Acquisition Of Technical Skills Research Articles

Colonoscopy: do operator motions and posture count?

Colonoscopy: do operator motions and posture count?

Construction and validation of a surgical skills assessment tool for general surgery residency program.

To develop and validate an instrument for measuring the acquisition of technical skills in conducting operations of increasing difficulty for use in General Surgery Residency (GSR) programs. we built a surgical skills assessment tool containing 11 operations in increasing levels of difficulty. For instrument validation we used the face validity method. Through an electronic survey tool (Survey MonKey®) we sent a questionnaire to Full and Emeritus members of the Brazilian College of Surgeons--CBC--all bearers of the CBC Specialist Title. Of the 307 questionnaires sent we received 100 responses. For the analysis of the data collected we used the Cronbach's alpha test. We observed that, in general, the overall alpha presented with values near or greater than 0.70, meaning good consistency to assess their points of interest. The evaluation instrument built was validated and can be used as a method of assessment of technical skill acquisition in the General Surgery Residency programs in Brazil.

A major trauma course based on posters, audio-guides and simulation improves the management skills of medical students: Evaluation via medical simulator

BackgroundMedical competence requires the acquisition of theoretical knowledge and technical skills. Severe trauma management teaching is poorly developed during internship. Nevertheless, the basics of major trauma management should be acquired by every future physician. For this reason, the major trauma course (MTC), an educational course in major traumatology, has been developed for medical students. Our objective was to evaluate, via a high fidelity medical simulator, the impact of the MTC on medical student skills concerning major trauma management. MethodsThe MTC contains 3 teaching modalities: posters with associated audio-guides, a procedural workshop on airway management and a teaching session using a medical simulator. Skills evaluation was performed 1 month before (step 1) and 1 month after (step 3) the MTC (step 2). Nineteen students were individually evaluated on 2 different major trauma scenarios. The primary endpoint was the difference between steps 1 and 3, in a combined score evaluating: admission, equipment, monitoring and safety (skill set 1) and systematic clinical examinations (skill set 2). ResultsAfter the course, the combined primary outcome score improved by 47% (P<0.01). Scenario choice or the order of use had no significant influence on the skill set evaluations. ConclusionThis study shows improvement in student skills for major trauma management, which we attribute mainly to the major trauma course developed in our institution.

The role of non-technical skills in surgery

Non-technical skills are of increasing importance in surgery and surgical training. A traditional focus on technical skills acquisition and competence is no longer enough for the delivery of a modern, safe surgical practice. This review discusses the importance of non-technical skills and the values that underpin successful modern surgical practice.This narrative review used a number of sources including written and online, there was no specific search strategy of defined databases. Modern surgical practice requires; technical and non-technical skills, evidence-based practice, an emphasis on lifelong learning, monitoring of outcomes and a supportive institutional and health service framework. Finally these requirements need to be combined with a number of personal and professional values including integrity, professionalism and compassionate, patient-centred care.

Development and Validation of a Novel Skills Training Model for Retrograde Intrarenal Surgery.

The aim of this study is to validate a training model that combines the use of nonbiologic and biologic simulators as well as live porcine animal model in endoscopic retrograde intrarenal surgery (RIRS). A total of 60 urologists took part in this study, and the activity lasted for 2 days. The training model was divided into three modules: Module-I, related to the acquisition of basic theoretical knowledge; Module-II, consisting of an internship with bench models; and Module III, in which animal models were used. First, trainees practiced with animals without using a lesion model (placement of an ureteral access sheath under fluoroscopic guidance and flexible ureterorenoscopy). Afterward, they practiced on a porcine animal model of bilateral renal lithiasis. Performance was measured using a validated global rating score and RIRS checklist score. Face and content validation as well as constructive validation provided by trainees in front of 15 experts were performed during the practice. Face and content validations were satisfactory. "Individual" constructive validity showed statistical significance between the first and the last time that trainees practiced on an animal model. Statistical significance was also found between trainees and expert scores. There were 73.4% of trainees who increased their skills by more than 40%. This RIRS training model allows for the acquisition of technical knowledge and skills as face, content, and constructive validation show. A structured use of nonbiologic, biologic, and animal model simulators allows the increase of RIRS skills.

Mannequins simples et complexes pour l’enseignement initial et continu des gestes

Learning gestures and behaviors is essential for the students' and doctors' formation. However, teaching at the bedside can be an ethical problem. Simulation, allowing a first practical without risk for the patient, became inevitable. More or less complex, lots of models are available in simulation centers to permit repetition of gestures and also their implementation in the context of a more comprehensive care, possibly in crisis thus permiting acquisition of technical and non-technical skills. The medical simulation center PRESAGE (Platform Research and Teaching by simulation for learning attitudes and gestures) of Lille Medical schoolfrom Lille University is a beautiful example of the use of simulation as a complementary educational tool. The proposed training offers to all students and medecine doctors a personal development.

The Effect of Stress on Task Acquisition in a Simulated Open Aortic Aneurysm Model

This study evaluated high levels of teaching stress compared with a nonstressful environment and its effects on standardized performance measures on an open abdominal aortic aneurysm (AAA) model using validated psychological and hemodynamic parameters. Participants were randomly divided into two groups of simulated open aortic tube graft repair for three sessions. Session 1 involved familiarization with the model and baseline stress and performance measures. Sessions 2 and 3 involved the use of supportive feedback for the control group with no stress (NS), and verbal and situational stressors for the intervention or stress (S) group. Stress levels were assessed by heart rate, blood pressure, and self-reported validated measure of stress levels (State Trait Anxiety Index [STAI]), immediately after each session. Performance measures were assessed by Objective Structured Assessment of Technical Skills (OSATS) and Global Performance Rating (GPR) tools. Session 3 performance was compared with the baseline performance at session 1. Statistical methods for comparison involved the sampled t-test (P < .05). Ten medical students participated. Within each group, OSATS scores significantly improved (3.88 points for NS, P = .003; 4.33 points for S, P = .003). GPR scores significantly improved (6.88 points for NS, P = .004; 5.33 points for S, P = .023). Between the two groups (Table), the S group's stress level increased with a STAI increase of 9.17 points, whereas the NS group's STAI score decreased 6.25 points (P = .001). Despite the increase in the anxiety measure, OSATS and GPR performance did not differ significantly between the groups from session 1 to session 3. This study suggests that technical skills can improve in a simulated AAA model irrespective of the stress level experienced by the participant. These findings raise questions about the impact of stress on surgical education and acquisition of technical skills. Studies using robust physiological stress measures are needed to potentially identify beneficial or detrimental levels of stress in training outcomes.TableBetween-group comparisons between session 3 and 1MeasurementControl group (NS) (n = 4)Intervention group (S) (n = 6)P valueOSATS3.8754.333.669GPR6.8755.333.496Blood pressure Systolic−15.5−9.00.542 Diastolic−9.50−3.33.263Pulse pressure−6.00−5.67.967Pulse7.000.667.263State−6.2509.167.001Trait3.2504.667.802GPR, Global Performance Rating; NS, no stress; OSATS, Objective Structured Assessment of Technical Skills; S, stress. Open table in a new tab

Use of an Objective Structured Assessment of Technical Skill (OSATS) after a Sports Rotation

Objectives:While the acquisition of competent technical skill is a defining characteristic of surgery, it is not measured systematically in residency. As all post-graduate medical training slowly shifts to a competency-based model, effective assessments of surgical and other technical skills after modules will become necessary. However, the best method for of assessing competence in technical skill in this setting is unknown, and is limited by both cost and access to resources. We hypothesized that a multi-station Objective Structured Assessment of Technical skill (OSATS), using sawbones models, would be a valid and reliable method of assessing resident competence in surgical skills after a sports medicine rotation.Methods:At the start of their three-month sports medicine rotation, each resident was provided a list of 10 surgical skills in which they were expected to demonstrate competence (Table 1). At the end of the rotation, each resident undertook an OSATS comprised of six randomly chosen stations - low-fidelity sawbones models were used in all stations. Residents were evaluated by faculty / staff surgeons using a previously validated global rating scale (the Arthroscopic Surgical Skill Evaluation Tool (ASSET)), as well as task-specific checklists created using a modified Delphi procedure, and a final five-point global rating scale (GRS) using the Drefus model of skill acquisition (1=novice, 2=advanced beginner, 3=competent, 4=proficient, 5=expert). All arthroscopic procedures were recorded, and all hand movements were videotaped - the videos were reviewed by a single, blinded observer, and correlation sought between the faculty ratings and the observer ratings.Results:Over 18 months, 27 residents (19 junior, 8 senior) sat the OSATS after their rotation, as well as seven sports medicine staff and seven fellows, for a total of 41 participants. The overall reliability of the OSATS as measured by Cronbach's Alpha was very high (0.9). A significant difference by year in training was seen for the overall GRS, the total ASSET score, and the total checklist score, as well as for each individual technical skill (p<0.001) - this difference was also seen for all stations. Post hoc analysis demonstrated a significant difference in the total ASSET score between junior (PGY1-3) and senior (PGY4&5) residents, senior residents and fellows, as well as between fellows and faculty (p<0.05)(Figure 1). A high correlation was seen between the faculty assessments and the blinded observer assessments for each station (>0.8).Conclusion:The results of this study demonstrate that an OSATS using dry models is a valid and reliable means of assessing technical skill in orthopaedic residents after a sports medical rotation. Interestingly, junior residents were not able to perform technical skills as well as senior residents despite an identical rotation, suggesting that overall surgical experience and exposure is as important as intensive teaching.

Predictive value of background experiences and visual spatial ability testing on laparoscopic baseline performance among residents entering postgraduate surgical training.

Emerging evidence suggests that despite dedicated practice, not all surgical trainees have the ability to reach technical competency in minimally invasive techniques. While selecting residents that have the ability to reach technical competence is important, evidence to guide the incorporation of technical ability into selection processes is limited. Therefore, the purpose of the present study was to evaluate whether background experiences and 2D-3D visual spatial test results are predictive of baseline laparoscopic skill for the novice surgical trainee. First-year residents were studied. Demographic data and background surgical and non-surgical experiences were obtained using a questionnaire. Visual spatial ability was evaluated using the PicSOr, cube comparison (CC) and card rotation (CR) tests. Technical skill was assessed using the camera navigation (LCN) task and laparoscopic circle cut (LCC) task. Resident performance on these technical tasks was compared and correlated with the questionnaire and visual spatial findings. Previous experience in observing laparoscopic procedures was associated with significantly better LCN performance, and experience in navigating the laparoscopic camera was associated with significantly better LCC task results. Residents who scored higher on the CC test demonstrated a more accurate LCN path length score (r s(PL)=-0.36, p=0.03) and angle path (r s(AP)=-0.426, p=0.01) score when completing the LCN task. No other significant correlations were found between the visual spatial tests (PicSOr, CC or CR) and LCC performance. While identifying selection tests for incoming surgical trainees that predict technical skill performance is appealing, the surrogate markers evaluated correlate with specific metrics of surgical performance related to a single task but do not appear to reliably predict technical performance of different laparoscopic tasks. Predicting the acquisition of technical skills will require the development of a series of evidence-based tests that measure a number of innate abilities as well as their inherent interactions.

Competency-Based Medical Education: Use of an Objective Structured Assessment of Technical Skill (OSATS) after an Orthopaedic Sports Medicine Rotation

The introduction of Competency Based Medical Education (CBME) in orthopaedics at the University of Toronto demands validated methods of evaluation, especially in technical skill. We hypothesized that a multi-station Objective Structured Assessment of Technical Skill (OSATS) would be a valid and reliable method of assessing resident competence in surgical skill after a sports medicine rotation. At the start of their three-month sports medicine rotation, each resident was provided a list of 10 surgical skills in which they were expected to demonstrate competence (Table 1). At the end of the rotation, each resident undertook an OSATS comprised of six randomly chosen stations. Low-fidelity sawbones models were used in all stations. Residents were evaluated by staff surgeons using a previously validated global rating scale (ASSET), task-specific checklists created using a modified Delphi procedure, and a final five-point rating using the Drefus model of skill acquisition. Over 18 months, 27 residents (19 junior, 8 senior) sat the OSATS after their rotation, as well as 14 sports medicine staff and fellows. The overall reliability of the OSATS was 0.97. A significant difference by year in training was seen for the overall global rating (p<0.05). The use of low-fidelity sawbones models is a valid and reliable method of assessing surgical skills in orthopaedic residents after a sports medicine rotation. On this OSATS, junior residents were not able to perform technical skills as well as senior residents. This research suggests that despite intensive teaching within a CBME model, overall surgical experience is crucial to the acquisition of technical skills within a rotation.

Impact of a simulation training curriculum on technical and nontechnical skills in colonoscopy: a randomized trial

GI endoscopy simulation-based training augments early clinical performance; however, the optimal manner by which to deliver training is unknown. We aimed to validate a simulation-based structured comprehensive curriculum (SCC) designed to teach technical, cognitive, and integrative competencies in colonoscopy. Single-blinded, randomized, controlled trial. Endoscopic simulation course at an academic hospital. Thirty-three novice endoscopists were allocated to an SCC group or self-regulated learning (SRL) group. The SCC group received a curriculum consisting of 6 hours of didactic lectures and 8 hours of virtual reality simulation-based training with expert feedback. The SRL group was provided a list of desired objectives and was instructed to practice on the simulator for an equivalent time (8 hours). Clinical transfer was assessed during 2 patient colonoscopies using the Joint Advisory Group Direct Observation of Procedural Skills (JAG DOPS) scale. Secondary outcome measures included differences in procedural knowledge, immediate post-training simulation performance, and delayed post-training (4-6 weeks) performance during an integrated scenario test on the JAG DOPS communication and integrated scenario global rating scales. There was no significant difference in baseline or post-training performance on the simulator task. The SCC group performed superiorly during their first and second clinical colonoscopies. Additionally, the SCC group demonstrated significantly better knowledge and colonoscopy-specific performance, communication, and global performance during the integrated scenario. We were unable to measure SRL participants' effort outside of mandatory training. In addition, feedback metrics and number of available simulation cases are limited. These results support integration of endoscopy simulation into a structured curriculum incorporating instructional feedback and complementary didactic knowledge as a means to augment technical, cognitive, and integrative skills acquisition, as compared with SRL on virtual reality simulators. ( NCT01991522.)

Introduction of a fresh cadaver laboratory during the surgery clerkship improves emergency technical skills

BackgroundStudent acquisition of technical skills during the clinical years of medical school has been steadily declining. To address this issue, the authors instituted a fresh cadaver-based Emergency Surgical Skills Laboratory (ESSL). MethodsSixty-three medical students rotating through the third-year surgery clerkship participated in a 2-hour, fresh cadaver-based ESSL conducted during the first 2 days of the clerkship. The authors evaluated students utilizing both surgical skills and written examination before the ESSL and at 4 weeks post ESSL. ResultsStudents demonstrated a mean improvement of 64% (±11) (P < .001) and 38% (±17) (P < .001) in technical skills and clinical knowledge, respectively. When technical skills were compared between cohorts, there were no differences observed in both pre- and post-testing (P = .08). ConclusionsA fresh cadaver laboratory is an effective method to provide proficiency in emergency technical skills not acquired during the clinical years of medical school.

The impact of a surgical boot camp on early acquisition of technical and nontechnical skills by novice surgical trainees

BackgroundAcquisition of skills early in surgical training represents a significant challenge at present because of training time constraints. The aim of this study was to investigate if an intensive surgical boot camp was effective in transferring skills at the beginning of a surgical training program. MethodsNew core surgical trainees (n = 58) took part in a 5-day boot camp. There were pretest and posttest assessments of knowledge, technical skills, and confidence levels. The boot camp used simulation and senior surgical faculty to teach a defined range of technical and nontechnical skills. ResultsThe scores for knowledge (53.8% vs 68.4%, P < .01), technical skills (35.9% to 60.6% vs 50.6% to 78.2%, P < .01), and confidence levels improved significantly during boot camp. Skills improvements were still present a year later. ConclusionThe 5-day surgical boot camp proved to be an effective way to rapidly acquire surgical knowledge and skills while increasing the confidence levels of trainees.

Strategies for Enhancing Females Participation in Technical, Vocational Education and Training (TVET) in Nigeria

There is generally low enrolment of female students in Technical, Vocational Education and Training (TVET) in Nigeria. This study was carried out to determine strategies to enhance female participation in TVET in Nigeria hitherto dominated by males. The study adopted a survey research design. Three research questions were formulated to guide the study. The population of 153 comprised 95 female technical teachers, 58 female administrators in the technical colleges and skill acquisition centres in the zones covered by the study. The instrument was face-validated by three TVET experts in University of Nigeria, Nsukka. Cronbach Alpha was used to establish the reliability and a reliability coefficient of 0.85 was obtained. Mean and standard deviation were used to analyse the data collected. The strategies determined were agreed upon as enhancement strategies as well as benefits accruable if females embrace TVET. It was recommended that wives of State governors should establish women organization in technology to sensitize females on the benefits of TVET. Money should be earmarked by government and other stake holders in technical education to ensure effective running of female-enhanced TVET programme. KEYWORDS: Technical, Vocational Education and Training, Females in TVET, Participation, Strategies.

Barbed reposition pharyngoplasty (BRP) for OSAHS: a feasibility, safety, efficacy and teachability pilot study. "We are on the giant's shoulders".

A new palatal procedure for snoring/obstructive sleep apnea (OSA) is described. The procedure was named as barbed reposition pharyngoplasty (BRP). The technique is described step by step. The new surgical technique was carried out in ten adult OSA patients with mean age of 53.4 ± 12.4 years (average 30-70) with confirmed retropalatal obstruction. In this pilot study; we assessed the feasibility by calculating the number of cases that failed to be operated and converted to other palatal technique during the same surgical setting, safety was assessed by evaluating both intra-operative and post-operative complications, teachability measured by the learning curve of our team members (the time of surgical procedure). In this study, the technique is proved to be feasible in all cases. There were no significant intra-operative or post-operative complications. Objective clinical improvement was confirmed by polysomnography 6 months post-operative with significant decrease in mean AHI from 43.65 ± 26.83 to 13.57 ± 15.41 (P = 0.007), daytime sleepiness assessed by Epworth Sleepiness Scale from 11.6 ± 4.86 to 4.3 ± 2 (P < 0.01), ODI from 44.7 ± 27.3 to 12.9 ± 16.3 (P = 0.004). Operative time decreased over the course of the study with an initial steep ascent in technical skill acquisition followed by more gradual improvement, and a steady decrease in operative time to as short as 20 min. Our preliminary results suggest that BRP technique is feasible, safe and effective in management of OSA patients. Moreover, it is easy to learn even for not experienced surgeons, less time consuming and with no significant complications.

Yes, but does it produce better doctors?

Yes, but does it produce better doctors?

MP23-13 MEDICAL STUDENT DELIBERATE PRACTICE ON A VIRTUAL-REALITY CURRICULUM CAN ACHIEVE EQUIVALENCY TO SENIOR UROLOGY RESIDENT REAL-TIME TRAINING

You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment II1 Apr 2015MP23-13 MEDICAL STUDENT DELIBERATE PRACTICE ON A VIRTUAL-REALITY CURRICULUM CAN ACHIEVE EQUIVALENCY TO SENIOR UROLOGY RESIDENT REAL-TIME TRAINING Ahmed Ghazi, Aisha Siebert, Anees Fazili, Vineet Agrawal, Changyong feng, and Sarah Peyre Ahmed GhaziAhmed Ghazi More articles by this author , Aisha SiebertAisha Siebert More articles by this author , Anees FaziliAnees Fazili More articles by this author , Vineet AgrawalVineet Agrawal More articles by this author , Changyong fengChangyong feng More articles by this author , and Sarah PeyreSarah Peyre More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1256AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Robotic virtual reality (VR) trainers have become an integral part of most urology programs. However, most surgical training programs struggle to incorporate them into their residency curricula. Several trials have demonstrated it is not the simulator that provides the learning, but rather it is the type of practice on the simulator that results in effective technical skills acquisition. Factors common to effective simulation training include; feedback, repetitive practice and task variation with clearly defined goals, the foundation of what has been termed deliberate practice. There has been little work to systematically investigate the effectiveness of deliberate practice within urological training. We hypothesized that novice trainees who engaged in a VR, deliberate practice, partial-task curriculum would demonstrate technical ability similar to residents with conventional informal teaching and feedback in the operating room. METHODS 13 medical students without any prior urologic experience completed a VR curriculum designed for vesicourethral anastomosis (VUA). This included: thread the rings, needle targeting, suture sponge, tubes, continuous suturing and knot tying exercises on the daVinci surgical skills simulator. Students trained to proficiency (90% overall score without critical errors) with expert feedback. At the end of training, each student was filmed completing a VUA on a dry-lab physical model (3-Dmed Franklin, Ohio) using the daVinci robot. 5 current and previous urology residents (PGY 4-6) with hands on radical prostatectomy training were filmed performing a similar anastomosis. 3 skilled urologists graded films in a blinded fashion using a modified Objective Structured Assessment of Technical Skill scale (range 1-30). RESULTS The median combined final score for medical students was 25.7 (IQR, 6.5-19.5), compared with 26 (IQR, 6.4-19.3) for residents (P=0.57). For each individual grader, there was no difference in median final scores between both groups (table 1). CONCLUSIONS Deliberate, individualized practice on a VR simulator improves technical performance similar to real-time training. This has implications to greatly improve the future of implementing simulation-based curricula in residency training programs. Modified OSATS† Medical students Deliberate Practice (Mean score) Residents hands-on operative training (Mean score) P-value Needle positioning 3.8 4.2 Needle entry 4.6 4.2 Tissue trauma 3.9 4 Suture alignment 4.2 4.2 Tissue approximation 4.5 5 Knot tying 4.6 4.4 Total score 25.6 26 0.57 † OSATS: Objective Structured Assessment of Technical Skill scale © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e272 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ahmed Ghazi More articles by this author Aisha Siebert More articles by this author Anees Fazili More articles by this author Vineet Agrawal More articles by this author Changyong feng More articles by this author Sarah Peyre More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Difficulties encountered by physicians in interpreting focused echocardiography using a pocket ultrasound machine in prehospital emergencies

Pocket ultrasound devices (PUDs) increase the scope of transthoracic echocardiography. We assessed the ability of emergency physicians (EPs) to obtain and interpret views using PUDs in prehospital emergencies. Nine EPs underwent a 2-day training program focused on acquisition of four views and on evaluation of left ventricular function, right ventricular size, the inferior vena cava, and detection of pericardial effusion. Then, EPs used a PUD to perform transthoracic echocardiography in patients with shock or acute respiratory failure. The quality and interpretation of views were graded by an expert as not obtained/inadequate, adequate, or optimal. Agreement between the expert and the physicians was evaluated using Cohen's κ test. One hundred consecutive exams were evaluated in patients with shock or acute respiratory failure. Parasternal long-axis and short-axis views, and a subcostal view were not obtained or inadequate in 56, 54, and 54 patients, respectively. An apical four-chamber view was not obtained or inadequate in 33 patients. One, two, or three views were graded as adequate or optimal in 86, 65, and 35 patients. Agreement between physicians and experts for left ventricular systolic function, right ventricular size, and pericardial effusion was weak [κ 0.37 (0.17; 0.59), 0.27 (0.023; 0.53), and 0.33 (-0.008; 0.67)]. Agreement for inferior vena cava evaluation was very weak [0.13 (-0.17; 0.43)]. After a very short training program, echocardiography using a PUD in prehospital emergencies was feasible in half of patients. Acquisition of technical skills is reasonable, but accurate evaluation of cardiac function may require more extensive training.

Photography as an agent of transformation: education, community and documentary photography in post-war Britain

Radical political activism in the 1970s and 1980s had a huge impact on documentary photography in Britain. Community organisations and photography collectives emerged and endeavoured to democratise the arts for those who would not otherwise have come into contact with them. Community photography used the technology to break down the barriers between artist and audience. It involved participation in the production of ideas and meanings, the active transference of skills and the acquisition of technical and aesthetic skills within communities in the hope that arts techniques/activity would become an integral part of everyday lives. For many of the projects the central objective was about learning – enabling an understanding of how events, ideas, and social relations are made meaningful through the promotion of visual literacy. This paper will document the emergence of the community photography movement in 1970s and ’80s Britain, the learning strategies developed and the arguments around the fragmenting of alternative photographic practice in the 1980s with the movement away from putting cameras into people’s hands towards greater engagement with cultural theory and the politics of representation.

Want to Graduate Clinicians Who Care? A Caring Behavior Scale for Healthcare Students (S740)

Objectives Discuss the importance of incorporating a caring behavior measuring instrument into palliative care education. Summarize the process of developing an instrument. Describe the psychometric properties of The Caring Behavior Scale. Background. Caring is the core and essence of quality humanized care. However, caring and other affective objectives receive little to no attention in healthcare education compared with the current emphasis on the acquisition of technical skills. A valid and reliable tool to measure caring behaviors of healthcare students could help cultivate and motivate their caring behaviors. However, no caring behaviors measuring instrument is currently available that is designed from an educational perspective. Research Objective. The development and the psychometric evaluation of an instrument to measure healthcare students’ caring behaviors. Methods. The study consisted of two phases and five steps. The first phase was concerned with the development of content domains and items, while the second phase focused on the initial psychometric evaluation and data analysis of the scale. In phase I, content domains were defined based on a qualitative study conducted by the researcher to examine the meaning of caring for patients in Egypt. Scale items were generated, the instrument content validity was evaluated, and the instrument was pretested. In phase II, the instrument was used to measure the caring behaviors of 112 nursing students. The derived data was used in the factor analysis to determine construct validity. Results. The scale was proved to be valid with a CVI (Content Validity Index) of 0.97 and showed high internal consistency reliability with a Cronbach’s alpha of .93. The resulting scale consists of 28 items in three subscales. Subscale I: ‘‘Having a relationship as a human being/Presencing,’’ subscale II: ‘‘Preserving patient’s dignity’’ & subscale III: ‘‘Comforting.’’ Conclusions. The Caring Behavior Scale is a reliable and valid instrument to measure caring behaviors of healthcare students. Implications. Further research is needed to accumulate evidence for the validity and reliability of the scale. Incorporating the scale into undergraduate healthcare education and ongoing behavioral training of healthcare professionals could help promote the perception of patients and their families of the quality of clinicians’ caring behaviors.