Evaluation Of Clinical Competence Research Articles

A novel resident physician examination using clinical simulation video to assess clinical competence in Japan: a cross-sectional study

BackgroundThe general medicine in-training examination (GM-ITE) assesses physicians’ clinical knowledge. This study expanded on findings from a previous pilot study to assess the relationship between general medicine in-training examination (GM-ITE) scores and the diagnostic skills of resident physicians in Japan by employing an innovative clinical simulation video (CSV-IE).MethodsThis multicenter cross-sectional study included 4,677 resident physicians who took the GMITE between January 17 and 30, 2023. Participants watched the CSV-IE, depicting an emergency room scenario, and provided a diagnosis. The CSV-IE depicts an emergency case and provides a diagnosis. Discrimination indices were used to assess the CSV-IE’s effectiveness across clinical competence domains, and multilevel logistic regression was used to analyze physician- and hospital-level factors associated with correct diagnoses.ResultsCorrect diagnoses were provided by 470 participants (10.0%). The CSV-IE demonstrated high discriminatory power across all assessed domains, including basic clinical knowledge (DI = 0.44), symptomatology and clinical reasoning (DI = 0.31), physical examination and clinical procedure (DI = 0.35), and knowledge about the disease (DI = 0.25), supporting its utility as an effective assessment tool. In the multivariable analysis, factors associated with a higher likelihood of providing a correct CSV-IE diagnosis included a higher annual number of emergency outpatients (adjusted odds ratio: 1.025; 95% confidence interval [CI]: 1.003–1.047; P = .0230) and being in a higher postgraduate year (adjusted odds ratio: 1.387; 95% CI: 1.104–1.742; P = .005). Conversely, resident physicians at university hospitals were less likely to provide a correct CSV-IE response (adjusted odds ratio: 0.624; 95% CI: 0.435–0.896; P = .0107).ConclusionsCSV-IE modules may provide an integrative and realistic evaluation of clinical competence, addressing limitations of traditional MCQ-based assessments by offering contextualized, real-world scenarios that require dynamic decision-making and diagnostic reasoning.

Rasch analysis implementation in nursing research: A methodological approach

The design and validation of tools constitutes a fundamental pillar of nursing research, where it is essential to incorporate the most current methodologies and analyses in order to guarantee validity and reliability in their clinical application.The aim of this paper is to describe the characteristics of the Rasch analysis and the methodology for its development as well as to discuss its relevance and applicability in nursing research, highlighting its potential contribution to the improvement of the quality and accuracy of measurement instruments in the discipline.Through a narrative synthesis, the theoretical foundations of Rasch analysis are described and the characteristics and assumptions that must be fulfilled to carry out this type of analysis are presented. Subsequently, the implementation methodology is presented in 11 steps: definition of objectives and preparation, instrument design, data collection, initial and unidimensionality analysis, goodness-of-fit assessment (infit-outfit, reliability and separation), item local independence assessment (Yen's Q3 coefficient), item calibration and estimation of skills, measurement invariance analysis (DIF analysis), review and modification of the instrument, final analysis and validation, interpretation of results. Examples of use are presented, as well as the advantages and limitations of the method. In conclusion, the Rasch analysis provides a valuable methodology for the evaluation of clinical competencies and skills, as well as for the development and validation of measurement instruments of great utility for research in care, although it would be necessary to promote training and standardization in its use.

Changes in Clinical Competence of Novice Physical Therapists During Their First Year of Employment: A Single Center Retrospective Observational Study in Japan

Background and Objectives: This study aimed to examine the development of clinical competence of novice physical therapists (PTs) during their first year of employment, following the implementation of an original in-house educational program. The educational program was designed to offer diverse training opportunities at an early stage, during the first year of employment. Methods: Thirty-eight novice PTs (21 males and 17 females, mean age 23.4 ± 3.2 years) participated in this study. All participants underwent educational programs and a self-assessment using the Clinical Competence Evaluation Scale in Physical Therapy (CEPT) on the first day of employment (entry-level) and after 1, 3, 6, and 12 months of employment. The total score and CEPT component-wise scores—“knowledge,” “clinical reasoning,” “skill,” “communication,” “attitude,” “self-education,” and “self-management”—at the 4 assessment points (1, 3, 6, and 12 months) were compared with values on the first day. Results: The total scores at 3, 6, and 12 months of employment were significantly higher than those on the first day of employment (P < .05). Among the total scores on the 7 components, those for “knowledge,” “clinical reasoning,” “skill,” and “communication” at 3, 6, and 12 months after employment were also significantly higher than those on the first day of employment (P < .05). The scores for “attitude” and “self-education” 12 months after employment were significantly higher than those on the first day of employment. However, the “self-management” scores at 1, 3, 6, and 12 months after employment did not significantly change compared with those on the first day of employment. Conclusions: The total score was significantly higher after 3 months. The participant’s clinical competence may have improved because they participated in an educational program related to “knowledge,” “clinical reasoning,” “skills,” and “communication” at an earlier stage in the first year. However, their progress was comparatively slower in other areas, suggesting that the content might not have been sufficient. This study revealed the effectiveness of the educational program on novice PTs’ clinical competence at a single institution in Japan. Positive outcomes were obtained for several parameters. Furthermore, the results reveal the need for content modifications within the educational program to improve PTs’ performance across all evaluated items.

Implementation of a Mental Health Objective Structured Clinical Examination (OSCE) Using Standards of Best Practice.

The objective structured clinical examination (OSCE) is effective for the evaluation of clinical competence. Studies examining the use of OSCEs in undergraduate mental health nursing education in the United States are limited. A pilot study and a follow-up study were conducted to establish the reliability and validity of a mental health OSCE to evaluate the clinical competence of prelicensure nursing students. International Nursing Association for Clinical Simulation and Learning Standards of Best Practice were used to guide the design and implementation. Results from both studies provide evidence for the use of OSCE in undergraduate mental health nursing education.

Implementación del mini-CEX en el pregrado médico: Una experiencia con simulación

Evaluation is a systematic process that results in a judgment to make decisions. The instruments used to obtain data on student performance require a systematic and objective process for their implementation. The mini-CEX is a direct observation tool that has been used for the evaluation of clinical competence in undergraduate and postgraduate students since its invention in 1955. It has different validity evidence for use in different educational and clinical contexts. It allows rapid evaluations, accompanied by feedback and providing relevant information on the development of clinical competence.

The implementation of OSCE as a method of evaluation of clinical competencies in the education of midwives in Slovakia

The implementation of OSCE as a method of evaluation of clinical competencies in the education of midwives in Slovakia

Actividad científica sobre Mini-Clinical Evaluation Exercise (mini-CEX) en áreas de ciencias de la salud: un estudio bibliométrico

IntroductionThe Mini Clinical Evaluation Exercise is an educational tool that allows the evaluation of various clinical competencies and work scenarios. The aim of this study was to analyze the bibliometric characteristics and impact of the scientific production of Mini-Clinical Evaluation Exercise (mini-CEX) in the health sciences. MethodsBibliometric study whose search source was Scopus, the query was performed on May 8, 2023, considering a search strategy consisting of Boolean operators and key terms. The SciVal tool and the RStudio Bibliometrix module were used to estimate and visualize the bibliometric parameters. ResultsWeller and Chen were representative authors and showed dissemination connections with the main countries (Australia and China). The journal Education for Primary Care (Q2) was the most productive. Among the subcategories, General Medicine (34 publications) and Anaesthesiology and Pain Medicine (21.1 citations per publication) had more publications and higher impact, respectively. Most manuscripts are published in Q3 quartile journals (30.9%), followed by Q1 quartile (25.5%); moreover, in the period 2017 to 2021 there was an increase in publications (50 articles). Publications with institutional were more frequent, but those with international collaboration had more citations per publication. ConclusionsIn the last five years there is an increase in the number of published research on mini-CEX, and the main journal for dissemination was Education for Primary Care. National and institutional collaboration were the most frequent; in addition, Australia, China and the United States led the scientific activity in this field.

Competency-based evaluation: Collaboration and consistency from academia to practice

Competency-based evaluation is not a new concept in nursing education. The Essentials: Core Competencies for Professional Nursing Education (AACN Essentials), published in 2021, and the NONPF Nurse practitioner Role Core Competencies (2022) have provided us with the most recent roadmap for curriculum development and student evaluation. Using these two national guidelines and the Standards for Quality Nurse practitioner Education (2022), we examined ways to unify curriculum and competency in clinical practice. Through a review of the available literature, the lack of standardization in evaluating competency in clinical practice was evident. A framework for evaluation was developed including concepts from other health care discipline competency models. This article presents the resulting evaluation of a tool across academia and practice. Clinical preceptors are an extension of the faculty and play a significant role in developing practice competencies in advanced practice nursing students. Providing preceptors with a comprehensive framework we derived from the already existing PRIME model, and which we use with simulated patients, allows for the evaluation of clinical competencies in a variety of clinical settings. Consistency of evaluation across settings assures the attainment of the competencies necessary to perform safely and effectively in the practice environment.

Effectiveness of an Educational Intervention on Clinical Competency among Mental Health Nurses Working at a Government Mental Health Hospital: A Quasi-experimental Study

Background: Mental health nurses play an important role in caring for patients with mental illnesses. In order to provide comprehensive mental health nursing care, it is important to establish periodic educational interventions about mental health and psychiatric nursing in any mental health institution. The presence of frequent educational programs can lead to improvements in mental health nurses' clinical competency. Aim: To evaluate the effectiveness of an educational intervention on the clinical competency of mental health nurses. Methods: A quasi-experiment study pretest and posttest with one group study design were conducted among 80 nurses in a large mental health hospital in Tabuk city, Saudi Arabia. Data were collected by using the clinical competence evaluation in mental health nurses scale to evaluate the effectiveness of an educational intervention on the clinical competency of mental health nurses by comparing the result of the pretest and posttest scores. Result & Discussion: The total score for the pre-test was (74.83±14.25/Average), and then the score increased dramatically for the post-test (96.18±26.53/Good) also, the Wilcoxon signed-rank test indicated that Post-test (Mean rank=102) significantly higher than pre-test (Mean rank=59) (U=1480, p<0.001). As a result of the current study, the program showed great effectiveness (p<0.001) with an advantage for post-test. Conclusion: The collected data analysis revealed a statistically significant positive effect of educational programs on improving mental health clinical competency, hence, Healthcare organizations and senior decision-makers should develop well designed periodic mental health programs that involve nurses who have a master's and doctorate degrees in mental health nursing to enhance mental health clinical competency.

Evaluation of Clinical Competence and Job Satisfaction and Their Related Factors Among Emergency Nurses in Palestinian Hospitals.

Nurses are responsible for providing primary care to millions of patients, and emergency nurses serve on the frontline in providing care for mildly to severely critically ill patients. This study aims to assess and evaluate the clinical competence and its related factors among emergency nurses in Palestinian hospitals. A cross-sectional study was conducted among 170 nurses working in the emergency units of hospitals in the West Bank, Palestine. Data collection utilized the Nurse Competence Scale, and the Job Satisfaction Scale. The results showed that only 33(19.4%) of the participants exhibited a good level of clinical competence, with none reaching the very good level. Among them, the highest proportion of good level 60 (35.3%) was in the helping role, while the lowest 38 (22.4%) was in ensuring quality. About 35% of nurses reported very low or low job satisfaction, while 58% had high or very high job satisfaction. Additionally, the results revealed a statistically significant relationship between clinical competence and job satisfaction (P < 0.05). Both clinical competence and job satisfaction were positively correlated with age and experience. The study found a significant relationship between demographic characteristics (e.g., education, experience, and marital status) and clinical competency among emergency nurses. Notably, less than half of the participants demonstrated good clinical competency, with none reaching a very good level. The highest scores were observed in the helping role domain, while the lowest were in the ensuring quality domain. Furthermore, clinical competence was found to be significantly associated with job satisfaction. Consequently, enhancing nurses' clinical competency will lead to an improvement in the quality of patient care.

Acute Chest Syndrome.

Acute Chest Syndrome.

Approach to advanced practice nursing student clinical during COVID-19.

Approach to advanced practice nursing student clinical during COVID-19.

Influence of Years of Experience on Clinical Competence of Novice Physical and Occupational Therapists in Japan

Purpose: To increase the clinical competence of novice physical and occupational therapists, an accurate assessment of their clinical competence is necessary. However, no previous study has objectively analyzed the changes in novice therapists’ clinical competence in Japan. Hence, this study investigated and evaluated the changes in the clinical competence of such therapists using an objective analysis. Method: The study included 34 novice therapists with 1–3 years of experience in clinical practice. Participants were divided into groups according to their years of experience. The clinical competence of the novice therapists was evaluated twice using a clinical competency evaluation scale. For comparison among the 3 groups, the scores of the first evaluation were used. For comparison within each experience-year, the scores from both evaluations were used. Results: A comparison of the 3 groups showed that therapists with 3 years of clinical experience had significantly higher clinical competence than therapists with 1 year of clinical experience. Between the first and second evaluations, all therapists with 1 year of clinical experience demonstrated increased scores, whereas scores decreased by approximately 50% for therapists with 2–3 years of clinical experience. Conclusion: These findings suggest that it is necessary to increase educational opportunities for therapists with 2−3 years of clinical experience and re-examine the content of their education and training.

Effects of a standardized patient-based simulation in anaphylactic shock management for new graduate nurses

BackgroundPatients may be endangered if new graduate nurses cannot recognize and manage anaphylactic shock. Consequently, enhancing the new graduate nurses’ understanding of their roles and responsibilities during the rescue of a patient with anaphylactic shock is important. However, due to its inherent limitations, traditional classroom-based teaching makes it difficult to explore the potential of the students. Although popular simulation teaching has several notable advantages, it has not been proven to be effective in training inexperienced nurses on anaphylactic shock. We investigated the effect of a standardized patient-based simulation on the behaviors of new graduate nurses’ during anaphylactic shock rescue to identify an effective and safe method for contemporary nursing education.MethodsExcept for the ill or pregnant, all the new graduate nurses were included in the study as students to undergo a standardized patient-based simulation conducted in the clinical skills center of a general hospital. The simulation training was designed to teach students to recognize the signs and symptoms of anaphylactic shock, place the patient in the correct position, stop the ongoing intravenous infusion of the antibiotic which triggers the anaphylactic shock, restart an intravenous infusion on a new infusion apparatus, give 100% oxygen via a nasal cannula or mask, preserve airway patency, call the rapid response team, and correctly administer the medications prescribed by the clinicians. Before and after the training, the instructors evaluated each student’s skills and behaviors using a clinical competency evaluation list. After the training, all students completed the Chinese version of the Simulation Design Scale (SDS) to demonstrate their satisfaction with the program and then participated in semi-structured interviews with their instructors.ResultsAll 104 graduate nurses had a significant improvement on the 6 competencies of the clinical competency evaluation list after the simulation training (P < 0.001). The SDS scores revealed that the students were highly satisfied with all the aspects of the simulation training (the 20 satisfaction rates were all above 90.00%). During the semi-structured interviews, most of the new graduate nurses reported that simulation training in the management of anaphylactic shock was critical and would guide them in clinical practice.ConclusionSimulation training in anaphylactic shock is a potentially viable and effective method for teaching new graduate nurses to manage clinical incidents.

Correlation between self-awareness, communication ability and caring ability of undergraduate nursing students/A cross-sectional study

BackgroundCaring ability is the core ability of nursing. Here we explored the factors affecting the caring ability of undergraduate nursing students. Self-awareness and communication ability are potential variables to improve caring ability. ObjectiveTo explore the relationship between self-awareness, communication ability and caring ability of domestic undergraduate nursing students and to explore whether communication ability has an intermediary effect between self-awareness and caring ability. DesignA descriptive cross-sectional study using an online questionnaire. Setting and participantsUndergraduate nursing students (n = 1411) who attended Dalian Medical University, Liaoning, China. Participants were recruited through convenience and snowball sampling methods using online platforms. MethodsThe questionnaire used the Self-Consciousness Scale, Clinical Communication Competence Evaluation Scale and Caring Ability Inventory. The data were processed and analyzed by SPSS 24.0 and Amos 23.0. Descriptive statistics, Pearson correlation analysis and structural equation modeling were performed for data analysis. ResultsThere was a significant positive correlation between undergraduate nursing students' caring ability and their self-awareness and communication ability (p < 0.001). Communication ability played a partial mediating role between self-awareness and caring ability (p < 0.001), and the mediating effect was 34.2 %. ConclusionsThe self-awareness of undergraduate nursing students directly affects their caring ability and can also indirectly affect their caring ability through their communication ability. Educators can guide and cultivate student self-awareness and communication ability and promote self-regulation, so as to improve students' caring ability and improve clinical development.

Practical Guide to the Evaluation of Clinical Competence

Practical Guide to the Evaluation of Clinical Competence

A New Immersive Virtual Reality Station for Cardiopulmonary Resuscitation Objective Structured Clinical Exam Evaluation.

The Objective Structured Clinical Exam (OSCE) is an assessment tool used as a reliable method for clinical competence evaluation of students. This paper presents an investigation focused on the chain of survival, its related exploration, management, and technical skills, and how Virtual Reality (VR) can be used for the creation of immersive environments capable of evaluating students’ performance while applying the correct protocols. In particular, the Cardiopulmonary Resuscitation (CPR) procedure is studied as an essential step in the development of the chain of survival. The paper also aims to highlight the limitations of traditional methods using mechanical mannequins and the benefits of the new approaches that involve the students in virtual, immersive, and dynamic environments. Furthermore, an immersive VR station is presented as a new technique for assessing CPR performance through objective data collection and posterior evaluation. A usability test was carried out with 33 clinicians and OSCE evaluators to test the viability of the presented scenario, reproducing conditions of a real examination. Results suggest that the environment is intuitive, quick, and easy to learn and could be used in clinical practice to improve CPR performance and OSCE evaluation.

Comparison of standardized, structured clinical case examination and traditional long-case examination for assessment of final-year medical students: a non-randomized control trial

&lt;p&gt;&lt;strong&gt;Background and Objective:&lt;/strong&gt; To improve the reliability and validity of assessment methods, it is always required to revisit older modalities and introduce new ways to promote students&amp;rsquo; engagement and learning. The objective of this study was to compare standardized, structured clinical case and traditional long-case examination systems for the evaluation of clinical competency of final-year medical students.&lt;br /&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A non-randomized control study was conducted at the Department of Obstetrics (Obs) and Gynecology (Gyne), Shalamar Medical and Dental College, Lahore, Pakistan, from January 2021 to 2022. All the final-year MBBS students were assessed by standardized, structured clinical case examination at the end of the clinical rotation of Gyne/Obs. Their scores were compared with the scores of previous year students who were examined by traditional long case at the end of the clinical rotation in the same discipline. The perceptions of&lt;br /&gt;students and examiners were also obtained by using the predesigned questionnaire using the Likert scale.&lt;br /&gt;&lt;strong&gt;Results:&lt;/strong&gt; The mean scores obtained by the students assessed by traditional long case structured long case were 64.3 and 69.2, respectively (p = 0.001). An overall positive perception for structured long-case examination by students and examiners were seen in comparison to the traditional long-case method of assessment.&lt;br /&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; The standardized, structured clinical case evaluation system is better than the traditional long-case examination as it helps in identifying areas of weakness and covers a wide range of clinical skills to be assessed. However, time management for each station remains a challenge for both examiners and students.&lt;/p&gt;

Is Technology Enhanced Learning Cost-effective to Improve Skills?: The Monash Objective Structured Clinical Examination Virtual Experience.

Objective Structured Clinical Examinations (OSCEs) are an accepted technique for evaluation of clinical competence in healthcare. However, the economic imperative requires faculty to control cost, using innovative educational strategies such as virtual simulation. The objective of this study was to evaluate the cost implications of implementing an online interactive learning module [Monash OSCE Virtual Experience (MOVE)]. All fourth-year pharmacy students enrolled in Monash University in 2017 were provided access to MOVE. Cost-minimization analyses were performed to evaluate the cost of introducing MOVE in the pharmacy course using the smallest cohort size (Malaysia campus) of 40 students as the base case. We also determined under what circumstances MOVE would be more cost-effective, considering the different operational situations such as when student numbers increased or when the number of simulation modules created were increased. The overall cost of setup and implementation of MOVE in the first year of implementation among 40 students was US $94.38 per student. In comparison, the face-to-face workshop cost was US $64.14 per student. On the second year of implementation, the ongoing cost of operation of MOVE was US $32.86 per student compared with US $58.97 per student using face-to-face workshop. A net benefit using MOVE was observed after the third year of implementation. Larger savings were noted when the cohort size extends larger than 100 students. Monash OSCE Virtual Experience was a flexible and cost-effective approach to aid students in preparation for an OSCE and enhanced students' learning experience. The wider applicability of these findings will need to be explored in other settings.

3rd-Degree Atrioventricular Block.

3rd-Degree Atrioventricular Block.