Clinical Problem-solving Skills Research Articles

Exploring pharmacists' attitude, willingness and barriers to provide extended community pharmacy services: Implications for improved pharmacy services.

This study aimed to evaluate pharmacists' attitude and willingness to provide extended community pharmacy services (ECPS), the barriers to ECPS, and the factors associated with attitude and willingness to implement ECPS. In this cross-sectional study, a validated, self-administered questionnaire was distributed online to community pharmacists across the United Arab Emirates between September and November 2023. In addition to sociodemographic data, the questionnaire evaluated attitudes toward ECPS, willingness to provide ECPS, and barriers to its implementation. Binary logistic regression was conducted to explore the factors associated with attitude and willingness to implement ECPS. The study included 409 pharmacists. Over half of the participants reported below the median attitude (58.7%) and willingness (59.4%) scores. Female pharmacists had a lower attitude towards ECPS (OR = 0.425, 95%CI: 0.242-0.747). Higher number of daily prescriptions (OR = 1.066, 95%CI: 1.029-1.105) and being a Pharm D graduate (OR = 2.664, 95%CI: 1.439-4.932) were associated with higher willingness to provide ECPS, while an increased number of employed pharmacists (OR = 0.518, 95%CI: 0.397-0.676) was associated with a lower willingness (OR = 0.049, 95%CI: 0.004-0.660). Patients' preoccupation (76.5%), lack of specific training (76.3%), lack of clinical problem-solving skills (74.6%) and lack of a private consultation room (74.6%) were the most commonly reported barriers to ECPS. Community pharmacists demonstrated unsatisfactory levels of attitude and willingness towards ECPS provision. Therefore, providing training and education programs that enhance pharmacists' perception and willingness to implement ECPS and emphasize improving clinical problem-solving skills, as well as setting up specific private consultation rooms, is deemed necessary. Female pharmacy graduates, pharmacists dispensing fewer daily prescriptions, and those working with a higher number of employed pharmacists should be specifically targeted when implementing these strategies.

Outcomes of an Interprofessional Opioid Training Program for Graduate Students in Nursing and Social Work

ABSTRACT Social workers and other behavioral health professionals trained to provide prevention, treatment, and recovery services for opioid use disorders (OUD) remain urgently needed in the U.S. particularly in states with widespread health professional shortage areas. To help mitigate this workforce gap, faculty in social work and nursing at a public university in Alabama developed and piloted an innovative HRSA-funded interprofessional traineeship to prepare graduate-level nursing and social work students to assess and treat opioid use disorders (OUD). The yearlong traineeship included specialized coursework on evidenced-based practice in addictions, interprofessional telemedicine and simulation training, and multi-semester field practica in outpatient treatment settings. Impact of the pilot training was evaluated using a pre-experimental one group design. Baseline and post-training surveys assessed knowledge, attitudes, and skills related to OUD and interprofessional practice and perceived program impact. Significant increases were observed for trainees’ self-reported knowledge, attitudes, and skills. Moreover, at graduation students reported that the traineeship had improved their abilities to interact with underserved populations, collaborate interprofessionally, and understand ethical issues in SUD treatment as well as enhancing their professional competence, clinical problem-solving, and health workforce skills. Findings suggest that the interprofessional training program may prepare social work and nursing graduate students to effectively serve clients with OUD and help to address a critical workforce gap in medically underserved communities.

The Digital Story Teaching Method for Master of Nursing Specialist Students

As future healthcare professionals, Master of Nursing Specialist (MNS) students will play an important role in nursing and healthcare. MNS education emphasises the cultivation of students’ critical and clinical thinking. Traditional classroom methods often result in students being unable to combine theory with practice and reduce their ability to problem-solve within the scope of clinical or professional services. However, in economically underdeveloped areas with insufficient educational resources, it is difficult to use real clinical situations or virtual reality technology to carry out teaching. To fill this gap, we introduced the digital story teaching method into classroom teaching in Shanxi Province in northern China, which is an economically underdeveloped agricultural province. Real clinical cases were adapted into stories, with integrated digital media elements. A before-and-after study design was adopted to compare the differences between the digital story teaching method group and the traditional teaching method group. The results indicate that students engaged in learning with the digital story teaching method demonstrated more active learning styles, clinical problem-solving skills, and higher academic achievements in classroom performance and examinations. As a continuous and low-cost flexible education method, the digital story teaching method is a teaching mode suitable for popularisation in areas where clinical teaching resources are relatively scarce.

Exploring medical students’ metacognitive and regulatory dimensions of diagnostic problem solving

ABSTRACT Solving clinical problems requires an individual to apply not only domain-specific medical knowledge and cognitive skills for reasoning, but also to be consciously aware of, monitor, and evaluate their thinking processes (i.e., metacognition). The purpose of this study was to map critical metacognitive dimensions of clinical problem solving and to explore the structural relationships among them, which may help frame a conceptual framework and better pedagogy for effective intervention. A context-specific inventory was adapted and modified from a domain-general instrument to capture essential metacognitive skills for learning and solving clinical problems. This inventory was administered to 72 undergraduate medical students to survey their capabilities in five dimensions: knowledge of cognition, objectives, problem representation, monitoring, and evaluation. The interplay among these dimensions was further examined using partial least squares structural equation modeling. Our findings revealed that the medical students fell short of some expert-like, metacognitive, and regulatory competence, even after receiving years of medical education and on-site training. In particular, they did not know when a holistic understanding of a problem had been reached. Many of them often do not have a set of clear diagnostic procedures in mind, nor do they concurrently monitor their thinking during diagnostic reasoning. Moreover, their lack of self-improving approaches seemed to worsen their learning. Finally, the structural equation model indicated that knowledge of cognition and objectives significantly predicted problem representation, suggesting that medical learners’ knowledge of and goals for learning are influential in framing the clinical problems at hand. A significant linear prediction path was observed from problem representation, monitoring, to evaluation, signifying a possible sequenced process of clinical problem solving. Metacognitive-based instruction can help improve clinical problem-solving skills and awareness of potential biases or errors.

Comparing the efficacy of problem-based learning vs. lectures on the academic achievement and educational motivation of nursing students: A 3-year quasi-experimental study

Background: The expansion of roles and the professionalization of nursing obligates instructors to use novel teaching methods, especially problem-based learning (PBL), which provides students with clinical problem-solving skills and promotes lifelong learning. Methods: In a quasi-experimental study, the effects of two teaching methods (traditional lectures and PBL) on academic achievement and educational motivation of nursing students were compared. The study participants consisted of four different classes across four academic semesters of students who had taken a "Respiratory System Diseases and Disorders" theoretical course. The Solomon four-group test was used to remove the sensitizing effect of the pre-test and avoid compromising the external validity of the research. Two classes used the PBL method and two classes used the lecture method. An academic achievement test and the Inventory of School Motivation (ISM) were used to compare the pre-and post-test results. Results: The pre-test indicated the same random effect on all the participants (P>0.05). Both control groups were treated as one general control group (n=52) and both experimental groups were treated as one general experimental group (n=56). The difference between the post-test mean scores of academic achievement and educational motivation was not significant between the two PBL groups (P>0.05) nor the two lecture groups (P>0.05). The PBL and lecture groups differed in their mean post-test scores of academic achievement and educational motivation (P < 0.05), wherein the PBL group showed higher scores than the control group. Conclusion: In traditional learning methods, students gain required knowledge for problem-solving before encountering problems. In PBL, however, knowledge is acquired by actually working on problems. The advantages of PBL include gaining basic knowledge for clinical use, developing effective care, developing personal learning skills, and increasing the desire to learn.

OSCE Finest Practice Guidelines—Pertinency for Nursing Simulations

OSCEs are a form of simulation and are often collective but may be determinative. This educational tactic requiresrobust design based on sound pedagogy to assure practice and evaluation of holistic nursing care. The OSCE,first used in the 1970s, is an assessment of capability carried out in a well-planned, arranged and objective way.Summative OSCEs are often used at the end of courses or programmes or on accomplishment of a module to teststudents in contradiction of set objectives and learning consequences. OSCE is used in different areas like historytaking skills, interpersonal and communication skills, Mental Health Assessment, clinical diagnosis making,clinical problem-solving skills etc. Preparation is vital and increases students’ self-confidence in performingskills during the OSCE and in clinical areas. The OSCE examination entails of about 10-15 stations, each of whichrequires about 4-5 minutes. The number of stations and time consumed on each station may vary based on needsof evaluation. Thus, using 15 stations of 4 minutes separately, 15 students can complete the examination within1 hour. The OSCE style of clinical evaluation, given its obvious advantages, specifically in terms of objectivity,standardization and resourcefulness of clinical scenarios that can be measured, shows superiority over so calledclinical assessment methods especially in medical fields majorly in nursing practices.

Interprofessional Education: Medical Students Create a Cadaver Lab Workshop for Nursing Students at a Neutral Cost.

Cadaver labs are one of the staples of medical education in the United States, yet it is relatively uncommon for nursing students to have the opportunity to engage in the direct observation, hands-on learning, and the efficiency of the immersive environment in a cadaver-based anatomy lab. The primary aim of this project was to determine if medical students could create and deliver a cadaver lab workshop for nursing students that would provide educational benefits to both groups of students at a neutral cost. The purpose of this activity was to evaluate how a cadaver lab for nursing students could increase understanding of clinically-relevant anatomy, disease, and indwelling medical devices, while enhancing overall clinical problem-solving skills. The participants, nursing and medical students, completed a five-hour workshop followed by completion of a four-question survey of their overall learning experience and the value of the workshop from an interprofessional perspective. The surveys were analyzed individually for qualitative central themes; similar central themes were compiled by question, and overarching themes were identified and reported. Self-reflections completed by the students revealed that this shared encounter between trainees resulted in a better understanding of the visualization of the size, spatial relations, and physical interactions between organ systems; increased confidence in patient care regarding the physical exam and medical device management; and a better-perceived understanding of each profession’s approach in providing patient-centered care. Medical students may also benefit by participation in this interprofessional activity through the development of clinical teaching skills that are needed while working with patients and clinical colleagues.

Integrating Clinical Reasoning Skills in a Pre-professional Undergraduate Human Anatomy Course.

Clinically integrated curricula in health science education has been shown to promote the development of problem-solving schema and positively impact knowledge acquisition. Despite its' purported benefits, this type of curricula can impose a high cognitive load, which may negatively impact novice learners' knowledge acquisition and problem-solving schema development. Introducing explicit clinical reasoning instruction within pre-professional undergraduate basic science courses may limit factors that increase cognitive load, enhance knowledge acquisition, and foster developing clinical problem-solving skills. This study, conducted over the Fall and Spring semesters of the 2018-2019 school year, sought to evaluate whether the implementation of a clinical reasoning instructional intervention within a clinically integrated pre-professional undergraduate general human anatomy course influenced students' acquisition of anatomical knowledge and development of clinical problem-solving skills. Results of the study were mixed regarding the acquisition of anatomical knowledge. Both the intervention and comparison groups performed similarly on multiple choice examinations of anatomical knowledge. However, the clinical reasoning intervention positively impacted students' ability to apply clinical reasoning skills to anatomically based clinical case studies. Results from M\mixed between-within subjects analysis of variance comparing scores on Written Clinical Reasoning Assessments revealed a significant interaction between time and group affiliation, with the groups receiving the interventions outperforming the comparison groups: Fall, P<0.001; Spring, P<0.001. The results of this study may imply that explicit clinical reasoning instruction within a clinically integrated undergraduate Human Anatomy course could hold potential for fostering students' early clinical reasoning skills.

Use of Eye-Tracking Technology by Medical Students Taking the Objective Structured Clinical Examination: Descriptive Study.

BackgroundThe objective structured clinical examination (OSCE) is a test used throughout Spain to evaluate the clinical competencies, decision making, problem solving, and other skills of sixth-year medical students.ObjectiveThe main goal of this study is to explore the possible applications and utility of portable eye-tracking systems in the setting of the OSCE, particularly questions associated with attention and engagement.MethodsWe used a portable Tobii Glasses 2 eye tracker, which allows real-time monitoring of where the students were looking and records the voice and ambient sounds. We then performed a qualitative and a quantitative analysis of the fields of vision and gaze points attracting attention as well as the visual itinerary.ResultsEye-tracking technology was used in the OSCE with no major issues. This portable system was of the greatest value in the patient simulators and mannequin stations, where interaction with the simulated patient or areas of interest in the mannequin can be quantified. This technology proved useful to better identify the areas of interest in the medical images provided.ConclusionsPortable eye trackers offer the opportunity to improve the objective evaluation of candidates and the self-evaluation of the stations used as well as medical simulations by examiners. We suggest that this technology has enough resolution to identify where a student is looking at and could be useful for developing new approaches for evaluating specific aspects of clinical competencies.

Assessing dental hygiene students' readiness for interprofessional learning and collaborative practice.

The need for interprofessional education (IPE) has been well documented and communicated by many prominent governmental bodies and health organizations. However, more longitudinal outcomes research is needed to demonstrate the impact of IPE on students' attitudes and behaviors. This study assessed dental hygiene students' readiness for IPE and collaborative practice at the University of British Columbia, Canada. A modified Readiness for Interprofessional Learning Scale (RIPLS) survey was conducted on 23 (96% response rate) second-year dental hygiene students prior to commencing the university's newly integrated 4-week IPE curriculum and immediately following its completion 1 month later. A focus group comprising 5 students then explored learning experiences and impact on attitudes about collaborative practice in greater depth. Curriculum content included professionalism, ethical practice, Indigenous cultural safety, and resiliency. Attitudinal shifts were observed in 3 of the RIPLS measures suggesting that students found greater clarity regarding their professional roles and became more receptive to learning clinical problem-solving skills with other disciplines. No statistically significant differences surfaced between the pre-attitudinal and post-attitudinal RIPLS measures. The focus group revealed 3 prominent themes: greater role clarification, recognition of similarities in knowledge and practice with other professions, and cultivation of professional identity, collegiality, and respect. Students found greater clarity about professional roles and developed an enhanced appreciation for working with other health professions after completing the university's month-long integrated IPE curriculum.

The Impact of Active Learning in a Speech-Language Pathology Swallowing and Dysphagia Course

The signature pedagogy in Speech-Language Pathology (SLP) higher education programs has been criticized for its instructor-centric lecture format and emphasis on the lower tiers of Bloom’s taxonomy (simply memorizing knowledge) at the expense of helping students develop the clinical problem-solving skills required for a lifetime of practice and learning. The purpose of this study was to examine the responses of a cohort of graduate speech-language pathology students to an active learning-oriented swallowing and dysphagia course design. A potential relationship between student perceptions of the active learning pedagogy and academic performance was also explored. The results suggest that active learning positively impacted both student perceptions and performance in the redesigned swallowing and dysphagia course.

Implementation of problem-oriented learning sessions in para-clinical years of medical college

Background: In order to develop competent health care professionals and to help medical students to acquire clinical reasoning, critical thinking and problem-solving skills, it was decided to initiate problem-oriented learning (POL) sessions as a part of implementation of integrated learning in the second year of undergraduate education of medical students in a medical college. Methods: A group of 150 students in the second year of their undergraduate education was divided into 10 sets of 15 members each. For each weekly POL session, one lead department was identified and from that department, one faculty member was assigned for each of the 10 groups for clarity and guidance. Four to five departments in all were involved in these POL sessions based on the topic and were instructed to frame their objectives and share these with the lead department at least one week prior to each session to develop appropriate problems for discussion. Results: Initial results failed to meet the desired objectives. The entire exercise was restructured and attention was given to the areas where weaknesses were identified. Faculty members were provided with additional information about POL and the number of sessions was reduced to two per month. Faculty members were instructed to be discussion facilitators rather than to become involved in didactic teaching. Subsequently, a significant improvement was observed both in terms of outcomes and student participation. Conclusion: It is relatively easy to start a new mode of teaching-learning; however, outcomes improve when efforts are planned systematically and implementation is revisited after challenges and gaps are identified.

An Investigation of Entry Level Doctor of Physical Therapy Student Perspectives of Peer Evaluation

Purpose: To describe the perceptions of peer evaluation as an instructional method when used by entry-level doctor of physical therapy (DPT) students as preparation for practical examinations within a clinically oriented course. Methods/Description: Forty first year, entry-level doctor of physical therapy students participated in structured peer-skills checks prior to practical exams as part a clinically based course. Each student was required to observe and provide critical feedback for at least four other students as they performed simulated patient care activities. Peer-evaluators rated the students on their level of competency with the skills using a Visual Analog Scale and provided written feedback specifying areas of strength and areas needing improvement. Following the conclusion of the course, students completed a questionnaire using online survey software. The questionnaire was designed to investigate student perceptions related to skill acquisition, giving and accepting feedback, and the overall value of peer-feedback. Results: Themes emerged regarding the value of practice and repetition, emerging reflective practice skills, emerging critical thinking and problem solving skills, and the use of peer feedback for improved performance. The value of practice and repetition was reflected in statements such as the skills checks “helped me organize my interviews…and get over my fear of the unknown.” Emerging reflective practice was demonstrated by comments such as "made me self-reflect on my abilities to perform skills.” The development of clinical reasoning and problem solving skills were evidenced by comments of “the skills check helped me think through what to do when things did not go as planned...” The value of feedback was reflected in comments such as “It helped me refine my skills and develop the areas that aren't as strong,” “I embraced the feedback...I could work on my weaknesses.” Conclusions: Literature supports peer evaluation as an instructional tool within allied health education; however, minimal research has been completed within the profession of physical therapy education. Based on the results of this study, entry-level doctor of physical therapy students perceive peer-evaluation as an effective instructional method to assist in developing psychomotor skills necessary for patient care, as well as, affective skills necessary for reflective practice and cognitive skills related to clinical reasoning.

Chief Resident Immersion Training in the Care of Older Adults: A Successful National Replication of an Interspecialty Educational Intervention.

Nongeriatricians must acquire skills and knowledge in geriatric medicine to ensure coordinated care of older adults' complex conditions by interspecialty and interprofessional teams. Chief residents (CRs) are an ideal target for an educational intervention. This study examined whether the Boston Medical Center Chief Resident Immersion Training (CRIT) in the Care of Older Adults was replicable at diverse medical institutions. Between 2008 and 2010, 12 institutions in 11 states received funding, technical support, and a common program model. Each implemented 2.5-day CRITs, consisting of a patient case, geriatrics-related lectures, CR leadership sessions, action project planning, and networking time. Site faculty conducted 21 CRITs for 295 CRs representing 28 specialties. CRs completed knowledge pre- and posttests, and self-report baseline and six-month follow-up surveys. Outcome measures were change in pre- and posttest score, and change from baseline to six months in self-reported surveys. Response rate for CRs was 99% (n = 293) for the pre-post tests and 78% (n = 231) for matchable baseline and follow-up surveys. Participants' knowledge increased from 6.32 to 8.39 (P < .001) averaged from 12 questions. CRs' self-reported ability to apply clinical problem-solving skills to older patients (P < .001), number of geriatrics topics taught (P < .001), frequency of geriatrician consultations (P = .017), confidence in leadership skills (P < .001), and confidence to conduct CR work (P < .001) increased from baseline to follow-up. CRIT is an innovative way to give nongeriatricians knowledge and skills to treat complex older patients.

Incorporation of autopsy case–based learning into PhD graduate education: a novel approach to bridging the “bench-to-bedside” gap

Given the current rapid expansion of biological knowledge and the challenges of translating that knowledge into clinical practice, finding effective methods of teaching graduate students clinical medicine concepts has become even more critical. The utility of autopsy in medical student and resident education has been well established. Multiple studies have reported it to be a helpful means of teaching anatomy, pathophysiology, clinical problem-solving skills, and medical diagnostic techniques. Although various models of training PhD candidates in clinical medicine have been reported, an autopsy-based curriculum has not been previously described. For over 4 years, our pathology department has offered a novel semester-long autopsy-based course to educate future Cellular and Molecular Pathology scientists about clinical medicine. Our results indicate that this "hands-on" approach is a popular as well as effective means of teaching the pathogenesis of disease at the level of the cell, organ, and patient. The course reputation has recently led to requests to open registration to graduate students from other university programs as well as undergraduate students. Additionally, it has played an important role in our Cellular and Molecular Pathology program's recent receipt of a 5-year renewal National Institutes of Health-funded T32 award. Overall, this course model has been successful at our own institution and could provide a useful template for other institutions seeking to provide graduate investigators with in-depth exposure to clinical medicine.

Clinical teaching and learning within a preceptorship model in an acute care hospital in Ireland; a qualitative study

BackgroundA preceptorship model of clinical teaching was introduced to support the new all-graduate nurse education programme in Ireland in 2002. Little is known about how this model impacts upon the pedagogical practices of the preceptor or student learning in clinical practice leading to question what constitutes effective teaching and learning in clinical practice at undergraduate level. AimThis study aimed to explore the clinical teaching and learning within a preceptorship model in an acute care hospital in Ireland and identify when best practice, based on current theoretical professional and educational principles occurred. MethodA qualitative research study of a purposively selected sample of 13 students and 13 preceptors, working together in four clinical areas in one hospital in Ireland. Methods were semi-structured interviews, analysed thematically, complemented by documentary analysis relating to the teaching and assessment of the students. Ethical approval was gained from the hospital's Ethics Committee. FindingsPreceptor-student contact time within an empowering student-preceptor learning relationship was the foundation of effective teaching and learning and assessment. Dialoguing and talking through practice enhanced the students' knowledge and understanding, while the ability of the preceptor to ask higher order questions promoted the students' clinical reasoning and problem solving skills. Insufficient time to teach, and an over reliance on students' ability to participate in and contribute to practice with minimal guidance were found to negatively impact students' learning. Conclusions & ImplicationsConcepts such as cognitive apprenticeship, scaffolding and learning in communities of practice can be helpful in understanding the processes entailed in preceptorship. Preceptors need extensive educational preparation and support to ensure they have the pedagogical competencies necessary to provide the cognitive teaching techniques that foster professional performance and clinical reasoning. National competency based standards for preceptor preparation should be developed.

Comparison of student perception and performance between case-based learning and lecture-based learning in a clinical laboratory immunology course

Abstract Background: Case-based learning (CBL), an educational method of problem-based learning, provides students with a venue to relate content learned in the classroom to performance in professional practice. This study compared CBL in the teaching of a clinical laboratory immunology (CLI) course to lecture-based learning (LBL), and evaluated the effect on students regarding the CBL. Methods: Data were collected from senior students (n=85; 46% males, 54% females) at Lanzhou University in China. The students were divided into two groups, one group was offered CBL, while the other LBL as a teaching instrument. After intervention, perceptions of both the groups about their respective teaching method were evaluated using questionnaires, the resulting scores were compared to those obtained in the LBL group. Results: The CBL group showed significantly better scores in course examination (p&lt;0.05) as compared to the LBL group. Seventy-seven (90.6%) students in the CBL group opined that CBL improved their learning and clinical problem-solving skills. CBL also provided them with better understanding (90.6%) and preparation for examinations (90.6%). CBL group improved markedly in comparison to the LBL group with regard to learning motivation (p=0.040), clinical reasoning ability (p=0.023) and clinical problem-solving ability (p=0.022). Conclusions: Our findings demonstrate that CBL is a more effective teaching strategy as compared to LBL in a CLI course. Consequently, the implementation of CBL in teaching a CLI course helps students to improve their learning motivation, problem solving abilities and mastery of knowledge.

Reforming the 4th-Year Curriculum as a Springboard to Graduate Medical Training: One School's Experiences and Lessons Learned

ABSTRACTProblem: Concerns regarding the quality of training in the 4th year of medical school and preparation of graduates to enter residency education persist and are borne out in the literature. Intervention: We reviewed the published literature regarding Year 4 concerns as well as institutional efforts to improve the 4th-year curriculum from several schools. Based on input from key stakeholders, we established 4 goals for our Year 4 curriculum reform: (a) standardize the curricular structure, (b) allow flexibility and individualization, (c) improve the preparation for residency, and (d) improve student satisfaction. After the reform, we evaluated the outcomes using results from the Association of American Medical Colleges Questionnaire, student focus groups, and program director surveys. Context: This article describes the context, process, and outcomes of the reform of the Year 4 curriculum at Stony Brook University School of Medicine. Outcome: We were able to achieve all four stated goals for the reform. The significant components of the change included a flexible adaptable curriculum based on individual needs and preferences, standardized learning objectives across the year, standardized competency-based evaluations regardless of discipline, reinforcement of clinical skills, and training for the transition to the workplace as an intern. The reform resulted in increased student satisfaction, increased elective time, and increased preparedness for residency training as perceived by the graduates. The Program Director survey showed significant changes in ability to perform a medical history and exam, management of common medical conditions and emergencies, clinical reasoning and problem-solving skills, working and communication with the healthcare team, and overall professionalism in meeting obligations inherent in the practice of medicine. Lessons Learned: Lessons learned from our 4th-year reform process are discussed. Listening to the needs of the stakeholders was an important step in ensuring buy-in, having an institutional champion with an organizational perspective on the overall institutional mission was helpful in building the guiding coalition for change, building highly interactive collaborative interdisciplinary teams to work together addressed departmental silos and tunnel vision early on, and planning a curriculum is exciting but planning the details of the implementation can be quite tedious.

Attitudes of the first cohort of student groups trained together at the University of Portsmouth Dental Academy towards dental interprofessional education

This study explored, and compared, the attitudes of student groups trained at the University of Portsmouth Dental Academy (UPDA) in 2010/2011 towards dental interprofessional education (IPE). The study population consisted of fifth-year student dentists (n = 80) from King's College London Dental Institute, second- and third-year dental hygiene and therapy (n = 38) and first-year dental nursing (n = 14) students from UPDA. A 19-item, validated and dentally modified questionnaire, 'Readiness for Inter-Professional Learning Scale (RIPLS)', was administered. RIPLS contains three subscales: teamwork and collaboration, professional identity and roles and responsibilities. Mean (x¯) and standard deviation (SD) of the scores were calculated, following reversal of negative items. All the analyses were carried out using SPSS version 20 and STATA version 11. An overall response rate of 71% (n = 94) was achieved. In reference to teamwork and collaboration, all groups strongly indicated that IPE can contribute to learning teamwork skills (x¯ = 24.98, SD = 3.5) and improving relationships with team members (x¯ = 12.93, SD = 1.63); however, the scores did not differ between the groups (P = 0.09 and P = 0.16, respectively). Concerning professional identity, student dentists had significantly higher preference for a discipline-based approach (P = 0.002); were more likely to agree that 'it is not necessary for undergraduate dental and dental care professional students to learn together' (P = 0.01); and perceived that 'clinical problem-solving skills can only be learnt effectively with other students from their own discipline' (P = 0.02) than dental hygiene and therapy students. In relation to roles and responsibilities, participants demonstrated a strong sense of their own professional role. Student dentists reported that they had 'to gain more knowledge and skills' than dental hygiene and therapy (P = 0.01) and dental nursing (P = 0.01) students. Dental hygiene and therapy students were less likely than student dentists to agree that 'the role of dental nurses and hygienists was to mainly provide support for dentists' (P = 0.001). The findings suggest that IPE was perceived as beneficial in relation to teamwork; however, the study raises issues regarding professional identity and roles. Educators should consider differing perceptions of professional roles and identities when planning and delivering interprofessional programmes.

How do Medical Students Learn?

Background & Objectives: In this paper, we try to define learning, to describe how retention of memorized material can be improved and to describe how to help students improve clinical reasoning and problem solving skills. The goal of teaching is to improve learning, but how do we know that students are learning in the proper way? Methods: We depend on our experience in medical and clinical teaching of our undergraduate and postgraduate students during implementation of the curriculum. We interview 1st year (preclinical) and 6th year medical students by certain questionnaires (VARK) in order to know their learning methods and their knowledge about the styles of learning and the techniques of learning. Learning is viewed here as developing a way of thinking and acting that is a characteristic of an expert physician. Such a way of thinking consists of three important elements: We utilize Working Memory in 3 main approaches: First, attention in a way through questions, focus attention and uses of first letter of statement of the word; Second, rule of 7 (Teach < 7 steps); Third, concentration on important relevant materials. We have to keep in our mind that even if we remember something, it doesn't mean we understand it. In addition, the case learning approach & problem solving learning approach are the methods used and we try to be cooperative, active, and experimental and the student must be self directed and the students should be competent in his learning methods, most are confident of their ability. Results: Most of the first year students have poor knowledge in regards to style & learning techniques. For final year students around 30% learn two styles and 20% trimodel, especially more in female students, 10% mention single model in their learning and the remaining learn by Quad modals. In conclusion, learning how to learn must be a standard part of the curriculum in medical school, and student must be aware of that.