Spanish-speaking patients' satisfaction with clinical pharmacists' communication skills and demonstration of cultural sensitivity.

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Kim-Romo, Dawn N; Barner, Jamie C; Brown, Carolyn M; Rivera, José O; Garza, Aida A; Klein-Bradham, Kristina; Jokerst, Jason R; Janiga, Xan; Brown, Bob

2014-01-01

OBJECTIVE To assess Spanish-speaking patients' satisfaction with their clinical pharmacists' communication skills and demonstration of cultural sensitivity, while controlling for patients' sociodemographic, clinical, and communication factors, as well as pharmacist factors, and to identify clinical pharmacists' cultural factors that are important to Spanish-speaking patients. DESIGN Cross-sectional study. SETTING Central Texas during August 2011 to May 2012. PARTICIPANTS Spanish-speaking patients of federally qualified health centers (FQHCs). MAIN OUTCOME MEASURE(S) A Spanish-translated survey assessed Spanish-speaking patients' satisfaction with their clinical pharmacists' communication skills and demonstration of cultural sensitivity. RESULTS Spanish-speaking patients (N = 101) reported overall satisfaction with their clinical pharmacists' communication skills and cultural sensitivity. Patients also indicated that pharmacists' cultural rapport (e.g., ability to speak Spanish, respectfulness) was generally important to Spanish speakers. Multiple linear regression analyses showed that cultural rapport was significantly related to satisfaction with pharmacists' communication skills and demonstration of cultural sensitivity. CONCLUSION Overall, patients were satisfied with pharmacists' communication skills and cultural sensitivity. Patient satisfaction initiatives that include cultural rapport should be developed for pharmacists who provide care to Spanish-speaking patients with limited English proficiency.

Improving efficiency of clinical skills training

DEFF Research Database (Denmark)

Tolsgaard, Martin G; Bjørck, Sebastian; Birkvad Rasmussen, Maria

2013-01-01

The rising number of medical students and the impact this has on students' learning of clinical skills is a matter of concern. Cooperative learning in pairs, called dyad training, might help address this situation.......The rising number of medical students and the impact this has on students' learning of clinical skills is a matter of concern. Cooperative learning in pairs, called dyad training, might help address this situation....

Effect of Objective Structured Clinical Examination on Nursing Students' Clinical Skills

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Seyedeh Narjes Mousavizadeh

2018-01-01

Full Text Available Considering the daily increasing changes in clinical training approaches, the necessity of using new evaluation methods in proportion with these approaches is also becoming more and more obvious for measuring all of the cognitive, emotional and psychomotor dimensions of students. The present study was designed and conducted for reviewing the effect of objective structured clinical examination method on the clinical skills of nursing students. In this quasi-experimental study, 48 nursing students have participated that were randomly assigned to two groups of intervention and control. The intervention group students were evaluated at the end of educational period of their clinical skills and principles course using objective structured clinical examination (OSCE. The OSCE included five core skills in this course: assessing and fulfilling patients’ basic needs, dressing up, injectable drug therapy, noninjectable drug therapy, infection control. The control group students were evaluated using the routine method. Both groups of students were followed up in the next semester and were compared in terms of learning enhancement in these five skills. Evaluation of procedures was based on valid and reliable check-lists made by the researcher. Results were analyzed using descriptive and inferential statistics (Chi-square, independent and paired T tests. The mean score of the final evaluation in the intervention group was significantly higher than that of the control group (P= 0.000. Final evaluation scores of the intervention group students showed a better performance than their previous semester (P= 0.000, while the final evaluation scores of the control group students showed a lack of progress in their skills (P<0.05. It seems that this evaluation method also is a support for students' learning and resulted in improvement of clinical skills among them. Accordingly, it is recommended that nursing education centers apply this method to assess students�

Collaborative learning of clinical skills in health professions education

DEFF Research Database (Denmark)

Tolsgaard, Martin G.; Kulasegaram, Kulamakan M.; Ringsted, Charlotte V

2016-01-01

Objectives: This study is designed to provide an overview of why, how, when and for whom collaborative learning of clinical skills may work in health professions education. Why: Collaborative learning of clinical skills may influence learning positively according to the non-medical literature...... suggests that learning is dependent on cognitive co-construction, shared knowledge and reduced cognitive load. When and for whom: The literature on the collaborative learning of clinical skills in health science education is reviewed to support or contradict the hypotheses provided by the theories outlined...... above. Collaborative learning of clinical skills leads to improvements in self-efficacy, confidence and performance when task processing is observable or communicable. However, the effects of collaborative learning of clinical skills may decrease over time as benefits in terms of shared cognition...

An interview study of how clinical teachers develop skills to attend to different level learners.

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Chen, H Carrie; Fogh, Shannon; Kobashi, Brent; Teherani, Arianne; Ten Cate, Olle; O'Sullivan, Patricia

2016-06-01

One clinical teaching challenge is the engagement of learners at different levels. Faculty development offerings mostly address general strategies applicable to all learners. This study examined how clinical faculty members develop the skills to work with different level learners. We conducted semi-structured interviews with medical school faculty members identified as excellent clinical teachers teaching multiple levels of learners. They discussed how they developed their approach to teaching different level learners and how their teaching evolved over time. We performed thematic analysis of the interview transcripts using open and axial coding. We interviewed 19 faculty members and identified three themes related to development of teaching practices: teacher agency and work-based learning of teaching strategies, developmental trajectory of clinical teachers, and interplay between clinical confidence and teaching skills. Faculty members were proactive in using on-the-job experiences to develop their teaching practices. Their teaching practices followed a developmental trajectory towards learner centeredness, and this evolution was associated with the development of clinical skills and confidence. Learning skills to teach multi-level learners requires workplace learning. Faculty development should include workplace learning opportunities and use a developmental approach that accounts for the trajectory of teaching as well as clinical skills attainment.

Simulation-based medical education in clinical skills laboratory.

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Akaike, Masashi; Fukutomi, Miki; Nagamune, Masami; Fujimoto, Akiko; Tsuji, Akiko; Ishida, Kazuko; Iwata, Takashi

2012-01-01

Clinical skills laboratories have been established in medical institutions as facilities for simulation-based medical education (SBME). SBME is believed to be superior to the traditional style of medical education from the viewpoint of the active and adult learning theories. SBME can provide a learning cycle of debriefing and feedback for learners as well as evaluation of procedures and competency. SBME offers both learners and patients a safe environment for practice and error. In a full-environment simulation, learners can obtain not only technical skills but also non-technical skills, such as leadership, team work, communication, situation awareness, decision-making, and awareness of personal limitations. SBME is also effective for integration of clinical medicine and basic medicine. In addition, technology-enhanced simulation training is associated with beneficial effects for outcomes of knowledge, skills, behaviors, and patient-related outcomes. To perform SBME, effectively, not only simulators including high-fidelity mannequin-type simulators or virtual-reality simulators but also full-time faculties and instructors as professionals of SBME are essential in a clinical skills laboratory for SBME. Clinical skills laboratory is expected to become an integrated medical education center to achieve continuing professional development, integrated learning of basic and clinical medicine, and citizens' participation and cooperation in medical education.

Using computer assisted learning for clinical skills education in nursing: integrative review.

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Bloomfield, Jacqueline G; While, Alison E; Roberts, Julia D

2008-08-01

This paper is a report of an integrative review of research investigating computer assisted learning for clinical skills education in nursing, the ways in which it has been studied and the general findings. Clinical skills are an essential aspect of nursing practice and there is international debate about the most effective ways in which these can be taught. Computer assisted learning has been used as an alternative to conventional teaching methods, and robust research to evaluate its effectiveness is essential. The CINAHL, Medline, BNI, PsycInfo and ERIC electronic databases were searched for the period 1997-2006 for research-based papers published in English. Electronic citation tracking and hand searching of reference lists and relevant journals was also undertaken. Twelve studies met the inclusion criteria. An integrative review was conducted and each paper was explored in relation to: design, aims, sample, outcome measures and findings. Many of the study samples were small and there were weaknesses in designs. There is limited empirical evidence addressing the use of computer assisted learning for clinical skills education in nursing. Computer assisted learning has been used to teach a limited range of clinical skills in a variety of settings. The paucity of evaluative studies indicates the need for more rigorous research to investigate the effect of computer assisted learning for this purpose. Areas that need to be addressed in future studies include: sample size, range of skills, longitudinal follow-up and control of confounding variables.

Effects of basic clinical skills training on objective structured clinical examination performance.

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Jünger, Jana; Schäfer, Sybille; Roth, Christiane; Schellberg, Dieter; Friedman Ben-David, Miriam; Nikendei, Christoph

2005-10-01

The aim of curriculum reform in medical education is to improve students' clinical and communication skills. However, there are contradicting results regarding the effectiveness of such reforms. A study of internal medicine students was carried out using a static group design. The experimental group consisted of 77 students participating in 7 sessions of communication training, 7 sessions of skills-laboratory training and 7 sessions of bedside-teaching, each lasting 1.5 hours. The control group of 66 students from the traditional curriculum participated in equally as many sessions but was offered only bedside teaching. Students' cognitive and practical skills performance was assessed using Multiple Choice Question (MCQ) testing and an objective structured clinical examination (OSCE), delivered by examiners blind to group membership. The experimental group performed significantly better on the OSCE than did the control group (P < 0.01), whereas the groups did not differ on the MCQ test (P < 0.15). This indicates that specific training in communication and basic clinical skills enabled students to perform better in an OSCE, whereas its effects on knowledge did not differ from those of the traditional curriculum. Curriculum reform promoting communication and basic clinical skills are effective and lead to an improved performance in history taking and physical examination skills.

The Group Objective Structured Clinical Experience: building communication skills in the clinical reasoning context.

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Konopasek, Lyuba; Kelly, Kevin V; Bylund, Carma L; Wenderoth, Suzanne; Storey-Johnson, Carol

2014-07-01

Students are rarely taught communication skills in the context of clinical reasoning training. The purpose of this project was to combine the teaching of communication skills using SPs with clinical reasoning exercises in a Group Objective Structured Clinical Experience (GOSCE) to study feasibility of the approach, the effect on learners' self-efficacy and attitude toward learning communication skills, and the effect of providing multiple sources of immediate, collaborative feedback. GOSCE sessions were piloted in Pediatrics and Medicine clerkships with students assessing their own performance and receiving formative feedback on communication skills from peers, standardized patients (SPs), and faculty. The sessions were evaluated using a retrospective pre/post-training questionnaire rating changes in self-efficacy and attitudes, and the value of the feedback. Results indicate a positive impact on attitudes toward learning communication skills and self-efficacy regarding communication in the clinical setting. Also, learners considered feedback by peers, SPs, and faculty valuable in each GOSCE. The GOSCE is an efficient and learner-centered method to attend to multiple goals of teaching communication skills, clinical reasoning, self-assessment, and giving feedback in a formative setting. The GOSCE is a low-resource, feasible strategy for experiential learning in communication skills and clinical reasoning. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

A descriptive survey investigating pre-registration student nurses' perceptions of clinical skill development in clinical placements.

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Stayt, Louise C; Merriman, Clair

2013-04-01

Clinical skill development is essential to nurse education. Clinical skills are frequently taught in higher education institutions using clinical simulation. It is unclear if clinical skills are subsequently consolidated and developed in clinical placements. The aim of this survey was to evaluate pre-registration student nurses perceptions of the frequency of opportunities to practise, the level of supervision and assessment of, clinical skills in their clinical placements. This was a cross-sectional survey design using an online, self-report questionnaire including a Likert-type scale and open ended comments. Four hundred and twenty one students, from all year groups, from a university in the south of England on a wide variety of clinical placements participated. Participants evaluated the frequency of opportunity to practise, level of supervision and assessment of and feedback on performance of specific clinical skills. Clinical skills evaluated were measurement of vital signs, aseptic non-touch technique, assisting with eating and drinking, and assisting with comfort and hygiene. Data were analysed utilising Statistical Package for the Social Sciences Version 19. The frequency of opportunities to practise skills in clinical placement was variable with some participants reporting that they never had opportunity to practise essential skills. Similarly the level of supervision and assessment was also inconsistent suggesting that participants frequently practised clinical skills unsupervised without being assessed as competent. Inconsistencies in clinical skill development may lead to graduates who are not work ready and as a result, insufficient clinical competence potentially leads to unsafe practice and poor patient care. This calls for stronger partnerships between educators and clinical areas and the prioritisation of mentor preparation and education as well as organisational support in terms of mentor workload planning. Copyright © 2012 Elsevier Ltd. All

Capacity-building in clinical skills of rehabilitation workforce in low- and middle-income countries

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Fary Khan

2018-02-01

Full Text Available Objective: Despite the prevalence of disability in low-and middle-income countries, the clinical skills of the rehabilitation workforce are not well described. We report health professionals’ perspectives on clinical skills in austere settings and identify context-specific gaps in workforce capacity. Methods: A cross-sectional pilot survey (Pakistan, Morocco, Nigeria, Malaysia of health professionals’ working in rehabilitation in hospital and community settings. A situational-analysis survey captured assessment of clinical skills required in various rehabilitation settings. Responses were coded in a line-by-line process, and linked to categories in domains of the International Classification of Functioning, Disability and Health (ICF. Results: Respondents (n = 532 from Pakistan 248, Nigeria 159, Morocco 93 and Malaysia 32 included the following: physiotherapists (52.8%, nurses (8.8%, speech (5.3% and occupational therapists (8.5%, rehabilitation physicians (3.8%, other doctors (5.5% and prosthetist/orthotists (1.5%. The 10 commonly used clinical skills reported were prescription of: physical activity, medications, transfer-techniques, daily-living activities, patient/carer education, diagnosis/screening, behaviour/cognitive interventions, comprehensive patient-care, referrals, assessments and collaboration. There was significant overlap in skills listed irrespective of profession. Most responses linked with ICF categories in activities/participation and personal factors. Conclusion: The core skills identified reflect general rehabilitation practice and a task-shifting approach, to address shortages of health workers in low-and middle-income countries.

Objective Structured Clinical Examination as an Assessment Tool for Clinical Skills in Dermatology.

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Saceda-Corralo, D; Fonda-Pascual, P; Moreno-Arrones, Ó M; Alegre-Sánchez, A; Hermosa-Gelbard, Á; Jiménez-Gómez, N; Vañó-Galván, S; Jaén-Olasolo, P

2017-04-01

Objective Structured Clinical Evaluation (OSCE) is an excellent method to evaluate student's abilities, but there are no previous reports implementing it in dermatology. To determine the feasibility of implementation of a dermatology OSCE in the medical school. Five stations with standardized patients and image-based assessment were designed. A specific checklist was elaborated in each station with different items which evaluated one competency and were classified into five groups (medical history, physical examination, technical skills, case management and prevention). A total of 28 students were tested. Twenty-five of them (83.3%) passed the exam globally. Concerning each group of items tested: medical interrogation had a mean score of 71.0; physical examination had a mean score of 63.0; management had a mean score of 58.0; and prevention had a mean score of 58.0 points. The highest results were obtained in interpersonal skills items with 91.8 points. Testing a small sample of voluntary students may hinder generalization of our study. OSCE is an useful tool for assessing clinical skills in dermatology and it is possible to carry it out. Our experience enhances that medical school curriculum needs to establish OSCE as an assessment tool in dermatology. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

Airway management by the general practitioner in trauma patients. Technical and non-technical skills

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Juan David Dominguez-Sánchez

2016-07-01

Full Text Available General practitioners must constantly face challenges imposed by their profession when performing interventions that are necessary for their patients. Many of these interventions not only require proper use of theoretical knowledge, but also putting into practice non-technical and psychomotor skills developed through professional training. Given the specific characteristics of each patient, the clinical setting in the which procedure takes place and the limited skills of the professional, the management of the airway of a patient with trauma injuries in the emergency room represents a major challenge for physicians.

Enhancing Higher Order Thinking Skills through Clinical Simulation

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Varutharaju, Elengovan; Ratnavadivel, Nagendralingan

2014-01-01

Purpose: The study aimed to explore, describe and analyse the design and implementation of clinical simulation as a pedagogical tool in bridging the deficiency of higher order thinking skills among para-medical students, and to make recommendations on incorporating clinical simulation as a pedagogical tool to enhance thinking skills and align the…

Knowledge and skills of cancer clinical trials nurses in Australia.

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Scott, Kathleen; White, Kate; Johnson, Catherine; Roydhouse, Jessica K

2012-05-01

  This paper is a report of the development and testing of a questionnaire measuring knowledge and skills of cancer clinical trials nurse in Australia.   The role of cancer clinical trials nurse, widely acknowledged as an integral member of the clinical research team, has evolved in recent years. Elements of the clinical trials nurse role in cancer have previously been described. To evaluate specific cancer clinical trials nurse educational and training needs, the development of a valid and reliable tool is required.   In 2009, a study was conducted in three stages. Stage I: questionnaire development and pilot testing; stage II: focus group; stage III: national survey. Internal consistency reliability testing and multi-trait analysis of item convergent/divergent validity were employed. Regression analysis was used to identify predictors of clinical trials nurse knowledge and skills.   The national survey was a 48-item questionnaire, measuring six clinical trial knowledge and seven skills sub-scales. Of 61 respondents, 90% were women, with mean age 43 years, 19 years as a Registered Nurse and 5 years as a cancer clinical trials nurse. Self-reported knowledge and skills were satisfactory to good. Internal consistency reliability was high (Cronbach's alpha: knowledge = 0·98; skills = 0·90). Criteria for item convergent/divergent validity were met. Number of years as cancer clinical trials nurse was positively related to self-reported knowledge and skills.   Preliminary data suggest that the national survey is reliable and valid. Data have contributed to better understanding the knowledge and skills of cancer clinical trials nurse in Australia and development of a postgraduate course in clinical trials. © 2011 Blackwell Publishing Ltd.

Utility of an Equine Clinical Skills Course: A Pilot Study.

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Christensen, Bruce W; Danielson, Jared A

Recent publications have revealed inadequacies in the veterinary training of future equine practitioners. To help address this problem, a 2-week Equine Clinical Skills course was designed and implemented to provide fourth-year veterinary students with opportunities to have hands-on experience with common equine clinical skills using live animals and cadavers. Alumni and employers of alumni were surveyed to determine whether or not students participating in the course were more competent performing clinical skills during their first year post-graduation than those who had not participated in the course. Students who participated in the course were also surveyed before and after completing the course to determine whether or not their self-assessed skills improved during the course. Alumni who had taken the course rated their ability to perform the clinical skills more highly than alumni who had not taken the course. Similarly, students participating in the course indicated that they were significantly more able to perform the clinical skills after the course than when it began. Employers did not indicate a difference between the clinical skills of those who had taken the course and those who had not. Because this study involved a limited number of respondents from one institution, further studies should be conducted to replicate these findings and determine their generalizability.

Formative assessment of GP trainees' clinical skills.

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Wiener-Ogilvie, Sharon; Begg, Drummond

2012-03-01

Clinical skill assessment (CSA) has been an integral part of the Royal College of General Practitioners' membership examination (MRCGP) since 2008. It is an expensive, high-stakes examination with first time pass rates ranging from 76.4 to 81.3. In this paper we describe the South East Scotland Deanery, NHS Education Scotland, pilot of a formative clinical skills assessment (fCSA) using the principles of formative assessment and OSCE. The purpose of the study was to assess the acceptability of the fCSA and to examine whether trainees, identified during the fCSA as 'at risk of failing the MRCGP CSA exam', are more likely to fail the MRCGP CSA exam later on in the year. Trainees were assessed in four clinical skills stations under exam conditions. After each station they were given verbal feedback and subsequently both trainee and their trainer received written feedback. We assessed the value of the exercise through written feedback from trainees and trainers. Each trainee's performance in fCSA was triangulated with trainer assessment to identify 'flagged trainees'. We compared flagged and non-flagged trainees' performance in MRCGP CSA. Both trainees and trainers highly rated the fCSA. Overall 97% of non-flagged trainees have passed the RCGP CSA exam by May of that year in comparison to 80% of flagged trainees who have passed the RCGP CSA (P = 0.005). Trainers and trainees rated the fCSA as excellent and useful. We were able to demonstrate that the fCSA can be used to identify those trainees likely to fail the RCGP CSA. Contrary to reservations about the potential to demoralise trainees, the fCSA was viewed as a useful and a positive experience by both trainees and trainers. In addition, we suggest that feedback from fCSA was useful in triggering appropriate educational interventions. Early intervention with trainees who are predicted to fail the CSA has the potential to reduce deaneries overall fail rate. Preventing one trainee failure could save over £30 000.

Self-confidence of medical students in performing clinical skills acquired during their surgical rotation. Assessing clinical skills education in Kuwait.

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Karim, Jumanah A; Marwan, Yousef A; Dawas, Ahmed M; Akhtar, Saeed

2012-12-01

To assess the self-confidence of clinical years` medical students in performing clinical skills/procedures. A cross-sectional study was conducted in April 2011 at the Department of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, Safat, Kuwait. A questionnaire was used to collect data from students who had completed their surgical rotation of their first clinical year. The students reported their level of self-confidence in performing specific skills/procedures related to that rotation. Data were presented using frequencies and percentages. A total score of confidence was calculated for each student. The Mann-Whitney and Kruskal-Wallis tests were used to assess the association between the students` sociodemographic characteristics and confidence score. Of the 122 students invited to participate in the study, only 15 (12.3%) declined to comply. Most students reported high confidence level (more than 75%) in performing 7 of the 13 history taking/physical examination skills, and 2 of the 39 diagnostic/treatment procedure skills. The highest confidence level was in performing abdominal examination, while the lowest level was in care of Jackson-Pratt drain site and emptying the drain bulb. The total confidence score was significantly higher among males (p=0.021), and students with higher monthly income (p=0.002). Medical students appeared to have poor self-confidence in performing clinical skills/procedures. Curriculum planners should explore potential reasons, and methods for the improvement of confidence level among medical students in performing skills/procedures they were expected to learn during their surgical rotation.

Clinical skill development for community pharmacists.

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Barnette, D J; Murphy, C M; Carter, B L

1996-09-01

The importance of establishing clinical pharmacy services in the community cannot be understated in light of current challenges to the traditional dispensing role as the primary service of the community pharmacist. Advancements in automated dispensing technology and declining prescription fee reimbursement are rapidly forcing pharmacists to seek alternative sources of revenue. Providing pharmaceutical care is a viable option to increase customer loyalty job satisfaction, and reimbursement. To support the development of clinical services, academic institutions are forming partnerships with individual community practitioners to overcome perceived educational and training barriers. The authors describe the design and development of two unique clinical skill development programs at the University of Illinois at Chicago. This paper also outlines the patient focused services that the participants have established upon completing the training. These programs successfully enhanced participants' therapeutic knowledge base and facilitated development of the clinical skills necessary for direct patient care.

Nursing physical assessment for patient safety in general wards: reaching consensus on core skills.

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Douglas, Clint; Booker, Catriona; Fox, Robyn; Windsor, Carol; Osborne, Sonya; Gardner, Glenn

2016-07-01

To determine consensus across acute care specialty areas on core physical assessment skills necessary for early recognition of changes in patient status in general wards. Current approaches to physical assessment are inconsistent and have not evolved to meet increased patient and system demands. New models of nursing assessment are needed in general wards that ensure a proactive and patient safety approach. A modified Delphi study. Focus group interviews with 150 acute care registered nurses at a large tertiary referral hospital generated a framework of core skills that were developed into a web-based survey. We then sought consensus with a panel of 35 senior acute care registered nurses following a classical Delphi approach over three rounds. Consensus was predefined as at least 80% agreement for each skill across specialty areas. Content analysis of focus group transcripts identified 40 discrete core physical assessment skills. In the Delphi rounds, 16 of these were consensus validated as core skills and were conceptually aligned with the primary survey: (Airway) Assess airway patency; (Breathing) Measure respiratory rate, Evaluate work of breathing, Measure oxygen saturation; (Circulation) Palpate pulse rate and rhythm, Measure blood pressure by auscultation, Assess urine output; (Disability) Assess level of consciousness, Evaluate speech, Assess for pain; (Exposure) Measure body temperature, Inspect skin integrity, Inspect and palpate skin for signs of pressure injury, Observe any wounds, dressings, drains and invasive lines, Observe ability to transfer and mobilise, Assess bowel movements. Among a large and diverse group of experienced acute care registered nurses consensus was achieved on a structured core physical assessment to detect early changes in patient status. Although further research is needed to refine the model, clinical application should promote systematic assessment and clinical reasoning at the bedside. © 2016 John Wiley & Sons Ltd.

Negotiation skills for clinical research professionals

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Sanjay Hake

2011-01-01

Full Text Available Negotiation as a skill is a key requirement for each and every job profile where dealing with multiple parties is involved. The important focus while negotiating should be on the interest then position. Key to every successful negotiation is advance planning, preparation, and patience as the objective is to create value and establish the terms on which parties with differing and often conflicting aims will co-operate. While preparing one should collect facts, know priorities, principles, identify common ground, decide on walk-away position, and try and identify the next best alternative. Negotiation is a set of skills that can be learned and practiced so that your ability to utilize relationship, knowledge, money, power, time, and personality to negotiate improves with each negotiation. In a successful negotiation, all parties win. Important thing to note is that not every negotiation involves money. Anytime you want something from someone else and anytime someone wants something from you, you are negotiating. Everything is negotiable and every day you negotiate with customers, suppliers, colleagues, your wife, and even your children. Negotiation is a game, and like any game it has its rules and tactics. Clinical Research professionals deal with various parties for different purposes at the same time; hence, they require excellent negotiation skills. Project Mangers and Clinical Research Associates are the two most important roles in clinical research industry who require negotiation skills as they deal with various internal and external customers and vendors.

Negotiation skills for clinical research professionals

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Hake, Sanjay; Shah, Tapankumar

2011-01-01

Negotiation as a skill is a key requirement for each and every job profile where dealing with multiple parties is involved. The important focus while negotiating should be on the interest then position. Key to every successful negotiation is advance planning, preparation, and patience as the objective is to create value and establish the terms on which parties with differing and often conflicting aims will co-operate. While preparing one should collect facts, know priorities, principles, identify common ground, decide on walk-away position, and try and identify the next best alternative. Negotiation is a set of skills that can be learned and practiced so that your ability to utilize relationship, knowledge, money, power, time, and personality to negotiate improves with each negotiation. In a successful negotiation, all parties win. Important thing to note is that not every negotiation involves money. Anytime you want something from someone else and anytime someone wants something from you, you are negotiating. Everything is negotiable and every day you negotiate with customers, suppliers, colleagues, your wife, and even your children. Negotiation is a game, and like any game it has its rules and tactics. Clinical Research professionals deal with various parties for different purposes at the same time; hence, they require excellent negotiation skills. Project Mangers and Clinical Research Associates are the two most important roles in clinical research industry who require negotiation skills as they deal with various internal and external customers and vendors. PMID:21897886

Changes in communication skills of clinical residents through psychiatric training.

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Yutani, Motoki; Takahashi, Megumi; Miyaoka, Hitoshi

2011-10-01

The objective of this study was to clarify whether the communication skills (CS) of clinical residents change before and after psychiatric training and, if so, what factors are related to the change. The 44 clinical residents who agreed to participate in this study were provided with an originally developed self-accomplished questionnaire survey on CS (communication skills questionnaire [CSQ]) and a generally used questionnaire on self-esteem, anxiety, and depressive mood considered to be related to CS at the start and end of a 2-month psychiatric training session. Statistical analysis was conducted for the 34 residents who completed both questionnaires. The CSQ score (t[32]: -2.17, P self-esteem and negatively with anxiety and depressive tendency. The amount of change in assertive CS score showed a weakly positive correlation with self-esteem. The results suggested that CS, including assertive CS and cooperative CS, were improved by the psychiatric training. Increasing self-esteem and reducing the tendency toward depression and anxiety are considered to be useful for further improving CS. © 2011 The Authors. Psychiatry and Clinical Neurosciences © 2011 Japanese Society of Psychiatry and Neurology.

Producing Competent Doctors - The Art and Science of Teaching Clinical Skills.

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Dhaliwal, Upreet; Supe, Avinash; Gupta, Piyush; Singh, Tejinder

2017-05-15

For a doctor to provide medical care with competence, he must not only have knowledge but must also be able to translate that knowledge into action. It is his competence in clinical skills that will enable him to practice safely and effectively in the real world. To ensure acquisition of clinical skills, medical teachers must adopt teaching methods that prioritise observation, practice, feedback; and more practice. We try to elucidate the meaning of clinical skills, the challenges inherent in clinical skills training in India, training models that have shown success in practice and can be adopted in the Indian context, and various techniques to enhance skill-training, including the giving of feedback, which is a critically important component of skills development.

The Effect of a Surgical Skills Course on Confidence Levels of Rural General Practitioners: An Observational Study.

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Byrd, Pippa; Ward, Olga; Hamdorf, Jeffrey

2016-10-01

Objective  To investigate the effect of a short surgical skills course on general practitioners' confidence levels to perform procedural skills. Design  Prospective observational study. Setting  The Clinical Evaluation and Training Centre, a practical skills-based educational facility, at The University of Western Australia. Participants  Medical practitioners who participated in these courses. Nurses, physiotherapists, and medical students were excluded. The response rate was 61% with 61 participants providing 788 responses for pre- and postcourse confidence levels regarding various surgical skills. Intervention  One- to two-day surgical skills courses consisting of presentations, demonstrations, and practical stations, facilitated by specialists. Main Outcome Measures  A two-page precourse and postcourse questionnaire was administered to medical practitioners on the day. Participants rated their confidence levels to perform skills addressed during the course on a 4-point Likert scale. Results  Of the 788 responses regarding confidence levels, 621 were rated as improved postcourse, 163 were rated as no change, and 4 were rated as lower postcourse. Seven of the courses showed a 25% median increase in confidence levels, and one course demonstrated a 50% median increase. All courses showed statistically significant results ( p  skills course resulted in a statistically significant improvement in the confidence levels of rural general practitioners to perform these skills.

A randomized controlled study of a social skills training for preadolescent children with autism spectrum disorders: generalization of skills by training parents and teachers?

Science.gov (United States)

2014-01-01

Background Social skills training (SST) is a common intervention for children with autism spectrum disorders (ASDs) to improve their social and communication skills. Despite the fact that SSTs are often applied in clinical practice, the evidence for the effectiveness of these trainings for children with ASD is inconclusive. Moreover, long term outcome and generalization of learned skills are little evaluated. Additionally, there is no research on the influence of involvement of parents and teachers on effectiveness of SST and on the generalization of learned social skills to daily life. We expect parent and teacher involvement in SST to enhance treatment efficacy and to facilitate generalization of learned skills to daily life. Method/Design In a randomized controlled trial (RCT) with three conditions, 120 participants with ASD at the end of primary school (10–12 years of calendar age) have been randomized to SST, SST-PTI (SST with Parent & Teacher Involvement), or care-as-usual. The SST consists of 18 group sessions of 1.5 hours for the children. In the SST-PTI condition, parents additionally participate in 8 parent sessions and parents and teachers are actively involved in homework assignments. Assessment takes place at three moments: before and immediately after the intervention period and at 6 months follow-up. Primary outcome is socialization, as an aspect of adaptive functioning. Secondary outcomes focus on specific social skills children learn during SST and on more general social skills pertaining to home and community settings from a multi-informant perspective. Additionally, possible predictors of treatment outcome will be assessed. Discussion The current study is an RCT study evaluating SST in a large sample of Dutch children with ASD in a specific age range (10–12 years). Strengths of the study are the use of one manualized protocol, application of standardized and internationally used rating instruments, use of multiple raters, investigation of

Setting pass scores for clinical skills assessment.

Science.gov (United States)

Liu, Min; Liu, Keh-Min

2008-12-01

In a clinical skills assessment, the decision to pass or fail an examinee should be based on the test content or on the examinees' performance. The process of deciding a pass score is known as setting a standard of the examination. This requires a properly selected panel of expert judges and a suitable standard setting method, which best fits the purpose of the examination. Six standard setting methods that are often used in clinical skills assessment are described to provide an overview of the standard setting process.

Using systematically observed clinical encounters (SOCEs to assess medical students’ skills in clinical settings

Directory of Open Access Journals (Sweden)

George R Bergus

2010-11-01

Full Text Available George R Bergus1–3, Jerold C Woodhead4, Clarence D Kreiter2,51Performance Based Assessment Program, Office of Student Affairs and Curriculum, 2Department of Family Medicine, 3Department of Psychiatry, 4Department of Pediatrics, 5Office of Consultation and Research in Medical Education, Roy J and Lucille A Carver College of Medicine, The University of Iowa, Iowa City, IA, USAIntroduction: The Objective Structured Clinical Examination (OSCE is widely used to assess the clinical performance of medical students. However, concerns related to cost, availability, and validity, have led educators to investigate alternatives to the OSCE. Some alternatives involve assessing students while they provide care to patients – the mini-CEX (mini-Clinical Evaluation Exercise and the Long Case are examples. We investigated the psychometrics of systematically observed clinical encounters (SOCEs, in which physicians are supplemented by lay trained observers, as a means of assessing the clinical performances of medical students.Methods: During the pediatrics clerkship at the University of Iowa, trained lay observers assessed the communication skills of third-year medical students using a communication checklist while the students interviewed and examined pediatric patients. Students then verbally presented their findings to faculty, who assessed students’ clinical skills using a standardized form. The reliability of the combined communication and clinical skills scores was calculated using generalizability theory.Results: Fifty-one medical students completed 199 observed patient encounters. The mean combined clinical and communication skills score (out of a maximum 45 points was 40.8 (standard deviation 3.3. The calculated reliability of the SOCE scores, using generalizability theory, from 10 observed patient encounters was 0.81. Students reported receiving helpful feedback from faculty after 97% of their observed clinical encounters.Conclusion: The SOCE can

A Model for Evaluating Student Clinical Psychomotor Skills.

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And Others; Fiel, Nicholas J.

1979-01-01

A long-range plan to evaluate medical students' physical examination skills was undertaken at the Ingham Family Medical Clinic at Michigan State University. The development of the psychomotor skills evaluation model to evaluate the skill of blood pressure measurement, tests of the model's reliability, and the use of the model are described. (JMD)

Setting Pass Scores for Clinical Skills Assessment

Directory of Open Access Journals (Sweden)

Min Liu

2008-12-01

Full Text Available In a clinical skills assessment, the decision to pass or fail an examinee should be based on the test content or on the examinees' performance. The process of deciding a pass score is known as setting a standard of the examination. This requires a properly selected panel of expert judges and a suitable standard setting method, which best fits the purpose of the examination. Six standard setting methods that are often used in clinical skills assessment are described to provide an overview of the standard setting process.

Clinical skills temporal degradation assessment in undergraduate medical education.

Science.gov (United States)

Fisher, Joseph; Viscusi, Rebecca; Ratesic, Adam; Johnstone, Cameron; Kelley, Ross; Tegethoff, Angela M; Bates, Jessica; Situ-Lacasse, Elaine H; Adamas-Rappaport, William J; Amini, Richard

2018-01-01

Medical students' ability to learn clinical procedures and competently apply these skills is an essential component of medical education. Complex skills with limited opportunity for practice have been shown to degrade without continued refresher training. To our knowledge there is no evidence that objectively evaluates temporal degradation of clinical skills in undergraduate medical education. The purpose of this study was to evaluate temporal retention of clinical skills among third year medical students. This was a cross-sectional study conducted at four separate time intervals in the cadaver laboratory at a public medical school. Forty-five novice third year medical students were evaluated for retention of skills in the following three procedures: pigtail thoracostomy, femoral line placement, and endotracheal intubation. Prior to the start of third-year medical clerkships, medical students participated in a two-hour didactic session designed to teach clinically relevant materials including the procedures. Prior to the start of their respective surgery clerkships, students were asked to perform the same three procedures and were evaluated by trained emergency medicine and surgery faculty for retention rates, using three validated checklists. Students were then reassessed at six week intervals in four separate groups based on the start date of their respective surgical clerkships. We compared the evaluation results between students tested one week after training and those tested at three later dates for statistically significant differences in score distribution using a one-tailed Wilcoxon Mann-Whitney U-test for non-parametric rank-sum analysis. Retention rates were shown to have a statistically significant decline between six and 12 weeks for all three procedural skills. In the instruction of medical students, skill degradation should be considered when teaching complex technical skills. Based on the statistically significant decline in procedural skills noted

A comparison of clinical communication skills between two groups of ...

African Journals Online (AJOL)

a comprehensive clinical model and a “golden thread” for communication skills in the ... sity, South Africa, based on the primary ..... Planning: shared decision making ... Explanation and planning. Incorporate clinical reasoning skills. Develop.

[Feedback in relation to training of practical clinical skills

DEFF Research Database (Denmark)

Hansen, C.S.; Ringsted, Charlotte Vibeke

2008-01-01

Feedback has been identified as an essential component of motor learning. However, feedback principles derived from motor learning theories cannot uncritically be applied to clinical skills training because this knowledge is based primarily on the study of very simple motor skills. Research...... into feedback in relation to clinical skills training is currently limited. Theories on motor learning can serve as the basis for designing research in this domain, especially the importance of including retention tests when measuring permanent learning outcomes Udgivelsesdato: 2008/10/27...

Design and Effectiveness of a Required Pre-Clinical Simulation-based Curriculum for Fundamental Clinical Skills and Procedures

Directory of Open Access Journals (Sweden)

Daryl P. Lofaso

2011-12-01

Full Text Available For more than 20 years, medical literature has increasingly documented the need for students to learn, practice and demonstrate competence in basic clinical knowledge and skills. In 2001, the Louisiana State University Health Science Centers (LSUHSC School of Medicine – New Orleans replaced its traditional Introduction in to Clinical Medicine (ICM course with the Science and Practice of Medicine (SPM course. The main component within the SPM course is the Clinical Skills Lab (CSL. The CSL teaches 30 plus skills to all pre-clinical medical students (Years 1 and 2. Since 2002, an annual longitudinal evaluation questionnaire was distributed to all medical students targeting the skills taught in the CSL. Students were asked to rate their self- confidence (Dreyfus and Likert-type and estimate the number of times each clinical skill was performed (clinically/non-clinically. Of the 30 plus skills taught, 8 were selected for further evaluation. An analysis was performed on the eight skills selected to determine the effectiveness of the CSL. All students that participated in the CSL reported a significant improvement in self-confidence and in number performed in the clinically/non-clinically setting when compared to students that did not experience the CSL. For example, without CSL training, the percentage of students reported at the end of their second year self-perceived expertise as “novice” ranged from 21.4% (CPR to 84.7% (GU catheterization. Students who completed the two-years CSL, only 7.8% rated their self-perceived expertise at the end of the second year as “novice” and 18.8% for GU catheterization. The CSL design is not to replace real clinical patient experiences. It's to provide early exposure, medial knowledge, professionalism and opportunity to practice skills in a patient free environment.

Evaluation of Clinical and Communication Skills of Pharmacy Students and Pharmacists with an Objective Structured Clinical Examination.

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Urteaga, Elizabeth M; Attridge, Rebecca L; Tovar, John M; Witte, Amy P

2015-10-25

Objective. To evaluate how effectively pharmacy students and practicing pharmacists communicate and apply knowledge to simulations of commonly encountered patient scenarios using an objective structured clinical examination (OSCE). Design. Second-, third-, and fourth-year pharmacy students completed an OSCE as part of their required courses in 2012 and 2013. All students in both years completed identical OSCE cases. Licensed pharmacists were recruited to complete the OSCE and serve as controls in 2012. A survey assessed student perception and acceptance of the OSCE as well as student confidence in performance. Assessment. Licensed pharmacists had significantly higher clinical and communication skills scores than did pharmacy students. Student progression in communication and clinical skills improved significantly over time. Survey results indicated that students felt the OSCE was well-structured and assessed clinical skills taught in pharmacy school; 86% of students felt confident they could provide these skills. Conclusion. Objective structured clinical examinations can evaluate clinical competence and communication skills among professional students. Implementation of OSCEs may be an effective tool for assessment of the Center for the Advancement of Pharmacy Education domains.

A survey of clinical nursing skills in intellectual disability nursing

OpenAIRE

McKeon, Michael

2009-01-01

In this study the question asked is: what clinical nursing skills are predominantly used in intellectual disability nursing? A survey of the nursing needs of people with moderate to severe intellectual disability in both residential and community units was undertaken with a questionnaire.The measure was a Likert design scale ranging across: skills used more than once a day, skills used daily, skills used weekly, skills used monthly, skills very rarely used, and skills never used.The results o...

Walking the bridge: Nursing students' learning in clinical skill laboratories.

Science.gov (United States)

Ewertsson, Mona; Allvin, Renée; Holmström, Inger K; Blomberg, Karin

2015-07-01

Despite an increasing focus on simulation as a learning strategy in nursing education, there is limited evidence on the transfer of simulated skills into clinical practice. Therefore it's important to increase knowledge of how clinical skills laboratories (CSL) can optimize students' learning for development of professional knowledge and skills, necessary for quality nursing practice and for patient safety. Thus, the aim was to describe nursing students' experiences of learning in the CSL as a preparation for their clinical practice. Interviews with 16 students were analysed with content analysis. An overall theme was identified - walking the bridge - in which the CSL formed a bridge between the university and clinical settings, allowing students to integrate theory and practice and develop a reflective stance. The theme was based on categories: conditions for learning, strategies for learning, tension between learning in the skills laboratory and clinical settings, and development of professional and personal competence. The CSL prepared the students for clinical practice, but a negative tension between learning in CSL and clinical settings was experienced. However, this tension may create reflection. This provides a new perspective that can be used as a pedagogical approach to create opportunities for students to develop their critical thinking. Copyright © 2015 Elsevier Ltd. All rights reserved.

Registered nurses' clinical reasoning skills and reasoning process: A think-aloud study.

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Lee, JuHee; Lee, Young Joo; Bae, JuYeon; Seo, Minjeong

2016-11-01

As complex chronic diseases are increasing, nurses' prompt and accurate clinical reasoning skills are essential. However, little is known about the reasoning skills of registered nurses. This study aimed to determine how registered nurses use their clinical reasoning skills and to identify how the reasoning process proceeds in the complex clinical situation of hospital setting. A qualitative exploratory design was used with a think-aloud method. A total of 13 registered nurses (mean years of experience=11.4) participated in the study, solving an ill-structured clinical problem based on complex chronic patients cases in a hospital setting. Data were analyzed using deductive content analysis. Findings showed that the registered nurses used a variety of clinical reasoning skills. The most commonly used skill was 'checking accuracy and reliability.' The reasoning process of registered nurses covered assessment, analysis, diagnosis, planning/implementation, and evaluation phase. It is critical that registered nurses apply appropriate clinical reasoning skills in complex clinical practice. The main focus of registered nurses' reasoning in this study was assessing a patient's health problem, and their reasoning process was cyclic, rather than linear. There is a need for educational strategy development to enhance registered nurses' competency in determining appropriate interventions in a timely and accurate fashion. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of an intensive clinical skills course on senior nursing students' self-confidence and clinical competence: A quasi-experimental post-test study.

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Park, Soohyun

2018-02-01

To foster nursing professionals, nursing education requires the integration of knowledge and practice. Nursing students in their senior year experience considerable stress in performing the core nursing skills because, typically, they have limited opportunities to practice these skills in their clinical practicum. Therefore, nurse educators should revise the nursing curricula to focus on core nursing skills. To identify the effect of an intensive clinical skills course for senior nursing students on their self-confidence and clinical competence. A quasi-experimental post-test study. A university in South Korea during the 2015-2016 academic year. A convenience sample of 162 senior nursing students. The experimental group (n=79) underwent the intensive clinical skills course, whereas the control group (n=83) did not. During the course, students repeatedly practiced the 20 items that make up the core basic nursing skills using clinical scenarios. Participants' self-confidence in the core clinical nursing skills was measured using a 10-point scale, while their clinical competence with these skills was measured using the core clinical nursing skills checklist. Independent t-test and chi-square tests were used to analyze the data. The mean scores in self-confidence and clinical competence were higher in the experimental group than in the control group. This intensive clinical skills courses had a positive effect on senior nursing students' self-confidence and clinical competence for the core clinical nursing skills. This study emphasizes the importance of reeducation using a clinical skills course during the transition from student to nursing professional. Copyright © 2017. Published by Elsevier Ltd.

The mechanism of suppression: a component of general comprehension skill.

Science.gov (United States)

Gernsbacher, M A; Faust, M E

1991-03-01

We investigated whether the cognitive mechanism of suppression underlies differences in adult comprehension skill. Less skilled comprehenders reject less efficiently the inappropriate meanings of ambiguous words (e.g., the playing card vs. garden tool meaning of spade), the incorrect forms of homophones (e.g., patients vs. patience), the highly typical but absent members of scenes (e.g., a tractor in a farm scene), and words superimposed on pictures or pictures surrounding words. However, less skilled comprehenders are not less cognizant of what is contextually appropriate; in fact, they benefit from a biasing context just as much (and perhaps more) as more skilled comprehenders do. Thus, less skilled comprehenders do not have difficulty enhancing contextually appropriate information. Instead, we suggest that less skilled comprehenders suffer from a less efficient suppression mechanism, which we conclude is an important component of general comprehension skill.

The Dreyfus model of clinical problem-solving skills acquisition: a critical perspective.

Science.gov (United States)

Peña, Adolfo

2010-06-14

The Dreyfus model describes how individuals progress through various levels in their acquisition of skills and subsumes ideas with regard to how individuals learn. Such a model is being accepted almost without debate from physicians to explain the 'acquisition' of clinical skills. This paper reviews such a model, discusses several controversial points, clarifies what kind of knowledge the model is about, and examines its coherence in terms of problem-solving skills. Dreyfus' main idea that intuition is a major aspect of expertise is also discussed in some detail. Relevant scientific evidence from cognitive science, psychology, and neuroscience is reviewed to accomplish these aims. Although the Dreyfus model may partially explain the 'acquisition' of some skills, it is debatable if it can explain the acquisition of clinical skills. The complex nature of clinical problem-solving skills and the rich interplay between the implicit and explicit forms of knowledge must be taken into consideration when we want to explain 'acquisition' of clinical skills. The idea that experts work from intuition, not from reason, should be evaluated carefully.

Clinical skill center: a review of present situation and importance in medical education curriculum

Directory of Open Access Journals (Sweden)

Haleh Talaei

2002-07-01

Full Text Available Clinical skill centers were designed in 1960, offers innovative, more effective clinical health care and treatment curriculum. Clinical skill center (CSC can provide a special facility for clinical and communication skills practice in a setting outside hospital wards in order to train students with enough confidence of confronting real patients. Learning clinical skills in these centers are not patient-dependent and by practicing on manikins and simulated models errors in real patients can be prevented. Moreover, possible feedback of this method can be used for evaluation and can improve quality and quantity of the education. This review intends to determine the purpose, undertaking, and structure of CSC. The study emphasizes the importance of integrating the clinical skill centers into the teaching curriculum of medical universities. Apparently, organizing clinical skill centers can play an important role for improving the quality and quantity of the educational system and consequently post-graduate performance. The authors recommend this program can be a solution for having both the knowledge and skill of diagnosis and treatment seasonal and rare diseases. Key words clinical skill center, medical education, curriculum

An evaluation of the generalization and maintenance of functional communication and self-control skills with preschoolers.

Science.gov (United States)

Luczynski, Kevin C; Hanley, Gregory P; Rodriguez, Nicole M

2014-01-01

The preschool life skills (PLS) program (Hanley, Heal, Tiger, & Ingvarsson, 2007; Luczynski & Hanley, 2013) involves teaching social skills as a means of decreasing and preventing problem behavior. However, achieving durable outcomes as children transition across educational settings depend on the generalization and long-term maintenance of those skills. The purpose of this study was to evaluate procedures for promoting generalization and long-term maintenance of functional communication and self-control skills for 6 preschool children. When the children's social skills decreased across repeated observations during a generalization assessment, we incorporated modifications to the teaching procedures. However, the effects of the modifications were variable across skills and children. Satisfactory generalization was observed only after the teacher was informed of the target skills and teaching strategies. Maintenance of most social skills was observed 3 months after teaching was discontinued. We discuss the importance of improving child and teacher behavior to promote generalization and maintenance of important social skills. © Society for the Experimental Analysis of Behavior.

Investigating the Problem of Skill Generalization: Literature Review III.

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Haring, Norris

The third in a series of literature reviews, this monograph presents three articles on skill generalization among individuals with severe disabilities. Kathleen A. Liberty analyzes the results of 15 studies to determine how teaching self-control affected students' performance in training and generalization, "Behavior-Control of Stimulus Events to…

Developing advanced clinical practice skills in gastrointestinal consequences of cancer treatment.

Science.gov (United States)

Gee, Caroline; Andreyev, Jervoise; Muls, Ann

2018-03-08

This article explores the transition from a clinical nurse specialist (CNS) towards developing advanced clinical practice skills within a gastrointestinal consequences of cancer clinic. It presents data on the first 50 patients assessed by the CNS from a prospective service evaluation, demonstrating how this informed the nurse's future learning. There is high demand for advanced clinical practice skills to address unmet health needs and improve the quality, efficiency, and sustainability of healthcare services. However, a literature review found no literature on developing advanced clinical practice skills in this setting. Emerging themes from the service evaluation focused on barriers and enablers, ongoing support, organisational commitment and working in a multidisciplinary team. Blended learning provided both structured and opportunistic learning, embedding both formal and tacit knowledge, as roles require increasing flexibility. Clinical supervision and reflective practice were key in maintaining professional and peer support.

Clinical Skills Verification, Formative Feedback, and Psychiatry Residency Trainees

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Dalack, Gregory W.; Jibson, Michael D.

2012-01-01

Objective: The authors describe the implementation of Clinical Skills Verification (CSV) in their program as an in-training assessment intended primarily to provide formative feedback to trainees, strengthen the supervisory experience, identify the need for remediation of interviewing skills, and secondarily to demonstrating resident competence…

Clinical skills training in undergraduate medical education using a student-centered approach

DEFF Research Database (Denmark)

Tolsgaard, Martin Grønnebæk

2013-01-01

This thesis focuses on how to engage students in self-directed learning and in peer-learning activities to improve clinical skills training in undergraduate medical education. The first study examined the clinical skills teaching provided by student teachers compared to that provided by associate...... demonstrated remarkable advantages to peer-learning in skills-lab. Thus, peer-learning activities could be essential to providing high-quality medical training in the face of limited clinical teacher resources in future undergraduate medical education.......This thesis focuses on how to engage students in self-directed learning and in peer-learning activities to improve clinical skills training in undergraduate medical education. The first study examined the clinical skills teaching provided by student teachers compared to that provided by associate....... The Reporter-Interpreter-Manager-Educator framework was used to reflect this change and construct validity was explored for RIME-based evaluations of single-patient encounters. In the third study the effects of training in pairs--also known as dyad practice--examined. This study showed that the students...

Transfer of communication skills to the workplace during clinical rounds: impact of a program for residents.

Science.gov (United States)

Liénard, Aurore; Merckaert, Isabelle; Libert, Yves; Bragard, Isabelle; Delvaux, Nicole; Etienne, Anne-Marie; Marchal, Serge; Meunier, Julie; Reynaert, Christine; Slachmuylder, Jean-Louis; Razavi, Darius

2010-08-26

Communication with patients is a core clinical skill in medicine that can be acquired through communication skills training. Meanwhile, the importance of transfer of communication skills to the workplace has not been sufficiently studied. This study aims to assess the efficacy of a 40-hour training program designed to improve patients' satisfaction and residents' communication skills during their daily clinical rounds. Residents were randomly assigned to the training program or to a waiting list. Patients' satisfaction was assessed with a visual analog scale after each visit. Transfer of residents' communication skills was assessed in audiotaped actual inpatient visits during a half-day clinical round. Transcripted audiotapes were analyzed using content analysis software (LaComm). Training effects were tested with Mann-Whitney tests and generalized linear Poisson regression models. Eighty-eight residents were included. First, patients interacting with trained residents reported a higher satisfaction with residents' communication (Median=92) compared to patients interacting with untrained residents (Median=88) (p=.046). Second, trained residents used more assessment utterances (Relative Risk (RR)=1.17; 95% Confidence intervals (95%CI)=1.02-1.34; p=.023). Third, transfer was also observed when residents' training attendance was considered: residents' use of assessment utterances (RR=1.01; 95%CI=1.01-1.02; p=.018) and supportive utterances (RR=0.99; 95%CI=0.98-1.00; p=.042) (respectively 1.15 (RR), 1.08-1.23 (95%CI), ptransfer of residents' communication skills learning to the workplace. Transfer was directly related to training attendance but remained limited. Future studies should therefore focus on the improvement of the efficacy of communication skills training in order to ensure a more important training effect size on transfer.

Feedback on students' clinical reasoning skills during fieldwork education.

Science.gov (United States)

de Beer, Marianne; Mårtensson, Lena

2015-08-01

Feedback on clinical reasoning skills during fieldwork education is regarded as vital in occupational therapy students' professional development. The nature of supervisors' feedback however, could be confirmative and/or corrective and corrective feedback could be with or without suggestions on how to improve. The aim of the study was to evaluate the impact of supervisors' feedback on final-year occupational therapy students' clinical reasoning skills through comparing the nature of feedback with the students' subsequent clinical reasoning ability. A mixed-method approach with a convergent parallel design was used combining the collection and analysis of qualitative and quantitative data. From focus groups and interviews with students, data were collected and analysed qualitatively to determine how the students experienced the feedback they received from their supervisors. By quantitatively comparing the final practical exam grades with the nature of the feedback, their fieldwork End-of-Term grades and average academic performance it became possible to merge the results for comparison and interpretation. Students' clinical reasoning skills seem to be improved through corrective feedback if accompanied by suggestions on how to improve, irrespective of their average academic performance. Supervisors were inclined to underrate high performing students and overrate lower performing students. Students who obtained higher grades in the final practical examinations received more corrective feedback with suggestions on how to improve from their supervisors. Confirmative feedback alone may not be sufficient for improving the clinical reasoning skills of students. © 2015 The Authors. Australian Occupational Therapy Journal published by Wiley Publishing Asia Pty Ltd on behalf of Occupational Therapy Australia.

Clinical Research Careers: Reports from a NHLBI Pediatric Heart Network Clinical Research Skills Development Conference

Science.gov (United States)

Lai, Wyman W.; Richmond, Marc; Li, Jennifer S.; Saul, J. Philip; Mital, Seema; Colan, Steven D.; Newburger, Jane W.; Sleeper, Lynn A.; McCrindle, Brain W.; Minich, L. LuAnn; Goldmuntz, Elizabeth; Marino, Bradley S.; Williams, Ismee A.; Pearson, Gail D.; Evans, Frank; Scott, Jane D.; Cohen, Meryl S.

2013-01-01

Background Wyman W. Lai, MD, MPH, and Victoria L. Vetter, MD, MPH. The Pediatric Heart Network (PHN), funded under the U.S. National Institutes of Health-National Heart, Lung, and Blood Institute (NIH–NHLBI), includes two Clinical Research Skills Development (CRSD) Cores, which were awarded to The Children's Hospital of Philadelphia and to the Morgan Stanley Children's Hospital of New York–Presbyterian. To provide information on how to develop a clinical research career to a larger number of potential young investigators in pediatric cardiology, the directors of these two CRSD Cores jointly organized a one-day seminar for fellows and junior faculty from all of the PHN Core sites. The participants included faculty members from the PHN and the NHLBI. The day-long seminar was held on April 29, 2009, at the NHLBI site, immediately preceding the PHN Steering Committee meeting in Bethesda, MD. Methods The goals of the seminar were 1) to provide fellows and early investigators with basic skills in clinical research 2) to provide a forum for discussion of important research career choices 3) to introduce attendees to each other and to established clinical researchers in pediatric cardiology, and 4) to publish a commentary on the future of clinical research in pediatric cardiology. Results The following chapters are compilations of the talks given at the 2009 PHN Clinical Research Skills Development Seminar, published to share the information provided with a broader audience of those interested in learning how to develop a clinical research career in pediatric cardiology. The discussions of types of clinical research, research skills, career development strategies, funding, and career management are applicable to research careers in other areas of clinical medicine as well. Conclusions The aim of this compilation is to stimulate those who might be interested in the research career options available to investigators. PMID:21167335

Pairing as an instructional strategy to promote soft skills amongst clinical dental students.

Science.gov (United States)

Abu Kasim, N H; Abu Kassim, N L; Razak, A A A; Abdullah, H; Bindal, P; Che' Abdul Aziz, Z A; Sulaiman, E; Farook, M S; Gonzalez, M A G; Thong, Y L; Ahmad, N A; Naimie, Z; Abdullah, M; Lui, J L; Abdul Aziz, A

2014-02-01

Training dentists today is challenging as they are expected to provide a wide range of dental care. In the provision of good dental care, soft skills are equally important as clinical skills. Therefore in dental education the development of soft skills are of prime concern. This study sought to identify the development of soft skills when dental students are paired in their clinical training. In this perception study, four open-ended items were used to elicit students' feedback on the appropriateness of using clinical pairing as an instructional strategy to promote soft skills. The most frequently cited soft skills were teamwork (70%) and communication (25%) skills. However, both negative and positive behaviours were reported. As for critical thinking and problem solving skills, more positive behaviours were reported for abilities such as to explain, analyze, find ideas and alternative solutions, and make decisions. Leadership among peers was not evident as leading without legitimate authority could be a hindrance to its development. If clinical pairing is to be used as an effective instructional strategy to promote soft skills amongst students, clear guidelines need to be developed to prepare students to work in a dental team and the use of appropriate assessment tools can facilitate the development of these soft skills. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The evolution of integration: innovations in clinical skills and ethics in first year medicine.

Science.gov (United States)

Brunger, Fern; Duke, Pauline S

2012-01-01

Critical self-reflection, medical ethics and clinical skills are each important components of medical education but are seldom linked in curriculum development. We developed a curriculum that builds on the existing integration of ethics education into the clinical skills course to more explicitly link these three skills. The curriculum builds on the existing integration of clinical skills and ethics in first year medicine. It refines the integration through scheduling changes; adds case studies that emphasise the social, economic and political context of our province's patient population; and introduces reflection on the "culture of medicine" as a way to have students articulate and understand their own values and moral decision making frameworks. This structured Clinical Skills course is a model for successfully integrating critical self-reflection, reflection on the political, economic and cultural contexts shaping health and healthcare, and moral decision making into clinical skills training.

Educational climate seems unrelated to leadership skills of clinical consultants responsible of postgraduate medical education in clinical departments.

Science.gov (United States)

Malling, Bente; Mortensen, Lene S; Scherpbier, Albert J J; Ringsted, Charlotte

2010-09-21

The educational climate is crucial in postgraduate medical education. Although leaders are in the position to influence the educational climate, the relationship between leadership skills and educational climate is unknown. This study investigates the relationship between the educational climate in clinical departments and the leadership skills of clinical consultants responsible for education. The study was a trans-sectional correlation study. The educational climate was investigated by a survey among all doctors (specialists and trainees) in the departments. Leadership skills of the consultants responsible for education were measured by multi-source feedback scores from heads of departments, peer consultants, and trainees. Doctors from 42 clinical departments representing 21 specialties participated. The response rate of the educational climate investigation was moderate 52% (420/811), Response rate was high in the multisource-feedback process 84.3% (420/498). The educational climate was scored quite high mean 3.9 (SD 0.3) on a five-point Likert scale. Likewise the leadership skills of the clinical consultants responsible for education were considered good, mean 5.4 (SD 0.6) on a seven-point Likert scale. There was no significant correlation between the scores concerning the educational climate and the scores on leadership skills, r = 0.17 (p = 0.29). This study found no relation between the educational climate and the leadership skills of the clinical consultants responsible for postgraduate medical education in clinical departments with the instruments used. Our results indicate that consultants responsible for education are in a weak position to influence the educational climate in the clinical department. Further studies are needed to explore, how heads of departments and other factors related to the clinical organisation could influence the educational climate.

Residency Programs and Clinical Leadership Skills Among New Saudi Graduate Nurses.

Science.gov (United States)

Al-Dossary, Reem Nassar; Kitsantas, Panagiota; Maddox, P J

2016-01-01

Nurse residency programs have been adopted by health care organizations to assist new graduate nurses with daily challenges such as intense working environments, increasing patient acuity, and complex technologies. Overall, nurse residency programs are proven beneficial in helping nurses transition from the student role to independent practitioners and bedside leaders. The purpose of this study was to assess the impact of residency programs on leadership skills of new Saudi graduate nurses who completed a residency program compared to new Saudi graduate nurses who did not participate in residency programs. The study design was cross-sectional involving a convenience sample (n = 98) of new graduate nurses from three hospitals in Saudi Arabia. The Clinical Leadership Survey was used to measure the new graduate nurses' clinical leadership skills based on whether they completed a residency program or not. Descriptive statistics, correlation, and multiple linear regression analyses were conducted to examine leadership skills in this sample of new Saudi graduate nurses. A significant difference was found between residents and nonresidents in their leadership skills (t = 10.48, P = .000). Specifically, residents were significantly more likely to show higher levels of leadership skills compared to their counterparts. Attending a residency program was associated with a significant increase in clinical leadership skills. The findings of this study indicate that there is a need to implement more residency programs in hospitals of Saudi Arabia. It is imperative that nurse managers and policy makers in Saudi Arabia consider these findings to improve nurses' leadership skills, which will in turn improve patient care. Further research should examine how residency programs influence new graduate nurses' transition from student to practitioner with regard to clinical leadership skills in Saudi Arabia. Copyright © 2016 Elsevier Inc. All rights reserved.

Practical Clinical Training in Skills Labs: Theory and Practice

Directory of Open Access Journals (Sweden)

Bugaj, T. J.

2016-08-01

Full Text Available Today, skills laboratories or “skills labs”, i.e. specific practical skill training facilities, are a firmly established part of medical education offering the possibility of training clinical procedures in a safe and fault-forging environment prior to real life application at bedside or in the operating room. Skills lab training follows a structured teaching concept, takes place under supervision and in consideration of methodological-didactic concepts, ideally creating an atmosphere that allows the repeated, anxiety- and risk-free practice of targeted skills.In this selective literature review, the first section is devoted to (I the development and dissemination of the skills lab concept. There follows (II an outline of the underlying idea and (III an analysis of key efficacy factors. Thereafter, (IV the training method’s effectiveness and transference are illuminated, before (V the use of student tutors, in the sense of peer-assisted-learning, in skills labs is discussed separately. Finally, (VI the efficiency of the skills lab concept is analyzed, followed by an outlook on future developments and trends in the field of skills lab training.

Improving the training process of highly skilled bodybuilders in the preparatory period, general preparatory phase

Directory of Open Access Journals (Sweden)

Olexandr Tyhorskyy

2015-08-01

Full Text Available Purpose: to improve the method of training highly skilled bodybuilders during the general preparatory phase. Material and Methods: the study involved eight highly skilled athletes, members of the team of Ukraine on bodybuilding. Results: comparative characteristics of the most commonly used methods of training process in bodybuilding. Developed and substantiated the optimal method of training highly skilled bodybuilders during the general preparatory phase of the preparatory period, which can increase body weight through muscle athletes component. Conclusions: based on studies, recommended the optimum method of training highly skilled bodybuilders depending on mezotsykles and microcycles general preparatory phase

Using Self-Reflection To Increase Science Process Skills in the General Chemistry Laboratory

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Veal, William R.; Taylor, Dawne; Rogers, Amy L.

2009-03-01

Self-reflection is a tool of instruction that has been used in the science classroom. Research has shown great promise in using video as a learning tool in the classroom. However, the integration of self-reflective practice using video in the general chemistry laboratory to help students develop process skills has not been done. Immediate video feedback and direct instruction were employed in a general chemistry laboratory course to improve students' mastery and understanding of basic and advanced process skills. Qualitative results and statistical analysis of quantitative data proved that self-reflection significantly helped students develop basic and advanced process skills, yet did not seem to influence the general understanding of the science content.

Factors shaping how clinical educators use their educational knowledge and skills in the clinical workplace: a qualitative study.

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Kumar, Koshila; Greenhill, Jennene

2016-02-18

In order to consolidate their educational knowledge and skills and develop their educational role, many clinicians undertake professional development in clinical education and supervision. It is well established that these educationally-focussed professional development activities have a positive impact. However, it is less clear what factors within the clinical workplace can shape how health professionals may use and apply their educational knowledge and skills and undertake their educational role. Looking through the lens of workplace affordances, this paper draws attention to the contextual, personal and interactional factors that impact on how clinical educators integrate their educational knowledge and skills into the practice setting, and undertake their educational role. Data were gathered via a survey of 387 clinical educators and semi-structured interviews with 12 clinical educators and 6 workplace managers. In this paper, we focus on analysing and reporting the qualitative data gathered in this study. This qualitative data were subject to a thematic analysis and guided by theoretical constructs related to workplace affordances. Three key themes were identified including contextual, personal and interactional factors. Contextual elements referred to organisational structures and systems that impact on participants' educational role, how participants' clinical education role was articulated and configured within the organisation, and how the organisation shaped the educational opportunities available to clinicians. Personal factors encompassed clinicians' personal motivations and goals to teach and be involved in education, develop their own educational skills and function as a role model for students. Interactional factors referred to the professional interactions and networks through which clinicians shared their educational knowledge and skills and further consolidated their profile as educational advocates in their workplace. There are a number of

OSCE vs. TEM: Different approaches to assess clinical skills of nursing students

Directory of Open Access Journals (Sweden)

Prasuna Jelly

2017-01-01

Full Text Available Introduction: Nurses are trained with specific clinical skills, and objective structured clinical examination (OSCE could be a better approach to assess clinical skills of nursing students. Materials and Methods: A comparative study was conducted by observational checklist regarding antenatal care and opinionnaire on the usefulness of OSCE and tradition evaluation method (TEM was used to assess the clinical skills and to get opinion. Results: The mean score of OSCE was more than TEM and the difference was statistically significant (P < 0.001. The opinion of students regarding the usefulness of OSCE was higher than TEM. Conclusions: The study concluded that implementing OSCE will overweigh the advantages of the TEM.

[MODERN EDUCATIONAL TECHNOLOGY MASTERING PRACTICAL SKILLS OF GENERAL PRACTITIONERS].

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Kovalchuk, L I; Prokopchuk, Y V; Naydyonova, O V

2015-01-01

The article presents the experience of postgraduate training of general practitioners--family medicine. Identified current trends, forms and methods of pedagogical innovations that enhance the quality of learning and mastering the practical skills of primary professionals providing care.

Assessing nursing clinical skills competence through objective structured clinical examination (OSCE) for open distance learning students in Open University Malaysia.

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Oranye, Nelson Ositadimma; Ahmad, Che'an; Ahmad, Nora; Bakar, Rosnida Abu

2012-06-01

The objective structured clinical skills examination (OSCE) has over the years emerged as a method of evaluating clinical skills in most medical and allied professions. Although its validity and objectivity has evoked so much debate in the literature, little has been written about its application in non-traditional education systems such as in distance learning. This study examined clinical skills competence among practising nursing students who were enrolled in a distance learning programme. The study examined the effect of work and years of nursing practice on nurses' clinical skills competence. This study used observational design whereby nursing students' clinical skills were observed and scored in five OSCE stations. Two instruments were used for the data collection - A self-administered questionnaire on the students' bio-demographic data, and a check list on the clinical skills which the examiners rated on a four point scale. The findings revealed that 14% of the nurses had level four competence, which indicated that they could perform the tasks correctly and complete. However, 12% failed the OSCE, even though they had more than 10 years experience in nursing and post basic qualifications. Inter-rater reliability was 0.92 for the five examiners. Factor analysis indicated that five participant factors accounted for 74.1% of the variations in clinical skills performance. An OSCE is a necessary assessment tool that should be continuously applied in nursing education, regardless of the mode of the education program, the student's years of experience or his/her clinical placement. This study validates the need for OSCE in both the design of tertiary nursing degree programs and the assessment of nurses' clinical competency level.

Interprofessional teamwork skills as predictors of clinical outcomes in a simulated healthcare setting.

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Shrader, Sarah; Kern, Donna; Zoller, James; Blue, Amy

2013-01-01

Teaching interprofessional (IP) teamwork skills is a goal of interprofessional education. The purpose of this study was to examine the relationship between IP teamwork skills, attitudes and clinical outcomes in a simulated clinical setting. One hundred-twenty health professions students (medicine, pharmacy, physician assistant) worked in interprofessional teams to manage a "patient" in a health care simulation setting. Students completed the Interdisciplinary Education Perception Scale (IEPS) attitudinal survey instrument. Students' responses were averaged by team to create an IEPS attitudes score. Teamwork skills for each team were rated by trained observers using a checklist to calculate a teamwork score (TWS). Clinical outcome scores (COS) were determined by summation of completed clinical tasks performed by the team based on an expert developed checklist. Regression analyses were conducted to determine the relationship of IEPS and TWS with COS. IEPS score was not a significant predictor of COS (p=0.054), but TWS was a significant predictor (pstudents' interprofessional teamwork skills are significant predictors of positive clinical outcomes. Interprofessional curricular models that produce effective teamwork skills can improve student performance in clinical environments and likely improve teamwork practice to positively affect patient care outcomes.

A Novel Clinical-Simulated Suture Education for Basic Surgical Skill: Suture on the Biological Tissue Fixed on Standardized Patient Evaluated with Objective Structured Assessment of Technical Skill (OSATS) Tools.

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Shen, Zhanlong; Yang, Fan; Gao, Pengji; Zeng, Li; Jiang, Guanchao; Wang, Shan; Ye, Yingjiang; Zhu, Fengxue

2017-06-21

Clinical-simulated training has shown benefit in the education of medical students. However, the role of clinical simulation for surgical basic skill training such as suturing techniques remains unclear. Forty-two medical students were asked to perform specific suturing tasks at three stations with the different settings within four minutes (Station 1: Synthetic suture pad fixed on the bench, Station 2: Synthetic suture pad fixed on the standardized patient, Station 3: Pig skin fixed on the standardized patient); the OSATS (Objective Structured Assessment of Technical Skill) tool was used to evaluate the performance of students. A questionnaire was distributed to the students following the examination. Mean performance score of Station 3 was significant lower than that of Station 1 and 2 in the general performance including tissue handling, time, and motion. The suturing techniques of students at Station 2 and 3 were not as accurate as that at Station 1. Inappropriate tension was applied to the knot at Station 2 compared with Station 1 and 3. On the questionnaire, 93% of students considered clinical-simulated training of basic surgical skills was necessary and may increase their confidence in future clinical work as surgeons; 98% of students thought the assessment was more objective when OSATS tool was used for evaluation. Clinical simulation examination assessed with OSATS might throw a novel light on the education of basic surgical skills and may be worthy of wider adoption in the surgical education of medical students.

Trained, generalized, and collateral behavior changes of preschool children receiving gross-motor skills training.

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Kirby, K C; Holborn, S W

1986-01-01

Three preschool children participated in a behavioral training program to improve their gross-motor skills. Ten target behaviors were measured in the training setting to assess direct effects of the program. Generalization probes for two gross-motor behaviors, one fine-motor skill, and two social behaviors were conducted in other settings. Results indicated that the training program improved the gross-motor skills trained and that improvements sometimes generalized to other settings. Contrary...

Instructor and Dental Student Perceptions of Clinical Communication Skills via Structured Assessments.

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McKenzie, Carly T

2016-05-01

The aim of this study was to use structured assessments to assess dental students' clinical communication skills exhibited during patient appointments. Fourth-year dental students (n=55) at the University of Alabama at Birmingham evaluated their own interpersonal skills in a clinical setting utilizing the Four Habits Coding Scheme. An instructor also assessed student-patient clinical communication. These assessments were used to identify perceived strengths and weaknesses in students' clinical communication. Both instructor assessments and student self-assessments pinpointed the following clinical communication skills as effective the most often: patient greeting, avoidance of jargon, and non-verbal behavior. There was also relative agreement between instructor assessments and student self-assessments regarding clinical communication skills that were rated as not effective most frequently: ensuring patient comprehension, identification of patient feelings, and exploration of barriers to treatment. These resulted pointed to strengths and weaknesses in the portion of the curriculum designed to prepare students for effective provider-patient communication. These results may suggest a need for the school's current behavioral science curriculum to better address discussion of potential treatment barriers and patient feelings as well as techniques to ensure patient comprehension.

Students' performance in the different clinical skills assessed in OSCE: what does it reveal?

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Sim, Joong Hiong; Abdul Aziz, Yang Faridah; Mansor, Azura; Vijayananthan, Anushya; Foong, Chan Choong; Vadivelu, Jamuna

2015-01-01

The purpose of this study was to compare students' performance in the different clinical skills (CSs) assessed in the objective structured clinical examination. Data for this study were obtained from final year medical students' exit examination (n=185). Retrospective analysis of data was conducted using SPSS. Means for the six CSs assessed across the 16 stations were computed and compared. Means for history taking, physical examination, communication skills, clinical reasoning skills (CRSs), procedural skills (PSs), and professionalism were 6.25±1.29, 6.39±1.36, 6.34±0.98, 5.86±0.99, 6.59±1.08, and 6.28±1.02, respectively. Repeated measures ANOVA showed there was a significant difference in the means of the six CSs assessed [F(2.980, 548.332)=20.253, pskill to be acquired by medical students before entering the workplace. Despite its challenges, students must learn the skills of clinical reasoning, while clinical teachers should facilitate the clinical reasoning process and guide students' clinical reasoning development.

Pairing students in clinical assignments to develop collaboration and communication skills.

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Bartges, Mali

2012-01-01

Skillful collaboration and communication among healthcare team members are associated with favorable patient outcomes. Student nurses need opportunities for supervised development of these crucial and intertwined skills. The author describes the implementation of a practice-change project for simultaneously developing collaboration and communication skills by pairing prelicensure student nurses in clinical assignments. This easily adapted strategy increases options for faculty looking to stimulate student acquisition of these professional skills.

Using simulation pedagogy to teach clinical education skills: A randomized trial.

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Holdsworth, Clare; Skinner, Elizabeth H; Delany, Clare M

2016-05-01

Supervision of students is a key role of senior physiotherapy clinicians in teaching hospitals. The objective of this study was to test the effect of simulated learning environments (SLE) on educators' self-efficacy in student supervision skills. A pilot prospective randomized controlled trial with concealed allocation was conducted. Clinical educators were randomized to intervention (SLE) or control groups. SLE participants completed two 3-hour workshops, which included simulated clinical teaching scenarios, and facilitated debrief. Standard Education (StEd) participants completed two online learning modules. Change in educator clinical supervision self-efficacy (SE) and student perceptions of supervisor skill were calculated. Between-group comparisons of SE change scores were analyzed with independent t-tests to account for potential baseline differences in education experience. Eighteen educators (n = 18) were recruited (SLE [n = 10], StEd [n = 8]). Significant improvements in SE change scores were seen in SLE participants compared to control participants in three domains of self-efficacy: (1) talking to students about supervision and learning styles (p = 0.01); (2) adapting teaching styles for students' individual needs (p = 0.02); and (3) identifying strategies for future practice while supervising students (p = 0.02). This is the first study investigating SLE for teaching skills of clinical education. SLE improved educators' self-efficacy in three domains of clinical education. Sample size limited the interpretation of student ratings of educator supervision skills. Future studies using SLE would benefit from future large multicenter trials evaluating its effect on educators' teaching skills, student learning outcomes, and subsequent effects on patient care and health outcomes.

Learning clinical communication skills: outcomes of a program for professional practitioners.

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Carvalho, Irene P; Pais, Vanessa G; Almeida, Susana S; Ribeiro-Silva, Raquel; Figueiredo-Braga, Margarida; Teles, Ana; Castro-Vale, Ivone; Mota-Cardoso, Rui

2011-07-01

To assess the effects of a communication skills program on professional practitioners' performance and self-confidence in clinical interviewing. Twenty-five health professionals took 3 months of basic communication skills followed by 3 months of advanced communication skills. An additional quarter dealt with self-awareness and communication in special situations. Participants' performances were evaluated in clinical interviews with standardized patients before, during and after the program by external observers and standardized patients, using standardized instruments. Participants assessed their own confidence in their communication skills before and after the program. Data were analysed using GLM repeated-measures procedures in SPSS. Basic communication skills and self-confidence improved throughout the 6 months; competencies declined but self-confidence continued to increase 4 months later. Compared with taking no course, differences were statistically significant after the 6 months (external observers only) and 4 months later (external observers and participants). The program effectively improved communication skills, although significantly only when assessed by external observers. Four months later, effects were significant in communication skills (external observers), despite the decline and in self-confidence. While periodical enrollment in programs for the practice of communication skills may help maintain performance, more knowledge on communication and self-awareness may enhance self-confidence. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Structured assessment of microsurgery skills in the clinical setting.

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Chan, WoanYi; Niranjan, Niri; Ramakrishnan, Venkat

2010-08-01

Microsurgery is an essential component in plastic surgery training. Competence has become an important issue in current surgical practice and training. The complexity of microsurgery requires detailed assessment and feedback on skills components. This article proposes a method of Structured Assessment of Microsurgery Skills (SAMS) in a clinical setting. Three types of assessment (i.e., modified Global Rating Score, errors list and summative rating) were incorporated to develop the SAMS method. Clinical anastomoses were recorded on videos using a digital microscope system and were rated by three consultants independently and in a blinded fashion. Fifteen clinical cases of microvascular anastomoses performed by trainees and a consultant microsurgeon were assessed using SAMS. The consultant had consistently the highest scores. Construct validity was also demonstrated by improvement of SAMS scores of microsurgery trainees. The overall inter-rater reliability was strong (alpha=0.78). The SAMS method provides both formative and summative assessment of microsurgery skills. It is demonstrated to be a valid, reliable and feasible assessment tool of operating room performance to provide systematic and comprehensive feedback as part of the learning cycle. Copyright 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Use of the objective structured clinical examination for assessment of vocational trainees for general practice

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Walker, Robert; Walker, Barrie

1987-01-01

General practice training schemes currently have no structured methods of assessment and most rely on a variety of subjective ratings of performance. In West Cumbria the `objective structured clinical examination' has been used to assess training performance in areas covered by small group teaching during the preceding terms. Consultation skills, interpretation of clinical data and a number of aspects of practice management were tested. The examination was conducted in the local postgraduate ...

Collaborative learning of clinical skills in health professions education: the why, how, when and for whom.

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Tolsgaard, Martin G; Kulasegaram, Kulamakan M; Ringsted, Charlotte V

2016-01-01

This study is designed to provide an overview of why, how, when and for whom collaborative learning of clinical skills may work in health professions education. Collaborative learning of clinical skills may influence learning positively according to the non-medical literature. Training efficiency may therefore be improved if the outcomes of collaborative learning of clinical skills are superior or equivalent to those attained through individual learning. According to a social interaction perspective, collaborative learning of clinical skills mediates its effects through social interaction, motivation, accountability and positive interdependence between learners. Motor skills learning theory suggests that positive effects rely on observational learning and action imitation, and negative effects may include decreased hands-on experience. Finally, a cognitive perspective suggests that learning is dependent on cognitive co-construction, shared knowledge and reduced cognitive load. The literature on the collaborative learning of clinical skills in health science education is reviewed to support or contradict the hypotheses provided by the theories outlined above. Collaborative learning of clinical skills leads to improvements in self-efficacy, confidence and performance when task processing is observable or communicable. However, the effects of collaborative learning of clinical skills may decrease over time as benefits in terms of shared cognition, scaffolding and cognitive co-construction are outweighed by reductions in hands-on experience and time on task. Collaborative learning of clinical skills has demonstrated promising results in the simulated setting. However, further research into how collaborative learning of clinical skills may work in clinical settings, as well as into the role of social dynamics between learners, is required. © 2015 John Wiley & Sons Ltd.

Use of online clinical videos for clinical skills training for medical students: benefits and challenges.

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Jang, Hye Won; Kim, Kyong-Jee

2014-03-21

Multimedia learning has been shown effective in clinical skills training. Yet, use of technology presents both opportunities and challenges to learners. The present study investigated student use and perceptions of online clinical videos for learning clinical skills and in preparing for OSCE (Objective Structured Clinical Examination). This study aims to inform us how to make more effective us of these resources. A mixed-methods study was conducted for this study. A 30-items questionnaire was administered to investigate student use and perceptions of OSCE videos. Year 3 and 4 students from 34 Korean medical schools who had access to OSCE videos participated in the online survey. Additionally, a semi-structured interview of a group of Year 3 medical students was conducted for an in-depth understanding of student experience with OSCE videos. 411 students from 31 medical schools returned the questionnaires; a majority of them found OSCE videos effective for their learning of clinical skills and in preparing for OSCE. The number of OSCE videos that the students viewed was moderately associated with their self-efficacy and preparedness for OSCE (p mobile devices; they agreed more with the statement that it was convenient to access the video clips than their peers who accessed the videos using computers (p students reported lack of integration into the curriculum and lack of interaction as barriers to more effective use of OSCE videos. The present study confirms the overall positive impact of OSCE videos on student learning of clinical skills. Having faculty integrate these learning resources into their teaching, integrating interactive tools into this e-learning environment to foster interactions, and using mobile devices for convenient access are recommended to help students make more effective use of these resources.

Midwifery students' experiences of learning clinical skills in Iran: a qualitative study.

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Ahmadi, Golnoosh; Shahriari, Mohsen; Keyvanara, Mahmood; Kohan, Shahnaz

2018-03-09

A qualitative study was used. Midwifery students from three universities in Iran participated. The study used a convenience sample of eighteen students. Data for this study was collected using semi-structured interviews (N=12) and focus groups (N=6). Data were recorded on a digital audio recorder and then transcribed. The qualitative data were analyzed using a content analysis approach. Six broad themes emerged from the analysis: Limited opportunities to experience skills, difficulties with course plan gaps, need for creating a supportive clinical environment, learning drives, confusion between different methods, and stress in the clinical setting. Short verbatim quotations from the participants were presented to provide evidence for the interpretation of data. The findings of this study have provided a clear picture of the factors and mechanisms involved in learning clinical skills by midwifery students. This study showed that students had some difficulties and concerns during learning of clinical midwifery skills. The findings of this study suggest that midwifery educators conduct further studies to tackle these issues in clinical skills learning. The findings of this study are subject to some limitations which are discussed.

Educational climate seems unrelated to leadership skills of clinical consultants responsible of postgraduate medical education in clinical departments

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Malling, Bente Vigh; Mortensen, Lene S.; Scherpbier, Albert J J

2010-01-01

The educational climate is crucial in postgraduate medical education. Although leaders are in the position to influence the educational climate, the relationship between leadership skills and educational climate is unknown. This study investigates the relationship between the educational climate...... in clinical departments and the leadership skills of clinical consultants responsible for education....

Communication skills: an essential component of medical curricula. Part I: Assessment of clinical communication: AMEE Guide No. 51.

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Laidlaw, Anita; Hart, Jo

2011-01-01

This AMEE Guide in Medical Education is Part 1 of a two part Guide covering the issues of Communication. This Guide has been written to provide guidance for those involved in planning the assessment of clinical communication and provides guidance and information relating to the assessment of various aspects of clinical communication; its underlying theory; its practical ability to show that an individual is competent and its relationship to students' daily performance. The advantages and disadvantages of assessing specific aspects of communication are also discussed. The Guide draws attention to the complexity of assessing the ability to communicate with patients and healthcare professionals, with issues of reliability and validity being highlighted for each aspect. Current debates within the area of clinical communication teaching are raised: when should the assessment of clinical communication occur in undergraduate medical education?; should clinical communication assessment be integrated with clinical skills assessment, or should the two be separate?; how important should the assessment of clinical communication be, and the question of possible failure of students if they are judged not competent in communication skills? It is the aim of the authors not only to provide a useful reference for those starting to develop their assessment processes, but also provide an opportunity for review and debate amongst those who already assess clinical communication within their curricula, and a resource for those who have a general interest in medical education who wish to learn more about communication skills assessment.

Transfer of communication skills to the workplace during clinical rounds: impact of a program for residents.

Directory of Open Access Journals (Sweden)

Aurore Liénard

2010-08-01

Full Text Available Communication with patients is a core clinical skill in medicine that can be acquired through communication skills training. Meanwhile, the importance of transfer of communication skills to the workplace has not been sufficiently studied. This study aims to assess the efficacy of a 40-hour training program designed to improve patients' satisfaction and residents' communication skills during their daily clinical rounds.Residents were randomly assigned to the training program or to a waiting list. Patients' satisfaction was assessed with a visual analog scale after each visit. Transfer of residents' communication skills was assessed in audiotaped actual inpatient visits during a half-day clinical round. Transcripted audiotapes were analyzed using content analysis software (LaComm. Training effects were tested with Mann-Whitney tests and generalized linear Poisson regression models.Eighty-eight residents were included. First, patients interacting with trained residents reported a higher satisfaction with residents' communication (Median=92 compared to patients interacting with untrained residents (Median=88 (p=.046. Second, trained residents used more assessment utterances (Relative Risk (RR=1.17; 95% Confidence intervals (95%CI=1.02-1.34; p=.023. Third, transfer was also observed when residents' training attendance was considered: residents' use of assessment utterances (RR=1.01; 95%CI=1.01-1.02; p=.018 and supportive utterances (RR=0.99; 95%CI=0.98-1.00; p=.042 (respectively 1.15 (RR, 1.08-1.23 (95%CI, p<.001 for empathy and 0.95 (RR, 0.92-0.99 (95%CI, p=.012 for reassurance was proportional to the number of hours of training attendance.The training program improved patients' satisfaction and allowed the transfer of residents' communication skills learning to the workplace. Transfer was directly related to training attendance but remained limited. Future studies should therefore focus on the improvement of the efficacy of communication skills

Prepared for Practice? Interns’ Experiences of Undergraduate Clinical Skills Training in Ireland

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M. Morris

2016-01-01

Full Text Available Background Many previous studies on internship have reported a lack of preparedness for the role. More recently in Ireland, medical schools have introduced formal clinical skills training programmes. This study sought to evaluate the impact, if any, of formal skills training in the medical training on intern's preparedness for practice. Methods The study utilized a survey approach followed by focus group discussions. The aim was to identify the skills that were taught and assessed in medical training and the skills that were actually required in their intern year. Results Most interns had received skills training in designated skills laboratories. No intern had received training in all skills advised in the European guidelines. Skills taught to all interns were intravenous cannulation, basic life support, and basic suture. Skills required from all interns were intravenous cannulation, phlebotomy, and arterial blood sampling. Removal of peripherally inserted central line (PICC lines, central lines, and chest drains were commonly requested but not taught. Senior staff underestimated skill abilities and expected failure. Conclusion These findings identify discordance between the skills taught and the skills required in the job. There is a need for standardization in the clinical skills training to ensure that all interns enter practice with equal competencies. Consideration should be given to experiential learning opportunities such as subintern programmes to consolidate learning and improve preparedness. Improvement in communications with senior clinicians is indicated to ensure that expectations are realistic and reflective of actual training.

An Investigation of Factors Influencing Nurses' Clinical Decision-Making Skills.

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Wu, Min; Yang, Jinqiu; Liu, Lingying; Ye, Benlan

2016-08-01

This study aims to investigate the influencing factors on nurses' clinical decision-making (CDM) skills. A cross-sectional nonexperimental research design was conducted in the medical, surgical, and emergency departments of two university hospitals, between May and June 2014. We used a quantile regression method to identify the influencing factors across different quantiles of the CDM skills distribution and compared the results with the corresponding ordinary least squares (OLS) estimates. Our findings revealed that nurses were best at the skills of managing oneself. Educational level, experience, and the total structural empowerment had significant positive impacts on nurses' CDM skills, while the nurse-patient relationship, patient care and interaction, formal empowerment, and information empowerment were negatively correlated with nurses' CDM skills. These variables explained no more than 30% of the variance in nurses' CDM skills and mainly explained the lower quantiles of nurses' CDM skills distribution. © The Author(s) 2016.

Are general surgeons able to accurately self-assess their level of technical skills?

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Rizan, C; Ansell, J; Tilston, T W; Warren, N; Torkington, J

2015-11-01

Self-assessment is a way of improving technical capabilities without the need for trainer feedback. It can identify areas for improvement and promote professional medical development. The aim of this review was to identify whether self-assessment is an accurate form of technical skills appraisal in general surgery. The PubMed, MEDLINE(®), Embase(™) and Cochrane databases were searched for studies assessing the reliability of self-assessment of technical skills in general surgery. For each study, we recorded the skills assessed and the evaluation methods used. Common endpoints between studies were compared to provide recommendations based on the levels of evidence. Twelve studies met the inclusion criteria from 22,292 initial papers. There was no level 1 evidence published. All papers compared the correlation between self-appraisal versus an expert score but differed in the technical skills assessment and the evaluation tools used. The accuracy of self-assessment improved with increasing experience (level 2 recommendation), age (level 3 recommendation) and the use of video playback (level 3 recommendation). Accuracy was reduced by stressful learning environments (level 2 recommendation), lack of familiarity with assessment tools (level 3 recommendation) and in advanced surgical procedures (level 3 recommendation). Evidence exists to support the reliability of self-assessment of technical skills in general surgery. Several variables have been shown to affect the accuracy of self-assessment of technical skills. Future work should focus on evaluating the reliability of self-assessment during live operating procedures.

Profile of science process skills of Preservice Biology Teacher in General Biology Course

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Susanti, R.; Anwar, Y.; Ermayanti

2018-04-01

This study aims to obtain portrayal images of science process skills among preservice biology teacher. This research took place in Sriwijaya University and involved 41 participants. To collect the data, this study used multiple choice test comprising 40 items to measure the mastery of science process skills. The data were then analyzed in descriptive manner. The results showed that communication aspect outperfomed the other skills with that 81%; while the lowest one was identifying variables and predicting (59%). In addition, basic science process skills was 72%; whereas for integrated skills was a bit lower, 67%. In general, the capability of doing science process skills varies among preservice biology teachers.

A Comparison Study of Communication Skills between General Surgery and General Practice Residents on First-time Patient Visits

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Ahmed Al Ansari

2012-04-01

Full Text Available Background: There is little published research about differences in doctor-patient communication of different specialties. Accordingly, we compared doctor-patient communication skills in two different specialties, general surgery (GS and general practice (GP. Methods: Twenty residents training at the Bahrain Defence Force Hospital (10 men and 10 women; mean age 28 years; 10 GS and 10 GP participated in 200 patient first visit consultations. The consultations were video-recorded and analysed by four trained observers using the MAAS Global scale. Results: 1 Internal consistency reliability of the MAAS Global (> 0.91 and Ep2 = 0.84 for raters was high, 2 GP residents spent more time (12 minutes than GS residents (7 minutes, in the visits, 3 There were several differences on the MAAS Global items between GP and GS residents (GS > GP, p GS, p < 0.05 on information giving, and 4 The present participants performed well compared to normative samples as well as to criterion-referenced cut-off scores. The general level of communication skills in both specialties, however, was ‘unsatisfactory’ and ‘doubtful’, as it is for normative samples. Conclusion: Excellent doctor-patient communication is essential but does not appear to receive the amount of attention that it deserves in practice settings. There are some differences between specialties as well as unsatisfactory communication skills for both specialties, since residents from both programs spent less time than recommended on each consultation. Our findings emphasize the need to improve the communication skills of physicians in general and for surgeons in particular.

Live transference of surgical subspecialty skills using telerobotic proctoring to remote general surgeons.

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Ereso, Alexander Q; Garcia, Pablo; Tseng, Elaine; Gauger, Grant; Kim, Hubert; Dua, Monica M; Victorino, Gregory P; Guy, T Sloane

2010-09-01

Certain clinical environments, including military field hospitals or rural medical centers, lack readily available surgical subspecialists. We hypothesized that telementoring by a surgical subspecialist using a robotic platform is feasible and can convey subspecialty knowledge and skill to a remotely located general surgeon. Eight general surgery residents evaluated the effect of remote surgical telementoring by performing 3 operative procedures, first unproctored and then again when teleproctored by a surgical subspecialist. The clinical scenarios consisted of a penetrating right ventricular injury requiring suture repair, an open tibial fracture requiring external fixation, and a traumatic subdural hematoma requiring craniectomy. A robotic platform consisting of a pan-and-tilt camera with laser pointer attached to an overhead surgical light with integrated audio allowed surgical subspecialists the ability to remotely teleproctor residents. Performance was evaluated using an Operative Performance Scale. Satisfaction surveys were given after performing the scenario unproctored and again after proctoring. Overall mean performance scores were superior in all scenarios when residents were proctored than when they were not (4.30 +/- 0.25 versus 2.43 +/- 0.20; p knowledge of anatomy, were all superior when residents were proctored (p < 0.001). Satisfaction surveys showed greater satisfaction and comfort among residents when proctored. Proctored residents believed the robotic platform facilitated learning and would be feasible if used clinically. This study supports the use of surgical teleproctoring in guiding remote general surgeons by a surgical subspecialist in the care of a wounded patient in need of an emergency subspecialty operation. Copyright 2010. Published by Elsevier Inc.

Students’ performance in the different clinical skills assessed in OSCE: what does it reveal?

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Joong Hiong Sim

2015-02-01

Full Text Available Introduction: The purpose of this study was to compare students’ performance in the different clinical skills (CSs assessed in the objective structured clinical examination. Methods: Data for this study were obtained from final year medical students’ exit examination (n=185. Retrospective analysis of data was conducted using SPSS. Means for the six CSs assessed across the 16 stations were computed and compared. Results: Means for history taking, physical examination, communication skills, clinical reasoning skills (CRSs, procedural skills (PSs, and professionalism were 6.25±1.29, 6.39±1.36, 6.34±0.98, 5.86±0.99, 6.59±1.08, and 6.28±1.02, respectively. Repeated measures ANOVA showed there was a significant difference in the means of the six CSs assessed [F(2.980, 548.332=20.253, p<0.001]. Pairwise multiple comparisons revealed significant differences between the means of the eight pairs of CSs assessed, at p<0.05. Conclusions: CRSs appeared to be the weakest while PSs were the strongest, among the six CSs assessed. Students’ unsatisfactory performance in CRS needs to be addressed as CRS is one of the core competencies in medical education and a critical skill to be acquired by medical students before entering the workplace. Despite its challenges, students must learn the skills of clinical reasoning, while clinical teachers should facilitate the clinical reasoning process and guide students’ clinical reasoning development.

Promoting fundamental clinical skills: a competency-based college approach at the University of Washington.

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Goldstein, Erika A; Maclaren, Carol F; Smith, Sherilyn; Mengert, Terry J; Maestas, Ramoncita R; Foy, Hugh M; Wenrich, Marjorie D; Ramsey, Paul G

2005-05-01

The focus on fundamental clinical skills in undergraduate medical education has declined over the last several decades. Dramatic growth in the number of faculty involved in teaching and increasing clinical and research commitments have contributed to depersonalization and declining individual attention to students. In contrast to the close teaching and mentoring relationship between faculty and students 50 years ago, today's medical students may interact with hundreds of faculty members without the benefit of a focused program of teaching and evaluating clinical skills to form the core of their four-year curriculum. Bedside teaching has also declined, which may negatively affect clinical skills development. In response to these and other concerns, the University of Washington School of Medicine has created an integrated developmental curriculum that emphasizes bedside teaching and role modeling, focuses on enhancing fundamental clinical skills and professionalism, and implements these goals via a new administrative structure, the College system, which consists of a core of clinical teachers who spend substantial time teaching and mentoring medical students. Each medical student is assigned a faculty mentor within a College for the duration of his or her medical school career. Mentors continuously teach and reflect with students on clinical skills development and professionalism and, during the second year, work intensively with them at the bedside. They also provide an ongoing personal faculty contact. Competency domains and benchmarks define skill areas in which deepening, progressive attention is focused throughout medical school. This educational model places primary focus on the student.

Identifying the nontechnical skills required of nurses in general surgical wards.

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Marshall, Dianne C; Finlayson, Mary P

2018-04-01

To identify the nontechnical skills (NTS) required of nurses in general surgical wards for safe and effective care. As the largest occupational group, nurses are in an ideal position to block the vulnerabilities of patient adverse events in a surgical ward. Previous studies in the surgical environment have identified the NTS required of nurses for safe care in operating rooms; however, these skills have not been identified for nurses in general surgical wards. A nonparticipant observational descriptive design was used. A purposive sample of 15 registered nurses was recruited from four surgical wards and observed for a full shift on a morning, afternoon or night shift. Nonparticipant observations were conducted using field notes to collect data. A coding frame was developed, and an inductive process was used to analyse the data. A taxonomy comprising seven NTS required of nurses in their roles in surgical ward teams emerged from the data analysis. They are communication, leadership and management, planning, decision-making, situation awareness, teamwork and patient advocacy. Patient care provided by general surgical nurses involved the seven identified key NTS. These particular NTS are an important component of safe nursing practice as they underpin the provision of safe and effective care for general surgical patients. Nurses block the trajectory of error by using NTS to address the vulnerabilities in the system that can lead to adverse patient events. Identifying general surgical nurses' NTS enables the development of teaching strategies that target the learning of those skills to achieve successful work outcomes and improve patient safety. © 2018 John Wiley & Sons Ltd.

An Innovative Clinical Skills “Boot Camp” for Dental Medicine Residents

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Jenny Castillo

2017-05-01

Full Text Available During a 1-year hospital-based residency, dental residents are required to rotate through many departments including surgery, medicine, and emergency medicine. It became apparent that there was a gap between clinical skills knowledge taught in dental school curriculum and skills required for hospital-based patient care. In response, a simulation-based intensive clinical skill “boot camp” was created. The boot camp provided an intensive, interactive 3-day session for the dental residents. During the 3 days, residents were introduced to medical knowledge and skills that were necessary for their inpatient hospital rotations but were lacking in traditional dental school curriculum. Effectiveness of the boot camp was assessed in terms of knowledge base and comfort through presession and postsession surveys. According to resident feedback, this intensive introduction for the dental residents improved their readiness for their inpatient hospital-based residency.

Fostering clinical engagement and medical leadership and aligning cultural values: an evaluation of a general practice specialty trainee integrated training placement in a primary care trust.

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Ruston, Annmarie; Tavabie, Abdol

2010-01-01

To report on the extent to which a general practice specialty trainee integrated training placement (ITP) developed the leadership skills and knowledge of general practice specialty trainees (GPSTRs) and on the potential of the ITP to improve clinical engagement. A case study method was used in a Kent primary care trust (PCT). Sources of data included face-to-face and telephone interviews (three GPSTRs, three PCT clinical supervisors, three general practitioner (GP) clinical supervisors and three Deanery/PCT managers), reflective diaries, documentary sources and observation. Interview data were transcribed and analysed using the constant comparative method. All respondents were positive about the value and success of the ITP in developing the leadership skills of the GPSTRs covering three dimensions: leadership of self, leadership of teams and leadership of organisations within systems. The ITP had enabled GP trainees to understand the context for change, to develop skills to set the direction for change and to collect and apply evidence to decision making. The ITP was described as an effective means of breaking down cultural barriers between general practice and the PCT and as having the potential for improving clinical engagement. The ITP provided a model to enable the effective exchange of knowledge and understanding of differing cultures between GPSTRs, general practice and the PCT. It provided a sound basis for effective, dispersed clinical engagement and leadership.

Trained, Generalized, and Collateral Behavior Changes of Preschool Children Receiving Gross-Motor Skills Training.

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Kirby, Kimberly C.; Holborn, Stephen W.

1986-01-01

Three preschool children participated in a behavioral training program to improve their gross-motor skills. Results indicated that the program improved the 10 targeted gross-motor skills and that improvements sometimes generalized to other settings. The program did not produce changes in fine-motor skills or social behaviors. Implications are…

Using newly deceased patients in teaching clinical skills: its ethical and educational challenges.

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Saber, Mahboobeh; Enjoo, Seyed Ali; Mahboudi, Ali; Tabei, Seyed Ziaadin

2018-04-01

The newly deceased patients have long been used in medical schools to teach clinical skills without any challenges as it helps to train skilled doctors. Nowadays, the use of moulages and simulators are common in teaching clinical skills since these tools provide the opportunity for frequent practice without any pain and injury. There are specific procedures which still require the use of cadavers. However, the increased significance of patient rights has generally challenged the practicality of using the deceased bodies for this purpose. This study was designed with the aim of determining to what extent clinical skill training is dependent on the recently deceased patients. This was a cross-sectional mixed-method triangulation design conducted in two phases. In the first phase, a researcher-made questionnaire was used to collect quantitative data of the medical students and residents. The data were used to assess the frequency of experience. In the second stage, semi-structured interviews were conducted with faculty members and fellows in order to evaluate the educational impact of this type of procedure and the influential factors. The quantitative data were analyzed using statistical software, and the qualitative codes were extracted following a content analysis. Finally, a comparative analysis was performed. Twenty five residents (26%) and seven medical students (14%) had the experience of performing procedures on the recently deceased patients for training purposes. About half of the residents and 33% of the medical students had observed their colleagues practicing procedures on cadavers. In the qualitative phase, the main categories included professional ethics, law and educational requirements. A relatively low number of medical students and residents had experienced procedures on the newly deceased patients. In this regard, ethical, religious and legal concerns might have played a part despite the desire to learn. It would be effective to direct these

Medical Students’ Clinical Skills Do Not Match Their Teachers’ Expectations: Survey at Zagreb University School of Medicine, Croatia

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Sičaja, Mario; Romić, Dominik; Prka, Željko

2006-01-01

Aim To evaluate self-assessed level of clinical skills of graduating medical students at Zagreb University School of Medicine and compare them with clinical skill levels expected by their teachers and those defined by a criterion standard. Method The study included all medical students (n = 252) graduating from the Zagreb University School of Medicine in the 2004-2005 academic year and faculty members (n = 129) teaching clinical skills. The participants completed anonymous questionnaire listing 99 clinical skills divided into nine groups. Students were asked to assess their clinical skills on a 0-5 scale, and faculty members were asked to assess the minimum necessary level of clinical skills expected from graduating medical students, using the same 0-5 scale. We compared the assessment scores of faculty members with students’ self-assessment scores. Participants were grouped according to their descriptive characteristics for further comparison. Results The response rate was 91% for students and 70% for faculty members. Students’ self-assessment scores in all nine groups of clinical skills ranged from 2.2 ± 0.8 to 3.8 ± 0.5 and were lower than those defined by the criterion standard (3.0-4.0) and those expected by teachers (from 3.1 ± 1.0 to 4.4 ± 0.5) (P<0.001 for all). Students who had additional clinical skills training had higher scores in all groups of skills, ranging from 2.6 ± 0.9 to 4.0 ± 0.5 (P<0.001 for all). Male students had higher scores than female students in emergency (P<0.001), neurology (P = 0.017), ear, nose, and throat (P = 0.002), urology (P = 0.003), and surgery skills (P = 0.002). Teachers’ expectations did not vary according to their sex, academic position, or specialty. Conclusion Students’ self-assessed level of clinical skills was lower than that expected by their teachers. Education during clinical rotations is not focused on acquiring clinical skills, and additional clinical

General surgery training and robotics: Are residents improving their skills?

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Finnerty, Brendan M; Afaneh, Cheguevara; Aronova, Anna; Fahey, Thomas J; Zarnegar, Rasa

2016-02-01

While robotic-assisted operations have become more prevalent, many general surgery residencies do not have a formal robotic training curriculum. We sought to ascertain how well current general surgery training permits acquisition of robotic skills by comparing robotic simulation performance across various training levels. Thirty-six participants were categorized by level of surgical training: eight medical students (MS), ten junior residents (JR), ten mid-level residents (MLR), and eight senior residents (SR). Participants performed three simulation tasks on the da Vinci (®) Skills Simulator (MatchBoard, EnergyDissection, SutureSponge). Each task's scores (0-100) and cumulative scores (0-300) were compared between groups. There were no differences in sex, hand dominance, video gaming history, or prior robotic experience between groups; however, SR was the oldest (p Robotic skillsets acquired during general surgery residency show minimal improvement during the course of training, although laparoscopic experience is correlated with advanced robotic task performance. Changes in residency curricula or pursuit of fellowship training may be warranted for surgeons seeking proficiency.

Forensic psychiatric nursing: skills and competencies: II clinical aspects.

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Mason, T; Coyle, D; Lovell, A

2008-03-01

This study reports on research undertaken to identify the skills and competencies of forensic psychiatric nurses working in secure psychiatric services in the UK. The rationale for this research is the lack of clarity in the role definition of nurses working in these environments and the specific content that may underscore the curriculum for training forensic nurses. Over 3300 questionnaires were distributed to forensic psychiatric nurses, non-forensic psychiatric nurses and other disciplines and information obtained on (1) the perceived clinical problems that give forensic nurses the most difficulty; (2) the skills best suited to overcome those problems; and (3) the priority aspects of clinical nursing care that needs to be developed. A 35% response rate was obtained with 1019 forensic psychiatric nurses, 110 non-forensic psychiatric nurses and 43 other disciplines. The results highlighted a 'top ten' list of main problems with possible solutions and main areas for development. The conclusions drawn include a focus on skills and competencies regarding the management of personality disorders and the management of violence and aggression.

Effectiveness of a Clinical Skills Workshop for drug-dosage calculation in a nursing program.

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Grugnetti, Anna Maria; Bagnasco, Annamaria; Rosa, Francesca; Sasso, Loredana

2014-04-01

Mathematical and calculation skills are widely acknowledged as being key nursing competences if patients are to receive care that is both effective and safe. Indeed, weaknesses in mathematical competence may lead to the administration of miscalculated drug doses, which in turn may harm or endanger patients' lives. However, little attention has been given to identifying appropriate teaching and learning strategies that will effectively facilitate the development of these skills in nurses. One such approach may be simulation. To evaluate the effectiveness of a Clinical Skills Workshop on drug administration that focused on improving the drug-dosage calculation skills of second-year nursing students, with a view to promoting safety in drugs administration. A descriptive pre-post test design. Educational. Simulation center. The sample population included 77 nursing students from a Northern Italian University who attended a 30-hour Clinical Skills Workshop over a period of two weeks. The workshop covered integrated teaching strategies and innovative drug-calculation methodologies which have been described to improve psychomotor skills and build cognitive abilities through a greater understanding of mathematics linked to clinical practice. Study results showed a significant improvement between the pre- and the post-test phases, after the intervention. Pre-test scores ranged between 0 and 25 out of a maximum of 30 points, with a mean score of 15.96 (SD 4.85), and a median score of 17. Post-test scores ranged between 15 and 30 out of 30, with a mean score of 25.2 (SD 3.63) and a median score of 26 (pstudy shows that Clinical Skills Workshops may be tailored to include teaching techniques that encourage the development of drug-dosage calculation skills, and that training strategies implemented during a Clinical skills Workshop can enhance students' comprehension of mathematical calculations. Copyright © 2013 Elsevier Ltd. All rights reserved.

Student teachers can be as good as associate professors in teaching clinical skills

DEFF Research Database (Denmark)

Tolsgaard, Martin G; Gustafsson, Amandus; Rasmussen, Maria B

2007-01-01

AIM: The aim of this study is to compare student teachers and clinical associate professors regarding the quality of procedural skills teaching in terms of participants' technical skills, knowledge and satisfaction with the teaching. METHODS: This is an experimental, randomized, controlled study....... CONCLUSION: Trained student teachers can be as good as associate professors in teaching clinical skills. Udgivelsesdato: 2007-Sep...... comparing the teaching of student teachers and associate professors regarding participants' learning outcome and satisfaction with the teaching. Two skills are chosen for the experiment, i.v.-access and bladder catheterization. Learning outcome is assessed by a pre- and post testing of the participants...

Effects of additional team-based learning on students' clinical reasoning skills: a pilot study.

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Jost, Meike; Brüstle, Peter; Giesler, Marianne; Rijntjes, Michel; Brich, Jochen

2017-07-14

In the field of Neurology good clinical reasoning skills are essential for successful diagnosing and treatment. Team-based learning (TBL), an active learning and small group instructional strategy, is a promising method for fostering these skills. The aim of this pilot study was to examine the effects of a supplementary TBL-class on students' clinical decision-making skills. Fourth- and fifth-year medical students participated in this pilot study (static-group comparison design). The non-treatment group (n = 15) did not receive any additional training beyond regular teaching in the neurology course. The treatment group (n = 11) took part in a supplementary TBL-class optimized for teaching clinical reasoning in addition to the regular teaching in the neurology course. Clinical decision making skills were assessed using a key-feature problem examination. Factual and conceptual knowledge was assessed by a multiple-choice question examination. The TBL-group performed significantly better than the non-TBL-group (p = 0.026) in the key-feature problem examination. No significant differences between the results of the multiple-choice question examination of both groups were found. In this pilot study participants of a supplementary TBL-class significantly improved clinical decision-making skills, indicating that TBL may be an appropriate method for teaching clinical decision making in neurology. Further research is needed for replication in larger groups and other clinical fields.

Developing clinical piano improvisation skills

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Wigram, Anthony Lewis

2003-01-01

Teaching piano improvisation skills for use in clinical work relies on the development of a range of musical techniques and therapeutic methods that are combined and integrated. Simple musical styles of playing such as melody dialogues, two chord accompaniments, walking basses (tonal and atonal), 6...... skilful way of helping a client or group of clients move, or develop their musical expression (Wigram & Bonde 2002 pp 278-279). Frame-working is a method that offers a musical structure to the music of a client. This structure could have the goal of enhancing the music aesthetically, or guiding the client...

Transfer of communication skills training from workshop to workplace: the impact of clinical supervision.

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Heaven, Cathy; Clegg, Jenny; Maguire, Peter

2006-03-01

Recent studies have recognised that the communication skills learned in the training environment are not always transferred back into the clinical setting. This paper reports a study which investigated the potential of clinical supervision in enhancing the transfer process. A randomised controlled trial was conducted involving 61 clinical nurse specialists. All attended a 3-day communication skills training workshop. Twenty-nine were then randomised to 4 weeks of clinical supervision, aimed at facilitating transfer of newly acquired skills into practice. Assessments, using real and simulated patients, were carried out before the course, immediately after the supervision period and 3 months later. Interviews were rated objectively using the Medical Interview Aural Rating Scale (MIARS) to assess nurses' ability to use key skills, respond to patient cues and identify patient concerns. Assessments with simulated patients showed that the training programme was extremely effective in changing competence in all three key areas. However, only those who experienced supervision showed any evidence of transfer. Improvements were found in the supervised groups' use of open questions, negotiation and psychological exploration. Whilst neither group facilitated more disclosure of cues or concerns, those in the experimental group responded more effectively to the cues disclosed, reduced their distancing behaviour and increasing their exploration of cues. The study has shown that whilst training enhances skills, without intervention, it may have little effect on clinical practice. The potential role of clinical supervision as one way of enhancing the clinical effectiveness of communication skills training programmes has been demonstrated. PRACTISE IMPLICATIONS: This study raises questions about the effectiveness of training programmes which do not incorporate a transfer element, and provides evidence to support the need for clinical supervision for clinical nurse specialist.

Who Is the Preferred Tutor in Clinical Skills Training: Physicians, Nurses, or Peers?

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Abay, Ece Şükriye; Turan, Sevgi; Odabaşı, Orhan; Elçin, Melih

2017-01-01

Phenomenon: Clinical skills centers allow structured training of undergraduate medical students for the acquisition of clinical skills in a simulated environment. Physician, nurse, or peer tutors are employed for training in those centers. All tutors should have appropriate training about the methodology used in the clinical skills training. Many of the studies revealed the effectiveness of various types of tutors. The aim of our study was to evaluate medical students' satisfaction with clinical skills training, and their opinions about the differences in coaching skills among the physician, nurse, and peer tutors. This study was conducted with third-year students (467 students) in 2013-2014 academic year at Hacettepe University Faculty of Medicine. Participation rate was 85 % (397 students). The students attended the suturing skill training in groups of 40 students. First, a faculty member from the Department of Medical Education delivered a video demonstration and conducted discussion. After the demonstration, the students were divided into groups of 5-6 students. A physician, nurse, or a peer tutor facilitated each group. The students were asked to complete the Coaching Skills Evaluation Form after the practicum session. It contained 13 criteria for assessing the coaching skills. Additionally, the form included a question for rating the student's satisfaction with the tutor. The performance of the tutors at each step was rated on a three-point scale. Kruskal Wallis analysis was used to compare students' scores for their tutors. The students' satisfaction with tutors was high for all of the tutors. However, there was no difference between students' scores in suturing skill, and between physician, nurse, and peer tutors' coaching skills. Insights: In this study, we revealed that physician, nurse, and peer tutors were equally effective on the students' performances. They were also regarded as effective in their teaching role by students. But the most important

[Skills lab training in veterinary medicine. Effective preparation for clinical work at the small animal clinic of the University for Veterinary Medicine Hannover, Foundation].

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Engelskirchen, Simon; Ehlers, Jan; Kirk, Ansgar T; Tipold, Andrea; Dilly, Marc

2017-09-20

During five and a half years of studying veterinary medicine, students should in addition to theoretical knowledge acquire sufficient practical skills. Considering animal welfare and ethical aspects, opportunities for hands-on learning on living animals are limited because of the high annual number of students. The first German veterinary clinical-skills lab, established in 2013 at the University for Veterinary Medicine Hannover, Foundation (TiHo), offers opportunities for all students to learn, train and repeat clinical skills on simulators and models as frequently as they would like, until they feel sufficiently confident to transfer these skills to living animals. This study describes the establishment of clinical-skills lab training within the students' practical education, using the example of the small-animal clinic of the TiHo. Two groups of students were compared: without skills lab training (control group K) and with skills lab training (intervention group I). At the end of both the training and a subsequent 10-week clinical rotation in different sections of the clinic, an objective structured clinical examination (OSCE) was performed, testing the students' practical skills at 15 stations. An additional multiple-choice test was performed before and after the clinical rotation to evaluate the increased theoretical knowledge. Students of group I achieved significantly (p ≤ 0.05) better results in eight of the 15 tested skills. The multiple-choice test revealed a significant (p ≤ 0.05) gain of theoretical knowledge in both groups without any differences between the groups. Students displayed a high degree of acceptance of the skills lab training. Using simulators and models in veterinary education is an efficient teaching concept, and should be used continually and integrated in the curriculum.

Using Facebook to enhance commencing student confidence in clinical skill development: A phenomenological hermeneutic study.

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Watson, Bernadette; Cooke, Marie; Walker, Rachel

2016-01-01

The purpose of this study was to explore commencing nursing students' experience of Facebook as an adjunct to on-campus course delivery to determine its impact as a learning strategy for improving confidence in clinical skill development. Approaches supporting nursing students in the development of clinical skills have relied on 'real-life' clinical placements and simulated on-campus clinical laboratories. However students continue to report a lack of confidence in their clinical skills for practice. Social networking sites including Facebook are being used as a learning strategy to stimulate active and collaborative learning approaches. A hermeneutic phenomenological approach was used to provide an understanding of the experience of confidence in clinical skills development for nursing students. Data were collected through in-depth interviews with commencing students about their experience as learners using Facebook and their perceptions of the impact on their clinical skill development. Ten first-year student nurses at one university in south-east Queensland, Australia. Four themes emerged from the data including: 'We're all in this together'; 'I can do this'; 'This is about my future goals and success'; and, 'Real time is not fast enough!'. These themes provide new meaningful insights demonstrating students' sense of confidence in clinical skills was increased through engagement with a dedicated Facebook page. The findings of this study have relevance to academics in the design of learning strategies for clinical courses to further support student confidence and engagement through peer collaboration and active learning processes. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Evaluation of clinical skills for first-year surgical residents using orientation programme and objective structured clinical evaluation as a tool of assessment

Directory of Open Access Journals (Sweden)

Pandya J

2010-01-01

Full Text Available Background: Postgraduate specialities require a combination of knowledge and clinical skills. The internship year is less structured. Clinical and practical skills that are picked up during training are not well regulated and the impact is not assessed. In this study, we assessed knowledge and skills using objective structured clinical examination (OSCE. Aim: To evaluate the clinical skills of new first-year surgical residents using orientation programme and OSCE as a tool for assessment. Settings and Design: Observational study. Materials and Methods: Twenty new first-year surgical residents (10 each in 2008 and 2009 participated in a detailed structured orientation programme conducted over a period of 7 days. Clinically important topics and skills expected at this level (e.g., suturing, wound care etc. were covered. The programme was preceded by an OSCE to test pre-programme knowledge (the "pre-test". The questions were validated by senior department staff. A post-programme OSCE (the "post-test" helped to evaluate the change in clinical skill level brought about by the orientation programme. Statistical Analysis: Wilcoxson matched-pairs signed-ranks test. Results: Passing performance was achieved by all participants in both pre- and post-tests. Following the orientation programme, significant improvement was seen in tasks testing the psychomotor and cognitive domains. (P = 0.0001 and P = 0.0401, respectively. Overall reliability of the OSCE was found to be 0.7026 (Cronbach′s coefficient alpha. Conclusions: This study highlighted the lacunae in current internship training, especially for skill-based tasks. There is a need for universal inclusion of structured orientation programmes in the training of first-year residents. OSCE is a reliable, valid and effective method for the assessment of clinical skills.

Elementary General and Special Education Teachers' Mathematics Skills and Efficacy

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Flores, Margaret M.; Thornton, Jennifer; Franklin, Toni M.; Hinton, Vanessa M.; Strozier, Shaunita

2014-01-01

The purpose of this study was to extend the literature regarding elementary teachers' beliefs about mathematics instruction to include special education teachers by surveying special education and general education teachers' mathematics teaching efficacy. In addition, the researchers' surveyed teachers' mathematics skills. The participants (n =…

Clinical skills assessment of procedural and advanced communication skills: performance expectations of residency program directors

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Langenau, Erik E.; Zhang, Xiuyuan; Roberts, William L.; DeChamplain, Andre F.; Boulet, John R.

2012-01-01

Background High stakes medical licensing programs are planning to augment and adapt current examinations to be relevant for a two-decision point model for licensure: entry into supervised practice and entry into unsupervised practice. Therefore, identifying which skills should be assessed at each decision point is critical for informing examination development, and gathering input from residency program directors is important. Methods Using data from previously developed surveys and expert panels, a web-delivered survey was distributed to 3,443 residency program directors. For each of the 28 procedural and 18 advanced communication skills, program directors were asked which clinical skills should be assessed, by whom, when, and how. Descriptive statistics were collected, and Intraclass Correlations (ICC) were conducted to determine consistency across different specialties. Results Among 347 respondents, program directors reported that all advanced communication and some procedural tasks are important to assess. The following procedures were considered ‘important’ or ‘extremely important’ to assess: sterile technique (93.8%), advanced cardiovascular life support (ACLS) (91.1%), basic life support (BLS) (90.0%), interpretation of electrocardiogram (89.4%) and blood gas (88.7%). Program directors reported that most clinical skills should be assessed at the end of the first year of residency (or later) and not before graduation from medical school. A minority were considered important to assess prior to the start of residency training: demonstration of respectfulness (64%), sterile technique (67.2%), BLS (68.9%), ACLS (65.9%) and phlebotomy (63.5%). Discussion Results from this study support that assessing procedural skills such as cardiac resuscitation, sterile technique, and phlebotomy would be amenable to assessment at the end of medical school, but most procedural and advanced communications skills would be amenable to assessment at the end of the first

Measuring general surgery residents' communication skills from the patient's perspective using the Communication Assessment Tool (CAT).

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Stausmire, Julie M; Cashen, Constance P; Myerholtz, Linda; Buderer, Nancy

2015-01-01

The Communication Assessment Tool (CAT) has been used and validated to assess Family and Emergency Medicine resident communication skills from the patient's perspective. However, it has not been previously reported as an outcome measure for general surgery residents. The purpose of this study is to establish initial benchmarking data for the use of the CAT as an evaluation tool in an osteopathic general surgery residency program. Results are analyzed quarterly and used by the program director to provide meaningful feedback and targeted goal setting for residents to demonstrate progressive achievement of interpersonal and communication skills with patients. The 14-item paper version of the CAT (developed by Makoul et al. for residency programs) asks patients to anonymously rate surgery residents on discrete communication skills using a 5-point rating scale immediately after the clinical encounter. Results are reported as the percentage of items rated as "excellent" (5) by the patient. The setting is a hospital-affiliated ambulatory urban surgery office staffed by the residency program. Participants are representative of adult patients of both sexes across all ages with diverse ethnic backgrounds. They include preoperative and postoperative patients, as well as those needing diagnostic testing and follow-up. Data have been collected on 17 general surgery residents from a single residency program representing 5 postgraduate year levels and 448 patient encounters since March 2012. The reliability (Cronbach α) of the tool for surgery residents was 0.98. The overall mean percentage of items rated as excellent was 70% (standard deviations = 42%), with a median of 100%. The CAT is a useful tool for measuring 1 facet of resident communication skills-the patient's perception of the physician-patient encounter. The tool provides a unique and personalized outcome measure for identifying communication strengths and improvement opportunities, allowing residents to receive

The effect of student self-video of performance on clinical skill competency: a randomised controlled trial.

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Maloney, Stephen; Storr, Michael; Morgan, Prue; Ilic, Dragan

2013-03-01

Emerging technologies and student information technology literacy are enabling new methods of teaching and learning for clinical skill performance. Facilitating experiential practice and reflection on performance through student self-video, and exposure to peer benchmarks, may promote greater levels of skill competency. This study examines the impact of student self-video on the attainment of clinical skills. A total of 60 Physiotherapy students (100%) consented to participate in the randomised controlled trial. One group (50%) was taught a complex clinical skill with regular practical tutoring, whilst the other group (50%) supplemented the tutoring with a self-video task aimed at promoting reflection on performance. Student skill performance was measured in an objective structured clinical examination (OSCE). Students also completed an anonymous questionnaire, which explored their perception of their learning experiences. Students received significantly higher scores in the OSCE when the examined clinical skill had been supplemented with a self-video of performance task (P = 0.048). Descriptive analysis of the questionnaires relating to student perceptions on the teaching methods identified that the self-video of performance task utilised contributed to improvement in their clinical performance and their confidence for future clinical practice. Students identified a number of aspects of the submission process that contributed to this perception of educational value. The novel results of this study demonstrate that greater clinical skill competency is achieved when traditional tutoring methods are supplemented with student self-video of performance tasks. Additional benefits included the ability of staff and students to monitor longitudinal performance, and an increase in feedback opportunities.

Clinical Skills Performed By Iranian Emergency Nurses: Perceived Competency Levels and Attitudes Toward Expanding Professional Roles.

Science.gov (United States)

Hassankhani, Hadi; Hasanzadeh, Firooz; Powers, Kelly A; Dadash Zadeh, Abbas; Rajaie, Rouzbeh

2018-03-01

Emergency nurses play an important role in the care of critically ill and injured patients, and their competency to perform clinical skills is vital to safe and effective patient care. The aim of this study was to evaluate the frequency of clinical skills performed and perceived competency levels among Iranian emergency nurses. In addition, attitudes toward expanding the professional roles of Iranian emergency nurses were also assessed. In this descriptive correlational study, 319 emergency nurses from 30 hospitals in northwest Iran participated. Data were collected using a self-report questionnaire. Descriptive statistics and Pearson's correlation coefficient were used to present the findings. Overall competency of the emergency nurses was 73.31 ± 14.2, indicating a good level of perceived competence. The clinical skills most frequently performed were in the domains of organizational and workload competencies (3.43 ± 0.76), diagnostic function (3.25 ± 0.82), and the helping role (3.17 ± 0.83). A higher level of perceived competence was found for skills within these domains. Less frequently, participants performed skills within the domains of effective management of rapidly changing situations (2.70 ± 0.94) and administering and monitoring therapeutic interventions (2.60 ± 0.97); a lower perceived level of competence was noted for these clinical skills. There was a significant correlation between frequency of performing clinical skills and perceived competency level (r = 0.651, P skills. This has implications for nurse managers and educators who may consider offering more frequent experiential and educational opportunities to emergency nurses. Expansion of nurses' roles could also result in increased experience in clinical skills and higher levels of competency. Research is needed to investigate nurses' clinical competence using direct and observed measures. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Teaching perceptual skills in clinical diagnostics using digital media

NARCIS (Netherlands)

Scheiter, Katharina; Jarodzka, Halszka

2011-01-01

Scheiter, K., & Jarodzka, H. (2011, May). Teaching perceptual skills in clinical diagnostics using digital media. Presentation at the 2nd International Conference “Research in Medical Education”: Shaping diamonds from bench to bedside, Universität Tübingen.

Impact of the site specialty of a continuity practice on students' clinical skills: performance with standardized patients.

Science.gov (United States)

Pfeiffer, Carol A; Palley, Jane E; Harrington, Karen L

2010-07-01

The assessment of clinical competence and the impact of training in ambulatory settings are two issues of importance in the evaluation of medical student performance. This study compares the clinical skills performance of students placed in three types of community preceptors' offices (pediatrics, medicine, family medicine) on yearly clinical skills assessments with standardized patients. Our goal was to see if the site specialty impacted on clinical performance. The students in the study were completing a 3-year continuity preceptorship at a site representing one of the disciplines. Their performance on the four clinical skills assessments was compared. There was no significant difference in history taking, physical exam, communication, or clinical reasoning in any year (ANOVA p< or = .05) There was a small but significant difference in performance on a measure of interpersonal and interviewing skills during Years 1 and 2. The site specialty of an early clinical experience does not have a significant impact on performance of most of the skills measured by the assessments.

Tracing the evolution of chiropractic students’ confidence in clinical and patient communication skills during a clinical internship: a multi-methods study

Science.gov (United States)

2012-01-01

Background Anecdotal evidence points to variations in individual students’ evolving confidence in clinical and patient communication skills during a clinical internship. A better understanding of the specific aspects of internships that contribute to increasing or decreasing confidence is needed to best support students during the clinical component of their study. Methods A multi-method approach, combining two large-scale surveys with 269 students and three in-depth individual interviews with a sub-sample of 29 students, was used to investigate the evolution of change in student confidence during a 10-month long internship. Change in levels of confidence in patient communication and clinical skills was measured and relationship to demographic factors were explored. The interviews elicited students’ accounts and reflections on what affected the evolution of their confidence during the internship. Results At the start of their internship, students were more confident in their patient communication skills than their clinical skills but prior experience was significantly related to confidence in both. Initial confidence in patient communication skills was also related to age and prior qualification but not gender whilst confidence in clinical skills was related to gender but not age or prior qualification. These influences were maintained over time. Overall, students’ levels of confidence in patient communication and clinical skills confidence increased significantly over the duration of the internship with evidence that change over time in these two aspects were inter-related. To explore how specific aspects of the internship contributed to changing levels of confidence, two extreme sub-groups of interviewees were identified, those with the least increase and those with the highest increase in professional confidence over time. A number of key factors affecting the development of confidence were identified, including among others, interactions with clinicians

Tracing the evolution of chiropractic students' confidence in clinical and patient communication skills during a clinical internship: a multi-methods study.

Science.gov (United States)

Hecimovich, Mark; Volet, Simone

2012-06-19

Anecdotal evidence points to variations in individual students' evolving confidence in clinical and patient communication skills during a clinical internship. A better understanding of the specific aspects of internships that contribute to increasing or decreasing confidence is needed to best support students during the clinical component of their study. A multi-method approach, combining two large-scale surveys with 269 students and three in-depth individual interviews with a sub-sample of 29 students, was used to investigate the evolution of change in student confidence during a 10-month long internship. Change in levels of confidence in patient communication and clinical skills was measured and relationship to demographic factors were explored. The interviews elicited students' accounts and reflections on what affected the evolution of their confidence during the internship. At the start of their internship, students were more confident in their patient communication skills than their clinical skills but prior experience was significantly related to confidence in both. Initial confidence in patient communication skills was also related to age and prior qualification but not gender whilst confidence in clinical skills was related to gender but not age or prior qualification. These influences were maintained over time. Overall, students' levels of confidence in patient communication and clinical skills confidence increased significantly over the duration of the internship with evidence that change over time in these two aspects were inter-related. To explore how specific aspects of the internship contributed to changing levels of confidence, two extreme sub-groups of interviewees were identified, those with the least increase and those with the highest increase in professional confidence over time. A number of key factors affecting the development of confidence were identified, including among others, interactions with clinicians and patients, personal agency and

A digital peer-to-peer learning platform for clinical skills development.

Science.gov (United States)

Basnak, Jesse; Ortynski, Jennifer; Chow, Meghan; Nzekwu, Emeka

2017-02-01

Due to constraints in time and resources, medical curricula may not provide adequate opportunities for pre-clerkship students to practice clinical skills. To address this, medical students at the University of Alberta developed a digital peer-to-peer learning initiative. The initiative assessed if students can learn clinical skills from their peers in co-curricular practice objective structured clinical exams (OSCEs). A total of 144 first-year medical students participated. Students wrote case scenarios that were reviewed by physicians. Students enacted the cases in practice OSCEs, acting as the patient, physician, and evaluator. Verbal and electronic evaluations were completed. A digital platform was used to automate the process. Surveys were disseminated to assess student perceptions of their experience. Seventy-five percent of participants said they needed opportunities to practice patient histories and physical exams in addition to those provided in the medical school curriculum. All participants agreed that the co-curricular practice OSCEs met this need. The majority of participants also agreed that the digital platform was efficient and easy to use. Students found the practice OSCEs and digital platform effective for learning clinical skills. Thus, peer-to-peer learning and computer automation can be useful adjuncts to traditional medical curricula.

Perceived versus actual condom skills among clients at sexually transmitted disease clinics.

OpenAIRE

Langer, L M; Zimmerman, R S; Cabral, R J

1994-01-01

The primary aim of this study was to investigate whether individual self-reports of perceived ability to use a condom correctly correlated with the actual ability to do so. Participants in the study were 3,059 clients of a sexually transmitted disease clinic. The findings revealed that the participants' perceived self-efficacy with regard to using a condom effectively was a poor indicator of their clinically demonstrated skills using a penile model as scored on the 6-point Condom Skills Index...

Impact of Facilitated Asynchronous Distance Education on Clinical Skills Development of International Pharmacy Graduates

Science.gov (United States)

Austin, Zubin; Dean, Marie Rocchi

2006-01-01

The use of distance education for clinical skills development in the health professions has not been extensively described, due in part to the intensive nature of the relationship between the patient and practitioner. In the context of pharmacy practice, there are specific needs to develop new vehicles for clinical skills education due to growing…

Cultural competency and communication skills of dental students: clinical supervisors' perceptions.

Science.gov (United States)

Mariño, R; Ghanim, A; Morgan, M; Barrow, S

2017-11-01

This study explored clinical supervisor's (CS) views and experiences of dental students' cultural competence (CC) at the Melbourne Dental School, The University of Melbourne, Australia. Additionally, this study explored CS insights into how CC could be taught. Semi-structured one-to-one interviews were organised with consenting CS. Interview topics included the following: the importance of CC, communication and rapport, the role of culture in oral health and the need for curriculum enhancement. Interviews were recorded, transcribed and thematically analysed to identify key areas using NVivo software. A total of 12 CS participated in this study. CS acknowledged the importance of CC and felt that it was important for good patient management. CS's definition of CC focused primarily on language and communication skills. CS felt that dental students were generally able to manage culturally diverse patients. However, CS indicated that additional training in this area would be beneficial. Concerns were raised about the students' ability to establish good rapport and communication, with CS highlighting areas such as misuse of interpreters and use of jargon. CS felt that clinical experience, confidence and a positive attitude are effective tools for overcoming cultural barriers. Furthermore, some CS also felt that cultural competency was a skill that is learnt through experience. For most CS, cultural competence was an important part of the clinician-patient exchange which would benefit from enhanced curriculum. They also highlighted areas where transcultural education could be improved. The majority of CS believed dental students managed culturally diverse patients well. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Skills in clinical communication: Are we correctly assessing them at undergraduate level?

Directory of Open Access Journals (Sweden)

Alberto Zamora Cervantes

2014-07-01

Full Text Available Communicating with the patient in clinical practice refers to the way in which the doctor and the patient interact both verbally and nonverbally, in order to achieve a shared understanding of problems and solutions. Traditional learning and assessment systems are overwhelmed when it comes to addressing the complex and multi-dimensional problems of professional practice. Problem Based Learning (PBL has been put forward as an alternative to the mere reproduction of knowledge and pre-established patterns, enabling students to develop their own learning strategies to overcome problems in their future professional practice. The challenge is to determine how to assess the acquisition of clinical communication skills. The authors have recommended a summative assessment of clinical communication skills based on the combination of different methods. It highlights the importance of feedback-based formative assessment. This raises the need to develop and validate assessment scales in clinical communication at an undergraduate level. Based on this work, the authors put forward a "fanned out" assessment in terms of clinical communication skills in Medicine degrees, with the use of different instruments in a "spiraled" manner, where the greater the contact with clinical practice in the various degree and integral courses, the greater difficulty experienced, with the participation of all the stakeholders involved (self, hetero and peer assessment without precluding the involvement of patients (real or simulated in the design of assessment instruments.

Utilizing visual art to enhance the clinical observation skills of medical students.

Science.gov (United States)

Jasani, Sona K; Saks, Norma S

2013-07-01

Clinical observation is fundamental in practicing medicine, but these skills are rarely taught. Currently no evidence-based exercises/courses exist for medical student training in observation skills. The goal was to develop and teach a visual arts-based exercise for medical students, and to evaluate its usefulness in enhancing observation skills in clinical diagnosis. A pre- and posttest and evaluation survey were developed for a three-hour exercise presented to medical students just before starting clerkships. Students were provided with questions to guide discussion of both representational and non-representational works of art. Quantitative analysis revealed that the mean number of observations between pre- and posttests was not significantly different (n=70: 8.63 vs. 9.13, p=0.22). Qualitative analysis of written responses identified four themes: (1) use of subjective terminology, (2) scope of interpretations, (3) speculative thinking, and (4) use of visual analogies. Evaluative comments indicated that students felt the exercise enhanced both mindfulness and skills. Using visual art images with guided questions can train medical students in observation skills. This exercise can be replicated without specially trained personnel or art museum partnerships.

Developing students' time management skills in clinical settings: practical considerations for busy nursing staff.

Science.gov (United States)

Cleary, Michelle; Horsfall, Jan

2011-06-01

In clinical settings, nursing staff often find themselves responsible for students who have varying time management skills. Nurses need to respond sensitively and appropriately, and to teach nursing students how to prioritize and better allocate time. This is important not only for developing students' clinical skills but also for shaping their perceptions about the quality of the placement and their willingness to consider it as a potential work specialty. In this column, some simple, practical strategies that nurses can use to assist students with improving their time management skills are identified. Copyright 2011, SLACK Incorporated.

Exploring the use of mobile technologies for the acquisition of clinical skills.

Science.gov (United States)

Clay, Collette A

2011-08-01

Mobile learning has the potential to supplement information communication technology (ICT), online learning and the traditional teaching and learning methods to educate practitioners in the clinical practice area. Following the development of several Post Graduate modules of learning for the theory and clinical skills required to undertake the Newborn Infant Physical Examination (NIPE), a small research study was undertaken to combine mobile learning and NIPE. The research study explored the hypothesis that mobile devices could be used in pedagogically effective ways to support and enhance the learning and acquisition of clinical skills in the clinical arena. Participants in the study each received a handheld mobile device (iPod) that had been loaded with several Reusable Learning Objects (RLO) outlining each aspect of the physical examination to be performed. At the end of the module (12 weeks in duration), each participant completed an evaluation questionnaire. Participants confirmed that mobile learning afforded flexibility in time and place of learning and captured their interest in the learning material. This study reports that the use of mobile technology for skill acquisition is creative and innovative, placing learning firmly in the hands of the learner. Copyright © 2010 Elsevier Ltd. All rights reserved.

[Assessment of clinical observation skills of last year medical students].

Science.gov (United States)

Steichen, O; Georgin-Lavialle, S; Grateau, G; Ranque, B

2015-05-01

Clinical examination skills are poorly evaluated by theoretical tests. We observed the clinical examination of real patients by 6th year medical students. Four internists involved in teaching activities defined 11 clinical examination items, with two objective performance criteria each. The students were evaluated in two internal medicine departments during the rotation preceding or following their national graduation test. Scores by item and by criterion and an overall score were calculated and correlated with their rank at the national graduation test. Thirty-two students were evaluated in one department and 18 in the other; each evaluation lasted approximately 30 minutes. The results were similar in both departments. Only 2 items got a score over 75% in this students' sample (acute respiratory failure, peripheral pulses); 4 items were satisfied at less than 50% (lymph nodes, right heart failure, liver failure, and attention). The mean overall score was 6.5/11 (standard deviation 1.5). National rankings were good (median 1605/8001, interquartile 453-3036) but uncorrelated with the global score (Spearman coefficient -0.13; P=0.39). Bedside evaluation of the students reveals substantial deficiencies, a few months or weeks before taking their position as residents. Several elementary skills are mastered by a minority of them (search for an asterixis, distended jugular veins, deep tendon reflexes), even among those successful at the national graduation test. Bedside evaluation of clinical examination skills should be more systematically performed. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Development of a tool to support holistic generic assessment of clinical procedure skills.

Science.gov (United States)

McKinley, Robert K; Strand, Janice; Gray, Tracey; Schuwirth, Lambert; Alun-Jones, Tom; Miller, Helen

2008-06-01

The challenges of maintaining comprehensive banks of valid checklists make context-specific checklists for assessment of clinical procedural skills problematic. This paper reports the development of a tool which supports generic holistic assessment of clinical procedural skills. We carried out a literature review, focus groups and non-participant observation of assessments with interview of participants, participant evaluation of a pilot objective structured clinical examination (OSCE), a national modified Delphi study with prior definitions of consensus and an OSCE. Participants were volunteers from a large acute teaching trust, a teaching primary care trust and a national sample of National Health Service staff. Results In total, 86 students, trainees and staff took part in the focus groups, observation of assessments and pilot OSCE, 252 in the Delphi study and 46 candidates and 50 assessors in the final OSCE. We developed a prototype tool with 5 broad categories amongst which were distributed 38 component competencies. There was > 70% agreement (our prior definition of consensus) at the first round of the Delphi study for inclusion of all categories and themes and no consensus for inclusion of additional categories or themes. Generalisability was 0.76. An OSCE based on the instrument has a predicted reliability of 0.79 with 12 stations and 1 assessor per station or 10 stations and 2 assessors per station. This clinical procedural skills assessment tool enables reliable assessment and has content and face validity for the assessment of clinical procedural skills. We have designated it the Leicester Clinical Procedure Assessment Tool (LCAT).

Clinical training in medical students during preclinical years in the skill lab

Directory of Open Access Journals (Sweden)

Upadhayay N

2017-03-01

Full Text Available Namrata Upadhayay Department of Physiology, Gandaki Medical College Teaching Hospital and Research Center, Kaski, Nepal Background: In Nepal, medical education is a high-stakes and stressful course. To enhance learning and minimize students’ stress, the conventional method has been replaced by integrated, student-centered learning. As an approach to train effectively, colleges have started establishing skill labs.Objectives: To evaluate the effectiveness of clinical skill training on exam performance as compared with the conventional teaching practice. Further, to assess the perceptions of students of the importance of skill lab training in college.Method: Twenty students were randomly selected to participate in this cross-sectional study. On the internal examination, students showed skills on manikins, and examiners evaluated them. A sample question in the exam was “To perform cardiopulmonary resuscitation (CPR on half body human manikin.” On completion of the exam, opinions were collected from the students via a predesigned self-administered questionnaire. The questionnaire included questions regarding skill lab use and its benefits to them in developing their skills, with a few questions related to the exam pattern. The responses were expressed in frequencies.Results: We found that all (20/20 students performed CPR with confidence and without hesitation on the manikin. The practical examination performance (marks was categorized as excellent (7/20, good (8/20, average (3/20, and poor (2/20. The pass percentage after skill training was increased by 25% as compared with conventional teaching practice. The majority of the students (17/20 mentioned that skill is better learned by doing than by observing others’ performance or watching videos. A few students (6/20 said skills are better learned by observing the real disease state. They mentioned that skill lab is the better choice for learning major skills such as catheterization, opening

Qualified nurses' rate new nursing graduates as lacking skills in key clinical areas.

Science.gov (United States)

Missen, Karen; McKenna, Lisa; Beauchamp, Alison; Larkins, Jo-Ann

2016-08-01

The aim of this study was to explore perceptions of qualified nurses on the abilities of newly registered nursing graduates to perform a variety of clinical skills. Evidence from the literature suggests that undergraduate nursing programmes do not adequately prepare nursing students to be practice-ready on completion of their nursing courses. A descriptive quantitative design was used. Participants were recruited through the Australian Nursing and Midwifery Federation, Victorian branch. A brief explanation of the study and a link to the survey were promoted in their monthly e-newsletter. A total of 245 qualified nurses in the state of Victoria, Australia participated in this study. A survey tool of 51 clinical skills and open-ended questions was used, whereby participants were asked to rate new nursing graduates' abilities using a 5-point Likert scale. Overall participants rated new nursing graduates' abilities for undertaking clinical skills as good or very good in 35·3% of skills, 33·3% were rated as adequate and 31·4% rated as being performed poorly or very poorly. Of concern, essential clinical skills, such as critical thinking and problem solving, working independently and assessment procedures, were found to be poorly executed and affecting new registered nurses graduates' competence. The findings from this study can further serve as a reference for nursing education providers to enhance nursing curricula and work collaboratively with healthcare settings in preparing nurses to be competent, safe practitioners on completion of their studies. Identifying key areas in which new nursing graduates are not yet competent means that educational providers and educators from healthcare settings can focus on these skills in better preparing our nurses to be work ready. © 2016 John Wiley & Sons Ltd.

Standardized Patients Provide a Reliable Assessment of Athletic Training Students' Clinical Skills

Science.gov (United States)

Armstrong, Kirk J.; Jarriel, Amanda J.

2016-01-01

Context: Providing students reliable objective feedback regarding their clinical performance is of great value for ongoing clinical skill assessment. Since a standardized patient (SP) is trained to consistently portray the case, students can be assessed and receive immediate feedback within the same clinical encounter; however, no research, to our…

The role of peer assisted learning to improve the effectivity of clinical skill laboratory learning in dental education

Directory of Open Access Journals (Sweden)

Agus Ardinansyah

2016-06-01

Full Text Available Nowadays, the clinical skill learning in dental education has begun in pre-clinic, known as Clinical Skill Laboratory (CSL which needs human resources, many and expensive tools and manikins, and enough times for practise. One of the method used in CSL in dental education is PeerAssisted Learning (PAL defined as “the development of knowledge and skill through active help and support among status equals or match companions”. This paper aims is to explain the role of PAL method to improve the effectivity of CSL learning in dental education in preclinical stage. Reviewing on the relevant literatures regarding peer assisted learning on the implementation of the clinical skill laboratory in dental education. The effectivity of CSL learning needs close supervision and individual feedback, so enough tutors is important through the process. This PAL method considered to be helpfull with the increasing numbers of dental students and the limitation of staff faculty. This method is found feasible, well accepted by peer-tutors and students, and can be as effective as conventional learning method. This is also useful for peer-teacher because they more intrinsically motivated, have higher conceptual learning scores, and perceive themselves to be more actively engaged with the environment than students who learn in order to be tested.  However, there are several limitation of this method. The contact time between students and medical doctors may decrease significantlyand it does not seem to be generally qualified to transfer such complex procedures.It also needs peer-teachers training and a detailed manual. Questions concerning the cost-effectiveness and profitability of student tutor-guided technical skills training may thus arise. But one institution that implemented this method states that the majority of their tutors decided to continue their teaching activity in the skills lab and that these experienced tutors, in addition to established faculty staff

Instructional scaffolding to improve students' skills in evaluating clinical literature.

Science.gov (United States)

Dawn, Stefani; Dominguez, Karen D; Troutman, William G; Bond, Rucha; Cone, Catherine

2011-05-10

To implement and assess the effectiveness of an activity to teach pharmacy students to critically evaluate clinical literature using instructional scaffolding and a Clinical Trial Evaluation Rubric. The literature evaluation activity centered on a single clinical research article and involved individual, small group, and large group instruction, with carefully structured, evidence-based scaffolds and support materials centered around 3 educational themes: (1) the reader's awareness of text organization, (2) contextual/background information and vocabulary, and (3) questioning, prompting, and self-monitoring (metacognition). Students initially read the article, scored it using the rubric, and wrote an evaluation. Students then worked individually using a worksheet to identify and define 4 to 5 vocabulary/concept knowledge gaps. They then worked in small groups and as a class to further improve their skills. Finally, they assessed the same article using the rubric and writing a second evaluation. Students' rubric scores for the article decreased significantly from a mean pre-activity score of 76.7% to a post-activity score of 61.7%, indicating that their skills in identifying weaknesses in the article's study design had improved. Use of instructional scaffolding in the form of vocabulary supports and the Clinical Trial Evaluation Rubric improved students' ability to critically evaluate a clinical study compared to lecture-based coursework alone.

A randomized controlled pilot trial comparing the impact of access to clinical endocrinology video demonstrations with access to usual revision resources on medical student performance of clinical endocrinology skills.

Science.gov (United States)

Hibbert, Emily J; Lambert, Tim; Carter, John N; Learoyd, Diana L; Twigg, Stephen; Clarke, Stephen

2013-10-03

Demonstrating competence in clinical skills is key to course completion for medical students. Methods of providing clinical instruction that foster immediate learning and potentially serve as longer-term repositories for on-demand revision, such as online videos demonstrating competent performance of clinical skills, are increasingly being used. However, their impact on learning has been little studied. The aim of this study was to determine the value of adjunctive on-demand video-based training for clinical skills acquisition by medical students in endocrinology. Following an endocrinology clinical tutorial program, 2nd year medical students in the pre-assessment revision period were recruited and randomized to either a set of bespoke on-line clinical skills training videos (TV), or to revision as usual (RAU). The skills demonstrated on video were history taking in diabetes mellitus (DMH), examination for diabetes lower limb complications (LLE), and examination for signs of thyroid disease (TE). Students were assessed on these clinical skills in an observed structured clinical examination two weeks after randomization. Assessors were blinded to student randomization status. For both diabetes related clinical skills assessment tasks, students in the TV group performed significantly better than those in the RAU group. There were no between group differences in thyroid examination performance. For the LLE, 91.7% (n = 11/12) of students randomized to the video were rated globally as competent at the skill compared with 40% (n = 4/10) of students not randomized to the video (p = 0.024). For the DMH, 83.3% (n = 10/12) of students randomized to the video were rated globally as competent at the skill compared with 20% (n = 2/10) of students not randomized to the video (p = 0.007). Exposure to high quality videos demonstrating clinical skills can significantly improve medical student skill performance in an observed structured clinical examination of these skills, when

Building consensus on clinical procedural skills for South African ...

African Journals Online (AJOL)

Background: The development of registrar training as part of the newly created speciality of family medicine in South Africa requires the development of a national consensus on the clinical procedural skills outcomes that should be expected of training programmes. Methods: This study utilized a Delphi technique to ...

Clinical program leadership: skill requirements for contemporary leaders.

Science.gov (United States)

Spallina, Joseph M

2002-01-01

With knowledge of these leadership requirements and a shrinking base of experienced managers, healthcare organizations and professional societies have little choice in their approach to prepare for the leadership development challenges of the future. Organizations will focus leadership development, training, and continuing management education on integrating business tools and skills into clinical program management. The management requirements for clinical programs will continue to grow in complexity and the number of qualified managers will continue to diminish, New approaches to solving this shortage will evolve. Professional, forprofit companies, healthcare provider organizations, and academic programs will develop clinical program management training tracks. Organizations that create solutions to this management imperative will maintain their competitive edge in the challenging times that will greet the industry in the future.

The outcomes and acceptability of near-peer teaching among medical students in clinical skills.

Science.gov (United States)

Khaw, Carole; Raw, Lynne

2016-06-12

To determine the outcomes and acceptability of final-year students tutoring in Clinical Skills to Years 1-2 students in a 4-week Medical Education elective. A paper-based survey with 14 questions requiring responses on a Likert-like scale and 2 questions with free-text responses was used to investigate Year 6 student-tutor (n=45) and Years 1-2 tutee (n=348) perceptions of near-peer teaching in Clinical Skills. The independent t-test compared mean responses from student-tutors and tutees, and thematic analysis of free-text responses was conducted. Tutee perceptions were significantly higher than student-tutor self-perceptions in small-group teaching and facilitation skills (p=0.000), teaching history-taking skills (p=0.046) and teaching physical examination skills (p=0.000). Perceptions in aspects of 'Confidence in tutoring' were not significantly different for student-tutors and tutees, with both having lowest perceptions for identifying and providing remediation for underperforming tutees. Student-tutors rated all areas of personal and professional development highly. Main themes emerging from analysis of student comments were the benefits to student-tutors, benefits to tutees and areas needing improvement, with outcomes of this near-peer teaching relating well to cognitive and social theories in the literature. Both student tutors and their tutees perceived near-peer teaching in Clinical Skills to be acceptable and beneficial with particular implications for Medical Education.

Curriculum content and assessment of pre-clinical dental skills: A survey of undergraduate dental education in Europe.

Science.gov (United States)

Field, J; Stone, S; Orsini, C; Hussain, A; Vital, S; Crothers, A; Walmsley, D

2018-05-01

Since 1981, the qualifications for various healthcare professionals across the European Union have enjoyed mutual recognition in accordance with the EU Directive 81/1057/EEC. Whilst the directive includes dental practitioners, it is recognised that significant variation exists in curriculum structure, content and scope of practice across institutions. This article aimed to explore pan-European practice in relation to curriculum content, teaching and learning strategies and assessment of pre-clinical dental skills. A request to complete an online questionnaire, in English, was sent electronically to skills leads at all Association of Dental Education in Europe member schools. The questionnaire collected information in relation to institution and country, regulatory requirements to demonstrate safety, details of specific pre-clinical skills courses, learning materials and teaching staff. Forty-eight institutions, from 25 European countries responded. Seven countries (n=7, 28%) reported no requirement to demonstrate student operative safety prior to patient treatment. Several core and operative clinical skills are common to the majority of institutions. The most commonly taught core skills related directly to the clinical environment such as cross-infection control and hand washing. The least common were skills that indirectly related to patient care, such as communication skills and working as a team. There are clear differences within European pre-clinical dental education, and greater efforts are needed to demonstrate that all European students are fit to practice before they start treating patients. Learning outcomes, teaching activities and assessment activities of pre-clinical skills should be shared collaboratively to further standardise curricula. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

From the general managerial skills to the school manager’s skills

OpenAIRE

Stan, Cristina

2016-01-01

Training and skill development represents a process in progress during the whole career and involves specialized training both within the organization and throughout the professional and social environment. Notion of skill/ com-petence has been the object of investigation for many sciences. Clarification of notion of competence/skill is necessary for those who want to deal with compe-tences, no matter is about their competences or of the others. In cognitive psychology and in educational scie...

A digital peer-to-peer learning platform for clinical skills development.

Directory of Open Access Journals (Sweden)

Jesse Paul Basnak

2017-02-01

Conclusion: Students found the practice OSCEs and digital platform effective for learning clinical skills. Thus, peer-to-peer learning and computer automation can be useful adjuncts to traditional medical curricula.

The impact of case specificity and generalisable skills on clinical performance: a correlated traits-correlated methods approach.

Science.gov (United States)

Wimmers, Paul F; Fung, Cha-Chi

2008-06-01

The finding of case or content specificity in medical problem solving moved the focus of research away from generalisable skills towards the importance of content knowledge. However, controversy about the content dependency of clinical performance and the generalisability of skills remains. This study aimed to explore the relative impact of both perspectives (case specificity and generalisable skills) on different components (history taking, physical examination, communication) of clinical performance within and across cases. Data from a clinical performance examination (CPX) taken by 350 Year 3 students were used in a correlated traits-correlated methods (CTCM) approach using confirmatory factor analysis, whereby 'traits' refers to generalisable skills and 'methods' to individual cases. The baseline CTCM model was analysed and compared with four nested models using structural equation modelling techniques. The CPX consisted of three skills components and five cases. Comparison of the four different models with the least-restricted baseline CTCM model revealed that a model with uncorrelated generalisable skills factors and correlated case-specific knowledge factors represented the data best. The generalisable processes found in history taking, physical examination and communication were responsible for half the explained variance, in comparison with the variance related to case specificity. Conclusions Pure knowledge-based and pure skill-based perspectives on clinical performance both seem too one-dimensional and new evidence supports the idea that a substantial amount of variance contributes to both aspects of performance. It could be concluded that generalisable skills and specialised knowledge go hand in hand: both are essential aspects of clinical performance.

Critical Thinking Skills among Elementary School Students: Comparing Identified Gifted and General Education Student Performance

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Kettler, Todd

2014-01-01

Education reform efforts, including the current adoption of Common Core State Standards, have increased attention to teaching critical thinking skills to all students. This study investigated the critical thinking skills of fourth-grade students from a school district in Texas, including 45 identified gifted students and 163 general education…

YouTube as a source of clinical skills education.

Science.gov (United States)

Duncan, Ian; Yarwood-Ross, Lee; Haigh, Carol

2013-12-01

YouTube may be viewed as a great 'time waster' but a significant amount of educative material can be found if the user is carefully selective. Interestingly, the growth of educational video on YouTube is closely associated to video viewership which increased from 22% to 38% between 2007 and 2009. This paper describes the findings of a study undertaken to assess the quality of clinical skills videos available on the video sharing site YouTube. This study evaluated 100 YouTube sites, approximately 1500 min or 25 h worth of content across 10 common clinical skill related topics. In consultation with novice practitioners, nurses in the first year of their university diploma programme, we identified ten common clinical skills that typically students would explore in more detail or would wish to revisit outside of the formal teaching environment. For each of these topics, we viewed each of the first 10 videos on the YouTube website. The videos were evaluated using a modification of the criteria outlined in Evaluation of Video Media Guideline. The topic with the biggest number of both postings and views was cardiopulmonary resuscitation and more specialist, nursing or health related topics such as managing a syringe driver or undertaking a pain assessment had less video content and lower numbers of viewers. Only one video out of the 100 analysed could be categorised as 'good' and that was the one in the Cannulation section. 60% of the CPR and venepuncture content was categorised as 'satisfactory'. There is a clear need for the quality of YouTube videos to be subjected to a rigorous evaluation. Lecturers should be more proactive in recommending suitable YouTube material as supplementary learning materials after appropriately checking for quality. Copyright © 2013 Elsevier Ltd. All rights reserved.

A self-help problem-solving video for parents and teens : social validity and generalization of acquired skills

OpenAIRE

Hook, Richard J.

1993-01-01

A self-administered problem-solving skill training video for nonclinical families with teens is evaluated. The study focuses on the generalization of skills to naturalistic family conversations and the program's social validity: potential iatrogenic aggravation of family problems, perceived effectiveness, and program enjoyment. Seventy families with young teens were randomly assigned to two treatment groups. One group (skill) viewed a skill training program that included information about ...

Should we use philosophy to teach clinical communication skills?

Science.gov (United States)

Gerber, Berna

2016-11-16

Effective communication between the doctor and patient is crucial for good quality health care. Yet, this form of communication is often problematic, which may lead to several negative consequences for both patients and doctors. Clinical communication skills have become important components of medical training programmes. The traditional approach is to teach students particular communication skills, such as listening to patients and asking open-ended questions. Despite their importance, such training approaches do not seem to be enough to deliver medical practitioners who are able and committed to communicate effectively with patients. This might be due to the pervasive negative influence of the medical profession's (mistaken) understanding of itself as a natural science on doctor-patient communication. Doctors who have been trained according to a positivist framework may consider their only responsibility to be the physical treatment of physical disorders. They may thus have little regard for the patient's psychological and social world and by extension for communication with the patient and/or their caregivers. To address this problem, I propose a curriculum, based on the academic field of philosophy, for teaching clinical communication.

Clinical skills-related learning goals of senior medical students after performance feedback.

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Chang, Anna; Chou, Calvin L; Teherani, Arianne; Hauer, Karen E

2011-09-01

Lifelong learning is essential for doctors to maintain competence in clinical skills. With performance feedback, learners should be able to formulate specific and achievable learning goals in areas of need. We aimed to determine: (i) the type and specificity of medical student learning goals after a required clinical performance examination; (ii) differences in goal setting among low, average and high performers, and (iii) whether low performers articulate learning goals that are concordant with their learning needs. We conducted a single-site, multi-year, descriptive comparison study. Senior medical students were given performance benchmarks, individual feedback and guidelines on learning goals; each student was subsequently instructed to write two clinical skills learning goals. Investigators coded the learning goals for specificity, categorised the goals, and performed statistical analyses to determine their concordance with student performance level (low, average or high) in data gathering (history taking and physical examination) or communication skills. All 208 students each wrote two learning goals and most (n=200, 96%) wrote two specific learning goals. Nearly two-thirds of low performers in data gathering wrote at least one learning goal that referred to history taking or physical examination; one-third wrote learning goals pertaining to the organisation of the encounter. High performers in data gathering wrote significantly more patient education goals and significantly fewer history-taking goals than average or low performers. Only 50% of low performers in communication wrote learning goals related to communication skills. Low performers in communication were significantly more likely than average or high performers to identify learning goals related to improving performance in future examinations. The provision of performance benchmarking, individual feedback and brief written guidelines helped most senior medical students in our study to write specific

Technology-based strategies for promoting clinical reasoning skills in nursing education.

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Shellenbarger, Teresa; Robb, Meigan

2015-01-01

Faculty face the demand of preparing nursing students for the constantly changing health care environment. Effective use of online, classroom, and clinical conferencing opportunities helps to enhance nursing students' clinical reasoning capabilities needed for practice. The growth of technology creates an avenue for faculty to develop engaging learning opportunities. This article presents technology-based strategies such as electronic concept mapping, electronic case histories, and digital storytelling that can be used to facilitate clinical reasoning skills.

Faculty Development for Fostering Clinical Reasoning Skills in Early Medical Students Using a Modified Bayesian Approach.

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Addy, Tracie Marcella; Hafler, Janet; Galerneau, France

2016-01-01

Clinical reasoning is a necessary skill for medical students to acquire in the course of their education, and there is evidence that they can start this process at the undergraduate level. However, physician educators who are experts in their given fields may have difficulty conveying their complex thought processes to students. Providing faculty development that equips educators with tools to teach clinical reasoning may support skill development in early medical students. We provided faculty development on a modified Bayesian method of teaching clinical reasoning to clinician educators who facilitated small-group, case-based workshops with 2nd-year medical students. We interviewed them before and after the module regarding their perceptions on teaching clinical reasoning. We solicited feedback from the students about the effectiveness of the method in developing their clinical reasoning skills. We carried out this project during an institutional curriculum rebuild where clinical reasoning was a defined goal. At the time of the intervention, there was also increased involvement of the Teaching and Learning Center in elevating the status of teaching and learning. There was high overall satisfaction with the faculty development program. Both the faculty and the students described the modified Bayesian approach as effective in fostering the development of clinical reasoning skills. Through this work, we learned how to form a beneficial partnership between a clinician educator and Teaching and Learning Center to promote faculty development on a clinical reasoning teaching method for early medical students. We uncovered challenges faced by both faculty and early learners in this study. We observed that our faculty chose to utilize the method of teaching clinical reasoning in a variety of manners in the classroom. Despite obstacles and differing approaches utilized, we believe that this model can be emulated at other institutions to foster the development of clinical

Learning outcomes using video in supervision and peer feedback during clinical skills training

DEFF Research Database (Denmark)

Lauridsen, Henrik Hein; Toftgård, Rie Castella; Nørgaard, Cita

supervision of clinical skills (formative assessment). Demonstrations of these principles will be presented as video podcasts during the session. The learning outcomes of video supervision and peer-feedback were assessed in an online questionnaire survey. Results Results of the supervision showed large self......Objective New technology and learning principles were introduced in a clinical skills training laboratory (iLab). The intension was to move from apprenticeship to active learning principles including peer feedback and supervision using video. The objective of this study was to evaluate student...... learning outcomes in a manual skills training subject using video during feedback and supervision. Methods The iLab classroom was designed to fit four principles of teaching using video. Two of these principles were (a) group work using peer-feedback on videos produced by the students and, (b) video...

Nursing students' perceptions of factors influencing their learning environment in a clinical skills laboratory: A qualitative study.

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Haraldseid, Cecilie; Friberg, Febe; Aase, Karina

2015-09-01

The mastery of clinical skills learning is required to become a trained nurse. Due to limited opportunities for clinical skills training in clinical practice, undergraduate training at clinical skills laboratories (CSLs) is an essential part of nursing education. In a sociocultural learning perspective learning is situated in an environment. Growing student cohorts, rapid introduction of technology-based teaching methods and a shift from a teaching- to a learning-centered education all influence the environment of the students. These changes also affect CSLs and therefore compel nursing faculties to adapt to the changing learning environment. This study aimed to explore students' perceptions of their learning environment in a clinical skills laboratory, and to increase the knowledge base for improving CSL learning conditions identifying the most important environmental factors according to the students. An exploratory qualitative methodology was used. Nineteen second-year students enrolled in an undergraduate nursing program in Norway participated in the study. They took the same clinical skills course. Eight were part-time students (group A) and 11 were full-time students (group B). Focus group interviews and content analysis were conducted to capture the students' perception of the CSL learning environment. The study documents students' experience of the physical (facilities, material equipment, learning tools, standard procedures), psychosocial (expectations, feedback, relations) and organizational (faculty resources, course structure) factors that affect the CSL learning environment. Creating an authentic environment, facilitating motivation, and providing resources for multiple methods and repetitions within clinical skills training are all important for improving CSL learning environments from the student perspective. Copyright © 2015 Elsevier Ltd. All rights reserved.

Developing critical thinking skills from clinical assignments: a pilot study on nursing students' self-reported perceptions.

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Marchigiano, Gail; Eduljee, Nina; Harvey, Kimberly

2011-01-01

Clinical assignments in nursing education provide opportunities for students to develop thinking skills vital to the effective delivery of patient care. The purpose of the present study was to examine students' perceived levels of confidence for using thinking skills when completing two types of clinical assignments. Clinical educators and managers are challenged to develop teaching and learning strategies that help students think critically and reflectively and transfer these skills into sound nursing practice. This study is based on the theoretical framework of critical thinking within the nursing process framework. Undergraduate nursing students (n=51) completed surveys indicating their confidence in using seven thinking skills for nursing care. Students indicated significantly more confidence when implementing the journal format as compared with the care plan format when analysing information, determining relevance, making connections, selecting appropriate information, applying relevant knowledge and evaluating outcomes. The findings of the present study propose a new approach for enhancing students' thinking skills. Journaling is an effective strategy for enhancing students' thinking skills. Nursing managers are in key organisational positions for supporting and promoting the use of the journal format and building supportive and collaborative learning environments for students to develop thinking skills for managing patient care. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

The relationship of motor skills and social communicative skills in school-aged children with autism spectrum disorder.

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MacDonald, Megan; Lord, Catherine; Ulrich, Dale A

2013-07-01

Motor skill deficits are present and persist in school-aged children with autism spectrum disorder (ASD; Staples & Reid, 2010). Yet the focus of intervention is on core impairments, which are part of the diagnostic criteria for ASD, deficits in social communication skills. The purpose of this study is to determine whether the functional motor skills, of 6- to 15-year-old children with high-functioning ASD, predict success in standardized social communicative skills. It is hypothesized that children with better motor skills will have better social communicative skills. A total of 35 children with ASD between the ages of 6-15 years participated in this study. The univariate GLM (general linear model) tested the relationship of motor skills on social communicative skills holding constant age, IQ, ethnicity, gender, and clinical ASD diagnosis. Object-control motor skills significantly predicted calibrated ASD severity (p skills have greater social communicative skill deficits. How this relationship exists behaviorally, needs to be explored further.

Video-recorded simulated patient interactions: can they help develop clinical and communication skills in today's learning environment?

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Seif, Gretchen A; Brown, Debora

2013-01-01

It is difficult to provide real-world learning experiences for students to master clinical and communication skills. The purpose of this paper is to describe a novel instructional method using self- and peer-assessment, reflection, and technology to help students develop effective interpersonal and clinical skills. The teaching method is described by the constructivist learning theory and incorporates the use of educational technology. The learning activities were incorporated into the pre-clinical didactic curriculum. The students participated in two video-recording assignments and performed self-assessments on each and had a peer-assessment on the second video-recording. The learning activity was evaluated through the self- and peer-assessments and an instructor-designed survey. This evaluation identified several themes related to the assignment, student performance, clinical behaviors and establishing rapport. Overall the students perceived that the learning activities assisted in the development of clinical and communication skills prior to direct patient care. The use of video recordings of a simulated history and examination is a unique learning activity for preclinical PT students in the development of clinical and communication skills.

Wiki Activities in Blended Learning for Health Professional Students: Enhancing Critical Thinking and Clinical Reasoning Skills

Science.gov (United States)

Snodgrass, Suzanne

2011-01-01

Health professionals use critical thinking, a key problem solving skill, for clinical reasoning which is defined as the use of knowledge and reflective inquiry to diagnose a clinical problem. Teaching these skills in traditional settings with growing class sizes is challenging, and students increasingly expect learning that is flexible and…

The impacts of observing flawed and flawless demonstrations on clinical skill learning.

Science.gov (United States)

Domuracki, Kurt; Wong, Arthur; Olivieri, Lori; Grierson, Lawrence E M

2015-02-01

Clinical skills expertise can be advanced through accessible and cost-effective video-based observational practice activities. Previous findings suggest that the observation of performances of skills that include flaws can be beneficial to trainees. Observing the scope of variability within a skilled movement allows learners to develop strategies to manage the potential for and consequences associated with errors. This study tests this observational learning approach on the development of the skills of central line insertion (CLI). Medical trainees with no CLI experience (n = 39) were randomised to three observational practice groups: a group which viewed and assessed videos of an expert performing a CLI without any errors (F); a group which viewed and assessed videos that contained a mix of flawless and errorful performances (E), and a group which viewed the same videos as the E group but were also given information concerning the correctness of their assessments (FA). All participants interacted with their observational videos each day for 4 days. Following this period, participants returned to the laboratory and performed a simulation-based insertion, which was assessed using a standard checklist and a global rating scale for the skill. These ratings served as the dependent measures for analysis. The checklist analysis revealed no differences between observational learning groups (grand mean ± standard error: [20.3 ± 0.7]/25). However, the global rating analysis revealed a main effect of group (d.f.2,36 = 4.51, p = 0.018), which describes better CLI performance in the FA group, compared with the F and E groups. Observational practice that includes errors improves the global performance aspects of clinical skill learning as long as learners are given confirmation that what they are observing is errorful. These findings provide a refined perspective on the optimal organisation of skill education programmes that combine physical and observational practice

Promoting the self-regulation of clinical reasoning skills in nursing students.

Science.gov (United States)

Kuiper, R; Pesut, D; Kautz, D

2009-10-02

The purpose of this paper is to describe the research surrounding the theories and models the authors united to describe the essential components of clinical reasoning in nursing practice education. The research was conducted with nursing students in health care settings through the application of teaching and learning strategies with the Self-Regulated Learning Model (SRL) and the Outcome-Present-State-Test (OPT) Model of Reflective Clinical Reasoning. Standardized nursing languages provided the content and clinical vocabulary for the clinical reasoning task. This descriptive study described the application of the OPT model of clinical reasoning, use of nursing language content, and reflective journals based on the SRL model with 66 undergraduate nursing students over an 8 month period of time. The study tested the idea that self-regulation of clinical reasoning skills can be developed using self-regulation theory and the OPT model. This research supports a framework for effective teaching and learning methods to promote and document learner progress in mastering clinical reasoning skills. Self-regulated Learning strategies coupled with the OPT model suggest benefits of self-observation and self-monitoring during clinical reasoning activities, and pinpoints where guidance is needed for the development of cognitive and metacognitive awareness. Thinking and reasoning about the complexities of patient care needs requires attention to the content, processes and outcomes that make a nursing care difference. These principles and concepts are valuable to clinical decision making for nurses globally as they deal with local, regional, national and international health care issues.

A Simulated Clinical Skills Scenario to Teach Interprofessional Teamwork to Health Profession Students

Directory of Open Access Journals (Sweden)

Eileen Adel Herge

2015-01-01

Full Text Available The Eastern Pennsylvania Delaware Geriatric Education Center developed an Interprofessional Clinical Skills Scenario (CSS to facilitate development of teamwork skills, specifically decision making, communication and collaboration, in health professions students in medicine, nursing, pharmacy, occupational and physical therapy programs. The case scenario provides students with the opportunity to practice communication and collaboration with a team and standardized patient and caregiver in a simulated clinical setting. The CSS was integrated into an existing occupational therapy course in 2011. Students were recruited by faculty from various schools (health professions, pharmacy, nursing, medicine throughout the university to participate in the CSS. The program evaluation included demographic assessment, process, and outcome measures. 166 students have participated in the CSS. Pre- and post-tests measured students' attitude toward healthcare teams. A Team Observation Tool was used by faculty and standardized patients/caregivers to evaluate student teams on communication, information sharing, and team interaction. A satisfaction survey was completed by the learners at the end of the CSS. This simulated Clinical Skills Scenario is a practical, interactive exercise that allows teams of interprofessional students to practice teamwork skills and patient-centered care with standardized patients and caregivers. Following a review of the learning activity and evaluation tools, the authors reflect on the effectiveness of the evaluation process for this CSS.

Exploring the Role and Skill Set of Physiotherapy Clinical Educators in Work-Integrated Learning

Science.gov (United States)

Edgar, Susan; Connaughton, Joanne

2014-01-01

Clinical educators are under increasing pressures in the workplace to provide quality education of healthcare students within varying supervision frameworks. Along with facilitating the teaching of clinical skills, clinical educators play a support role for students and so require more than expert clinical abilities in their vital position linking…

One-year retention of general and sequence-specific skills in a probabilistic, serial reaction time task.

Science.gov (United States)

Romano, Jennifer C; Howard, James H; Howard, Darlene V

2010-05-01

Procedural skills such as riding a bicycle and playing a musical instrument play a central role in daily life. Such skills are learned gradually and are retained throughout life. The present study investigated 1-year retention of procedural skill in a version of the widely used serial reaction time task (SRTT) in young and older motor-skill experts and older controls in two experiments. The young experts were college-age piano and action video-game players, and the older experts were piano players. Previous studies have reported sequence-specific skill retention in the SRTT as long as 2 weeks but not at 1 year. Results indicated that both young and older experts and older non-experts revealed sequence-specific skill retention after 1 year with some evidence that general motor skill was retained as well. These findings are consistent with theoretical accounts of procedural skill learning such as the procedural reinstatement theory as well as with previous studies of retention of other motor skills.

A Preliminary Investigation of General and Technique-specific Assessments for the Evaluation of Laparoscopic Technical Skills.

Science.gov (United States)

Vergis, Ashley; Steigerwald, Sarah

2017-10-07

Background  Both general and technique-specific assessments of technical skill have been validated in surgical education. The purpose of this study was to assess the correlation between the objective structured assessment of technical skills (OSATS) and the global operative assessment of laparoscopic skills (GOALS) rating scales using a high-fidelity porcine laparoscopic cholecystectomy model. Methods Post-graduate year-one general surgery and urology residents (n=14) performed a live laparoscopic porcine cholecystectomy. Trained surgeons rated their performance using OSATS and GOALS assessment scales. Results Pearson's correlation coefficient between OSATS and GOALS was 0.96 for overall scores. It ranged from 0.78 - 0.89 for domains that overlapped between the two scales. Conclusion There is a very high correlation between OSATS and GOALS. This implies that they likely measure similar constructs and that either may be used for summative-type assessments of trainee skill. However, further investigation is needed to determine if technique-specific assessments may provide more useful feedback in formative evaluation.

Training oncology and palliative care clinical nurse specialists in psychological skills: evaluation of a pilot study.

Science.gov (United States)

Clark, Jane E; Aitken, Susan; Watson, Nina; McVey, Joanne; Helbert, Jan; Wraith, Anita; Taylor, Vanessa; Catesby, Sarah

2015-06-01

National guidelines in the United Kingdom recommend training Clinical Nurse Specialists in psychological skills to improve the assessment and intervention with psychological problems experienced by people with a cancer diagnosis (National Institute for Health and Clinical Excellence, 2004). This pilot study evaluated a three-day training program combined with supervision sessions from Clinical Psychologists that focused on developing skills in psychological assessment and intervention for common problems experienced by people with cancer. Questionnaires were developed to measure participants' levels of confidence in 15 competencies of psychological skills. Participants completed these prior to the program and on completion of the program. Summative evaluation was undertaken and results were compared. In addition, a focus group interview provided qualitative data of participants' experiences of the structure, process, and outcomes of the program. Following the program, participants rated their confidence in psychological assessment and skills associated with providing psychological support as having increased in all areas. This included improved knowledge of psychological theories, skills in assessment and intervention and accessing and using supervision appropriately. The largest increase was in providing psycho-education to support the coping strategies of patients and carers. Thematic analysis of interview data identified two main themes including learning experiences and program enhancements. The significance of the clinical supervision sessions as key learning opportunities, achieved through the development of a community of practice, emerged. Although this pilot study has limitations, the results suggest that a combined teaching and supervision program is effective in improving Clinical Nurse Specialists' confidence level in specific psychological skills. Participants' experiences highlighted suggestions for refinement and development of the program

Should we use philosophy to teach clinical communication skills?

Directory of Open Access Journals (Sweden)

Berna Gerber

2016-11-01

Full Text Available Effective communication between the doctor and patient is crucial for good quality health care. Yet, this form of communication is often problematic, which may lead to several negative consequences for both patients and doctors. Clinical communication skills have become important components of medical training programmes. The traditional approach is to teach students particular communication skills, such as listening to patients and asking open-ended questions. Despite their importance, such training approaches do not seem to be enough to deliver medical practitioners who are able and committed to communicate effectively with patients. This might be due to the pervasive negative influence of the medical profession’s (mistaken understanding of itself as a natural science on doctor–patient communication. Doctors who have been trained according to a positivist framework may consider their only responsibility to be the physical treatment of physical disorders. They may thus have little regard for the patient’s psychological and social world and by extension for communication with the patient and/or their caregivers. To address this problem, I propose a curriculum, based on the academic field of philosophy, for teaching clinical communication.

Should we use philosophy to teach clinical communication skills?

Science.gov (United States)

2016-01-01

Effective communication between the doctor and patient is crucial for good quality health care. Yet, this form of communication is often problematic, which may lead to several negative consequences for both patients and doctors. Clinical communication skills have become important components of medical training programmes. The traditional approach is to teach students particular communication skills, such as listening to patients and asking open-ended questions. Despite their importance, such training approaches do not seem to be enough to deliver medical practitioners who are able and committed to communicate effectively with patients. This might be due to the pervasive negative influence of the medical profession’s (mistaken) understanding of itself as a natural science on doctor–patient communication. Doctors who have been trained according to a positivist framework may consider their only responsibility to be the physical treatment of physical disorders. They may thus have little regard for the patient’s psychological and social world and by extension for communication with the patient and/or their caregivers. To address this problem, I propose a curriculum, based on the academic field of philosophy, for teaching clinical communication. PMID:28155325

Staff and students' perceptions and experiences of teaching and assessment in Clinical Skills Laboratories: interview findings from a multiple case study.

Science.gov (United States)

Houghton, Catherine E; Casey, Dympna; Shaw, David; Murphy, Kathy

2012-08-01

The Clinical Skills Laboratory has become an essential structure in nurse education and several benefits of its use have been identified. However, the literature identifies the need to examine the transferability of skills learned there into the reality of practice. This research explored the role of the Clinical Skills Laboratory in preparing nursing students for the real world of practice. This paper focuses specifically on the perceptions of the teaching and assessment strategies employed there. Qualitative multiple case study design. Five case study sites. Interviewees (n=58) included academic staff, clinical staff and nursing students. Semi-structured interviews. The Clinical Skills Laboratory can provide a pathway to practice and its authenticity is significant. Teaching strategies need to incorporate communication as well as psychomotor skills. Including audio-visual recording into assessment strategies is beneficial. Effective relationships between education institutions and clinical settings are needed to enhance the transferability of the skills learned. The Clinical Skills Laboratory should provide an authentic learning environment, with the appropriate use of teaching strategies. It is crucial that effective links between educators and clinical staff are established and maintained. Copyright © 2011 Elsevier Ltd. All rights reserved.

Preparing clinical laboratory science students with teaching skills.

Science.gov (United States)

Isabel, Jeanne M

2010-01-01

Training clinical laboratory science (CLS) students in techniques of preparation and delivery of an instructional unit is an important component of all CLS education programs and required by the national accrediting agency. Participants of this study included students admitted to the CLS program at Northern Illinois University and enrolled in the teaching course offered once a year between the years of 1997 and 2009. Courses on the topic of "teaching" may be regarded by CLS students as unnecessary. However, entry level practitioners are being recruited to serve as clinical instructors soon after entering the workforce. Evaluation of the data collected indicates that students are better prepared to complete tasks related to instruction of a topic after having an opportunity to study and practice skills of teaching. Mentoring CLS students toward the career role of clinical instructor or professor is important to maintaining the workforce.

Do Simulation-Based Skill Exercises and Post-Encounter Notes Add Additional Value to a Standardized Patient-Based Clinical Skills Examination?

Directory of Open Access Journals (Sweden)

Michael D. Prislin

2011-01-01

Full Text Available Background. Standardized patient (SP clinical assessments have limited utility in assessing higher-level clinical competencies. This study explores the value of including simulation exercises and postencounter notes in an SP clinical skills examination. Methods. Two exercises involving cardiac auscultation and ophthalmic funduscopy simulations along with written post encounter notes were added to an SP-based performance examination. Descriptive analyses of students' performance and correlations with SP-based performance measures were obtained. Results. Students' abilities to detect abnormalities on physical exam were highly variable. There were no correlations between SP-based and simulation-derived measures of physical examination competency. Limited correlations were found between students' abilities to perform and document physical examinations and their formulation of appropriate differential diagnoses. Conclusions. Clinical simulation exercises add depth to SP-based assessments of performance. Evaluating the content of post encounter notes offers some insight into students' integrative abilities, and this appears to be improved by the addition of simulation-based post encounter skill exercises. However, further refinement of this methodology is needed.

Improving the training process of highly skilled bodybuilders in the preparatory period, general preparatory phase

Directory of Open Access Journals (Sweden)

Olexandr Tyhorskyy

2015-10-01

Full Text Available Purpose: to improve the method of training highly skilled bodybuilders. Material and Methods: the study involved eight highly skilled athletes, members of the team of Ukraine on bodybuilding. Results: comparative characteristics of the most commonly used methods of training process in bodybuilding. Developed and substantiated the optimal method of training highly skilled bodybuilders during the general preparatory phase of the preparatory period, which can increase body weight through muscle athletes component. Conclusions: dynamic load factor to raise the intensity of training loads allows orientation help to increase volumes shoulder muscles

Clinically speaking: A communication skills program for students from non-English speaking backgrounds.

Science.gov (United States)

Miguel, Caroline San; Rogan, Fran; Kilstoff, Kathleen; Brown, Di

2006-09-01

This paper reports on the design, delivery and evaluation of an innovative oral communication skills program for first year students in a Bachelor of Nursing degree at an Australian university. This program was introduced in 2004 to meet the needs of first year undergraduate students from non-English speaking backgrounds who had experienced difficulties with spoken English while on clinical placement. The program consisted of early identification of students in need of communication development, a series of classes incorporated into the degree program to address students' needs, followed by a clinical placement block. This paper describes the structure of the program, discusses some of the major problems encountered by students in the clinical setting and presents some of the teaching strategies used to address these problems. Evaluations of the program suggest that students' communication skills and confidence improved, resulting in a more positive clinical experience for the majority of students.

Analyzing communication skills of Pediatric Postgraduate Residents in Clinical Encounter by using video recordings.

Science.gov (United States)

Bari, Attia; Khan, Rehan Ahmed; Jabeen, Uzma; Rathore, Ahsan Waheed

2017-01-01

To analyze communication skills of pediatric postgraduate residents in clinical encounter by using video recordings. This qualitative exploratory research was conducted through video recording at The Children's Hospital Lahore, Pakistan. Residents who had attended the mandatory communication skills workshop offered by CPSP were included. The video recording of clinical encounter was done by a trained audiovisual person while the resident was interacting with the patient in the clinical encounter. Data was analyzed by thematic analysis. Initially on open coding 36 codes emerged and then through axial and selective coding these were condensed to 17 subthemes. Out of these four main themes emerged: (1) Courteous and polite attitude, (2) Marginal nonverbal communication skills, (3) Power game/Ignoring child participation and (4) Patient as medical object/Instrumental behaviour. All residents treated the patient as a medical object to reach a right diagnosis and ignored them as a human being. There was dominant role of doctors and marginal nonverbal communication skills were displayed by the residents in the form of lack of social touch, and appropriate eye contact due to documenting notes. A brief non-medical interaction for rapport building at the beginning of interaction was missing and there was lack of child involvement. Paediatric postgraduate residents were polite while communicating with parents and child but lacking in good nonverbal communication skills. Communication pattern in our study was mostly one-way showing doctor's instrumental behaviour and ignoring the child participation.

From the general managerial skills to the school manager’s skills

Directory of Open Access Journals (Sweden)

Cristina Stan

2016-09-01

Full Text Available Training and skill development represents a process in progress during the whole career and involves specialized training both within the organization and throughout the professional and social environment. Notion of skill/ com-petence has been the object of investigation for many sciences. Clarification of notion of competence/skill is necessary for those who want to deal with compe-tences, no matter is about their competences or of the others. In cognitive psychology and in educational sciences, in ergonomics and in economy or in human resources management, the concept of skill or competence is situated in the middle of the individual and collective performance and all of us want to develop. In education, the art of management is very important because it better highlights the principle’s/ school manager’s personality and his/ her personal example has an essential role in realizing the established objectives for school. The art of running a school is in fact the art of working with people that means a new, modern and distinct dimension of the one who runs the education institution.

Exploring the use of high-fidelity simulation training to enhance clinical skills.

Science.gov (United States)

Ann Kirkham, Lucy

2018-02-07

The use of interprofessional simulation training to enhance nursing students' performance of technical and non-technical clinical skills is becoming increasingly common. Simulation training can involve the use of role play, virtual reality or patient simulator manikins to replicate clinical scenarios and assess the nursing student's ability to, for example, undertake clinical observations or work as part of a team. Simulation training enables nursing students to practise clinical skills in a safe environment. Effective simulation training requires extensive preparation, and debriefing is necessary following a simulated training session to review any positive or negative aspects of the learning experience. This article discusses a high-fidelity simulated training session that was used to assess a group of third-year nursing students and foundation level 1 medical students. This involved the use of a patient simulator manikin in a scenario that required the collaborative management of a deteriorating patient. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

A Survey of Established Veterinary Clinical Skills Laboratories from Europe and North America: Present Practices and Recent Developments.

Science.gov (United States)

Dilly, Marc; Read, Emma K; Baillie, Sarah

Developing competence in clinical skills is important if graduates are to provide entry-level care, but it is dependent on having had sufficient hands-on practice. Clinical skills laboratories provide opportunities for students to learn on simulators and models in a safe environment and to supplement training with animals. Interest in facilities for developing veterinary clinical skills has increased in recent years as many veterinary colleges face challenges in training their students with traditional methods alone. For the present study, we designed a survey to gather information from established veterinary clinical skills laboratories with the aim of assisting others considering opening or expanding their own facility. Data were collated from 16 veterinary colleges in North America and Europe about the uses of their laboratory, the building and associated facilities, and the staffing, budgets, equipment, and supporting learning resources. The findings indicated that having a dedicated veterinary clinical skills laboratory is a relatively new initiative and that colleges have adopted a range of approaches to implementing and running the laboratory, teaching, and assessments. Major strengths were the motivation and positive characteristics of the staff involved, providing open access and supporting self-directed learning. However, respondents widely recognized the increasing demands placed on the facility to provide more space, equipment, and staff. There is no doubt that veterinary clinical skills laboratories are on the increase and provide opportunities to enhance student learning, complement traditional training, and benefit animal welfare.

Learning curves in highly skilled chess players: a test of the generality of the power law of practice.

Science.gov (United States)

Howard, Robert W

2014-09-01

The power law of practice holds that a power function best interrelates skill performance and amount of practice. However, the law's validity and generality are moot. Some researchers argue that it is an artifact of averaging individual exponential curves while others question whether the law generalizes to complex skills and to performance measures other than response time. The present study tested the power law's generality to development over many years of a very complex cognitive skill, chess playing, with 387 skilled participants, most of whom were grandmasters. A power or logarithmic function best fit grouped data but individuals showed much variability. An exponential function usually was the worst fit to individual data. Groups differing in chess talent were compared and a power function best fit the group curve for the more talented players while a quadratic function best fit that for the less talented. After extreme amounts of practice, a logarithmic function best fit grouped data but a quadratic function best fit most individual curves. Individual variability is great and the power law or an exponential law are not the best descriptions of individual chess skill development. Copyright © 2014 Elsevier B.V. All rights reserved.

An assessment of student satisfaction with peer teaching of clinical communication skills.

Science.gov (United States)

Mills, Jonathan K A; Dalleywater, William J; Tischler, Victoria

2014-10-13

Peer teaching is now used in medical education with its value increasingly being recognised. It is not yet established whether students differ in their satisfaction with teaching by peer-teachers compared to those taught by academic or clinical staff. This study aimed to establish satisfaction with communication skills teaching between these three teaching groups. Students participated in a role-play practical facilitated either by clinicians, peer-teachers or non-clinical staff. A questionnaire was administered to first-year medical students after participating in a communication skills role-play session asking students to evaluate their satisfaction with the session. Data were analysed in SPSS 20. One hundred and ninety eight students out of 239 (83%) responded. Students were highly satisfied with the teaching session with no difference in satisfaction scores found between those sessions taught by peers, clinical and non-clinical staff members. 158 (80%) considered the session useful and 139 (69%) strongly agreed tutors facilitated their development. There was no significant difference in satisfaction scores based on tutor background. Satisfaction is as high when tutored by peer-teachers compared to clinicians or non-clinical staff. Constructive feedback is welcomed from a range of personnel. Final-year students could play an increasing role in the teaching of pre-clinical medical students.

Perception versus reality: a comparative study of the clinical judgment skills of nurses during a simulated activity.

Science.gov (United States)

Fenske, Cynthia L; Harris, Margaret A; Aebersold, Michelle L; Hartman, Laurie S

2013-09-01

This study was conducted to determine how closely nurses' perceptions of their clinical judgment abilities matched their demonstrated clinical judgment skills during a simulation. Seventy-four registered nurses participated in a simulation using a video format. After the simulation, the nurses self-assessed their performance using the Lasater Clinical Judgment Rubric. This rubric was then used to rate the nurses' actual performance in the simulation activity. The study results showed a significant discrepancy between nurses' perceptions of their own clinical judgment abilities and their demonstrated clinical judgment skills. Age and length of nursing experience enhanced the difference between the findings of self-assessment and actual performance. Younger nurses and those with 1 year or less of nursing experience were significantly more likely to have self-assessed their abilities at a much higher level compared with their actual skills. Copyright 2013, SLACK Incorporated.

Clinical reasoning skills in final-year dental students: A qualitative cross-curricula comparison.

Science.gov (United States)

Nafea, E T; Dennick, R

2018-05-01

The aim of this research was to explore the perceptions of undergraduate dental students regarding clinical reasoning skills and also discover the influences of different curriculum designs on the acquisition of these skills by students. Eighteen final-year students from three different dental schools with varied curricula and cultures participated in the current research. The research used qualitative methodology. The study took place in 2013-2014. Interviews captured the participants' own understanding of clinical reasoning and its acquisition plus they "talked through" a clinical problem using a "think-aloud" technique. Thematic analysis was used to analyse the transcripts of the recorded interviews. Results obtained were related to curriculum structure. Unfamiliarity with the term clinical reasoning was common in students. Students from different schools used different strategies to reason when discussing clinical vignettes. Clinical reasoning process was dominated by pattern recognition. Students' behaviours seemed to be influenced by cultural factors. This research contributes to a greater understanding of how students learn, understand and apply dental clinical reasoning which will improve educational practices in the future. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

DEVELOPMENT OF BODY COMPOSITION, HORMONE PROFILE, PHYSICAL FITNESS, GENERAL PERCEPTUAL MOTOR SKILLS, SOCCER SKILLS AND ON-THE-BALL PERFORMANCE IN SOCCER-SPECIFIC LABORATORY TEST AMONG ADOLESCENT SOCCER PLAYERS

Directory of Open Access Journals (Sweden)

Tomi Vänttinen

2010-12-01

Full Text Available The aim of the present study was to examine the development of on-the-ball skills in soccer-specific laboratory test and to examine how traditional measures of body composition, hormone profile, physical fitness, general perceptual motor skills and soccer skills were related to performance measured in open skill environment among 10, 12, and 14-year-old regional male soccer players (n = 12/group. The measured variables were height, weight, fat, muscle mass, testosterone, 10m sprint, agility, counter movement jump, peripheral awareness, Eye- Hand-Foot coordination, passing skill, dribbling skill and on-the-ball skills (performance time and passing accuracy in soccer-specific laboratory test. A significant main effect by age was found in all measured variables except in fat, in peripheral awareness and in passing accuracy. In discriminant analysis 63.9% (λ = 0.603, F = 4.600, p < 0.01 of the players were classified correctly based on physical fitness and general perceptual motor skills into three ability groups originally classified with performance time in soccer-specific laboratory test. Correlation co- efficient analysis with-in age groups revealed that variables associated with performance time in soccer-specific laboratory test were peripheral awareness (r = 0.72, p < 0.01 in 10-year-olds; testosterone (r = -0.70, p < 0.05, dribbling skill (r = 0.73, p < 0.01 and passing skill (r = 0.73, p < 0.01 in 12-year-olds; agility (r = 0.79, p < 0.01, counter movement jump (r = - 0.62, p < 0.01, dribbling skill (r = 0.80, p < 0.01 and passing skill (r = 0.58, p < 0. 05 in 14-year olds. Corresponding relationships with passing accuracy were weight (r = 0.59, p < 0.05, fat (r = 0.66, p < 0.05, 10m sprint (r = 0.71, p < 0.01 and countermovement jump (r = -0.64, p < 0.05 in 10-year-olds; Eye-Hand-Foot coordination (r = 0.63, p < 0.05 in 14-year- olds. The relationship between soccer-specific anticipation time and performance time in soccer- specific

Curricular Innovation in the Surgery Clerkship: Can Assessment Methods Influence Development of Critical Thinking and Clinical Skills?

Science.gov (United States)

McClintic, James A; Snyder, Clifford L; Brown, Kimberly M

2018-03-12

Although key clinical skills have been defined in the Core Entrustable Professional Activities, there is a need to improve medical school curricula with standardized training opportunities and assessments of these skills. Thus, we aimed to develop an innovative curriculum that emphasized critical thinking and clinical skills. We hypothesized that we would be able to observe measurable improvement on assessments of students' critical thinking and clinical skills after the implementation of the new curriculum. Prospective, Quasi-Experimental study with the use of historical controls. This study took place through the third-year surgical clerkship at the University of Texas Medical Branch at the Galveston, Houston, and Austin, Texas, locations. A total of 214 students taking the third-year surgical clerkship for the first time during the periods of interest were included. Although the students with traditional curriculum improved 9.5% on a short answer exam from preclerkship to postclerkship completion, the students with new curriculum improved by 40%. Students under the new curriculum performed significantly better on the Objective Structured Clinical Exam; however, their shelf scores were lower. Under this new curriculum and grading system, we demonstrated that students can be incentivized to improve critical thinking and clinical skills, but this needs to be balanced with knowledge-based incentives. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

[Standardizing the manipulation procedure of acupuncture-moxibustion, reinforcing the training of' clinical skill: learning experience of Acupuncture-moxibustion Clinical Skills Training: Chapter of Commonly Used Needling and Moxibustion Techniques].

Science.gov (United States)

Tian, Hongfang; Yang, Chao; Tang, Jie; Qin, Qiuguo; Zhao, Mingwen; Zhao, Jiping

2015-07-01

The book Acupuncture-moxibustion Clinical Skills Training is one of "Twelfth Five-Year Plan" in novative teaching materials, which is published by People's Medical Publishing House. Through learning the first half of the book commonly used needling and moxibustion techniques, it is realized that the selection of book content is reasonable and much attention is paid to needling and moxibustion techniques; the chapter arrangement is well-organized, and the form is novel, which is concise and intuitive; for every technique, great attention is paid to standardize the manipulation procedure and clarify the technique key, simultaneously the safety of acupuncture and moxibustion is also emphasized. The characteristics of the book, including innovativeness, practicability, are highlighted, and it greatly helps to improve students' clinical skills and examination ability.

Clinical history and physical examination skills - A requirement for radiographers?

International Nuclear Information System (INIS)

Snaith, Beverly A.; Lancaster, Anne

2008-01-01

Radiographer's roles have evolved with their scope broadening over the last 20 years culminating in the development of advanced and consultant posts. Yet one development has not been embraced, despite being inherent in medicine and a common extension of nurse and other allied health professionals' roles, is that of clinical assessment. This article explores the evolving role of the radiographer and discusses whether this should include skills in clinical history taking and physical examination. Issues for education and development will be addressed together with examples of current and potential roles

A critical incident study of general practice trainees in their basic general practice term.

Science.gov (United States)

Diamond, M R; Kamien, M; Sim, M G; Davis, J

1995-03-20

To obtain information on the experiences of general practice (GP) trainees during their first general practice (GP) attachment. Critical incident technique--a qualitative analysis of open-ended interviews about incidents which describe competent or poor professional practice. Thirty-nine Western Australian doctors from the Royal Australian College of General Practitioners' (RACGP) Family Medicine Program who were completing their first six months of general practice in 1992. Doctors reported 180 critical incidents, of which just over 50% involved problems (and sometimes successes) with: difficult patients; paediatrics; the doctor-patient relationship; counselling skills; obstetrics and gynaecology; relationships with other health professionals and practice staff; and cardiovascular disorders. The major skills associated with both positive and negative critical incidents were: the interpersonal skills of rapport and listening; the diagnostic skills of thorough clinical assessment and the appropriate use of investigations; and the management skills of knowing when and how to obtain help from supervisors, hospitals and specialists. Doctors reported high levels of anxiety over difficult management decisions and feelings of guilt over missed diagnoses and inadequate management. The initial GP term is a crucial transition period in the development of the future general practitioner. An analysis of commonly recurring positive and negative critical incidents can be used by the RACGP Training Program to accelerate the learning process of doctors in vocational training and has implications for the planning of undergraduate curricula.

Family Generated and Delivered Social Story Intervention: Acquisition, Maintenance, and Generalization of Social Skills in Youths with ASD

Science.gov (United States)

Olcay-Gül, Seray; Tekin-Iftar, Elif

2016-01-01

The purpose of this study was to examine whether (a) family members were able to learn to write a social story and deliver social story intervention to teach social skills to their children (age 12 to 16) with ASD, (b) youths with ASD acquired and maintained the targeted social skills and generalized these skills across novel situations. Multiple…

Strategies for Improving Maintenance and Generalization of Academic Skills--So Students "Don't Leave Class without It."

Science.gov (United States)

Gable, Robert A.; And Others

1992-01-01

An instructional process for facilitating maintenance and generalization of academic skills is presented, using the ABCD'S (Antecedent Events, Behavior, Consequent Events, Data, and Setting Events) Generalization Intervention Model. (JDD)

Are 2 Years Enough? Exploring Technical Skills Acquisition Among General Surgery Residents in Brazil.

Science.gov (United States)

Santos, Elizabeth G; Salles, Gil F

2016-01-01

Phenomenon: Recent studies have shown that up to 40% of the General Surgery (GS) residents are not confident with their surgical skills. There is concern that residents are at risk of receiving inadequate training due to the low number of operations they perform. In Brazil, although all GS residents receive by law the Board Certification at the end of their programs, the assessment of their technical skills is not mandatory in Medical Residency programs' training. Consequently, our concern was that current GS medical residency format might be insufficient to create competent and autonomous general surgery residents after 2 years of regular training. Hence, the aim was to assess GS residents' surgical skills in their final months of training to evaluate the present format of GS residency programs in Brazil. Trained surgical faculty members directly observed 11 operations of varying difficulty performed by 2nd-year regular GS residents and by 4th-year residents in the optional Advanced Program in General Surgery. Participants were located at 3 university and 3 nonuniversity hospitals in Rio de Janeiro and Sao Paulo (Brazil's largest cities). Surgical skills were assessed using an internally developed observation checklist reviewed by subject matter experts. Sixty residents (46 regular 2nd-year trainees and 14 advanced 4th-year trainees) were assessed on performing 499 operations. Only 10 residents (17%), all advanced 4th-year residents, satisfactorily performed all operations and were considered eligible for the Board Certification. Even after excluding the 2 operations of greatest difficulty, only 24 regular 2nd-year residents (52%) satisfactorily performed the other 9 operations. Residents from hospitals with open Emergency Departments performed better than those from hospitals without Emergency Departments. Insights: The results of this pilot study suggest that residents with 2 years of training are not prepared for independent high-level surgical practice. The

Effects of an experiential learning program on the clinical reasoning and critical thinking skills of occupational therapy students.

Science.gov (United States)

Coker, Patty

2010-01-01

This study examined the effects of participation in a 1-week, experiential, hands-on learning program on the critical thinking and clinical reasoning skills of occupational therapy students. A quasi-experimental, nonrandomized pre- and post-test design was used with a sample of 25 students. The students had completed three semesters of didactic lecture coursework in a master's level OT educational program prior to participation in a hands-on therapy program for children with hemiplegic cerebral palsy. Changes in critical thinking and clinical reasoning skills were evaluated using the following dependent measures: Self-Assessment of Clinical Reflection and Reasoning (SACRR) and the California Critical Thinking Skills Test (CCTST). Changes in pretest and posttest scores on the SACRR and the CCTST were statistically significant (p>0.05) following completion of the experiential learning program. This study supports the use of hands-on learning to develop clinical reasoning and critical thinking skills in healthcare students, who face ever more diverse patient populations upon entry-level practice. Further qualitative and quantitative investigations are needed to support the results of this study and determine which components of experiential learning programs are essential for developing clinical reasoning and critical thinking skills in future allied health professionals.

Reducing symptoms of major depressive disorder through a systematic training of general emotion regulation skills: protocol of a randomized controlled trial.

Science.gov (United States)

Ehret, Anna M; Kowalsky, Judith; Rief, Winfried; Hiller, Wolfgang; Berking, Matthias

2014-01-27

Major Depressive Disorder is one of the most challenging mental health problems of our time. Although effective psychotherapeutic treatments are available, many patients fail to demonstrate clinically significant improvements. Difficulties in emotion regulation have been identified as putative risk and maintaining factors for Major Depressive Disorder. Systematically enhancing adaptive emotion regulation skills should thus help reduce depressive symptom severity. However, at this point, no study has systematically evaluated effects of increasing adaptive emotion regulation skills application on symptoms of Major Depressive Disorder. In the intended study, we aim to evaluate stand-alone effects of a group-based training explicitly and exclusively targeting general emotion regulation skills on depressive symptom severity and assess whether this training augments the outcome of subsequent individual cognitive behavioral therapy for depression. In the evaluation of the Affect Regulation Training, we will conduct a prospective randomized-controlled trial. Effects of the Affect Regulation Training on depressive symptom severity and outcomes of subsequent individual therapy for depression will be compared with an active, common factor based treatment and a waitlist control condition. The study sample will include 120 outpatients meeting criteria for Major Depressive Disorder. Depressive symptom severity as assessed by the Hamilton Rating Scale will serve as our primary study outcome. Secondary outcomes will include further indicators of mental health and changes in adaptive emotion regulation skills application. All outcomes will be assessed at intake and at 10 points in time over the course of the 15-month study period. Measures will include self-reports, observer ratings, momentary ecological assessments, and will be complemented in subsamples by experimental investigations and the analysis of hair steroids. If findings should support the hypothesis that enhancing

Training and generalization of laundry skills: a multiple probe evaluation with handicapped persons.

Science.gov (United States)

Thompson, T J; Braam, S J; Fugua, R W

1982-01-01

An instructional procedure composed of a graded sequence of prompts and token reinforcement was used to train a complex chain of behaviors which included sorting, washing, and drying clothes. A multiple probe design with sequential instruction across seven major components of the laundering routine was used to demonstrate experimental control. Students were taught to launder clothing using machines located in their school and generalization was assessed later on machines located in the public laundromat. A comparison of students' laundry skills with those of normal peers indicated similar levels of proficiency. Follow-up probes demonstrated maintenance of laundry skills over a 10-month period.

Effectiveness of Standardized Patient Simulations in Teaching Clinical Communication Skills to Dental Students.

Science.gov (United States)

McKenzie, Carly T; Tilashalski, Ken R; Peterson, Dawn Taylor; White, Marjorie Lee

2017-10-01

The aim of this study was to investigate dental students' long-term retention of clinical communication skills learned in a second-year standardized patient simulation at one U.S. dental school. Retention was measured by students' performance with an actual patient during their fourth year. The high-fidelity simulation exercise focused on clinical communication skills took place during the spring term of the students' second year. The effect of the simulation was measured by comparing the fourth-year clinical performance of two groups: those who had participated in the simulation (intervention group; Class of 2016) and those who had not (no intervention/control group; Class of 2015). In the no intervention group, all 47 students participated; in the intervention group, 58 of 59 students participated. Both instructor assessments and students' self-assessments were used to evaluate the effectiveness of key patient interaction principles as well as comprehensive presentation of multiple treatment options. The results showed that students in the intervention group more frequently included cost during their treatment option presentation than did students in the no intervention group. The instructor ratings showed that the intervention group included all key treatment option components except duration more frequently than did the no intervention group. However, the simulation experience did not result in significantly more effective student-patient clinical communication on any of the items measured. This study presents limited evidence of the effectiveness of a standardized patient simulation to improve dental students' long-term clinical communication skills with respect to thorough presentation of treatment options to a patient.

Improving communication in general practice when mental health issues appear: piloting a set of six evidence-based skills.

Science.gov (United States)

Stensrud, Tonje Lauritzen; Gulbrandsen, Pål; Mjaaland, Trond Arne; Skretting, Sidsel; Finset, Arnstein

2014-04-01

To test a communication skills training program teaching general practitioners (GPs) a set of six evidence-based mental health related skills. A training program was developed and tested in a pilot test-retest study with 21 GPs. Consultations were videotaped and actors used as patients. A coding scheme was created to assess the effect of training on GP behavior. Relevant utterances were categorized as examples of each of the six specified skills. The GPs' self-perceived learning needs and self-efficacy were measured with questionnaires. The mean number of GP utterances related to the six skills increased from 13.3 (SD 6.2) utterances before to 23.6 (SD 7.2) utterances after training; an increase of 77.4% (PSkills exploring emotions, cognitions and resources, and the skill Promote coping, increased significantly. Self-perceived learning needs and self-efficacy did not change significantly. The results from this pilot test are encouraging. GPs enhanced their use on four out of six mental health related communication skills significantly, and the effects were medium to large. This training approach appears to be an efficacious approach to mental health related communication skills training in general practice. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Reaching national consensus on the core clinical skill outcomes for family medicine postgraduate training programmes in South Africa.

Science.gov (United States)

Akoojee, Yusuf; Mash, Robert

2017-05-26

Family physicians play a significant role in the district health system and need to be equipped with a broad range of clinical skills in order to meet the needs and expectations of the communities they serve. A previous study in 2007 reached national consensus on the clinical skills that should be taught in postgraduate family medicine training prior to the introduction of the new speciality. Since then, family physicians have been trained, employed and have gained experience of working in the district health services. The national Education and Training Committee of the South African Academy of Family Physicians, therefore, requested a review of the national consensus on clinical skills for family medicine training. A Delphi technique was used to reach national consensus in a panel of 17 experts: family physicians responsible for training, experienced family physicians in practice and managers responsible for employing family physicians. Consensus was reached on 242 skills from which the panel decided on 211 core skills, 28 elective skills and 3 skills to be deleted from the previous list. The panel was unable to reach consensus on 11 skills. The findings will guide training programmes on the skills to be addressed and ensure consistency across training programmes nationally. The consensus will also guide formative assessment as documented in the national portfolio of learning and summative assessment in the national exit examination. The consensus will be of interest to other countries in the region where training programmes in family medicine are developing.

Rethinking workforce boundaries: roles, responsibilities and skill mix and readiness for change in general practice

OpenAIRE

Topping, Annie; Nkosana Nyawata, Idah; Stephenson, John; Featherstone, Valerie A.

2012-01-01

Title: Rethinking workforce boundaries: roles, responsibilities and skill mix and readiness for change in general practice \\ud The Problem \\ud The last 10 years has seen major changes in the way services are delivered in primary care. Skill mix, has offered many practices real opportunities for doing things differently. As the introduction of advanced nurse practitioners (ANPs) and health care assistants (HCAs) into the primary care workforce demonstrate. While workforce redesign has its crit...

Exploring Clinical Rotation Competence Improvements after Interpersonal Skills Development in At-Risk Medical Students

Directory of Open Access Journals (Sweden)

Sri Linuwih Menaldi

2014-12-01

Full Text Available AbstractPrior to admission, medical students were subject to psychological tests to measure their logical thinking skills and personality, hence predicting their ability to complete their studies. The results showed 56,45% of medical students obtained recommendation category 4 (doubtful and 5 (not recommended, two categories which are considered to be at-risk group with a very small probability of completing their studies. These results predicted that students in the mentioned groups will have difficulties in achieving the clinical competence level required by the Indonesian Doctors’ Competency Standard (IDCS. The aim of the study was to investigate clinical competency achievement by at-risk medical students in the third year, after following interpersonal skills development training program on July 2011. This research used qualitative study design through psychological examination, written self-reflection and in-depth interview after the training. Interpersonal skills development training for at-risk medical students gave positive effects to theircharacter development for the helping profession. It was concluded that interpersonal skills training could help improve medical student’s achievement of clinical competence especially for at-risk group in their clinical rotations stage.Keywords: medical students, at-risk group, interpersonal skills, clinical competence AbstrakPada mahasiswa kedokteran yang baru masuk dilakukan pemeriksaan psikologis untuk memperoleh gambaran penalaran dan kepribadian untuk memprediksi kemampuan mahasiswa dalam menyelesaikan pendidikan. Berdasarkan pemeriksaan tersebut diperoleh 56,45% mahasiswa dengan hasil uji psikometrik kategori rekomendasi 4 (diragukan dan 5 (tidak disarankan yang disebut sebagai kelompok at-risk. Kelompok at risk memiliki peluang keberhasilan rendah untuk menyelesaikan pendidikan dan akan mengalami kesulitan mencapai kompetensi klinik sesuai Standar Kompetensi Dokter Indonesia. Tujuan

Self- and rater-assessed effectiveness of "thinking-aloud" and "regular" morning report to intensify young physicians' clinical skills.

Science.gov (United States)

Hsu, Hui-Chi; Lee, Fa-Yauh; Yang, Ying-Ying; Tsao, Yen-Po; Lee, Wen-Shin; Chuang, Chiao-Lin; Chang, Ching-Chih; Huang, Chia-Chang; Huang, Chin-Chou; Ho, Shung-Tai

2015-09-01

This study compared the effects of the "thinking aloud" (TA) morning report (MR), which is characterized by sequential and interactive case discussion by all participants, with "regular" MR for clinical skill training of young physicians. Between February 2011 and February 2014, young physicians [including postgraduate year-1 (PGY1) residents, interns, and clerks) from our hospital were sequentially enrolled and followed for 3 months. The self- and rater-assessed educational values of two MR models for building up clinical skills of young physicians were compared. The junior (intern and clerk) attendees had higher self-assessed educational values scores and reported post-training application frequency of skills trained by TA MR compared with the senior (PGY1 resident) attendees. Higher average and percentage of increased overall rater-assessed OSCE scores were noted among the regular MR senior attendees and TA MR junior attendees than in their corresponding control groups (regular MR junior attendees and TA MR senior attendees). Interestingly, regular MRs provided additional beneficial effects for establishing the "professionalism, consulting skills and organization efficiency" aspects of clinical skills of senior/junior attendees. Moreover, senior and junior attendees benefited the most by participating in seven sessions of regular MR and TA MR each month, respectively. TA MR effectively trains junior attendees in basic clinical skills, whereas regular MR enhances senior attendees' "work reports, professionalism, organizational efficiency, skills in dealing with controversial and professional issues." Undoubtedly, all elements of the two MR models should be integrated together to ensure patient safety and good discipline among young physicians. Copyright © 2015. Published by Elsevier Taiwan.

Development and validation of an instrument to assess and improve clinical consultation skills

OpenAIRE

Lefroy, JE; Gay, SP; Gibson, S; Williams, S; McKinley, RK

2011-01-01

Context: Development of medical students’ consultation skills with patients is at the core of the UK General Medical Council’s 'Tomorrow’s Doctors' guide (2009). Teaching and assessment of these skills must therefore be a core component of the medical undergraduate curriculum. The Calgary Cambridge guide to the medical interview and the Leicester Assessment Package (LAP) provide a foundation for teaching and assessment, but both have different strengths. Objective: To develop and validate a c...

Reliable assessment of general surgeons' non-technical skills based on video-recordings of patient simulated scenarios.

Science.gov (United States)

Spanager, Lene; Beier-Holgersen, Randi; Dieckmann, Peter; Konge, Lars; Rosenberg, Jacob; Oestergaard, Doris

2013-11-01

Nontechnical skills are essential for safe and efficient surgery. The aim of this study was to evaluate the reliability of an assessment tool for surgeons' nontechnical skills, Non-Technical Skills for Surgeons dk (NOTSSdk), and the effect of rater training. A 1-day course was conducted for 15 general surgeons in which they rated surgeons' nontechnical skills in 9 video recordings of scenarios simulating real intraoperative situations. Data were gathered from 2 sessions separated by a 4-hour training session. Interrater reliability was high for both pretraining ratings (Cronbach's α = .97) and posttraining ratings (Cronbach's α = .98). There was no statistically significant development in assessment skills. The D study showed that 2 untrained raters or 1 trained rater was needed to obtain generalizability coefficients >.80. The high pretraining interrater reliability indicates that videos were easy to rate and Non-Technical Skills for Surgeons dk easy to use. This implies that Non-Technical Skills for Surgeons dk (NOTSSdk) could be an important tool in surgical training, potentially improving safety and quality for surgical patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Designing a clinical skills training laboratory with focus on video for better learning

DEFF Research Database (Denmark)

Lauridsen, Henrik Hein; Toftgård, Rie Castella; Nørgaard, Cita

resources of varying quality on the internet if this is not made available during teaching. The objective of this project was to design a new clinical skills laboratory with IT and video facilities to support learning processes. Methods Teaching principles were described before decisions on the design......Objective The principles of apprenticeship in clinical skills training are increasingly being challenged. First, most students are proficient in learning from visual multimedia and will expect this to be part of a modern university education. Second, students will often find visual teaching...... on a priori described teaching and learning designs related to active learning principles. This was a complex process involving teachers, IT-experts, e-learning specialists and a variety of university employees....

Acceptability and Impact of a Required Palliative Care Rotation with Prerotation and Postrotation Observed Simulated Clinical Experience during Internal Medicine Residency Training on Primary Palliative Communication Skills.

Science.gov (United States)

Vergo, Maxwell T; Sachs, Sharona; MacMartin, Meredith A; Kirkland, Kathryn B; Cullinan, Amelia M; Stephens, Lisa A

2017-05-01

Improving communication training for primary palliative care using a required palliative care rotation for internal medicine (IM) residents has not been assessed. To assess skills acquisition and acceptability for IM residents not selecting an elective. A consecutive, single-arm cohort underwent preobjective structured clinical examination (OSCE) with learner-centric feedback, two weeks of clinical experience, and finally a post-OSCE to crystallize learner-centric take home points. IM second year residents from Dartmouth-Hitchcock were exposed to a required experiential palliative care rotation. Pre- and post-OSCE using a standardized score card for behavioral skills, including patient-centered interviewing, discussing goals of care/code status, and responding to emotion, as well as a confidential mixed qualitative and quantitative evaluation of the experience. Twelve residents were included in the educational program (two were excluded because of shortened experiences) and showed statistically significant improvements in overall communication and more specifically in discussing code status and responding to emotions. General patient-centered interviewing skills were not significantly improved, but prerotation scores reflected pre-existing competency in this domain. Residents viewed the observed simulated clinical experience (OSCE) and required rotation as positive experiences, but wished for more opportunities to practice communication skills in real clinical encounters. A required palliative care experiential rotation flanked by OSCEs at our institution improved the acquisition of primary palliative care communication skills similarly to other nonclinical educational platforms, but may better meet the needs of the resident and faculty as well as address all required ACGME milestones.

Can the 'Assessment Drives Learning' effect be detected in clinical skills training? - Implications for curriculum design and resource planning

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Buss, Beate; Krautter, Markus; Möltner, Andreas; Weyrich, Peter; Werner, Anne; Jünger, Jana; Nikendei, Christoph

2012-01-01

Purpose: The acquisition of clinical-technical skills is of particular importance for the doctors of tomorrow. Procedural skills are often trained for the first time in skills laboratories, which provide a sheltered learning environment. However, costs to implement and maintain skills laboratories are considerably high. Therefore, the purpose of the present study was to investigate students’ patterns of attendance of voluntary skills-lab training sessions and thereby answer the following question: Is it possible to measure an effect of the theoretical construct related to motivational psychology described in the literature – ‘Assessment drives learning’ – reflected in patterns of attendance at voluntary skills-lab training sessions? By answering this question, design recommendations for curriculum planning and resource management should be derived. Method: A retrospective, descriptive analysis of student skills-lab attendance related to voluntary basic and voluntary advanced skills-lab sessions was conducted. The attendance patterns of a total of 340 third-year medical students in different successive year groups from the Medical Faculty at the University of Heidelberg were assessed. Results: Students showed a preference for voluntary basic skills-lab training sessions, which were relevant to clinical skills assessment, especially at the beginning and at the end of the term. Voluntary advanced skills-lab training sessions without reference to clinical skills assessment were used especially at the beginning of the term, but declined towards the end of term. Conclusion: The results show a clear influence of assessments on students’ attendance at skills-lab training sessions. First recommendations for curriculum design and resource management will be described. Nevertheless, further prospective research studies will be necessary to gain a more comprehensive understanding of the motivational factors impacting students’ utilisation of voluntary skills

Vocational trainees' views and experiences regarding the learning and teaching of communication skills in general practice.

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Van Nuland, Marc; Thijs, Gabie; Van Royen, Paul; Van den Noortgate, Wim; Goedhuys, Jo

2010-01-01

To explore the views and experiences of general practice (GP) vocational trainees regarding communication skills (CS) and the teaching and learning of these skills. A purposive sample of second and third (final) year GP trainees took part in six focus group (FG) discussions. Transcripts were coded and analysed in accordance with a grounded theory approach by two investigators using Alas-ti software. Finally results were triangulated by means of semi-structured telephone interviews. The analysis led to three thematic clusters: (1) trainees acknowledge the essential importance of communication skills and identified contextual factors influencing the learning and application of these skills; (2) trainees identified preferences for learning and receiving feedback on their communication skills; and (3) trainees perceived that the assessment of communication skills is subjective. These themes are organised into a framework for a better understanding of trainees' communication skills as part of their vocational training. The framework helps in leading to a better understanding of the way in which trainees learn and apply communication skills. The unique context of vocational training should be taken into account when trainees' communication skills are assessed. The teaching and learning should be guided by a learner-centred approach. The framework is valuable for informing curricular reform and future research.

Medical students' communication skills in clinical education: Results from a cohort study.

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Bachmann, Cadja; Roschlaub, Silke; Harendza, Sigrid; Keim, Rebecca; Scherer, Martin

2017-10-01

To assess students' communication skills during clinical medical education and at graduation. We conducted an observational cohort study from 2007 to 2011 with 26 voluntary undergraduate medical students at Hamburg University based on video-taped consultations in year four and at graduation. 176 consultations were analyzed quantitatively with validated and non-validated context-independent communication observation instruments (interrater reliability ≥0.8). Based on observational protocols each consultation was also documented in free-text comments, salient topics were extracted afterwards. 26 students, seven males, were enrolled in the survey. On average, graduates scored higher in differential-diagnostic questioning and time management but showed deficiencies in taking systematic and complete symptom-oriented histories, in communication techniques, in structuring consultations and in gathering the patients' perspectives. Patient-centeredness and empathy were rather low at graduation. Individual deficiencies could barely be eliminated. Medical students were able to enhance their clinical reasoning skills and their time management. Still, various communication deficiencies in final year students became evident regarding appropriate history taking, communication skills, empathy and patient-centeredness. The necessity of developing a longitudinal communication curriculum with enhanced communication trainings and assessments became evident. A curriculum should ensure that students' communication competencies are firmly achieved at graduation. Copyright © 2017. Published by Elsevier B.V.

The assessment of mindfulness skills: the "what" and the "how".

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Iani, Luca; Lauriola, Marco; Cafaro, Valentina

2017-10-06

The five facets mindfulness questionnaire-short form (FFMQ-SF) is a new, brief measure for the assessment of mindfulness skills in clinical and nonclinical samples. The construct validity of the FFMQ-SF has not been previously assessed in community samples. The present study investigated the factor structure of the Italian version of the FFMQ-SF. Structured equation modeling was used to test the fit of three alternative models in a sample of highly educated adults (n = 211). A hierarchical model with a single second-order factor loaded by observing, describing, and acting with awareness (i.e. the mindfulness "what" skills) performed slightly better than both a five-factor model with correlated factors and a hierarchical model with a general second-order factor. The FFMQ-SF scores were significantly higher than those reported in both Dutch depressed patients and Australian undergraduate students for all facets (but nonreactivity for the Australian sample). Data support the multifaceted nature of mindfulness skills. Because of its brevity and simplicity of use, the FFMQ-SF is a promising questionnaire in longitudinal and clinical research. This questionnaire can serve as a guideline to help clinicians assess and monitor mindfulness skills acquisition, strengthening, and generalization, and prioritize mindfulness skills that need immediate attention.

Identifying emotional intelligence skills of Turkish clinical nurses according to sociodemographic and professional variables.

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Kahraman, Nilgün; Hiçdurmaz, Duygu

2016-04-01

This study aimed to identify the emotional intelligence skills of Turkish clinical nurses according to sociodemographic and professional variables. Emotional intelligence is "the ability of a person to comprehend self-emotions, to show empathy towards the feelings of others, and to control self-emotions in a way that enriches life." Nurses with a higher emotional intelligence level offer more efficient and professional care, and they accomplish more in their social and professional lives. We designed a descriptive cross-sectional study. The Introductory Information Form and the Bar-On emotional intelligence Inventory were used to collect data between 20th June and 20th August 2012. The study was conducted with 312 nurses from 37 hospitals located within the borders of the metropolitan municipality in Ankara. There were no significant differences between emotional intelligence scores of the nurses according to demographic variables such as age, gender, marital status, having children. Thus, sociodemographic factors did not appear to be key factors, but some professional variables did. Higher total emotional intelligence scores were observed in those who had 10 years or longer experience, who found oneself successful in professional life, who stated that emotional intelligence is an improvable skill and who previously received self-improvement training. Interpersonal skills were higher in those with a graduate degree and in nurses working in polyclinics and paediatric units. These findings indicate which groups require improvement in emotional intelligence skills and which skills need improvement. Additionally, these results provide knowledge and create awareness about emotional intelligence skills of nurses and the distribution of these skills according to sociodemographic and professional variables. Implementation of emotional intelligence improvement programmes targeting the determined clinical nursing groups by nursing administrations can help the increase in

[Need for clinical guidelines for chronic periodontitis in general and specialized Belgian practice].

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Cosyn, Jan; Thevissen, Eric; Reners, Michèle; Rompen, Eric; Klinge, Björn; De Bruyn, Hugo

2008-01-01

As the prevalence of periodontitis is more than 40 % in the adult Belgian population, periodontists are clearly understaffed to treat this disease in all patients. Therefore, it seems logic that mild forms of chronic periodontitis are treated by the general practitioner especially because Belgium lacks dental hygienists. Important prerequisites for organizing periodontal care as such relate to the general practitioner who should use the same techniques, have comparable communicative skills to motivate patients and create a similar amount of time for periodontal treatment as the specialist. After all, the patient has the right to qualitative treatment regardless of the level of education of the care provider. In order to guarantee this in general practice as much as possible, there is a need for clinical guidelines developed by specialists. These guidelines should not only support the general practitioner in treating disease; above all, they should assist the dentist in periodontal diagnosis. Hitherto, periodontal screening by general dentists seems to be infrequently performed even though reimbursement of the Dutch Periodontal Screening Index is implemented in the Belgian healthcare security system. In this manuscript possible explanations for this phenomenon are discussed. Apart from the need for guidelines in general practice, guidelines for surgical treatment seem compulsory to uniform treatment protocols in specialized practice. Extreme variation in the recommendation of surgery among Belgian specialists calls for consensus statements.

Impact of a Multifaceted and Clinically Integrated Training Program in Evidence-Based Practice on Knowledge, Skills, Beliefs and Behaviour among Clinical Instructors in Physiotherapy: A Non-Randomized Controlled Study.

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Nina Rydland Olsen

Full Text Available Physiotherapists practicing at clinical placement sites assigned the role as clinical instructors (CIs, are responsible for supervising physiotherapy students. For CIs to role model evidence-based practice (EBP they need EBP competence. The aim of this study was to assess the short and long term impact of a six-month multifaceted and clinically integrated training program in EBP on the knowledge, skills, beliefs and behaviour of CIs supervising physiotherapy students.We invited 37 CIs to participate in this non-randomized controlled study. Three self-administered questionnaires were used pre- and post-intervention, and at six-month follow-up: 1 The Adapted Fresno test (AFT, 2 the EBP Belief Scale and 3 the EBP Implementation Scale. The analysis approach was linear regression modeling using Generalized Estimating Equations.In total, 29 CIs agreed to participate in the study: 14 were invited to participate in the intervention group and 15 were invited to participate in the control group. One in the intervention group and five in the control group were lost to follow-up. At follow-up, the group difference was statistically significant for the AFT (mean difference = 37, 95% CI (15.9 -58.1, p < 0.001 and the EBP Beliefs scale (mean difference = 8.1, 95% CI (3.1 -13.2, p = 0.002, but not for the EBP Implementation scale (mean difference = 1.8. 95% CI (-4.5-8.1, p = 0.574. Comparing measurements over time, we found a statistically significant increase in mean scores related to all outcome measures for the intervention group only.A multifaceted and clinically integrated training program in EBP was successful in improving EBP knowledge, skills and beliefs among CIs. Future studies need to ensure long-term EBP behaviour change, in addition to assessing CIs' abilities to apply EBP knowledge and skills when supervising students.

Online video in clinical skills education of oral medication administration for undergraduate student nurses: a mixed methods, prospective cohort study.

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Holland, Agi; Smith, Fiona; McCrossan, Gill; Adamson, Elizabeth; Watt, Susan; Penny, Kay

2013-06-01

Improvements in the safety of the prescribing, dispensing and administration of medicines are identified as a priority across international healthcare systems. It is therefore essential that higher education institutions play their part in helping to meet this patient safety objective. New developments in clinical skills education which are aligned to emerging educational theory are available, but evaluations and supportive evidence are limited. To evaluate the use of an online best practice exemplar as an adjunct to the clinical skills teaching of oral medication administration to undergraduate student nurses. Mixed-methods prospective cohort design. Two intakes of undergraduate nursing students (n=168, n=154) undertaking a first year clinical skills based module at a British university. The Control group received standard teaching using lectures and skills classes facilitated by experienced clinical skills lecturers. The Intervention group received the standard teaching and unlimited access to an online video clip of medication administration. Performance and satisfaction were measured using module assessment results and a satisfaction questionnaire. Qualitative data were gathered using focus groups (n=16, n=20). The Intervention group was significantly (p=0.021) more likely to pass the assessment and rate their satisfaction with the teaching significantly higher (pTeaching and Time and when Classroom Learning was positive, the Transfer to Practice of the clinical skill was enhanced. An online video of a best practice exemplar as an adjunct to taught clinical skills sessions improves student assessment results and satisfaction ratings. The video was also reported to positively influence all themes identified in Classroom Learning and was perceived to promote the Transfer to Practice of teaching input. Copyright © 2012 Elsevier Ltd. All rights reserved.

Evaluating clinical simulations for learning procedural skills: a theory-based approach.

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Kneebone, Roger

2005-06-01

Simulation-based learning is becoming widely established within medical education. It offers obvious benefits to novices learning invasive procedural skills, especially in a climate of decreasing clinical exposure. However, simulations are often accepted uncritically, with undue emphasis being placed on technological sophistication at the expense of theory-based design. The author proposes four key areas that underpin simulation-based learning, and summarizes the theoretical grounding for each. These are (1) gaining technical proficiency (psychomotor skills and learning theory, the importance of repeated practice and regular reinforcement), (2) the place of expert assistance (a Vygotskian interpretation of tutor support, where assistance is tailored to each learner's needs), (3) learning within a professional context (situated learning and contemporary apprenticeship theory), and (4) the affective component of learning (the effect of emotion on learning). The author then offers four criteria for critically evaluating new or existing simulations, based on the theoretical framework outlined above. These are: (1) Simulations should allow for sustained, deliberate practice within a safe environment, ensuring that recently-acquired skills are consolidated within a defined curriculum which assures regular reinforcement; (2) simulations should provide access to expert tutors when appropriate, ensuring that such support fades when no longer needed; (3) simulations should map onto real-life clinical experience, ensuring that learning supports the experience gained within communities of actual practice; and (4) simulation-based learning environments should provide a supportive, motivational, and learner-centered milieu which is conducive to learning.

Use of simulated patients to assess the clinical and communication skills of community pharmacists.

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Weiss, Marjorie C; Booth, Anneka; Jones, Bethan; Ramjeet, Sarah; Wong, Eva

2010-06-01

To investigate the quality and appropriateness of Emergency Hormonal Contraception (EHC) supply from community pharmacies. Community pharmacies in the southwest of England during 2007. Two simulated patient ('mystery shopper') scenarios to each participating pharmacy, one where the supply of EHC would be appropriate (scenario 1) and one where there was a drug interaction between EHC and St John's Wort, and the supply inappropriate (scenario 2). Pharmacy consultations were rated using criteria developed from two focus groups: one with pharmacist academics and one with female university students. Feedback to pharmacists to inform their continuing professional development was provided. Scores on rating scales encompassing the clinical and communication skills of the participating community pharmacists completed immediately after each mystery shopper visit. 40 pharmacist visits were completed: 21 for scenario 1 and 19 for scenario 2. Eighteen pharmacists were visited twice. Five pharmacists visited for scenario 2 supplied EHC against professional guidance, although other reference sources conflicted with this advice. Pharmacies which were part of the local PGD scheme scored higher overall in scenario 1 (P = 0.005) than those not part of the scheme. Overall the communication skills of pharmacists were rated highly although some pharmacists used jargon when explaining the interaction for scenario 2. Formatively assessing communication skills in an integrative manner alongside clinical skills has been identified as an important part of the medical consultation skills training and can be incorporated into the routine assessment and feedback of pharmacy over-the-counter medicines advice.

Using video podcasting to enhance the learning of clinical skills: A qualitative study of physiotherapy students' experiences.

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Hurst, Kay M

2016-10-01

Video podcasts, or vodcasts are increasingly used by a range of healthcare professions in the mastery of new skills. Little is known about the experiences of using vodcasts in physiotherapy education. Traditional pedagogic strategies have been employed in order to master those skills required for physiotherapy practice. There have been advances in the use of technology in medical education in the nursing, dentistry and medical fields. Vodcasts offer great versatility and potential when used as a pedagogical tool, embedded within a physiotherapy curriculum. To explore students' experiences of using technology enhanced learning, namely vodcasts, in the Physiotherapy curriculum to develop the learning of clinical skills. A series of focus groups were carried out with undergraduate and pre-registration physiotherapy students (n=31). Students valued the versatility and audio-visual nature of vodcasts; helpful in revising for practical examinations and practising their skills prior to, during and after taught skills classes. Watching and practising simultaneously allowed students to practice repeatedly and formulate a process for each skill. When learning a new skill, a combination of teaching and learning approaches was favoured, marrying traditional approaches with those that utilise technology. This study's findings add to the existing body of evidence in skills based teaching and support a multi-media, blended approach in those disciplines involved in the learning and teaching of clinical skills. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Vocational trainees’ views and experiences regarding the learning and teaching of communication skills in general practice

OpenAIRE

Van Nuland, Marc; Thijs, Gaby; Van Royen, Paul; Van Den Noortgate, Wim; Goedhuys, Jo

2010-01-01

Objective: To explore the views and experiences of general practice (GP) vocational trainees regarding communication skills (CS) and the teaching and learning of these skills. METHODS: A purposive sample of second and third (final) year GP trainees took part in six focus group (FG) discussions. Transcripts were coded and analysed in accordance with a grounded theory approach by two investigators using Alas-ti software. Finally results were triangulated by means of semi-structured telephone in...

How novice, skilled and advanced clinical researchers include variables in a case report form for clinical research: a qualitative study.

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Chu, Hongling; Zeng, Lin; Fetters, Micheal D; Li, Nan; Tao, Liyuan; Shi, Yanyan; Zhang, Hua; Wang, Xiaoxiao; Li, Fengwei; Zhao, Yiming

2017-09-18

Despite varying degrees in research training, most academic clinicians are expected to conduct clinical research. The objective of this research was to understand how clinical researchers of different skill levels include variables in a case report form for their clinical research. The setting for this research was a major academic institution in Beijing, China. The target population was clinical researchers with three levels of experience, namely, limited clinical research experience, clinicians with rich clinical research experience and clinical research experts. Using a qualitative approach, we conducted 13 individual interviews (face to face) and one group interview (n=4) with clinical researchers from June to September 2016. Based on maximum variation sampling to identify researchers with three levels of research experience: eight clinicians with limited clinical research experience, five clinicians with rich clinical research experience and four clinical research experts. These 17 researchers had diverse hospital-based medical specialties and or specialisation in clinical research. Our analysis yields a typology of three processes developing a case report form that varies according to research experience level. Novice clinician researchers often have an incomplete protocol or none at all, and conduct data collection and publication based on a general framework. Experienced clinician researchers include variables in the case report form based on previous experience with attention to including domains or items at risk for omission and by eliminating unnecessary variables. Expert researchers consider comprehensively in advance data collection and implementation needs and plan accordingly. These results illustrate increasing levels of sophistication in research planning that increase sophistication in selection for variables in the case report form. These findings suggest that novice and intermediate-level researchers could benefit by emulating the comprehensive

Getting fit for practice: an innovative paediatric clinical placement provided physiotherapy students opportunities for skill development.

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Shields, Nora; Bruder, Andrea; Taylor, Nicholas F; Angelo, Tom

2013-06-01

Negative attitudes to disability among physiotherapy students in paediatric placements might be addressed by providing clinical placement opportunities for students early in their course. The aim of this qualitative research study was to explore what physiotherapy students reported learning from an innovative paediatric placement option. Qualitative research with in-depth interviews. Seventeen first and second year physiotherapy students (15 women, 2 men; mean age 19.9 (SD 1.4) years) who took part in the clinical education experience. The experience comprised a student-led progressive resistance training programme performed twice a week for 10 weeks at a community gymnasium with an adolescent with Down syndrome. In-depth interviews were completed after the 10-week programme and were audio-recorded, transcribed verbatim and independently coded by two researchers. Data were analysed using thematic analysis. Two themes emerged from the data, one about being a student mentor and the second about skill development and application. The physiotherapy students indicated the programme was a challenging yet rewarding experience, and that they gained an increased appreciation of disability. They reported developing and applying a range of communication, professional and physiotherapy specific skills. The results suggest that the clinical experience provided physiotherapy students with opportunities to learn clinical skills, generic professional skills, and better understand disability in young people. Many of the learning outcomes identified by the participating students align with desired graduate capabilities and required professional competencies. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Effects of participation in a cross year peer tutoring programme in clinical examination skills on volunteer tutors' skills and attitudes towards teachers and teaching

Directory of Open Access Journals (Sweden)

Zamora Javier

2007-06-01

Full Text Available Abstract Background Development of students' teaching skills is increasingly recognised as an important component of UK undergraduate medical curricula and, in consequence, there is renewed interest in the potential benefits of cross-year peer tutoring. Whilst several studies have described the use of cross-year peer tutoring in undergraduate medical courses, its use in the clinical setting is less well reported, particularly the effects of peer tutoring on volunteer tutors' views of teachers and teaching. This study explored the effects of participation in a cross-year peer tutoring programme in clinical examination skills ('OSCE tutor' on volunteer tutors' own skills and on their attitudes towards teachers and teaching. Methods Volunteer tutors were final year MBChB students who took part in the programme as part of a Student Selected Component (SSC. Tutees were year 3 MBChB students preparing for their end of year 'OSCE' examination. Pre and post participation questionnaires, including both Likert-type and open response questions, were used. Paired data was compared using the Wilcoxon signed-rank test. All tests were two-tailed with 5% significance level. Results Tutors reflected their cohort in terms of gender but were drawn from among the more academically successful final year students. Most had previous teaching experience. They were influenced to participate in 'OSCE tutor' by a desire to improve their own teaching and associated generic skills and by contextual factors relating to the organisation or previous experience of the OSCE tutor programme. Issues relating to longer term career aspirations were less important. After the event, tutors felt that participation had enhanced their skills in various areas, including practical teaching skills, confidence in speaking to groups and communication skills; and that as a result of taking part, they were now more likely to undertake further teacher training and to make teaching a major part

Residents' perceived needs in communication skills training across in- and outpatient clinical settings.

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Junod Perron, Noelle; Sommer, Johanna; Hudelson, Patricia; Demaurex, Florence; Luthy, Christophe; Louis-Simonet, Martine; Nendaz, Mathieu; De Grave, Willem; Dolmans, Diana; Van der Vleuten, Cees

2009-05-01

Residents' perceived needs in communication skills training are important to identify before designing context-specific training programmes, since learrners' perceived needs can influence the effectiveness of training. To explore residents' perceptions of their training needs and training experiences around communication skills, and whether these differ between residents training in inpatient and outpatient clinical settings. Four focus groups (FG) and a self-administered questionnaire were conducted with residents working in in- and outpatient medical service settings at a Swiss University Hospital. Focus groups explored residents' perceptions of their communication needs, their past training experiences and suggestions for future training programmes in communication skills. Transcripts were analysed in a thematic way using qualitative analytic approaches. All residents from both settings were asked to complete a questionnaire that queried their sociodemographics and amount of prior training in communication skills. In focus groups, outpatient residents felt that communication skills were especially useful in addressing chronic diseases and social issues. In contrast, inpatient residents emphasized the importance of good communication skills for dealing with family conflicts and end-of-life issues. Felt needs reflected residents' differing service priorities: outpatient residents saw the need for skills to structure the consultation and explore patients' perspectives in order to build therapeutic alliances, whereas inpatient residents wanted techniques to help them break bad news, provide information and increase their own well-being. The survey's overall response rate was 56%. Its data showed that outpatient residents received more training in communication skills and more of them than inpatient residents considered communication skills training to be useful (100% vs 74%). Outpatient residents' perceived needs in communication skills were more patient

Exploring cultural and linguistic influences on clinical communication skills: a qualitative study of International Medical Graduates.

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Verma, Anju; Griffin, Ann; Dacre, Jane; Elder, Andrew

2016-06-10

International Medical Graduates (IMGs) are known to perform less well in many postgraduate medical examinations when compared to their UK trained counterparts. This "differential attainment" is observed in both knowledge-based and clinical skills assessments. This study explored the influence of culture and language on IMGs clinical communication skills, in particular, their ability to seek, detect and acknowledge patients' concerns in a high stakes postgraduate clinical skills examination. Hofstede's cultural dimensions framework was used to look at the impact of culture on examination performance. This was a qualitative, interpretative study using thematic content analysis of video-recorded doctor-simulated patient consultations of candidates sitting the MRCP(UK) PACES examination, at a single examination centre in November 2012. The research utilised Hofstede's cultural dimension theory, a framework for comparing cultural factors amongst different nations, to help understand the reasons for failure. Five key themes accounted for the majority of communication failures in station 2, "history taking" and station 4, "communication skills and ethics" of the MRCP(UK) PACES examination. Two themes, the ability to detect clues and the ability to address concerns, related directly to the overall construct managing patients' concerns. Three other themes were found to impact the whole consultation. These were building relationships, providing structure and explanation and planning. Hofstede's cultural dimensions may help to contextualise some of these observations. In some cultures doctor and patient roles are relatively inflexible: the doctor may convey less information to the patient (higher power distance societies) and give less attention to building rapport (high uncertainty avoidance societies.) This may explain why cues and concerns presented by patients were overlooked in this setting. Understanding cultural differences through Hofstede's cultural dimensions theory

Mentor Tutoring: An Efficient Method for Teaching Laparoscopic Colorectal Surgical Skills in a General Hospital.

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Ichikawa, Nobuki; Homma, Shigenori; Yoshida, Tadashi; Ohno, Yosuke; Kawamura, Hideki; Wakizaka, Kazuki; Nakanishi, Kazuaki; Kazui, Keizo; Iijima, Hiroaki; Shomura, Hiroki; Funakoshi, Tohru; Nakano, Shiro; Taketomi, Akinobu

2017-12-01

We retrospectively assessed the efficacy of our mentor tutoring system for teaching laparoscopic colorectal surgical skills in a general hospital. A series of 55 laparoscopic colectomies performed by 1 trainee were evaluated. Next, the learning curves for high anterior resection performed by the trainee (n=20) were compared with those of a self-trained surgeon (n=19). Cumulative sum analysis and multivariate regression analyses showed that 38 completed cases were needed to reduce the operative time. In high anterior resection, the mean operative times were significantly shorter after the seventh average for the tutored surgeon compared with that for the self-trained surgeon. In cumulative sum charting, the curve reached a plateau by the seventh case for the tutored surgeon, but continued to increase for the self-trained surgeon. Mentor tutoring effectively teaches laparoscopic colorectal surgical skills in a general hospital setting.

The effect of short-term workshop on improving clinical reasoning skill of medical students.

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Yousefichaijan, Parsa; Jafari, Farshad; Kahbazi, Manijeh; Rafiei, Mohammad; Pakniyat, AbdolGhader

2016-01-01

Clinical reasoning process leads clinician to get purposeful steps from signs and symptoms toward diagnosis and treatment. This research intends to investigate the effect of teaching clinical reasoning on problem-solving skills of medical students. This research is a semi-experimental study. Nineteen Medical student of the pediatric ward as case group participated in a two-day workshop for training clinical reasoning. Before the workshop, they filled out Diagnostic Thinking Inventory (DTI) questionnaires. Fifteen days after the workshop the DTI questionnaire completed and "key feature" (KF) test and "clinical reasoning problem" (CRP) test was held. 23 Medical student as the control group, without passing the clinical reasoning workshop DTI questionnaire completed, and KF test and CRP test was held. The average score of the DTI questionnaire in the control group was 162.04 and in the case group before the workshop was 153.26 and after the workshop was 181.68. Compare the average score of the DTI questionnaire before and after the workshop there is a significant difference. The difference between average KF test scores in the control and the case group was not significant but between average CRP test scores was significant. Clinical reasoning workshop is effectiveness in promoting problem-solving skills of students.

Rapid application design of an electronic clinical skills portfolio for undergraduate medical students.

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Dornan, Tim; Lee, Catherine; Stopford, Adam; Hosie, Liam; Maredia, Neil; Rector, Alan

2005-04-01

The aim was to find how to use information and communication technology to present the clinical skills content of an undergraduate medical curriculum. Rapid application design was used to develop the product, and technical action research was used to evaluate the development process. A clinician-educator, two medical students, two computing science masters students, two other project workers, and a hospital education informatics lead, formed a design team. A sample of stakeholders took part in requirements planning workshops and continued to advise the team throughout the project. A university hospital had many features that favoured fast, inexpensive, and successful system development: a clearly defined and readily accessible user group; location of the development process close to end-users; fast, informal communication; leadership by highly motivated and senior end-users; devolved authority and lack of any rigidly imposed management structure; cooperation of clinicians because the project drew on their clinical expertise to achieve scholastic goals; a culture of learning and involvement of highly motivated students. A detailed specification was developed through storyboarding, use case diagramming, and evolutionary prototyping. A very usable working product was developed within weeks. "SkillsBase" is a database web application using Microsoft Active Server Pages, served from a Microsoft Windows 2000 Server operating system running Internet Information Server 5.0. Graphing functionality is provided by the KavaChart applet. It presents the skills curriculum, provides a password-protected portfolio function, and offers training materials. The curriculum can be presented in several different ways to help students reflect on their objectives and progress towards achieving them. The reflective portfolio function is entirely private to each student user and allows them to document their progress in attaining skills, as judged by self, peer and tutor assessment, and

Factors affecting acquisition of psychomotor clinical skills by student nurses and midwives in CHAM Nursing Colleges in Malawi: A qualitative exploratory study.

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Mwale, Omero Gonekani; Kalawa, Roselyn

2016-01-01

Acquisition of psychomotor clinical skills has been shown to improve the quality of care provided to patients when care providers are competent. The aim of this study was to explore students, nurses and tutors experience on factors affecting acquisition of psychomotor clinical skills. The study employed an exploratory qualitative research design. The population was students, clinical nurses and tutors from a nursing College and mission hospital in the southern region of Malawi. In depth interviews using a semi structured guide was used to collect data. Thematic analysis method was employed to analyze the collected data. Ethical principles of respect of human dignity, beneficence and justice were observed. The findings have shown that acquisition of psychomotor skills is affected by: student motivation, lack of resources, learning environment, knowledge gap between the qualified nurses and tutors, and role modeling. In principle when student nurses have acquired necessary skills the quality of care provided to patients improve. Basing on the findings of this study it is recommended that Student should be well prepared before clinical placement Nurses and tutors should also update their knowledge and clinical teaching skills for them to adequately guide students. The clinical arena should have adequate resources.

Validation of a clinical critical thinking skills test in nursing

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Shin, Sujin; Jung, Dukyoo; Kim, Sungeun

2015-01-01

Purpose: The purpose of this study was to develop a revised version of the clinical critical thinking skills test (CCTS) and to subsequently validate its performance. Methods: This study is a secondary analysis of the CCTS. Data were obtained from a convenience sample of 284 college students in June 2011. Thirty items were analyzed using item response theory and test reliability was assessed. Test-retest reliability was measured using the results of 20 nursing college and graduate school stud...

Self-reported confidence and skills of general practitioners in management of mental health disorders.

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Oakley Browne, Mark; Lee, Adeline; Prabhu, Radha

2007-10-01

To identify the predictors of self-reported confidence and skills of GPs in management of patients with mental health problems. Cross-sectional survey, with questionnaire presented to 246 GPs working in 62 practices throughout Gippsland. Rural general practices in Gippsland. One hundred and thirty-four GPs across Gippsland. GPs completed a questionnaire assessing self-perception of knowledge and skills in recognition and management of common mental health problems. Of 134 GPs, 45% reported that they have a specific interest in mental health, and 39% of GPs reported that they had previous mental health training. Only 22% of GPs describe having both an interest and prior training in mental health care. Age and years since graduation are not significantly related to self-reported confidence and skills. The results of this study highlight that self-professed interest and prior training in mental health are associated. Self-professed interest in mental health care predicts confidence and self-perceived skills in recognition, assessment and management of common mental health disorders. Similarly, prior training in mental health care predicts confidence and self-perceived skills in recognition, assessment and management of common mental health problems. Self-professed interest in mental health issues is also associated with hours of participation in continuing medical education related to mental health care. Unfortunately, only a minority described having both interest and prior training in mental health care.

Investigation of blended learning video resources to teach health students clinical skills: An integrative review.

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Coyne, Elisabeth; Rands, Hazel; Frommolt, Valda; Kain, Victoria; Plugge, Melanie; Mitchell, Marion

2018-04-01

The aim of this review is to inform future educational strategies by synthesising research related to blended learning resources using simulation videos to teach clinical skills for health students. An integrative review methodology was used to allow for the combination of diverse research methods to better understand the research topic. This review was guided by the framework described by Whittemore and Knafl (2005), DATA SOURCES: Systematic search of the following databases was conducted in consultation with a librarian using the following databases: SCOPUS, MEDLINE, COCHRANE, PsycINFO databases. Keywords and MeSH terms: clinical skills, nursing, health, student, blended learning, video, simulation and teaching. Data extracted from the studies included author, year, aims, design, sample, skill taught, outcome measures and findings. After screening the articles, extracting project data and completing summary tables, critical appraisal of the projects was completed using the Mixed Methods Appraisal Tool (MMAT). Ten articles met all the inclusion criteria and were included in this review. The MMAT scores varied from 50% to 100%. Thematic analysis was undertaken and we identified the following three themes: linking theory to practice, autonomy of learning and challenges of developing a blended learning model. Blended learning allowed for different student learning styles, repeated viewing, and enabled links between theory and practice. The video presentation needed to be realistic and culturally appropriate and this required both time and resources to create. A blended learning model, which incorporates video-assisted online resources, may be a useful tool to teach clinical skills to students of health including nursing. Blended learning not only increases students' knowledge and skills, but is often preferred by students due to its flexibility. Copyright © 2018 Elsevier Ltd. All rights reserved.

Providing specialist clinical skills in soft tissue and intra-articular injection through a postgraduate masters module.

Science.gov (United States)

Stevenson, Kay; Waterfield, Jackie

2005-01-01

Current philosophy and policy changes in the National Health Service are encouraging healthcare practitioners to extend their clinical skills to create a more patient-centred approach thus allowing patients to be seen in a timely and more appropriate manner. This often requires further development of the practitioners' skills and knowledge. One approach to achieve this is through collaboration between employers and educational providers to ensure that educational experience is not only evidence based but also responsive to the needs of the current and future workforce. A postgraduate module was developed to raise critical and evaluative skills, as well as the technical skills of practitioners using injections in the management of joint and soft tissue pathology, while developing a professional responsibility towards injection practice. The module emphasized learning though experience by contextualizing the theoretical aspects of the module and by its student centred assessments. Further strengths of this module are that it has utilized academic and clinical expertise and knowledge to enable clinicians to gain additional skills and the multidisciplinary approach engendered good working practice Overall the module was evaluated positively by both tutors and students and not only met its aims but also addressed the current professional and policy issues around continuing professional development. Copyright (c) 2005 John Wiley & Sons, Ltd.

Developing an Evaluation Tool for Assessing Clinical Ethics Consultation Skills in Simulation Based Education: The ACES Project.

Science.gov (United States)

Wasson, Katherine; Parsi, Kayhan; McCarthy, Michael; Siddall, Viva Jo; Kuczewski, Mark

2016-06-01

The American Society for Bioethics and Humanities has created a quality attestation (QA) process for clinical ethics consultants; the pilot phase of reviewing portfolios has begun. One aspect of the QA process which is particularly challenging is assessing the interpersonal skills of individual clinical ethics consultants. We propose that using case simulation to evaluate clinical ethics consultants is an approach that can meet this need provided clear standards for assessment are identified. To this end, we developed the Assessing Clinical Ethics Skills (ACES) tool, which identifies and specifies specific behaviors that a clinical ethics consultant should demonstrate in an ethics case simulation. The aim is for the clinical ethics consultant or student to use a videotaped case simulation, along with the ACES tool scored by a trained rater, to demonstrate their competence as part of their QA portfolio. The development and piloting of the tool is described.

An integrated 2-year clinical skills peer tutoring scheme in a UK-based medical school: perceptions of tutees and peer tutors

Science.gov (United States)

2018-01-01

Background Several benefits of peer tutoring in medical school teaching have been described. However, there is a lack of research on the perceptions of peer tutoring, particularly from tutees who partake in a long-term clinical skills scheme integrated into the medical school curriculum. This study evaluates the opinions of preclinical tutees at the end of a 2-year peer-tutored clinical skills program and peer tutors themselves. Methods A cross-sectional study was conducted in a UK-based medical school that primarily utilizes peer tutoring for clinical skills teaching. A questionnaire was designed to assess the views of preclinical tutees and peer tutors. Likert scales were used to grade responses and comment boxes to collect qualitative data. Results Sixty-five questionnaires were collected (52 tutees, 13 peer tutors). Seventy-nine percent of students felt satisfied with their teaching, and 70% felt adequately prepared for clinical placements. Furthermore, 79% believed that peer tutoring is the most effective method for clinical skills teaching. When compared to faculty teaching, tutees preferred being taught by peer tutors (63%), felt more confident (73%), and were more willing to engage (77%). All peer tutors felt that teaching made them more confident in their Objective Structured Clinical Examination performance, and 91% agreed that being a tutor made them consider pursuing teaching in the future. Thematic analysis of qualitative data identified 3 themes regarding peer tutoring: a more comfortable environment (69%), a more personalized teaching approach (34%), and variation in content taught (14%). Conclusion Preclinical tutees prefer being taught clinical skills by peer tutors compared to faculty, with the peer tutors also benefitting. Studies such as this, looking at long-term schemes, further validate peer tutoring and may encourage more medical schools to adopt this method as an effective way of clinical skills teaching. PMID:29922105

Teaching communication skills: beyond wishful thinking.

Science.gov (United States)

Junod Perron, Noelle; Sommer, Johanna; Louis-Simonet, Martine; Nendaz, Mathieu

2015-01-01

Communication skills tend to decline with time unless they are regularly recalled and practiced. However, most medical schools still deliver clinical communication training only during pre-clinical years although the clinical environment is considered to be ideal for acquiring and teaching clinical communication. The aim of this article is to review the barriers that prevent communication skills teaching and training from occurring in clinical practice and describe strategies that may help enhance such activities. Barriers occur at several levels: students, junior doctors and clinical supervisors sometimes have negative attitudes towards communication training; structured training in communication skills is often insufficient; clinical supervisors behave as poor role models and lack effective communication and teaching skills; finally, there are organisational constraints such as lack of time, competing priorities, weak hierarchy support and lack of positive incentives for using, training or teaching good communication skills in clinical practice. Given the difficulty of assessing transfer of communication skills in practice, only few studies describe successful educational interventions. In order to optimise communication skills learning in practice, there is need to: (1.) modify the climate and structure of the working environment so that that use, training and teaching of good communication skills in clinical practice becomes valued, supported and rewarded; (2.) extend communication skills training to any field of medicine; (3.) provide regular structured trainings and tailor them to trainees' needs. Practical implications of such findings are discussed at the end of this review.

Simulation-guided cardiac auscultation improves medical students' clinical skills: the Pavia pilot experience.

Science.gov (United States)

Perlini, Stefano; Salinaro, Francesco; Santalucia, Paola; Musca, Francesco

2014-03-01

Clinical evaluation is the cornerstone of any cardiac diagnosis, although excessive over-specialisation often leads students to disregard the value of clinical skills, and to overemphasize the approach to instrumental cardiac diagnosis. Time restraints, low availability of "typical" cardiac patients on whom to perform effective bedside teaching, patients' respect and the underscoring of the value of clinical skills all lead to a progressive decay in teaching. Simulation-guided cardiac auscultation may improve clinical training in medical students and residents. Harvey(©) is a mannequin encompassing more than 50 cardiac diagnoses that was designed and developed at the University of Miami (Florida, USA). One of the advantages of Harvey(©) simulation resides in the possibility of listening, comparing and discussing "real" murmurs. To objectively assess its teaching performance, the capability to identify five different cardiac diagnoses (atrial septal defect, normal young subject, mitral stenosis with tricuspid regurgitation, chronic mitral regurgitation, and pericarditis) out of more than 50 diagnostic possibilities was assessed in 523 III-year medical students (i.e. at the very beginning of their clinical experience), in 92 VI-year students, and in 42 residents before and after a formal 10-h teaching session with Harvey(©). None of them had previously experienced simulation-based cardiac auscultation in addition to formal lecturing (all three groups) and bedside teaching (VI-year students and residents). In order to assess the "persistence" of the acquired knowledge over time, the test was repeated after 3 years in 85 students, who did not repeat the formal 10-h teaching session with Harvey(©) after the III year. As expected, the overall response was poor in the "beginners" who correctly identified 11.0 % of the administered cardiac murmurs. After simulation-guided training, the ability to recognise the correct cardiac diagnoses was much better (72.0 %; p

Situated cognition and cognitive apprenticeship: a model for teaching and learning clinical skills in a technologically rich and authentic learning environment.

Science.gov (United States)

Woolley, Norman N; Jarvis, Yvonne

2007-01-01

The acquisition of a range of diverse clinical skills is a central feature of the pre-registration nursing curriculum. Prior to exposure to clinical practice, it is essential that learners have the opportunity to practise and develop such skills in a safe and controlled environment under the direction and supervision of clinical experts. However, the competing demands of the HE nursing curriculum coupled with an increased number of learners have resulted in a reduced emphasis on traditional apprenticeship learning. This paper presents an alternative model for clinical skills teaching that draws upon the principles of cognitive apprenticeship [Collins, A., Brown, J.S., Newman, S., 1989. Cognitive Apprenticeship: teaching the crafts of reading, writing and mathematics. In: Resnick, L.B. (Ed.) Knowing. Learning and Instruction: Essays in Honor of Robert Glaser. Lawrence Erlbaum Associates, New Jersey, pp. 453-494] and situated cognition within a technologically rich and authentic learning environment. It will show how high quality DVD materials illustrating clinical skills performed by expert practitioners have been produced and used in conjunction with CCTV and digital recording technologies to support learning within a pedagogic framework appropriate to skills acquisition. It is argued that this model not only better prepares the student for the time they will spend in the practice setting, but also lays the foundation for the development of a clinically competent practitioner with the requisite physical and cognitive skills who is fit for purpose [UKCC, 1999. Fitness for Practice: The UKCC Commission for Nursing and Midwifery Education. United Kingdom Central Council for Nursing Midwifery and Health Visiting, London].

Assessing the Clinical Skills of Dental Students: A Review of the Literature

Science.gov (United States)

Taylor, Carly L.; Grey, Nick; Satterthwaite, Julian D.

2013-01-01

Education, from a student perspective, is largely driven by assessment. An effective assessment tool should be both valid and reliable, yet this is often not achieved. The aim of this literature review is to identify and appraise the evidence base for assessment tools used primarily in evaluating clinical skills of dental students. Methods:…

Fostering Spatial Skill Acquisition by General Chemistry Students

Science.gov (United States)

Carlisle, Deborah; Tyson, Julian; Nieswandt, Martina

2015-01-01

The study of chemistry requires the understanding and use of spatial relationships, which can be challenging for many students. Prior research has shown that there is a need to develop students' spatial reasoning skills. To that end, this study implemented guided activities designed to strengthen students' spatial skills, with the aim of improving…

Developing a General Outcome Measure Off Growth in Social Skills for Infants and Toddlers

Science.gov (United States)

Carta, Judith; Greenwood, Charles; Luze, Gayle; Cline, Gabriel; Kuntz, Susan

2004-01-01

Proficiency in social interaction with adults and peers is an important outcome in early childhood. The development of an experimental measure for assessing growth in social skills in children birth to 3 years is described. Based on the general outcome measurement (GOM) approach (e.g., Deno, 1997), the measure is intended for use by early…

Developing a General Outcome Measure of Growth in Social Skills for Infants and Toddlers

Science.gov (United States)

Carta, Judith; Greenwood, Charles; Luze, Gayle; Cline, Gabriel; Kuntz, Susan

2004-01-01

Proficiency in social interaction with adults and peers is an important outcome in early childhood. The development of an experimental measure for assessing growth in social skills in children birth to 3 years is described. Based on the general outcome measurement (GOM) approach (e.g., Deno, 1997), the measure is intended for use by early…

Tensions in learning professional identities - nursing students' narratives and participation in practical skills during their clinical practice: an ethnographic study.

Science.gov (United States)

Ewertsson, Mona; Bagga-Gupta, Sangeeta; Allvin, Renée; Blomberg, Karin

2017-01-01

Clinical practice is a pivotal part of nursing education. It provides students with the opportunity to put the knowledge and skills they have acquired from lectures into practice with real patients, under the guidance of registered nurses. Clinical experience is also essential for shaping the nursing students' identity as future professional nurses. There is a lack of knowledge and understanding of the ways in which students learn practical skills and apply knowledge within and across different contexts, i.e. how they apply clinical skills, learnt in the laboratory in university settings, in the clinical setting. The aim of this study was therefore to explore how nursing students describe, and use, their prior experiences related to practical skills during their clinical practice. An ethnographic case study design was used. Fieldwork included participant observations (82 h), informal conversations, and interviews ( n  = 7) that were conducted during nursing students' ( n  = 17) clinical practice at an emergency department at a university hospital in Sweden. The overarching theme identified was "Learning about professional identities with respect to situated power". This encompasses tensions in students' learning when they are socialized into practical skills in the nursing profession. This overarching theme consists of three sub-themes: "Embodied knowledge", "Divergent ways of assessing and evaluating knowledge" and "Balancing approaches". Nursing students do not automatically possess the ability to transfer knowledge from one setting to another; rather, their development is shaped by their experiences and interactions with others when they meet real patients. The study revealed different ways in which students navigated tensions related to power differentials. Reflecting on actions is a prerequisite for developing and learning practical skills and professional identities. This highlights the importance of both educators' and the preceptors' roles for

Videopodcasts in a “blended learning” approach to medical skills training

DEFF Research Database (Denmark)

Nørgaard, Cita; Graumann, Ole; Bollen, Peter

This study aims to challenge the traditional tutor based teaching of practical skills in the Clinical Skills Centre and other experimental settings. The concept of learning was changed to “blended” as the teachers constructed an online task as preparation for the practical lessons. The online......-organized studies after the tutorial sessions. Take-home message The use of videopodcasts in blended learning around clinical skills training is considered to be of great importance among students and teachers....... student questionnaires and the teacher evaluations. Summary of results Students generally evaluated that the use of videos enhanced their performance and the learning outcomes. Teachers tell that the face-to-face lessons became more efficient due to the new standards for student preparation. The results...

Online learning versus blended learning of clinical supervisee skills with pre-registration nursing students: A randomised controlled trial.

Science.gov (United States)

McCutcheon, Karen; O'Halloran, Peter; Lohan, Maria

2018-06-01

The World Health Organisation amongst others recognises the need for the introduction of clinical supervision education in health professional education as a central strategy for improving patient safety and patient care. Online and blended learning methods are growing exponentially in use in higher education and the systematic evaluation of these methods will aid understanding of how best to teach clinical supervision. The purpose of this study was to test whether undergraduate nursing students who received clinical supervisee skills training via a blended learning approach would score higher in terms of motivation and attitudes towards clinical supervision, knowledge of clinical supervision and satisfaction of learning method, when compared to those students who received an online only teaching approach. A post-test-only randomised controlled trial. Participants were a total of 122 pre-registration nurses enrolled at one United Kingdom university, randomly assigned to the online learning control group (n = 60) or the blended learning intervention group (n = 62). The blended learning intervention group participated in a face-to-face tutorial and the online clinical supervisee skills training app. The online learning control group participated in an online discussion forum and the same online clinical supervisee skills training app. The outcome measures were motivation and attitudes using the modified Manchester Clinical Supervision Scale, knowledge using a 10 point Multiple Choice Questionnaire and satisfaction using a university training evaluation tool. Statistical analysis was performed using independent t-tests to compare the differences between the means of the control group and the intervention group. Thematic analysis was used to analyse responses to open-ended questions. All three of our study hypotheses were confirmed. Participants who received clinical supervisee skills training via a blended learning approach scored higher in terms of motivation

A survey of clinical performance skills requirements in medical radiation technology

International Nuclear Information System (INIS)

Rowntree, P.A.; Veitch, J.D.

1993-01-01

This paper outlines the reasons behind carry out a study of clinical performance skills requirements and the method being used to gather data. It describes the changes which have occurred in radiographer education in Queensland, the broader impact brought about by changes in professional body requirements and the development of a Competency based Standards Document for the profession. The paper provides examples of the survey design and layout being developed for distribution to third year students in the Medical Imaging Technology major of the Bachelor of Applied Science (Medical Radiation Technology) Queensland University of Technology, graduates and clinical departments in Queensland. 1 tab., 1 fig

Decoding Skills Acquired by Low Readers Taught in Regular Classrooms Using Clinical Techniques. Research Report No. 35.

Science.gov (United States)

Gallistel, Elizabeth; Fischer, Phyllis

This study evaluated the decoding skills acquired by low readers in an experimental project that taught low readers in regular class through the use of clinical procedures based on a synthetic phonic, multisensory approach. An evaluation instrument which permitted the tabulation of specific decoding skills was administered as a pretest and…

A model for educational feedback based on clinical communication skills strategies: beyond the "feedback sandwich".

Science.gov (United States)

Milan, Felise B; Parish, Sharon J; Reichgott, Michael J

2006-01-01

Feedback is an essential tool in medical education, and the process is often difficult for both faculty and learner. There are strong analogies between the provision of educational feedback and doctor-patient communication during the clinical encounter. Relationship-building skills used in the clinical setting-Partnership, Empathy, Apology, Respect, Legitimation, Support (PEARLS)-can establish trust with the learner to better manage difficult feedback situations involving personal issues, unprofessional behavior, or a defensive learner. Using the stage of readiness to change (transtheoretical) model, the educator can "diagnose" the learner's stage of readiness and employ focused interventions to encourage desired changes. This approach has been positively received by medical educators in faculty development workshops. A model for provision of educational feedback based on communication skills used in the clinical encounter can be useful in the medical education setting. More robust evaluation of the construct validity is required in actual training program situations.

Predicting failing performance on a standardized patient clinical performance examination: the importance of communication and professionalism skills deficits.

Science.gov (United States)

Chang, Anna; Boscardin, Christy; Chou, Calvin L; Loeser, Helen; Hauer, Karen E

2009-10-01

The purpose is to determine which assessment measures identify medical students at risk of failing a clinical performance examination (CPX). Retrospective case-control, multiyear design, contingency table analysis, n = 149. We identified two predictors of CPX failure in patient-physician interaction skills: low clerkship ratings (odds ratio 1.79, P = .008) and student progress review for communication or professionalism concerns (odds ratio 2.64, P = .002). No assessments predicted CPX failure in clinical skills. Performance concerns in communication and professionalism identify students at risk of failing the patient-physician interaction portion of a CPX. This correlation suggests that both faculty and standardized patients can detect noncognitive traits predictive of failing performance. Early identification of these students may allow for development of a structured supplemental curriculum with increased opportunities for practice and feedback. The lack of predictors in the clinical skills portion suggests limited faculty observation or feedback.

Clinical psychomotor skills among left and right handed medical students: are the left-handed medical students left out?

Science.gov (United States)

Alnassar, Sami; Alrashoudi, Aljoharah Nasser; Alaqeel, Mody; Alotaibi, Hala; Alkahel, Alanoud; Hajjar, Waseem; Al-Shaikh, Ghadeer; Alsaif, Abdulaziz; Haque, Shafiul; Meo, Sultan Ayoub

2016-03-22

There is a growing perception that the left handed (LH) medical students are facing difficulties while performing the clinical tasks that involve psychomotor skill, although the evidence is very limited and diverse. The present study aimed to evaluate the clinical psychomotor skills among Right-handed (RH) and left-handed (LH) medical students. For this study, 54 (27 left handed and 27 right handed) first year medical students were selected. They were trained for different clinical psychomotor skills including suturing, laparoscopy, intravenous cannulation and urinary catheterization under the supervision of certified instructors. All students were evaluated for psychomotor skills by different instructors. The comparative performance of the students was measured by using a global rating scale, each selected criteria was allotted 5-points score with the total score of 25. There were no significant differences in the performance of psychomotor skills among LH and RH medical students. The global rating score obtained by medical students in suturing techniques was: LH 15.89 ± 2.88, RH 16.15 ± 2.75 (p = 0.737), cannulation techniques LH 20.44 ± 2.81, RH 20.70 ± 2.56 (p = 0.725), urinary catheterization LH 4.33 ± 0.96 RH 4.11 ± 1.05 (p = 0.421). For laparoscopic skills total peg transfer time was shorter among LH medical students compared to RH medical students (LH 129.85 ± 80.87 s vs RH 135.52 ± 104.81 s) (p = 0.825). However, both RH and LH students completed their procedure within the stipulated time. Among LH and RH medical students no significant difference was observed in performing the common surgical psychomotor skills. Surgical skills for LH or RH might not be a result of innate dexterity but rather the academic environment in which they are trained and assessed. Early laterality-related mentoring in medical schools as well as during the clinical residency might reduce the inconveniences faced by the left

Non-technical skills assessment for prelicensure nursing students: An integrative review.

Science.gov (United States)

Pires, Sara; Monteiro, Sara; Pereira, Anabela; Chaló, Daniela; Melo, Elsa; Rodrigues, Alexandre

2017-11-01

In nursing, non-technical skills are recognized as playing an important role to increase patient safety and successful clinical outcomes (Pearson and McLafferty, 2011). Non-technical skills are cognitive and social resource skills that complement technical skills and contribute to safe and efficient task performance (Flin et al., 2008). In order to effectively provide non-technical skills training, it is essential to have an instrument to measure these skills. An online search was conducted. Articles were selected if they referred to and/or described instruments assessing non-technical skills for nurses and/or prelicensure nursing students in educational, clinical and/or simulated settings with validation evidence (inclusion criteria). Of the 53 articles located, 26 met the inclusion criteria. Those referred to and/or described 16 instruments with validation evidence developed to assess non-technical skills in multidisciplinary teams including nurses. Although articles have shown 16 valid and reliable instruments, to our knowledge, no instrument has been published or developed and validated for the assessment of non-technical skills of only nurses in general, relevant for use in high-fidelity simulation-based training for prelicensure nursing students. Therefore, there is a need for the development of such an instrument. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Simulation-based training and OR apprenticeship for medical students : A prospective, randomized, single-blind study of clinical skills].

Science.gov (United States)

Ott, T; Schmidtmann, I; Limbach, T; Gottschling, P F; Buggenhagen, H; Kurz, S; Pestel, G

2016-11-01

Simulation-based training (SBT) has developed into an established method of medical training. Studies focusing on the education of medical students have used simulation as an evaluation tool for defined skills. A small number of studies provide evidence that SBT improves medical students' skills in the clinical setting. Moreover, they were strictly limited to a few areas, such as the diagnosis of heart murmurs or the correct application of cricoid pressure. Other studies could not prove adequate transferability from the skills gained in SBT to the patient site. Whether SBT has an effect on medical students' skills in anesthesiology in the clinical setting is controversial. To explore this issue, we designed a prospective, randomized, single-blind trial that was integrated into the undergraduate anesthesiology curriculum of our department during the second year of the clinical phase of medical school. This study intended to explore the effect of SBT on medical students within the mandatory undergraduate anesthesiology curriculum of our department in the operating room with respect to basic skills in anesthesiology. After obtaining ethical approval, the participating students of the third clinical semester were randomized into two groups: the SIM-OR group was trained by a 225 min long SBT in basic skills in anesthesiology before attending the operating room (OR) apprenticeship. The OR-SIM group was trained after the operating room apprenticeship by SBT. During SBT the students were trained in five clinical skills detailed below. Further, two clinical scenarios were simulated using a full-scale simulator. The students had to prepare the patient and perform induction of anesthesia, including bag-mask ventilation after induction in scenario 1 and rapid sequence induction in scenario 2. Using the five-point Likert scale, five defined skills were evaluated at defined time points during the study period. 1) application of the safety checklist, 2) application of

Transferring clinical communication skills from the classroom to the clinical environment: perceptions of a group of medical students in the United kingdom.

Science.gov (United States)

Brown, Jo

2010-06-01

To better understand the transfer of classroom-learned clinical communication skills (CCS) to the clinical environment of the hospital ward, where they are practiced and refined by students. The author first briefly presents the literature on clinical communication, provides an overview of the debates around the notion of transfer, and presents a sociocultural model of developmental transfer applied to CCS learning. Second, she describes a focus group and nine individual interviews carried out with 17 fourth-year medical students at one medical school in the United Kingdom in 2008. The goal was to elicit their views of CCS teaching, learning, and transfer of CCS to the clinical workplace. The findings are presented under the four main themes of transition, where students experienced the transition from the medical school to the hospital ward as a mixture of positive and negative impacts on transferring their CCS skills; the clinical culture, where senior doctors had the greatest impact on student learning and emergent clinical practice; clinical communication as a vehicle for professionalism and being a "good" doctor; and, finally, transfer mechanisms, where simulated practice with actors and the clinical history template were powerful learning tools. Findings indicate that more needs to be done to support, develop, and embed CCS into the professional practice of medical students in the clinical workplace. This may be achieved by greater collaboration of educators in the academic and clinical environments. Using the developmental transfer model applied to CCS learning may help foster this relationship.

Assessment of first-year veterinary students' communication skills using an objective structured clinical examination: the importance of context.

Science.gov (United States)

Hecker, Kent G; Adams, Cindy L; Coe, Jason B

2012-01-01

Communication skills are considered to be a core clinical skill in veterinary medicine and essential for practice success, including outcomes of care for patients and clients. While veterinary schools include communication skills training in their programs, there is minimal knowledge on how best to assess communication competence throughout the undergraduate program. The purpose of this study was to further our understanding of the reliability, utility, and suitability of a communication skills Objective Structured Clinical Examination (OSCE). Specifically we wanted to (1) identify the greatest source of variability (student, rater, station, and track) within a first-year, four station OSCE using exam scores and scores from videotape review by two trained raters, and (2) determine the effect of different stations on students' communication skills performance. Reliability of the scores from both the exam data and the two expert raters was 0.50 and 0.46 respectively, with the greatest amount of variance attributable to student by station. The percentage of variance due to raters in the exam data was 16.35%, whereas the percentage of variance for the two expert raters was 0%. These results have three important implications. First, the results reinforce the need for communication educators to emphasize that use of communication skills is moderated by the context of the clinical interaction. Second, by increasing rater training the amount of error in the scores due to raters can be reduced and inter-rater reliability increases. Third, the communication assessment method (in this case the OSCE checklist) should be built purposefully, taking into consideration the context of the case.

A systematic review evaluating the impact of online or blended learning vs. face-to-face learning of clinical skills in undergraduate nurse education.

Science.gov (United States)

McCutcheon, Karen; Lohan, Maria; Traynor, Marian; Martin, Daphne

2015-02-01

To determine whether the use of an online or blended learning paradigm has the potential to enhance the teaching of clinical skills in undergraduate nursing. The need to adequately support and develop students in clinical skills is now arguably more important than previously considered due to reductions in practice opportunities. Online and blended teaching methods are being developed to try and meet this requirement, but knowledge about their effectiveness in teaching clinical skills is limited. Mixed methods systematic review, which follows the Joanna Briggs Institute User guide version 5. Computerized searches of five databases were undertaken for the period 1995-August 2013. Critical appraisal and data extraction were undertaken using Joanna Briggs Institute tools for experimental/observational studies and interpretative and critical research. A narrative synthesis was used to report results. Nineteen published papers were identified. Seventeen papers reported on online approaches and only two papers reported on a blended approach. The synthesis of findings focused on the following four areas: performance/clinical skill, knowledge, self-efficacy/clinical confidence and user experience/satisfaction. The e-learning interventions used varied throughout all the studies. The available evidence suggests that online learning for teaching clinical skills is no less effective than traditional means. Highlighted by this review is the lack of available evidence on the implementation of a blended learning approach to teaching clinical skills in undergraduate nurse education. Further research is required to assess the effectiveness of this teaching methodology. © 2014 John Wiley & Sons Ltd.

The effect of high-fidelity patient simulation on the critical thinking and clinical decision-making skills of new graduate nurses.

Science.gov (United States)

Maneval, Rhonda; Fowler, Kimberly A; Kays, John A; Boyd, Tiffany M; Shuey, Jennifer; Harne-Britner, Sarah; Mastrine, Cynthia

2012-03-01

This study was conducted to determine whether the addition of high-fidelity patient simulation to new nurse orientation enhanced critical thinking and clinical decision-making skills. A pretest-posttest design was used to assess critical thinking and clinical decision-making skills in two groups of graduate nurses. Compared with the control group, the high-fidelity patient simulation group did not show significant improvement in mean critical thinking or clinical decision-making scores. When mean scores were analyzed, both groups showed an increase in critical thinking scores from pretest to posttest, with the high-fidelity patient simulation group showing greater gains in overall scores. However, neither group showed a statistically significant increase in mean test scores. The effect of high-fidelity patient simulation on critical thinking and clinical decision-making skills remains unclear. Copyright 2012, SLACK Incorporated.

Psychomotor skills in medical ultrasound imaging: an analysis of the core skill set.

Science.gov (United States)

Nicholls, Delwyn; Sweet, Linda; Hyett, Jon

2014-08-01

Sonographers use psychomotor skills to perform medical ultrasound examinations. Psychomotor skills describe voluntary movements of the limb, joints, and muscles in response to sensory stimuli and are regulated by the motor neural cortex in the brain. We define a psychomotor skill in relation to medical ultrasound imaging as "the unique mental and motor activities required to execute a manual task safely and efficiently for each clinical situation." Skills in clinical ultrasound practice may be open or closed; most skills used in medical ultrasound imaging are open. Open skills are both complex and multidimensional. Visuomotor and visuospatial psychomotor skills are central components of medical ultrasound imaging. Both types of skills rely on learners having a visual exemplar or standard of performance with which to reference their skill performance and evaluate anatomic structures. These are imperative instructional design principles when teaching psychomotor skills. © 2014 by the American Institute of Ultrasound in Medicine.

Developing the Blueprint for a General Surgery Technical Skills Certification Examination: A Validation Study.

Science.gov (United States)

de Montbrun, Sandra; Louridas, Marisa; Szasz, Peter; Harris, Kenneth A; Grantcharov, Teodor P

There is a recognized need to develop high-stakes technical skills assessments for decisions of certification and resident promotion. High-stakes examinations requires a rigorous approach in accruing validity evidence throughout the developmental process. One of the first steps in development is the creation of a blueprint which outlines the potential content of examination. The purpose of this validation study was to develop an examination blueprint for a Canadian General Surgery assessment of technical skill certifying examination. A Delphi methodology was used to gain consensus amongst Canadian General Surgery program directors as to the content (tasks or procedures) that could be included in a certifying Canadian General Surgery examination. Consensus was defined a priori as a Cronbach's α ≥ 0.70. All procedures or tasks reaching a positive consensus (defined as ≥80% of program directors rated items as ≥4 on the 5-point Likert scale) were then included in the final examination blueprint. Two Delphi rounds were needed to reach consensus. Of the 17 General Surgery Program directors across the country, 14 (82.4%) and 10 (58.8%) program directors responded to the first and second round, respectively. A total of 59 items and procedures reached positive consensus and were included in the final examination blueprint. The present study has outlined the development of an examination blueprint for a General Surgery certifying examination using a consensus-based methodology. This validation study will serve as the foundational work from which simulated model will be developed, pilot tested and evaluated. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A Clinic-Based Assessment for Evaluating Job-Related Social Skills in Adolescents and Adults with Autism.

Science.gov (United States)

Lerman, Dorothea C; White, Bridgette; Grob, Carolyn; Laudont, Courtney

2017-12-01

Many individuals with autism spectrum disorder (ASD) have difficulties obtaining and maintaining employment, yet little research has evaluated methods for assessing and improving critical vocational skills. In this study, we evaluated an assessment of job-related social skills for individuals with ASD by arranging conditions that simulated on-the-job experiences in a clinic setting. The experimenter contrived situations to assess a variety of social skills, including asking for help, asking for more materials, and responding to corrective feedback. A total of eight individuals, aged 16 to 32 years, participated. Results suggested that the assessment was useful for identifying specific social skills that could be targeted for intervention to increase success in the work environment. These findings add to the current literature by demonstrating an objective method for assessing a variety of job-related social skills under controlled, naturalistic conditions.

Skills and attributes required by clinical nurse specialists to promote evidence-based practice.

Science.gov (United States)

Campbell, T Diane; Profetto-McGrath, Joanne

2013-01-01

The purposes of this article were to describe the challenges that clinical nurse specialists (CNS) face in their role and to examine how CNSs describe the skills and attributes that are needed to promote the use of evidence-based practice (EBP) in their workplaces. This article is based on findings from a dissertation regarding how CNSs promote EBP in a western Canadian province. A sequential explanatory participant selection mixed-methods design was used for this study. The study took place in a western Canadian province that has a population of 1 million people, with 42.7% of the population residing in the 2 largest cities. The sample was drawn from a provincial registered nurse database. The sample for the survey was 23, and for the interviews, there were 11 participants. The telephone survey contained 113 questions grouped into several subcategories. SPSS 18 was used to analyze the survey data. The semistructured interviews were conducted face to face, transcribed, and reviewed for recurrent themes. Interpretive description was used to analyze the themes. The major challenges faced by CNSs are role strain, lack of support and resources, and role ambiguity. The skills and attributes required to be a CNS are graduate preparation, clinical expertise, and people/communication skills. Clinical nurse specialists can improve patient outcomes by promoting EBP; to do so, they need to work in supportive contexts that give those in the CNS role a set of clear role expectations. There are challenges faced by CNSs in Canada, and there is a need to strengthen the CNS's role by standardizing the regulatory requirements at a national level.

The motivational interviewing skill code : Reliability and a critical appraisal

NARCIS (Netherlands)

de Jonge, JM; Schippers, GM; Schaap, CPDR

The Motivational Interviewing Skill Code (MISC) is a coding system developed to measure adherence to motivational interviewing (MI). MI is an effective clinical style used in different treatment situations. Counsellors practising MI have to follow general principles and avoid certain traps. In the

Emergency nurses' knowledge, attitude and clinical decision making skills about pain.

Science.gov (United States)

Ucuzal, Meral; Doğan, Runida

2015-04-01

Pain is the most common reason that patients come to the emergency department. Emergency nurses have an indispensable role in the management of this pain. The aim of this study was to examine emergency nurses' knowledge, attitude and clinical decision-making skills about pain. This descriptive study was conducted in a state and a university hospital between September and October 2012 in Malatya, Turkey. Of 98 nurses working in the emergency departments of these two hospitals, 57 returned the questionnaires. The response rate was 58%. Data were collected using the Demographic Information Questionnaire, Knowledge and Attitude Questionnaire about Pain and Clinical Decision Making Survey. Frequency, percentage, mean and standard deviation were used to evaluate data. 75.4% of participant nurses knew that patients' own statement about their pain was the most reliable indicator during pain assessment. Almost half of the nurses believed that patients should be encouraged to endure the pain as much as possible before resorting to a pain relief method. The results also indicate that most of nurses think that a sleeping patient does not have any pain and pain relief should be postponed as it can influence the diagnosis negatively. It is determined that the pain scale was not used frequently. Only 35.1% of nurses reported keeping records of pain. Despite all the recommendations of substantial past research the results of this study indicate that emergency nurses continue to demonstrate inadequate knowledge, clinical decision-making skills and negative attitudes about pain. Copyright © 2014 Elsevier Ltd. All rights reserved.

A predeployment trauma team training course creates confidence in teamwork and clinical skills: a post-Afghanistan deployment validation study of Canadian Forces healthcare personnel.

Science.gov (United States)

McLaughlin, Thomas; Hennecke, Peter; Garraway, Naisan Robert; Evans, David C; Hameed, Morad; Simons, Richard K; Doucet, Jay; Hansen, Daniel; Annand, Siobhan; Bell, Nathaniel; Brown, D Ross

2011-11-01

The 10-day Intensive Trauma Team Training Course (ITTTC) was developed by the Canadian Forces (CFs) to teach teamwork and clinical trauma skills to military healthcare personnel before deploying to Afghanistan. This article attempts to validate the impact of the ITTTC by surveying participants postdeployment. A survey consisting of Likert-type multiple-choice questions was created and sent to all previous ITTTC participants. The survey asked respondents to rate their confidence in applying teamwork skills and clinical skills learned in the ITTTC. It explored the relevancy of objectives and participants' prior familiarity with the objectives. The impact of different training modalities was also surveyed. The survey showed that on average 84.29% of participants were "confident" or "very confident" in applying teamwork skills to their subsequent clinical experience and 52.10% were "confident" or "very confident" in applying clinical knowledge and skills. On average 43.74% of participants were "familiar" or "very familiar" with the clinical topics before the course, indicating the importance of training these skills. Participants found that clinical shadowing was significantly less valuable in training clinical skills than either animal laboratory experience or experience in human patient simulators; 68.57% respondents thought that ITTTC was "important" or "very important" in their training. The ITTTC created lasting self-reported confidence in CFs healthcare personnel surveyed upon return from Afghanistan. This validates the importance of the course for the training of CFs healthcare personnel and supports the value of team training in other areas of trauma and medicine.

Competence in performing emergency skills: How good do doctors really think they are?

Directory of Open Access Journals (Sweden)

Nicholas Dufourq

2017-12-01

Discussion: General Surgery and Internal Medicine trainees had a higher level of self-perceived competence in various emergency skills than their non- clinical counterparts. Current certification in advanced life support courses had a positive impact on trainees’ self- perceived levels of competence in emergency skills. Specialist trainees who had less delay before starting their specialist training also demonstrated higher levels of perceived competence.

Teaching general problem-solving skills is not a substitute for, or a viable addition to, teaching mathematics

NARCIS (Netherlands)

Sweller, John; Clark, Richard; Kirschner, Paul A.

2010-01-01

Sweller, J., Clark, R., & Kirschner, P. A. (2010). Teaching general problem-solving skills is not a substitute for, or a viable addition to, teaching mathematics. Notices of the American Mathematical Society, 57, 1303-1304.

Exploring Factors Affecting Voluntary Adoption of Electronic Medical Records Among Physicians and Clinical Assistants of Small or Solo Private General Practice Clinics.

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Or, Calvin; Tong, Ellen; Tan, Joseph; Chan, Summer

2018-05-29

The health care reform initiative led by the Hong Kong government's Food and Health Bureau has started the implementation of an electronic sharing platform to provide an information infrastructure that enables public hospitals and private clinics to share their electronic medical records (EMRs) for improved access to patients' health care information. However, previous attempts to convince the private clinics to adopt EMRs to document health information have faced challenges, as the EMR adoption has been voluntary. The lack of electronic data shared by private clinics carries direct impacts to the efficacy of electronic record sharing between public and private healthcare providers. To increase the likelihood of buy-in, it is essential to proactively identify the users' and organizations' needs and capabilities before large-scale implementation. As part of the reform initiative, this study examined factors affecting the adoption of EMRs in small or solo private general practice clinics, by analyzing the experiences and opinions of the physicians and clinical assistants during the pilot implementation of the technology, with the purpose to learn from it before full-scale rollout. In-depth, semistructured interviews were conducted with 23 physicians and clinical assistants from seven small or solo private general practice clinics to evaluate their experiences, expectations, and opinions regarding the deployment of EMRs. Interview transcripts were content analyzed to identify key factors. Factors affecting the adoption of EMRs to record and manage health care information were identified as follows: system interface design; system functions; stability and reliability of hardware, software, and computing networks; financial and time costs; task and outcome performance, work practice, and clinical workflow; physical space in clinics; trust in technology; users' information technology literacy; training and technical support; and social and organizational influences. The

Communication skills training in surgical residency: a needs assessment and metacognition analysis of a difficult conversation objective structured clinical examination.

Science.gov (United States)

Falcone, John L; Claxton, René N; Marshall, Gary T

2014-01-01

The objective structured clinical examination (OSCE) can be used to evaluate the Accreditation Council for Graduate Medical Education Core Competencies of Professionalism and Interpersonal and Communication Skills. The aim of this study was to describe general surgery resident performance on a "difficult conversation" OSCE. In this prospective study, junior and senior residents participated in a 2-station OSCE. Junior stations involved discussing operative risks and benefits and breaking bad news. Senior stations involved discussing goals of care and discussing transition to comfort measures only status. Residents completed post-OSCE checklist and Likert-based self-evaluations of experience, comfort, and confidence. Trained standardized patients (SPs) evaluated residents using communication skill-based checklists and Likert-based assessments. Pearson correlation coefficients were determined between self-assessment and SP assessment. Mann-Whitney U tests were conducted between junior and senior resident variables, using α = 0.05. There were 27 junior residents (age 28.1 ± 1.9 years [29.6% female]) and 27 senior residents (age 32.1 ± 2.5 years [26.9% female]). The correlation of self-assessment and SP assessment of overall communication skills by junior residents was -0.32 on the risks and benefits case and 0.07 on the breaking bad news case. The correlation of self-assessment and SP assessment of overall communication skills by senior residents was 0.30 on the goals of care case and 0.26 on the comfort measures only case. SP assessments showed that junior residents had higher overall communication skills than senior residents (p = 0.03). Senior residents perceived that having difficult conversations was more level appropriate (p skills are correlated, and that skills-based training is needed across all residency levels. This well-received method may be used to observe, document, and provide resident feedback for these important skills. © 2014 Published by

Faculty Development on Clinical Teaching Skills: An Effective Model for the Busy Clinician

Directory of Open Access Journals (Sweden)

Julie B. Damp

2016-01-01

Full Text Available Introduction The authors developed and evaluated a faculty development program on clinical teaching skills to address barriers to participation and to impact teaching behaviors. Methods Four one-hour workshops were implemented over five months. Evaluation included participant satisfaction and pre/post self-assessment. Pre/post faculty teaching ratings by trainees were compared. Results A total of 82% of faculty ( N = 41 attended. Participants rated workshops highly (mean, 4.43/5.00. Self-assessment of skills and comfort with teaching activities improved. A total of 59% of residents and 40% of fellows felt that teaching received from participating faculty was highly effective. The majority observed targeted teaching behaviors by the faculty. Teaching ratings improved after the workshops ( P = 0.042. Conclusion Our series of short workshops during a standing conference time was associated with increased self-assessed skill and comfort and an increase in faculty ratings on teaching evaluations. Effective faculty development programs can be implemented in flexible formats and overcome common barriers to participation.

Faculty Development on Clinical Teaching Skills: An Effective Model for the Busy Clinician

Science.gov (United States)

Damp, Julie B.; Dewey, Charlene M.; Wells, Quinn; Horn, Leora; Kroop, Susan F.; Mendes, Lisa

2016-01-01

Introduction The authors developed and evaluated a faculty development program on clinical teaching skills to address barriers to participation and to impact teaching behaviors. Methods Four one-hour workshops were implemented over five months. Evaluation included participant satisfaction and pre/post self-assessment. Pre/post faculty teaching ratings by trainees were compared. Results A total of 82% of faculty (N = 41) attended. Participants rated workshops highly (mean, 4.43/5.00). Self-assessment of skills and comfort with teaching activities improved. A total of 59% of residents and 40% of fellows felt that teaching received from participating faculty was highly effective. The majority observed targeted teaching behaviors by the faculty. Teaching ratings improved after the workshops (P = 0.042). Conclusion Our series of short workshops during a standing conference time was associated with increased self-assessed skill and comfort and an increase in faculty ratings on teaching evaluations. Effective faculty development programs can be implemented in flexible formats and overcome common barriers to participation. PMID:29349327

The Flipped Classroom for pre-clinical dental skills teaching - a reflective commentary.

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Crothers, A J; Bagg, J; McKerlie, R

2017-05-12

A Flipped Classroom method for teaching of adult practical pre-clinical dental skills was introduced to the BDS curriculum in Glasgow during the 2015/2016 academic session. This report provides a commentary of the first year of employing this method - from the identification of the need to optimise teaching resources, through the planning, implementation and development of the method, with an early indication of performance.

Shared learning in general practice--facilitators and barriers.

Science.gov (United States)

van de Mortel, Thea; Silberberg, Peter; Ahern, Christine

2013-03-01

Capacity for teaching in general practice clinics is limited. Shared learning sessions are one form of vertically integrated teaching that may ameliorate capacity constraints. This study sought to understand the perceptions of general practitioner supervisors, learners and practice staff of the facilitators of shared learning in general practice clinics. Using a grounded theory approach, semistructured interviews were conducted and analysed to generate a theory about the topic. Thirty-five stakeholders from nine general practices participated. Facilitators of shared learning included enabling factors such as small group facilitation skills, space, administrative support and technological resources; reinforcing factors such as targeted funding, and predisposing factors such as participant attributes. Views from multiple stakeholders suggest that the implementation of shared learning in general practice clinics would be supported by an ecological approach that addresses all these factors.

A comparison of the scorings of real and standardized patients on physician communication skills.

Science.gov (United States)

Rezaei, Rita; Mehrabani, G

2014-05-01

To compare the scorings of real and standardized patients on physician communication skills. Patient scoring (n=183) on physicians' communication skills was determined by 93 real and 90 standardized patients. Eighty physicians (42 specialists and 38 general physicians) in private practice were enrolled. Data were analyzed using self administered questionnaires and checklists including 16 close ended questions. Twelve percent of patients were not satisfied with the physician communication skills. Poor communication skills were more reported by male patients and those with a higher educational level. The physician communication skill received a higher score with increase of age of patients. A good physician's communication skill was reported more by married patients. A good physician's communication skill was significantly more in female doctors, in general physicians and in doctors wearing a White Coat. Real patients scored physician's communication skills higher than standardized patients. It is important that physicians try to learn the principles of a good physician-patient communication skill. Therefore, providing medical educational programs on the role of a good doctor and patient relationship at all levels for the doctors and applying them in their clinical practice seem necessary to improve the physician communication skills.

Intelligent tutoring system for clinical reasoning skill acquisition in dental students.

Science.gov (United States)

Suebnukarn, Siriwan

2009-10-01

Learning clinical reasoning is an important core activity of the modern dental curriculum. This article describes an intelligent tutoring system (ITS) for clinical reasoning skill acquisition. The system is designed to provide an experience that emulates that of live human-tutored problem-based learning (PBL) sessions as much as possible, while at the same time permitting the students to participate collaboratively from disparate locations. The system uses Bayesian networks to model individual student knowledge and activity, as well as that of the group. Tutoring algorithms use the models to generate tutoring hints. The system incorporates a multimodal interface that integrates text and graphics so as to provide a rich communication channel between the students and the system, as well as among students in the group. Comparison of learning outcomes shows that student clinical reasoning gains from the ITS are similar to those obtained from human-tutored sessions.

A model linking clinical workforce skill mix planning to health and health care dynamics

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McDonnell Geoff

2010-04-01

Full Text Available Abstract Background In an attempt to devise a simpler computable tool to assist workforce planners in determining what might be an appropriate mix of health service skills, our discussion led us to consider the implications of skill mixing and workforce composition beyond the 'stock and flow' approach of much workforce planning activity. Methods Taking a dynamic systems approach, we were able to address the interactions, delays and feedbacks that influence the balance between the major components of health and health care. Results We linked clinical workforce requirements to clinical workforce workload, taking into account the requisite facilities, technologies, other material resources and their funding to support clinical care microsystems; gave recognition to productivity and quality issues; took cognisance of policies, governance and power concerns in the establishment and operation of the health care system; and, going back to the individual, gave due attention to personal behaviour and biology within the socio-political family environment. Conclusion We have produced the broad endogenous systems model of health and health care which will enable human resource planners to operate within real world variables. We are now considering the development of simple, computable national versions of this model.

A model linking clinical workforce skill mix planning to health and health care dynamics.

Science.gov (United States)

Masnick, Keith; McDonnell, Geoff

2010-04-30

In an attempt to devise a simpler computable tool to assist workforce planners in determining what might be an appropriate mix of health service skills, our discussion led us to consider the implications of skill mixing and workforce composition beyond the 'stock and flow' approach of much workforce planning activity. Taking a dynamic systems approach, we were able to address the interactions, delays and feedbacks that influence the balance between the major components of health and health care. We linked clinical workforce requirements to clinical workforce workload, taking into account the requisite facilities, technologies, other material resources and their funding to support clinical care microsystems; gave recognition to productivity and quality issues; took cognisance of policies, governance and power concerns in the establishment and operation of the health care system; and, going back to the individual, gave due attention to personal behaviour and biology within the socio-political family environment. We have produced the broad endogenous systems model of health and health care which will enable human resource planners to operate within real world variables. We are now considering the development of simple, computable national versions of this model.

Processing speed and executive functions predict real-world everyday living skills in adolescents with early-onset schizophrenia.

Science.gov (United States)

Puig, O; Penadés, R; Baeza, I; Sánchez-Gistau, V; De la Serna, E; Fonrodona, L; Andrés-Perpiñá, S; Bernardo, M; Castro-Fornieles, J

2012-06-01

Cognition and clinical variables are known to be among the most predictive factors of real-world social functioning and daily living skills in adult-onset schizophrenia. Fewer studies have focused on their impact in adolescents with early-onset schizophrenia (EOS). The aim of this study is to examine the relationships and the predictive value of cognition and clinical variables on real-world daily living skills in a sample of adolescents with EOS. Cognitive, clinical and real-world everyday living skills measures were administered to 45 clinically and pharmacologically stabilized adolescent outpatients with EOS and 45 healthy control subjects matched by age and sex. Multi-variant analyses to compare cognitive and real-world functioning profiles between patients and controls and regression analysis to identify predictors of real-world functioning scores in patients were used. Adolescents with EOS showed a generalized cognitive and real-world daily living skills dysfunction. Several cognitive and clinical variables significantly correlated with real-world daily living skills functioning but only the processing speed and executive functions emerged as independent predictors of everyday living skills scores, explaining 25.1% of the variance. Slowness in processing information and executive dysfunction showed a significant impact on real-world daily living skills in EOS, independently from clinical symptoms and other cognitive variables. Nevertheless, much of the variance in the daily living skills measure remained unaccounted for, suggesting that other factors were involved as well in this young population.

Clinical indications for antibiotic use in Danish general practice

DEFF Research Database (Denmark)

Aabenhus, Rune; Hansen, Malene Plejdrup; Siersma, Volkert Dirk

2017-01-01

of routine electronic antibiotic prescriptions from Danish general practice. Subjects: All 975,626 patients who redeemed an antibiotic prescription at outpatient pharmacies during the 1-year study period (July 2012 to June 2013). Main outcome measures: Number of prescriptions per clinical indication. Number......Objective: To assess the availability and applicability of clinical indications from electronic prescriptions on antibiotic use in Danish general practice. Design: Retrospective cohort register-based study including the Danish National Prescription Register. Setting: Population-based study...... from electronic prescriptions are accessible and available to provide an overview of drug use, in casu antibiotic prescriptions, in Danish general practice. These clinical indications may be further explored in detail to assess rational drug use and congruence with guidelines, but validation...

Alternating skills training and clerkships to ease the transition from preclinical to clinical training

NARCIS (Netherlands)

Van Hell, E.A.; Kuks, J.B.; Borleffs, J.C.; Cohen-Schotanus, J.

2011-01-01

Background: The transition from preclinical to clinical training is perceived as stressful with a high workload being the main difficulty. To ease this transition, we implemented a dual learning year, where just-in-time skills training and clerkships alternated. Aims: To examine the effect of the

The Integration of Psychomotor Skills in a Hybrid-PBL Dental Curriculum: The Clinical Clerkships.

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Walton, Joanne N.; MacNeil, M. A. J.; Harrison, Rosamund L.; Clark, D. Christopher

1998-01-01

Describes the restructuring of clinical clerkships at the University of British Columbia (Canada) dental school as part of a new, hybrid, problem-based learning (PBL) curriculum, focusing on strategies for integrating development of psychomotor skills. Methods of achieving both horizontal and vertical integration of competencies through grouping…

Implementation of an Electronic Objective Structured Clinical Exam for Assessing Practical Skills in Pre-Professional Physiotherapy and Occupational Therapy Programs: Examiner and Course Coordinator Perspectives

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Snodgrass, Suzanne J.; Ashby, Samantha E.; Rivett, Darren A.; Russell, Trevor

2014-01-01

Assessment of practical clinical skills is essential in the health fields. Objective Structured Clinical Exams (OSCEs), where examiners assess students performing clinical procedures on simulated patients (actors), are central to the evaluation of practical skills. However, traditional OSCEs require considerable time-investment to administer, and…

An exploration of the perceived factors that affect the learning and transfer of skills taught to student midwives.

Science.gov (United States)

Longworth, Mary K

2013-08-01

the aim of this study was to examine the attitudes of student midwives towards skills training and practise. The objectives were to explore the factors in the skills laboratory environment and in clinical practice which affect how successfully student midwives transfer into clinical practice the various skills they have learnt in preparation for an Objective Structured Clinical Examination. a review of the background literature revealed that there were many variables related to successful transfer of skills in general but there appeared to be a gap around perceived factors affecting transfer of skills of student midwives. a mixed methods design was conducted using both questionnaires and semi-structured interviews between June and August 2010. questionnaires were administered to all midwifery students at one university in Wales. These were later followed by semi-structured interviews for 6 student midwives who were purposively selected from all year groups. the results from the questionnaires revealed that a majority of students had positive attitudes to educators and mentors and to their skills acquisition experience in the skills laboratory and to the available opportunities to practise in clinical practice. Although students believed in the transferability of skills from the laboratory setting to clinical practice, a majority thought that clinical practice provided them with a better opportunity to learn clinical skills. The semi-structured interviews demonstrated that facilitating factors in the skills laboratory included having adequate instruction as well as having a designated space. Hindering factors included unrealistic models and equipment. In clinical practice, facilitating factors included having the opportunities to practise skills and support and feedback from the mentor. Hindering factors included deficits in the student-mentor relationship. this study highlighted that midwifery students must be adequately prepared to carry out clinical skills

Characteristics of effective clinical guidelines for general practice.

NARCIS (Netherlands)

Burgers, J.S.; Grol, R.P.T.M.; Zaat, J.O.M.; Spies, T.H.; Bij, A.K. van der; Mokkink, H.G.A.

2003-01-01

BACKGROUND: The use of clinical guidelines in general practice is often limited. Research on barriers to guideline adherence usually focuses on attitudinal factors. Factors linked to the guideline itself are much less studied. AIM: To identify characteristics of effective clinical guidelines for

Clinical skills required of ophthalmic nurse practitioners in tertiary level public hospitals in the Western Cape Province

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U. Kyriacos

2009-09-01

Full Text Available Background: South Africa has a 32-year history of training ophthalmic nurse practitioners (ONPs. The role and required skills and competencies of ONPs are not well documented in the international literature and are also absent from South African publications, including South African Nursing Council publications. Aim: This study aims to inform curriculum development and human resource planning by reporting on the clinical skills expected of ONPs by members of multidisciplinary ophthalmology teams. Method: A limited survey was undertaken in the ophthalmology wards and outpatient departments of three tertiary level hospitals in the Western Cape Province. A researcher-designed structured self-completion questionnaire was distributed to 30 ophthalmology practitioners: doctors, nurses and technicians. Respondents were asked to indicate the expected clinical skills of ONPs. Findings: All questionnaires were completed. All respondents favoured ONPs taking histories and performing emergency eye irrigations. There was less support for more complex procedures, such as B-scans. One-third of respondents did not expect ONPs to have skills in eight key areas, including examination of the anterior chamber angle for glaucoma. No statistically significant differences were found between responses of doctors and nurses, with one exception: more nurses (15/18 than doctors (4/10 had confidence in the ONP undertaking basic eye examinations for ocular motility (Fisher‘s exact test, P = 0 .035. Conclusion: In the study settings, ONPs are not using their specialist skills to the full. Not all practitioners were receptive to ONPs using the skills that they had acquired during their postgraduate diploma, threatening the educational effectiveness of this initiative.

Effectiveness of a structured training program in psychotherapeutic skills used in clinical interviews for psychiatry and clinical psychology residents.

Science.gov (United States)

Fernandez-Liria, Alberto; Rodriguez-Vega, Beatriz; Ortiz-Sanchez, Deborah; Baldor Tubet, Isabel; Gonzalez-Juarez, Carlos

2010-01-01

The authors evaluated a training program based on a structured manual of psychotherapeutic skills, using a randomized controlled design. The experimental group consisted of 135 residents from 12 teaching units in Spain. To control the improvement in therapeutic skills that could be attributed to the training received during the residency, the authors compared the experimental group with a control group of 35 residents from three teaching units. Two types of assessment instruments were used: a paper-and-pencil questionnaire based on clinical cases and a videotape of a role-playing interview. Both were given before and after the experimental group attended the training program. The experimental group shows a statistically significant improvement compared with the control group in both measurements.

Promoting Assessment Efficacy through an Integrated System for Online Clinical Assessment of Practical Skills

Science.gov (United States)

Hay, Peter J.; Engstrom, Craig; Green, Anita; Friis, Peter; Dickens, Sue; Macdonald, Doune

2013-01-01

This paper presents evaluation outcomes from an externally funded research project involving the online clinical assessment of practical skills (eCAPS) using web-based video technologies within a university medical programme. eCAPS was implemented to trial this web-based approach for promoting the efficacy of "practical" skills…

The use of advanced physical assessment skills by cardiac nurses.

Science.gov (United States)

Edmunds, Linda; Ward, Susan; Barnes, Rhian

To establish what advanced physical assessment skills are being used by cardiac nurses after they undertook a clinical patient assessment module; and to explore the factors that influence their use of these skills. A longitudinal descriptive approach using convenience sampling was employed. Qualitative data was obtained from individual interviews, non-participant observation within the participants' clinical environment and self-reported activity logs. Five key themes emerged: use of advanced physical assessment skills varied; use and development of skills was linked to personal characteristics; use influenced by perceptions of role boundaries, permission and cooperation; use influenced by participants' perception of nursing and the development of their own nursing practice; and use influenced by the physical environment and the human support within it. Cardiac nurses selectively use physical assessment skills, predominately related to the cardiorespiratory systems. Organisational structure, professional relationships and the professionalism of the individual nurse appear to play a significant part in the use of physical assessment skills. Although the findings from this qualitative study cannot be generalized, they concur with findings from recent research into physical assessment skills used by a variety of UK nurses. The implications identified are: first, for those who provide the education, in terms of what should be taught and facilitated; and second, for organizations, in ensuring staff have assessment skills relevant to their role and that systems are in place to enable the development of a supportive and progressive culture that embraces modernization congruent with healthcare policy.

Personal values and self-esteem in general and clinical population

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Vanesa C. Góngora

2015-09-01

Full Text Available The aim of this study is to investigate the association between personal values and self-esteem in general population and clinical population. The sample was composed of a group of patients with a diagnosis of anxiety disorders and/or depression (n = 60 and a comparison group, paired by sex and age, of general population (n = 60. The Portrait Values Questionnaire of Schwartz (PVQ and the Autoe Self-esteem Scale were used. T-tests were performed to compare the scores of both instruments between the two groups. The clinical sample scored significantly lower in Self-esteem, Self- direction, Hedonism, and Openness to Change. For this reason, Pearson correlations were calculated in differential groups (clinical and general between the PVQ and the Self-esteem Scale. In the general population group self-esteem was associated to one value: Self-direction. In the clinical group, self-esteem was associated mainly to Self- direction, but also to Hedonism, Power and Security; and to the axis Self-promotion and Openness to Change. Both in the clinical and general population samples it was found a significant association between the interest in having independent thought, freedom of action and exploring with higher levels of self-esteem. 

Teaching Motivational Interviewing Skills to Psychiatry Trainees: Findings of a National Survey.

Science.gov (United States)

Abele, Misoo; Brown, Julie; Ibrahim, Hicham; Jha, Manish K

2016-02-01

The authors report on the current status of motivational interviewing education and training director attitudes about providing it to psychiatry residents. Training directors of general, child/adolescent and addiction psychiatry training programs were invited to participate in an anonymous online survey. Of the 333 training directors who were invited to participate, 66 of 168 (39.3%) general, 41 of 121 (33.9%) child/adolescent, and 19 of 44 (43.2%) addiction psychiatry training directors completed the survey. The authors found that 90.9% of general, 80.5% of child/adolescent, and 100% of addiction psychiatry training programs provided motivational interviewing education. Most programs used multiple educational opportunities; the three most common opportunities were didactics, clinical practice with formal supervision, and self-directed reading. Most training directors believed that motivational interviewing was an important skill for general psychiatrists. The authors also found that 83.3% of general, 87.8% of child/adolescent, and 94.7% of addiction psychiatry training directors reported that motivational interviewing should be taught during general psychiatry residency. Motivational interviewing skills are considered important for general psychiatrists and widely offered by training programs. Competency in motivational interviewing skills should be considered as a graduation requirement in general psychiatry training programs.

Student self-reported communication skills, knowledge and confidence across standardised patient, virtual and traditional clinical learning environments.

Science.gov (United States)

Quail, Michelle; Brundage, Shelley B; Spitalnick, Josh; Allen, Peter J; Beilby, Janet

2016-02-27

Advanced communication skills are vital for allied health professionals, yet students often have limited opportunities in which to develop them. The option of increasing clinical placement hours is unsustainable in a climate of constrained budgets, limited placement availability and increasing student numbers. Consequently, many educators are considering the potentials of alternative training methods, such as simulation. Simulations provide safe, repeatable and standardised learning environments in which students can practice a variety of clinical skills. This study investigated students' self-rated communication skill, knowledge, confidence and empathy across simulated and traditional learning environments. Undergraduate speech pathology students were randomly allocated to one of three communication partners with whom they engaged conversationally for up to 30 min: a patient in a nursing home (n = 21); an elderly trained patient actor (n = 22); or a virtual patient (n = 19). One week prior to, and again following the conversational interaction, participants completed measures of self-reported communication skill, knowledge and confidence (developed by the authors based on the Four Habit Coding Scheme), as well as the Jefferson Scale of Empathy - Health Professionals (student version). All three groups reported significantly higher communication knowledge, skills and confidence post-placement (Median d = .58), while the degree of change did not vary as a function of group membership (Median η (2)  communication skill, knowledge and confidence, though not empathy, following a brief placement in a virtual, standardised or traditional learning environment. The self-reported increases were consistent across the three placement types. It is proposed that the findings from this study provide support for the integration of more sustainable, standardised, virtual patient-based placement models into allied health training programs for the training of

The role of deliberate practice in the acquisition of clinical skills

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Duvivier Robbert J

2011-12-01

Full Text Available Abstract Background The role of deliberate practice in medical students' development from novice to expert was examined for preclinical skill training. Methods Students in years 1-3 completed 34 Likert type items, adapted from a questionnaire about the use of deliberate practice in cognitive learning. Exploratory factor analysis and reliability analysis were used to validate the questionnaire. Analysis of variance examined differences between years and regression analysis the relationship between deliberate practice and skill test results. Results 875 students participated (90%. Factor analysis yielded four factors: planning, concentration/dedication, repetition/revision, study style/self reflection. Student scores on 'Planning' increased over time, score on sub-scale 'repetition/revision' decreased. Student results on the clinical skill test correlated positively with scores on subscales 'planning' and 'concentration/dedication' in years 1 and 3, and with scores on subscale 'repetition/revision' in year 1. Conclusions The positive effects on test results suggest that the role of deliberate practice in medical education merits further study. The cross-sectional design is a limitation, the large representative sample a strength of the study. The vanishing effect of repetition/revision may be attributable to inadequate feedback. Deliberate practice advocates sustained practice to address weaknesses, identified by (self-assessment and stimulated by feedback. Further studies should use a longitudinal prospective design and extend the scope to expertise development during residency and beyond.

National Clinical Skills Competition: an effective simulation-based method to improve undergraduate medical education in China.

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Jiang, Guanchao; Chen, Hong; Wang, Qiming; Chi, Baorong; He, Qingnan; Xiao, Haipeng; Zhou, Qinghuan; Liu, Jing; Wang, Shan

2016-01-01

The National Clinical Skills Competition has been held in China for 5 consecutive years since 2010 to promote undergraduate education reform and improve the teaching quality. The effects of the simulation-based competition will be analyzed in this study. Participation in the competitions and the compilation of the questions used in the competition finals are summarized, and the influence and guidance quality are further analyzed. Through the nationwide distribution of questionnaires in medical colleges, the effects of the simulation-based competition on promoting undergraduate medical education reform were evaluated. The results show that approximately 450 students from more than 110 colleges (accounting for 81% of colleges providing undergraduate clinical medical education in China) participated in the competition each year. The knowledge, skills, and attitudes were comprehensively evaluated by simulation-based assessment. Eight hundred and eighty copies of the questionnaires were distributed to 110 participating medical schools in 2015. In total, 752 valid responses were received across 95 schools. The majority of the interviewees agreed or strongly agreed that competition promoted the adoption of advanced educational principles (76.8%), updated the curriculum model and instructional methods (79.8%), strengthened faculty development (84.0%), improved educational resources (82.1%), and benefited all students (53.4%). The National Clinical Skills Competition is widely accepted in China. It has effectively promoted the reform and development of undergraduate medical education in China.

Companion animal veterinarians' use of clinical communication skills.

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McArthur, M L; Fitzgerald, J R

2013-09-01

To describe the communication techniques used by clients and veterinarians during companion animal visits in Australia. A cross-sectional descriptive study. A total of 64 veterinary consultations were audiotaped and analysed with the Roter Interaction Analysis System (RIAS); clients completed appointment level measures, including their satisfaction and perceptions of relational communication. Participants were 24 veterinarians and 64 clients. Statements intended to reassure clients were expressed frequently in the consultations, but in 59% of appointments empathy statements were not expressed towards either the client or the patient. In 10% of appointments, veterinarians did not used any open-ended questions. Overall client satisfaction was high and veterinarians' expressions of empathy directed to the client resulted in higher levels of client satisfaction. Clients' perceptions of relational communication were related to several veterinarian and client nonverbal scales. A focus on developing evidence-based clinical communication skills is expected to further enhance the veterinarian-client-patient relationship and associated clinical outcomes. Particular recommendations include the development of a broader emotion-handling repertoire, increased emphasis on the use of open-ended enquiry, including assessment of the client's perspective, as well as attention to aspects of nonverbal communication. The study provides preliminary evidence for the importance of verbal expressions of empathy during the companion animal consultation. © 2013 Australian Veterinary Association.

A prospective study evaluating cochlear implant management skills: development and validation of the Cochlear Implant Management Skills survey.

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Bennett, R J; Jayakody, D M P; Eikelboom, R H; Taljaard, D S; Atlas, M D

2016-02-01

To investigate the ability of cochlear implant (CI) recipients to physically handle and care for their hearing implant device(s) and to identify factors that may influence skills. To assess device management skills, a clinical survey was developed and validated on a clinical cohort of CI recipients. Survey development and validation. A prospective convenience cohort design study. Specialist hearing implant clinic. Forty-nine post-lingually deafened, adult CI recipients, at least 12 months postoperative. Survey test-retest reliability, interobserver reliability and responsiveness. Correlations between management skills and participant demographic, audiometric, clinical outcomes and device factors. The Cochlear Implant Management Skills survey was developed, demonstrating high test-retest reliability (0.878), interobserver reliability (0.972) and responsiveness to intervention (skills training) [t(20) = -3.913, P = 0.001]. Cochlear Implant Management Skills survey scores range from 54.69% to 100% (mean: 83.45%, sd: 12.47). No associations were found between handling skills and participant factors. This is the first study to demonstrate a range in cochlear implant device handling skills in CI recipients and offers clinicians and researchers a tool to systematically and objectively identify shortcomings in CI recipients' device handling skills. © 2015 John Wiley & Sons Ltd.

Effects of nursing process-based simulation for maternal child emergency nursing care on knowledge, attitude, and skills in clinical nurses.

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Kim, Sunghee; Shin, Gisoo

2016-02-01

Since previous studies on simulation-based education have been focused on fundamental nursing skills for nursing students in South Korea, there is little research available that focuses on clinical nurses in simulation-based training. Further, there is a paucity of research literature related to the integration of the nursing process into simulation training particularly in the emergency nursing care of high-risk maternal and neonatal patients. The purpose of this study was to identify the effects of nursing process-based simulation on knowledge, attitudes, and skills for maternal and child emergency nursing care in clinical nurses in South Korea. Data were collected from 49 nurses, 25 in the experimental group and 24 in the control group, from August 13 to 14, 2013. This study was an equivalent control group pre- and post-test experimental design to compare the differences in knowledge, attitudes, and skills for maternal and child emergency nursing care between the experimental group and the control group. The experimental group was trained by the nursing process-based simulation training program, while the control group received traditional methods of training for maternal and child emergency nursing care. The experimental group was more likely to improve knowledge, attitudes, and skills required for clinical judgment about maternal and child emergency nursing care than the control group. Among five stages of nursing process in simulation, the experimental group was more likely to improve clinical skills required for nursing diagnosis and nursing evaluation than the control group. These results will provide valuable information on developing nursing process-based simulation training to improve clinical competency in nurses. Further research should be conducted to verify the effectiveness of nursing process-based simulation with more diverse nurse groups on more diverse subjects in the future. Copyright © 2015 Elsevier Ltd. All rights reserved.

General practice-based clinical trials in Germany - a problem analysis

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Hummers-Pradier Eva

2012-11-01

Full Text Available Abstract Background In Germany, clinical trials and comparative effectiveness studies in primary care are still very rare, while their usefulness has been recognised in many other countries. A network of researchers from German academic general practice has explored the reasons for this discrepancy. Methods Based on a comprehensive literature review and expert group discussions, problem analyses as well as structural and procedural prerequisites for a better implementation of clinical trials in German primary care are presented. Results In Germany, basic biomedical science and technology is more reputed than clinical or health services research. Clinical trials are funded by industry or a single national programme, which is highly competitive, specialist-dominated, exclusive of pilot studies, and usually favours innovation rather than comparative effectiveness studies. Academic general practice is still not fully implemented, and existing departments are small. Most general practitioners (GPs work in a market-based, competitive setting of small private practices, with a high case load. They have no protected time or funding for research, and mostly no research training or experience. Good Clinical Practice (GCP training is compulsory for participation in clinical trials. The group defined three work packages to be addressed regarding clinical trials in German general practice: (1 problem analysis, and definition of (2 structural prerequisites and (3 procedural prerequisites. Structural prerequisites comprise specific support facilities for general practice-based research networks that could provide practices with a point of contact. Procedural prerequisites consist, for example, of a summary of specific relevant key measures, for example on a web platform. The platform should contain standard operating procedures (SOPs, templates, checklists and other supporting materials for researchers. Conclusion All in all, our problem analyses revealed that

Nursing students' evaluation of a new feedback and reflection tool for use in high-fidelity simulation - Formative assessment of clinical skills. A descriptive quantitative research design.

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Solheim, Elisabeth; Plathe, Hilde Syvertsen; Eide, Hilde

2017-11-01

Clinical skills training is an important part of nurses' education programmes. Clinical skills are complex. A common understanding of what characterizes clinical skills and learning outcomes needs to be established. The aim of the study was to develop and evaluate a new reflection and feedback tool for formative assessment. The study has a descriptive quantitative design. 129 students participated who were at the end of the first year of a Bachelor degree in nursing. After highfidelity simulation, data were collected using a questionnaire with 19 closed-ended and 2 open-ended questions. The tool stimulated peer assessment, and enabled students to be more thorough in what to assess as an observer in clinical skills. The tool provided a structure for selfassessment and made visible items that are important to be aware of in clinical skills. This article adds to simulation literature and provides a tool that is useful in enhancing peer learning, which is essential for nurses in practice. The tool has potential for enabling students to learn about reflection and developing skills for guiding others in practice after they have graduated. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Clinical skills and outcomes of chair-side computer aided design and computer aided manufacture system].

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Yu, Q

2018-04-09

Computer aided design and computer aided manufacture (CAD/CAM) technology is a kind of oral digital system which is applied to clinical diagnosis and treatment. It overturns the traditional pattern, and provides a solution to restore defect tooth quickly and efficiently. In this paper we mainly discuss the clinical skills of chair-side CAD/CAM system, including tooth preparation, digital impression, the three-dimensional design of prosthesis, numerical control machining, clinical bonding and so on, and review the outcomes of several common kinds of materials at the same time.

Models of clinical reasoning with a focus on general practice: A critical review.

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Yazdani, Shahram; Hosseinzadeh, Mohammad; Hosseini, Fakhrolsadat

2017-10-01

Diagnosis lies at the heart of general practice. Every day general practitioners (GPs) visit patients with a wide variety of complaints and concerns, with often minor but sometimes serious symptoms. General practice has many features which differentiate it from specialty care setting, but during the last four decades little attention was paid to clinical reasoning in general practice. Therefore, we aimed to critically review the clinical reasoning models with a focus on the clinical reasoning in general practice or clinical reasoning of general practitioners to find out to what extent the existing models explain the clinical reasoning specially in primary care and also identity the gaps of the model for use in primary care settings. A systematic search to find models of clinical reasoning were performed. To have more precision, we excluded the studies that focused on neurobiological aspects of reasoning, reasoning in disciplines other than medicine decision making or decision analysis on treatment or management plan. All the articles and documents were first scanned to see whether they include important relevant contents or any models. The selected studies which described a model of clinical reasoning in general practitioners or with a focus on general practice were then reviewed and appraisal or critics of other authors on these models were included. The reviewed documents on the model were synthesized. Six models of clinical reasoning were identified including hypothetic-deductive model, pattern recognition, a dual process diagnostic reasoning model, pathway for clinical reasoning, an integrative model of clinical reasoning, and model of diagnostic reasoning strategies in primary care. Only one model had specifically focused on general practitioners reasoning. A Model of clinical reasoning that included specific features of general practice to better help the general practitioners with the difficulties of clinical reasoning in this setting is needed.

Models of clinical reasoning with a focus on general practice: a critical review

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SHAHRAM YAZDANI

2017-10-01

Full Text Available Introduction: Diagnosis lies at the heart of general practice. Every day general practitioners (GPs visit patients with a wide variety of complaints and concerns, with often minor but sometimes serious symptoms. General practice has many features which differentiate it from specialty care setting, but during the last four decades little attention was paid to clinical reasoning in general practice. Therefore, we aimed to critically review the clinical reasoning models with a focus on the clinical reasoning in general practice or clinical reasoning of general practitioners to find out to what extent the existing models explain the clinical reasoning specially in primary care and also identity the gaps of the model for use in primary care settings Methods: A systematic search to find models of clinical reasoning were performed. To have more precision, we excluded the studies that focused on neurobiological aspects of reasoning, reasoning in disciplines other than medicine decision making or decision analysis on treatment or management plan. All the articles and documents were first scanned to see whether they include important relevant contents or any models. The selected studies which described a model of clinical reasoning in general practitioners or with a focus on general practice were then reviewed and appraisal or critics of other authors on these models were included. The reviewed documents on the model were synthesized Results: Six models of clinical reasoning were identified including hypothetic-deductive model, pattern recognition, a dual process diagnostic reasoning model, pathway for clinical reasoning, an integrative model of clinical reasoning, and model of diagnostic reasoning strategies in primary care. Only one model had specifically focused on general practitioners reasoning. Conclusion: A Model of clinical reasoning that included specific features of general practice to better help the general practitioners with the difficulties

Impact of a faculty development programme for teaching communication skills on participants' practice.

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Junod Perron, Noelle; Cullati, Stephane; Hudelson, Patricia; Nendaz, Mathieu; Dolmans, Diana; van der Vleuten, Cees

2014-05-01

A 6-month faculty development programme was designed to improve supervisors' feedback to junior doctors on their clinical communication skills (CS) and included both CS and teaching skills training. The aim of this study was to assess supervisors' views on the impact of the programme on their subsequent teaching and communication practice. 28 clinical supervisors at the Geneva University Hospitals, from either inpatient or outpatient settings (general internists or primary care specialists), undertook a six-session faculty development programme, between 2009 and 2011, and each completed a short questionnaire before and 1 month after the course. Between 3 and 6 months after the course, the participants were interviewed about their views on the impact of the course on their practice using a semistructured interview. Interviews were audiotaped and transcribed verbatim and analysed thematically. The percentage of participants who reported teaching CS at least once a week had increased from 5/26 (19%) to 8/26 (30%), p=0.07. Participants reported using teaching skills, especially giving structured feedback. Use of newly acquired teaching skills was more likely when participants had protected time for teaching or were involved in formal teaching activities. Even participants who reported minimal teaching activity found the newly acquired CS to be useful, both with their own patients and in other professional situations. The few participants who explicitly reported teaching regularly CS in practice had generally become formal teachers in CS training. A faculty development programme on how to teach CS is perceived to be useful by clinical supervisors to acquire new skills, but using them in the workplace appears to depend on creation of a supportive environment with protected time for teaching. Involving supervisors in formal communication teaching may be one way to ensure continued use of newly learned teaching skills.

Improving Students' Inquiry Skills and Self-Efficacy through Research-Inspired Modules in the General Chemistry Laboratory

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Winkelmann, Kurt; Baloga, Monica; Marcinkowski, Tom; Giannoulis, Christos; Anquandah, George; Cohen, Peter

2015-01-01

Research projects conducted by faculty in STEM departments served as the inspiration for a new curriculum of inquiry-based, multiweek laboratory modules in the general chemistry 1 course. The purpose of this curriculum redesign was to improve students' attitudes about chemistry as well as their self-efficacy and skills in performing inquiry…

Self-study program on HTML browser--application to Clinical Nursing General Remarks Course.

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Ochiai, N; Sota, Y; Ezumi, H

1997-01-01

We created a self-study program using HTML browser on the Clinical Nursing General Remarks Course, Eighty-three students each selected a published book on a personal history (written personal reflections from individuals who had undergone medical treatment and hospitalization), read it and submitted reports of their impressions of the histories. Their reports were arranged from a nursing perspective and entered on the home page of our college using HTML browser. We intended that the students would become more interested in reading of the personal histories, and that they would acquire new self-study skills and increase their interest in Internet through use of our program. In addition, we hoped that this program would encourage positive communication and mutual sharing of information. The students were able to easily refer to a personal history according to their interest from a nursing perspective. Therefore this program realized the mutual learning among students and other users.

Promoting skill building and confidence in freshman nursing students with a "Skills-a-Thon".

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Roberts, Susan T; Vignato, Julie A; Moore, Joan L; Madden, Carol A

2009-08-01

Freshman nursing students returning for their second semester after summer break benefited by reviewing previously learned clinical skills presented in a Skills-a-Thon. Skills stations were established and facilitated by faculty and senior students. Senior students were first trained in mentoring and specific steps in skills competencies. Freshman students demonstrated skills in various mock clinical situations including catheter insertion, sterile dressings, medications, and physical assessment. The strategy reinforced learning and provided an opportunity for students to experience risk-free skills performance among peers. Freshman students gained proficiency and appreciated guidance by senior students without the pressures of testing. Seniors benefited from a condensed version of the program to review their own skills prior to the event. Responses were positive, with students reporting improved performance and confidence with hands-on application in a non-threatening environment. Nursing faculty observed improvement in skill performance and competence, and plan to offer future events. Copyright 2009, SLACK Incorporated.

Workplace-based communication skills training in clinical departments: Examining the role of collegial relations through positioning theory.

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Møller, Jane Ege; Malling, Bente Vigh

2018-04-27

Studies suggest that the workplace is a key to understanding how clinical communication skills learning takes place and that medical communication skills need to be reinforced over time in order not to deteriorate. This study explored the perceptions of doctors in four hospital departments who participated in a workplace-based communication training project. Its specific focus was the relationship between collegial relations and learning communication skills. The study applied a qualitative design using an ethnographic methodology, i.e. interviews and observations. Positioning theory was used as the theoretical framework. Training communication skills with colleagues in the actual workplace setting was valued by the participants who experienced more sharing of communication challenges, previously understood as something private one would not share with colleagues. However, collegial relations were also barriers for providing critical feedback, especially from junior doctors to their seniors. The position as "colleague" both reinforced the communication skills training and hindered it. The communication skills educational model had a flat, non-hierarchical structure which disturbed the hierarchical structure of the workplace, and its related positions.

Games as a measure of reading and writing generalization after computerized teaching of reading skills

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Ana Carolina Sella

2016-01-01

Full Text Available Abstract Behavior Analysis is usually accused of not being able to account for the generalization of verbal behavior that is present in linguistically competent individuals. However, several behavior analytic studies investigate this theme, and gamification has been seen as a useful way to study generalization. The purpose of this study was to evaluate reading and writing generalization in games, after these behaviors were taught through the program Learning to Read in Small Steps. Participants were four children between 7 and 12 years old who had reading and writing deficits. The experimental design was a pre-posttest design that encompassed five phases. Performance in probes suggests generalization of reading and writing skills to new activities (games and responses. This study represents a small step in a systematic understanding of how games can be used to assess behavior change.

Increased skills usage statistically mediates symptom reduction in self-guided internet-delivered cognitive-behavioural therapy for depression and anxiety: a randomised controlled trial.

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Terides, Matthew D; Dear, Blake F; Fogliati, Vincent J; Gandy, Milena; Karin, Eyal; Jones, Michael P; Titov, Nickolai

2018-01-01

Cognitive-behavioural therapy (CBT) is an effective treatment for clinical and subclinical symptoms of depression and general anxiety, and increases life satisfaction. Patients' usage of CBT skills is a core aspect of treatment but there is insufficient empirical evidence suggesting that skills usage behaviours are a mechanism of clinical change. This study investigated if an internet-delivered CBT (iCBT) intervention increased the frequency of CBT skills usage behaviours and if this statistically mediated reductions in symptoms and increased life satisfaction. A two-group randomised controlled trial was conducted comparing internet-delivered CBT (n = 65) with a waitlist control group (n = 75). Participants were individuals experiencing clinically significant symptoms of depression or general anxiety. Mixed-linear models analyses revealed that the treatment group reported a significantly higher frequency of skills usage, lower symptoms, and higher life satisfaction by the end of treatment compared with the control group. Results from bootstrapping mediation analyses revealed that the increased skills usage behaviours statistically mediated symptom reductions and increased life satisfaction. Although skills usage and symptom outcomes were assessed concurrently, these findings support the notion that iCBT increases the frequency of skills usage behaviours and suggest that this may be an important mechanism of change.

The impact of residency programs on new nurse graduates' clinical decision-making and leadership skills: a systematic review.

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AL-Dossary, Reem; Kitsantas, Panagiota; Maddox, P J

2014-06-01

Health care institutions have adapted residency programs to help new graduate nurses to become fully competent and transition from a student nurse to an independent practicing nurse and a bedside leader. The study's aim is to review the literature on the impact of residency programs on new graduate nurses' clinical decision-making and leadership skills. An electronic search was conducted between 1980 and 2013 using databases of the scientific literature in Medline, PubMed, Cochrane EPOC, Cumulative Index to Nursing & Allied Health Literature database guide (CINAHL), and PsychInfo using a range of keywords. Information gathered was evaluated for relevance. Thirteen studies that met the inclusion criteria were used in this systematic review. In several studies considered in this review, residency programs were developed to improve new graduates skills and promote their transition into the nursing workforce. In fact, the transition programs reduced turnover in that first year of practice and promoted professional growth of the new graduate such as hand-on nursing skills, clinical decision-making and leadership skills, satisfaction, and retention. There is a need for effective residency programs that are designed to prepare new graduate nurses in providing safe, competent and effective patient care. © 2013.

Non-technical skills evaluation in the critical care air ambulance environment: introduction of an adapted rating instrument--an observational study.

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Myers, Julia A; Powell, David M C; Psirides, Alex; Hathaway, Karyn; Aldington, Sarah; Haney, Michael F

2016-03-08

In the isolated and dynamic health-care setting of critical care air ambulance transport, the quality of clinical care is strongly influenced by non-technical skills such as anticipating, recognising and understanding, decision making, and teamwork. However there are no published reports identifying or applying a non-technical skills framework specific to an intensive care air ambulance setting. The objective of this study was to adapt and evaluate a non-technical skills rating framework for the air ambulance clinical environment. In the first phase of the project the anaesthetists' non-technical skills (ANTS) framework was adapted to the air ambulance setting, using data collected directly from clinician groups, published literature, and field observation. In the second phase experienced and inexperienced inter-hospital transport clinicians completed a simulated critical care air transport scenario, and their non-technical skills performance was independently rated by two blinded assessors. Observed and self-rated general clinical performance ratings were also collected. Rank-based statistical tests were used to examine differences in the performance of experienced and inexperienced clinicians, and relationships between different assessment approaches and assessors. The framework developed during phase one was referred to as an aeromedical non-technical skills framework, or AeroNOTS. During phase two 16 physicians from speciality training programmes in intensive care, emergency medicine and anaesthesia took part in the clinical simulation study. Clinicians with inter-hospital transport experience performed more highly than those without experience, according to both AeroNOTS non-technical skills ratings (p = 0.001) and general performance ratings (p = 0.003). Self-ratings did not distinguish experienced from inexperienced transport clinicians (p = 0.32) and were not strongly associated with either observed general performance (r(s) = 0.4, p = 0

Social phobia, anxiety, oppositional behavior, social skills, and self-concept in children with specific selective mutism, generalized selective mutism, and community controls.

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Cunningham, Charles E; McHolm, Angela E; Boyle, Michael H

2006-08-01

We compared social phobia, anxiety, oppositional behavior, social skills, and self-concept in three groups: (1) 28 children with specific mutism (who did not speak to teachers but were more likely to speak to parents and peers at home and school); (2) 30 children with generalized mutism (whose speaking was restricted primarily to their homes); and (3) 52 community controls. Children with generalized mutism evidenced higher anxiety at school, and more separation anxiety, OCD, and depressive symptoms at home. Parents and teachers reported that the social phobia and anxiety scores of children in both the specific and generalized mutism subgroups were higher than controls. Children in both the specific and generalized mutism groups evidenced greater deficits in verbal and nonverbal social skills at home and school than controls. Teachers and parents did not report differences in nonverbal measures of social cooperation and conflict resolution and we found no evidence that selective mutism was linked to an increase in externalizing problems such as oppositional behavior or ADHD. Although children with specific mutism speak in a wider range of situations and appear less anxious to their teachers than children with generalized mutism, significant socially phobic behavior and social skills deficits are present in both groups.

Early Career Mathematics Teachers' General Pedagogical Knowledge and Skills: Do Teacher Education, Teaching Experience, and Working Conditions Make a Difference?

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König, Johannes; Blömeke, Sigrid; Kaiser, Gabriele

2015-01-01

We examined several facets of general pedagogical knowledge and skills of early career mathematics teachers, asking how they are associated with characteristics of teacher education, teaching experience, and working conditions. Declarative general pedagogical knowledge (GPK) was assessed via a paper-and-pencil test, while early career teachers'…

Evaluation of the Effectiveness of Postgraduate General Medicine Training by Objective Structured Clinical Examination—Pilot Study and Reflection on the Experiences of Kaohsiung Medical University Hospital

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Jer-Chia Tsai

2008-12-01

Full Text Available Objective structured clinical examination (OSCE is an effective assessment method to evaluate medical students' clinical competencies performance. Postgraduate year 1 (PGY1 residents have been initiated in a general medicine training program in Taiwan since 2003. However, little is known about the learning effectiveness of trainees from this program. This pilot study aimed to evaluate the clinical core competencies of PGY1 residents using OSCE, and to reflect on the strengths and weaknesses of this pilot assessment project. OSCE was conducted for five PGY1 examinees (4 men, 1 woman with five stations covering core themes, including history taking, physical examination, clinical procedure of airway intubation, clinical reasoning, and communication skills for informing bad news. Itemized checklists and five-point Likert scale global ratings were used for evaluating performance. The results showed that the performance of our PGY1 residents on history taking was significantly better after about 2 months of postgraduate training on general internal medicine. Self-evaluation on performance by examinees revealed significantly lower global ratings on post-course OSCE (4.14 ± 0.80 vs. 3.68 ± 0.66; p < 0.02. Surveys from tutors and standardized patients (SPs completed at pre- and post-course OSCEs showed consistently favorable responses on the purposes, content, process, and environment of this assessment (4.0 ± 0.17 vs. 4.0 ± 0.12, nonsignificant. However, a survey of the examinees completed at preand post-course OSCEs showed relatively unfavorable responses to the same aspects, and to tutors and SPs (4.1 ± 0.09 vs. 3.7 ± 0.18; p < 0.05. Qualitative information revealed that tutors and SPs remarked that PGY1 residents' medical knowledge performance was satisfactory but their clinical reasoning performance, communication skills (giving bad news and self-confidence were unsatisfactory. In conclusion, this pilot study has demonstrated that OSCE is a

The Crucible simulation: Behavioral simulation improves clinical leadership skills and understanding of complex health policy change.

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Cohen, Daniel; Vlaev, Ivo; McMahon, Laurie; Harvey, Sarah; Mitchell, Andy; Borovoi, Leah; Darzi, Ara

2017-05-11

The Health and Social Care Act 2012 represents the most complex National Health Service reforms in history. High-quality clinical leadership is important for successful implementation of health service reform. However, little is known about the effectiveness of current leadership training. This study describes the use of a behavioral simulation to improve the knowledge and leadership of a cohort of medical doctors expected to take leadership roles in the National Health Service. A day-long behavioral simulation (The Crucible) was developed and run based on a fictitious but realistic health economy. Participants completed pre- and postsimulation questionnaires generating qualitative and quantitative data. Leadership skills, knowledge, and behavior change processes described by the "theory of planned behavior" were self-assessed pre- and postsimulation. Sixty-nine medical doctors attended. Participants deemed the simulation immersive and relevant. Significant improvements were shown in perceived knowledge, capability, attitudes, subjective norms, intentions, and leadership competency following the program. Nearly one third of participants reported that they had implemented knowledge and skills from the simulation into practice within 4 weeks. This study systematically demonstrates the effectiveness of behavioral simulation for clinical management training and understanding of health policy reform. Potential future uses and strategies for analysis are discussed. High-quality care requires understanding of health systems and strong leadership. Policymakers should consider the use of behavioral simulation to improve understanding of health service reform and development of leadership skills in clinicians, who readily adopt skills from simulation into everyday practice.

National Clinical Skills Competition: an effective simulation-based method to improve undergraduate medical education in China

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Guanchao Jiang

2016-02-01

Full Text Available Background: The National Clinical Skills Competition has been held in China for 5 consecutive years since 2010 to promote undergraduate education reform and improve the teaching quality. The effects of the simulation-based competition will be analyzed in this study. Methods: Participation in the competitions and the compilation of the questions used in the competition finals are summarized, and the influence and guidance quality are further analyzed. Through the nationwide distribution of questionnaires in medical colleges, the effects of the simulation-based competition on promoting undergraduate medical education reform were evaluated. Results: The results show that approximately 450 students from more than 110 colleges (accounting for 81% of colleges providing undergraduate clinical medical education in China participated in the competition each year. The knowledge, skills, and attitudes were comprehensively evaluated by simulation-based assessment. Eight hundred and eighty copies of the questionnaires were distributed to 110 participating medical schools in 2015. In total, 752 valid responses were received across 95 schools. The majority of the interviewees agreed or strongly agreed that competition promoted the adoption of advanced educational principles (76.8%, updated the curriculum model and instructional methods (79.8%, strengthened faculty development (84.0%, improved educational resources (82.1%, and benefited all students (53.4%. Conclusions: The National Clinical Skills Competition is widely accepted in China. It has effectively promoted the reform and development of undergraduate medical education in China.

Innovative approach using interprofessional simulation to educate surgical residents in technical and nontechnical skills in high-risk clinical scenarios.

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Nicksa, Grace A; Anderson, Cristan; Fidler, Richard; Stewart, Lygia

2015-03-01

The Accreditation Council for Graduate Medical Education core competencies stress nontechnical skills that can be difficult to evaluate and teach to surgical residents. During emergencies, surgeons work in interprofessional teams and are required to perform certain procedures. To obtain proficiency in these skills, residents must be trained. To educate surgical residents in leadership, teamwork, effective communication, and infrequently performed emergency surgical procedures with the use of interprofessional simulations. SimMan 3GS was used to simulate high-risk clinical scenarios (15-20 minutes), followed by debriefings with real-time feedback (30 minutes). A modified Oxford Non-Technical Skills scale (score range, 1-4) was used to assess surgical resident performance during the first half of the academic year (July-December 2012) and the second half of the academic year (January-June 2013). Anonymous online surveys were used to solicit participant feedback. Simulations were conducted in the operating room, intensive care unit, emergency department, ward, and simulation center. A total of 43 surgical residents (postgraduate years [PGYs] 1 and 2) participated in interdisciplinary clinical scenarios, with other health care professionals (nursing, anesthesia, critical care, medicine, respiratory therapy, and pharmacy; mean number of nonsurgical participants/session: 4, range 0-9). Thirty seven surgical residents responded to the survey. Simulation of high-risk clinical scenarios: postoperative pulmonary embolus, pneumothorax, myocardial infarction, gastrointestinal bleeding, anaphylaxis with a difficult airway, and pulseless electrical activity arrest. Evaluation of resident skills: communication, leadership, teamwork, problem solving, situation awareness, and confidence in performing emergency procedures (eg, cricothyroidotomy). A total of 31 of 35 (89%) of the residents responding found the sessions useful. Additionally, 28 of 33 (85%) reported improved confidence

Gateway to the Future. Skill Standards for the Bioscience Industry for Technical Workers in Pharmaceutical Companies, Biotechnology Companies, and Clinical Laboratories.

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Education Development Center, Inc., Newton, MA.

The Bioscience Industry Skills Standards Project (BISSP) is developing national, voluntary skill standards for technical jobs in biotechnology and pharmaceutical companies and clinical laboratories in hospitals, universities, government, and independent settings. Research with employees and educators has pinpointed three issues underscoring the…

Learning clinical skills in the simulation suite: the lived experiences of student nurses involved in peer teaching and peer assessment.

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Ramm, Dianne; Thomson, Anna; Jackson, Andrew

2015-06-01

The benefits of peer teaching and assessment are well documented within nurse education literature. However, research to date has predominantly focused on the advantages and disadvantages for the inexperienced learner, with a dearth of knowledge relating to the perceptions of senior nursing students involved in teaching their peers. This study sought to investigate the student experience of taking part in a peer teaching and assessment initiative to include the perceptions of both first year nursing students and second/third year participants. Data were collected via open-ended questionnaires and analysed with qualitative 'Framework' analysis. This initiative received a generally positive response both from students being taught and also from those acting as facilitators. Perceived benefits included the social learning experience, development of teaching skills, self-awareness and the opportunity to communicate both good and bad news. Suggestions for improvement included additional time working in small groups, specific supplementary learning materials and the introduction of peer teaching and assessment into other areas of the Adult Nursing Programme. Peer teaching and assessment principles represent valuable strategies which can be utilised in nurse education to develop clinical skills and prepare nurses for real-life scenarios. Further research needs to investigate how to enhance the student learning experience and to fully exploit the potential for simulated experience to prepare students for their future role as registered nurses in clinical practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

Objective Structured Clinical Examinations (OSCEs, psychiatry and the Clinical assessment of Skills and Competencies (CASCSame Evidence, Different Judgement

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Marwaha Steven

2011-05-01

Full Text Available Abstract Background The Objective Structured Clinical Examination (OSCE, originally developed in the 1970's, has been hailed as the "gold standard" of clinical assessments for medical students and is used within medical schools throughout the world. The Clinical assessment of Skills and Competencies (CASC is an OSCE used as a clinical examination gateway, granting access to becoming a senior Psychiatrist in the UK. Discussion Van der Vleuten's utility model is used to examine the CASC from the viewpoint of a senior psychiatrist. Reliability may be equivalent to more traditional examinations. Whilst the CASC is likely to have content validity, other forms of validity are untested and authenticity is poor. Educational impact has the potential to change facets of psychiatric professionalism and influence future patient care. There are doubts about acceptability from candidates and more senior psychiatrists. Summary Whilst OSCEs may be the best choice for medical student examinations, their use in post graduate psychiatric examination in the UK is subject to challenge on the grounds of validity, authenticity and educational impact.

Designing evidence-based medicine training to optimize the transfer of skills from the classroom to clinical practice: applying the four component instructional design model.

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Maggio, Lauren A; Cate, Olle Ten; Irby, David M; O'Brien, Bridget C

2015-11-01

Evidence-based medicine (EBM) skills, although taught in medical schools around the world, are not optimally practiced in clinical environments because of multiple barriers, including learners' difficulty transferring EBM skills learned in the classroom to clinical practice. This lack of skill transfer may be partially due to the design of EBM training. To facilitate the transfer of EBM skills from the classroom to clinical practice, the authors explore one instructional approach, called the Four Component Instructional Design (4C/ID) model, to guide the design of EBM training. On the basis of current cognitive psychology, including cognitive load theory, the premise of the 4C/ID model is that complex skills training, such as EBM training, should include four components: learning tasks, supportive information, procedural information, and part-task practice. The combination of these four components can inform the creation of complex skills training that is designed to avoid overloading learners' cognitive abilities; to facilitate the integration of the knowledge, skills, and attitudes needed to execute a complex task; and to increase the transfer of knowledge to new situations. The authors begin by introducing the 4C/ID model and describing the benefits of its four components to guide the design of EBM training. They include illustrative examples of educational practices that are consistent with each component and that can be applied to teaching EBM. They conclude by suggesting that medical educators consider adopting the 4C/ID model to design, modify, and/or implement EBM training in classroom and clinical settings.

Life Skills Training Effectiveness on Non- Metastatic Breast Cancer Mental Health: A Clinical Trial

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Mina Shabani

2012-10-01

Full Text Available Background: Patients with breast cancer are predisposed to some psychiatric symptoms and mental disorders as a result of their diagnosis or lifestyle. These problems cause patients to have daily stress, feelings of guilt, anxiety, a dysphoric mood, and impaired social relations. Such problems will lead to serious mental disorders.Therefore, life skills training may enable patients to cope better with these problems and improve their mental health.Methods: In an experimental study 50 breast cancer patients were randomly selected and assigned to two groups, experimental and control. The experimental group attended life skills training classes continuously for ten weeks. The duration of each class was two hours. Participants in both groups completed a General Health Questionnaire-28 form before the commencement of classes, after two weeks of training, and again at two months after course completion. The statistical method used in this study was the t-test.Results: In the life skills training group, patients' depressive and anxiety symptoms, somatization disorders, sleep disorders, and disorders of social functioning significantly decreased (P<0.0001. There was no change in the control group.Conclusion: The results show that life skills training can be considered a supportive method for symptoms of depression, anxiety, sleep, and somatic disorders in patients with breast cancer.

An exploratory trial exploring the use of a multiple intelligences teaching approach (MITA) for teaching clinical skills to first year undergraduate nursing students.

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Sheahan, Linda; While, Alison; Bloomfield, Jacqueline

2015-12-01

The teaching and learning of clinical skills is a key component of nurse education programmes. The clinical competency of pre-registration nursing students has raised questions about the proficiency of teaching strategies for clinical skill acquisition within pre-registration education. This study aimed to test the effectiveness of teaching clinical skills using a multiple intelligences teaching approach (MITA) compared with the conventional teaching approach. A randomised controlled trial was conducted. Participants were randomly allocated to an experimental group (MITA intervention) (n=46) and a control group (conventional teaching) (n=44) to learn clinical skills. Setting was in one Irish third-level educational institution. Participants were all first year nursing students (n=90) in one institution. The experimental group was taught using MITA delivered by the researcher while the control group was taught by a team of six experienced lecturers. Participant preference for learning was measured by the Index of Learning Styles (ILS). Participants' multiple intelligence (MI) preferences were measured with a multiple intelligences development assessment scale (MIDAS). All participants were assessed using the same objective structured clinical examination (OSCE) at the end of semester one and semester two. MI assessment preferences were measured by a multiple intelligences assessment preferences questionnaire. The MITA intervention was evaluated using a questionnaire. The strongest preference on ILS for both groups was the sensing style. The highest MI was interpersonal intelligence. Participants in the experimental group had higher scores in all three OSCEs (pmultiple choice questions as methods of assessment. MITA was evaluated positively. The study findings support the use of MITA for clinical skills teaching and advance the understanding of how MI teaching approaches may be used in nursing education. Copyright © 2015 Elsevier Ltd. All rights reserved.

A comparison of medical students', residents' and tutors' attitudes towards communication skills learning.

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Molinuevo, Beatriz; Aradilla-Herrero, Amor; Nolla, Maria; Clèries, Xavier

2016-01-01

The consensus about the importance of communication skills in patient-care does not guarantee that students and faculty perceive the usefulness of these skills. This study evaluated and compared medical students', residents' and tutors' attitudes towards learning communication skills, and examined the association with gender and year of residency. We conducted a cross-sectional survey with 492 participants (282 second-year students, 131 residents and 79 tutors). They completed the Communication Skills Attitude Scale (CSAS) and demographic/educational information. In general, participants showed positive attitudes towards learning communication skills. Medical students, residents and tutors did not differ on the Positive Attitudes Scale (CSAS-PAS). Residents scored higher than medical students on the Negative Attitudes Scale (CSAS-NAS) (P communication skills an essential component for clinical practice and they agree about the need to learn these communication skills. Attention should be paid to measuring attitudes at all three levels of medical education in the design of communication skills courses.

Factors Associated With Nursing Students' Resilience: Communication Skills Course, Use of Social Media and Satisfaction With Clinical Placement.

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Sigalit, Warshawski; Sivia, Barnoy; Michal, Itzhaki

The purpose of this study was to explore the (a) associations between students' personal and group resilience to their utilization of social networking platforms and formally taught communication skills, (b) students' personal and clinical characteristics that are related to personal and group resilience and the perceived helpfulness of communication course, and (c) factors that contribute to students' satisfaction with their clinical placement. Data were collected from 149 second year nursing students learning in a major university in the country of Israel with the use of a self-administered structured questionnaire. Students' satisfaction from their clinical placement was measured using 1 open-ended question, analyzed through qualitative methods. Results demonstrated positive correlations between students' use of social networking to their personal and group resilience (Pmedia use, religion, and clinical placement characteristics were related to resilience and to the perceived helpfulness of the communication course (P<.01). Students' satisfaction with their clinical placement was based primarily on the clinical instructors' personal and professional skills. In conclusion, social networking can and should be used as a learning tool to promote resilience among nursing students. Faculty and nurse managers should be aware of the central role of the clinical instructor and initiate collaborative and supporting initiatives. Copyright © 2016 Elsevier Inc. All rights reserved.

Identifying Culturally Competent Clinical Skills in Speech-Language Pathologists in the Central Valley of California

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Maul, Christine A.

2010-01-01

The purpose of this research was to identify specific clinical skills in speech-language pathologists (SLPs) that may constitute cultural competency, a term which currently lacks operational definition. Through qualitative interview methods, the following research questions were addressed: (1) What dominant themes, if any, can be found in SLPs'…

Development and implementation of an objective structured clinical examination to provide formative feedback on communication and interpersonal skills in geriatric training.

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O'Sullivan, Patricia; Chao, Serena; Russell, Matthew; Levine, Sharon; Fabiny, Anne

2008-09-01

Teaching and assessment of communication and interpersonal skills, one of the American Council for Graduate Medical Education-designated core competencies, is an important but difficult task in the training of physicians. Assessment of trainees offers an opportunity to provide explicit feedback on their skills and encourages learning. This article describes a pilot study in which clinician-educators affiliated with the geriatrics training programs at Beth Israel Deaconess Medical Center and Boston University Medical Center designed and piloted a novel Objective Structured Clinical Examination (OSCE) to assess the communication and interpersonal skills of medical, dental, and geriatric psychiatry fellows. The OSCE consisted of three stations where geriatricians and standardized patients evaluated candidates using specifically designed checklists and an abbreviated version of the Master Interview Rating Scale. Communication skills were assessed through performance of specific "real life" clinical tasks, such as obtaining a medical history, explaining a diagnosis and prognosis, giving therapeutic instructions, and counseling. Interpersonal skills were assessed through the effect of the communication between doctor and standardized patient on fostering trust, relieving anxiety, and establishing a therapeutic relationship. This pilot study demonstrated that the OSCE format of assessment provides a valid means of evaluating the communication and interpersonal skills of interdisciplinary geriatric trainees and provides a valuable forum for formative assessment and feedback. Given that geriatricians and non geriatricians involved in elder care both need communication and interpersonal skills, this novel OSCE can be used for assessment of these skills in trainees in diverse healthcare subspecialties.

Outcome measures and psychomotor skills related to shoulder conditions for clinical orthopedic training.

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Mahomed, Surreya; Al-Obaidi, Saud; Al-Zoabi, Baker

2008-01-01

This study was designed to assess the ability of physical therapy (PT) students to utilize selected outcome measures such as range of motion (ROM), pain and a number of psychomotor skills and to determine the efficacy of treatment they carried out during orthopedic clinical training. The clinical education booklets in orthopedics of all PT students over a 6-year period were reviewed. Students' application of psychomotor skills such as peripheral joint mobilizations (PJM), proprioceptive neuromuscular facilitation (PNF) techniques, therapeutic exercise techniques as well as utilization of basic outcome measures such as ROM and pain were analyzed with descriptive statistics and paired t test. A majority of students used PJM techniques (78.6%) and PNF techniques (58.6%). The paired t test indicated that treatment interventions used by the students were associated with improved shoulder joint ROM and decreased pain levels (p < 0.001). At the same time, therapeutic exercises were employed by the students after PJM and PNF. The most common 'comparable joint sign' was limitation in shoulder abduction ROM, which occurred in 44% of patients seen by the students. PT students' application of PJM, PNF, and therapeutic exercise improved ROM and decreased pain in patients with shoulder pathologies. (c) 2008 S. Karger AG, Basel.

New graduate nurse transition programs and clinical leadership skills in novice RNs.

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Chappell, Kathy B; Richards, Kathy C; Barnett, Scott D

2014-12-01

The objective of this study was to determine predictors of clinical leadership skill (CLS) for RNs with 24 months of clinical experience or less. New graduate nurse transition programs (NGNTPs) have been proposed as a strategy to increase CLS. CLS is associated with positive patient outcomes. Method used was hierarchical regression modeling to evaluate predictors of CLS among individual characteristics of RNs and characteristics of NGNTPs. Perceived overall quality of an NGNTP was the strongest predictor of CLS (R = 0.041, P < .01). Clinical experience and NGNTP characteristics accounted for 6.9% of the variance in CLS and 12.6% of the variance among RNs with assigned mentors (P < .01). RNs participating in NGNTPs for more than 24 weeks were 21 times more likely to remain employed within the organization when compared with NGNTPs of 12 weeks or less, a significant cost-benefit to the organization. Although perceived overall quality of a NGNTP was the strongest predictor of CLS, much of the variance in CLS remains unexplained.

Nursing in general practice: organizational possibilities for decision latitude, created skill, social support and identity derived from role.

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Merrick, Eamon; Duffield, Christine; Baldwin, Richard; Fry, Margaret

2012-03-01

This article is a report of a study to describe the factors that support organizational opportunities for practice nurse decision-making and skill development for nurses employed in general practice in New South Wales, Australia. Corresponding to the availability of subsidies from the Australian universal health insurer (Medicare), there has been an increase in the number of nurses employed in general practice. Currently, there is no Australian evidence as to the organizational possibilities for these practice nurses to make decisions, develop their own skills and abilities, derive identity from their role or how their role is influenced by social support. Over a 8-month period in 2008 practice, nurses employed in general practice in the State of New South Wales were invited to complete a 26-item self-administered online questionnaire utilizing constructs from Karaseks (1998) Job Content Questionnaire (valid n = 160). Confirmatory Factor Analysis indicated that all scales demonstrated acceptable levels of internal consistency. Sequential regression models revealed that social support exerts a weak influence on decision latitude (R(2) = 0·07); the addition of self-identity through work significantly improved the predictive ability of the model (R(2) = 0·16). Social support and self-identity through work exerted a negative influence on created skill (R(2) = 0·347), whereas social support was effective in predicting self-identity through work (R(2) = 0·148).   Collegial and supervisory support in the work environment predicts organizational possibilities for practice nurse decision-making. © 2011 Blackwell Publishing Ltd.

Evaluating Success of Pediatric Dentistry Department at Mashhad Dental School (Iran in Clinical Skills Education from Students’ Perspectives

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Hosein Nematollahi

Full Text Available Introduction: Periodic evaluation of educational programs provides insight into the course and teaching effectiveness. Effective evaluation provides valuable information, which contributes to both student’s and course success. The purpose of this study was to evaluate the success of pediatric dentistry department at Mashhad dental school in clinical education from students’ perspectives.Materials & Methods: This cross-sectional study was conducted on 116 fifth and sixth grade undergraduate dental students in pediatric dentistry at Mashhad dental school. A questionnaire including 21 multiple choice questions about 7 parts of clinical skills in pediatric dentistry was given to each student. Data were analyzed by Mann-Whitney in SPSS software. Results: According to the study results, among 7 different clinical skills in pediatric dentistry including: examination, behavior management, prevention, injection, restoration, pulp treatment and space management, the highest success rate of pediatric dentistry department was in prevention and injection and the lowest success rate in space management and behavior control. Furthermore, from the students’ perspective, male students compared to female students mentioned a higher rate of success in choosing the type of restoration material for pediatric dentistry department (P=0. 041. Conclusion: This study showed that the students’ self-reported clinical skills in different parts of pediatric dentistry has been adequate. Students reported a lack of confidence in “behavior management” and “space management” which warrants greater emphasis in the undergraduate curriculum.

Residents' perceived barriers to communication skills learning: comparing two medical working contexts in postgraduate training.

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van den Eertwegh, Valerie; van Dalen, Jan; van Dulmen, Sandra; van der Vleuten, Cees; Scherpbier, Albert

2014-04-01

Contextual factors are known to influence the acquisition and application of communication skills in clinical settings. Little is known about residents' perceptions of these factors. This article aims to explore residents' perceptions of contextual factors affecting the acquisition and application of communication skills in the medical workplace. We conducted an exploratory study comprising seven focus groups with residents in two different specialities: general practice (n=23) and surgery (n=18). Residents perceive the use of summative assessment checklists that reduce communication skills to behavioural components as impeding the learning of their communication skills. Residents perceive encouragement to deliberately practise in an environment in which the value of communication skills is recognised and support is institutionalised with appropriate feedback from role models as the most important enhancing factors in communication skills learning. To gradually realise a clinical working environment in which the above results are incorporated, we propose to use transformative learning theory to guide further studies. Provided it is used continuously, an approach that combines self-directed learning with observation and discussion of resident-patient consultations seems an effective method for transformative learning of communication skills. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The impact of a structured clinical training course on interns' self-reported confidence with core clinical urology skills.

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Browne, C; Norton, S; Nolan, J M; Whelan, C; Sullivan, J F; Quinlan, M; Sheikh, M; Mc Dermott, T E D; Lynch, T H; Manecksha, R P

2018-02-01

Undergraduate training in core urology skills is lacking in many Irish training programmes. Our aim was to assess newly qualified doctors' experience and confidence with core urological competencies. A questionnaire survey covering exposure to urology and confidence with core clinical skills was circulated to all candidates. The group then attended a skills course covering male/female catheterisation, insertion of three-way catheters, bladder irrigation and management of long-term suprapubic catheters. The groups were re-surveyed following the course. Forty-five interns completed the pre-course questionnaire (group 1) and 27 interns completed the post-course questionnaire (group 2). 24/45 (53%) had no experience of catheter insertion on a patient during their undergraduate training. 26/45 (58%) were unsupervised during their first catheter insertion. 12/45 (27%) had inserted a female catheter. 18/45 (40%) had inserted a three-way catheter. 12/45 (27%) had changed a suprapubic catheter. 40/45 (89%) in group 1 reported 'good' or 'excellent' confidence with male urinary catheterisation, compared to 25/27 (92.5%) in group 2. 18/45 (40%) in group 1 reported 'none' or 'poor' confidence with female catheterisation, compared to 7/27 (26%) in group 2. 22/45 (49%) in group 1 reported 'none' or 'poor' confidence with insertion of three-way catheters, compared to 2/27 (7%) in group 2. 32/45 (71%) in group 1 reported 'none' or 'poor' confidence in changing long-term suprapubic catheters, falling to 3/27 (11%) in group 2. This study raises concerns about newly qualified doctors' practical experience in urology. We suggest that this course improves knowledge and confidence with practical urology skills and should be incorporated into intern induction.

Working memory and language: skill-specific or domain-general relations to mathematics?

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Purpura, David J; Ganley, Colleen M

2014-06-01

Children's early mathematics skills develop in a cumulative fashion; foundational skills form a basis for the acquisition of later skills. However, non-mathematical factors such as working memory and language skills have also been linked to mathematical development at a broad level. Unfortunately, little research has been conducted to evaluate the specific relations of these two non-mathematical factors to individual aspects of early mathematics. Thus, the focus of this study was to determine whether working memory and language were related to only individual aspects of early mathematics or related to many components of early mathematics skills. A total of 199 4- to 6-year-old preschool and kindergarten children were assessed on a battery of early mathematics tasks as well as measures of working memory and language. Results indicated that working memory has a specific relation to only a few-but critically important-early mathematics skills and language has a broad relation to nearly all early mathematics skills. Copyright © 2014 Elsevier Inc. All rights reserved.

Role of SimMan in teaching clinical skills to preclinical medical students

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Swamy Meenakshi

2013-02-01

Full Text Available Abstract Background Simulation training has potential in developing clinical skills in pre-clinical medical students, but there is little evidence on its effectiveness. Methods Twenty four first year graduate entry preclinical medical students participated in this crossover study. They were divided into two groups, one performed chest examination on each other and the other used SimMan. The groups then crossed over. A pretest, midtest and post-test was conducted in which the students answered the same questionnaire with ten questions on knowledge, and confidence levels rated using a 5 point Likert scale. They were assessed formatively using the OSCE marking scheme. At the end of the session, 23 students completed a feedback questionnaire. Data was analyzed using one-way ANOVA and independent t-test. Results When the two groups were compared, there was no significant difference in the pretest and the post-test scores on knowledge questions whereas the midtest scores increased significantly (P Mean confidence ratings increased from the pretest to midtest and then further in the post-test for both groups. Their confidence ratings increased significantly in differentiating between normal and abnormal signs [Group starting with SimMan, between pretest and midtest (P= 0.01 and group starting with peer examination, between midtest and post-test (P=0.02]. When the students’ ability to perform examination on each other for both groups was compared, there was a significant increase in the scores of the group starting with SimMan (P=0.007. Conclusions This pilot study demonstrated a significant improvement in the students’ knowledge and competence to perform chest examination after simulation with an increase in the student’s perceived levels of confidence. Feedback from the students was extremely positive. SimMan acts as a useful adjunct to teach clinical skills to preclinical medical students by providing a simulated safe environment and thus aids

Psychomotor Skills for the General Professional Education of the Physician.

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Irby, David M.; And Others

1991-01-01

A University of Washington medical faculty survey identified 43 psychomotor skills deemed essential for physicians by over 60 percent of respondents. A committee of clerkship directors refined the list to 28 skills that should be required for graduation. The data are used to specify educational objectives and design tests. (Author/MSE)

Integration of Health Coaching Concepts and Skills into Clinical Practice Among VHA Providers: A Qualitative Study.

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Collins, David A; Thompson, Kirsten; Atwood, Katharine A; Abadi, Melissa H; Rychener, David L; Simmons, Leigh Ann

2018-01-01

Although studies of health coaching for behavior change in chronic disease prevention and management are increasing, to date no studies have reported on what concepts and skills providers integrate into their clinical practice following participation in health coaching courses. The purpose of this qualitative study was to assess Veterans Health Administration (VHA) providers' perceptions of the individual-level and system-level changes they observed after participating with colleagues in a 6-day Whole Health Coaching course held in 8 VHA medical centers nationwide. Data for this study were from the follow-up survey conducted with participants 2 to 3 months after completing the training. A total of 142 responses about individual-level changes and 99 responses about system-level changes were analyzed using content analysis. Eight primary themes emerged regarding individual changes, including increased emphasis on Veterans' values, increased use of listening and other specific health coaching skills in their clinical role, and adding health coaching to their clinical practice.Four primary themes emerged regarding system-level changes, including leadership support, increased staff awareness/support/learning and sharing, increased use of health coaching skills or tools within the facility, and organizational changes demonstrating a more engaged workforce, such as new work groups being formed or existing groups becoming more active. Findings suggest that VHA providers who participate in health coaching trainings do perceive positive changes within themselves and their organizations. Health coaching courses that emphasize patient-centered care and promote patient-provider partnerships likely have positive effects beyond the individual participants that can be used to promote desired organizational change.

Self- and rater-assessed effectiveness of “thinking-aloud” and “regular” morning report to intensify young physicians' clinical skills

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Hui-Chi Hsu

2015-09-01

Conclusion: TA MR effectively trains junior attendees in basic clinical skills, whereas regular MR enhances senior attendees' “work reports, professionalism, organizational efficiency, skills in dealing with controversial and professional issues.” Undoubtedly, all elements of the two MR models should be integrated together to ensure patient safety and good discipline among young physicians.

Impact of a Multifaceted and Clinically Integrated Training Program in Evidence-Based Practice on Knowledge, Skills, Beliefs and Behaviour among Clinical Instructors in Physiotherapy: A Non-Randomized Controlled Study.

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Olsen, Nina Rydland; Bradley, Peter; Espehaug, Birgitte; Nortvedt, Monica Wammen; Lygren, Hildegunn; Frisk, Bente; Bjordal, Jan Magnus

2015-01-01

Physiotherapists practicing at clinical placement sites assigned the role as clinical instructors (CIs), are responsible for supervising physiotherapy students. For CIs to role model evidence-based practice (EBP) they need EBP competence. The aim of this study was to assess the short and long term impact of a six-month multifaceted and clinically integrated training program in EBP on the knowledge, skills, beliefs and behaviour of CIs supervising physiotherapy students. We invited 37 CIs to participate in this non-randomized controlled study. Three self-administered questionnaires were used pre- and post-intervention, and at six-month follow-up: 1) The Adapted Fresno test (AFT), 2) the EBP Belief Scale and 3) the EBP Implementation Scale. The analysis approach was linear regression modeling using Generalized Estimating Equations. In total, 29 CIs agreed to participate in the study: 14 were invited to participate in the intervention group and 15 were invited to participate in the control group. One in the intervention group and five in the control group were lost to follow-up. At follow-up, the group difference was statistically significant for the AFT (mean difference = 37, 95% CI (15.9 -58.1), p students.

Communication skills training in orthopaedics.

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Lundine, Kristopher; Buckley, Richard; Hutchison, Carol; Lockyer, Jocelyn

2008-06-01

Communication skills play a key role in many aspects of both medical education and clinical patient care. The objectives of this study were to identify the key components of communication skills from the perspectives of both orthopaedic residents and their program directors and to understand how these skills are currently taught. This study utilized a mixed methods design. Quantitative data were collected with use of a thirty-item questionnaire distributed to all Canadian orthopaedic residents. Qualitative data were collected through focus groups with orthopaedic residents and semistructured interviews with orthopaedic program directors. One hundred and nineteen (37%) of 325 questionnaires were completed, twelve residents participated in two focus groups, and nine of sixteen program directors from across the country were interviewed. Both program directors and residents identified communication skills as being the accurate and appropriate use of language (i.e., content skills), not how the communication was presented (i.e., process skills). Perceived barriers to effective communication included time constraints and the need to adapt to the many personalities and types of people encountered daily in the hospital. Residents rarely have explicit training in communication skills. They rely on communication training implicitly taught through observation of their preceptors and clinical experience interacting with patients, peers, and other health-care professionals. Orthopaedic residents and program directors focus on content and flexibility within communication skills as well as on the importance of being concise. They value the development of communication skills in the clinical environment through experiential learning and role modeling. Education should focus on developing residents' process skills in communication. Care should be taken to avoid large-group didactic teaching sessions, which are perceived as ineffective.

Feasibility of automatic evaluation of clinical rules in general practice.

NARCIS (Netherlands)

Opondo, D.; Visscher, S.; Eslami, S.; Medlock, S.; Verheij, R.; Korevaar, J.C.; Abu-Hanna, A.

2017-01-01

Purpose: To assess the extent to which clinical rules (CRs) can be implemented for automatic evaluationof quality of care in general practice.Methods: We assessed 81 clinical rules (CRs) adapted from a subset of Assessing Care of Vulnerable Elders(ACOVE) clinical rules, against Dutch College of

The impact of expert- and peer feedback on communication skills of undergraduate dental students - a single-blinded, randomized, controlled clinical trial.

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Krause, Felix; Schmalz, Gerhard; Haak, Rainer; Rockenbauch, Katrin

2017-12-01

To evaluate the effect of peer- and expert feedback on communication skills of undergraduate dental students. All students of the first clinical treatment course (n=46) were randomly assigned into two groups. For three times a medical-dental interview/consultation of each student with a real patient was videotaped. After every consultation the videos were assessed either by a person experienced in communication (expert group) or by a fellow student (peer group), giving the students feedback regarding their chairside performed communication skills. Before and after the feedback-interventions all students conducted an interview with simulated patients, which was rated using a validated global rating and analyzed statistically. Global ratings mean scores after feedback-intervention were significantly improved (p0.05). During this study students improved their communication skills in dentist-patient interactions. The communication experience of the feedback provider seems not to have any impact on the communication skills in undergraduate dental students. The clinical courses in dentistry offer the opportunity to implement peer-feedback interventions in real treatment situation as part of communication training to longitudinally improve communication skills. Copyright © 2017 Elsevier B.V. All rights reserved.

Personality disorders and smoking in Spanish general and clinical population

OpenAIRE

Fernández del Río, Elena; López Durán, Ana; Martinez, Ursula; Becoña, Elisardo

2016-01-01

Background: There is consistent evidence about the relationship between smoking and mental health. This study compares the relationship between tobacco use and personality disorders (PDs) in Spanish adults from general and clinical population, taking into account nicotine dependence (ND), and the presence of any mental disorder. Method: The sample was made up of 1,079 smokers (519 from general population, 560 from clinical population). PDs were assessed by means of the Inter...

Collaborative and Bidirectional Feedback Between Students and Clinical Preceptors: Promoting Effective Communication Skills on Health Care Teams.

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Myers, Kara; Chou, Calvin L

2016-11-01

Current literature on feedback suggests that clinical preceptors lead feedback conversations that are primarily unidirectional, from preceptor to student. While this approach may promote clinical competency, it does not actively develop students' competency in facilitating feedback discussions and providing feedback across power differentials (ie, from student to preceptor). This latter competency warrants particular attention given its fundamental role in effective health care team communication and its related influence on patient safety. Reframing the feedback process as collaborative and bidirectional, where both preceptors and students provide and receive feedback, maximizes opportunities for role modeling and skills practice in the context of a supportive relationship, thereby enhancing team preparedness. We describe an initiative to introduce these fundamental skills of collaborative, bidirectional feedback in the nurse-midwifery education program at the University of California, San Francisco. © 2016 by the American College of Nurse-Midwives.

Motor-independent Visual Perception Skill Indexes are Related with Reading Skills in Children with Cerebral Palsy

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Vahid Reza Khodabandeh

2015-10-01

Full Text Available Objective: Cerebral palsy is one of the most common causes of physical disability in childhood that lead to various difficulties for children. These children may have abnormalities in visual perception. Visual perception plays an important role in learning of basic childhood’s skills. This research was designed to study the relation between each of subtests of visual perception with accuracy and speed components of reading skills in school-aged cerebral palsy children. Materials & Methods: In this cross-sectional study, 24 spastic cerebral palsy students in second grade (10 girls and 14 boy were selected be available as from Tehran’s rehabilitation clinics. Visual perception and Reading skills were evaluated with the Test of Visual Perceptual Skill-revised (TVPS-R and Diagnostic Reading Test. Results: The results showed that between standard score of visual perception with accuracy and speed components of reading skills of cerebral palsy student were significantly correlated. Visual Discrimination with accuracy (P<0.001 and with speed (P<0.001, Visual Memory with accuracy  (P=0.002 and with speed (P=0.004, Visual-Spatial with accuracy (P<0.001 and with speed (P<0.001, Form Constancy with accuracy (P=0.003 and with speed (p<0.001, Visual Sequential Memory with accuracy (P=0.023 and with speed (P<0.028, Figure Ground Discrimination with accuracy (P=0.010 and with speed (P<0.011, Visual Closure with accuracy (p=0.009 and with speed (P<0.009 Conclusion: In general we can say that the relationship between visual perception skills with reading skills in first and second grade students with cerebral palsy is evident.

A Serious Game for Teaching Nursing Students Clinical Reasoning and Decision-Making Skills.

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Johnsen, Hege Mari; Fossum, Mariann; Vivekananda-Schmidt, Pirashanthie; Fruhling, Ann; Slettebø, Åshild

2016-01-01

The aim of this study was to design and pilot-test a serious game for teaching nursing students clinical reasoning and decision-making skills in caring for patients with chronic obstructive pulmonary disease. A video-based serious game prototype was developed. A purposeful sample of six participants tested and evaluated the prototype. Usability issues were identified regarding functionality and user-computer interface. However, overall the serious game was perceived to be useful, usable and likable to use.

Ostomy Home Skills Program

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Full Text Available ... Congress Educational Program Events and Special Activities Resources Housing and Travel Exhibitors Media Information Clinical Congress 2017 ... Surgical Skills for Exposure in Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills ...

[Implementation of bedside training and advanced objective structured clinical examination (OSCE) trial to learn and confirm about pharmacy clinical skills].

Science.gov (United States)

Tokunaga, Jin; Takamura, Norito; Ogata, Kenji; Setoguchi, Nao; Sato, Keizo

2013-01-01

Bedside training for fourth-year students, as well as seminars in hospital pharmacy (vital sign seminars) for fifth-year students at the Department of Pharmacy of Kyushu University of Health and Welfare have been implemented using patient training models and various patient simulators. The introduction of simulation-based pharmaceutical education, where no patients are present, promotes visually, aurally, and tactilely simulated learning regarding the evaluation of vital signs and implementation of physical assessment when disease symptoms are present or adverse effects occur. A patient simulator also promotes the creation of training programs for emergency and critical care, with which basic as well as advanced life support can be practiced. In addition, an advanced objective structured clinical examination (OSCE) trial has been implemented to evaluate skills regarding vital signs and physical assessments. Pharmacists are required to examine vital signs and conduct physical assessment from a pharmaceutical point of view. The introduction of these pharmacy clinical skills will improve the efficacy of drugs, work for the prevention or early detection of adverse effects, and promote the appropriate use of drugs. It is considered that simulation-based pharmaceutical education is essential to understand physical assessment, and such education will ideally be applied and developed according to on-site practices.

‘Lets join hands and jump\\ud together’: Readiness and\\ud implementation of skill mix change\\ud in general practice

OpenAIRE

Topping, Annie; Nkosana- Nyawata, Idah; Featherstone, Valerie A.; Stephenson, John

2013-01-01

Background: The last 10 years has seen major\\ud changes in the ways general practices deliver\\ud UK primary care services. In a context of skill\\ud shortages, cost containment, policy reform,\\ud quality improvement and increasing volume of\\ud interventions delivered in primary care, new ways\\ud of working are becoming the norm. Skill mix, such\\ud the introduction of advanced nurse practitioners\\ud (ANPs) and health care assistants (HCAs), has\\ud fundamentally re-engineered the primary care\\ud...

Skills Development, Habits of Mind, and the Spiral Curriculum: A Dialectical Approach to Undergraduate General Education Curriculum Mapping

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Murray, Jeffrey W.

2016-01-01

This essay seeks to contribute to growing discussion concerning the need for more intentional inclusion of habits of mind in curriculum development, particularly in undergraduate general education, and to fuel an examination of the "dialectical" relationship between skills development and the development of habits of mind. The essay…

Medical students' experience in practical skills is far from stakeholders' expectations

DEFF Research Database (Denmark)

Ringsted, Charlotte; Schroeder, Torben V.; Henriksen, Jørgen

2001-01-01

This study compares medical graduates' experience in practical skills with a range of stakeholders' expectations. A questionnaire listing 58 practical skills was sent out to a group of graduating medical students. The medical students were asked to indicate their experience in each skill during...... medical school. A similar questionnaire was sent out to five groups of stakeholders asking for their expectations regarding graduates' experience. The stakeholders were: faculty members; consultants at clinical departments with interns in training; general practitioners; nurses; recently graduated junior...... doctors. A total of 472 questionnaires were sent out and 315 (67%) were returned. Medical graduates showed substantial variation in level of experience, and their experience was substantially lower than the expectations of the stakeholders. Nurses and junior doctors tended to have higher expectations...

A Procedural Skills OSCE: Assessing Technical and Non-Technical Skills of Internal Medicine Residents

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Pugh, Debra; Hamstra, Stanley J.; Wood, Timothy J.; Humphrey-Murto, Susan; Touchie, Claire; Yudkowsky, Rachel; Bordage, Georges

2015-01-01

Internists are required to perform a number of procedures that require mastery of technical and non-technical skills, however, formal assessment of these skills is often lacking. The purpose of this study was to develop, implement, and gather validity evidence for a procedural skills objective structured clinical examination (PS-OSCE) for internal…

Epilepsy, language, and social skills.

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Caplan, Rochelle

2017-10-04

Language and social skills are essential for intrapersonal and interpersonal functioning and quality of life. Since epilepsy impacts these important domains of individuals' functioning, understanding the psychosocial and biological factors involved in the relationship among epilepsy, language, and social skills has important theoretical and clinical implications. This review first describes the psychosocial and biological factors involved in the association between language and social behavior in children and in adults and their relevance for epilepsy. It reviews the findings of studies of social skills and the few studies conducted on the inter-relationship of language and social skills in pediatric and adult epilepsy. The paper concludes with suggested future research and clinical directions that will enhance early identification and treatment of epilepsy patients at risk for impaired language and social skills. Copyright © 2017 Elsevier Inc. All rights reserved.

Rated casemix of general practitioner referrals to practice counsellors and clinical psychologists: a retrospective survey of a year's caseload.

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Cape, J; Parham, A

2001-06-01

Although evidence-based guidelines are beginning to be produced as to which psychological therapies might be appropriate for which patients, little is known about how general medical practitioners (GPs) in practice distribute referrals between different psychological therapy services. In a retrospective survey, 19 practice counsellors and 10 clinical psychologists from the same geographical area rated a year's caseload of GP referrals using identical data collection methods. Rated casemix was found to be broadly similar, although practice counsellors rated relationship and bereavement problems as more common in their caseloads (totalling 986 patients), and clinical psychologists rated panic disorder, phobias, and obsessive-compulsive problems as more common in their caseloads (totalling 320 patients). Depression and anxiety reactions were the most common problems rated in both groups, but the clinical psychologist cases of depression were rated as more severe and complex. Where differences were found, they may have reflected the different ways that counsellors and clinical psychologists conceptualize cases rather than actual differences in casemix. The results are discussed in relation to evidence-based guideline recommendations about cases appropriate to be seen by practice counsellors and by clinical psychologists in primary and secondary care, and the need to adapt such guidance to local services and skills of practitioners.

Patient-based not problem-based learning: An Oslerian approach to clinical skills, looking back to move forward

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Franklyn-Miller A

2009-01-01

Full Text Available Context : There have been significant changes in the past decade in both the curriculum and its delivery, in undergraduate medical education. Many of these changes have been made simultaneously, preventing clear assessment of outcome measures. The move away from a pre-clinical science grounding, to an integrated ′problem-based learning (PBL approach′ has been widespread in many countries across the world. Purpose : One effect of these changes has been the way in which clinical skills, in particular history and examination are taught. By integrating clinical scenarios earlier in the undergraduate course, clinical skills are increasingly taught in tutorials. This approach, when used in the pre-clinical setting may have shortcomings in the development of the ability to construct a differential diagnosis. There has been little evidence that PBL improves problem-solving ability and this is critical to the differential diagnostic process. The concurrent decline in anatomical teaching and understanding contributes to this difficulty. Discussion : The authors outline a model which clinicians can re-emphasize to students and juniors based on the fundamentals of clinical practice. The apprenticeship is more important than ever in the days of small group learning. The relinquishing of the traditional model of undergraduate medicine is of concern. The effects of educational reform should be examined by further research into the competencies of graduates entering higher professional training, before it is accepted that this change has been for the better.

Reorganizing the General Clinical Research Center to improve the clinical and translational research enterprise.

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Allen, David; Ripley, Elizabeth; Coe, Antoinette; Clore, John

2013-12-01

In 2010, Virginia Commonwealth University (VCU) was granted a Clinical and Translational Science Award which prompted reorganization and expansion of their clinical research infrastructure. A case study approach is used to describe the implementation of a business and cost recovery model for clinical and translational research and the transformation of VCU's General Clinical Research Center and Clinical Trials Office to a combined Clinical Research Services entity. We outline the use of a Plan, Do, Study, Act cycle that facilitated a thoughtful transition process, which included the identification of required changes and cost recovery processes for implementation. Through this process, the VCU Center for Clinical and Translational Research improved efficiency, increased revenue recovered, reduced costs, and brought a high level of fiscal responsibility through financial reporting.

Determining the efficacy of social skills training in treatment of drug addiction in patients refering to Tehran Clinic

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Hava Ramezani

2012-04-01

Full Text Available Background and Aim: The purpose of this study is to investigate the effect of group social skill training on drug abuse treatment prognosis.Materials & Methods :To achieve this goal, 20 available subjects residing at Tehran Clinic were selected. These subjects were randomly assigned into two experimental and control groups. The experimental group participated in ten 2-hour sessions and were trained social skills ,and the control group was in the waiting list. Measurement tools consisted of ACIS Questionnaire and laboratory test; Both experimental and control groups were subjected to pre and post tests. Data were analyzed using paired t test, independent t test, Mann-Whitney u test. Results: Results indicated that, the communication and interaction skills in experimental group had improved significantly in comparison with control group, also in the control group of a person suffering from lapse , but none of those two groups relapsed after 1- month follow up.Conclusion: According to our results it can be concluded that social skills training can be used as a suitable tool to increase communication and interaction skills.

Robot skills for manufacturing

DEFF Research Database (Denmark)

Pedersen, Mikkel Rath; Nalpantidis, Lazaros; Andersen, Rasmus Skovgaard

2016-01-01

-asserting robot skills for manufacturing. We show how a relatively small set of skills are derived from current factory worker instructions, and how these can be transferred to industrial mobile manipulators. General robot skills can not only be implemented on these robots, but also be intuitively concatenated...... products are introduced by manufacturers. In order to compete on global markets, the factories of tomorrow need complete production lines, including automation technologies that can effortlessly be reconfigured or repurposed, when the need arises. In this paper we present the concept of general, self...... in running production facilities at an industrial partner. It follows from these experiments that the use of robot skills, and associated task-level programming framework, is a viable solution to introducing robots that can intuitively and on the fly be programmed to perform new tasks by factory workers....

Nursing students’ valuation on their clinical clerkship

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Ana R. Rodríguez Gonzalo

2011-05-01

Full Text Available Objectives: To know how the nursing students evaluate the clinical-practical knowledge appraised at their clinical clerkship, measured through the satisfaction with the nursing staff Teaching Skills, the Perceived Support and their Global Satisfaction. Methodology: Cross-section, descriptive study carried out at the Ramon y Cajal Hospital. The target population were the 2008/09 nursing students at their clinical clerkship in the hospital, with a total number of 459 shifts. Questionnaire was self-designed and self-administered. Analyzed variables were the student academic year, the hospital ward and their relation with: 1. Teaching Skills, 2. Perceived Support, 3. General Satisfaction.Results: 314 questionnaires were filled out and returned, which is 69,41% of the total number of questionnaires. Students at the Operating Rooms and at the Paediatric Wards gave statistically significant lower qualifications (p=0,005 and p=0,003 than the Emergencies students to the nursing staff Teaching Skills. Regarding the Perceived Support, statistically significant higher scores were given to the Paediatrics (p=0,002 and the Surgical Wards (0,001 compared to the Operating Rooms staff. Finally, in General Satisfaction the lowest, but non statistically significant, scores were given also to the Operating Rooms (p>0,05.Conclusions: Nursing staff from the Operating Rooms and the Paediatric Wards should ameliorate their teaching skills, and those at the Operating Rooms, also the support given during the students clinical clerkship. The proposed improvement actions suggest that meetings between supervisors, nursing staff and professors in order to discuss the teaching objectives are necessary, as well as informational sessions between students and nursing staff at the wards.

Experimenting clinical pathways in general practice: a focus group investigation with Italian general practitioners

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Lucia Zannini

2012-07-01

Full Text Available Background. Clinical governance is considered crucial in primary care. Since 2005, clinical pathways have been experimentally implemented at the Local Health Authority of Monza Brianza (ASLMB, Italy, to develop general practitioners’ (GPs care of patients affected by some chronic diseases. The experimentation was aimed at introducing clinical governance in primary care, increasing GPs’ involvement in the care of their patients, and improving both patients’ and professionals’ satisfaction. In the period 2005-2006, 12% of the 763 employed GPs in the ASLMB were involved in the experiment, while this percentage increased to 15-20% in 2007-2008. Design and Methods. Twenty-four GPs were purposively sampled, randomly divided into two groups and asked to participate in focus groups (FGs held in 2008, aimed at evaluating their perception of the experiment. The FGs were audio-recorded, dialogues were typed out and undergone to a thematic analysis, according to the Interpretative Phenomenological Approach. Results. Four major themes emerged: i clinical pathways can result in GPs working in a more efficient and effective fashion; ii they can assure higher levels of both patient and professional satisfaction, since they sustain a caring approach and strengthen the GPs’ role; iii nevertheless, clinical pathways increase the bureaucratic workload and problems can arise in relationships among GPs and the LHA; iv the implementation of clinical pathways can be improved, especially by reducing bureaucracy and by assuring their continuity. Conclusions. Managerial aspects should be considered with care in order to experimentally introduce clinical pathways in general practice, and continuity of the experimentation should be guaranteed to improve GPs’ adherence and commitment.

Effects of video-feedback on the communication, clinical competence and motivational interviewing skills of practice nurses: a pre-test posttest control group study.

NARCIS (Netherlands)

Noordman, J.; Weijden, T. van der; Dulmen, S. van

2014-01-01

Aims: To examine the effects of individual video-feedback on the generic communication skills, clinical competence (i.e. adherence to practice guidelines) and motivational interviewing skills of experienced practice nurses working in primary care. Background: Continuing professional education may be

Effects of video-feedback on the communication, clinical competence and motivational interviewing skills of practice nurses: a pre-test posttest control group study

NARCIS (Netherlands)

Noordman, J.; Weijden, T.T. van der; Dulmen, S. van

2014-01-01

AIMS: To examine the effects of individual video-feedback on the generic communication skills, clinical competence (i.e. adherence to practice guidelines) and motivational interviewing skills of experienced practice nurses working in primary care. BACKGROUND: Continuing professional education may be

Especial Skills in Experienced Archers.

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Nabavinik, Mahdi; Abaszadeh, Ali; Mehranmanesh, Mehrab; Rosenbaum, David A

2017-09-05

Especial skills are skills that are distinctive by virtue of massive practice within the narrow contexts in which they are expressed. In the first demonstration of especial skills, Keetch, Schmidt, Lee, and Young (2005) showed that experienced basketball players are better at shooting baskets from the foul line, where they had massive amounts of practice, than would expected from their success at other locations closer to or farther from the basket. Similar results were obtained for baseball throwing. The authors asked whether especial skills hold in archery, a sport requiring less movement. If the emergence of especial skills depends on large-scale movement, one would expect archery to escape so-called especialism. But if the emergence of especial skills reflects a more general tendency for highly specific learning, experienced archers should show especial skills. The authors obtained evidence consistent with the latter prediction. The expert archers did much better at their most highly practiced distance than would be expected by looking at the overall function relating shooting score to distance. We offer a mathematical model to account for this result. The findings attest to the generality of the especial skills phenomenon.

A mentor development program for clinical translational science faculty leads to sustained, improved confidence in mentoring skills.

Science.gov (United States)

Feldman, Mitchell D; Steinauer, Jody E; Khalili, Mandana; Huang, Laurence; Kahn, James S; Lee, Kathryn A; Creasman, Jennifer; Brown, Jeanette S

2012-08-01

Mentorship is crucial for academic productivity and advancement for clinical and translational (CT) science faculty. However, little is known about the long-term effects of mentor training programs. The University of California, San Francisco (UCSF), Clinical and Translational Science Institute launched a Mentor Development Program (MDP) in 2007 for CT faculty. We report on an evaluation of the first three cohorts of graduates from the MDP. In 2010, all Mentors in Training (MITs) who completed the MDP from 2007 to 2009 (n= 38) were asked to complete an evaluation of their mentoring skills and knowledge; all MITs (100%) completed the evaluation. Two-thirds of MDP graduates reported that they often apply knowledge, attitudes, or skills obtained in the MDP to their mentoring. Nearly all graduates (97%) considered being a mentor important to their career satisfaction. Graduates were also asked about the MDP's impact on specific mentoring skills; 95% agreed that the MDP helped them to become a better mentor and to focus their mentoring goals. We also describe a number of new initiatives to support mentoring at UCSF that have evolved from the MDP. To our knowledge, this is the first evaluation of the long-term impact of a mentor training program for CT researchers. © 2012 Wiley Periodicals, Inc.

The pattern of clinical advice sought by general practitioners from a medical consultant in clinical biochemistry.

Science.gov (United States)

Bhatnagar, D

1997-01-01

Clinical biochemistry departments can be a valuable source of clinical advice for further investigations and the need for referral to specialist clinics. This paper outlines the pattern of clinical advice sought by general practitioners in a district hospital setting, and addresses some of the issues regarding seeking such advice and the implications for continuing medical education and training. PMID:9196966

Sustained impact of a short small group course with systematic feedback in addition to regular clinical clerkship activities on musculoskeletal examination skills--a controlled study.

Science.gov (United States)

Perrig, Martin; Berendonk, Christoph; Rogausch, Anja; Beyeler, Christine

2016-01-28

The discrepancy between the extensive impact of musculoskeletal complaints and the common deficiencies in musculoskeletal examination skills lead to increased emphasis on structured teaching and assessment. However, studies of single interventions are scarce and little is known about the time-dependent effect of assisted learning in addition to a standard curriculum. We therefore evaluated the immediate and long-term impact of a small group course on musculoskeletal examination skills. All 48 Year 4 medical students of a 6 year curriculum, attending their 8 week clerkship of internal medicine at one University department in Berne, participated in this controlled study. Twenty-seven students were assigned to the intervention of a 6×1 h practical course (4-7 students, interactive hands-on examination of real patients; systematic, detailed feedback to each student by teacher, peers and patients). Twenty-one students took part in the regular clerkship activities only and served as controls. In all students clinical skills (CS, 9 items) were assessed in an Objective Structured Clinical Examination (OSCE) station, including specific musculoskeletal examination skills (MSES, 7 items) and interpersonal skills (IPS, 2 items). Two raters assessed the skills on a 4-point Likert scale at the beginning (T0), the end (T1) and 4-12 months after (T2) the clerkship. Statistical analyses included Friedman test, Wilcoxon rank sum test and Mann-Whitney U test. At T0 there were no significant differences between the intervention and control group. At T1 and T2 the control group showed no significant changes of CS, MSES and IPS compared to T0. In contrast, the intervention group significantly improved CS, MSES and IPS at T1 (p skills during regular clinical clerkship activities. However, an additional small group, interactive clinical skills course with feedback from various sources, improved these essential examination skills immediately after the teaching and several months later

Teaching pediatric communication skills to medical students.

Science.gov (United States)

Frost, Katherine A; Metcalf, Elizabeth P; Brooks, Rachel; Kinnersley, Paul; Greenwood, Stephen R; Powell, Colin Ve

2015-01-01

Delivering effective clinical pediatric communication skills training to undergraduate medical students is a distinct and important challenge. Pediatric-specific communication skills teaching is complex and under-researched. We report on the development of a scenario-based pediatric clinical communication skills program as well as students' assessment of this module. We designed a pediatric clinical communication skills program and delivered it five times during one academic year via small-group teaching. Students were asked to score the workshop in eight domains (learning objectives, complexity, interest, competencies, confidence, tutors, feedback, and discussion) using 5-point Likert scales, along with free text comments that were grouped and analyzed thematically, identifying both the strengths of the workshop and changes suggested to improve future delivery. Two hundred and twenty-one of 275 (80%) student feedback forms were returned. Ninety-six percent of students' comments were positive or very positive, highlighting themes such as the timing of teaching, relevance, group sizes, and the use of actors, tutors, and clinical scenarios. Scenario-based teaching of clinical communication skills is positively received by students. Studies need to demonstrate an impact on practice, performance, development, and sustainability of communications training.

Impact of postgraduate training on communication skills teaching: a controlled study.

Science.gov (United States)

Junod Perron, Noelle; Nendaz, Mathieu; Louis-Simonet, Martine; Sommer, Johanna; Gut, Anne; Cerutti, Bernard; van der Vleuten, Cees P; Dolmans, Diana

2014-04-14

Observation of performance followed by feedback is the key to good teaching of communication skills in clinical practice. The fact that it occurs rarely is probably due to clinical supervisors' perceived lack of competence to identify communication skills and give effective feedback. We evaluated the impact of a faculty development programme on communication skills teaching on clinical supervisors' ability to identify residents' good and poor communication skills and to discuss them interactively during feedback. We conducted a pre-post controlled study in which clinical supervisors took part to a faculty development program on teaching communication skills in clinical practice. Outcome measures were the number and type of residents' communication skills identified by supervisors in three videotaped simulated resident-patient encounters and the number and type of communication skills discussed interactively with residents during three feedback sessions. 48 clinical supervisors (28 intervention group; 20 control group) participated. After the intervention, the number and type of communication skills identified did not differ between both groups. There was substantial heterogeneity in the number and type of communication skills identified. However, trained participants engaged in interactive discussions with residents on a significantly higher number of communication items (effect sizes 0.53 to 1.77); communication skills items discussed interactively included both structural and patient-centered elements that were considered important to be observed by expert teachers. The faculty development programme did not increase the number of communication skills recognised by supervisors but was effective in increasing the number of communication issues discussed interactively in feedback sessions. Further research should explore the respective impact of accurate identification of communication skills and effective teaching skills on achieving more effective communication

[Clinical competence evaluation in undergraduate gynecology and obstetrics].

Science.gov (United States)

Larios Mendoza, Heriberto; Trejo Mejía, Juan Andrés; Gaviño Ambriz, Salvador; Cortés Gutiérrez, Ma Teresa

2002-11-01

Assess the clinical competence in Gynecology and obstetrics to the Internship students of the Faculty of Medicine, UNAM. The study design was descriptive, transverse type. We assessed 64 students, which had finished their gynecology field rotation with the objective structured clinical examination. The criteria to consider a competent performance level, was arbitrarily set up in 60%, both for individual problems and for the exam's global result. In 15 stations, the result was a 56.2 global average. The best performances were achieved in the following stations: take the pap smear (74.7), Pregnancy diagnostic (67.9), history of Gynecology and obstetrics (67.1), self examination of breast explanation (62.2) preclampsia (61.7) and cervicovaginitis (60). All the rest got a mark lower than 60. The results are lower than the ones obtained in written exams, because these cannot assess clinical skills. It could be observed that a student's performance in a clinical problem does not certainly predict his performance in other, so it seems to be determined more by the specific knowledge and the student's experience related to the case, than by a general problem-solving skill. The results show the advantages of this instrument to assess clinical skills, that justify its application in the formative process. This work evidences that its necessary to improve the acquisition of basic clinical skills trough systematic instructionals strategies and greater opportunities of learning.

The Mechanism of Suppression: A Component of General Comprehension Skill

OpenAIRE

Gernsbacher, Morton Ann; Faust, Mark E.

1991-01-01

We investigated whether the cognitive mechanism of suppression underlies differences in adult comprehension skill. Less skilled comprehenders reject less efficiently the inappropriate meanings of ambiguous words (e.g., the playing card vs. garden tool meaning of spade), the incorrect forms of homophones (e.g., patients vs. patience), the highly typical but absent members of scenes (e.g., a tractor in a farm scene), and words superimposed on pictures or pictures surrounding words. However, les...

The prevalence and clinical significance of maxillary sinus mucous retention cysts in a general clinic population.

Science.gov (United States)

Rhodus, N L

1990-02-01

Previous studies have documented the occurrence and potential clinical significance of MSMR cysts. Studies also have alluded to a relationship between the MSMR cyst and certain signs or symptoms of disease. We determined the prevalence of MSMR cysts in a general clinic population and identified some important correlations with clinical signs and symptoms.

The Effects of Word Box Instruction on Acquisition, Generalization, and Maintenance of Decoding and Spelling Skills for First Graders

Science.gov (United States)

Alber-Morgan, Sheila R.; Joseph, Laurice M.; Kanotz, Brittany; Rouse, Christina A.; Sawyer, Mary R.

2016-01-01

This study examined the effects of implementing word boxes as a supplemental instruction method on the acquisition, maintenance, and generalization of word identification and spelling. Word box intervention consists of using manipulatives to learn phonological decoding skills. The participants were three African-American urban first graders…

Developing skilled doctor-patient communication in the workplace: a qualitative study of the experiences of trainees and clinical supervisors.

Science.gov (United States)

Giroldi, Esther; Veldhuijzen, Wemke; Geelen, Kristel; Muris, Jean; Bareman, Frits; Bueving, Herman; van der Weijden, Trudy; van der Vleuten, Cees

2017-12-01

To inform the development of recommendations to facilitate learning of skilled doctor-patient communication in the workplace, this qualitative study explores experiences of trainees and supervisors regarding how trainees learn communication and how supervisors support trainees' learning in the workplace. We conducted a qualitative study in a general practice training setting, triangulating various sources of data to obtain a rich understanding of trainees and supervisors' experiences: three focus group discussions, five discussions during training sessions and five individual interviews. Thematic network analysis was performed during an iterative process of data collection and analysis. We identified a communication learning cycle consisting of six phases: impactful experience, change in frame of reference, identification of communication strategies, experimentation with strategies, evaluation of strategies and incorporation into personal repertoire. Supervisors supported trainees throughout this process by creating challenges, confronting trainees with their behaviour and helping them reflect on its underlying mechanisms, exploring and demonstrating communication strategies, giving concrete practice assignments, creating safety, exploring the effect of strategies and facilitating repeated practice and reflection. Based on the experiences of trainees and supervisors, we conclude that skilled communication involves the development of a personal communication repertoire from which learners are able to apply strategies that fit the context and their personal style. After further validation of our findings, it may be recommended to give learners concrete examples, opportunities for repeated practise and reflection on personal frames of reference and the effect of strategies, as well as space for authenticity and flexibility. In the workplace, the clinical supervisor is able to facilitate all these essential conditions to support his/her trainee in becoming a skilled

Therapist facilitative interpersonal skills and training status: A randomized clinical trial on alliance and outcome.