Teaching In Clinical Settings Research Articles

“Everyone who wants to can practice on me”– a qualitative study of patients’ view on health profession students’ learning in an interprofessional clinical placement

IntroductionHealthcare services face significant challenges due to the aging population, increasing complexity of health issues, and a global shortage of health professionals. Health professions education needs to adapt and develop with healthcare services’ needs. Interprofessional education and patient partnership are two trends that are increasingly being reinforced. Health professions students worldwide are expected to acquire competencies in interprofessional collaboration through undergraduate and postgraduate studies. Developing interprofessional collaborative skills in clinical placements is crucial. This study aims to explore two patients’ meetings with an interprofessional student team and better understand how the patient can participate actively in the students´ learning processes.MethodsThis is a small single-case study. Two patients participated. Data was generated through participant observation and qualitative interviews. A practical iterative framework for qualitative data analysis inspired the analysis.ResultsThe patients observed and reflected on the interprofessional students’ learning process and felt responsible for contributing to their learning. The patients contributed to students’ learning by making themselves available for practicing and sometimes giving feedback. They considered it a win-win situation to be involved in the interprofessional learning activity as they perceived being taken seriously by the students when addressing their problems and experienced positive outcomes for their situation, such as better physical functioning and adjustments to assistive devices. Patients emphasized the importance of learning collaboration between health professionals and how this could contribute to them feeling safer as patients.DiscussionThis study highlights the importance of including patients in interprofessional students’ learning processes. Patients’ active participation in interprofessional clinical placements can empower them, improve their self-efficacy, and potentially shift the power dynamic between patients and healthcare professionals. The study emphasizes the importance of the patient perspective in future research on interprofessional education in clinical settings. The study also highlights the need for clinical supervisors to facilitate patient involvement in interprofessional clinical placements and reinforce patients’ feedback for the student team.Concluding commentsOverall, this study contributes to the growing body of research on interprofessional education and patient partnership and emphasizes the importance of including patients in health professions education.

Multifaceted validity analysis of clinical skills test in the educational field setting

Introduction: The importance of clinical skills training in traditional Korean medicine education is increasingly emphasized. Since the clinical skills tests are high-stakes tests that determine success in national licensing exams, it is essential to develop reliable multifaceted analysis methods for clinical skills tests in actual education settings. In this study, we applied the multifaceted validity evaluation methods to the evaluation results of the cardiopulmonary resuscitation module to confirm the applicability and effectiveness of the methods.Methods: In this study, we used internal consistency, factor analysis, generalizability theory G-study and D-study, ANOVA, Kendall's tau, descriptive statistics, and other statistical methods to analyze the multidimensional validity of a cardiopulmonary resuscitation test in clinical education settings over the past three years.Results: The factor analysis and internal consistency analysis showed that the evaluation rubric had an unstable structure and low concordance. The G-study showed that the error of the clinical skills assessment was large due to the evaluator and unexpected errors. The D-study showed that the variance error of the evaluator should be significantly reduced to validate the evaluation. The ANOVA and Kendall's tau confirmed that evaluator heterogeneity was a problem.Discussion and Conclusion: Clinical skills tests should be continuously evaluated and managed for validity in two steps of pre-production and actual implementation. This study has presented specific methods for analyzing the validity of clinical skills training and testing in actual education settings. This study would contribute to the foundation for competency-based evidence-based education in practical clinical training.

Partnerships in health care: Delivering a just-in-time professional development intervention as an effective crisis response

Partnership between a government health department, a tertiary education provider and healthcare professionals is effective in providing professional development in response to a crisis in the form of just-in-time education. In 2020 and 2021, this type of partnership supported nurses and nurse educators in clinical settings when resources were stretched. The partnership fostered the provision of evidence-based practice. As a result of this partnership, nurse participants of a massive open online course demonstrated improved knowledge and confidence when caring for patients presenting with COVID-19.

Enabling knowledge translation: implementation of a web-based tool for independent walking prediction after traumatic spinal cord injury.

Several clinical prediction rules (CPRs) have been published, but few are easily accessible or convenient for clinicians to use in practice. We aimed to develop, implement, and describe the process of building a web-based CPR for predicting independent walking 1-year after a traumatic spinal cord injury (TSCI). Using the published and validated CPR, a front-end web application called "Ambulation" was built using HyperText Markup Language (HTML), Cascading Style Sheets (CSS), and JavaScript. A survey was created using QualtricsXM Software to gather insights on the application's usability and user experience. Website activity was monitored using Google Analytics. Ambulation was developed with a core team of seven clinicians and researchers. To refine the app's content, website design, and utility, 20 professionals from different disciplines, including persons with lived experience, were consulted. After 11 revisions, Ambulation was uploaded onto a unique web domain and launched (www.ambulation.ca) as a pilot with 30 clinicians (surgeons, physiatrists, and physiotherapists). The website consists of five web pages: Home, Calculation, Team, Contact, and Privacy Policy. Responses from the user survey (n = 6) were positive and provided insight into the usability of the tool and its clinical utility (e.g., helpful in discharge planning and rehabilitation), and the overall face validity of the CPR. Since its public release on February 7, 2022, to February 28, 2023, Ambulation had 594 total users, 565 (95.1%) new users, 26 (4.4%) returning users, 363 (61.1%) engaged sessions (i.e., the number of sessions that lasted 10 seconds/longer, had one/more conversion events e.g., performing the calculation, or two/more page or screen views), and the majority of the users originating from the United States (39.9%) and Canada (38.2%). Ambulation is a CPR for predicting independent walking 1-year after TSCI and it can assist frontline clinicians with clinical decision-making (e.g., time to surgery or rehabilitation plan), patient education and goal setting soon after injury. This tool is an example of adapting a validated CPR for independent walking into an easily accessible and usable web-based tool for use in clinical practice. This study may help inform how other CPRs can be adopted into clinical practice.

Anxiety and its associated factors Among Undergraduate Nursing Students During Psychiatry Clinical Placement: A Cross-sectional Study in MARDAN Khyber Pakhtunkhwa

The clinical education setting is a complex social unit that affects student skills within the clinical setting. Anxiety influences the student's performance in the clinical setting since it initiates the fight-or-flight response, leading to a positive or negative outcome. Objective: This study evaluates anxiety among students when they start rotation in the clinical area. Methods: An analytical cross-sectional survey was conducted to determine the anxiety level among undergraduate nursing students during psychiatry/mental health nursing clinical rotations in the psychiatry unit. Participants were recruited through the probability sample method. The sample of the study consists of 93 students of undergraduate level. A self-adapted questionnaire was distributed manually to collect data. Results: According to the survey result, 67.7% of students have a normal range of anxiety, whereas 32.3% of students have mild to moderate levels of anxiety during psychiatry clinical rotation. Conclusions: The study identifies a significant link between anxiety levels and semester, notably higher in the 6th semester and a marginal association with race. With majority in the normal range and few with mild to moderate anxiety, it suggests targeted support programs for students, especially in high-anxiety semesters.

Adopting self-directed learning principles in clinical education with Pebblepad

Self-directed learning (SDL), alternatively known as self-regulated learning (SRL), is an umbrella term that can be broadly defined as the learner’s ability to make plans according to their individual needs and use learning resources and methods to master a knowledge or necessary skills (Van der Walt, 2016; Russell et al. 2022). It is a systematic control of motivation and tightly linked to self-awareness, agency, and the sense of being in control of the learning process (Russell et al. 2022). Despite ever increasing reference to SDL in health professions education, it is not well-studied in clinical settings (Lui & Sullivan 2021, Murad et al. 2010, Yeo and Jang 2023). In 2021-2022 we adopted some of the main principles of the SDL approach, namely goal setting, self-monitoring, self-reflection, self-evaluation, to clinical education in Bachelor of Oral Health and Doctor of Dentistry programs at the University of Melbourne by utilising a digital e-portfolio platform, Pebblepad. In this presentation, we will walk you through the iterative design process of digital clinical assessment forms. This process allowed us to refine our materials and strategies in consultation with our students, teaching and learning staff and clinical supervisors as we go. We supported our students to a) identify gaps in application of their clinical knowledge via learning analytics dashboards, b) generate goals for improvement through structured reflection and c) assess their practice through self-evaluation rubrics. We are still improving our concept to foster SDL in our programs. We take this opportunity to reflect on what went well as opposed to areas for improvement, and demonstrate the power of using different digital tools in clinical education settings. We believe “thinking outside the box” can help students become self-directed learners through collaboration, continuous improvement, and flexibility.

Embedding Interprofessional Education in Clinical Settings: Medical and Dental Student Perceptions of a Patient Interview-Storytelling Experience.

Interprofessional education (IPE) is valued but difficult to deliver, given logistical and other barriers. Centering IPE around patients and grounding it in authentic practice settings are challenging within early undergraduate medical education. This intervention facilitated student-patient conversations to elicit patient reflections on the health care professionals who keep them healthy and care for them when they are unwell. After being introduced to the Interprofessional Education Collaborative (IPEC) core competencies, first-year medical (n = 127) and dental (n = 34) students conducted a brief semistructured patient interview, using an interview card with guiding questions, during a precepted outpatient clinic session in March-May 2021. Students transcribed patients' stories and wrote their own reflections on the interview card. These reflections were used as a stimulus for a class IPE discussion. The authors employed a pragmatic qualitative research approach to explore what students learned about interprofessional collaboration from reflecting on patients' stories. Of the 161 students, 158 (98%) completed an interview card. Sixteen health professions were represented in patients' stories. The patients' stories prompted students to recognize and expand their understanding of the IPEC competencies. Students' responses reflected synthesis of the competencies into 3 themes: students value patient-centered holistic care as the goal of interprofessional collaboration; students reflect emerging professional and interprofessional identities in relating to patients, teams, and systems; and students appreciate interprofessional care is complex and challenging, requiring sustained effort and commitment. Next steps include continuing to integrate patient voices through structured conversations across the undergraduate and graduate medical education spectrum and adapting the model to support conversations with other health professionals engaged in shared patient care. These experiences could foster ongoing deliberate reflection by students on their professional and interprofessional identity development but would require investments in student time and faculty development.

Update on Identifying and Evaluating Quality Measures for Adult Attention-Deficit/Hyperactivity Disorder

The limited recognition and treatment of attention-deficit/hyperactivity disorder (ADHD) in adults has been studied in the research setting and addressed in the clinical education setting during recent years. Despite these efforts, health care professionals continue to struggle with the management of adult ADHD in everyday practice. To better evaluate and measure meaningful practice metrics, a set of 10 key quality measures (QMs) that can help improve health care outcomes in adult ADHD was identified using a combination of evidence-based literature reviews and expert consensus. Subsequently, these QMs were field-tested in a sample of 71,310 adult ADHD patients in the primary care setting and behavioral health clinics over the course of a decade to assess whether these measures were attained. The results allowed us to understand how the clinician approach to diagnosing and treating ADHD has evolved in the past few years and highlighted the ongoing challenges in practice variation by clinicians caring for patients with adult ADHD. In turn, this information also guides our understanding of the next steps needed to improve the quality of care provided to adults with ADHD in different care settings. Accordingly, the American Professional Society of ADHD and Related Disorders (APSARD) assembled a guidelines committee to create a set of clinical practice guidelines to provide practitioners with a standardized, evidence-based approach to diagnosing and treating ADHD in adults. [ Psychiatr Ann . 2023;53(10):444–448.]

Exploring the barriers to Registered Nurses undertaking clinical teaching in clinical settings: A qualitative descriptive study.

The study aimed to explore and describe the barriers affecting Registered Nurses in undertaking clinical teaching in clinical settings. The exploration was based on the experiences of Registered Nurses at a selected teaching hospital in Namibia. The researcher intended to identify strategies that could be used to mitigate the negative effects of barriers to effective clinical teaching. A qualitative explorative, descriptive and contextual research design was used. Purposive sampling was used to select 16 participants. Data were collected through in-depth, semi-structured interviews, which were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis. Clinical teaching is negatively affected by several barriers that hamper clinical teaching and nursing students' learning outcomes. Seven main themes were identified: (1) participants' understanding of clinical teaching; (2) organizational barriers; (3) patient barriers; (4) Registered Nurse barriers; (5) student barriers; (6) training institution barriers; and (7) strategies to mitigate barriers to clinical teaching. The findings revealed that several barriers negatively affect clinical nursing education and hamper the clinical teaching and learning of nursing students. This study may assist in the development of targeted interventions that address the barriers that hinder clinical teaching at teaching hospitals. Additionally, this study could assist in improving the health care that is provided by nursing students to patients. The findings may assist with improved quality by reducing nursing students' theory-practice gap and by promoting collaboration between Registered Nurses and nurse educators in clinical settings.

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. 
 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.
 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.
 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.

Application of Kano model for optimizing the training system among nursing internship students: a mixed-method Egyptian study

BackgroundClinical experience is an important component of nursing education because it translates students' knowledge into practice, which serves as the cornerstone of nursing practice in health care delivery.PurposeThe study aims to explore the quality attributes required for optimizing the training system of nursing internship students using Kano model.MethodsA concurrent exploratory sequential triangulation design was used for mixed-methods research. A total of 295 nursing internship students (Target Population) were recruited (whole-population sampling) from the study settings in Egypt. Of them, 280 (97.2%) agreed to participate in the study and completed the interview and the self-administered questionnaire. Data collection was done over 6 months from February to August, 2022. Inferential statistics and thematic data analysis were used to analyze the results.ResultsFindings revealed that there were 35 fundamental attributes required for high-quality nursing students’ internship training. Kano model was used to categorize and prioritize the 35 quality attributes. Kano analysis revealed that 22 attributes were categorized as "attractive" and 11 attributes were as categorized as "must be" and two were indifferent attributes.ConclusionIncorporating the voice of nurse interns during their training is the key to providing efficient and high-quality internship training experience. It could give realistic impressions about the drawbacks of training and proposed solutions.Implications of the studyNurse managers and educators in clinical settings and educational institutions should put much emphasis on the training attributes and pillars to ensure that nursing internship students are mastering the skills of competent alumni. Provision of conducive training environment that fulfill the basic needs of internship students to maintain passion for learning as well as commitment of internship students to nursing profession will improve the satisfaction level and quality of education, training, and practice. Also, incorporating internship students support system with motivation strategies are helpful tools to maintain exemplary performance of internship students during the training period.

수술실 실습을 통한 간호대학생의 학습 경험 및 전문직관

Professionalism, which encompasses competencies, ethics, and societal expectations, is an essential feature of modern medical practice. For nurses, practical education in clinical settings, including the operating room, can foster professionalism by demonstrating the importance of patient safety, ethics, and collaboration. This article reports on a study that investigated nursing students’ learning journey and perceptions of professionalism during an operating room practicum. This qualitative descriptive study, which used Bengtsson (content analysis, analyzed 202 self-reflective reports written by junior students at a nursing college in one city in South Korea between 2021 and 2022. The analysis yielded 50 key meanings and 10 sub-categories and identified the following three categories: “Perceptions of a collaborative operating room care environment,” “Observations on nurses as advocates for surgical patients,” and “Challenges to professionalism and growth as future perioperative nurses.” The results of the study indicate that the operating room practicum offered more than clinical exposure; it also fostered professional growth and shaped ethical values. On the basis of these findings we suggest that practical education in the operating should be integrated with ethics education to enhance skills, cultivate professional awareness, and promote professionalism in nursing.

A pilot test of an infographic-based health communication intervention to enhance patient education among Latino persons with HIV.

To pilot test an infographic-based health communication intervention that our team rigorously designed and explore whether its implementation leads to better health outcomes among Latino persons with HIV (PWH). Latino PWH (N = 30) living in New York City received the intervention during health education sessions at 3 study visits that occurred approximately 3 months apart. At each visit, participants completed baseline or follow-up assessments and laboratory data were extracted from patient charts. We assessed 6 outcomes (HIV-related knowledge, self-efficacy to manage HIV, adherence to antiretroviral therapy, CD4 count, viral load, and current and overall health status) selected according to a conceptual model that describes pathways through which communication influences health outcomes. We assessed changes in outcomes over time using quantile and generalized linear regression models controlling for the coronavirus disease 2019 (COVID-19) research pause and new patient status (new/established) at the time of enrollment. Most participants were male (60%) and Spanish-speaking (60%); 40% of participants identified as Mixed Race/Mestizo, 13.3% as Black, 13.3% as White, and 33.3% as "other" race. Outcome measures generally improved after the second intervention exposure. Following the third intervention exposure (after the COVID-19 research pause), only the improvements in HIV-related knowledge and current health status were statistically significant. Our infographic-based health communication intervention may lead to better health outcomes among Latino PWH, but larger trials are needed to establish efficacy. From this work, we contribute suggestions for effective infographic use for patient-provider communication to enhance patient education in clinical settings.

Klinik Ortamlarda İntörn Hemşire Öğrencilerin Eğiticilerden Beklentileri: Kalitatif Çalışma

Eğitimlerinin önemli bir bölümünü klinik ortamlarda gerçekleştiren hemşirelik öğrencilerinin, uygulamalarda eğiticilerden beklentilerinin derinlemesine incelenmesi, öğrenme ortamlarının iyileştirilmesi ve mesleki bilincin geliştirilmesinde önemli bir ihtiyaçtır. Bu araştırma, klinik ortamlarda intörn hemşire öğrencilerin eğiticilerden beklentilerini incelemek amacıyla yapılmıştır. Çalışma, Akdeniz Üniversitesi Hastanesi’nde klinik uygulamaya çıkan ve bu kalitatif araştırmaya gönüllü yedi intörn hemşirelik öğrencisi ile gerçekleştirilmiştir. Veriler yarı yapılandırılmış derinlemesine bireysel görüşmeler yoluyla çevrimiçi olarak toplanmıştır. Tüm görüşmeler kelimesi kelimesine tam anlamıyla yazıya dökülmüş ve tekrarlı okumalarla içerik analizi yöntemi kullanılarak değerlendirilmiştir. 
 Verilerin analizinde “güvenli öğretim ortamı yaratma” ve “öğrenme kaynağı olarak bireyler” olmak üzere iki ana tema elde edilmiştir. Katılımcıların klinik ortamlarda güvenli öğretim ortamı yaratma teması dört ve öğrenme kaynağı olarak bireyler ise beş alt temadan oluşmaktadır.
 Bu çalışmada intörn hemşirelik öğrencilerinin, klinik ortamlardaki öğretici kaynak algıları ve güvenli öğrenme ortamının özelliklerine ilişkin görüşleri ön plana çıkmıştır.

Individuelle Kompetenzen und Team-Performance in klinischen Lernsettings der interprofessionellen Zusammenarbeit erfassen: Die empirische Entwicklung des Interprofessionelle Visiten Individual und Team Assessment Tools (IP-VITA)

BackgroundInterprofessional training wards (IPTW) can contribute to the development of interprofessional competencies. In order to evaluate the acquisition of competencies, instruments are needed that record both team performance and individual competencies in the clinical teaching setting in third-party assessment. This paper describes the Interprofessional Ward Round Individual and Team Assessment-Tool, IP-VITA (“Interprofessionelle Visiten Individual und Team Assessment Tool”) and its development. MethodBased on the empirical exploration of the three observation instruments “Teamwork Assessment Scale” (TAS), “McMaster-Ottawa Scale” and “Individual Teamwork Observation and Feedback Tool” (iTOFT) in at least four rounds each at the HIPSTA (with n=8 students and trainees each), a preliminary version of the IP-VITA was created. This preliminary version was then refined in subsequent empirical steps: a consensual validation in the research team was followed by a “member check“ with the clinical colleagues of the HIPSTA, the input from external experts and an empirical test in an alternative setting. ResultsThe IP-VITA is an empirically developed multimodal instrument to assess the interprofessional competencies of trainees and students as well as their team performance in clinical settings with patient interaction. It comprises three parts. In part A, structural data, the persons involved and the essential patient characteristics are recorded. Part B consists of 12 items and a free-text field for recording behaviour at the individual level. Part C also consists of 12 items and evaluates behaviour at team level. DiscussionThe IP-VITA instrument was developed specifically for the context of evaluating interprofessional ward rounds in a clinical educational setting. The instrument takes into account the ambiguous position of the assessment of interprofessional collaboration between individual competence and team performance. Beyond the HIPSTA, it can be used as a formative assessment instrument, and it may also be useful for summative assessments.

The effectiveness of spinal manipulative therapy procedures for spine pain: protocol for a systematic review and network meta-analysis

BackgroundSpinal manipulative therapy (SMT) is a guideline-recommended treatment option for spinal pain. The recommendation is based on multiple systematic reviews. However, these reviews fail to consider that clinical effects may depend on SMT “application procedures” (i.e., how and where SMT is applied). Using network meta-analyses, we aim to investigate which SMT “application procedures” have the greatest magnitude of clinical effectiveness for reducing pain and disability, for any spinal complaint, at short-term and long-term follow-up. We will compare application procedural parameters by classifying the thrust application technique and the application site (patient positioning, assisted, vertebral target, region target, Technique name, forces, and vectors, application site selection approach and rationale) against: 1. Waiting list/no treatment; 2. Sham interventions not resembling SMT (e.g., detuned ultrasound); 3. Sham interventions resembling SMT; 4. Other therapies not recommended in clinical practice guidelines; and 5. Other therapies recommended in clinical practice guidelines. Secondly, we will examine how contextual elements, including procedural fidelity (whether the SMT was delivered as planned) and clinical applicability (whether the SMT is similar to clinical practice) of the SMT.MethodsWe will include randomized controlled trials (RCT) found through three search strategies, (i) exploratory, (ii) systematic, and (iii) other known sources. We define SMT as a high-velocity low-amplitude thrust or grade V mobilization. Eligibility is any RCT assessing SMT against any other type of SMT, any other active or sham intervention, or no treatment control on adult patients with pain in any spinal region. The RCTs must report on continuous pain intensity and/or disability outcomes. Two authors will independently review title and abstract screening, full-text screening, and data extraction. Spinal manipulative therapy techniques will be classified according to the technique application and choice of application sites. We will conduct a network-meta analysis using a frequentist approach and multiple subgroup and sensitivity analyses.DiscussionThis will be the most extensive review of thrust SMT to date, and will allow us to estimate the importance of different SMT application procedures used in clinical practice and taught across educational settings. Thus, the results are applicable to clinical practice, educational settings, and research studies.PROSPERO registration: CRD42022375836.

Enhancing Medical Students’ Knowledge and Performance in Otolaryngology Rotation through Combining Microlearning and Task-Based Learning Strategies

Microlearning is recommended to be implemented within the context of a wider teaching-learning ecosystem, especially in real working environments. Task-based learning is used in clinical education setting. This study aims at assessing the effect of an integrated approach of microlearning with task-based learning on medical students' knowledge and performance in Ear, Nose and Throat clerkship rotation. A total of 59 final-year medical students participated in this quasi-experimental study which included two control groups (routine teaching and task-based learning methods) and one intervention group (combined microlearning and task-based learning method). Pre- and post-tests of students' knowledge and performance were assessed through a multiple-choice question test and a Direct Observation Procedural Skills (DOPS) instrument, respectively. Performing Analysis of Covariance for knowledge post-test scores among three groups revealed significant differences (F = 3.423, p-value = 0.040) and the intervention group had the highest score. Analyzing DOPS results showed that the intervention group achieved significantly higher scores compared to the control ones for all the expected tasks (p-values = 0.001). The findings of the present study show that the combined strategy of microlearning with task-based learning is an effective clinical teaching method for enhancing medical students' knowledge and performance in a real working environment.

Complexities of Delivering Corrective Feedback in Clinical Education for Speech-Language Pathologists

Purpose: The intent of this tutorial is to promote speech-language pathology clinical educators' professional knowledge of feedback as a pedagogical intervention. This tutorial was formatted to enhance an educator's effectiveness in implementing feedback to promote professional growth for speech-language pathology students, new graduates, and those learning new skills. Special attention is given to the use of feedback in the supervisory conference. Method: Online databases were used to complete a focused literature review to identify current trends and evidence for using feedback in clinical education. Discussion: The construct of feedback, corrective feedback, and the sequencing of feedback are described. Feedback as a teaching tool in clinical education settings is often characterized as a learning conversation grounded in adult learning theory. Comparisons between feedback, adult learning theory, and various pedagogical approaches will be drawn. This tutorial highlights the interpersonal nature of feedback and explains how giving and receiving feedback are influenced by the cognitive and affective states of both the educator and the learner. Examples of utilizing feedback in various situations are provided to promote generalization between the tutorial and the reader's daily work. Conclusion: Recommendations for the use of feedback to inform the next steps in research and educational implementation are provided.

Exploring the Inner Lens: Examining Oncology Consultants' Use of Competency and Assessment Frameworks in Clinical Teaching Settings.

Medical education in oncology has adopted a competency-based medical education (CBME) approach in Canada. Oncologist competencies are arranged within assessment frameworks, but it is unknown whether oncologists routinely use assessment frameworks when determining what to teach oncology trainees. Understanding oncologists' actual approaches to assessment and teaching as a form of enacted CBME could inform and focus faculty development efforts. Using a participatory action research approach, oncology faculty were interviewed regarding their teaching practices and use of assessment frameworks. Faculty suggestions regarding challenges in setting teaching goals and completing assessment within the CBME paradigm were solicited. Furthermore, teaching objectives developed by faculty in-house were assessed regarding the domains of competence targeted. Thirty-one of the 40 faculty members in the Department of Oncology, Western University, agreed to participate. Trainee factors (training level, areas of interest), faculty personal values and experience, the teaching setting, and some components of frameworks (medical expert, communicator, advocate, and professional) were articulated as determinants of teaching goals. Of the 1117 in-house objectives reviewed, 76% focused on the medical role. Faculty held widely disparate views on assessment framework features which would enable teaching and assessment. Oncology faculty members used a multifaceted approach to determine what to teach trainees. This approach contains elements both of the conventional apprenticeship models under which many faculty members themselves were trained and of the CBME paradigm. Future research should focus on exploring ways to resolve the tension between established individual teaching approaches and nationally standardized competency frameworks which are being implemented.

Creating a Supportive Clinical Learning Environment for Physiotherapy Students: A Feasibility Study to Enhance Collaboration Between Students and Educators Using the ‘Everything DiSC’

Aim: To investigate if an intervention aimed at creating a supportive clinical learning environment (through shared debriefing of behaviour styles for physiotherapy students and their educators) can i) improve the clinical skills outcomes (grades) and ii) enhance the perceived quality of clinical education experiences for students and educators compared to placements without this intervention. Method: This quasi-experimental, non-equivalent groups, mixed methods study was conducted across two Australian universities and two public health sector settings. For the intervention group, Everything DiSC profiles and comparison reports were utilised to indicate differences and similarities in behaviour traits and this information was shared with students and clinical educators attending a 5-week placement. Written strategies were provided to enhance collaboration. For the comparison group, physiotherapy students attending usual clinical placements. Outcomes: Assessment of Physiotherapy Practice (APP) grades, Clinical Learning Environment Inventory (CLEI), Maastricht Teaching Evaluation, perspectives of clinical educators (obtained through focus groups). Results: At the completion of the 5-week placement, no significant differences between groups were found in APP grades, CLEI, or Maastricht scores. Focus groups (n=2) with clinical educators (n=12) revealed mostly positive perspectives on the utility of DiSC in the clinical education setting. Conclusion: Whilst sharing DiSC profiles and comparison reports between physiotherapy students and their clinical educators did not demonstrate significant benefits for students in terms of grades, positive outcomes regarding the collaboration between physiotherapy clinical educators and their students were reported by clinical educators.