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1.
J Cutan Pathol ; 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39014546

RESUMO

CONTEXT: Merkel cell carcinoma diagnosis is often based on microscopic examination by pathologists. While histopathologic diagnosis primarily hinges on conscious and analytical cognition, the pathologist's decision-making process is also influenced by a rapid "gist" or "gestalt" approach. In this study, using cases of Merkel cell carcinoma as a model, we aim to assess how pathologists' viewing short videos containing conceptual clues and visual aids, in conjunction with reading an original article as a reference, may enhance their diagnostic performance. METHOD: Sixteen pathologists were included in the present work. After participants had read the original article, their ability to distinguish Merkel cell polyomavirus (MCPyV)+ and MCPyV- Merkel cell carcinoma cases was evaluated on a first preliminary series of 20 cases. Following this test, the participants watched the video and then evaluated a second "experimental" series of 20 independent cases. RESULTS: After reading the original article, for each case, a median number of 12 participants (75%, Q1-Q3: 10-13) classified the specimen in the correct category (92 incorrect answers in the whole series). An important interobserver variability was observed in this setting (Kappa coefficient = 0.465). By contrast, following the video, all cases were correctly classified by most of the participants, with only 12 incorrect answers on the whole series and excellent interobserver reproducibility (Kappa coefficient = 0.846). CONCLUSION: Our study demonstrated that providing a short video together with an original article may enhance pathologists' performance in diagnosing Merkel cell carcinoma.

2.
Biol Pharm Bull ; 47(3): 708-712, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38538324

RESUMO

In 2020, the coronavirus disease 2019 (COVID-19) pandemic made social distancing compulsory. In patient lectures by hepatitis B patients (Patient Lectures)-a humanity education initiative that had traditionally been delivered face-to-face to assembled students-it was necessary to divide the students into two groups, one that attended the Patient Lectures in person (face-to-face group) and another that assembled in a separate room to view the delivered lecture simultaneously and remotely via a teleconferencing platform (remote group). To investigate possible changes in students' awareness of hepatitis B patients before (pre-) and after (post-) the lecture that year, the face-to-face and remote-attendance groups were analyzed separately. The participants were 203 fourth-year students belonging to the Faculty of Pharmaceutical Sciences at Japan's Setsunan University, whose pre-clinical education curriculum prior to pharmacy practice experience included a Patient Lecture. The students were divided into two groups based on their student-ID numbers. Survey questionnaires were completed anonymously before and after the Patient Lecture. The students' awareness of hepatitis B patients' experience changed significantly after attending the Patient Lectures; this change was similar in both the face-to-face and remote-attendance groups. Regarding the possibility of hepatitis B virus infection, the remote group selected fewer answers implying strong convictions than did the face-to-face group, and both groups perceived several issues incorrectly. Although slight differences were observed between the two groups, the changes before and after the lectures were similar, indicating that humanity-education lectures are worthwhile not only when delivered in face-to-face contexts but also when delivered and viewed remotely within a class setting.


Assuntos
Hepatite B , Estudantes de Farmácia , Humanos , Currículo , Inquéritos e Questionários
3.
Artigo em Inglês | MEDLINE | ID: mdl-38842784

RESUMO

BACKGROUND: Although interprofessional student led health clinics have been implemented worldwide, the impact of this model await confirmation. OBJECTIVES: To conduct a critical analysis of the literature on interprofessional student led clinics, and the views of stakeholders on feasibility and the barriers and facilitators to implementation. DESIGN: A scoping review, evidence synthesis and quality appraisal were conducted using PRISMA Scr. Eight databases were searched from 2003 to 2023: Medline (Ovid), Embase (Ovid), CINAHL (EBSCO), Cochrane, Scopus, ERIC, Web of Science and Informit Health Collection. A qualitative descriptive approach was used to analyse data from patients, students and educators and inductive thematic analysis identified emergent themes. RESULTS: Forty-six studies were included from a yield of 3140 publications. A key theme to emerge was that patients perceived improvements in their health and wellbeing and valued gaining health information from student led clinics. Student experiences were mostly positive although some found it challenging to work in interprofessional teams and roles were not always clear. The clinics enabled students to improve communication skills and autonomy. Clinical educators reported that students benefited from experiential learning within an interprofessional context. The clinics were feasible, provided that sufficient funding, infrastructure, staff and resources were available. Barriers to implementation included lack of funding, excessive waiting times and non-aligned student timetables. Pre-clinic orientation and support from on-site clinical educators facilitated implementation. CONCLUSIONS: Despite some challenges with implementing interprofessional student led clinics, they can have a positive impact on student learning and patient experiences.

4.
BMC Health Serv Res ; 24(1): 8, 2024 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-38172818

RESUMO

BACKGROUND: Australia has one of the lowest perinatal morbidity and mortality rates in the world, however a cluster of perinatal deaths at a regional health service in the state of Victoria in 2015 led to state-wide reforms, including the introduction of the Maternity and Newborn Emergencies (MANE) program. MANE was a 2-day interprofessional maternity education program delivered by external expert facilitators to rural and regional Victorian maternity service providers. An independent evaluation found that the MANE program improved the confidence and knowledge of clinicians in managing obstetric emergencies and resulted in changes to clinical practice. While there is a large volume of evidence that supports the use of interprofessional education in improving clinicians' clinical practice, the impact of these programs on the overall safety culture of a health service has been less studied. Managers and educators have an important role in promoting the safety culture and clinical governance of the heath service. The aim of this study, therefore, was to explore Victorian rural and regional maternity managers' and educators' views and experiences of the MANE program. METHODS: Maternity managers and educators from the 17 regional and rural health services across Victoria that received the MANE program during 2018 and 2019 were invited to participate. Semi-structured interviews using mostly open-ended questions (and with a small number of fixed response questions) were undertaken. Qualitative data were transcribed verbatim and analysed thematically. Descriptive statistics were used for quantitative data. RESULTS: Twenty-one maternity managers and educators from the 17 health services participated in the interviews. Overall, participants viewed the MANE program positively. Four themes were identified: the value of external facilitation in providing obstetric emergency training; improved awareness and understanding of clinical governance; improved clinical practice; and the importance of maintaining the program. Participants agreed that MANE had improved the confidence (94%) and skills (94%) of clinicians in managing obstetric emergencies, as well as confidence to escalate concerns (94%), and most agreed that it had improved clinical practice (70%) and teamwork among attendees (82%). CONCLUSION: Maternity managers and educators were positive about MANE; they considered that it contributed to improving factors that impact the safety culture of health services, with delivery by external experts considered to be particularly important. Given the crucial role of maternity managers and educators on safety culture in health services, as well in program facilitation, these findings are important for future planning of maternity education programs across the state. TRIAL REGISTRATION: Trial registration was not required for this study.


Assuntos
Emergências , Serviços de Saúde Rural , Recém-Nascido , Humanos , Feminino , Gravidez , Vitória , Pesquisa Qualitativa , População Rural
5.
Teach Learn Med ; : 1-11, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38850212

RESUMO

Phenomenon: This study explored experiences of simulation-based clinical education in the Speech-Language Pathology and Audiology professions in South Africa, a Global South context where research on this topic is limited. In this context, the COVID-19 pandemic brought simulation to the forefront of clinical education as a training solution when in-person encounters were impossible. As these simulation-based training approaches gain traction, with continued use post-pandemic, it is important to understand how they are currently being used so that appropriate support can be offered to ensure their efficiency and success in the future. Approach: We distributed a survey to South African university departments offering Speech-Language Pathology and Audiology training, inviting participation from students across years of study and clinical educators. Data were collected between October 2022 and February 2023. Twelve responses were received: three from clinical educators and nine from students. We analyzed the responses using descriptive statistics and a domain summary approach. Findings: Simulated activities were implemented as options for clinical education in South African Speech-Language Pathology and Audiology (SLP/A) programs during the pandemic, albeit in a somewhat haphazard way depending on available resources, often with limited preparation or guidance. Some universities have continued using aspects of simulation training post-pandemic. Insights: Our findings, although preliminary, are somewhat consistent with Global North literature, particularly regarding barriers and challenges to implementing these approaches in clinical education. We offer suggestions for enhancing the support of simulation-based clinical education in our context.

6.
Int J Audiol ; : 1-7, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38701177

RESUMO

OBJECTIVE: This project sought to investigate the impact of a multi-national peer learning initiative in facilitating a student-led conference on person-centred care (PCC). The primary objective was to assess students' comprehension of PCC elements before and after engaging in the opportunity, with a concurrent evaluation of the efficacy of the opportunity. DESIGN: A mixed-methods study protocol was followed. Following the conference, participants completed a four-part survey including (a) demographics, (b) retrospective pre-post Likert scale, (c) Likert rating of conference experience and (d) five open-ended questions. STUDY SAMPLE: One hundred and four participants (92.4% female) with a mean age of 21 years (0.07 SD) participated in the study. RESULTS: A significant difference in awareness pre-post conference was demonstrated across all topics (WSR, p < 0.001) with participants satisfied with the conference. Qualitative analysis revealed three main themes: (a) application of PCC; (b) perspectives of PCC; and () barriers to PCC; with nine sub-themes. CONCLUSION: The conference was beneficial in enhancing students' awareness of topics and principles of PCC. Innovative pedagogical approaches should be considered in order to enhance healthcare education allowing future clinicians to better meet the dynamic needs of their clients.

7.
Int J Lang Commun Disord ; 59(1): 304-326, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37661291

RESUMO

BACKGROUND: People with aphasia are vulnerable recipients of healthcare. The nature of the communicative environment and the communication disability can adversely impact access to timely and quality healthcare. Student healthcare professionals are often underprepared to interact successfully with people with aphasia and may benefit from communication partner training (CPT). AIMS: To investigate the potential effectiveness and acceptability of a brief, two-part introductory Supported Conversation for Adults with Aphasia (SCA™)-based CPT package, delivered to a sample of students across a diverse range of healthcare disciplines. METHODS & PROCEDURES: A pre-post-within group experimental design was used to investigate the potential effectiveness and acceptability of an online CPT package (50 minute module + 1 hour workshop) for healthcare students. The Aphasia Attitudes, Strategies and Knowledge (AASK) survey measured participants' knowledge of aphasia, facilitative communication strategies and attitudes towards people with aphasia. Data were collected pre-training, following the training module and following the workshop, and 6 weeks post-training. Statistical analysis was conducted on the AASK data. In addition, participant feedback (ratings and open text responses) was collected after the workshop. Ratings were analysed descriptively, and thematic content analysis was used for open text responses. OUTCOMES & RESULTS: 236 participants completed the pre-training AASK and 106 completed the AASK at subsequent time points. Statistically significant gains were demonstrated from pre- to post-module completion. Between the end of the module and the end of the workshop, some gains were maintained and others showed further statistically significantly improvements. While all gains were not maintained at the 6-week follow-up, statistically significantly improvements from pre-training scores remained evident. Student feedback was predominantly positive, with suggested improvements for training content and length. CONCLUSIONS & IMPLICATIONS: The results provide preliminary evidence that a brief, online CPT package can support student healthcare professionals' knowledge and attitudes towards aphasia and communicating with people with aphasia. Online training was acceptable to students and feasible as an embedded or optional component of curriculum. Ongoing training (e.g., in the form of refresher sessions) and inclusion of a skills-based component are recommended to maximize communication skill development. WHAT THIS PAPER ADDS: What is already known on the subject Student healthcare professionals recognize the need to develop knowledge and skills to successfully support people with communication disability, such as aphasia, to participate effectively in their healthcare. Evidence in favour of online communication partner training for student healthcare professionals is currently limited. What this study adds to the existing knowledge This study demonstrates that a brief introductory online communication partner training program can be efficacious for improving knowledge and attitudes regarding communicating with people who have aphasia. What are the potential or actual clinical implications of this work? Students will likely need further ongoing refresher training with inclusion of practical components to develop and maintain the knowledge and skills required to be proficient communication partners with people with aphasia.


Assuntos
Afasia , Estudantes , Adulto , Humanos , Comunicação , Pessoal de Saúde/educação , Atenção à Saúde
8.
BMC Med Educ ; 24(1): 852, 2024 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-39112978

RESUMO

BACKGROUND: Assessment of undergraduate students using assessment instruments in the clinical setting is known to be complex. The aim of this study was therefore to examine whether two different assessment instruments, containing learning objectives (LO`s) with similar content, results in similar assessments by the clinical supervisors and to explore clinical supervisors' experiences of assessment regarding the two different assessment instruments. METHOD: A mixed-methods approach was used. Four simulated care encounter scenarios were evaluated by 50 supervisors using two different assessment instruments. 28 follow-up interviews were conducted. Descriptive statistics and logistic binary regression were used for quantitative data analysis, along with qualitative thematic analysis of interview data. RESULT: While significant differences were observed within the assessment instruments, the differences were consistent between the two instruments, indicating that the quality of the assessment instruments were considered equivalent. Supervisors noted that the relationship between the students and supervisors could introduce subjectivity in the assessments and that working in groups of supervisors could be advantageous. In terms of formative assessments, the Likert scale was considered a useful tool for evaluating learning objectives. However, supervisors had different views on grading scales and the need for clear definitions. The supervisors concluded that a complicated assessment instrument led to limited very-day usage and did not facilitate formative feedback. Furthermore, supervisors discussed how their experiences influenced the use of the assessment instruments, which resulted in different descriptions of the experience. These differences led to a discussion of the need of supervisor teams to enhance the validity of assessments. CONCLUSION: The findings showed that there were no significant differences in pass/fail gradings using the two different assessment instruments. The quantitative data suggests that supervisors struggled with subjectivity, phrasing, and definitions of the LO´s and the scales used in both instruments. This resulted in arbitrary assessments that were time-consuming and resulted in limited usage in the day-to-day assessment. To mitigate the subjectivity, supervisors suggested working in teams and conducting multiple assessments over time to increase assessment validity.


Assuntos
Competência Clínica , Avaliação Educacional , Estudantes de Enfermagem , Humanos , Avaliação Educacional/métodos , Feminino , Masculino , Bacharelado em Enfermagem , Adulto
9.
BMC Med Educ ; 24(1): 559, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38778350

RESUMO

BACKGROUND: Feedback is integral to medical education, enabling students to improve their knowledge, skills, and attitudes. Feedback practices may vary according to prevalent cultural and contextual factors. This study aimed to explore how feedback is conceptualized and practised in the clinical education of medical students in Sri Lanka. METHODS: The study was conducted in three medical schools and affiliated hospitals that represent the cultural diversity of Sri Lanka. Purposive sampling was utilized to recruit clinical teachers and students who would provide rich information for the study. The study had three components: an observation study, interviews with clinical teachers and focus group discussions with clinical students. During the observation study, video recording was used as a data collection tool to observe feedback in real-life clinical teaching/learning settings. A constructivist grounded theory approach was adapted for analysis to explore current practices and perceptions inductively. RESULTS: Feedback was conceptualised as spontaneous unidirectional provision of information for the improvement of students. It was often provided in public settings and in student groups. Error correction was the primary focus of feedback, but both teachers and students desired a balanced approach with reinforcement and reflection. Although the direct approach to corrective feedback was found beneficial for student learning, participants agreed that harsh feedback was to be avoided. The hierarchical culture and lack of programmed feedback in the curricula influenced feedback practices, suggesting the need for modification. CONCLUSIONS: This study highlighted feedback practices in the local context, emphasizing the need to address the hierarchical gap in clinical settings, balance reinforcement and correction, and promote dialogue and reflection in the feedback processes. The findings will help clinical teachers from both the global south as well as the global north to recognize cultural and contextual differences in providing feedback.


Assuntos
Educação de Graduação em Medicina , Pesquisa Qualitativa , Estudantes de Medicina , Humanos , Sri Lanka , Estudantes de Medicina/psicologia , Masculino , Grupos Focais , Feedback Formativo , Feminino , Retroalimentação , Ensino , Docentes de Medicina , Currículo , Teoria Fundamentada
10.
BMC Med Educ ; 24(1): 664, 2024 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-38880886

RESUMO

BACKGROUND: There is increasing demand for professional practice placement opportunities, supported by health professional educators, to enable future health workforce development. Early career health professionals performing the educator role is one strategy that can help meet this demand. However, there is a need to consider how best to prepare and support early career health professionals to become educators. This study aimed to explore the experiences and perspectives of early career occupational therapy clinical educators including their preparation and support needs. METHODS: Semi-structured interviews were completed with ten early career occupational therapists who had supervised their first or second student on a professional practice placement. The participants worked within an Australian tertiary hospital and health service in various clinical settings. Interviews were completed within six weeks of placement completion and lasted approximately one hour. They were recorded and transcribed verbatim and reflexive inductive thematic analysis was undertaken to identify key themes. RESULTS: Ten occupational therapists, who had been working for an average of two years and two months, consented to participate. Initially, participants expressed mixed emotions about taking on the clinical educator role. They then described their adjustment to the role responsibilities, challenges encountered, and the development of the educator-student relationship. Participants found that the experience of supervising a student enhanced their educator, clinical, and professional skills and confidence. The important support elements of tailored educator preparation, placement design, and timely access to relevant resources and experienced staff were identified. CONCLUSIONS: This study demonstrated how early career health professionals can possess desirable educator attributes, such as enthusiasm for taking on the role and cultivating collaborative learning relationships with their students. The experience of being an educator also presents a professional development opportunity for early career health professionals. Insights gained about the specific preparation and support needs of early career clinical educators warrant consideration by organisations and staff involved in the provision of student professional practice placements. Overall, this study's findings signify the importance of engaging and investing in early career health professionals to support student clinical education and to develop our current and future healthcare workforce.


Assuntos
Pesquisa Qualitativa , Humanos , Austrália , Feminino , Masculino , Adulto , Terapeutas Ocupacionais/psicologia , Centros de Atenção Terciária , Terapia Ocupacional/educação , Entrevistas como Assunto
11.
BMC Med Educ ; 24(1): 78, 2024 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-38254144

RESUMO

BACKGROUND: Distributed healthcare settings such as district hospitals, primary care, and public health facilities are becoming the real-life settings for workplace-based learning required to educate the future healthcare workforce. Therefore, a major focus should be on designing and developing workplace-based learning in these learning environments. Healthcare professionals and educational policymakers play a significant role in these settings as role models in workplace-based learning, and as leaders in integrating learning into their work environments. It is relevant to explore their beliefs, attitudes, and behaviors towards workplace-based learning in their own settings, in order to provide context-relevant recommendations that can assist in shaping workplace-based learning environments. METHODS: We used individual interviews to understand professionals' experiences with workplace-based learning in distributed healthcare settings. We - three clinicians, an educationalist, and a philosopher - thematically analyzed transcripts of 13 interviews with healthcare professionals and educational policymakers from different healthcare settings who were involved in the clinical phase of undergraduate medical education. RESULTS: Clustering and categorizing of the data led to the construction of five overarching themes: Identification with and attitude towards medical education, Sense of ownership, Perceived time and space, Mutual preconceptions and relations, and Curriculum for a changing profession. CONCLUSIONS: These themes accentuate aspects relevant to the development of workplace-based learning in distributed healthcare settings on the individual, team, or organizational level. We highlight the significance of individual professionals in the development of workplace-based learning and emphasize the need for recognition and support for those occupying the 'broker' role at the intersection of education and practice. For future research and educational practice, we recommend prioritizing initiatives that build on good-practices in workplace-based learning and involve dedicated individuals in distributed healthcare settings.


Assuntos
Instalações de Saúde , Local de Trabalho , Humanos , Escolaridade , Pesquisa Qualitativa , Condições de Trabalho
12.
BMC Med Educ ; 24(1): 678, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38890747

RESUMO

PURPOSE: The present study aimed to test the relationship between the components of the Cognitive Load Theory (CLT) including memory, intrinsic and extraneous cognitive load in workplace-based learning in a clinical setting, and decision-making skills of nursing students. METHODS: This study was conducted at Shahid Sadoughi University of Medical Sciences in 2021-2023. The participants were 151 nursing students who studied their apprenticeship courses in the teaching hospitals. The three basic components of the cognitive load model, including working memory, cognitive load, and decision-making as the outcome of learning, were investigated in this study. Wechsler's computerized working memory test was used to evaluate working memory. Cognitive Load Inventory for Handoffs including nine questions in three categories of intrinsic cognitive load, extraneous cognitive load, and germane cognitive load was used. The clinical decision-making skills of the participants were evaluated using a 24-question inventory by Lowry et al. based on a 5-point scale. The path analysis of AMOS 22 software was used to examine the relationships between components and test the model. FINDINGS: In this study, the goodness of fit of the model based on the cognitive load theory was reported (GIF = 0.99, CFI = 0.99, RMSEA = 0.03). The results of regression analysis showed that the scores of decision-making skills in nursing students were significantly related to extraneous cognitive load scores (p-value = 0.0001). Intrinsic cognitive load was significantly different from the point of view of nursing students in different academic years (p = 0.0001). CONCLUSION: The present results showed that the CLT in workplace-based learning has a goodness of fit with the components of memory, intrinsic cognitive load, extraneous cognitive load, and clinical decision-making skill as the key learning outcomes in nursing education. The results showed that the relationship between nursing students' decision-making skills and extraneous cognitive load is stronger than its relationship with intrinsic cognitive load and memory Workplace-based learning programs in nursing that aim to improve students' decision-making skills are suggested to manage extraneous cognitive load by incorporating cognitive load principles into the instructional design of clinical education.


Assuntos
Cognição , Estudantes de Enfermagem , Local de Trabalho , Humanos , Estudantes de Enfermagem/psicologia , Feminino , Masculino , Adulto Jovem , Competência Clínica , Memória de Curto Prazo , Tomada de Decisão Clínica , Irã (Geográfico) , Adulto , Aprendizagem
13.
BMC Med Educ ; 24(1): 184, 2024 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-38395817

RESUMO

BACKGROUND: Morning reports are an essential component of physicians' daily work. Attending morning reports is prioritized by junior doctors as it provides them with an opportunity to learn diagnostic reasoning through discussion of cases. While teaching formats during morning reports have previously been reported, an in-depth analysis of what learning opportunities exist, e.g., how teaching is enacted during morning reports, is lacking. This qualitative study explores learning opportunities during morning reports. METHODS: We used an explorative design based on video-recordings of 23 morning reports from two surgical departments, an internal medicine department and an emergency department. We used thematic analysis combined with and inspired by Eraut's theoretical framework of workplace learning. RESULTS: Both formal and informal learning opportunities were identified. Formal learning opportunities had the character of planned teaching activities, and we identified four themes: (1) modes of teaching, (2) structure, (3) presenter role, and (4) participant involvement. Informal learning, on the other hand, was often implicit and reactive, while deliberate learning opportunities were rare. The data showed many missed opportunities for learning. CONCLUSION: Both formal and informal learning opportunities are present during morning reports. However, a prevalent focus on medical topics exists, leaving other important aspects of the medical role under-discussed. Pedagogical methods could be employed more optimally, and harnessing the potential of missed opportunities should be encouraged.


Assuntos
Médicos , Visitas de Preceptoria , Humanos , Pesquisa Qualitativa , Aprendizagem
14.
Public Health Nurs ; 41(4): 825-828, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38573241

RESUMO

Amidst a critical shortage of registered nurses, nursing schools are aiming to expand enrollment while working with ongoing resource constraints. Service-learning clinical activities can enhance nursing education by improving clinical quality, addressing faculty and clinical site shortages, and meeting increasing enrollment demands. This paper describes a health fair experience that served as a service-learning clinical experience within an undergraduate public health nursing course. The experience bridged theoretical knowledge with real-world application, fostering competency-based learning and addressing community health needs, resulting in a positive impact on students, faculty, and the community.


Assuntos
Bacharelado em Enfermagem , Enfermagem em Saúde Pública , Humanos , Enfermagem em Saúde Pública/educação , Currículo , Aprendizagem Baseada em Problemas , Educação Baseada em Competências
15.
BMC Nurs ; 23(1): 263, 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38654226

RESUMO

INTRODUCTION: Clinical education is an important aspect of the training of nursing students but it is faced with challenges in Ghana. The development of a framework will respond to the need for improvement in the quality of clinical nursing education. This study describes part of a larger study which culminated in the development of a framework for a clinical education programme for undergraduate nursing students in Ghana. The aim of the current study was to integrate findings from a scoping review and situational analysis to develop a framework for clinical education in nursing. METHODS: A sequential multimethod design approach was used to conduct the study. A scoping review on the practices that facilitate clinical nursing education and situational analysis were first conducted. The lessons learnt from the scoping review and the situational analysis provided the data matrix that was triangulated to develop the framework. The framework was developed using the model for clinical education developed by South African Nursing Education Stakeholders in consultation with experts in nursing education. An implementation plan was developed from the framework and evaluated using a Delphi technique. FINDINGS: The resulting framework indicates the need for effective communication and collaboration between nursing education institution and the service setting to ensure that there is a well-structured clinical placement, formal supervision system and effective clinical assessment of students. The framework also proposes that to ensure quality clinical nursing education there is the need for Nursing Education Institutions to implement innovative and cost-effective clinical teaching methods. CONCLUSION: The framework spells out the functions of the various stakeholders in nursing education and how these can be integrated and implemented to enhance quality clinical nursing education. Effectiveness of the thematic areas of the framework will increase the quality of clinical nursing education.

16.
BMC Nurs ; 23(1): 576, 2024 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-39160515

RESUMO

BACKGROUND: Medication errors may occur due to shortcuts and pressures on time and resources on nurses. Nursing students are enculturated into these environments where their perceptions of norms around reporting and responding to medication errors are formative, yet simulated medication administration experiences are rarely reflective of the real-world environment. such as the standard use of medication scanning technology. The purpose of the present study is to test a pilot intervention, Medication Quick Response (QR) code scanning, and evaluate its effect on medication errors during simulation when compared to traditional simulation medication administration practices and to assess the students' perceptions of the intervention. METHODS: We conducted a quasi-experimental, observational study involving Junior and Senior (3rd and 4th year) undergraduate, pre-licensure nursing students from Spring 2022 until Fall 2023. Seven simulations were conducted in pediatric and obstetric courses. The intervention group used non-patented, low cost QR scanning during medication administration. The control group used standard manual administration. Medication errors were measured based on the quantity, type of error, and degree of patient risk. A Qualtrics survey was used to assess the students' perceptions of the intervention following simulation participation. RESULTS: A total of 166 students participated in the study. In each course, 7 groups were assigned to the intervention and 8 were assigned to the control. More than half of the groups made at least one medication error (n = 17), one-third of groups (n = 10) made a high-risk medication error. There was no statistically meaningful difference in the rate, type, or potential patient risk of medication errors between the intervention and control groups. The majority of participants (n = 53) felt that QR scanning more closely mimicked medication administration in clinical settings. Half of the participants responded that it improved their safety practices (n = 37). CONCLUSIONS: The results of this pilot study indicate that while there is a high risk for error among pre-licensure nursing students, the use of QR scanning did not increase the risk of medication errors. The next study iteration will build upon these pilot findings to integrate the use of embedded medication errors, time management tasks, and a multi-site implementation.

17.
BMC Nurs ; 23(1): 381, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38840192

RESUMO

BACKGROUND: Clinical education plays an essential role in shaping the nursing identity and is one of the central elements in the education of nursing students. Today, with the advancement of novel technologies, utilizing mobile phone-based technologies in the education of medical sciences is inevitable. Therefore, this study was conducted with the aim of investigating the impact of the urology educational application on nursing students' cognitive-functional criteria and satisfaction during the internship period. METHODS: This experimental educational intervention study was conducted during nursing students' urology internship course at Shahid Beheshti School of Nursing and Midwifery in Rasht. The data collection tools included a demographic characteristics questionnaire, cognitive skills scale, functional skills scale, and satisfaction scale (Stokes, 2001). The data were analyzed using SPSS software version 16, and a significance level was set at 0.05. RESULTS: Out of 48 studied students, 28 (58.3%) were males. The mean age of the students was 20.34 (SD = 1.51) years. In the application group, the mean of students' cognitive skills after the intervention significantly increased by 2.33 units (95% CI: 1.73 to 2.9) (t(23) = 7.97, P < 0.001, d = 1.626). By controlling the scores before the intervention, the adjusted mean score of cognitive skills in the application group was 0.56 units (95% CI: -0.16 to 1.28) higher than the traditional group; however, this difference was not statistically significant (F(1, 45) = 2.42, P = 0.127, η2p = 0.051). There was no statistically significant difference between the mean score of students' functional skills in traditional and application groups (t(46) = 0.63, P = 0.532, d = 0.184). The total mean score of satisfaction with education in the application group was 83.0 (SD: 10.7). According to the values ​​of the quartiles, 75% of the students scored higher than 75.9, 50% scored higher than 83.9, and 25% scored higher than 91.1. CONCLUSION: According to the results of this study, students' scores of functional and cognitive assessment and satisfaction with the application in urology clinical training were reported as favorable. Therefore, it is recommended that mobile phone-based technologies be used in students' clinical education and internships in combination with the traditional method.

18.
BMC Nurs ; 23(1): 155, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38438969

RESUMO

BACKGROUND: The TPSN model is an innovative model to create an integration and structured relationship between educational and healthcare provider institutions. This model is done to reduce the theoretical-practical gap in nursing. The present study aimed to explore the experiences of nursing students. METHODS: In a conventional content analysis, 11 undergraduate nursing students, 7 graduate nursing students, and 4 doctoral students were selected. Data was collected through focus group discussions and individual interviews. RESULTS: The findings from analyzing the students' experiences who had received education using this model resulted in four main categories: the feeling of being a nurse, an integrated and collaborative clinical education platform, the development of nursing clinical education, and educational challenges. CONCLUSION: The TPSN model provides a suitable platform for nursing clinical education. This model helps students integrate theoretical knowledge with clinical practice and helps them act as professional nurses in the future.

19.
Gerodontology ; 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39189305

RESUMO

OBJECTIVES: Evaluate oral health care access and utilisation, while identifying the specific oral health needs of the Native American Elders within the Wampanoag Tribe of Gay Head (WTGH) on Martha's Vineyard Island. BACKGROUND: Elders, particularly the WTGH face notable issues in obtaining oral health care. This study addressed the oral health gaps within the WTGH Elders through a comprehensive community needs assessment. METHODS: Employing a mixed-methods approach, qualitative concept mapping interviews with stakeholders and tribe members, a quantitative survey was conducted, and deidentified billing codes were analysed. RESULTS: Concept mapping revealed limited availability of services, accessibility and transportation, insurance challenges, lack of a centralised database, tribal/national policy and health-related self-sufficiency. Quantitative data indicated that 65% of Elders faced challenges in accessing oral health care, and 48% reported experiencing an oral health issue in the last 12 months. Additionally, 23% did not receive oral health care during this period, with a significant portion having previously utilised services at the Martha's Vineyard Hospital Oral Health Clinic. CONCLUSION: Establishing a formal relationship between the WTGH and an academic institution for creating a portable oral health clinic supervised by faculty and developing a structured referral system is essential. This initiative aims to dismantle barriers to oral health care, improve access, and meet the oral health needs among Elders while offering valuable educational experiences for students regarding diverse patient populations and access-to-care factors.

20.
J Interprof Care ; 38(4): 713-721, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38717845

RESUMO

In many healthcare settings, teams change composition regularly, so healthcare students must be trained to function effectively in dynamic teams before entering the workforce. Interprofessional clinical rotations provide an ideal venue for learners to practice these skills, but little is known about how student teams interact in such settings. In this qualitative observational evaluation, learners from multiple health professions at a single institution participated in scheduled clinics in low-income housing communities for older adults. Interprofessional student teams met with program participants for care coordination, health and wellness assessments, and assistance in setting and achieving health goals; team composition changed from week-to-week. A purposive sample was selected from video-recorded encounters between student teams and their program participants. The aim of this study was to explore team interactions and document learner behaviors. Two researchers independently reviewed discrete segments of each video, recorded their observations and reflections, and then the team discussed, categorized, and identified relevant examples of both effective and ineffective behaviors. Four major themes were observed: inclusiveness, leadership, joy of practice, and sharing of clinical knowledge. Students demonstrated both positive and negative examples of behaviors that aligned with each theme. Understanding how students behave on teams in dynamic settings where patient care is taking place can help educators establish practice-based interprofessional education models that better prepare learners to function effectively and strategies that may improve team interactions.


Assuntos
Relações Interprofissionais , Equipe de Assistência ao Paciente , Pesquisa Qualitativa , Humanos , Equipe de Assistência ao Paciente/organização & administração , Liderança , Comportamento Cooperativo , Estudantes de Ciências da Saúde/psicologia , Feminino , Masculino
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