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Instructional Course Lectures 2024Simulation training encompasses all methods of learning technical skills that do not require practicing on a live patient. Surgical training typically uses an...
Simulation training encompasses all methods of learning technical skills that do not require practicing on a live patient. Surgical training typically uses an apprenticeship model, in which responsibility is gradually shifted from attending surgeon to the trainee over years of experiences with live patients. Skill acquisition from simulation modalities can prevent unnecessary harm to patients if trainees have practice and experience from simulation before participation in live surgeries. Surgeons are morally required to prevent unnecessary harm to patients, regardless of whether they are consequentialist or nonconsequentialist in one's metaethics. It is the authors' opinion that simulation training is a moral imperative, as there is early empirical evidence for preventing harm to patients and it should be incorporated to the extent it is feasible in every surgical training program. Further definitive studies need to be performed.
Topics: Humans; Orthopedics; Surgeons; Orthopedic Procedures; Simulation Training; Clinical Competence
PubMed: 38090884
DOI: No ID Found -
Journal of Healthcare Quality Research 2024There was a widespread discontinuation of simulation programs during and after the COVID-19 pandemic. The objective is to explore how to facilitate greater integration... (Review)
Review
There was a widespread discontinuation of simulation programs during and after the COVID-19 pandemic. The objective is to explore how to facilitate greater integration of simulation in healthcare organizations. A literature review was conducted in PubMed, MEDES, IBECS and DOCUMED databases. Twenty-three articles published after the pandemic were selected, categorized in seven themes and critically reviewed. In order to consistently and fully integrate simulation into the organizational culture it is recommended to prioritize the development of new strategies that enhance the efficiency and safety of healthcare delivery. And also strategies that enhance the satisfaction and well-being of all stakeholders.
Topics: Humans; Pandemics; Delivery of Health Care; Health Facilities; COVID-19; Simulation Training
PubMed: 38176996
DOI: 10.1016/j.jhqr.2023.12.003 -
West African Journal of Medicine Sep 2023Postgraduate diploma in health systems management (PDHSM) curriculum was designed and developed to equip medical doctors with the knowledge, skills, and attitudes...
BACKGROUND
Postgraduate diploma in health systems management (PDHSM) curriculum was designed and developed to equip medical doctors with the knowledge, skills, and attitudes required to manage health systems and resources for quality patient care and safety.
OBJECTIVES
Describe processes and steps to design and develop a new curriculum using the development of PDHSM as a guide by identifying learning needs; using the six-step approach to curriculum development; incorporating quality assurance and quality enhancement frameworks; and identifying evaluation methods.
METHODOLOGY
Four (4) subject content experts in health policy, planning, and management and experienced public health physicians at the National Postgraduate Medical College of Nigeria deliberated, determined, and compiled learning needs that were incorporated into the design and development of the new curriculum for PDHSM. The learning needs, informal data on key learning issues in health system management and specific challenges in the context and operational environment were analyzed. Triangulation of information from these different perspectives and opinions was aligned with medical doctors' educational needs to acquire competency in managing health systems. The derived instructional needs, assessment methods, and resources were incorporated into the design, development, and evaluation of the PDHSM curriculum. The outline of the curriculum was developed using the curriculum matrix table.
RESULTS
The contents of the developed curriculum in PDHSM include the purpose, organization of the programme, educational experience, and evaluation of the curriculum. The curriculum was structured into modules. Each module has intended learning outcomes (ILOs) of major subject areas of HSM and teaching and learning activities that outline methods of instruction and assessments. The Indicative contents of each module are topics of each subject area of the PDHSM. The assessment formats in the curriculum included both formative and summative assessment methods and types. The resources required for instructional and assessment activities were identified. The evaluation methods of the curriculum will be through reviews of assessment results and performance evaluation of students, tutors, and the PDHSM programme.
CONCLUSION
The educational needs of medical doctors to function as managers in the health systems determine the development of intended learning outcomes, teaching and learning activities, indicative contents, resources required, and evaluation of the PDHSM curriculum. Quality assurance and quality enhancement should be part of curriculum design and development.
Topics: Humans; Curriculum; Learning; Students; Physicians; Nigeria
PubMed: 37759407
DOI: No ID Found -
e-Learning interventions for nurses to prevent venous thromboembolism in patients: A realist review.Journal of Clinical Nursing Aug 2023To synthesise published literature exploring online venous thromboembolism (VTE) prevention education programmes to identify, test and refine a program theory supporting... (Review)
Review
AIM
To synthesise published literature exploring online venous thromboembolism (VTE) prevention education programmes to identify, test and refine a program theory supporting translation of knowledge into practice for registered nurses.
BACKGROUND
Venous thromboembolism is a leading cause of preventable morbidity and mortality in hospitalised patients. Successful implementation of prevention strategies can be impeded by a lack of education and translation of knowledge to practice. Continuing professional development programs using e-learning platforms are increasingly common, however, there is little published literature exploring effective translation of such education to practice.
DESIGN
Realist Review.
METHODS
Searches were conducted in seven healthcare databases prior to July 2020 and updated in March 2022. Synthesis was informed by the unified theory of acceptance and use of technology (UTAUT) model and followed stages of a realist review outlined by Pawson et al. The results were reported according to the RAMESES publication standards.
RESULTS
Eight context-mechanism-outcome combinations were identified to explain engagement, completion and adoption of VTE e-learning into practice. Mechanisms included valuing content as relevant to practice, having confidence in the ability to use the technology and empowerment to enact change based on learning. Contextual factors that may constrain the completion of learning include the support of managers and organisations through time, and the availability of resources.
CONCLUSION
Translation of e-learning is critical to ensure clinical excellence. This realist review demonstrated the varying mechanisms contributing to engagement, completion and adoption of learning. These illustrate the complex nature of education for professional development. It demonstrates that the UTAUT model is suitable for guiding the design, implementation and adoption of e-learning programmes.
RELEVANCE TO CLINICAL PRACTICE
This review used a common clinical practice (VTE) to provide a program theory that can guide clinical educators to understand mechanisms which can facilitate engagement with, completion and adoption of e-learning into practice by nurses.
NO PATIENT OR PUBLIC CONTRIBUTION
The focus of this realist review was on e-learning for registered nurses. As such, no patient or public contribution was sought or given in the development, progress and writing of the submitted manuscript.
Topics: Humans; Venous Thromboembolism; Computer-Assisted Instruction; Learning; Delivery of Health Care; Nurses
PubMed: 36324243
DOI: 10.1111/jocn.16571 -
BMC Medical Education Oct 2023Problem-based learning (PBL) is a pedagogy involving self-directed learning in small groups around case problems. Group function is important to PBL outcomes, but there...
BACKGROUND
Problem-based learning (PBL) is a pedagogy involving self-directed learning in small groups around case problems. Group function is important to PBL outcomes, but there is currently poor scaffolding around key self-reflective practices that necessarily precedes students' and tutors' attempts to improve group function. This study aims to create a structured, literature-based and stakeholder-informed tool to help anchor reflective practices on group function. This article reports on the development process and perceived utility of this tool.
METHODS
Tool development unfolded in four steps: 1) a literature review was conducted to identify existent evaluation tools for group function in PBL, 2) literature findings informed the development of this new tool, 3) a group of PBL experts were consulted for engagement with and feedback of the tool, 4) four focus groups of stakeholders (medical students and tutors with lived PBL experiences) commented on the tool's constructs, language, and perceived utility. The tool underwent two rounds of revisions, informed by the feedback from experts and stakeholders.
RESULTS
Nineteen scales relating to group function assessment were identified in the literature, lending 18 constructs that mapped into four dimensions: Learning Climate, Facilitation and Process, Engagement and Interactivity, and Evaluation and Group Improvement. Feedback from experts informed the addition of missing items. Focus group discussions allowed further fine-tuning of the organization and language of the tool. The final tool contains 17 descriptive items under the four dimensions. Users are asked to rate each dimension holistically on a 7-point Likert scale and provide open comments. Researchers, faculty, and students highlighted three functions the tool could perform: (1) create space, structure, and language for feedback processes, (2) act as a reference, resource, or memory aid, and (3) serve as a written record for longitudinal benchmarking. They commented that the tool may be particularly helpful for inexperienced and poor-functioning groups, and indicated some practical implementation considerations.
CONCLUSION
A four-dimension tool to assist group function reflection in PBL was produced. Its constructs were well supported by literature and experts. Faculty and student stakeholders acknowledged the utility of this tool in addressing an acknowledged gap in group function reflection in PBL.
Topics: Humans; Curriculum; Education, Medical, Undergraduate; Learning; Problem-Based Learning; Students, Medical
PubMed: 37817205
DOI: 10.1186/s12909-023-04726-y -
American Journal of Pharmaceutical... Jun 2024Evidence suggests that both pharmacy students and preceptors are struggling in the experiential setting. Underlying this phenomenon is a potential interconnected and... (Review)
Review
Evidence suggests that both pharmacy students and preceptors are struggling in the experiential setting. Underlying this phenomenon is a potential interconnected and cyclic set of behaviors being reinforced between students and preceptors. These behaviors can contribute to or are the result of higher levels of burnout and a decrease in the development of student clinical skills and subsequent performance on rotation. In this review, the authors investigate various challenges commonly encountered in the experiential environment. These challenges can range from an observed decrease in student engagement, motivation, and critical thinking skills to an increase in preceptor burnout and culture shifts in the clinical practice environments. These factors all ultimately impact patient care and overall student performance. For each challenge identified, strategies will be presented that can be implemented by students, preceptors, and pharmacy programs to break the cyclic pattern identified.
Topics: Humans; Students, Pharmacy; Education, Pharmacy; Preceptorship; Motivation; Burnout, Professional; Problem-Based Learning; Clinical Competence
PubMed: 38750821
DOI: 10.1016/j.ajpe.2024.100710 -
Journal of Educational Evaluation For... 2024Despite explicit expectations and accreditation requirements for integrated curriculum, there needs to be more clarity around an accepted common definition, best... (Review)
Review
Despite explicit expectations and accreditation requirements for integrated curriculum, there needs to be more clarity around an accepted common definition, best practices for implementation, and criteria for successful curriculum integration. To address the lack of consensus surrounding integration, we reviewed the literature and herein propose a definition for curriculum integration for the health professions education audience. We further believe that health professions education is ready to move beyond "horizontal" (one-dimensional) and "vertical" (two-dimensional) integration and propose a model of "six degrees of curriculum integration" to expand the two-dimensional concept for future designs of health professions programs and best prepare learners to meet the needs of patients. These six degrees include: interdisciplinary, timing and sequencing, instruction and assessment, incorporation of basic and clinical sciences, knowledge and skills-based competency progression, and graduated responsibilities in patient care. We encourage medical educators to look beyond two-dimensional integration to best prepare physicians of the future.
Topics: Curriculum; Humans; Education, Medical; Clinical Competence; Accreditation; Models, Educational
PubMed: 38872249
DOI: 10.3352/jeehp.2024.21.15 -
The Journal of Physician Assistant... Sep 2023The purpose of this novel study was to determine whether any association exists between student well-being and physician assistant (PA) program approaches to teaching...
PURPOSE
The purpose of this novel study was to determine whether any association exists between student well-being and physician assistant (PA) program approaches to teaching provider health and well-being (provider wellness).
METHODS
Data were sourced from 3 PA Education Association surveys. Data from the 2019 Matriculating Student and End of Program Surveys (EOPS) were analyzed to compare student-reported well-being across 6 measures. Next, data from the 2019 Didactic Curriculum Survey were assessed and matched to the 2019 EOPS data. Finally, generalized estimating equation models were used to assess the independent effects of course structure, mode of instruction, and contact hours on well-being scores among end-of-program students (within one month of graduation).
RESULTS
While levels of well-being were generally favorable, except for "level of social activity" ( P = .20), across measures, graduating student levels of well-being ( P < .05) were statistically significantly lower than matriculating student levels of well-being. No associations were found between levels of student well-being and whether programs reported teaching or not teaching provider wellness. Some aspects of instruction (eg, contact hours) were inconsistently associated with various well-being measures.
CONCLUSION
In this study, no consistent associations between approaches to teaching provider wellness and various measures of student well-being were identified. Further research is needed to determine what approaches to promoting wellness are effective.
Topics: Humans; Physician Assistants; Curriculum; Students; Surveys and Questionnaires
PubMed: 37586068
DOI: 10.1097/JPA.0000000000000528 -
Health Literacy Research and Practice Aug 2023Effective communication with patients and between members of the health care team are important strategies to enhance health care outcomes. Despite the prevalence of low...
Effective communication with patients and between members of the health care team are important strategies to enhance health care outcomes. Despite the prevalence of low health literacy and associated risks in the population, health professionals are often not trained adequately in health literacy communication practices. The purpose of this pilot program is to determine if offering learners an opportunity to practice health literacy communication techniques in a simulated patient care team can increase skills, attitudes, and confidence in this important area of patient care. We implemented a novel, team-based interprofessional Objective Structured Clinical Examination (iOSCE) focused on health literacy. Evaluation took place on three levels: student self-assessment of health literacy communication skills and beliefs about interprofessional teamwork, standardized patient assessment of skills during the clinical encounter, and observer assessment of interprofessional teamwork. Statistically significant gains were seen in students' health literacy communication confidence, as well as beliefs, attitudes and understanding of interprofessional teamwork. The aim of this article is to describe our pilot health literacy iOSCE findings. This pilot shows that an OSCE is an effective assessment tool for a mix of health professional learners at different levels to demonstrate health literacy practices in an interprofessional teamwork environment. [].
Topics: Humans; Interprofessional Relations; Health Literacy; Health Personnel; Patient Simulation
PubMed: 37552489
DOI: 10.3928/24748307-20230713-01 -
BMC Medical Education Sep 2023The problem-based learning (PBL) model has been widely carried out in many fields of medical colleges and universities. Immunochemistry as a cross-disciplinary science...
BACKGROUND
The problem-based learning (PBL) model has been widely carried out in many fields of medical colleges and universities. Immunochemistry as a cross-disciplinary science plays a vital role in preventing the occurrence of diseases and bridging the development of Life Science and Medicine. But now the Immunochemistry course still lacks the teaching practice in PBL. To explore the significance of PBL applied in the Immunochemistry course, the effect of the PBL model on the learning of undergraduates majoring in Chemicobiology was systematically evaluated.
METHODS
The teaching objects were the undergraduates majoring in Chemicobiology from Guizhou Medical University. The PBL model was applied in the Immunochemistry course. 62 undergraduates in Grade 2018 were set as the control group and adopted the traditional expository model. 93 undergraduates in Grades 2019-2020 were separately set as the experimental groups, which adopted the PBL model based on traditional lecture-based learning. In the PBL model, six cases related to course contents were designed for the students to complete. The final exams of the undergraduates in Grades 2018-2020 were analyzed by the score ranges (< 60 points, 60-69 points, 70-79 points, and ≥ 80 points) and nonparametric test. Finally, the questionnaire survey about the teaching evaluation was performed in Grades 2019-2020.
RESULTS
In Grades 2019 and 2020, the excellent rates (≥ 80 points), pass rates (≥ 60 points), fail rates (< 60 points), and average scores of the undergraduates were separately about 29%, 91.11% and 93.75%, 6.25%, and 8.89%, and 72.55 and 74.45 points. But in Grade 2018, the excellent rate, pass rate, failure rate, and average score of the undergraduates were separately 9.68%, 59.68%, 40.32%, and 62.55 points. By the statistical analysis, it was found that the excellent rates (χ = 8.317, P < 0.005) and pass rates (χ = 24.52, P < 0.0001) in Grades 2018-2020 were different, of which Grade 2020were the highest (29.17%, 93.75%) and Grade 2018 was the lowest (9.68%, 59.68%). The average score, excellent rate, and pass rate in Grade 2018 had significant differences with Grade 2019 (P < 0.0001, P < 0.0167) and Grade 2020 (P < 0.001, P < 0.0167). The questionnaire survey also showed that the student's learning interests, independent problem-solving ability, knowledge structure system, and scientific thought and teamwork awareness were enhanced. In Grades 2019 and 2020, the ICC (95% CI) of criterion validity and inter-rater reliability were separately 0.42/0.34 and 0.81/0.80 (P < 0.0001).
CONCLUSION
The combination of PBL and traditional expository models played positive roles in the student's learning in the Immunochemistry course.
Topics: Humans; Problem-Based Learning; Immunochemistry; Reproducibility of Results; Students; Learning
PubMed: 37740215
DOI: 10.1186/s12909-023-04678-3