Clinical Skills Training Research Articles

Entrustable professional activities and feedback for learning: Insights from a mixed methods study.

Entrustable professional activities (EPAs) are used to support clinical skills training by providing a scaffold for practice and feedback. The aim of this study was to evaluate how written feedback provided for EPAs supports medical students' learning. The written feedback for two EPAs (admit or consult patient and discharge summary) was analysed using a mixed methods approach. Content analysis determined the types of feedback received. Qualitative analysis identified themes related to the feedback quality. Hattie and Timperley's feedback model that provides a framework for effective feedback was used as an interpretive lens for our analysis and integrated findings. Written feedback was provided for 89.5% of 997 EPAs. The proportions of feedback types to support learning were as follows: feedback related to what was done well (75.6%), areas for improvement (27.7%) and next steps (17.4%). Only 10% of EPAs received all three types of feedback. EPAs completed independently were more likely to receive any feedback. Feedback for supervised EPAs was more likely to include areas for improvement or next steps. Qualitative analysis identified two themes: effective feedback for present and future performance with detailed description of performance or targeted advice, and lack of specific guidance for improvement with affirmative statements or non-specific directions. EPAs most often elicited feedback about what is done well without areas or strategies for improvement. Descriptive feedback and tailored advice are ideal, but uncommon. Students and supervisors need guidance on how to optimise feedback through instruction and EPA form design.

Burnout level evaluation of undergraduate dental college students at middle eastern university

BackgroundPressure faced by dental students from academic activities, clinical skills training, and patient care may lead to high stress and potential burnout, negatively impacting their well-being and patient safety.AimThe study aimed to explore the burnout level of dental students at Qassim University, Saudi Arabia and to identify the factors that are associated with the level of burnout.MethodsThe descriptive cross-sectional study was carried out at Dental College, Qassim University, Saudi Arabia, from January to February 2024. The study was conducted to evaluate burnout levels among first to final-year undergraduate dental students enrolled at Qassim University using a pre-validated questionnaire; Burnout Clinical Subtype Questionnaire, via Google Forms. Analysis was performed with IBM SPSS-24, utilizing descriptive statistics and non-parametric tests, Mann-Whitney-U and Kruskal-Wallis. A multiple linear regression analysis was conducted to predict Burnout from demographic and academic factors.Results151 participants responded to the survey, with 49.7% male and 50.3% female. Results showed that burnout scores increased significantly (p < 0.05) with age and decreased family support. Males had lower burnout levels in comparison to their counterparts. The survey had three domains: Overload, Neglect, and Development, with ‘Overload’ having the highest mean score of 17.79 and a median score of 17.00. Age showed significant difference (p < .05) in the burnout scores amongst the groups across all three domains. 70.9% of the participants agreed that they invested an unhealthy amount of time towards their studies. The multiple regression model statistically significantly predicted Burnout, F (21, 129) = 2.190, p = .004, adj. R2 = 0.143. Gender was significant predictor, with female students reporting lower burnout scores compared to males (B=-5.633, p = .012). Family support also emerged as significant, with students reporting merely good family support showing higher burnout scores compared to those reporting very good family support (B = 6.147, p = .009).ConclusionFactors like age, family support and gender were found to have a significant with burnout levels and its domains. The study highlighted overload as the main contributing the most towards burnout in dental students of Qassim University, emphasizing the importance of tailored interventions to promote student well-being.

Teaching of magnification in the undergraduate curriculum: A position statement from the British Endodontic Society Teachers of Endodontology Group.

This position statement on undergraduate teaching on the use of magnification in endodontics represents the consensus of the British Endodontic Society Teachers of Endodontology Group. Current clinical and scientific evidence, as well as the expertise of the committee, has been used to develop this statement. The contributors to this position statement consider, as a minimum requirement, the use of dental loupes in non-surgical endodontics at undergraduate level. It is recommended that the use of dental loupes should be integrated into endodontic clinical skills training and the performance of endodontic treatment in the undergraduate curriculum.

Study of Nursing Students’ Experiences pre and post Clinical Practice at clinical skills training center in Duhok city

A novel approach to education called simulation-based training offers students excellent chances to acquire and safely apply what they learn about nursing care. The purpose of this study was to evaluate how simulation-based training affected nursing students' abilities as clinical practitioners and their sense of self- Efficaciousness. Subjects and Methods: This study (pre-posttest intervention) employed a quiz-experimental design and was conducted utilizing moderate- and high-fidelity simulators on 63 first-year nursing students for the academic year 2023–2024.At Duhok Polytechnic University and Duhok Technical Institute, this study was conducted. Data collection: demographic information, self-efficacy, and clinical proficiency tests. The software SPSS version 20 is used for analysis. Results: Following their involvement in the simulation program, participants who received the simulation-based training shown statistically significant improvements in their self-Efficaciousness and clinical proficiency levels. Conclusion: Self-Efficaciousness and clinical competency can be improved in nursing courses through simulation-based training. It is strongly advised that the nursing curriculum use multiple-patient simulations as a teaching-learning technique.

The application effect of the segmented teaching method in training medical students on clinical practice skills

BackgroundThe surgical clinical practice skill training is an important part of medical undergraduate education. Surgical skills are complex and difficult to master. However, the traditional teaching method has some disadvantages, for example, low student participation, weak learning atmosphere, inadequate mastery of the subject matter. We innovatively put forward the segmented teaching method in the field of clinical practice skills training. The segmented teaching method refers to dividing a specific teaching content into several relatively independent parts and providing segmented practice for each part. This approach enhances students’ learning outcomes.The aim of this controlled study is to investigate the effects of the segmented teaching methods on clinical practice skills training in medical students.Methods31 medical students participating in clinical practice skill training at The First Affiliated Hospital of University of South China from March to April 2024 were randomly assigned to either the experimental group (n = 16) receiving segmented teaching method or the control group (n = 15) receiving traditional teaching method. After completion of practical exercises, both groups underwent operational assessments, theoretical assessments, Mini-Clinical Evaluation Exercise (Mini-CEX), and Student Evaluation of Educational Quality (SEEQ) for teaching quality evaluation. A comparative analysis of the results between the two groups was conducted.ResultsAfter implementing the program, there were no statistically significant differences (P > 0.05) between the experimental and control groups in theoretical assessment scores, Mini-CEX clinical judgment scores, and SEEQ teaching quality evaluation scores. However, compared to the control group, the experimental group demonstrated better operational assessment scores, higher Mini-CEX scores in history taking, physical examination, professionalism, doctor-patient communication, organizational efficiency, and comprehensive abilities, with statistically significant differences (P < 0.05).ConclusionThe application of segmented teaching method in clinical practice skill training for medical students yields favorable training outcomes.

Links between learning goals, learning activities, and learning outcomes in simulation-based clinical skills training: a systematic review of the veterinary literature.

In veterinary education programs it is important to have a balance between providing students with valuable hands-on experience and ensuring the ethical treatment and welfare of the animals involved. In the last years simulation-based veterinary education played an important role helping with the replacement of experimental animals in education and at the same time creating a safe learning environment offering endless options for training in a safe environment. The aim of this systematic review was to discern which type of learning outcomes are used to evaluate specific learning goals of clinical skills training and to grasp the impact of diverse simulator characteristics on the measured learning outcomes in clinical skills training. A systematic search from 1977 until November 2023 has been conducted resulting in 103 included papers. The categories, learning goals, learning activities, and learning outcomes in clinical skills training were used for data extraction of all included studies. This study investigated the interplay between learning goals, learning activities, and learning outcomes. Competence and knowledge were the most frequently described learning outcomes; static and screen-based simulators are the are most frequently used technologies. Static simulators are primarily used to train procedural steps and screen-based simulators are primarily used to train relevant knowledge and clinical reasoning. Notably, none of the reviewed studies made explicit connections between learning goals, learning activities, and learning outcomes. In simulation-based education it is important to provide a structured, constructively aligned process where students gain relevant and effective experience. The results of this study underscore the importance of aligning the learning process in simulation-based clinical skills training, and that alignment in the learning process is not always evident.

Clinical Reasoning Skills Among Second-Phase Medical Students in West Bengal, India: An Exploratory Study.

Introduction Proper application of clinical reasoning skills is essential to reduce diagnostic and management errors. Explicit inclusion of training and assessment of clinical reasoning skills is the demand of time. The study intended to measure the clinical reasoning skills of second-phase undergraduate students in a medical college inWest Bengal, India, and its distribution across several individual variables. Methods The clinical reasoning skills of 105 undergraduate medical students were assessed in a cross-sectional exploratory study using key feature questions (KFQs) with the partial credit scoring system. Six case vignettes aligned to the core competencies in the subject of pharmacology, pathology, and microbiology were designed and validated by the subject material experts for this purpose. The responses of the participants were collected through Google Forms (Google, Mountain View, CA) after obtaining written informed consent. The scores obtained in all KFQs were added and expressed in percentage of the maximum attainable score. Results The mean (±SD) clinical reasoning score of the participants was 42.5 (±12.6). Only 29.6% of respondents scored ≥ 50. Students with higher subjective economic status (p-value = 0.01) and perceived autonomy (p-value < 0.001) were more likely to have higher clinical reasoning scores. The marks obtained in previous summative examinations were significantly correlated with clinical reasoning scores. Conclusion Average score < 50.0 and inability to score ≥ 50.0 by more than two-thirds of the participants reflected the deficit in the clinical reasoning skills of second-phase MBBSstudents. The association of clinical reasoning skills with economic status, autonomy, and previous academic performances needs further exploration.

A case study: exploring the impact of 3D printed models on cognitive integration during clinical skills training

Background: Cognitive integration occurs when trainees make conceptual connections between relevant knowledges and is known to improve learning. While several experimental studies have demonstrated how text and audio-visual instruction can be designed to enhance cognitive integration, clinical skills training in real-world contexts may require alternative educational strategies. Introducing three-dimensional (3D) printed models during clinical skills instruction may offer unique learning opportunities to support cognitive integration. Methods: Using case study methodology, we explore how learners and an instructor used 3D printed bones to augment their learning interactions during a clinical skills laboratory on shoulder on palpation, and to describe the instructional strategies with 3D printed bones that may support learning. Students (n = 21) worked in small groups and were given access to a 3D printed clavicle, scapula, and humerus. Data were collected through observation, a student focus group, and a semi-structured interview with the instructor. Thematic analysis to review and code the data and to generate themes. Results: We developed four themes that describe how 3D printed models were used in the classroom and how they may support cognitive integration: classroom interactivity, visualization of anatomy, integrating knowledge, and educational potential. Conclusions: The findings demonstrate several ways 3D printed models can augment how learners, instructors, and educational materials interact with one another and how readily learners make connections between different sources and types of knowledge. This research extends previous work by demonstrating how social learning processes and interactions with physical models can offer unique affordances that may support cognitive integration.

Contrasting on-line and face-to-face clinical communication skills training with simulated patients by mixed method analysis

Background: Medical education had to adapt quickly by switching to online learning due to the pandemic lockdown. This paper compared face-to-face clinical communication skills (CCS) teaching to delivering the same course online. Methods: During lockdown (2020-21), 175 medical students took the CCS course online, compared to 154 face-to-face trained students in the previous academic year. The CCS course aims to develop skills in history taking (2nd year) and motivational interviewing techniques (3rd year). Students participated in theoretical lectures and practical skills training sessions composed of SP encounters, followed by instant SP and tutor feed-back, all online. After the practical examination, multi-source feed-back was obtained. Multi-source feed back from the online course was qualitatively analyzed with hierarchical thematic coding of free text. Face-to-face and online teaching activities were compared in terms of attendance and course grades. Results: Eighty-eight second and 87 third year students received online training, 73 second and 81 third year students trained face-to-face. Attendance rates did not differ, average course grades were higher in the online delivered courses for both years (year 2 history taking skills course face-to-face 81,29±20.323 vs. online 95,45±20.949, p

Impact of Large Language Models on Medical Education and Teaching Adaptations.

This viewpoint article explores the transformative role of large language models (LLMs) in the field of medical education, highlighting their potential to enhance teaching quality, promote personalized learning paths, strengthen clinical skills training, optimize teaching assessment processes, boost the efficiency of medical research, and support continuing medical education. However, the use of LLMs entails certain challenges, such as questions regarding the accuracy of information, the risk of overreliance on technology, a lack of emotional recognition capabilities, and concerns related to ethics, privacy, and data security. This article emphasizes that to maximize the potential of LLMs and overcome these challenges, educators must exhibit leadership in medical education, adjust their teaching strategies flexibly, cultivate students' critical thinking, and emphasize the importance of practical experience, thus ensuring that students can use LLMs correctly and effectively. By adopting such a comprehensive and balanced approach, educators can train health care professionals who are proficient in the use of advanced technologies and who exhibit solid professional ethics and practical skills, thus laying a strong foundation for these professionals to overcome future challenges in the health care sector.

Qualification rate and associated factors regarding COVID-19 clinical skills training based on scenario simulation teaching to medical staffs in China: a hospital-based cross-sectional study

BackgroundThe coronavirus disease (COVID-19) pandemic has accentuated the need for effective clinical skills training in infectious diseases. This study aimed to explore the influencing factors of infectious disease clinical skills training based on scenario simulation teaching for medical staff in China.MethodsThis hospital-based, cross-sectional study was conducted at the Third People’s Hospital of Shenzhen between March and December 2022. Scenario simulation teaching was applied, and factors such as gender, educational level, professional background, and previous experience were examined to determine their impact on qualification outcomes.ResultsThe study included participants primarily between the ages of 20–40 years, with a higher proportion of women holding university degrees. Nurses and physicians were more likely to qualify, indicating the significance of professional backgrounds. Women showed a higher likelihood of qualifying than men and higher educational attainment correlated with better qualification rates. Prior experience with protective clothing in isolation wards was a significant determinant of successful qualification. Multivariate analysis underscored the influence of sex, education, and previous experience on training effectiveness.ConclusionScenario simulation is an effective strategy for training clinical skills in treating infectious diseases. This study highlights the importance of considering sex, education, professional background, and prior experience when designing training programs to enhance the efficacy and relevance of infectious disease training.

Using POV Wearable Technology as a Tool in Virtual Teaching Sessions to Supplement Clinical Skills Training: a Medical Student Perspective

Using POV Wearable Technology as a Tool in Virtual Teaching Sessions to Supplement Clinical Skills Training: a Medical Student Perspective

The application of blended teaching in medical practical course of clinical skills training

BackgroundBlended teaching is an effective approach that combines online and offline teaching methods, leading to improved outcomes in medical education compared to traditional offline teaching. In this study, we examined the impact of blended teaching in clinical skills training, a medical practice course.MethodsThis study involved forty-eight undergraduate students studying clinical medicine in the fifth semester at Wuhan University of Science and Technology. The students were divided into two groups: the control group, which received traditional offline teaching, and the experimental group, which received hybrid teaching. Following the completion of the 4-month course, both groups underwent the Objective Structured Clinical Examination (OSCE) to evaluate their proficiency in clinical skills. Furthermore, the experimental group was given a separate questionnaire to gauge their feedback on the Blended Teaching approach.ResultsBased on the OSCE scores, the experimental group outperformed the control group significantly (P<0.05). The questionnaire results indicated that a majority of students (54.2%, 3.71 ± 1.06) believed that blended teaching is superior to traditional offline teaching, and a significant number of students (58.3%, 3.79 ± 1.15) expressed their willingness to adopt blended teaching in other courses. Furthermore, students in the experimental group displayed varying levels of interest in different teaching contents, with emergency medicine (79.2%), internal medicine (70.8%), and surgery (66.7%) being the most popular among them.ConclusionsThis research demonstrates for the first time that blended teaching can achieve a good pedagogical effectiveness in the medical practice course, clinical skills training and practice. Moreover, in different teaching contents, the teaching effects are different. In the content of Emergency Medicine and Surgery, which is more attractive to students, the application of blended teaching could result in a better pedagogical outcome than other contents.

Gambaran Performa Instruktur Clinical Skill lab pada Masa Pandemi Covid-19 di Fakultas Kedokteran UMI

Skill labs are an important means for students to practice clinical skills, prepare them to achieve competency standards during their undergraduate education, and prepare themselves before entering professional education. Skill lab involves practicing communication skills, physical examination, as well as medical actions and invasive procedures. This study aims to determine the performance of clinical Skill lab instructors during the Covid-19 pandemic at the Faculty of Medicine, Universitas Muslim Indonesia (UMI), Class of 2019. Using a cross-sectional design, all respondents filled out a questionnaire through the Google Form application. Of the 155 respondents, 96.1% rated the instructor's teaching skills as good and very good, 92.9% rated the instructor's interpersonal and communication skills as good, and 92.9% rated the clinical skills training conditions or strategies at FK UMI as good. In general, the performance of clinical Skill lab instructors during the Covid-19 pandemic at FK UMI Class of 2019 is considered good based on student perceptions.

Clinical Skills Training of Metaverse-Based Learning: A Systematic Review

Clinical Skills Training of Metaverse-Based Learning: A Systematic Review

A 3-D interactive microbiology laboratory via virtual reality for enhancing practical skills

Virtual Reality (VR) laboratories are a new pedagogical approach to support psychomotor skills development in undergraduate programmes to achieve practical competency. VR laboratories are successfully used to carry out virtual experiments in science courses and for clinical skills training in professional courses. This paper describes the development and evaluation of a VR-based microbiology laboratory on Head-Mounted Display (HMD) for undergraduate students. Student and faculty perceptions and expectations were collected to incorporate into the laboratory design. An interactive 3-dimensional VR laboratory with a 360° view was developed simulating our physical laboratory setup. The laboratory environment was created using Unity with the (created) necessary assets and 3D models. The virtual laboratory was designed to replicate the physical laboratory environment as suggested by the students and faculty. In this VR laboratory, six microbiology experiments on Gram staining, bacterial streaking, bacterial motility, catalase test, oxidase test and biochemical tests were placed on the virtual platform. First-year biomedical science students were recruited to evaluate the VR laboratory. Students’ perception of the virtual laboratory was positive and encouraging. About 70% of the students expressed they felt safe using the VR laboratory and that it was engaging. They felt that the VR laboratory provided an immersive learning experience. They appreciated that they could repeat each experiment multiple times without worrying about mistakes or mishaps. They could personalise their learning by concentrating on the specific experiments. Our in-house VR-based microbiology laboratory was later extended to other health professions programmes teaching microbiology.

Virtual Reality Simulation-Based Clinical Procedure Skills Training for Nursing College Students: A Quasi-Experimental Study.

Core nursing skills are emphasized in nursing education, given their vital role in nurses' competence; however, invasive nursing procedures like catheterization and enemas are infrequently performed in actual clinical practice, primarily being observed rather than executed. Virtual reality simulation training involves performing core nursing skills on virtual patients in a three-dimensional virtual reality environment, following the correct procedures. The purpose of this study is to examine the effects of VR simulation on nursing students' confidence, proficiency, task engagement, and satisfaction. The study participants included 76 second-year nursing students, with 37 in the VR group and 39 in the control group. The VR group engaged in immersive VR (IVR) training sessions including enemas, nasogastric feeding, and nelaton catheterization. Conversely, the control group practiced these skills using mannequins. Assessments evaluated confidence, proficiency, learning satisfaction, and task engagement before and after the intervention. The average age of the study participants was 21.07 years, with 78.95% being female and 21.05% being male. The study findings revealed no significant differences between the VR and control groups regarding confidence (F = 3.878, p = 0.053), task engagement (F = 0.164, p = 0.687), and learning satisfaction (F = 0.668, p = 0.416). However, the VR group demonstrated significantly higher proficiency in the overall assessment of nasogastric feeding (F = 5.389, p = 0.023) and core components of nelaton catheterization (F = 4.046, p = 0.048). The IVR program emerged as an effective and valuable teaching tool, particularly well-suited for second-year nursing students, significantly enhancing proficiency.

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.

Electronic distance based clinical skills training development in family medicine in Namibia.

Workplace-based evaluation is one of the most important, but challenging aspects of medical education. The aim was to improve the assessment of the rural community-based clinical training for undergraduate 3rd and 4th year family medicine students at the University of Namibia (UNAM) and implement a paperless process. An online module was developed on the Moodle platform to include a study guide, an electronic portfolio, and electronic resources (e-books and apps) to replace the current paper version of the logbook. We explored local resources by engaging with students and clinical trainers on how to best conduct the initial implementation. Engagement also entailed motivating students to actively participate in the implementation process. All 3rd and 4th year community-based education end service (COBES) students are now submitting proof of clinical learning electronically with the use of their phones in their online portfolio and using online resources. In addition, students in the practical family medicine module that has been introduced in the 6th year since 2023 are now also using an electronic portfolio and these assessment tools.Contribution:Overall feedback from students and supervisors indicates a positive atmosphere of learning and constructive feedback on performance from all team members, hopefully improving work-based assessments and ultimately patient care. More members of the primary health care team were involved and the carbon footprint has also been decreased.

Designing an evaluation tool for evaluating training programs of medical students in clinical skill training center from consumers’ perspective

IntroductionThe Clinical Skill Training Center (CSTC) is the first environment where third year medical students learn clinical skills after passing basic science. Consumer- based evaluation is one of the ways to improve this center with the consumer. This study was conducted with the aim of preparing a consumer-oriented evaluation tool for CSTC among medical students.MethodThe study was mixed method. The first phase was qualitative and for providing an evaluation tool. The second phase was for evaluating the tool. At the first phase, after literature review in the Divergent phase, a complete list of problems in the field of CSTC in medicine schools was prepared. In the convergent step, the prepared list was compared with the standards of clinical education and values of scriven. In the second phase it was evaluated by the scientific and authority committee. Validity has been measured by determining CVR and CVI: Index. The face and content validity of the tool was obtained through the approval of a group of specialists.ResultsThe findings of the research were in the form of 4 questionnaires: clinical instructors, pre-clinical medical students, and interns. All items were designed as a 5-point Likert. The main areas of evaluation included the objectives and content of training courses, implementation of operations, facilities and equipment, and the environment and indoor space. In order to examine the long-term effects, a special evaluation form was designed for intern.ConclusionThe tool for consumer evaluation was designed with good reliability and trustworthiness and suitable for use in the CSTC, and its use can improve the effectiveness of clinical education activities.