Clinical Faculty Research Articles

71 Step by Step: A Three-Step Approach to Faculty Development

The Clinical Skills and Simulation Centre (CSSC) at Edge Hill University (EHU) was opened in September 2019 to enhance and standardize simulation-based education across all programmes in the Faculty of Health, Social Care and Medicine. Before the CSSC opened, academic staff had not received any formal guidance in using simulation-based education. With the impact of the pandemic, a three-step blended simulation faculty development approach was created to assist and support faculty in their understanding and in the delivery of simulation The aim of the study was to enhance, encourage and standardize the use of simulation-based education through the delivery of a three-step faculty development programme.The following are the three-step approach to faculty development: The introduction of simulation sessions is specifically designed and focussed on the newly appointed academic faculty and is embedded in the staff induction programme.Writing simulation scenarios, drop-in sessions are run once a month and are available to all academics from the faculty. They focus on designing and writing simulation scenarios.Shadowing and feedback. At this stage, faculty are offered support during their simulation session. The experienced simulation facilitator leads the first part of the event with the faculty member running the second part supported by the facilitator observing and providing feedback after the session.The evaluative methods included two approaches, quantitative incorporating Likert questionnaires, for evaluations, and qualitative focus groups, for faculty. Approximately 1700 student and faculty evaluations were obtained, and seven faculty members participated in the focus groups. These were obtained and conducted between June 2020 and August 2021.Evaluations are obtained from students and from faculty who are involved in the sessions. In addition, ethical approval has been obtained to carry out focus groups to identify the challenges and benefits that faculty have found in delivering simulation. Feedback from the evaluations and the focus groups were very positive. Examples include:The simulation team have been extremely supportive and always are. It makes my role so much easier and I appreciate all their hard work.We had 450 students over a fortnight, everyone worked so hard and were very supportive, especially to staff who had not facilitated simulation for some time.Data from June 2020 to August 2021The session: Was beneficial for my learning, 87.74%Archived the learning outcomes, 91.37%Did the session meet your expectations? 87.32%We will continue to offer a blended approach and, from August 2021, a 1-day simulation facilitation programme will be offered to potential adjunct clinical faculty.

Readiness of Medical Institutions, Academics and Practitioners for the Covid-19 Outbreak

Objective: To assess the readiness of medical institutions (academics and practitioners) to the COVID-19 outbreak in Pakistan.  Methods: It was a cross-sectional study. Two medical institutes were contacted in Sind and Punjab through the Vice Chancellors. Faculty members were asked to fill the questionnaire online. Convenience sampling was done, with no fixed sample size. Questionnaires were sent as google forms. Duration of the study was 4 months (Aug 2020 – Nov 2020).   Results: Out of 111 participants, there were 64 females and 47 males. Clinical faculty gave more correct answers on major warning signs of COVID-19 (35.6%) as compared to the basic science faculty (16.7%). Private sector is more prepared to deal with COVID in terms of availability of infection control materials and following of SOPs, however, public sector showed improved numbers (59.1%) for “Performing refresher training for HCP on infection control guidelines” as compared to private sector (33.7%). Total subjective score on IES range from 25 – 30 out of 75 in different groups which showed moderate stress.  The two most practiced life style modifications were avoiding crowded places and frequently washing the hands. The thought of passing on infection to the loved ones was found to be most worrisome for them.  Conclusion: The pandemic is a source of stress for healthcare workers. The institutional readiness for dealing with the pandemic needs consideration at institutional, government and policy level for better equipping the healthcare facilities with the infection control materials and PPEs.

Residency Program Diversity Recruitment and Education: Survey of Efforts and Barriers to Implementation

Examine underrepresented minority (URM) recruitment and diversity education initiatives provided by residency programs in ophthalmology and other specialties, and identify means to support programs as they work to enhance diversity efforts. Cross-sectional study. Multi-center survey of residency program leadership of the Association of University Professors of Ophthalmology, Johns Hopkins Medicine, University of Utah, and the University of California, Los Angeles. Residency program leadership (i.e., residency program directors and associate residency program directors) RESULTS: Our survey response rate was 34% (63/188); 56% percent of responses were from ophthalmology and 44% were from other specialties. Across all specialties, programs with a large number of clinical faculty and trainees were associated with having ≥1 URM resident in their program (p = 0.026 and p = 0.028, respectively). There was no significant difference between ophthalmology and other specialties with regard to the number of URM residents. Ninety-two percent of programs utilized strategies to recruit URM applicants. While certain strategies were more common for ophthalmology than other specialties, information sessions for URM students (62%) and a unique review of all URM residency applicants by a separate committee/person (46%) were most commonly used overall. Although 92% of residency program leadership believed it was highly important for health professionals to receive formal diversity training, only 54% of programs had a diversity education curriculum for both trainees and faculty, 11% had a curriculum for faculty only, and 3% had a curriculum for trainees only. Barriers to implementation of curricula included lack of faculty expertise (30%) and curricular time (30%). An overwhelming majority of programs in our study utilized strategies to recruit URM applicants, but 22% had 0 URM residents in their program. To address the reported barriers to diversity education implementation, shared central resources/diversity education toolkits should be created to provide programs with needed support.

Inviting a friend to evaluate potential grade III pancreatic injuries: Are they truly occult, or simply missed on CT?

SummaryTraumatic inuries to the pancreas are notoriously challenging to diagnose and treat. Detecting a main pancreatic ductal injury can be particularly difficult on screening computed tomography (CT). Twenty-four blinded faculty clinicians from 4 differing specialties and 6 institutions reviewed 9 video CT cases of potential pancreatic ductal injuries. Clinician performance in detection of confirmed grade III pancreatic injuries varied widely among specialties. This heterogeneity confirms the critical need for multidisciplinary care and image interpretation for even “minor” (i.e., not grade IV or V) potential pancreatic injuries to optimize outcomes for injured patients. The ubiquitous availability of electronic devices allows real-time collegial second opinions to be easily available.

The Use of Simulation for Clinical Nursing Faculty Orientation: A Multisite Study

BackgroundFormal preparation and orientation are necessary for clinical nursing instructors to ensure competence and a smooth transition from expert clinician to novice educator. Simulation can be used for clinical nursing faculty orientation to promote role transition. The purposes of this study were to explore the effect of simulation training on clinical nursing instructors’ anxiety and self-perceived competence related to clinical teaching, and to identify their perceptions of simulation use. MethodThis study used a multisite, quasi-experimental, pretest/posttest, convergent mixed-methods design. Participants attending orientation at control sites engaged in traditional clinical nursing faculty orientation, while participants attending orientation at experimental sites participated in six Quality and Safety Education for Nurses (QSEN)-based simulation scenarios. ResultsThere were significant increases in self-perceived competence and decreases in anxiety for all participants. The authors were unable to find statistically significant differences between the control and experimental groups. Participants had positive perceptions of simulation use for clinical faculty orientation. ConclusionThere is considerable variability in clinical nursing faculty orientation practices among institutions. Simulation is a feasible strategy for orientation that is well-received by clinical nursing instructors.

Clinical placements as a challenging opportunity in midwifery education: A qualitative study.

AimThe aim of this qualitative study was to explore some of the existing statuses of clinical education and examine the strengths and weaknesses of the clinical faculty programme.DesignA qualitative study.MethodsThis qualitative study was designed through the directed content analysis approach, which was completed according to the Context, Input, Process, and Product evaluation model. The purposeful sampling method of maximum variation was employed to select 33 participants, and the data were collected through in‐depth individual interviews and focus group discussion.ResultsAfter the interview transcripts were analysed, the participants' opinions of the clinical faculty programme and the relevant challenges, dimensions and factors were classified into four categories and sixteen subcategories. The categories were compiled in the CIPP evaluation model, including context, input, process and product. Based on the content analysis results, appropriate planning was recommended for teaching effective clinical skills to students.

Faculty Perceptions on Use of the Clinical Reasoning Assessment Tool to Support Learning in Physical Therapist Students: A Qualitative Study

Introduction. The clinical reasoning assessment tool (CRAT) is a patient-centered tool that was developed to assess students' progress in the development of clinical reasoning. The purpose of this qualitative study was to explore how academic and clinical faculty in a physical therapist curriculum use the CRAT to support the development and assessment of clinical reasoning in physical therapist student learners. Review of Literature. Clinical reasoning is a multifaceted process crucial to optimal patient care. The ability to teach, learn, and assess the development of clinical reasoning skills continues to be challenging due to the complexity of this necessary skill. Methods. A qualitative, thematic analysis approach was used to achieve the study objective. Qualitative data were collected from 3 focus group sessions, transcribed, and analyzed to identify, summarize, and interpret entry-level physical therapist educators' perceptions and experiences using the CRAT with physical therapist students. Results. Physical therapist educator participants (N = 13) reported using the CRAT as a guide for learning and assessment. Three qualitative themes were identified: 1) fostering understanding of clinical reasoning through organization and structure; 2) facilitating clinical reasoning through dialogue and self-reflection; and 3) assessment of clinical reasoning in the learner through benchmarking. Discussion and Conclusion. Study findings suggest that the structure and organization of the CRAT facilitated dialogue, student self-reflection, and assessment of clinical reasoning through benchmarking. The CRAT may support faculty in their work to further the learners' acquisition of clinical reasoning skills.

Photodynamic therapy procedures in coronavirus (COVID-19) outbreak: perception of health risks among clinical dental faculty and dental students.

The aim of the study was to investigate clinical faculty members and final year dentistry students' perceptions regarding their health concerns and risks of performing photodynamic therapy (PDT) procedure in dental clinics amidst the COVID-19 pandemic. A 21-item questionnaire comprising open and closed questions was sent to dental faculty members (n=43) and final year dentistry students (n=99) of Riyadh Elm University during mid-January 2021 that ended only after two weeks. The survey included health risks perception of performing PDT procedures, the impact of the COVID-19 outbreak on PDT performance and stress levels, perceived efficacy of the preventive steps, perception of the effect of the probable suspension of PDT procedure in dental clinics, and influence of alternative teaching methods of PDT procedure on clinical competence were reported. A response rate of 82% for faculty members (n=35) and 75% for students (n=74) was recorded. 91% of faculty members and 95% of students felt that their health was not at risk during performing PDT procedure in dental clinics amidst the COVID-19. 82% of faculty and 83% of students expressed that the PPE and universal preventive steps to perform PDT procedure were enough for preventing the cross-infection with the virus. 89% of faculty members and 91% of students thought that a provisional suspension of PDT procedures in dental clinics would assist in containment of the virus and reduce the infection risk from the contact and not the PDT procedure. Students and faculty members reported that their health is not at risk while performing PDT procedure in dental clinics amidst the COVID-19 outbreak.

The Impact of Standard in-Patients Exposure on Clinical Judgement among Undergraduate Nursing Students at SNC Lahore

Background: Clinical judgment skills development of nursing professional is essential and vital during clinical education. This quasi experimental study hasevaluated the impact of standardizedIn-patient’s exposure on clinical judgment among under graduate nursing students using observational measures. Method: A single group of undergraduate students was recruited with purposive sampling at College of Nursing, Shalamar Hospital Lahore, Pakistan and Tanner’s clinical rubric model was used. A total 78 under graduate nursing students accomplished in five In-patients exposure within 45 clinical hours. Two Clinical Nursing Instructors were hired to evaluate the outcome of nursing students; clinical judgment at the end of each standardized in-patient exposure session. The inter-rater reliability ranged 0.830 to 0.90 for the session. Results: Clinical judgment outcome were improved from first in-patient exposure to last patient exposure compared with pre and post data of clinical judgement of patient second, third, fourth and fifth. The debriefing method was helpful for the undergraduate nursing students to improve their critical thinking. The undergraduate nursing students confessed that in-patient exposure has not only uplifted their clinical experience but also strengthened the critical thinking in emergency situation and improve the ability to notice, interpret, and respond suitably. The clinical nursing faculty also highlighted and valued the newly learned knowledge and commented that exposure of In-patients to under graduate nursing students is essential for clinical skills preparation. Conclusion: Standardized In-patient exposure has potential to support the undergraduate nursing student for the development of clinical judgement. No doubt, the clinical instructor has enhanced nursing professional’s intrinsic motivation but standardized in-patient presented a true picture, while learning to complete assessment skills.A difference may exist between high fidelity simulator and standardized in-patient exposure among undergraduate nursing students, so further research can explore this phenomenology. Key words:Nursing students, Clinical Judgment, Standardized in-patients, Nursing professionals.

Assessment of Burnout, Professional Fulfillment, and Strategies for Improvement in Veterinary Faculty at a Large Academic Department.

Retention and recruitment of clinical faculty is crucial for the success of quality veterinary education. Clinical faculty in busy teaching hospital environments have the potential to experience significant burnout, though few studies have focused on identifying stressors in this group. The objective of this study was to measure burnout and professional fulfillment in clinical faculty using a recently validated instrument, the Stanford Professional Fulfillment Index (PFI). The survey was distributed to faculty in July 2020, a time that coincided with the COVID-19 pandemic. The survey was completed by 80% (52/65) of survey recipients. Scores for Overall Burnout were significantly higher (p = .027) and Professional Fulfillment scores significantly lower (p < .001) for veterinary faculty when compared with a reference group of academic physicians; 61.7% (29/47) of the faculty met the criteria for burnout, and 20.4% (10/49) met the criteria for professional fulfillment. Overall Burnout and Professional Fulfillment scores were not affected by faculty rank or gender, although interpersonal disengagement was greater in faculty who had worked > 6 years at the institution (p = .032). Responses indicated that faculty valued their work and their patients but faced an excessive workload and lacked autonomy to make changes. Faculty proposed improving efficiency, increasing staffing, and distributing work to technical staff. The PFI is a brief, no-cost instrument validated for measuring burnout and fulfillment in health care workers that can be used to assess well-being among veterinary faculty. Involving faculty in suggesting interventions may yield a variety of creative and actionable options.

An Interprofessional Group Intervention to Promote Faculty Well-Being: A Randomized Clinical Trial.

To evaluate the effect on engagement, relational connection, and burnout of an intervention involving clinical faculty meeting in interprofessional self-facilitated groups and to determine whether a written discussion guide is necessary to achieve benefit. This is a randomized controlled trial, conducted at a large US academic medical center from May to August 2018. Subjects included 25 clinical physicians, nurse practitioners, and certified nurse midwives. The intervention involved three monthly self-facilitated groups for faculty. Groups were randomized to have no discussion guide, or to receive a one-page guide. Outcomes of burnout, engagement, and empowerment in work, and stress from uncertainty were assessed using validated metrics. Rates of emotional exhaustion and depersonalization decreased significantly over the course of the 3-month study (56%-36%; P < .001; and 20%-15%; P = .006) and overall burnout decreased from 56% to 41% of faculty (P = .002). The percentage of faculty who felt engaged in their work increased from 80% to 96% (P = .03). No statistically significant differences in empowerment at work or in reaction to uncertainty were seen. The groups without a discussion guide had equivalent outcomes and benefits. Cost per participant was under $100. A three-month, low-cost, self-facilitated series of dinner meetings for interprofessional clinical faculty decreased burnout and improved engagement, sense of connection to colleagues, and sense of departmental commitment to well-being. Structured discussion guides were not necessary to achieve benefit. This study broadens the possibilities for cost-effective opportunities to transform institutional culture and effectively enhance faculty well-being.

Imposter phenomenon in radiology: incidence, intervention, and impact on wellness

PurposeImposter phenomenon refers to feelings of inadequacy due to inability to internalize evident success. While high achievers such as physicians have been known to exhibit imposter phenomenon, there is limited literature specific to radiologists. Our purpose was to (1) investigate imposter phenomenon in radiologists and assess correlation with burnout, and (2) pilot an intervention aimed at addressing imposter phenomenon through improvisational theater techniques. MethodsPart 1 - Clinical radiology faculty at a single large academic medical center completed an anonymous survey with questions related to demographics, burnout (derived from the validated Mini-Z assessment tool), and imposter phenomenon. Part 2 - A one-hour interactive workshop on imposter phenomenon was organized for the radiology department at the same institution. The workshop included the Clance Imposter Phenomenon Scale (CIPS). A post-workshop survey rating was also performed. ResultsPart 1 - Of 30 clinical radiology faculty who participated in the survey, 83% reported feelings of imposter phenomenon during their career. There was significant (p = 0.024) correlation between imposter phenomenon and burnout. Part 2 - Of 21 members of the Department of Radiology who completed the CIPS in the interactive workshop, 71% exhibited frequent or intense symptoms of imposter phenomenon. On the post-workshop survey asking participants to rate the workshop, the mean score was 4.4 and the mode score was 5 on a scale of 1 (poor) to 5 (excellent). ConclusionImposter phenomenon affects radiologists and is correlated with burnout. Innovative interventions to address imposter phenomenon such as workshops utilizing medical improvisational techniques are well-received.

BLS Knowledge: A comparison between clinical and basic medical professionals

Introduction Cardiopulmonary resuscitation (CPR) is performed on sudden cardiac arrest patients. There is significant morbidity and mortality due to SCA and choking. This high incidence raises a question regarding knowledge of BLS in health care professionals. Therefore, we will be assessing knowledge of BLS among clinical and basic medical health care professionals. Methodology A cross-sectional study was conducted on the Medical professionals of Jinnah Sindh Medical University (JSMU) and Jinnah Postgraduate Medical Centre (JPMC) to assess their knowledge of BLS, within a period of 10 months. Data was collected from 94 participants using a pretested questionnaire through convenient sampling technique. Adequate knowledge was assessed and compared between medical professionals of JSMU and JPMC. P-value was taken significant if it were &lt;0.05 after applying chi-square test. Result The mean age of participants was 33.0 ± 8.66 years. 48% candidates were related to Academics Faculty whereas 52% were Clinical Faculty. Overall 60 (63.8%) responders had “Adequate Knowledge”. Out of those, 23 (38.3%) were from JSMU and 37 (61.6%) were from JPMC. There was a significant difference of knowledge of BLS among the institutes (p-value= 0.003). There was also significant difference of adequate knowledge of participants of JSMU who have had previous BLS training and those who haven’t (p value =0.05). Conclusion BLS knowledge of medical professionals should be frequently revised and updated because they should be competent enough to handle any emergency situation, be it in a hospital or outside of it. Furthermore, this updated knowledge will have a positive effect on their students.

Abstract 11113: Telemedicine Services Are Acceptable to Neurologists for the Delivery of Outpatient Specialty Neurology Care During the Covid-19 Pandemic, but Require Improvement

Introduction: The COVID-19 pandemic accelerated the adoption of telemedicine services for the delivery of outpatient neurological care. To date, teleneurology has been primarily used in the hospital setting related to both billing restrictions and the need for hands-on maneuvers to complete the neurological assessment. We sought to understand perceptions of neurology specialists during rapid proliferation of telemedicine services into their outpatient practices and the acceptance of this technology. Hypothesis: Neurologists may report profound challenges acclimating to the telemedicine platform, completing visits, and making clinical decisions via telemedicine. We also expected that neurology sub-specialties would differ in their attitudes. Methods: Adapted from the Telehealth Usability Questionnaire (TUQ), our 29 item questionnaire evaluated the teleneurology system in three domains: quality of the telemedicine platform, ability to conduct a sufficient neurological examination, and areas for improvement. The survey was distributed to 88 clinical Neurology faculty in the Johns Hopkins Health System. Seven-point Likert scale responses were collapsed into “Favorable”, “Neutral”, and “Unfavorable.” Within each domain, responses to individual questions were analyzed by neurology sub-specialty using descriptive statistics. Results: We received completed surveys from 46/88 (52%) neurology faculty. Of those, most reported comfort with the current platform (98%) and favorably regarded the system’s ease of use (73%) and quality (80%). However, responses indicated only average ability to troubleshoot telemedicine platform issues when they occurred (55%) and to complete a neurological exam (52%). Sub-specialty comparisons revealed differences in diagnostic confidence; only 30% of neuromuscular faculty indicated they could make accurate neurological diagnoses through a tele-exam as opposed to 84% or greater for other specialties. Conclusions: Teleneurology appears to be feasible and acceptable to a majority of academic neurologists, though diagnostic confidence may differ by sub-specialty. Improvements in technological infrastructure and care models are needed to advance telemedicine neurological care delivery.

Near-peer-assisted learning for training undergraduate medical students in clinical ophthalmology skills

ObjectiveThis study aims to formally evaluate near-peer-assisted learning (NPAL) for teaching clinical ophthalmology skills to second-year undergraduate medical students through their fellow medical interns. MethodsInterns posted at the department of ophthalmology were included as tutors after an initial sensitization and assessment. Second-year undergraduate students were included as tutees. Sessions were conducted for pre-identified clinical skills in batches of 3–5 tutees each. Perceptions of tutors and tutees were captured on a 5-point Likert scale (Kirkpatrick level-1) and evaluated. Tutors were assessed by directly observed procedural skills (DOPS) and tutees by pre- and post-session scores and performance of the respective clinical skills (Kirkpatrick level-2). ResultsA total of 21 of 24 tutors and 82 of 100 tutees responded to the evaluation questionnaire. Tutors perceived themselves as knowledgeable and useful as instructors; scores of second DOPS session significantly improved compared to the first (p = 0.001) for all clinical skills. Tutees found the NPAL sessions effective for learning clinical skills. Pre- and post-test scores significantly improved (p = 0.001), and all clinical skills were satisfactorily performed in the end-of-term exam. ConclusionNPAL was perceived as an effective teaching-learning method by both tutees and tutors, and all clinical skills were performed successfully. NPAL can serve as a useful adjunct to traditional teaching for clinical training of small groups and can help alleviate teaching pressures on already burdened clinical faculty in Indian Medical colleges.

A collaborative clinical case conference model for teaching social and behavioral science in medicine: an action research study

BackgroundEffective social and behavioral sciences teaching in medical education requires integration with clinical experience, as well as collaboration between social and behavioral sciences experts and clinical faculty. However, teaching models for achieving this integration have not been adequately established, nor has the collaboration process been described. This study aims to propose a collaborative clinical case conference model to integrate social and behavioral sciences and clinical experience. Additionally, we describe how social and behavioral science experts and clinical faculty collaborate during the development of the teaching method.MethodsA team of medical teachers and medical anthropologists planned for the development of a case conference based on action research methodology. The initial model was planned for a 3-h session, similar to a Clinicopathological Conference (CPC) structure. We evaluated each session based on field notes taken by medical anthropologists and post-session questionnaires that surveyed participants’ reactions and points of improvement. Based on the evaluation, a reflective meeting was held to discuss revisions for the next trial. We incorporated the development process into undergraduate medical curricula in clinical years and in a postgraduate and continuous professional development session for residents and certified family physicians in Japan. We repeated the plan-act-observe-reflection process more than 15 times between 2015 and 2018.ResultsThe development of the collaborative clinical case conference model is summarized in three phases: Quasi-CPC, Interactive, and Co-constructive with unique structures and underlying paradigms. The model successfully contributed to promoting the participants’ recognition of the clinical significance of social and behavioral sciences. The case preparation entailed unique and significant learning of how social and behavioral sciences inform clinical practice. The model development process promoted the mutual understanding between clinical faculty and anthropologists, which might function as faculty development for teachers involved in social and behavioral sciences teaching in medical education.ConclusionsThe application of appropriate conference models and awareness of their underlying paradigms according to educational situations promotes the integration of social and behavioral sciences with clinical medicine education. Faculty development regarding social and behavioral sciences in medical education should focus on collaboration with scholars with different paradigmatic orientations.

Operational and financial impact of the COVID-19 pandemic on U.S. dental school clinics.

PurposeThis study assessed the impact of the COVID‐19 pandemic on U.S. dental schools and their school‐based clinic operations and finances during the first eight months (April to December 2020) of the outbreak. School‐based clinics are critical to training and educating future dentists and delivering oral health care services to underserved communities.MethodsThe American Dental Education Association (ADEA) conducted a structured survey with the 67 accredited U.S. dental schools between November 2020 and January 2021 to assess the impact of the COVID‐19 pandemic on their operations, especially on their school‐based clinics. The response rate was 67%. The authors employed descriptive statistics and text analysis to examine the survey results.ResultsThis study revealed that from April to December 2020, dental schools experienced a 50% reduction in patient visits at dental school clinics, a 7% median decrease in budget, a 42% decline in revenue, changes in clinical and nonclinical faculty and staff, and investments related to infection control measures to remain operational. Ninety‐two percent of dental school clinics suspended community‐based patient care experiences outside the dental school in the first eight months of the pandemic compared to the same time period the year prior.ConclusionsThis research shows the extent of the operational and financial challenges dental school clinics faced in the pandemic's first eight months, April to December 2020. In these unique times, dental school clinics continued to train and educate the dentists of tomorrow and deliver oral health care services to vulnerable communities while implementing safeguards and infection control measures to combat the propagation of the COVID‐19 virus in their institutions.

Non-academic admission criterion of certified nursing assistant status for undergraduate nursing programs: A comparative case study.

The number of nursing program graduates does not meet the current demand for nurses. Program faculty relies on the predictive power of admission criteria to admit students who will be successful. Non-academic admission criteria, such as Certified Nursing Assistant (CNA) status, should be considered to complement academic criteria. This study aimed to explore nursing students' perceptions and clinical faculty of the non-academic prerequisite of CNA status as an admission criterion. First-year students' preparedness for the clinical setting, self-confidence, and anxiety in clinical decision making (CDM) was considered. A multi-methods comparative case study design was utilized. The setting was two undergraduate baccalaureate nursing programs. Nine faculty and 54 students participated in the study. The researcher collected data through interviews with the participants, observations, document analysis, field notes, and self-report on the Nursing Anxiety and Self-Confidence with Clinical Decision Making (NASC-CDM) scale. Three themes emerged from the interview data: (a) student preparedness, (b) student learning, and (c) student program success. No statistically significant differences in student anxiety or self-confidence were found in the NASC-CDM scale. The investigation of CNA status could be an essential aspect of the undergraduate nursing program admission process.

Virtual learning experiences in population health nursing course during the COVID-19 pandemic.

AimTo discuss the virtual learning strategies used in population health nursing course during the coronavirus disease 2019 (COVID‐19) pandemic.BackgroundThe School of Nursing faculty in a South Central University in the United States quickly combined innovation with digital resources and transitioned a course in population health during the COVID‐19 pandemic. Nursing faculty were challenged to develop student nursing objectives in assessment, planning, intervention and evaluation of vulnerable populations in the community through a virtual environment.Reflections of population health nursing clinical educationThe experiences of five clinical groups are described, covering adults with disabilities, older people, patients with COVID‐19 and youth populations.DiscussionThe course objectives were met through use of a digital environment. Collaborative interventions were designed and implemented with community stakeholders while maintaining social distancing policies. Successes included increased frequency of communication and learning opportunities for students and the community, and student satisfaction. Barriers to student learning were not related to the digital learning environment, although the older adults required modifications to use electronic devices.ConclusionVirtual classrooms are a viable platform to teach population health nursing and to benefit vulnerable populations.Implications for nursing practiceVirtual learning offers benefits within academia and the community. Technology offers the possibility to improve mental health among older people and enhance knowledge among the general population. Students are better able to connect with clinical faculty and stakeholders through digital platforms.Implications for nursing policyNurses play a vital role in improving population health and can collaborate with community stakeholders to implement innovative and sustainable solutions to nursing education, practices and policy. Digital platforms can enhance the involvement of students through these collaborations during and after the pandemic.

“Brachy-mergency!”: Developing and Implementing an Effective HDR Emergency Response Training Course

A stuck HDR source during brachytherapy (BT) treatments is rare but serious medical emergency. A rapid and coordinated response by providers is necessary to limit exposure and avoid serious injury to the patient. At our institution, previous training consisted of informal verbal instruction and review of the HDR workflow, resulting in considerable variability in preparedness. As a quality improvement project, we developed a standardized BT emergency training program to improve the confidence and preparedness of our staff in responding to and resolving such emergencies.We developed an educational course using vendor material, AAPM Task Group publications, reviewed high-profile BT accidents, and integrated suggestions from physics and clinical faculty. Before and after the training session, participants completed an online quiz and survey to assess baseline knowledge and confidence (5-point Likert scale). Participants first underwent a timed simulation that required manual source retraction. This simulation was also repeated at the end of the training session. Next an educational 1-on-1 discussion and presentation was conducted to review the structure, function, and workflow of BT treatments and all equipment involved. We reviewed and virtually drilled the necessary steps for a stuck-source emergency, cardiac arrest, and other medical (e.g., seizure, unstable patient) and technical (aborted check cable run) predicaments. Statistical analysis comparing pre- and post-training quiz scores and simulation times was completed using paired t-tests.10 staff members volunteered to participate in the "brachy-mergency" training course including resident and attending physicians, medical physicists, and medical students. The average quiz score was 68% before training, and significantly increased to 90% (P = 0.002) after training. The average time to resolve the stuck-source simulation was 99 seconds before training, and significantly decreased to 47 seconds (P < 0.001) after training. Only 20% of subjects initially agreed that they were confident in their ability to recognize a stuck-source emergency, and 30% agreed in their ability to resolve the emergency. Post training these measures were 100%. Lastly, 90% of subjects agreed that the training session was a positive learning experience, and 100% agreed that it should be a standard component of radiation oncology training.We successfully developed and implemented an HDR emergency response training course for our department that significantly improved knowledge, response time, and confidence in resolving stuck-source and other BT emergencies. We plan to refine and expand this program to improve our preparedness for years to come.