Clinical Communication Skills Research Articles

Acquisition of key clinical communication skills through simulation-based education: findings from a program for postgraduate psychiatry trainees (ComPsych)

ObjectiveFew studies have investigated the maintenance of skills acquired in classroom-based clinician education. Using an advanced simulation-based clinical communication skill training program for postgraduate psychiatry education (ComPsych), we aimed to investigate skill acquisition through assessing changes in competence (abilities) and performance (practice).MethodsForty trainee psychiatrists (15 males; age range 26–48) participated. Video-recorded Standardized Patient Assessments (SPAs) were delivered twice pre- and post-training to assess learning. Skills were coded by independent psychologists using the Core Communication Skills (CCS) coding system. Simulated patients (SPs) rated trainees' communication performance using the Sim-Patient SPA checklist. Paired t-tests, linear mixed models and logistic mixed models assessed changes in communication skills over time.ResultsFor SPAs, reliability of coder ratings was deemed acceptable (ICC range 0.67 to 0.87). Mean post-training communication performance significantly increased for skills in agenda setting (p < 0.001), information organization (p < 0.001), empathic skills (p = 0.046), and overall skills performance (p = 0.001). Significant decreases for questioning skills were indicative of reduced reliance on these skills post-training. SPs rated all skillsets higher post-training. A modest relationship was detected between frequency (coded) and (SP-rated) quality of communication skills. Improvements in agenda setting and information organisation skills were retained ~ 6 weeks post-training.ConclusionsTraining improved patient-centered communication skills in psychiatry trainees, particularly skills in agenda setting and information organization, with skills retained ~ 6 weeks post-training. There was reduced reliance on questioning skills, which are well utilised generally. The study supports the benefits of this method of communication skills training into postgraduate psychiatry education.

Exploring Medical Student Experiences With Direct Observation During the Pediatric Clerkship.

Direct observation (DO) enables assessment of vital competencies, such as clinical skills. Despite national requirement that medical students experience DOs during each clerkship, the frequency, length, quality, and context of these DOs are not well established. This study examines the quality, quantity, and characteristics of DOs obtained during pediatrics clerkships across multiple institutions. This multimethod study was performed at 6 U.S.-based institutions from March through October 2022. In the qualitative phase, focus groups and/or semistructured interviews were conducted with third-year medical students at the conclusion of pediatrics clerkships. In the quantitative phase, the authors administered an internally developed instrument after focus group discussions or interviews. Qualitative data were analyzed using thematic analysis, and quantitative data were analyzed using anonymous survey responses. Seventy-three medical students participated in 20 focus groups, and 71 (97.3%) completed the survey. The authors identified 7 themes that were organized into key principles: before, during, and after DO. Most students reported their DOs were conducted primarily by residents (62 [87.3%]) rather than attendings (6 [8.4%]) in inpatient settings. Participants reported daily attending observation of clinical reasoning (38 [53.5%]), communication (39 [54.9%]), and presentation skills (58 [81.7%]). One-third reported they were never observed taking a history by an inpatient attending (23 [32.4%]), and one-quarter reported they were never observed performing a physical exam (18 [25.4%]). This study revealed that students are not being assessed for performing vital clinical skills in the inpatient setting by attendings as frequently as previously believed. When observers set expectations, create a safe learning environment, and follow up with actionable feedback, medical students perceive the experience as valuable; however, the DO experience is currently suboptimal. Therefore, a high-quality, competency-based clinical education for medical students is necessary to directly drive future patient care by way of a competent physician workforce.

An innovative clinical interprofessional education experience to advance knowledge and skill in communication with aphasic patients: A randomized controlled pilot study

BackgroundBecause of its impact on communication, aphasia increases patients’ risk for poor healthcare outcomes. Healthcare teams should be equipped to effectively serve this population. PurposeThe primary aim was to pilot the effectiveness of an aphasia communication.partner training program for healthcare students by examining changes in knowledge and behavior. A secondary aim assessed learners' understanding of other healthcare professionals’ roles and responsibilities. MethodStudents in pharmacy, physician assistant, and occupational therapy were randomly assigned to experimental or control groups. The former participated in didactic training with speech-language pathology students and mentored interactions with aphasic patients. Both groups completed pre-/post-training knowledge assessments and participated in semi-structured patient interactions. DiscussionThe clinical IPE experience resulted in statistically significant differences in aphasia knowledge and associated behaviors. Additionally, learners’ understanding of healthcare professions improved. ConclusionsClinical IPE experiences are effective at improving clinical communication skills and increasing knowledge of language-impaired populations.

Does Medical Curriculum Impact on Empathy? A Longitudinal Study in a Sample of Undergraduate Medical Students

AbstractEmpathy in medical students is receiving increasing attention as it is fundamental to build and develop a functional patient-physician relationship. When looking at its determinants, demographic and academic factors seem to concur in shaping empathy in this population. Although data show strong gender differences and changes in empathy throughout medical school, it is not clear the direction of these changes and whether gender and curriculum features modulate them. This longitudinal study examined changes in empathy and explored gender differences throughout the medical school. Four consecutive cohorts of Italian medical students (N = 336) completed the Jefferson Scale of Empathy – Student (JSE-S) and the Interpersonal Reactivity Index (IRI) in their second year of study (before any clinical clerkship and communication skills courses) and fifth year of study (after a 2-year clinical clerkship and communication skills courses). Analysis of variance for repeated-measures revealed that, beyond the effect of gender, JSE-S total score and IRI Perspective Taking increased, whereas IRI Personal Distress and IRI Fantasy significantly decreased throughout medical school. No significant change in IRI Empathic Concern emerged over time. Student’s t-tests showed that female students displayed significantly higher mean scores than their male counterparts for all empathy measures in both their second and fifth years of medical training. The findings suggest that the medical curriculum affects self-reported empathy dimensions among undergraduate medical students. Further research is needed to deepen the understanding of the educational factors that promote the changes in empathy levels during medical training.

Audiology Students' Clinical Communication During Simulated Peer Role Play Consultations: An Exploratory Study.

The objectives of this study were to describe the clinical communication practices of student audiologists during case history taking and feedback giving using simulated peer role play consultations and to explore whether clinical communication skills outcomes can be achieved through simulated peer role play. An exploratory, qualitative research design was used for this pilot study. A total of four simulated peer role play consultations were video-recorded, comprising two adult diagnostic audiology case scenarios. Eight online interviews were conducted with the student participants following the simulated audiological consultation. Analysis of the video-recorded sessions incorporated an interactional sociolinguistic focus, and interviews were analyzed using inductive thematic analysis. Findings from the video analysis and interviews were triangulated, with a specific focus on establishing commonalities in terms of communication skills of student clinicians, reflections of their own skills, and the simulated peer patient's reflections on the student clinician's skills. Although variation was noted in terms of case history taking skills, feedback giving was similar among all student clinicians. These communication practices are consistent with findings from related literature on consultations with real patients. Student clinicians reflected on feedback giving as more challenging than case history taking, with room for improvement suggested by the simulated peer patients. Our findings highlight key questions regarding the use of peer simulation in facilitating the development of communication skills for audiological consultations among student audiologists. We discuss some considerations for using this approach to clinical training more effectively. https://doi.org/10.23641/asha.25492804.

Development and psychometric evaluation of a 360-degree evaluation instrument to assess medical students’ performance in clinical settings at the emergency medicine department in Iran: a methodological study

In the Iranian context, no 360-degree evaluation tool has been developed to assess the performance of prehospital medical emergency students in clinical settings. This article describes the development of a 360-degree evaluation tool and presents its first psychometric evaluation. There were 2 steps in this study: step 1 involved developing the instrument (i.e., generating the items) and step 2 constituted the psychometric evaluation of the instrument. We performed exploratory and confirmatory factor analyses and also evaluated the instrument’s face, content, and convergent validity and reliability. The instrument contains 55 items across 6 domains, including leadership, management, and teamwork (19 items), consciousness and responsiveness (14 items), clinical and interpersonal communication skills (8 items), integrity (7 items), knowledge and accountability (4 items), and loyalty and transparency (3 items). The instrument was confirmed to be a valid measure, as the 6 domains had eigenvalues over Kaiser’s criterion of 1 and in combination explained 60.1% of the variance (Bartlett’s test of sphericity [1,485]=19,867.99, P<0.01). Furthermore, this study provided evidence for the instrument’s convergent validity and internal consistency (α=0.98), suggesting its suitability for assessing student performance. We found good evidence for the validity and reliability of the instrument. Our instrument can be used to make future evaluations of student performance in the clinical setting more structured, transparent, informative, and comparable.

Measures of Clinical Performance and Communication Skills of EM Residents on Simulated Resuscitations are not Correlated

Measures of Clinical Performance and Communication Skills of EM Residents on Simulated Resuscitations are not Correlated

Hubungan Self-Compassion Dengan Tingkat Stress Dalam Menghadapi Osce Pada Siswa-Siswi Keperawatan Kelas Akhir Di SMK Kesehatan Logos

OSCE is a form of test used as a formative and summative exam to assess skill competency in various health sciences. OSCE requires students to demonstrate clinical skills, medical knowledge, and communication skills in realistic simulated situations. This makes the stress level in adolescence higher based on one of the factors that can reduce stress and improve students' well-being is self-compassion. This research is a quantitative research with a correlational descriptive design with a cross sectional approach. Results: Low category Self-Compassion means the lower the Self-Compassion, the higher the stress level and respondents with Stress Levels are in the medium stress category. And in the severe stress category. And the Pvalue is .002, so there is a significant relationship between self-compassion and stress levels in final year nursing students at Logos Health Vocational School in 2023. Conclusion: There is a relationship between self-compassion and stress levels in facing the OSCE among final year nursing students in Logos Health Vocational School in 2023.

Enhancing Surgical Nursing Student Performance: Comparative Study of Simulation-Based Learning and Problem-Based Learning.

Surgical nursing is a high-risk, high-pressure, and complex field. Nurses need extensive knowledge, skills, and abilities. Problem-Based Learning (PBL) and Simulation-Based Learning (SBL) are effective student-centered methods. Which method is better for surgical nurse training? More research is needed to determine the best approach for undergraduate surgical nurse education. To compare the impact of PBL and SBL on undergraduate nursing students' performance and improve learning outcomes in surgical nursing education. We used a pretest/post-test design with 318 nursing undergraduates randomly assigned to two groups. Participants completed three progressive scenarios focused on surgical nursing cases. Experts blindly reviewed video recordings using the 70-item Korean Nurses' Core Competence Scale (KNCCS) to assess performance. The 13-item Satisfaction and Self-confidence in learning Scale (SSS) measured learning confidence and satisfaction. SBL participants also completed the 16-item Educational Practices in Simulation Scale (EPSS) and 20-item Simulation Design Scale (SDS). The study found significant positive effects on both groups, with noticeable improvements in post-test, retention, and follow-up test results (P < 0.001). The SBL group showed higher competency levels in nurses (P < 0.001). The Cohen's d and effect size (r) for various skills were as follows: clinical performance (0.84767 and 6.39023), critical thinking (0.31017 and 0.15325), professional attitude (0.85868 and 0.39452), and communication skills (1.55149 and 0.61294). The satisfaction and self-confidence of nurses were higher in the SBL group (4.53±0.596; 4.47±0.611) compared to the PBL group (4.32±0.689; 4.25±0.632) in all dimensions of SSS (all P < 0.05). The SBL group also scored high in simulation design and EPSS. However, improvements are needed in fidelity, objectives, information, and students' expectations. SBL and PBL improve nurses' core competence, satisfaction, and self-confidence. SBL is superior. This study promotes student-centered education, enhancing surgical nursing professionals' quality and ensuring future patient safety.

Improving Adolescent Psychosocial Assessment through Standardized Patient Simulation: An Interdisciplinary Quality Improvement Initiative.

Adolescent suicide and mental illness have increased at alarming rates. Healthcare professionals report a lack of skill and confidence in obtaining adolescent histories and managing confidential care due to limited training in residency. Nursing professional development practitioners face challenges of adequately preparing interdisciplinary healthcare providers to assess, identify, and intervene at all points of contact with adolescents. To increase the confidence in clinical communication skills and clinical competency, and to increase the number of social work referrals related to modifiable risk factors for adolescent patients, a Texas pediatric tertiary care center utilized standardized patient (SP) methodology to supplement traditional clinical experiences with communication-focused education based on the Home, Education, Eating, Activities, Drugs, Sexuality, Suicidality, and Safety (HEEADSSS) interviewing. This quality improvement (QI) pilot demonstrated the benefits of utilizing standardized patient methodology in communication-focused education based on the HEEADSSS interviewing. Following the SP simulations, confidence in clinical communication skills increased by 13%, clinical competency in performing comprehensive psychosocial interviews increased by 11%, use of HEEADSSS increased by 64%, and social work referrals increased by 89%. This interdisciplinary SP interviewing simulation pilot was beneficial in improving the 36 physician and nursing residents' ability to conduct psychosocial assessments for risk factors of suicidality among adolescents.

Providing family updates: a primer for the medical trainee.

Providing family updates is a common clinical task for medical trainees and practitioners working in hospital settings. Good clinical communication skills are essential in clinical care as it is associated with improved patient satisfaction, understanding of condition, treatment adherence, and better overall clinical outcomes. Moreover, poor communications are often the source of medical complaints. However, while patient-centred communication skills training has generally been incorporated into clinical education, there hitherto remains inadequate training on clinical communications with patients' families, which carry different nuances. In recent years, it is increasingly recognized that familial involvement in the care of hospitalized patients leads to better clinical and psychological outcomes. In fact, in Asian populations with more collectivistic cultures, families are generally highly involved in patient care and decision-making. Therefore, effective clinical communications and regular provision of family updates are essential to build therapeutic rapport, facilitate familial involvement in patient care, and also provide a more holistic understanding of the patient's background and psychosocial set-up. In this article, we herein describe a seven-step understand the clinical context, gather perspectives, deliver medical information, address questions, concerns and expectations, provide tentative plans, demonstrate empathy, postcommunication reflections model as a practical guide for medical trainees and practitioners in provision of structured and effective family updates in their clinical practice.

1945 Hospital at Home - developing a novel simulation induction programme through quality improvement

Abstract Introduction The UK is expanding provision of acute medical care in people’s own homes through Hospital at Home (H@H) and virtual wards. Our H@H service is training junior doctors to meet the growing clinical need in this environment. We describe the use of simulation training to improve the H@H induction process. Methods From their experiences in H@H, junior doctors identified specific training needs to build relevant competencies. From this feedback, PDSA cycle one involved junior doctors designing a dedicated simulation training (H@H-SIM). Stations addressed clinical, practical and advanced communication skills required in H@H using high- and low-fidelity simulation. PDSA cycle two used post-course evaluation to refine H@H-SIM through introduction of FP10 prescribing stations, point-of-care testing (POCT) and greater emphasis on practical skills. Revisions were evaluated via participant questionnaire before and after the H@H-SIM. Results Cycle two of H@H-SIM involved twenty doctors. The clinical scenarios, prescribing and practical skills stations, including POCT and IV administration, were perceived as the most useful parts of training. Overall self-rated confidence in knowledge and skills to work in H@H improved from a mean of 6.9 to 7.7/10. Before H@H-SIM, 60% were ‘not confident’ with recognising end of life (EOL), IV administration or decision-making around remaining at home; 10% with advance care planning (ACP). After H@H-SIM, 10% felt ‘not confident’ with recognising EOL or ACP and 5% with IV administration. Concerns persisted with using equipment, prescribing and availability of senior support. An additional station on recording ECGs was suggested. Conclusions Working in a H@H context and seeing patients in their homes can be daunting for junior doctors. H@H-SIM embedded into induction is one way to prepare doctors for this role, improve their confidence and has potential for wider replication.

Video feedback combined with peer role-playing: a method to improve the teaching effect of medical undergraduates.

The purpose of this study was to investigate the effectiveness of implementation of video feedback combined with peer role-playing (PRP) teaching method in medical undergraduates adopting problem-based learning (PBL) teaching mode. The undergraduates of five-year clinical medicine who get enrollment of Wuhan local University from 2016 and 2018 were selected to be the research objects. The same grade level is randomly divided into several groups to carry out PBL, with 6-10 students in each group. Following the principle of voluntary participation, 34 students were enrolled in the study group and 33 students in the control group finally. The research regards group as the unit, and study report in group should be carried out to fulfill the research. In the study group, the students were asked to perform PRP report, and the report videos were used for feedback. At the same time, the control group reported by PPT, and the feedback was carried out according to the PPT. At the end of the study, the "Competency Improvement Satisfaction Questionnaire (CISQ)" was distributed to investigate students' satisfaction with this teaching method to improve their ability, Arizona Clinical Interview Score (ACIR) was administered in Chinese by a trained teacher unrelated using PRP method to assess students' clinical inquiry ability and communication skills, and theory test was performed to assess mastery of theoretical knowledge. The results show that the study group is superior to the control group in improving the interest of learning and the ability of independent learning, interpersonal communication and active problem solving. Although it is in terms of the confidence in becoming a real doctor and the ability of teamwork, language expression, clinical thinking cultivated, active knowledge acquired and understood that study group are better than the control group, the difference was not statistically significant. ACIR shows that the study group is significantly better than the control group in organization, timeline planning, and transition statements, openly questioning, smooth progress, and avoiding repetition, summarizing, understandable language, documentation and total score. There is no significant difference in eye contact and no interruption. The differences between the two groups are not statistically significant in terms of responsing to concerns, positive feedback, and additional questions. The theoretical test scores of the study group are significantly higher than those of the control group. Video feedback combined with peer role-playing teaching method implemented in medical undergraduates adopting PBL teaching mode is effective, it could stimulate interest in learning actively, improve interpersonal communication ability, improve learning efficiency and clinical knowledge and skills, and improve the confidence of becoming a real doctor. It is worthy of further research and promotion.

Assessment of Dental Student Satisfaction after Internships in Collaborative Dental Practices in Saxony-A Retrospective Questionnaire Analysis.

The goal for dental students of a university-based program should be to learn about practice procedures in a dental office as part of their studies in order to gain insight into day-to-day activities, such as organizational management, patient communication, and problem-solving strategies. All dental students from the Faculty of Medicine at the University of Dresden in Germany, who completed a one-week internship in an external dental office in the last year before taking the final exam, were invited to participate in the survey (total n = 182 in years 2017-2019 and 2022). After completing the internship, the students were asked to anonymously rate the distinctive competencies they had acquired during their dental studies in terms of clinical and social communication skills. The results of the survey showed a good practicability of the acquired dental knowledge and a general satisfaction of students during their internships. No significant influence of the COVID-19 outbreak and the resulting special regulations in dental practices during the pandemic on student satisfaction was found. Students were more satisfied with their completed internships in smaller cities. Therefore, a stronger inclusion of practices outside the big cities should be considered in the current implementation of the new Dental Licensure Act in Germany.

Evaluating clinical communication skills of medical students, assistants, and professors

BackgroundThe skill of communicating with the patient is one of the basic clinical skills and part of the necessary competencies for medical doctors. The present study aimed to evaluate the knowledge, attitude, and performance (KAP) of medical students, assistants, and professors of Shahrekord University of Medical Sciences regarding clinical communication skills with patients.MethodThis cross-sectional study was conducted at the hospitals of Shahrekord University of Medical Sciences in Iran. The study included a total of 289 participants, consisting of 51 professors, 72 assistants, 90 external staff, and 76 interns who work at these hospitals. The participants were selected through a convenience sampling method. The data-gathering tools used included a questionnaire to collect demographic characteristics, a researcher-made questionnaire to assess knowledge, a communication skills attitude questionnaire, and a communication skills survey questionnaire. The data were analyzed using descriptive statistics such as mean, standard deviation, and frequency, as well as statistical tests that included one-way ANOVA and Pearson’s correlation test. The significance level for the study was considered to be 0.05.ResultsThe mean scores of knowledge of professors were higher compared to other groups (P = 0.002). All participating groups had a positive attitude toward learning communication skills. There were statistically significant differences between the mean scores of the communication performance of the study groups (P < 0.001). There was a positive relationship between positive attitude and communication performance, and a significant negative relationship was observed between negative attitude and communication performance.ConclusionThe results indicate the relatively favorable attitude and performance of the groups and their low knowledge. It is suggested that the doctor-patient communication skills courses be included as one of the necessary courses in the medical education curriculum.

Clinical communication skills: analysis of the self-assessment of family medicine residents

Resumo Introdução: O conhecimento das habilidades de comunicação clínica é primordial para o adequado exercício da medicina de família e comunidade (MFC), visto que um dos princípios da especialidade advém da relação médico-pessoa. A comunicação assertiva é uma competência clínica básica que deve ser aprendida, sobretudo, durante a residência médica. Não se trata de uma característica inata, perpassa um processo de conhecer, aplicar e dominar, necessitando, portanto, de avaliações. Objetivo: Este estudo teve como objetivo avaliar a percepção dos médicos residentes de MFC em relação às suas habilidades de comunicação. Método: Trata-se de um estudo quantitativo, descritivo e transversal. O cenário de estudo foi o conjunto de programas de residência de MFC do município de João Pessoa, na Paraíba. A coleta de dados foi feita a partir de um questionário on-line, disponível para preenchimento de setembro a novembro de 2022. Utilizamos para a construção do questionário o instrumento A Consulta em 7 Passos. Desenvolvemos escores denominados índice de desempenho geral (IDg), índice de desempenho por passo da consulta (IDp) e índice de desempenho por item (IDitem). Na análise estatística, utilizamos o teste t para amostras independentes. Resultado: O IDg médio foi de 72,0%. Os residentes tiveram o maior índice de IDp no passo 5 da consulta (81,7%), seguido pelos passos 2 (77,6%), 3 (76,1%) e 6 (75,9%). Os menores desempenhos foram nos passos 4 (68,9%), 7 (63,7%) e 1 (63,3%). Não houve significância estatística quanto ao desempenho quando se compararam sexo, ano de residência e programa. Conclusão: Os residentes de MFC avaliam positivamente suas habilidades de comunicação. Entretanto, ainda há o que aprimorar, como fomentar momentos crítico-reflexivos sobre os fenômenos subjetivos que ocorrem na consulta. Destarte, a utilização do instrumento A Consulta em 7 Passos se revelou, no presente estudo, como uma ferramenta importante no processo de formação e avaliação da comunicação clínica durante a residência.

Relationship between Clinical Practice Stress, Communication Skills, and Clinical Performance in Nursing Students Who Experienced Virtual Online Clinical Practice

Background: This study aims to investigate the relationship between clinical practice stress, communication skills, and clinical performance of nursing students who have engaged in virtual online practicum due to coronavirus disease-19 (COVID-19). The findings will serve as foundational data for developing education programs to enhance nursing students’ clinical performance.Methods: The data were collected from 111 third- and fourth-year nursing students at a nursing school in Busan Metropolitan City who experienced virtual online clinical practice due to COVID-19, from October 4 to October 15, 2021. Instruments to measure clinical practice stress, communication skills, and clinical performance were used. The collected data were analyzed using descriptive statistics, independent t-test, one way analysis of variance, and Pearson’s correlation coefficients.Results: Among nursing students who have engaged in a virtual online clinical practice, the mean clinical practice stress score was 2.49±0.53, and the mean communication skills score was 4.01±0.43. The mean clinical performance score was 3.80±0.56. Clinical performance was significantly positively correlated with communication skills (&lt;i&gt;r&lt;/i&gt;=0.62; &lt;i&gt;P&lt;/i&gt;&lt;0.001).Conclusions: Based on these results, it is important to develop and implement education programs that enhance communication skills in order to improve clinical performance in nursing students who have experienced virtual online practice. As this study was conducted on nursing students at a single school, interpretation of the results requires caution. Thus, future research should recruit a larger study population and identify relevant variables.

Barreras en la Geronto Comunicación detectadas por Profesionales de la Salud

A group of 31 Chilean professionals in the Clinical Gerontology area evaluated the interpersonal communication that arises from the clinical encounter with the elderly. The results obtained through a questionnaire and subsequent content analysis supported the use of a linear communication model when participants approach elderly patients. Individuals also reported that sociocultural obstacles, linked to low levels of education, are the main barriers to overcome during the encounter with elderly patients while the best strategy to improve therapeutic results is the empathy of health professionals. The results of the present study aimed to promotethe discussion on the necessity to strengthen clinical communication skills from an undergraduate level formation to become an effective tool to improve therapeutic results at a professional level.

Simulation to improve healthcare pathway and inequities for people with disabilities.

Introduction: The Convention on the Rights of People with Disabilities (1) reported that people with disabilities do not have equitable access to health services. People with intellectual disabilities, especially the ageing, are more susceptible to somatic disease and other lifestyle diseases than the general population (2, 3, 4, 5, 6). &#x0D; General practitioners' (GP) competence in the field of intellectual disability is largely experience-based, not systematic and research-based (7). In municipalities, approximately half of healthcare workers (HCWs) at municipal housing for people with intellectual disabilities are unskilled. These HCWs have experienced not being taken seriously when calling either their patients’ GP or accident and emergency (A&amp;E) department to report that the resident is 'not well', resulting in residents receiving inadequate healthcare. Municipal leaders and educators decided to address the inadequate clinical observation and communication skills among HCWs with a simulation-based training program (SBTP), to improve competence and treatment of residents when escalating levels of care.&#x0D; Methods: Based on national recommendations about ""Early detection of deteriorating condition"" and the urgency of the covid-pandemic, the SBTP was quickly rolled out to all HCW. The SBTP consisted of both theoretical teaching and e-learning in ABCDE, training in the tool NEWS2, as well as the communication technique ISBAR. Baseline NEWS2 scores were established for all residents.&#x0D; Based on positive experience with SBTP in donning and doffing of personal protection equipment (8) in the municipality early in the pandemic, and uncertainty about safer care for sick corona patients in residential homes, leaders requested continued use SMTP to improve observational skills.&#x0D; Results &amp; Discussion: Evidence of improved competency at work and resulting improved escalation of care came fast.&#x0D; One example was of a resident with backpain whose relatives’ recommended painkillers. HCWs performed NEWS2 scoring, discovered pathological changes, contacted A&amp;E, received treatment advice, continually followed up on NEWS2 measurements, secured ambulance help &amp; reaction based on baseline NEWS2, and admission where sepsis was discovered. Similarly, another group of HCWs performed NEWS2 scoring on a patient with presenting manic symptoms, discovered clinical signs of somatic illness, which lead to a completely different medication than expected. These cases were seen as post-SBTP improvements in HCWs behavior, and patient safety.&#x0D; &#x0D; SBTP to improve observational skills in the municipality has led to better differential diagnosis in the early stage, more precise communication with GP and A&amp;E which in turn has led to better healthcare pathways for a vulnerable patient group.&#x0D; Keywords: simulation, observational competence, competence, health rights&#x0D;

Comparative study of outcome of the Teaching methods for Early Clinical Exposure in 1st Professional MBBS students: Ward side patient demonstration method Vs Video &amp; Dummy patient demonstration method

Background: Early Clinical Exposure (ECE) is a newer concept of teaching learning methodology which provides clinical perspective and relevance to learning of basic sciences. ECE also orients towards actual clinical scenarios and helps the medical students to correlate their theoretical knowledge with real life situations right from the first year of medical college. Aims and Objectives: This study aimed to compare the outcome of teaching methods for Early Clinical Exposure in 1st Professional MBBS students and to assess the effect and efficiency in their performance. Materials and Methods: This prospective comparative study was carried with a sample population of 50 students of MBBS 1st prof. 2021 batch who were selected by random allocation method and divided into two groups of 25 students each, one acting as Bedside ECE group and other as Virtual ECE group. Pre training evaluation was performed at the beginning of study and Post training evaluation was performed after three months. The student’s feedback was taken regarding advantages, disadvantages and suggestions for further improvement. Results: A statistically significant difference was observed between the Bedside ECE and Virtual ECE group at post training in theory (t=15.682, p&lt;0.001), practical (t=12.671, p&lt;0.001) and total (t=17.460, p&lt;0.001) marks of the students after 3 months training. The mean scores of participants were significantly improved more in the Bedside ECE group (39.92±3.23) as compared to Virtual ECE group (23.04±3.60). Analysis of students’ feedback revealed that Bedside ECE was found to be more interesting method of teaching as compared to virtual methods and helped to develop empathy towards the patients as well as motivated them to read more about the topic and helped in retention. Conclusion: Direct contact with patient has been seen to play a crucial role in development of clinical reasoning, communication skills and professional attitudes. The concept of Bedside Early Clinical Exposure goes longway in helping young minds in grasping clinical and theoretical concepts better by involving all domains of learning. KEY WORDS: Competency Based Medical Education, Early Clinical Exposure, Empathy, Reflection, Bedside ECE, Virtual ECE