODS: Participants included applicants to five admission cycles of the Centralized Application Service for Physician Assistant from 2012 to 2020. Logistic regression was utilized to investigate association between applicant ESL status and odds of program matriculation in both bivariate and multivariable regression models. Models were adjusted for citizenship status, undergraduate grade point average, gender, age, race/ethnicity, number of programs applied to, and patient care hours. RESULTS: In unadjusted and adjusted models, ESL status was associated with a significantly lower odds of matriculation to a PA program across all study years. In adjusted multivariable models, associations were strongest for 2014-2015 where ESL status was associated with a 35% lower odds of matriculation (odds ratio 0.65, 95% confidence interval 0.56, 0.76) when controlling for demographics, citizenship status, patient care experience, and academic achievement. In sensitivity analyses restricting to (a) those with TOEFL scores ≥ 100, and (b) restricting to those ESL applicants without TOEFL scores, we did not observe important changes in our results. CONCLUSIONS: Results indicated that non-native English-speaking applicants have lower odds of PA program matriculation. Decrements in matriculation odds were large magnitude, minimally impacted by adjustment for confounders and persistent across the years. These findings suggest that PA program admission processes may disadvantage non-native English-speaking applicants. While there are potential explanations for the observed findings, they are cause for concern. Matriculating and training PAs who have language concordance with underserved populations are important means of improving patient outcomes.


Assuntos
Sucesso Acadêmico , Assistentes Médicos , Humanos , Escolaridade , Área Carente de Assistência Médica , Assistentes Médicos/educação , Estudantes
4.
BMC Med Educ ; 24(1): 124, 2024 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-38326786

RESUMO

The PRIME-NP (Professional-Reporter-Interpreter-Manager-Educator/Evaluation-Nurse Practitioner) Model is adapted from the RIME (Reporter-Interpreter-Manager-Educator) model used in medical education to guide medical student and resident education. The Delphi technique was used to validate the PRIME-NP Model. After two rounds of review by a group of experts in NP curriculum, the model was determined to be valid based on expert consensus. Agreement percent increase from the first round to the second round in all categories. Interrater reliability (IRR) was assessed using interclass correlation after instrument validation was completed for each of the five levels of the PRIME-NP model. Overall, the IRR of the instrument was found to be acceptable with some notable exceptions. No variance was noted in professional behaviors at any level. Variance was increased in management and educator/evaluator behaviors in higher/later course levels. The PRIME-NP Model and PRIME-NP OSCE Rubric is a valid and reliable instrument to assess NP student progression in objective structured clinical examinations. This instrument has the potential for adaptation for use in other types of health sciences education and settings.


Assuntos
Profissionais de Enfermagem , Estudantes de Medicina , Humanos , Competência Clínica , Reprodutibilidade dos Testes , Currículo , Profissionais de Enfermagem/educação
5.
Psychother Psychosom Med Psychol ; 74(2): 78-84, 2024 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-38316436

RESUMO

OBJECTIVE: The current study follows the question if psychotherapists with lived experiences of crisis and treatment address these experiences during their processes of self-experience. Further, the conceptual differentiation between self-experience and psychotherapy of this group of staff is explored. METHODS: 108 professionals with psychotherapeutic qualification were surveyed on their training self-experience. Relationships between processing of crisis experiences, crises frequency, and experienced benefit were analyzed using correlation analyses. Conceptual differences between self-experience and psychotherapy were gauged via nine content categories whose importance for self-experience and psychotherapy were rated by the participants. The means of these ratings were compared via t-test. RESULTS: Most participants reported that they had used their self-experience to process lived crisis experiences, and that they benefited from their self-experience, with processing and benefit being correlated significantly and positively. Conceptual differentiation of the two formats appeared to be complex. Participants ascribed biographical and personal categories rather to psychotherapy, and professional categories to self-experience. DISCUSSION: Given the prevalence of stigmatization towards individuals with mental health problems, it was surprising that most of the participants were able to address and process their lived experiences during their self-experience. It was surprising too that personal factors were ascribed to psychotherapy rather than self-experience, as the major importance of the therapeutic relationship and, by extension, personality development is well-known. CONCLUSION: Training self-experience should be a stigma-free setting, where future therapists are able to address their biographical burdens freely and thereby develop their personalities.


Assuntos
Hospitais Psiquiátricos , Psicoterapia , Humanos , Berlim , Psicoterapia/educação , Psicoterapeutas , Personalidade
6.
Emergencias ; 36(1): 41-47, 2024 Jan.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-38318741

RESUMO

OBJECTIVES: Educational programs based on high-fidelity simulation training aim to promote students' acquisition of nontechnical competencies such as understanding crisis resource management (CRM). This study evaluated the efficacy of a CRM course for students in their last year of university studies in health sciences. The course was developed by the Spanish Society of Emergency Medicine (SEMES). MATERIAL AND METHODS: Quasi-experimental study of a high-fidelity simulation course to teach emergency CRM (E-CRM) using preand postcourse measures of achievement in a single student cohort. A total of 209 students completed 2 selfadministered self-efficacy evaluations of their acquisition of nontechnical competencies and resilience. External observers also assessed the students' nontechnical competencies with objective measurement scales. RESULTS: Scores on resilience and self-efficacy assessments improved through the intervention (F = 25.90 and F = 68.02, respectively; P .001, for both pre-post comparisons). Statistically significant differences were found between students in different health sciences at baseline (t = 2.67; P = .008). Scores improved significantly on the Mayo High Performance Teamwork Scale (F = 6.18, P .001, eta2 = 0.20) and the Ottawa CRM Global Rating Scale (F = 5.58; P .005, eta2 = 0.19). CONCLUSION: The E-CRM course developed by a coordinated multiprofessional team based on high-fidelity simulations improved self-efficacy assessments of resilience and all nontechnical competencies.


OBJETIVO: Los programas educativos dirigidos a la adquisición de competencias no técnicas, tales como el Crisis Resource Management (CRM), basado en simulación de alta fidelidad, implican un aumento de las competencias del alumno en el manejo de situaciones de crisis. El objetivo del presente trabajo es evaluar la eficacia del programa Emergency CRM (E-CRM) de la Sociedad Española de Medicina de Urgencias y Emergencias, dirigido a estudiantes de último año de los grados de ciencias de la salud. METODO: Se llevó a cabo un estudio cuasiexperimental con medidas pre y posintervención, que consistió en un programa de E-CRM con simulación de alta fidelidad, en un único grupo. Participaron un total de 209 estudiantes que completaron dos instrumentos autoadministrados sobre la autoeficacia hacia las competencias no técnicas y la resiliencia. Además, a través de observadores externos se evaluó sus competencias no técnicas con instrumentos de evaluación objetivos. RESULTADOS: El alumnado mejoró las puntuaciones de resiliencia (F = 25,90; p < 0,001) y autoeficacia (F = 68,02; p 0,001) tras la intervención, con diferencias estadísticamente significativas para la resiliencia en la línea basal en función del grupo de estudios (t = 2,67; p = 0,008). Por otro lado, se encontraron mejoras de las puntuaciones obtenidas tanto para el instrumento Mayo High Performance Teamwork Scale (F = 6,18; p 0,001; eta2 = 0,20) como para el Ottawa Global Rating Scale Crisis Resource Management (F = 5,58; p 0,005; eta2 = 0,19). CONCLUSIONES: El programa de E-CRM, basado en simulación de alta fidelidad, con un equipo interprofesional coordinado, mejora la autoeficacia en todas las competencias no técnicas medidas y aumenta la resiliencia.


Assuntos
Medicina de Emergência , Humanos , Medicina de Emergência/educação , Estudantes
7.
J Matern Fetal Neonatal Med ; 37(1): 2311072, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38326280

RESUMO

OBJECTIVE: While there is increasing information regarding the occupational risks to pregnant physicians, there is inconsistent and limited subspecialty data. Physicians may be at increased risk for pregnancy complications due to occupational exposure, long work hours, nightshifts, and physical/mental demands. Additionally, little is known regarding the education physicians receive pertaining to pregnancy risks respective to their specialties as well as departmental/institutional support for pregnancy loss or complication. Therefore, a survey was developed and distributed across multiple academic sites to ascertain if there is an inherent occupation-associated risk of pregnancy complication(s) and/or pregnancy loss for anesthesiologists (ANES) when compared to obstetrician/gynecologists (OB/GYN). METHODS: A specialty-specific survey was distributed electronically to attending ANES and OB/GYN, via departmental listservs at six participating academic medical centers. Responses were collected from March to October 2022 and included demographic information, practice characteristics, education about pregnancy risks and details of pregnancy complications and loss. The primary comparison between specialty groups was the occurrence of at least one pregnancy complication and/or loss. Logistic regression was used to evaluate specialty outcome associations. Additionally, complication rates and types between specialties were compared using univariate and multivariable models. RESULTS: The survey was distributed to 556 anesthesiology and 662 obstetrics-gynecology faculty members with 224 ANES and 168 OB/GYN respondents, yielding an overall 32.2% response rate. Of the survey respondents, 103 ANES and 116 OB/GYN reported at least one pregnancy. Demographics were similar between the two cohorts. ANES had higher gravidity and parity relative to OB/GYN and tended to be earlier in their career at first pregnancy (p = .008, <.001, and .043, respectively). The rate of any pregnancy complication, including loss, was similar between specialties (65.1% (67/103) vs. 65.5% (76/116), p = .942). Of the respondents reporting at least one pregnancy, 56.7% of ANES and 53.9% of OB/GYN experienced a complication while at work. Obstetrician-gynecologists had higher use of reproductive assistance (28% (47/116) vs. 11% (20/103), p < .001). There were no notable differences between cohorts for complications, prematurity, and neonatal intensive care admission. Forty-one percent (161/392) of total respondents recalled learning about occupational risks to pregnancy, and ANES were more likely than OB/GYN to have recalled learning about these risks (121/224 (54%) and 40/168 (23.8%), respectively, p < .001). CONCLUSIONS: ANES and OB/GYN had similar risks for pregnancy complications and loss. Anesthesiologists were more likely to recall receiving education regarding occupational risk to pregnancy, though fewer than half of all survey respondents recalled learning about these risks. Our survey results are similar to the previously identified higher rate of pregnancy complications and loss in female physicians while uncovering areas of potential knowledge gaps for which institutions and practices could strive to improve upon. More research is needed to examine the relationship between occupation and pregnancy risk pertaining to female physicians with the goal being to identify modifiable risk factors.


Assuntos
Aborto Espontâneo , Ginecologia , Obstetrícia , Complicações na Gravidez , Humanos , Gravidez , Recém-Nascido , Feminino , Ginecologia/educação , Anestesiologistas , Ginecologista , Obstetra , Complicações na Gravidez/epidemiologia , Inquéritos e Questionários
8.
JCI Insight ; 9(3)2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38329127

RESUMO

The 2014 NIH Physician-Scientist Workforce Working Group predicted a future shortage of physician-scientists. Subsequent studies have highlighted disparities in MD-PhD admissions based on race, income, and education. Our analysis of data from the Association of American Medical Colleges covering 2014-2021 (15,156 applicants and 6,840 acceptees) revealed that acceptance into US MD-PhD programs correlates with research experience, family income, and research publications. The number of research experiences associated with parental education and family income. Applicants were more likely to be accepted with a family income greater than $50,000 or with one or more publications or presentations. Applicants were less likely to be accepted if they had parents without a graduate degree, were Black/African American, were first-generation college students, or were reapplicants, irrespective of the number of research experiences, publications, or presentations. These findings underscore an admissions bias that favors candidates from affluent and highly educated families, while disadvantaging underrepresented minorities.


Assuntos
Pesquisa Biomédica , Educação Médica , Médicos , Humanos , Fatores Sociodemográficos , Pesquisa Biomédica/educação , Recursos Humanos
9.
Afr J Prim Health Care Fam Med ; 16(1): e1-e3, 2024 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-38299547

RESUMO

Quality vocational training is important to ensure that family physicians can strengthen the district health system. Competent clinical trainers and supervisors, with the necessary educational knowledge and skills, are required for this job. In 2014, a formal Train the Clinical Trainer (TCT) course was introduced in South Africa as a collaborative effort between the Royal College of General Practitioners (RCGP) and the South African Academy of Family Physicians (SAAFPs). To make the training relevant, the course was aligned with the National Unit Standards for Family Medicine, as these defined the learning outcomes for registrars. The aim of the TCT course was to equip workplace-based clinical trainers with an essential set of educational skills, which could be further developed through mentoring and support. Accredited trainers present the face-to-face course yearly to two family physicians from each of the nine departments of family medicine in South Africa. The TCT course is built around the educational principles of learner-centredness and andragogy. During these 5 days of training the roles and responsibilities of trainers and learners, the learning environment, alignment with the curriculum, assessment for and of learning, and leadership are covered. Recently online assessment, the e-portfolio and the use of entrustable professional activities were added to the course content. In the future we would like to accredit more clinical trainers through a process of workplace-based self-evaluation and 360-degree feedback from peers and students. Lastly, we want to expand the training course in the African region.Contribution: The Train the Clinical Trainer (TCT) course, established in 2014 through RCGP and SAAFP collaboration in South Africa, ensures family physicians have essential educational skills. Aligned with national standards, the course embraces learner-centered principles. Ongoing enhancements include online assessments and future plans involve accrediting more trainers through self-evaluation and expanding across the African region.


Assuntos
Medicina de Família e Comunidade , Clínicos Gerais , Humanos , Medicina de Família e Comunidade/educação , Médicos de Família/educação , Aprendizagem , Currículo , Competência Clínica
10.
J Drugs Dermatol ; 23(2): 85-89, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38306146

RESUMO

Sensitive skin (SS) is a common patient complaint presenting to the dermatology office, but there exists a lack of consensus on defining criteria and evidence-based management approaches. Furthermore, incorporation of SS training into the dermatology residency curriculum is unknown, and therefore the authors herein sought to determine dermatology resident physicians' exposure to education about SS, perspectives on SS, and management approaches. Ninety-nine percent of residents believe that SS should be included in some capacity in their dermatology residency training. However, less than half of responding residents received education specifically about SS during their training and less than one-fourth of residents reported feeling very knowledgeable about SS diagnosis, clinical evaluation, or management. Residents who had received specific education about SS were significantly more likely to self-describe as "very knowledgeable" about all queried topics. Residents reported challenges with all aspects of SS patient care, and cited heterogenous approaches to SS patients. These data highlight a gap in residency education, as indicated by limited consensus over diagnostic and management approaches to SS.J Drugs Dermatol. 2024;23(2):85-89.   doi:10.36849/JDD.7830.


Assuntos
Dermatologia , Internato e Residência , Dermatopatias , Humanos , Dermatologia/educação , Inquéritos e Questionários , Currículo
11.
CBE Life Sci Educ ; 23(1): ar11, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38306615

RESUMO

Many students who enroll in a public U.S. 4-y college will not graduate. The odds of completing a college degree are even lower for students who have been marginalized in higher education, especially in Science, Technology, Engineering, and Math (STEM) fields. Can undergraduate research increase a student's likelihood of graduating college and close educational equity gaps in college completion? To answer this question, we use data from six public U.S. universities (N = 120,308 students) and use Propensity Score Matching to generate a comparison group for analyses. We conducted logistic regressions on graduation rates and equity gaps in 4 and 6 y using the matched comparison group and undergraduate researchers in STEM (n = 2727). When being compared with like-peers and controlling for background characteristics and prior academic performance, students who participated in undergraduate research were twice as likely to graduate in 4 y and over 10 times as likely to graduate in 6 y. We also found that equity gaps in 4-y graduation rates for students of color, low-income, and first-generation students were cut in half for undergraduate researchers. At 6 y, these gaps were completely closed for undergraduate researchers. As we seek ways to close education gaps and increase graduation rates, undergraduate research can be a meaningful practice to improve student success.


Assuntos
Engenharia , Estudantes , Humanos , Engenharia/educação , Tecnologia/educação , Avaliação Educacional , Matemática
12.
CBE Life Sci Educ ; 23(1): ar10, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38306614

RESUMO

A "critical access point in the STEM pipeline for Latinx students and other students of color" (Herrera et al., 2018), community colleges provide a seminal breeding ground for academic pursuits (Bahr et al., 2017). However, how personal networks influence STEM pathways of two-year college students remains largely unexplored. This mixed methods case study explores influence of personal networks on pursuing STEM fields via social network analysis and qualitative narratives. 36 women of color STEM majors at a two-year urban Hispanic-Serving Institution were interviewed via social network questionnaire. Participants nominated anyone who has influenced their STEM trajectory, which signifies influence to their reason for pursuing a STEM path; they also had an option to qualitatively elaborate on any nomination but this was not required. Nominations were counted towards degree centrality and categorized into social relationships. Participants nominated diverse relationship influences, with family as the most influential relationship group, followed by college faculty/staff. Qualitative narratives revealed that family influenced participants, regardless of relatives' educational attainment level at the high school or lower level. In alignment with community cultural wealth, family members provided the impetus for pursuing STEM pathways through influence on participants' (1) aspirational capital, (2) familial capital, and (3) resistant capital.


Assuntos
Família , Ciência , Estudantes , Feminino , Humanos , Hispânico ou Latino , Relações Interpessoais , Ciência/educação
13.
Hum Resour Health ; 22(1): 13, 2024 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-38308369

RESUMO

BACKGROUND: Regulation can improve professional practice and patient care, but is often weakly implemented and enforced in health systems in low- and middle-income countries (LMICs). Taking a de-centred and frontline perspective, we examine national regulatory actors' and health professionals' views and experiences of health professional regulation in Kenya and Uganda and discuss how it might be improved in LMICs more generally. METHODS: We conducted large-scale research on professional regulation for doctors and nurses (including midwives) in Uganda and Kenya during 2019-2021. We interviewed 29 national regulatory stakeholders and 47 subnational regulatory actors, doctors, and nurses. We then ran a national survey of Kenyan and Ugandan doctors and nurses, which received 3466 responses. We thematically analysed qualitative data, conducted an exploratory factor analysis of survey data, and validated findings in four focus group discussions. RESULTS: Kenyan and Ugandan regulators were generally perceived as resource-constrained, remote, and out of touch with health professionals. This resulted in weak regulation that did little to prevent malpractice and inadequate professional education and training. However, interviewees were positive about online licencing and regulation where they had relationships with accessible regulators. Building on these positive findings, we propose an ambidextrous approach to improving regulation in LMIC health systems, which we term deconcentrating regulation. This involves developing online licencing and streamlining regulatory administration to make efficiency savings, freeing regulatory resources. These resources should then be used to develop connected subnational regulatory offices, enhance relations between regulators and health professionals, and address problems at local level. CONCLUSION: Professional regulation for doctors and nurses in Kenya and Uganda is generally perceived as weak. Yet these professionals are more positive about online licencing and regulation where they have relationships with regulators. Building on these positive findings, we propose deconcentrating regulation as a solution to regulatory problems in LMICs. However, we note resource, cultural and political barriers to its effective implementation.


Assuntos
Médicos , Humanos , Quênia , Uganda , Pessoal de Saúde/educação , Grupos Focais
14.
Afr J Reprod Health ; 28(1): 39-52, 2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38308524

RESUMO

The main objective of this study was to adopt a simulation-based advanced cardiac life support training program to assess nursing students' level of knowledge and practice regarding paediatric advanced cardiac life support and to identify the major knowledge and practice gaps. The methods used in this study were pre-experimental, one group pre and post-test investigation. This study was conducted between September 2022 and November 2022, at the University College of Farasan in the Kingdom of Saudi Arabia. Quantitative data were obtained using the "Cardio Pulmonary Resuscitation Knowledge Questionnaire", "Students' Satisfaction and Self-Confidence Scale," and the "CPR Skill Checklist," which were applied to 75 participants in focus groups. Before the simulation-based CPR training, the students' mean pre-test Paediatric CPR knowledge score was 6.5±2.3 out of 42.0. After the simulation, the mean post-test CPR knowledge score (38.1±2.9) considerably improved (p 0.05). The mean post-test CPR skills score (44.7±1.2) was also considerably higher than the mean pre-test CPR skills score (11.4±2.8) at (p 0.05). Additionally, after the simulation training, students' happiness and confidence levels (61.9±2.2) greatly increased. Themes from the qualitative data showed that the simulation was viewed as an engaging and effective teaching tool by the students. Two themes emerged from the study: "Worries before simulation" and "Satisfaction after simulation". Simulation-based paediatric cardio Pulmonary resuscitation training program has raised nursing students' level of expertise in knowledge, performance, and self-efficacy. Additionally, strong satisfaction and self-confidence levels were discovered following the simulation training.


L'objectif principal de cette étude était d'adopter un programme de formation avancé en réanimation cardiaque basé sur la simulation pour évaluer le niveau de connaissances et de pratique des étudiants en soins infirmiers en matière de réanimation cardiaque avancée en pédiatrie et pour identifier les principales lacunes en matière de connaissances et de pratique. Les méthodes utilisées dans cette étude étaient des enquêtes pré-expérimentales, pré- et post-test sur un groupe. Cette étude a été menée entre septembre 2022 et novembre 2022, au Collège universitaire de Farasan, au Royaume d'Arabie saoudite. Des données quantitatives ont été obtenues à l'aide du « Questionnaire de connaissances sur la réanimation cardio-pulmonaire ¼, de l'« Échelle de satisfaction et de confiance en soi des étudiants ¼ et de la « Liste de contrôle des compétences en RCR ¼, qui ont été appliquées à 75 participants dans des groupes de discussion. Avant la formation en RCR basée sur la simulation, le score moyen des étudiants en matière de connaissances en RCR pédiatrique avant le test était de 6,5 ± 2,3 sur 42,0. Après la simulation, le score moyen de connaissances en RCR post-test (38,1 ± 2,9) s'est considérablement amélioré (p = 0,05). Le score moyen des compétences en RCR après le test (44,7 ± 1,2) était également considérablement plus élevé que le score moyen des compétences en RCR avant le test (11,4 ± 2,8) à (p 0,05). De plus, après la formation par simulation, les niveaux de bonheur et de confiance des étudiants (61,9 ± 2,2) ont considérablement augmenté. Les thèmes issus des données qualitatives ont montré que la simulation était considérée comme un outil pédagogique engageant et efficace par les étudiants. Deux thématiques sont ressorties de l'étude : « Les soucis avant la simulation ¼ et « La satisfaction après la simulation ¼. Le programme de formation en réanimation cardio-pulmonaire pédiatrique basé sur la simulation a élevé le niveau d'expertise des étudiants en soins infirmiers en termes de connaissances, de performance et d'auto-efficacité. De plus, de forts niveaux de satisfaction et de confiance en soi ont été découverts à la suite de la formation par simulation.


Assuntos
Reanimação Cardiopulmonar , Estudantes de Enfermagem , Humanos , Criança , Arábia Saudita , Reanimação Cardiopulmonar/educação , Avaliação Educacional , Inquéritos e Questionários , Competência Clínica
15.
PLoS One ; 19(2): e0298067, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38349912

RESUMO

We implemented flipped learning for a gross anatomy dissection course and compared its effects on students' motivation and academic achievement with those of traditional dissection methods. We invited 142 first-year medical students at Chonnam National University Medical School to participate in this study. All participants engaged in traditional dissection methods in the first part of the study and flipped learning in the latter part. Medical students' motivation to learn anatomy by cadaveric dissection was measured using the ARCS (Attention, Relevance, Confidence, and Satisfaction) model. Thereafter, all students completed a written examination consisting of 96 multiple-choice questions. The students' mean motivational score regarding attention was significantly higher in association with flipped learning than with traditional learning. However, the students' mean motivational scores regarding relevance, confidence, and satisfaction were not significantly different between the methods. Additionally, the mean anatomy practice test score was significantly higher in association with flipped learning than with traditional learning. The students' motivational scores and anatomy practice test scores associated with flipped learning positively correlated with the extent of learning material completion. The students' responses indicated that flipped learning helped enhance the learning process, improve time management, reduce confusion during practice, and promote independent practice. The application of flipped learning to a cadaveric dissection course increased individual learning motivation, which improved learning activities both in and out of class, as well as academic achievement.


Assuntos
Anatomia , Estudantes de Medicina , Humanos , Avaliação Educacional , Aprendizagem , Dissecação , Currículo , Cadáver , Aprendizagem Baseada em Problemas/métodos , Anatomia/educação
16.
MedEdPORTAL ; 20: 11384, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38352651

RESUMO

Introduction: Ketamine and propofol are commonly used agents for sedation in the pediatric emergency department (PED). While these medications routinely provide safe sedations, there are side effects providers should be able to recognize and manage. Currently, no pediatric sedation simulations exist in the literature. Methods: We created two sedation simulation cases for learners, including pediatric emergency medicine (PEM) fellows, working in the PED: case 1, a 12-year-old male with a shoulder dislocation requiring reduction under propofol sedation, and case 2, a forearm fracture requiring reduction under ketamine sedation. Learner actions included setting up equipment for sedations, dosing medications correctly, and managing complications. Additionally, in case 2, learners assigned an American Society of Anesthesiologists classification and selected the appropriate candidate for PED sedation from amongst three patients. A debrief followed the cases. Next, a didactic presentation reinforced concepts discussed in the debrief. Participants then completed an evaluation of the simulation. Results: Fifty-eight emergency medicine residents and PEM fellows across four sites at three institutions participated. Participants scored the simulations and the debriefing session on a 5-point Likert scale. Learners rated the scenario as clinically relevant (M = 4.37) and effective at improving their comfort level in caring for critically ill patients (M = 4.36). Learners felt the debrief provided valuable learning (M = 4.40) and was a safe learning environment (M = 4.50). Discussion: These cases can be utilized as resources for learners in any emergency department and can be tailored to any training background of learner providing sedation.


Assuntos
Medicina de Emergência , Ketamina , Medicina de Emergência Pediátrica , Propofol , Treinamento por Simulação , Masculino , Humanos , Criança , Medicina de Emergência Pediátrica/educação , Propofol/efeitos adversos , Medicina de Emergência/educação
17.
J Coll Physicians Surg Pak ; 34(2): 217-221, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38342875

RESUMO

OBJECTIVE: To determine the optimum working hours per week for CPSP trainees of Fellowship Programmes in the disciplines of General Surgery and General Medicine. STUDY DESIGN: Mixed-methods, explanatory study. Place and Duration of the Study: Department of General Medicine and Department of General Surgery, Abbasi Shaheed Hospital, Karachi, from February to August 2023. METHODOLOGY: The total number of subjects included were 33 residents, 7 supervisors (4 from General Medicine and 3 from Geneneral Surgery), and 3 hospital managers (from private sector), constituting a representative sample. Postgraduate trainees (PGTs) of third-and fourth-year FCPS training programme who showed willingness to participate were included as were all supervisors and hospital managers involved in the training programme. FCPS residents, who were not willing, on leave, and on rotation to other departments were excluded, as were PGTs enrolled in university and other programmes. For quantitative analysis, survey forms were distributed to the selected participants. For qualitative analysis, one-to-one interviews were conducted in-person and through video-link. Data collection procedure included distribution by hand and via email. SPSS was used for the data analysis. RESULTS: All residents recorded that duty stress, fatigue, and burnout resulted in poor quality of family and social life. All the stakeholders were convinced that acquisition of skills, learning outcomes, and patient safety with optimum care is compromised. The duration of emergency calls varied from 30 to 36 hours. There were 19 out of 33 residents (57.5%) who recommended 24 hours of rest after each emergency call. All the supervisors recommended six to eight daily duty hours and 66 to 90 weekly working hours. Four out of seven supervisors (57.1%) suggested emergency duty of 30 hours with post-call rest of 24 hours at every 3rd  day. CONCLUSION: There is a need for a comprehensive approach that caters to the patient care as well as learning outcomes and residents' well-being when devising the duty schedules. KEY WORDS: Training hours, Fellowship programme, Fatigue, Learning outcomes.


Assuntos
Cirurgia Geral , Internato e Residência , Cirurgiões , Humanos , Paquistão , Bolsas de Estudo , Universidades , Cirurgia Geral/educação
18.
J Dent Hyg ; 98(1): 58-67, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38346899

RESUMO

Purpose It has been suggested that compassion may decrease as students progress through their health care education and into clinical practice. The purpose of this pilot study was to determine whether an immersive curriculum thread of tobacco use disorder (TUD) cessation methodology, including behavioral techniques and communication skills, was associated with any change in dental hygiene and dental students perceived levels of compassion.Methods Dental hygiene (DH) and dental (DS) students (n=300) who had experienced an immersive TUD curriculum from West Virginia University were invited to complete the Sussex-Oxford Compassion Scale-Toward Others (SOC-O) online survey during the academic years 2022-2023. Possible scores on the SOC-O ranged from 20 (no or low compassion) to 100 (high compassion). The SOC-O scores for students who did not have clinical experience and limited TUD content (first- and second-year DH and DS students) were compared with SOC-O scores of students who had clinically applied the immersive tobacco cessation curriculum thread (third and fourth year DH and DS students) using t-tests.Results A total of seventy DH and DS students completed the SOC-O survey for a response rate of 23.3%. The overall mean SOC-O score was 83.0 for participants who lacked clinical experience (DH1, DH2, DS1, DS2) and 85.8 for participants with clinical experience using the TUD content (DH3, DH4, DS3, DS4) (p >0.05). For the SOC-O subscale analysis, both groups were similar in the recognition of suffering, universality of suffering, empathy/compassion for a person suffering, tolerance of uncomfortable feelings, and action/motivation to act to alleviate suffering.Conclusion A high level of perceived compassion among dental hygiene and dental students was associated with an immersive behavioral sciences curriculum thread for the assessment/treatment of TUD. Perceived levels of compassion were maintained for participants with and without clinical experience. Additional focus on compassion philosophy research within educational methodology is needed to maintain and improve compassion outcomes in the health care professions.


Assuntos
Empatia , Faculdades de Odontologia , Humanos , Projetos Piloto , Currículo , Estudantes de Odontologia , Higienistas Dentários/educação
19.
J Surg Educ ; 81(3): 339-343, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38302298

RESUMO

OBJECTIVE: To determine whether participation in certain hobbies (e.g., participation in sports, playing musical instruments, or other hobbies requiring fine motor skills), preresidency, are associated with higher technical skills ratings at the time of residency graduation. DESIGN: Faculty members from 14 general surgery residency programs scored individual graduates from 2017 to 2020 on their technical skills using a 5-point Likert scale. Hobbies for these residents were collected from their Electronic Residency Application Service (ERAS) data. A single reviewer classified each ERAS hobby into predefined categories including musical instruments, sports requiring hand-eye coordination, team sports, and activities necessitating hand-eye coordination. Spearman correlation coefficients were calculated for the relationship between each category of hobby-as well as the total number of hobbies in each category-and the outcome of surgical faculty ratings of residents' technical surgical skills during their last year of residency. A proportional odds model including the above predictive variables was also fit to the data. SETTING: Fourteen general surgery residency programs. PARTICIPANTS: General surgery residency graduates from 14 different programs from 2017 to 2020. RESULTS: There were 296 residents across 14 institutions. The average ranking of residents' technical skills was 3.24 (SD 1.1). A total of 40% of residents played sports involving hand-eye coordination, 31% played team sports, 28% participated in nonsport hobbies that require eye-hand coordination, and 20% played musical instruments. Correlation coefficients were not statistically significant for any of the categories. In the proportional odds model, none of the variables were associated with statistically significant increased odds of a higher technical skills rating. CONCLUSIONS: There was no correlation between general surgery chief residents' technical skills as rated by faculty, and self-reported pre-residency hobbies on the ERAS application. These findings suggest such hobbies prior to residency are unlikely to predict future technical skills prowess.


Assuntos
Cirurgia Geral , Internato e Residência , Humanos , Passatempos , Cirurgia Geral/educação , Competência Clínica
20.
J Palliat Med ; 27(2): 231-235, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38301158

RESUMO

Background: Communication and interpersonal skills are essential medical components of oncology patient care. Patients and families rely on physicians for treatment, expertise, guidance, hope, meaning, and compassion throughout a life-threatening illness. A provider's inability to empathize with patients is linked to physician-related fatigue and burnout. Because oncology training programs focus on teaching evidence-based medicine and clinical acumen, little time may be dedicated to professional development and acquisition of interactive skills. Traditional communication courses typically include two components: formal, knowledge-based learning skills, which are gained from didactic lectures, and role-playing, which usually occurs in small groups. We report the implementation of a novel longitudinal communication curriculum for trainees in Oncology. Materials and Methods: At a single-center institution, an innovative communication curriculum titled "REFLECT" (Respect, Empathy, Facilitate Effective Communication, Listen, Elicit Information, Compassion, and Teach Others) was implemented for radiation oncology residents and medical oncology fellows to improve and refine physician/patient interactions. All oncology specialty residents and fellows were eligible to participate in this communication curriculum. The curriculum emphasized a reflective process to guide trainees through challenging scenarios. Results: Since October 2018, this comprehensive course consisted of quarterly (four hour) workshops comprising assigned reading, knowledge assessments, didactic lectures, expert guest lecturers, standardized patient simulations, role-playing, patient/expert panels, coaching, reflective writing, and debriefing/feedback sessions. The curriculum provided longitudinal communication training integrated with the learners' daily physician/patient encounters rather than occasional isolated experiences. Fifteen workshops have been completed. Each focused on navigating challenging situations with patients, loved ones, or colleagues. Conclusions: Future directions of the curriculum will entail improving the communication skills of oncology trainees and gathering communication improvement data to assess the program's success formally.


Assuntos
Internato e Residência , Neoplasias , Humanos , Educação de Pós-Graduação em Medicina , Oncologia/educação , Currículo , Comunicação , Relações Médico-Paciente
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