Clinical Knowledge Assessment Research Articles

Training assessment of clinical knowledge and skills in the use of negative pressure wound dressings in cardiac patients

Funding AcknowledgementsType of funding sources: None.ObjectiveAn assessment was conducted to analyse the level of improvement impact one can have on clinical knowledge and skills in the use of a novel negative pressure wound dressings in high-risk cardiac patients along with their years of experience following a training program conducted among our cardiac staff.MethodsIn a prospective study involving twenty cardiac nursing staff from December 2020 to June 2021 who voluntarily participated in the study. Their pre and post training assessment of clinical knowledge and skills were assessed using twenty questionnaires. The pre and post training educational knowledge and skills scores were analysed along with their years of clinical experience.ResultsIn the six-month period n=20 (100 %) were compliant to the training despite the covid-19 pandemic.The study group showed an average pre-training score of 10.5% (Knowledge 5.25% and Skills 5.25%)The average post-training score of84.75% (Knowledge 42.25% and Skills 42.25%)While comparing the years of clinical experience against the pre and post training scoresSeventeen (n=17/20, 85%) had five to ten years experience compared to three (n-3/20, 15%) with more than 20 years of experience.ConclusionBoth clinical knowledge and skills can be augmented through regular training members with more than ten years of clinical experience might have an added benefit and their experience could be important to train younger staff members with less clinical experience.

The Foundation Programme application: an alternative to the Situational Judgement Test.

Dear editor We read with great interest the article by Singagireson et al on the fairness of the Situational Judgement Test (SJT) as a method for ranking medical students applying to the UK Foundation Programme.1 The SJT assesses the applicant’s approach to hypothetical, yet realistic, situations which could be encountered by a newly qualified, Foundation Year 1 (FY1) doctor. To perform well, applicants should be familiar with the roles and responsibilities of an FY1 doctor. However, as the SJT is not an assessment of clinical knowledge, revision is difficult and therefore students aiming to do well cannot necessarily rely on extensive preparation. Many would argue that this is unfair. The lack of correlation between the performance at medical school and the performance in the SJT is also worrying.2 We strongly believe that students who excel in medical school should excel as doctors since the curricula of all UK medical schools are individually approved by the General Medical Council – the organization which sets standards for doctors and oversees their education and training. Accordingly, we believe that the SJT should be replaced by an assessment that correlates more strongly with performance in medical school. This is likely to be the one evaluating the clinical knowledge of the candidates. We find it difficult to understand why this would pose a problem as the SJT is essentially used as a tool to compare medical students across the country. An additional advantage of using such an assessment is that students are better able to prepare for it. Another alternative to the SJT is to interview and subsequently score all Foundation Programme applicants. However, due to the vast number of candidates every year, this is unlikely to be practical. Nevertheless, we feel that it is important for all medical students to have good insight into the role of an FY1 doctor and therefore an assessment similar to the SJT could perhaps be integrated into undergraduate medical education as a summative examination.

A trial of e-simulation of sudden patient deterioration (FIRST2ACT WEB™) on student learning

High-fidelity simulation pedagogy is of increasing importance in health professional education; however, face-to-face simulation programs are resource intensive and impractical to implement across large numbers of students. To investigate undergraduate nursing students' theoretical and applied learning in response to the e-simulation program-FIRST2ACT WEBTM, and explore predictors of virtual clinical performance. Multi-center trial of FIRST2ACT WEBTM accessible to students in five Australian universities and colleges, across 8 campuses. A population of 489 final-year nursing students in programs of study leading to license to practice. Participants proceeded through three phases: (i) pre-simulation-briefing and assessment of clinical knowledge and experience; (ii) e-simulation-three interactive e-simulation clinical scenarios which included video recordings of patients with deteriorating conditions, interactive clinical tasks, pop up responses to tasks, and timed performance; and (iii) post-simulation feedback and evaluation. Descriptive statistics were followed by bivariate analysis to detect any associations, which were further tested using standard regression analysis. Of 409 students who commenced the program (83% response rate), 367 undergraduate nursing students completed the web-based program in its entirety, yielding a completion rate of 89.7%; 38.1% of students achieved passing clinical performance across three scenarios, and the proportion achieving passing clinical knowledge increased from 78.15% pre-simulation to 91.6% post-simulation. Knowledge was the main independent predictor of clinical performance in responding to a virtual deteriorating patient R(2)=0.090, F(7, 352)=4.962, p<0.001. The use of web-based technology allows simulation activities to be accessible to a large number of participants and completion rates indicate that 'Net Generation' nursing students were highly engaged with this mode of learning. The web-based e-simulation program FIRST2ACTTM effectively enhanced knowledge, virtual clinical performance, and self-assessed knowledge, skills, confidence, and competence in final-year nursing students.

Workplace‐based assessment: a new approach to existing tools

Key content Implementation of workplace‐based assessment (WPBA) has been fraught with difficulties and the RCOG is changing the assessments in light of these issues. Current WPBA tools are principally formative assessments rather than summative assessments. The distinction between formative assessment (for learning) and summative assessment (of learning) is crucial to understand the changes. A revised approach to WPBA, with formative and summative encounters, is aimed at engaging both trainees and trainers. Delivery of the changes to WPBA is the greatest challenge and the impact will need evaluation. Learning objectives To understand that WPBA entails the use of robust tools capable of capturing elements of clinical assessment and reflective practice. To appreciate the role of WPBA within the assessment of clinical knowledge, skills and practice more widely. To explore the new categorisation of WPBA tools currently used within O&amp;G specialty training, informed by the principal objective of individual encounters To appreciate that formative WPBA encounters will focus on the provision of structured, mandatory feedback whilst encouraging reflective practice by the trainee. To understand that summative WPBA encounters will constitute assessments of observed performance, which allow trainees to demonstrate competence. EthicsNot applicable

An audit of the UK national cancer referral guidelines for suspected oral mucosal malignancy

To carry out an in depth evaluation of the vocational training year.Qualitative structured focus groups and interviews.Three regional vocational training schemes in the south of England.Each scheme provided a group of six vocational dental practitioners (VDPs) who met with researchers at three points in the training year. Additionally one of the researchers interviewed advisers and trainers.and recommendations Possible improvements were identified in the appointment process, induction, tutorials, assessment of clinical knowledge, technical skill, social and communication skills and development of the skills of reflective practice.The vocational training year is a very good learning experience, which could be further enhanced to make it excellent.

'In the real world we're all put on the spot at some time or other, so you need to be prepared for it': An exploratory study of an oral method of assessing knowledge of mental health law

The education and training of Approved Social Workers (ASWs) involves at least 60 days of college and practice-based learning. A major component of the college-based curriculum is the teaching and assessment of knowledge of mental health law. One programme in England assesses student knowledge of law by an oral examination that includes a case discussion and questions about the Mental Health Act 1983. Oral assessment of knowledge of law is commonplace for those entering legal professions. Oral assessment of clinical knowledge in professions such as medicine and psychiatry is similarly frequent. However, examination by oral assessment is not usual in social work education. An exploratory study by postal questionnaire of all past students of the programme and their line managers was undertaken to establish their views of this means of assessing knowledge of law. This paper considers the results of the research and outlines student perceptions of the law oral assessment as preparation for practice as an ASW. The paper focuses on three distinct but interlinked areas--education, assessment and practice--and suggests some implications for educators and practitioners, which are especially relevant in the light of the current review of mental health legislation.

The structured oral examination as a method for assessing surgical residents

The purpose of this study was to determine the overall reliability, inter-rater reliability, and criterion validity of the structured oral examination (SOE) for assessing surgical residents. An SOE consisting of four predetermined clinically oriented scenarios was administered to 23 second postgraduate year surgical residents. Each scenario had five to six questions, each with a specific marking scheme. Candidates were assessed by two examiners and scores were derived independently. Overall reliability (Cronbach's alpha) was 0.75. Inter-rater reliability was significant for each pair of examiners and each question (r = 0.78 to 0.91; p < 0.0001). Criterion validity was measured by correlating SOE scores with multiple-choice examination (MCQ) and objective structured clinical examination (OSCE) scores. Correlations between the SOE and MCQ and OSCE were significant and fell into the moderate range (0.48 to 0.51). The results of this study show that the SOE is useful in the assessment of clinical knowledge and problem-solving abilities of the surgical resident. Overall and inter-rater reliabilities achieved exceed those of traditional oral examination formats.