Allied Health Professional Training Research Articles

Qualitative exploration of medical student experiences during the Covid-19 pandemic: implications for medical education

BackgroundDuring the Covid-19 pandemic medical students were offered paid roles as medical student healthcare assistants. Anecdotal reports suggested that students found this experience rich for learning. Previous studies have explored alternative models of student service, however this defined medical student support role is novel.MethodsIndividual semi-structured interviews were recorded with 20 medical students at a UK medical school exploring their experiences of placement learning and experiences of working as healthcare assistants. Responses were analysed qualitatively using a framework approach. The framework was developed into a model describing key findings and their relationships.ResultsInterviews yielded data that broadly covered aspects of (1) Medical students’ experiences of clinical placement learning (2) Medical students’ experiences of working as medical student healthcare assistants (3) Learning resulting from working as a healthcare assistant (4) Hierarchies and professional barriers in the clinical environment (5) Influences on professional identity.Participants described barriers and facilitators of clinical learning and how assuming a healthcare assistant role impacted on learning and socialisation within the multidisciplinary team. Students became increasingly socialised within the healthcare team, contributing directly to patient care; the resulting social capital opened new opportunities for learning, team working and enhanced students’ interprofessional identity. Students described the impact of these experiences on their aspirations for their future practice.ConclusionsChanges to work patterns in healthcare and delivery models of medical education have eroded opportunities for students to contribute to healthcare delivery and be embedded within a team. This is impacting negatively on student learning and socialisation and we suggest that medical curricula have much to learn from nursing and allied health professional training. Longitudinal embedment with a multidisciplinary team, where students have a defined role and work directly with patients may not only add value to clinical service, but also overcome current barriers to effective placement learning and interprofessional identity formation for medical students.

Perceptions, attitudes and training needs of primary healthcare professionals in identifying and managing frailty: a qualitative study

Key summary pointsAimTo explore the perceptions and attitudes of primary health care (PHC) professionals towards frailty in a country where geriatrics is not recognised as a specialty, and to explore their training needs in the identification and management of frailty.FindingsThe main barriers towards identifying and managing frailty are associated with the healthcare system, with the most important ones identified to be a gap in geriatric education and training of professionals, as well as problems with staffing of allied health professionals (AHPs) in community settings. However, PHC professionals are motivated and receptive to training in frailty, and they particularly value interactive learning with a focus on practical skills.MessageThere is an imperative need for education and training of PHC professionals, recruitment and training of AHPs and interdisciplinary collaboration for the delivery of person-centred care for people with frailty living in the community.

P050: The Northern Amazing and Awesome Model: Using positive deviance to impact patient care

Introduction: Positive deviance recognizes that there are individuals and teams within our community of practice that succeed in spite of system constraints. Amazing and awesome rounds has been proposed as a forum to identify behaviours and processes that lead to exceptional results. The objective of this study was to determine the feasibility and acceptability of a structured amazing and awesome rounds model through an innovative educational intervention. Methods: The authors engaged a broad range of professional designations(physicians, surgeons, nurses, respiratory therapists, administrative staff) at a tertiary care institution. A&A rounds were open to all allied health professionals and administrative staff. The Northern A&A rounds model was developed, implemented, and then evaluated as a four-part intervention. This consisted of: 1) Allied health professional training on case selection and analysis, 2) Engaging inter professional members, 3) disseminating lessons learned, and 4) creating an administrative pathway for acting on issues identified through the A&A rounds. The measures of intervention feasibility included the proportion of sessions adherent to the new model and A&A rounds attendance. Post intervention surveys of presenters and attendees were used to determine intervention acceptability. A&A presentation content was reviewed to determine the most frequently adopted components of the model. Results: Nine out of 9(100%) of presented cases were adherent to the three components of the Northern A&A Model. A&A rounds were highest attended of all hospital wide grand rounds(N = 75 SD 2.4 P < 0.001). Nine case presentations were analyzed and 7 action items were identified for amplification across the hospital. Including 3 case reports published of a novel approach to a patient case,a rapid referral for trauma patients at risk for PTSD, AED placement in all community clinics and routine debrief after resuscitations. Presenters included a broad representation of hospital staff including surgeons, emergency physicians, radiologists, nurses, and administrators. Conclusion: The Northern A&A Model was a feasible intervention that was perceived to be effective by both presenters and attendees. The authors believe that this could be readily applied to any hospital seeking to enhance quality of care and patient safety.

African Forum for Research in health (AFREhealth) student exchange pilot: an impact assessment

Abstract Background For many medical and allied health students from African countries, the opportunity to undertake a global health elective abroad is unaffordable or inaccessible. Therefore, an imbalance has emerged where many African institutions host students from developed countries but their own students rarely go on electives in developed countries. Global Educational Exchange in the Medical and Health professions (GEMx), a service programme of the Educational Commission for Foreign Medical Graduates (ECFMG) partnered with the African Forum for Research in Health (AFREhealth) to implement a south-to-south student exchange pilot through intra-institutional partnerships. The aim was to provide affordable global-health learning opportunities to African students. Methods 13 medical and nursing institutions in eight African countries participated in the AFREhealth pilot. Institutions entered into a multilateral agreement. The GEMx web-based system was used to centralise elective placements where students gained access to opportunities and applied online. Host institutions waived their administrative fees and provided a manager to support incoming students. ECFMG hired a contractor to do partnership development and work with students and leaders at participating institutions. ECFMG GEMx provided student mini-grants to cover travel, accommodation, and living expenses. We used SurveyMonkey to collect feedback from students, institutions, and AFREhealth leadership and to run descriptive analysis. Findings Between April, 2017, and June, 2018, GEMx facilitated 48 student exchanges in medicine, nursing, and pharmacy in Ghana, Kenya, Malawi, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe. 20 students (42%) reported that they had not previously gone on an elective exchange in another country and that this opportunity would not have been possible without GEMx. The most common learning experiences reported by institutions were that students: learned about and compared different health systems; improved clinical skills and gained knowledge that is applicable back home; increased confidence; developed professional networks; and managed and cared for patients who differed from those in their previous educational experience. These findings correlated with feedback collected from students. Interpretation Translation and implementation for impact in global health requires models that provide opportunities for global exposure to various health-care settings. With little global exposure for African medical and allied health professional training students, the south-to-south model provides a suitable and cost-effective platform to address the gap. Outcomes from the pilot showed a strong commitment from intra-institutional partners within AFREhealth to the south-to-south model. Although ECFMG GEMx funding made student exchanges possible for the AFREhealth student exchange pilot, additional funding contributions are needed to expand the south-to-south student exchange programme. Funding ECFMG Challenge Grant.

Interprofessional Education for BSW Students: A Pilot Course

The focus on interprofessional education (IPE) for professional training programs in allied health professions such as social work has increased recently. There is limited pedagogical literature regarding either the instruction or application of IPE in any given profession. Based on a co-teaching model of instruction, this article delineates the preparation and integration process of a pilot course on IPE. The pilot course was taught at a small liberal arts college where it was cross-listed in two undergraduate professional programs in social work and speech-language pathology. This article discusses the relevance of including IPE in allied health professional training programs. Additionally, this article outlines the timeline for developing and implementing the course, from conceptualization to the integration phases including implications from student evaluations of their experience in the course. Elements of the course including delivery, descriptions of assignments, and projects also are discussed.

3D printed reproductions of orbital dissections: a novel mode of visualising anatomy for trainees in ophthalmology or optometry.

The teaching of human head, neck and orbital anatomy forms a critical part of undergraduate and postgraduate medical and allied health professional training, including optometry. While still largely grounded in cadaveric dissection, this method of instruction is constrained in some countries and regional areas by access to real human cadavers, costs of cadaver bequest programmes, health and safety of students and staff and the shortage of adequate time in modern curricula. Many candidates choosing a postgraduate pathway in ophthalmological training, such as those accepted into the Royal Colleges of Ophthalmology in the UK, Australia and New Zealand programmes and the American Academy of Ophthalmologists in the USA, are compelled as adult learners to revise or revisit human orbital anatomy, ocular anatomy and select areas of head and neck anatomy. These candidates are often then faced with the issue of accessing facilities with dissected human cadaveric material. In light of these difficulties, we developed a novel means of creating high-resolution reproductions of prosected human cadaver orbits suitable for education and training. 3D printed copies of cadaveric orbital dissections (superior, lateral and medial views) showing a range of anatomical features were created. These 3D prints offer many advantages over plastinated specimens as they are suitable for rapid reproduction and as they are not human tissue they avoid cultural and ethical issues associated with viewing cadaver specimens. In addition, they are suitable for use in the office, home, laboratory or clinical setting in any part of the world for patient and doctor education.

The production of anatomical teaching resources using three-dimensional (3D) printing technology.

The teaching of anatomy has consistently been the subject of societal controversy, especially in the context of employing cadaveric materials in professional medical and allied health professional training. The reduction in dissection-based teaching in medical and allied health professional training programs has been in part due to the financial considerations involved in maintaining bequest programs, accessing human cadavers and concerns with health and safety considerations for students and staff exposed to formalin-containing embalming fluids. This report details how additive manufacturing or three-dimensional (3D) printing allows the creation of reproductions of prosected human cadaver and other anatomical specimens that obviates many of the above issues. These 3D prints are high resolution, accurate color reproductions of prosections based on data acquired by surface scanning or CT imaging. The application of 3D printing to produce models of negative spaces, contrast CT radiographic data using segmentation software is illustrated. The accuracy of printed specimens is compared with original specimens. This alternative approach to producing anatomically accurate reproductions offers many advantages over plastination as it allows rapid production of multiple copies of any dissected specimen, at any size scale and should be suitable for any teaching facility in any country, thereby avoiding some of the cultural and ethical issues associated with cadaver specimens either in an embalmed or plastinated form.

An analysis of allied health professional training in care homes for older people in Glasgow

The training of care staff in care homes for older people is important to ensure the maintenance of evidence‐based and effective care. Moreover, training can assist in changing attitudes and promoting improved quality care for residents.To this end the Allied Health Professional (AHP) Care Homes Training Team provides training to care staff throughout the greater Glasgow area. This study sought to elicit service user views and opinions about the team's current provision to assist in informing prospective developments and enhancing future performance. Many of the responses discussed training in general in care homes and so should be of interest to all AHPs and others with an interest in care homes. Ten semi‐structured interviews were undertaken with home management staff, which were thematically analysed. The response rate was 100%. 648 care staff had received training from the team in the ten care homes. However, only 36% of these staff remained employed by the homes at the time of the study. Therefore, only the remaining staff received postal semi‐structured questionnaires. The response rate was 14% for these staff. A range of service users' opinions and views were elicited.Topics covered included: induction training, career progression through training, training records, team training and support provision, changes implemented as a result of training, barriers to implementing training, structure/times/content and delivery of training sessions, training gaps, information and training for managers and appropriate topics for training. Feedback was extremely positive but the study raised wider implications for older people's care in care homes, which merit further research and debate.

More than a device: today's medical technology companies provide value through service.

When physicians implant cardiac rhythm management devices, they establish a long-term relationship with those devices and with the manufacturers of those devices. The therapeutic value that each device will provide to its patient is enhanced throughout the life of the device by the services that the manufacturer provides. Services are provided prior to, during and long after implantation. Services include physician and allied health professional training, quality assurance programs, therapy outreach initiatives, on site technical support during device implantation and follow-up, technical service expertise and customer service support. The costs of these services are substantial. When assessed on a per device basis, the service costs may actually exceed the costs of manufacture. Further, the costs of these services are rising. Over the past five years, the number of implanted cardiac rhythm management devices has doubled. Industry field forces have tripled in size. Clearly, industry is dedicated to providing service as a critical element in achieving excellent patient outcomes.

The optimum utilization and appropriate responsibilities of allied health professionals

A number of issues related to the optimum utilization and appropriate responsibilities of allied health professionals are raised based upon the perspective of the experience of the U.S. in recent years. Various definitions and concepts related to these issues are presented in order to assess the state of both training and use of allied health professionals in diverse settings. It is suggested that idiosyncratic needs and solutions in specific cultural contexts do not allow a generalizable conclusion to be drawn, although several principles can be put forward. The experience in the development and training of allied health professionals in the U.S. is analyzed using a variety of frameworks, including structural-organizational models as well as an historical approach. An empirical example of the extent and level of responsibilities of a variety of types of allied health professionals is offered, and the role of associated practice characteristics is observed to impinge upon role performance, giving an insight into the problems and potentials of these manpower resources. Finally, a discussion of the western model as a paradigm for allied health professional training and utilization in the global context is considered, and various strategies and suggestions for the future are offered.