Acquisition Of Clinical Skills Research Articles

Education of postpartum hemorrhage management clinical skills among midwifery students in Malawi: A qualitative study

BackgroundUnskilled health professionals in healthcare systems are contributing to the high numbers of maternal mortality in Malawi. It is therefore essential that midwifery students acquire postpartum hemorrhage management clinical skills, especially in view of high maternal mortality, with postpartum hemorrhage being the leading cause. However, there is limited evidence on how the teaching is conducted with regard to students’ learning of postpartum hemorrhage management clinical skills. PurposeThis study aimed to describe the current teaching of postpartum hemorrhage management clinical skills in undergraduate nursing and midwifery program in Malawi. MethodsThe study applied a qualitative exploratory descriptive design. Data were collected through ten individual interviews with lecturers and three focus group discussions with twenty-four students in a midwifery education program in Malawi. The data were analyzed using thematic analysis. ResultsTwo themes emerged from the data analysis: (1) there are various teaching and learning approaches for postpartum hemorrhage management in use and (2) unpreparedness of midwifery students in postpartum hemorrhage management for patient care. ConclusionThe present study demonstrated that teaching of postpartum hemorrhage management clinical skills in an undergraduate nursing and midwifery programme in Malawi focuses on theoretical knowledge rather than practical skills, leaving midwifery students unprepared for postpartum hemorrhage management during clinical practice. The findings from the present study may provide knowledge guiding revision of the curriculum for the undergraduate nursing and midwifery programme in Malawi to consider global standards of midwifery education; enhance the lecturer to student ratio to provide the students with appropriate supervision; and to employ innovative teaching and learning strategies that promote peer education and skills practice among midwifery students. In addition, to conduct more research related to various teaching approaches in nursing and midwifery educational programs and among qualified midwives in Malawi. Statement of significancePostpartum hemorrhage management education in undergraduate nursing and midwifery programme in Malawi focuses more on theory than clinical skills. Improving midwifery students' acquisition of postpartum hemorrhage management clinical skills is needed to ultimately help lower Malawi's maternal mortality ratio.

INFLUENCE OF MANAGEMENT OF CLERKSHIP TRAINING ON STUDENTS’ ACQUISITION OF CLINICAL SKILLS IN MBALE CITY HEALTH TRAINING INSTITUTIONS, UGANDA.A CROSS-SECTIONAL STUDY.

Background: This study focused on assessing the influence management of clerkship training on Students’ Acquisition of Clinical Skills in Health Training institutions in Mbale City. Methodology: The study adopted the cross-sectional design with a sample of 124 respondents from the medical staff in Mbale Regional Referral Hospital, Data was collected using questionnaires and interview guides for quantitative and qualitative data respectively. Data was analyzed using SSPSS software and content analysis respectively. Results: Th study targeted 127 respondents but got a response rate of 124 participants and among these, nurses comprised 53(44.2%) of the sample, 46(38.3%) were Allied Health, 13(10.8%) were Midwives while 8(6.7%) were medical officers. The duration planned for clinical clerkship training is appropriate to promote students’ skills acquisition (Mean=2.11, Standard deviation=0.994). The decision rule is that the calculated p-value (level of significance) must be less than or equal to 0.05. Since the calculated p-value of 0.000 is less than 0.05, the regression model was found to be statistically significant (F=105.838, Df=1, ρ< 0.05, β=0.688) hence the Management of the Clerkships Training positively influences Students’ acquisition of clinical skills. Conclusion: Management of the Clerkships has a significant positive influence on Students’ acquisition of clinical skills. This was interpreted to mean that if Health Training Institutions in Mbale City enhance on Management of the Clerkships, there will be a positive enhancement in Students’ acquisition of clinical skills. Recommendation: Health Training Institutions in Mbale City should work more towards boosting the Management of the Clerkships towards supporting Students’ acquisition of clinical skills.

Does an instructional video as a stand-alone tool promote the acquisition of practical clinical skills? A randomised simulation research trial of skills acquisition and short-term retention

BackgroundThe effectiveness of instructional videos as a stand-alone tool for the acquisition of practical skills is yet unknown because instructional videos are usually didactically embedded. Therefore, we evaluated the acquisition of the skill of a humeral intraosseous access via video in comparison to that of a self-study with an additional retention test.MethodsAfter ethical approval, we conducted two consecutive studies. Both were designed as randomised controlled two-armed trials with last-year medical students as independent samples at our institutional simulation centre of a tertiary university hospital centre. In Study 1, we randomly assigned 78 participants to two groups: Vid-Self participants watched an instructional video as an intervention, followed by a test, and after seven days did a self-study as a control, followed by a test. Self-Vid ran through the trial in reverse order.In Study 2, we investigated the influence of the sequence of the two teaching methods on learning success in a new sample of 60 participants: Vid-Self watched an instructional video and directly afterward did the self-study followed by a test, whereas Self-Vid ran through that trial in reverse order.In Studies 1 and 2, the primary outcome was the score (worst score = 0, best score = 20) of the test after intervention and control. The secondary outcome in Study 1 was the change in score after seven days.ResultsStudy 1: The Vid-Self (Participants n = 42) was superior to the Self-Vid (n = 36) (mean score 14.8 vs. 7.7, p < 0.001). After seven days, Self-vid outperformed Vid-Self (mean score 15.9 vs. 12.5, p < 0.001).Study 2: The Vid-Self (n = 30) and Self-Vid (n = 30) scores did not significantly differ (mean 16.5 vs. mean 16.5, p = 0.97).ConclusionAn instructional video as a stand-alone tool effectively promotes the acquisition of practical skills. The best results are yielded by a combination of an instructional video and self-study right after each other, irrespective of sequence.Trial registrationsClinicalTrials.gov: NCT05066204 (13/04/2021) (Study 1) and NCT04842357 (04/10/2021) (Study 2).

Education of postpartum hemorrhage management clinical skills among midwifery students in Malawi: a qualitative study

BackgroundUnskilled health professionals in healthcare systems are contributing to the high numbers of maternal mortality in Malawi. It is therefore essential that midwifery students acquire postpartum hemorrhage management clinical skills, especially in view of high maternal mortality, with postpartum hemorrhage being the leading cause. However, there is limited evidence on how the teaching is conducted with regard to students’ learning of PPH management clinical skills. PurposeThis study aimed to describe the current teaching of postpartum hemorrhage management clinical skills in undergraduate nursing and midwifery program in Malawi. MethodsThe study applied a qualitative exploratory descriptive design. Data were collected through ten individual interviews with lecturers and three focus group discussions with twenty-four students in a midwifery education program in Malawi. The data were analyzed using thematic analysis. ResultsTwo themes emerged from the data analysis: (1) there are various teaching and learning approaches for PPH management in use and (2) unpreparedness of midwifery students in postpartum hemorrhage management for patient care. ConclusionThe present study demonstrated that teaching of postpartum hemorrhage management clinical skills in an undergraduate nursing and midwifery programme in Malawi focuses on theoretical knowledge rather than practical skills, leaving midwifery students unprepared for postpartum hemorrhage management during clinical practice. The findings from the present study may provide knowledge guiding revision of the curriculum for the undergraduate nursing and midwifery programme in Malawi to consider global standards of midwifery education; enhance the lecturer to student ratio to provide the students with appropriate supervision; and to employ innovative teaching and learning strategies that promote peer education and skills practice among midwifery students. In addition, to conduct more research related to various teaching approaches in nursing and midwifery educational programs and among qualified midwives in Malawi. Statement of significancePostpartum hemorrhage management education in undergraduate nursing and midwifery programme in Malawi focuses more on theory than clinical skills. Improving midwifery students' acquisition of PPH management clinical skills is needed to ultimately help lower Malawi's maternal mortality ratio.

Nurses, midwives and students' reports of effective dedicated education units in five European countries: A qualitative study.

To investigate nursing/midwifery students, Clinical Mentors, Link Teachers and Head Nurses experiences within "Dedicated Education Unit" model in 6 European clinical placements and analyse the necessary elements for a powerful clinical learning environment. A multi-country, phenomenological, qualitative study. Focus group interviews were performed to identify the personal and organizational factors of importance for students and nurses/midwives. Data analysis produced 4 main themes (1) Clinical placement organization, (2) students' clinical knowledge and skill acquisition, (3) students, and nurses/midwives' experiences within the DEU model and (4) factors for creating an effective learning environment. A close educational-service collaboration, a realistic clinical placement planning, a focus on student learning process and an investment in professionals' education and development among others, are elements to set up a powerful clinical learning environment. It is considered advisable and urgent to improve the working conditions of nurses/midwives and the learning environments of students as a strategy to alleviate the global shortage of nurses and respond to the increasingly demanding health needs of the population. Due to the close relationship between students' learning and features of the clinical environment nurse educators seek innovative models which allow students to manage patient care and their transition to professional practice. To implement new learning strategies, identifying students, nurses and midwives perceptions and suggestions is a powerful information to evaluate implementation process and outcomes. Our findings could help academic and clinical managers to meet the human and organizational requirements to create a successful learning environment in every student placement.

The Retrospective Stressor Analysis (RSA): a novel qualitative tool for identifying causes of burnout and mitigation strategies during residency

BackgroundResident physicians are at an increased risk of burnout due to their high-pressure work environments and busy schedules which can lead to poor mental health outcomes and decreased performance quality. Given variability among training programs and institutions across the United States, stressors likely differ, and interventions must be tailored to the local context, but few tools exist to assist in this process.MethodsA tool commonly used in adverse event analysis was adapted into a “retrospective stressor analysis” (RSA) for burnout prevention. The RSA was tested in a group of chief residents studying quality improvement and patient safety in veteran’s hospitals across the United States. The RSA prompted them to identify stressors experienced during their residencies across four domains (clinical practice, career development, personal life, and personal health), perceived causes of the stressors, and potential mitigation strategies.ResultsFifty-eight chief residents completed the RSA. Within the clinical domain, they describe the stress of striving for efficiency and clinical skills acquisition, all while struggling to provide quality care in high pressure environments. In the career domain, identifying mentors and opportunities for research engagement was stressful. Within their personal lives, a lack of time-constrained their ability to maintain hobbies, relationships, and attend meaningful social events while also reducing their engagement in healthy behaviors such as exercise, optimal nutrition, and attending medical appointments. Within each of these domains, they identified and described stress mitigation strategies at the individual, departmental, and national levels.ConclusionThe RSA is a novel tool that can identify national trends in burnout drivers while simultaneously providing tailored prevention strategies for residents and their training sites.

INFLUENCE OF MANAGEMENT OF CLERKSHIP TRAINING ON STUDENTS’ ACQUISITION OF CLINICAL SKILLS IN MBALE CITY HEALTH TRAINING INSTITUTIONS, UGANDA.A CROSS-SECTIONAL STUDY.

Background: This study focused on assessing the influence management of clerkship training on Students’ Acquisition of Clinical Skills in Health Training institutions in Mbale City. Methodology: The study adopted the cross-sectional design with a sample of 124 respondents from the medical staff in Mbale Regional Referral Hospital, Data was collected using questionnaires and interview guides for quantitative and qualitative data respectively. Data was analyzed using SSPSS software and content analysis respectively. Results: Th study targeted 127 respondents but got a response rate of 124 participants and among these, nurses comprised 53(44.2%) of the sample, 46(38.3%) were Allied Health, 13(10.8%) were Midwives while 8(6.7%) were medical officers. The duration planned for clinical clerkship training is appropriate to promote students’ skills acquisition (Mean=2.11, Standard deviation=0.994). The decision rule is that the calculated p-value (level of significance) must be less than or equal to 0.05. Since the calculated p-value of 0.000 is less than 0.05, the regression model was found to be statistically significant (F=105.838, Df=1, ρ&lt; 0.05, β=0.688) hence the Management of the Clerkships Training positively influences Students’ acquisition of clinical skills. Conclusion: Management of the Clerkships has a significant positive influence on Students’ acquisition of clinical skills. This was interpreted to mean that if Health Training Institutions in Mbale City enhance on Management of the Clerkships, there will be a positive enhancement in Students’ acquisition of clinical skills. Recommendation: Health Training Institutions in Mbale City should work more towards boosting the Management of the Clerkships towards supporting Students’ acquisition of clinical skills.

Acquisition of key clinical communication skills through simulation-based education: findings from a program for postgraduate psychiatry trainees (ComPsych)

ObjectiveFew studies have investigated the maintenance of skills acquired in classroom-based clinician education. Using an advanced simulation-based clinical communication skill training program for postgraduate psychiatry education (ComPsych), we aimed to investigate skill acquisition through assessing changes in competence (abilities) and performance (practice).MethodsForty trainee psychiatrists (15 males; age range 26–48) participated. Video-recorded Standardized Patient Assessments (SPAs) were delivered twice pre- and post-training to assess learning. Skills were coded by independent psychologists using the Core Communication Skills (CCS) coding system. Simulated patients (SPs) rated trainees' communication performance using the Sim-Patient SPA checklist. Paired t-tests, linear mixed models and logistic mixed models assessed changes in communication skills over time.ResultsFor SPAs, reliability of coder ratings was deemed acceptable (ICC range 0.67 to 0.87). Mean post-training communication performance significantly increased for skills in agenda setting (p < 0.001), information organization (p < 0.001), empathic skills (p = 0.046), and overall skills performance (p = 0.001). Significant decreases for questioning skills were indicative of reduced reliance on these skills post-training. SPs rated all skillsets higher post-training. A modest relationship was detected between frequency (coded) and (SP-rated) quality of communication skills. Improvements in agenda setting and information organisation skills were retained ~ 6 weeks post-training.ConclusionsTraining improved patient-centered communication skills in psychiatry trainees, particularly skills in agenda setting and information organization, with skills retained ~ 6 weeks post-training. There was reduced reliance on questioning skills, which are well utilised generally. The study supports the benefits of this method of communication skills training into postgraduate psychiatry education.

Exploring the role of moulage in facilitating the acquisition of clinical skills among medical students

Training of medical students in the domain of clinical skills is an indispensable component of medical education delivery. Moulage in medical training deals with producing genuine simulations of wounds, injuries, and other medical conditions, so that students can relate to lifelike scenarios. Medical students through moulage are exposed to the complexities of real-world clinical practice to bring about an improvement in their confidence and competence levels as healthcare professionals. Integrating moulage into medical training essentially requires systematic planning and implementation to ensure that simulations are effective. The success of moulage, in terms of attainment of the learning objectives, can be enhanced by beginning with a few modules and then based on the experience, success, and acceptance, gradually expanding the process. In conclusion, the introduction of moulage into the existing medical curriculum can prove to be an effective tool to enrich the learning experience and aid in the process of acquisition of clinical skills. However, the success of the same in terms of attainment of the learning outcomes essentially depends on the planning and collaboration between different departments and stakeholders.

Audio podcast and procedural video use in anaesthesiology and intensive care: A nationwide survey of Swedish anaesthetists.

Digital modalities which enable asynchronous learning, such as audio podcasts and videos demonstrating procedures, may benefit acquisition and retention of knowledge and clinical skills. The main objective of this nationwide cross-sectional survey study was to evaluate key aspects and factors related to usage of audio podcasts and procedural videos in anaesthesiology and intensive care. A 20-item multiple-choice-question online survey was created through a consensus process including pilot testing among residents and consultants. Data were collected over a 3-month period, September-November 2023. The survey was completed by 466 anaesthetists. More than a third reported using procedural videos ≥1 time per week, whereas fewer than one in four participants used audio podcasts at least once per week. Multivariable logistic regression analysis showed that working at a university hospital, male sex, and younger age were independently associated with podcast use ≥1 time per week, with the highest odds ratio (OR) for younger age (<40 years vs. ≥40 years old; OR 5.86 (95% confidence interval 3.55-9.67), p < .001). Younger age was also significantly associated with higher frequency of video use (OR 1.71 (1.13-2.58), p = .011), while working predominantly in intensive care was associated with a lower frequency of video use. Podcasts were often used during commuting (42.3%), household work (30.7%), and exercise (24.9%), indicating a role in multi-tasking. Approximately half of respondents expressed that audio podcast-based learning has a moderate to very large positive impact on acquisition of theoretical knowledge, as well as practical skills. A vast majority, 85.2%, reported that procedural videos have a moderate to very large impact on development of clinical skills. Audio podcasts and procedural videos are appreciated tools with potential to supplement more traditional didactic techniques in anaesthesiology and intensive care. Procedural video use is common, with perceived large effects on development of clinical skills. Further data are needed to fully understand learning outcomes, quality of peer-review processes, and potential sex-differences.

Technology-Supported Guidance Models to Stimulate Nursing Students' Self-Efficacy in Clinical Practice: Scoping Review.

In nursing education, bridging the gap between theoretical knowledge and practical skills is crucial for developing competence in clinical practice. Nursing students encounter challenges in acquiring these essential skills, making self-efficacy a critical component in their professional development. Self-efficacy pertains to individual's belief in their ability to perform tasks and overcome challenges, with significant implications for clinical skills acquisition and academic success. Previous research has underscored the strong link between nursing students' self-efficacy and their clinical competence. Technology has emerged as a promising tool to enhance self-efficacy by enabling personalized learning experiences and in-depth discussions. However, there is a need for a comprehensive literature review to assess the existing body of knowledge and identify research gaps. The aim of this study is to systematically map and identify gaps in published studies on the use of technology-supported guidance models to stimulate nursing students' self-efficacy in clinical practice. This scoping review followed the framework of Arksey and O'Malley and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). A systematic, comprehensive literature search was conducted in ERIC, CINAHL, MEDLINE, Embase, PsycINFO, and Web of Science for studies published between January 2011 and April 2023. The reference lists of the included papers were manually searched to identify additional studies. Pairs of authors screened the papers, assessed eligibility, and extracted the data. The data were thematically organized. A total of 8 studies were included and four thematic groups were identified: (1) technological solutions for learning support, (2) learning focus in clinical practice, (3) teaching strategies and theoretical approaches for self-efficacy, and (4) assessment of self-efficacy and complementary outcomes. Various technological solutions were adopted in the guidance models to stimulate the self-efficacy of nursing students in clinical practice, leading to positive findings. A total of 7 out of 8 studies presented results that were not statistically significant, highlighting the need for further refinement of the applied interventions. Nurse educators play a pivotal role in applying learning strategies and theoretical approaches to enhance nursing students' self-efficacy, but the contributions of nurse preceptors and peers should not be overlooked. Future studies should consider involving users in the intervention process and using validated instruments tailored to the studies' intervention objectives, ensuring relevance and enabling comparisons across studies.

Psychometric Testing of a Tool to Assess Nurse Anesthesia Clinical Educator Skill Acquisition.

Nurse anesthesia clinical educators bridge didactic content and clinical practice. A sample of 99 nurse anesthesia clinical educators completed the Academic Clinical Nurse Educator Skill Acquisition Tool (ACNESAT) to assess their skill acquisition and ACNESAT psychometric properties. Participants reported extreme confidence ( M = 170.07, SD = 22.31) overall; highest confidence with Ensures Safe Care is Delivered by Learners in the Clinical Setting ( M = 4.55, SD = 0.627) and lowest with Applies Theory to Clinical Practice ( M = 4.01, SD = 0.942). Academic leaders can utilize the ACNESAT to support role development and excellence among clinical educators.

Effectiveness of simulation-based training in medical education: Assessing the impact of simulation-based training on clinical skills acquisition and retention: A systematic review

Simulation-based training has gained popularity as an educational strategy in medical education, and while research on its effectiveness is growing, the evidence remains limited in quality and quantity. Background: Simulation-based training is increasingly recognized as a valuable educational approach in medical settings. Despite a growing body of research exploring its effectiveness, the available evidence is still constrained in terms of both quality and quantity. Methods: To assess the effectiveness of simulation-based training in medical education, a systematic review was conducted. Studies were included if they were randomized controlled trials (RCTs) or quasi-experimental studies comparing simulation-based training to either no intervention or traditional training methods. The outcomes of interest focused on clinical skills acquisition and retention. Aim: The aim of this study was to evaluate the overall effectiveness of simulation-based training in medical education. Conclusion: Simulation-based training proves to be an effective educational strategy for acquiring and retaining clinical skills in medical education. The evidence suggests its superiority over no intervention and, in some cases, traditional training methods. However, the mixed quality of evidence highlights the need for further high-quality research to confirm these findings. This systematic review seeks to comprehensively evaluate the impact of simulation-based training on the acquisition and retention of clinical skills among medical professionals.

Toward enhanced competence acquisition in clinical practice: implementing blended learning for physical therapy students

BackgroundThe curricular changes in educational activities, teaching methodologies, and assessment systems brought about by the COVID-19 closure, which restricted attendance in curricular practices, required adjustments. However, the impact of these curricular adaptations on the acquisition of competencies in the clinical context has not been sufficiently explored.ObjectiveThe objective of this study was to assess the potential impact on the expected learning outcomes in the Basic Manual Therapy course following curricular adaptations made during the COVID-19 lockdown. We specifically must be focused on acquiring competencies related to the clinical domain, including clinical practice, medical history, and reflective journaling during clinical practices. We aimed to compare these experiences with those of students who did not undergo any adaptations in the previous academic year.MethodsThis is a retrospective cohort study in a sample of physical therapy university students, conducted in accordance with Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. We divided students into two groups based on when they enrolled: the ‘non-exposed group’ (NE), which includes those who finished the Basic Manual Therapy course in 2018–2019 and Clinical Stays I in 2019–2020, and the ‘exposed group’ (E), consisting of students who completed the Basic Manual Therapy course in 2019–2020 and later took part in Clinical Stays I during 2020–2021.ResultsA total of 282 students were included in the study. The results indicated that the curricular adaptations implemented for the Basic Manual Therapy [U(E Mdn = 7.7000, NE Mdn = 7.7000) = 9,286, z = −0.546, p = 0.585] and Clinical Stays I subjects [U(E Mdn = 8.5900, NE Mdn = 8.4700) = 9,600, z = −0.078, p = 0.938] did not have a statistically significant impact on the acquisition of competencies and learning outcomes when comparing the two groups. Most differences between groups were observed in reflective journaling marks [U(E Mdn =8.300, NE Mdn = 8.000) = 7770.5, z = −2.796, p = 0.005] and Student Progress item of this Reflective Journaling [U(E Mdn = 9.000, NE Mdn = 8.000) = 7216.5, z = −3,668, p = 0.000], favoring the E cohort. In both groups, a low and positive correlation was found between the ordinary BMT mark and the ordinary CS I mark [Rho (E = 0.206, NE = 0.170), p &amp;lt; 0.05].ConclusionWhile this study has certain limitations, the findings highlight that the non-face-to-face curricular adjustments implemented during the COVID-19 pandemic, as a substitute for in-person teaching, effectively prevented the pandemic from negatively impacting the acquisition of clinical skills. The activities designed in Basic Manual Therapy subject facilitated positive skill development in Clinical Practice for students in clinical physiotherapy stays, contributing to good learning outcomes, especially in the formulation of Clinical History and Reflective Journaling.

How COVID-19 pandemic affected clinical exposure of final year medical students: A comparison study of portfolio assessments

Background and Objective COVID-19 restrictions had a major impact on the academic sector globally. The aim of this study was to compare the clinical exposure of final year medical students at the professorial unit of Obstetrics and Gynaecology of Colombo South Teaching Hospital during the COVID-19 pandemic with those who attended clinical training prior to the pandemic. Methods Systematic sampling of 66 medical students belonging to two clinical groups, who had completed their professorial Obstetrics and Gynaecology appointment during the pandemic, was done, using their student portfolios recording the clinical skills and procedures performed during the appointment. The pre-COVID-19 data were gathered from a previous study carried out in the same unit in 2018. Results Most students managed to complete both the Gynaecological and the Obstetrics Mini–Clinical Evaluation Exercise (62.1% and 56.1% respectively) but, compared to the pre-pandemic era, a higher percentage presented only one case or none. All students completed the Objective Structured Assessment of Technical Skills in episiotomy suturing (100%) and a majority (90.9%) performed artificial rupture of membranes (ARM). However, only 36.4% had the opportunity to perform a PAP smear independently. Majority (95.1%) of the cases were presented to the registrars attached to the unit while only a minority was evaluated by a consultant (3.8%). The Obstetric and Gynaecological clinical procedures and skill acquisition showed slightly lower percentages than in the pre-COVID-19 period with the means and the medians lying in between the 1st and 2nd quartiles of the distribution. Conclusion On average, there was a slight decrease in the clinical exposure to procedures and skills during the COVID-19 outbreak compared to the non-COVID-19 period. Additionally, the opportunity of the medical students to be supervised by a consultant Obstetrician and Gynaecologist reduced drastically during the pandemic.

Using the Delphi method to develop a clinical skills assessment tool for advanced practice nurses in psychiatry and mental health

In France, advanced practice for psychiatric and mental health nurses has been developing since 2019. The acquisition of clinical skills by advanced practice nursing students requires monitoring and evaluation. This article outlines the process for creating an internship logbook. To develop and verify a tool for assessing the skills of advanced practice nursing students specializing in psychiatry and mental health during the internship stage. The Delphi method described by Hasson was used, with the aim of obtaining a consensus of over 80% of the experts consulted. A panel of ten experts, all internship tutors at partner healthcare establishments of Aix Marseille University, was consulted twice. The internship logbook was composed of 68 items. This tool is the product of a multidisciplinary process including nurses and psychiatric nurses. It can be adapted to a variety of learning environments and helps tutors track the acquisition of clinical skills during the internships, both through external and self-assessment. A new Delphi consultation will foster uptake of this tool. Advanced practice nurses in psychiatry and mental health will be included in the group of experts.

Designing and maintaining a rescue extracorporeal life support program: A holistic simulation approach.

Rescue Extracorporeal Life Support Programs based at non-cardiac surgery centers have unique needs to be able to ensure successful outcomes despite low patient volumes. In this paper we describe the important role simulation had in each stage of development, implementation, and maintenance of our pediatric Rescue ECLS Program. Systems-focused simulations were used to develop robust workflows, processes, and bundles. Simulation-based education targeted the acquisition and maintenance of clinical skills for individual team members, bringing together a multidisciplinary team of local clinicians who do not routinely perform pediatric cannulation related tasks. Translational simulation ensured continued improvement by addressing adverse events or latent safety threats observed during system-focused or educational simulations. Realism of all simulations was our priority, and was achieved through in situ simulations, participation of multidisciplinary teams, use of real equipment and medical supplies, and use of a high-fidelity cannulation manikin. This holistic simulation approach allowed us to overcome the barriers to high quality care, and maintain outcomes comparable to high volume centers. A similar approach can help other centers design simulation for their own Rescue ECLS Program, and can be translated to other high-risk and high-acuity critical care programs.

Whole task simulation in surgical training: A hybrid method of teaching undergraduate medical students

Background: The current Competency-Based Medical Education (CBME) curriculum practiced in India accentuates that medical graduates must demonstrate competency in safely diagnosing, investigating, and managing clinical presentations across both community and secondary care settings. Therefore, there is a need for more hybrid teaching methods that simulate real situations. This approach will help newly qualified doctors gain confidence and prepare them for the future. We used the whole task simulation method to teach them one of the most common surgical problems i.e., breast cancer along with communication skills, professionalism, Interprofessional teamwork, asepsis, and safe surgery practices. Methods: The study enrolled 20 final-year MBBS students through purposeful sampling. Following classroom-based teaching on a Breast case, a simulated scenario was given, based on SECO (The Safe and Effective Clinical Outcome) design, and was modified with the addition of a simulated operating room setup. History taking, examination, ordering investigations and interpreting them, pre-operative counseling and consent and operation theatre scenario was done using standardized patient and mannequins. Pre- and post-simulation survey was conducted. Quantitative data were collected through Google Forms to assess their conceptual knowledge and qualitative data by Focused group discussions. Results: Students preferred a shift to this hybrid method of learning in a simulated environment over classical classroom-based teaching. They all felt that getting involved in a real-life situation helps in understanding surgical management better. They also understood the concept of teamwork and effective communication. "I feel it’s the best way to learn clinical medicine. No amount of literature could ever replace the knowledge we get from being in the scenario", was one of the responses given by the participants. Conclusion: Integration of surgical simulated clinics along with the operation room (OR) set up into the undergraduate curriculum could facilitate the acquisition of clinical skills actively and interactively. Such a hybrid method of teaching is an effective tool for teaching communication skills, professionalism, interprofessional teamwork along clinical skills.

A roadmap for starting, growing and sustaining a comprehensive pediatric surgery service in a low resource area

The Tanzania-Oxford Children's Surgery Partnership is a longstanding capacity building and research collaboration. Over a 21-year period, this non-hierarchical partnership has worked to develop from service delivery to children surgical system strengthening in Tanzania. This has directly impacted the children's surgery and workforce by increasing the number of pediatric surgeons in the country and upskilling nurses, anesthetists, and pediatricians. Clinical skills acquisition has been complemented by the development of leadership, mentorship, and research acumen. The partnership has also delivered critical upgrading of infrastructure which has significantly increased operative volume and allowed for the provision of minimally invasive children's surgery. A children's research network has been established, with a focus on research equity and local data ownership adhering to local ethics, leading to prolific academic output. At the core of this partnership has been the recognition that achieving sustainable change requires local leadership, long-term commitment, and ‘bottom-up’ change. We described the historical events and steps taken by our partners to achieve the universal provision of children's surgery in Tanzania.

Education and Training Adaptations for Health Workers during the COVID-19 Pandemic: A Scoping Review of Lessons Learned and Innovations.

Introduction: The COVID-19 pandemic has considerably impacted the clinical education and training of health workers globally, causing severe disruptions to learning environments in healthcare facilities and limiting the acquisition of new clinical skills. Consequently, urgent adaptation measures, including simulation training and e-learning, have been implemented to mitigate the adverse effects of clinical education. This scoping review aims to assess the impact of COVID-19 on medical education and training, examine the implemented adaptation measures, and evaluate their effectiveness in improving health workers' education and training during the pandemic. Methods: Employing the PRISMA-ScR framework and Arksey and O'Malley's methodological guidance, we conducted a scoping review, systematically searching PubMed, medRxiv, Google, and DuckDuckGo databases to account for the grey literature. The search included studies published between 1 December 2019 and 13 October 2021, yielding 10,323 results. Of these, 88 studies focused on health worker education and training during the pandemic. Results: Our review incorporated 31,268 participants, including physicians, medical trainees, nurses, paramedics, students, and health educators. Most studies (71/88, 81%) were conducted in high-income and lower-middle-income countries. The pandemic's effects on health workers' clinical skills and abilities have necessitated training period extensions in some cases. We identified several positive outcomes from the implementation of simulation training and e-learning as adaptation strategies, such as enhanced technical and clinical performance, increased confidence and comfort, and an expanded global educational outreach. Conclusions: Despite challenges like insufficient practical experience, limited interpersonal interaction opportunities, and internet connectivity issues, simulation training, e-learning, and virtual training have proven effective in improving clinical education and training during the COVID-19 pandemic. Further research is required to bolster preparedness for future pandemics or similar situations.