Context Of Clinical Teaching Research Articles

Oncology residents' experiences of decision-making in a clinical learning environment: a phenomenological study.

Oncology residents routinely engage in ethically complex decision-making discussions with patients, while observing and interacting with their teaching consultant. If clinical competency in oncology decision-making guidance is to be taught deliberately and effectively, it is necessary to understand resident experiences in this context to develop appropriate educational and faculty development initiatives. Four junior and two senior postgraduate oncology residents participated in semi-structured interviews during October and November 2021 which explored their experiences of real-world decision-making scenarios. Van Manen's phenomenology of practice was used in an interpretivist research paradigm. Transcripts were analysed to articulate essential experiential themes, and composite vocative narratives were created. Three essential themes were identified: (1) residents often endorsed different decision-making approaches than supervising consultants, (2) residents experienced inner conflict, and (3) residents struggled to find their own approach to decision-making. Residents experienced being torn between a perceived obligation to defer to consultant directives, and a desire for increasing ownership of decision-making while not feeling empowered to discuss their opinions with the consultants. Residents described their experiences around ethical position awareness during decision-making in a clinical teaching context as challenging, with experiences suggesting moral distress combined with inadequate psychological safety to address ethical conflicts and unresolved questions of decision ownership with supervisors. These results suggest the need for enhanced dialogue and more research to reduce resident distress during oncology decision-making. Future research should be aimed at discovering novel ways in which residents and consultants could interact in a unique clinical learning context including graduated autonomy, a hierarchical gradient, ethical positions, physician values, and sharing of responsibility.

Attitude and Motivation of Medical Professors in the Use of Virtual Simulation Technology of Radiotherapy in Clinical Teaching Context in Chongqing Medical University

Virtual simulation technology of radiotherapy has completely changed the way we teach and learn. In the context of medical school education, the technology bridges the gap between abstract knowledge and ordinary life. Technology advances the possibilities available to mankind and are essential to medical professors in the teaching. However, educators are faced with the challenge of guiding students through this transition and ensuring they don’t lose valuable time using their devices. The rise of technology in learning has also carried some disadvantages with it, some of which might be overlooked. This study aimed to determine the attitude and motivation of medical professors to adopt virtual simulation technology of radiotherapy in clinical teaching context. Descriptive statistics, t-test analysis, one-way ANOVA, Pearson-r correlation, and chi-squared test were used in this study. It is recommended to upskill the technological and pedagogical knowledge and skills of faculty member, crucial especially in the context of a post-pandemic education

Attitude and Motivation of Medical Professors in the Use of Virtual Simulation Technology of Radiotherapy in Clinical Teaching Context in Chongqing Medical University

Virtual simulation technology of radiotherapy has completely changed the way we teach and learn. In the context of medical school education, the technology bridges the gap between abstract knowledge and ordinary life. Technology advances the possibilities available to mankind and are essential to medical professors in the teaching. However, educators are faced with the challenge of guiding students through this transition and ensuring they don’t lose valuable time using their devices. The rise of technology in learning has also carried some disadvantages with it, some of which might be overlooked. This study aimed to determine the attitude and motivation of medical professors to adopt virtual simulation technology of radiotherapy in clinical teaching context. Descriptive statistics, t-test analysis, one-way ANOVA, Pearson-r correlation, and chi-squared test were used in this study. It is recommended to upskill the technological and pedagogical knowledge and skills of faculty member, crucial especially in the context of a post-pandemic education.

Ipsative Assessment and Peer Feedback in an Orthopaedic Junior Doctor Teaching Programme: A Project Plan and Narrative Review of the Literature.

The main aim of this study is to describe a plan for a project to introduce the use of formative ipsative assessment and peer feedback within an orthopaedic junior doctor teaching programme. These changes will ensure that students demonstrate objective progress and understand that they are making progress in their learning journey. It will also improve learner collaboration through the creation of communities of practice. Key stakeholders involved include the junior doctors, tutors, consultants, medical education department, research/audit department, and orthopaedic company representatives. Outcomes will be measured using a four-point Likert scale on Google forms digital portfolios for the domains of clinical knowledge, technical skills, communication, teamwork, and basic research skills. Progress will be audited at six-month intervals. Full project implementation will be within 6-12 months. A narrative review of relevant literature and theories of learning in relation to ipsative assessment and peer feedback within a clinical teaching context was also performed. The future of medical education will still contain large components of ipsative assessment. In addition, a problem-based collaborative learning approach is now utilized in many medical schools and peer feedback will become more frequently utilized as a part of this in future. The author looks forward to implementing this project successfully and anticipates that the knowledge/skills gained from this will be useful for any future career projects both within and outside medical education.

Health Promotion and Disease Prevention in the Elderly: The Perspective of Nursing Students.

Health promotion and disease prevention are closely linked to health literacy. Therefore, intervention to increase individuals’ knowledge is essential if action is to be taken to promote a healthy lifestyle with support from health professionals for decision making on choices leading to behavioral change. Taking into account the growing aging population, nurses and nursing students have to develop interventions to promote health and prevent disease in these people, in order to keep them healthy and with quality of life. This study aims to understand how nursing students’ experiences in a clinical teaching context contributed to the development of their competencies in the promotion of health and prevention of disease in the elderly. Method: Qualitative, exploratory, and descriptive study carried out with ten students about to finish a graduate nursing course in a higher education institution in the South of Portugal. This study was carried out through narratives, one of the most common data collection procedures in social and health investigations. The content analysis technique, more specifically the thematic categorical analysis, was used for data analysis. The study received authorization from the Ethics Committee of the institution where it took place. Results: Three categories were found: “Strategies to promote health and prevent disease in the elderly”, “Health improvements from the implementation of the strategies to promote health and prevent disease in the elderly”, and “The impact your participation in these strategies to promote health and prevent disease in the elderly had on your formative process”. Conclusion: The students developed competencies during their clinical teaching experiences through the implementation of strategies of health promotion and disease prevention adapted to/focused on the needs of the elderly.

A Tutorial for Implementing Strategic Questioning in the Clinical Teaching Environment

Purpose The implementation of strategic questioning within the clinical teaching context has recently gained appeal among clinical educators as a method for stimulating critical thinking and other higher order thinking skills. This article will (a) address evidence for the use of strategic questioning approaches in the clinical teaching environment, (b) examine some of the complexities associated with effectively selecting and implementing questioning types, and (c) discuss the potential significance that supervisory training and self-assessment may have on effective application of strategic questioning. Conclusion Strategic questioning can be a highly valuable teaching methodology within the clinical teaching context. Current available external evidence, albeit limited, provides some insight into the complexities involved with effectively implementing strategic questioning methods. Further research is needed to explore the efficacy and feasibility of specific strategic questioning approaches within the scope of communication sciences and disorders.

Would Socrates Have Actually Used the "Socratic Method" for Clinical Teaching?

Medical students and residents are familiar with clinical teaching methods in which a faculty member poses a series of questions to them. This technique is often called the "Socratic method," but it is frequently perceived by learners as an attempt to demean them, a practice that is colloquially known as "pimping." The distinction between Socratic teaching and pimping lies in the perception of "psychological safety." Psychological safety allows learners to answer questions or ask for help without threats to their dignity or worthiness. In a psychologically safe clinical teaching context, learners recognize that questions posed by attending physicians probe their current understanding and guide them to expand their knowledge. In pimping, questions are posed to embarrass the learner and to reinforce the teacher's position of power over them. Absent a threat of disparagement or condemnation, learners are able to focus on building schema for knowledge, skills, and attitudes, rather than worrying about shielding their self-worth. This article presents the proper Socratic method, as intended by Socrates, and contrasts it with pimping. This perspective defines psychological safety as the pivotal factor distinguishing Socratic teaching from pimping, and establishes the foundation for empirical studies of these common practices in medical education.

Family medicine in undergraduate medical education in India.

The Medical Council of India has set appropriate and relevant objectives to train each medical student into a basic doctor for the country. Even though they envisage that these basic doctors would work as physicians of first contact, providing for the health needs of India at primary and secondary care level, the site of training and the context of clinical teaching do not seem to empower the students to become a basic doctor. ‘Vision 2015’, the document written by the board of governors of medical council of India suggests reforms in medical education such as early clinical exposure, integration of principles of family medicine, and clinical training in the secondary care level. Family medicine training with trained family medicine faculty might add this missing ingredient to our basic doctor training. This article discusses the role of family medicine in undergraduate medical training. We also propose the objectives of such training, the structure of the training process, and the road blocks with possible solutions to its implementation.

Motivations for the Use of Problem-Based Learning (PBL)for Preparation of Undergraduate Nursing Students for Professional Competences: A Literature Review

Trad itional nursing education as characterized byclassroom approaches inter alia the lectures, where students are merely passive listeners and more concern about the final grade than learningtends to produce graduate with information to memo rize while unable to apply knowledge into practicefor problem solving. Thus the intensive basic lectures, followed by equally exhausting clinical teaching has proven ineffect ive in preparing professional nurses who are problem-solvers. These factors dictate the need for a shift fro m a focus on teaching to a focus on learning by adoptinga problem-based, student-centered and self-directed learn ing approach in a form of problem-based learning for both classroom and clinical teaching context. As opposed to the traditional reductive lecturing method of teaching, Problem-Based Learning approach is more inductive; students learn contents as they try to solve the problems. Problem-Based Learning approach therefore facilitates the development of discip linary knowledge bases, skills and problem solving strategies by placing the students in the active role of problem solvers for the problems that are aligned with real-life situation.

The context of clinical teaching and learning in Australia

Gaining clinical experience for an extended period of time in teaching hospitals is one of the enduring strengths of medical education. Teaching hospitals have recently faced significant challenges, with increasing specialisation of services and workload pressures reducing clinical learning opportunities. New clinical teaching environments have been established in Australia, particularly in rural and regional areas; these are proving to be ideal contexts for student learning. The new clinical teaching environments have shown the importance of developing symbiotic relationships between universities and health services. Symbiotic clinical learning is built around longitudinal, patient-based learning emphasising priority health concerns. The symbiotic framework provides a basis for reconstructing clinical teaching in teaching hospitals so th@they continue to play a vital role in Australian medical education, with additional clinical experience provided by primary care and community, rural and regional hospitals.

Medical students on the value of role models for developing 'soft skills' - "That's the way you do it

Objective : The Soft Skills Project examined the professional development of medical students at the University of Pretoria, especially their doctor-patient interaction skills and professional socialisation. This paper reports on one of the findings of the project, namely the importance that medical students attach to role models in the development of soft skills. Methods : We used a qualitative method with symbolic interactionism and grounded theory as framework. Fourty two final-year students from the last cohort following the traditional curriculum at the University of Pretoria in 2001, and 49 final years from the first cohort following the reformed curriculum in 2002 were recruited. Data were collected by applying focus groups, in-depth, individual interviews, as well as autobiographical sketches. Data were captured by means of audio tape recordings, transcripts of the tapes, researchers' field notes, and written accounts by students, and were analysed by using a general inductive approach. Results : There were no striking differences between the comments of the two groups. Students considered registrars to be the most influential role models in the clinical teaching context, followed by specialist consultants. Their idea of a good role model was a clinically and academically competent doctor that cared about patients, had good interpersonal skills, and who could inspire students. Students needed and appreciated good role models to help them to develop their own soft skills. They expected guidance and behavioural examples from clinical teachers. Although there were competent role models, the students were exposed to poor role models. Poor role models mainly affect students negatively. Students tend to imitate and perpetuate unacceptable behaviour. Furthermore, poor role models have a negative emotional effect on students and are detrimental to their moral and learning environment. Sometimes, poor role models have a paradoxical positive effect in the sense that they inform students how not to behave. Conclusion : Medical schools and medical doctors working with medical students should be consciously aware of the importance of role models both when allocating clinical teachers to students, and while performing duties with students. It is especially necessary to realise that poor role modelling has important detrimental effects on students. Therefore, an attempt should be made to ensure that not only clinical examination skills, but also soft skills, are demonstrated at the bedside. Measures to ensure adequate exposure of students to positive role models could include: staff development; the identification of good role models to guide registrars; and a reallocation of tasks, where possible, to increase the exposure of students to the ‘natural' role models. Keywords : soft skills, role models, medical students, professionalism South African Psychiatry Review Vol. 9(1) 2006: 28-32

Medical teachers' concerns about the clinical teaching context.

Despite several unique aspects of the medical teacher's role compared to other teachers in higher education, there has been little research in this area. In particular there have been few studies which have explored teachers' perspectives on their role. This study aimed to elicit teachers' perceptions of the teaching environment in a single medical school at a time of curriculum change. As part of an ethnographic study to explore the culture of the school, 22 teachers took part in in-depth, semi-structured interviews to ascertain their views and experiences of teaching. Additional data were collected through participant observation of curriculum meetings, and informal data collection. The data were analysed using a grounded approach, which resulted in over 200 analytic codes being assigned, which were later grouped into six main themes. The strongest themes to emerge were teachers' concerns about the students, the infrastructure for teaching and their relationship with the medical school. These included concerns about the lack of student clerking activity, insufficient monitoring of students, poor support or recognition of teaching and a perceived lack of inclusion in the medical school. The structure and culture within the medical school and associated hospital trust appeared to offer little support for doctors in their teaching role. This suggested that teaching was not highly valued. Teachers were preoccupied with the practical issues of teaching, leaving little time to consider more fundamental educational issues. These findings have implications for the quality of teaching and implementation of curricular change.