Clinical Education Environment Research Articles

Evaluation of Clinical Education Based on Cognitive Apprenticeship Model Using Maastricht Clinical Education Questionnaire

Introduction: One of the main aspects of medical students is clinical education. The cognitive apprenticeship model is one of the principles of clinical education and contains six dimensions, including modeling, coaching, scaffolding, articulation, reflection, and exploration. This research aimed to evaluate the clinical education at Kerman University of Medical Sciences based on the cognitive apprenticeship model in 2021. Method: In this descriptive-analytical cross-sectional research, the Maastricht Clinical Education Questionnaire was separated among 150 students, and with a response rate of 74%, 112 of them completed this. Results: In the evaluation of the clinical education at Kerman University of Medical Sciences, the score of the articulation domain was higher than others, and the lowest score was given to the reflection domain. Clinical education in the internal medicine department was the most consistent with the cognitive apprenticeship model. Conclusion: Identifying the strengths and weaknesses of clinical education is the first step toward improving the quality of medical education. In the subsequent steps, the practitioners and planners of the faculty member empowerment programs should design, implement, and evaluate educational empowerment programs for clinical faculty members to improve their academic skills in the clinical education environment.

Investigating Students' Clinical Experiences of Learning the Nursing Process Using an Integrated Teaching-Learning Method at Shahid Qazi Tabatabaei Hospital: A Qualitative Content Analysis

Introduction: Integrated teaching-learning methods have demonstrated potential in enhancing students' cognitive skills and, subsequently, the quality of patient care. This qualitative study aimed to explore the learning experiences of nursing students engaged in an integrated teaching-learning method during their clinical education in oncology nursing. Method: : Semi-structured interviews were conducted with 19 nursing students who had completed a clinical training program in oncology nursing using an integrated teaching-learning method. Conventional qualitative content analysis was employed to analyze the data, identifying sub-categories and categories related to students' experiences. Results: The analysis revealed four main categories: (1) sustained cognitive learning, (2) non-cognitive learning, (3) application of learned concepts in real-world situations, and (4) students' suggestions for improving the learning of the nursing process. Conclusion: The findings suggest that an integrated teaching-learning method, implemented as a creative and student-centered approach at the bedside, effectively enhances both cognitive and non-cognitive skills, facilitating the practical application of learned concepts. To fully leverage the benefits of this method, its implementation should be expanded across clinical education units, starting in lower semesters. Simultaneously, optimizing real-world clinical education environments will further accelerate positive educational outcomes, enhancing students' cognitive and non-cognitive skills and creating a foundation for applying learned concepts in clinical practice.

Empathy Level and its Related Factors in the Different Specialties of Medical Residents

Introduction: Given the importance of empathy in the process of caring for patients, this study investigated the level of empathy and its associated factors among medical residents at Ahvaz Jundishapur University of Medical Sciences (AJUMS).
 Method: This cross-sectional study was conducted at AJUMS in 2022. All 473 medical residents who were studying at AJUMS were included in the study using census method. Participants completed the Jefferson Scale of Physician Empathy. This scale has 20 items that are scored based on a 7-point Likert scale. Data were analyzed using independent t-test, ANOVA, and Pearson's correlation coefficient.
 Results: The number of medical residents who completed the questionnaires was 290 (response rate 61.3%). These medical residents' mean score of empathy was 102.81±12.75 (out of a total of 140 points). Empathy scores had no statistically significant relationship with sex, marital status, and entry year (p˃ 0.05). Pearson's correlation coefficient showed that there is a significant relationship between the level of empathy and age (r=0.223, p=0.001). Also, there was a significant difference between the empathy scores of medical residents of different specialties (p=0.0001, F=5.249), with the psychiatry residents having the highest mean empathy score (118.31±6.1) and the ophthalmology residents having the lowest (92.85±14.2).
 Conclusion: The findings showed that the empathy score of the residents is at a moderate level, and given the significant difference between the empathy scores of residents of different specialties, it can be argued that empathy changes under the influence of the clinical education environment and is a teachable skill.

Radiography students' viewpoints of the clinical learning environment: A cross-sectional study

IntroductionThe quality of clinical learning environments (CLEs) impact learners' experience and competence development. Objective instruments have been developed to evaluate CLEs from the perspective of medical and nursing students. No such instruments have been used in Radiography. MethodsRadiography students' perspectives of CLEs were investigated using the validated Undergraduate Clinical Education Environment Measure (UCEEM). Undergraduate (UG) (n = 365) and graduate entry (GE) radiography students (n = 45) from an Irish university were invited to participate. CLEs consisted of 25 public and 10 private hospitals. The UCEEM contains 25 items under two overarching dimensions, experiential learning and social participation, with four subscales: opportunities to learn in and through work and quality of supervision; preparedness for student entry; workplace interaction patterns and student inclusion; and equal treatment. ResultsTwo hundred and fifteen students participated (response rate 52.4%; n = 185 UG, n = 30 GE), most of whom were based in public hospitals (87.4%). The mean UCEEM score was 107.5 ± 17.7 (optimal range: 90–125). Experiential learning and social participation were scored 74.2 ± 12.5 (optimal range: 60–85) and 33.37 ± 6.29 (optimal range: 30–40), respectively. Private hospitals ranked slightly higher than public hospitals for ‘opportunities to learn in and through work and quality of supervision’ (p = 0.018). Items ranked highest related to ‘equal treatment’ and ‘opportunity to put theory into practice’. Clinical supervision-related items were scored highest by first-year students. ConclusionHigh UCEEM scores indicate radiography students' positive perceptions of their CLEs, particularly regarding equality and experiential learning. Findings support the expansion of radiography placement to include public and private hospitals. Implications for practiceThe UCEEM is a theoretically robust, validated tool which appears suitable for evaluating radiography CLEs. This study provides valuable baseline data for comparison of Radiography CLEs.

Development of a pharmacy educational environment questionnaire

IntroductionA robust instrument for measuring the educational environment in a pharmacy patient care setting is currently lacking. The authors aimed to develop a person-reported outcome measure to gauge trainee pharmacists' perceptions of their clinical workplace-based educational environment. This paper reports the various sources of validity evidence. MethodsA preliminary, three-domain (system, relationship, and personal), 36-item measurement instrument was developed by incorporating results from literature review, focus group interviews, iterative discussions among educators, and cognitive interviews. The preliminary instrument, together with the Dundee Ready Educational Environment Measure (DREEM) and Orientation to Happiness Scale (OHS), were administered to trainee pharmacists recruited from one pharmacy school and one healthcare cluster in Singapore. Rasch analysis was conducted on the overall instrument as well as three domains: System, Relationship, and Personal. ResultsThe 36-item instrument was administered to 145 learners, of which 66 were trainee pharmacists and 79 undergraduate interns. Upon removal of the middle “neutral” category to resolve poorly functioning categories and removal of five poorly functioning items, the overall instrument and its domains generally showed good fit with the Rasch model. Moreover, the overall 31-item Singapore Pharmacy Educational Environment Questionnaire (SPEEQ) and its three domains showed moderate to high convergent correlation with all the five DREEM domains and low to non-significant divergent correlation with the OHS Pleasure of Life subscale. ConclusionsAmong one sample of pharmacy trainees, the 31-item SPEEQ and its three component domains demonstrated notable validity evidence to gauge trainees' perceptions of their learning environment.

Midwifery students' perceptions of clinical learning experiences and midwifery preceptors in Turkey

BackgroundThe clinical education environment presents a valuable opportunity for students to learn, acquire and develop the clinical skills essential for professional midwifery practice. The presence of competent and relevant preceptors plays a pivotal role in ensuring the success of midwifery students and fostering positive clinical experiences. AimThis study was conducted to evaluate the clinical practice experiences of midwifery students and their perceptions of midwifery preceptors. DesignA descriptive and cross-sectional study. MethodsThis study was conducted with 205 students enrolled in the midwifery department of the Faculty of Health Sciences of a state university in Turkey. Data collection used a participant information form and the Clinical Learning Environment and Midwifery Preceptor Scales designed to assess factors affecting midwifery students' clinical learning. Data analysis was performed using the SPSS 22.0 program, employing methods such as the Independent Sample T-Test, One-Way Analysis of Variance and Tukey test. ResultsThe average total score on the Clinical Learning Environment scale was 31.08±2.16 out of a possible 32, while the average total score on the Midwifery Preceptors scale was 17.60 (SD 1.27) out of a possible 18. The mean total score of the Midwifery Preceptor Scale and the mean scores of the sub-dimensions of Skill Development and Midwifery Practice Philosophy were found to be statistically significantly higher in those aged 21 years and older than aged 20 years and younger (P < 0.05). The Midwifery Preceptor Scale total score, the Clinical Learning Environment Scale total score and Skill Development sub-dimensions mean scores of the second-year students were found to be statistically significantly higher than the first and third-year students (P <0.05). Furthermore, students who received education in larger groups and willingly chose and had a passion for the midwifery profession demonstrated significant positive perceptions regarding their clinical learning environment experiences and the impact of their preceptors on their professional growth. ConclusionsUnderstanding the perspectives of midwifery students regarding the clinical education environment, preceptors and the teaching and learning process holds great importance for enhancing the quality of the clinical education environment and fostering the development of clinical competencies among midwifery preceptors.

간호대학생의 임상실습교육환경과 감정노동 및 진로정체감 간의 관계

Objectives The purpose of this study was to verify the relationship among clinical learning environment and emo-tional labor on career identity of nursing students.&#x0D; Methods The subjects of this study were 283 nursing students in third and fourth grades located in J province, and data were collected using self-administered questionnaires. To analyse the data, Cronbach's α, t-test, ANOVA, Pearson correlation, Scheffé test were used with an SPSS 20.0 program. &#x0D; Results Mean score of subjects was 3.14 clinical learning environment score, 3.35 emotional labor score and 3.02 career identity score. Clinical learning environment showed a significant difference in grade and satisfaction with nursing as a major. Emotional labor showed a significant difference in application motivation, school life and sat-isfaction with nursing as a major. Career identity showed a significant difference in religion, application motivation and satisfaction with nursing as a major. Clinical learning environment and career identity had significant positive correlations. Emotional labor demonstrated a negative correlation with both the clinical learning environment and career identity.&#x0D; Conclusions The findings of this study revealed that the clinical practice education environment and emotional la-bor exert significant influence on the establishment of career identity among nursing students. Moreover, it was identified that the implementation of a program is necessary to enhance the capacity for managing the negative emotional labor experienced.

Explaining the Clinical Education Stressors in Nursing Students: A Qualitative Study

Background: Nurses are an important part of the health system, and the effectiveness of their clinical education has a significant impact on community health. The clinical environment is constantly changing, making student education very stressful. Due to the negative effects of stressors on education, the present study was conducted to explain the stressors in the clinical environment. Methods: In this qualitative study (content analysis), the participants were selected using the purposive sampling method. In-depth semi-structured interviews were conducted with 16 nursing students who had completed at least one semester of internship in Khalkhal University of Medical Sciences until data saturation was achieved. The data were coded, the related codes were classified into categories, and the main themes were extracted. Results: Four categories were obtained in this study: personal problems, the interaction between students and patients, patients’ families, instructors, and ward staff, executive planning, and clinical education environment. The most important source of stress was personal problems, including a lack of awareness and fear of following some clinical guidelines. The lower-semester students were reported to have more stress than last-semester students. Conclusion: Due to the many clinical stressors, the related authorities should be required to promote students’ professional development by identifying the clinical environment stressors and providing appropriate solutions to reduce and control them. In this regard, considering the role of instructors in reducing stress and facilitating student learning, providing educational programs to train instructors in this area can be one of the main steps to reduce student stress.

의과대학 임상실습 교육에 대한 학생·교수의 인식 비교 연구

Objectives The purpose of this study was to determine if there is a difference in perceptions of clinical clerkship education between professors, who are the primary decision makers in medical school clinical clerkship education, and medical students, who are taking their first steps as future healthcare providers.&#x0D; Methods A survey was conducted among 66 students and 60 professors who participated in clinical training in the Department of Medicine at Ewha Womans University in Seoul, Korea, and analyzed using independent sample t-tests and cross-over analysis.&#x0D; Results First, the student group perceived the satisfaction and appropriateness of clinical education more positively than the faculty group. Second, the faculty group perceived the clinical education environment sub-component “readiness of the environment” more positively than the student group. Some of the sub-factors such as learning, relationships, and space also showed significant mean differences between the student and faculty groups. Third, when we examined the differences between faculty and students in the achievement of practice skills.&#x0D; Conclusions This study is significant in that it empirically confirms experiential differences in perceptions of the clinical clerkship education process between students and professors, and provides information for the effective implementation of clinical clerkship education.

Actual and Ideal Support and Supervision in Clinical Education Settings: Comparing the Perspectives of Nursing Students and Clinical Instructors

Introduction: Nursing is a practical profession in which clinical training is the basic medical training program. Clinical training is so important that it is considered as the core of professional education. The aim of the present study was to compare the perceptions of nursing students and clinical instructors about the actual and ideal support and supervision in a clinical setting. &#x0D; Methods: In this descriptive-analytic study, 130 nursing students and 30 clinical instructors of Gonabad Medical Science University are reviewed via census method. The data collection instrument includes the “Perception of Extent of Support and Supervision Survey” questionnaire which is designed in both real and expected status. The findings were analyzed using SPSS20 software and descriptive and analytical statistics.&#x0D; Results: There is a significant difference between the actual and ideal perception of nursing students and clinical instructors in the support and supervision domains, so in the support domain, the expectation of nursing students was not met by clinical instructors, and in the supervision domain, the actual degree of supervision is greater than the students' expectation. However, clinical instructors have believed that the ideal support and supervision of students is provided by the clinical instructor.&#x0D; Conclusion: Conclusion: The results indicate that there is a gap in the view of clinical instructors and nursing students towards the actual and ideal support and supervision of students in clinical education environments. This gap may have negative effects on the clinical learning of students.

Exploring Sustainability of Educational Environment among Health Science Students at the Largest Public University in Brunei Darussalam: A Convergent Mixed-Methods Study

Health science students are the future healthcare workforce. Understanding and fostering a sustainable educational environment (EE) is essential in optimising their learning and the successful completion of their studies. A convergent mixed-methods study was conducted to explore health science students’ experiences of their EE at the largest public university in Brunei Darussalam. A cross-sectional design using the DREEM questionnaire (n = 150) and four focus group discussions (n = 31) involving five health science programs (biomedical sciences, dentistry, medicine, nursing/midwifery, and pharmacy) was conducted between November 2021 and May 2022. Descriptive and linear regression analyses and thematic analysis were respectively performed on the quantitative and qualitative data. Although the university EE was experienced by students as “more positive than negative” (86.7%), 13.3% perceived it as having “plenty of problems”. This perception of learning was statistically significant among nursing/midwifery students (p = 0.012). Dentistry students reported positive perceptions across all five domains of the DREEM (an overall mean of 119.3 ± 10.3). The importance of a stimulating home learning environment, supportive peers, innovative teaching methods, soft skill development, and clinical learning enhancement were highlighted. To foster independence and student-centred learning, an educational program that empowers students on their EE, including ‘survival skills’ is recommended. Future research should compare health science students’ experiences in university and clinical EE, nationally and abroad (medical and dentistry twinning program), and develop indicators measuring the sustainability of the EE throughout health science programs.

Workplace Learning: Learning Experiences Of Pre-Clerkship Students In Their Clinical Learning Environment At A Medical University In UAE.

To explore how studentsin the pre-clerkship phase perceive the workplace clinical learning environment based on their experiential learning and social participation. The cross-sectional study was conducted at the Gulf Medical University, United Arab Emirates in June 2019 and comprised 2nd and 3rd year medical students. Data was collected using the undergraduate clinical education environment measure tool which is a valid and reliable instrument to measure clinical learning environment for undergraduate medical students. There were 858 students, and 70.3% of the students expressed satisfaction with clinical learning environment categories. The average satisfaction level of the students regarding the quality of supervision was better than that of workplace environment and learning opportunities provided.

Clinical learning environments across two different healthcare settings using the undergraduate clinical education environment measure

BackgroundThe clinical placements of our medical students are almost equally distributed across private and public sectors. This study aims to assess medical students’ perceptions of their Clinical learning Environment (CLE) across these two different healthcare settings, using the Undergraduate Clinical Education Environment Measure (UCEEM).Methods76 undergraduate medical students (Year 5 and 6), were invited to participate. Data were collected using an online UCEEM with additional questions related to demographics and case load exposure. The UCEEM consists of two overarching domains of experiential learning and social participation, with four subdomains of learning opportunities, preparedness, workplace interaction, and inclusion.Results38 questionnaires were received. Of 225 responses to the individual UCEEM items, 51 (22.6%) scored a mean of ≥ 4 (range 4-4.5, representing strong areas), 31 (13.7%) scored a mean of ≤ 3 (range 2.1-3, needing attention) and 143 (63.6%) scored a mean of 3.1–3.9 (areas that could be improved). The majority (63%) of the case load exposure responses scored a mean of ≥ 4 (range 4-4.5). Compared to the private sittings, there is a significant reduction in total UCEEM (p = 0.008), preparedness for student entry (p = 0.003), and overarching dimension of social participation (p = 0.000) scores for the public sector. Similarly, both workplace interaction patterns and student inclusion and equal treatment scored significantly lower for the public sector (p = 0.000 and p = 0.011 respectively). Two out of three case load exposure items scored significantly higher for the public sector (p = 0.000).DiscussionThe students’ CLE perceptions were generally positive. The lower UCEEM ratings in the public sector items were related to student entry preparedness, workplace interactions, student inclusiveness and workforce equity of treatment. In contrast the students were exposed to more variety and larger number of patients in the public sector. These differences indicated some significantly different learning environments between the two sectors.

Undergraduate Students' and Interns' Perception towards Learning Environment at Dental Clinics, Qassim University, Saudi Arabia.

Dental clinical educational environment plays a critical part in the inculcation of skills and enhancement of knowledge for the dental students. The objective was to assess undergraduate dental students' and interns' perceptions towards the clinical learning environment. Current cross-sectional study was conducted from December 2020 to February 2021, using the 24-item dental clinical learning environment inventory (DECLEI) on a six point Likert scale. The possible range of cumulative score for DECLEI was from 0 to 100 (interpretation poor to excellent). The inventory was emailed to 111 students and interns at College of Dentistry, Qassim University. The relationship between the independent variables and DECLEI scores was determined by using Pearson correlation test. SPSS version-23 was used for statistical analysis. Overall response rate was 78.37%. The mean DECLEI score was noted as 67.5 ± 17.98. Among the factors, the highest mean score was documented for the systematic self-evaluation and the lowest mean score was observed for the item related to patients' punctuality for appointments. A factor-wise analysis of three subscales of DECLEI demonstrated the respondents had good perception towards all subscales with the highest mean score (72.3 ± 18.06) for Factor III and lowest mean score (61.3 ± 19.81) for Factor II. Overall, the DECELI was found to be reliable with the Cronbach's Alpha value of 0.94. The Pearson's correlation test showed the weak positive insignificant correlation of mean DECLEI score with gender and categories. Present study indicated more positive than negative perceptions of the dental students related to their clinical learning environment. The DECLEI helped in recognizing both strengths and shortcomings of the dental clinical learning environment.

From disobedience to struggle for adaptation: ​​nursing students’ experiences of attending the clinical learning environment during Covid-19 pandemic

BackgroundThe Covid-19 pandemic has affected the clinical education of nursing students all over the world. Considering the importance of clinical education and clinical learning environment (CLE) in the education of nursing students, identifying the challenges and problems faced by these students during the covid-19 pandemic helps to plan more effectively in this regard. The aim of this study was to investigate the experiences of nursing students in CLEs during the Covid-19 pandemic.MethodsA descriptive qualitative research was conducted, which used a purposive sampling technique to recruit 15 undergraduate nursing students from Shiraz University of Medical Sciences between July 2021 and September 2022. Data were collected through in-depth semi-structured interviews. For data analysis, conventional qualitative content analysis based on Graneheim and Lundman approach was used.ResultsThe data analysis led to emergence of two themes of “disobedience " and “struggle for adaptation”. The disobedience theme consists of two categories: “objection to attend CLE” and “patient marginalization”. The theme of struggle for adaptation includes two categories: “using support sources” and “applying problem-oriented strategies”.ConclusionAt the beginning of the pandemic, the students were unfamiliar due to the disease, as well as fear of contracting themselves and infecting others, so they tried not to be in the clinical environment. However, they gradually tried to adapt to the existing conditions by applying support resources and using problem-oriented strategies. Policymakers and educational planners can use the results of this study to plan for solving the challenges of students during future pandemics and improve the condition of CLE.

Students' Perspectives on Clinical Education environment in a Military Medical University

Introduction: The educational environment has an important effect on students' learning and their learning activities. The purpose of the present study was to investigate the students' views on clinical education environment in Aja university of medical sciences. Methods: In this cross- sectional descriptive analytic study, the climate governing the educational environment was measured using the Dundee Ready Educational Environment Measure (DREEM) standard questionnaire. The research population was all the students of the clinical training course of Aja University of Medical Sciences in 2022. Sampling was done by proportional stratified method and randomly in each stratum. Data analysis was done through descriptive and inferential statistical tests using SPSS. Results: The results showed that the average of the total educational climate is 3.19 ± 0.50, which indicates a relatively favorable situation. The highest average score of students' perception was 3.42 ± 0.65 related to the area of students' perception of their academic ability and the lowest average score was related to students' perception of learning with an average of 2.97 ± 0.60. There was no significant relationship between the gender variable and students' perception of the educational atmosphere (P&lt; 0.05). In addition, the results showed that there is a significant relationship between the GPA variable of students and their perceptions of the overall environment of clinical education (P=0.002). There was significant relationship between the variable of school and students' perception of clinical education environment (P= 0.010). Conclusion: The atmosphere of clinical education from the perspective of the students in this study was relatively favorable. Improvement is needed to have a better quality educational environment, and future qualitative studies are recommended to confirm and deeply understand this finding.

Assessment of the Educational Environment of Plastic Surgery Training Programs in Iran using the PHEEM Questionnaire: A Cross-sectional Study.

Clinical educational environments play a substantial role in the teaching of medical residents and fellows. In order to improve the quality of clinical education, its status should be evaluated. Therefore, we aimed to inquire about the educational environment of Plastic Surgery fellows in two teaching hospitals in Tehran, Iran using the Postgraduate Hospital Educational Environment Measure (PHEEM). In this descriptive cross-sectional study, Plastic Surgery fellows studying in two teaching hospitals in Tehran, Iran, in 2022 were included. The Persian version of the PHEEM questionnaire was applied for assessing the clinical educational environment. The collected data were analyzed by SPSS software version 22. Twenty six Plastic Surgery fellows were studied, 15.4% of whom were women (n=4) and 84.6% were men (n=22). The mean total score of the PHEEM questionnaire was 89.68±26.02. The highest mean score was in the teaching dimension (35.08), while the lowest mean score was in the social support dimension (25.42). Most dissatisfaction among Plastic Surgery fellows were in the field of social support. It is necessary to adopt proper educational policies to improve the supportive resources for Plastic Surgery fellows.

Evaluation of the clinical educational environment based on the DREEM model from the viewpoint of the OR students.

The most important part of learning happens in the clinic. To determine the differences between the real educational environment and the desirable environment, the DREEM1 model is used. The present study was conducted to evaluate the clinical educational environment based on the DREEM model from the viewpoint of the OR2 students of the Lorestan University of Medical Sciences. The present descriptive-analytical cross-sectional study evaluated the viewpoint of 118 students of operation room (OR) technology using the DREEM (Dundee Ready Educational Environment Measure) questionnaire in the hospitals affiliated with the Lorestan University of Medical Sciences during the second semester of 2020. The DREEM questionnaire has 50 statements and is divided into five sections, which are rated on a five-point Likert scale (0-4). The data were analyzed using frequency distribution tables, mean and standard deviation indices, Mann-Whitney and Kruskal-Wallis tests. Data analysis was conducted using IBM SPSS Statistics 22.0. IBM Corp.; 2013. and the level of significance was set at 0.05. The total perception of the students of the clinical educational environment was good and excellent in 73.8% of the cases and of the subscales was also good (50.8%-63.2%). There was a significant relation between the total score of students' perception of the clinical educational environment and age (Z = 5.618, P < 0.001), semester (χ2= 43.929, df = 3, P < 0.001), internship hospital (χ2= 12.948, df = 6, P = 0.044) and also the mean score of the subscales (P < 0.001). As the GPA3 and interest in the major increased, the mean score of total perception and its subscales also increased except for perception from the educators (P < 0.05). According to the results, the studied students had a positive perception of the clinical educational environment. It is recommended that the scientific foundation of the educators, the physical facilities of the operating rooms, and social communication should be strengthened to improve the care, treatment, and educational services. It will be useful to use the results to improve the accreditation level of medical centers.

Validity of the UCEEM in use: How Does it Triangulate with Qualitative Data in Measuring the Effect of an Educational Intervention?

Improving medical student placements relies on being able to reliably evaluate how students experience clinical learning environments. The Undergraduate Clinical Education Environment Measure (UCEEM) is an increasingly used validated tool designed to allow such evaluations. This study aims to further characterize how the UCEEM relates to qualitative evaluation. Students on placement at one hospital were invited to complete the UCEEM before and after the implementation of an innovative new placement structure. Additionally, focus groups were employed to collect qualitative data on their experiences. a novel protocol to triangulate the output of the UCEEM with the qualitative data was developed. The UCEEM showed good internal consistency (Cronbach's Alpha 0.79-0.91) and internal correlation. Implementation of the intervention created significant improvements in the overall UCEEM scores (P = .008) and in the "Learning in and through work and quality of supervision" (P = .048), "Preparedness for student entry" (P = .033) and "Workplace interaction patterns and student inclusion" (P = .039) domains. The triangulation of qualitative data with UCEEM output showed that the UCEEM allowed evaluation of some perceptions not reached through open questioning. However, mixed interpretations of UCEEM items by students led to the conflation of themes and challenges in deriving the meaning behind the score. This appeared to be the case for 14 of the 24 UCEEM items. This investigation adds to the literature supporting the UCEEM as a validated tool. It also elucidates the limitations and relationships to qualitative data that investigators need to be aware of in its use.

Investigation of Improvement Items Based on Students' Perspectives on Practical Training for Raising Pharmaceutical Problem-solving Capability at Pharmacies

Experience-based clinical training has been introduced in long-term practical training at pharmacies in Japan. Satisfaction and motivation of pharmacy students differs among pharmacies; however, the underlying causes of the differences are unclear. The purpose of this study was to investigate items for improvement for long-term practical training for raising pharmaceutical problem-solving capability at pharmacies based on students' perspectives. We performed a questionnaire survey to evaluate student satisfaction in clinical education and learning environments. The results were analyzed using customer satisfaction (CS) analysis. After long-term practical training at pharmacies, questionnaires were distributed to 126 pharmacy students at Fukuyama University between November 2021 and March 2022. Ninety-eight students responded. "The practice hours per prescription or pharmacotherapy screening and intervention (improvement factor: 14.954)", "the discussion hours for optimization of prescribing and rational medication use, or patient education with pharmacist (9.493)", and "the self-learning place (3.490)" were identified as items requiring improvement. Our findings suggest that the university should work together with pharmacies to improve the learning strategy and environments to increase direct and continuous interaction with pharmacists at pharmacies. Such interventions may result in improvement of students' satisfaction and a wide variety of practical pharmacy skills.