Clinical Education Program Research Articles

간호대학생의 환자안전역량과 전문직 간 태도

This is a descriptive research study that attempted to identify patient safety competencies and interprofessional attitudes among nursing students and provide basic data for improving the quality of patient safety education and developing various clinical practice education programs. Data were collected through self-report questionnaires from August 29, 2023 to October 23, 2023, targeting 142 3rd and 4th year nursing students in K City. The PSCSE tool was used for patient safety competency, and the IPAS-K tool was used for interprofessional attitudes. The collected data were analyzed using descriptive statistics, paired t-test, Pearson's correlation coefficients, and multiple regression analysis using the SPSS 25.0 program.The subjects' patient safety competency scored an average of 4.04±0.53 out of 5, and interprofessional attitudes scored an average of 4.32±0.61 out of 5. There was a significant difference in interprofessional attitudes according to patient safety education experience(t=3.509, p=.001). Interprofessional Attitudes showed a positive correlation with patient safety competency(r= .716, p<.001). Factors affecting interprofessional attitudes were attitude of patient safety(β=.424 p<.001), skill of patient safety(β=.377 p<.001) and explained 56% of interprofessional attitudes. Based on the research results, it is believed that it can be used as basic data for patient safety education programs and interprofessional collaboration programs that can improve nursing students' patient safety capabilities and interprofessional attitudes.

Knowledge and Attitudes of Oncology Nurses Toward Clinical Trials — A Secondary Publication

Purpose: The purpose of this study was to identify the knowledge and attitudes of oncology nurses toward clinical trials and to provide evidence for the development of clinical trial education programs for oncology nurses. Methods: The study was conducted on 142 nurses who had more than six months of nursing experience working with cancer patients at a tertiary hospital in Seoul, Korea. A structured questionnaire was used to measure the knowledge and attitudes of oncology nurses toward clinical trials. Results: The participants scored an average of 15.03 ± 3.52 out of 19 in terms of knowledge about clinical trials. In terms of attitudes toward clinical trials, the participants scored an average of 5.91 ± 1.37 out of 8. There was a significant positive correlation between the knowledge and attitudes of the participants toward clinical trials (r = 0.23, P = 0.007). Conclusion: This study found that there was a relationship between the knowledge and attitudes of oncology nurses toward clinical trials. To improve the competency of oncology nurses and provide high-quality care to patients participating in clinical trials, more systematic and sustainable education is required.

Legal reform and access to justice in Uzbekistan: a comprehensive approach through free legal aid

This article explores the significant legal reforms and initiatives implemented in Uzbekistan aimed at enhancing access to justice and strengthening the rule of law. Since 2016, these reforms have included the ratification of international conventions, the introduction of free legal aid, and the development of clinical legal education programs. Notable advancements such as the 'MADAD' legal aid initiative and the 'E-SUD' e-justice system are highlighted as key tools in improving legal service delivery and judicial efficiency. While acknowledging the progress made in promoting gender equality and protecting vulnerable populations, the article identifies ongoing challenges in funding, public awareness, and service delivery. It concludes with recommendations for sustaining reform efforts and enhancing access to justice for all citizens of Uzbekistan.

Validating evidence for the knowledge, management and involvement of dentists in a dental approach to sickle-cell disease.

This study validated the content of an instrument designed to assess the knowledge, involvement (attitudes) and management (practice) of dentists relative to sickle-cell disease (KAPD-SCD). The instrument consisted of five domains composed of a total of thirteen items: I. Dentist's self-assessment relative to sickle-cell disease; II. Dentist's knowledge of the repercussions of sickle-cell disease on the stomatognathic system; III. Dentist's knowledge of the complications of sickle-cell disease in the stomatognathic system; IV. Dentist's knowledge concerning the dental management of sickle-cell disease patients; and V. Dentist's involvement in an approach to sickle-cell disease. Twelve experts assigned scores to each item of the instrument. The criteria were clarity, understanding and appropriateness, leaving open fields for comments. Descriptive and content analyses of the data were made. Each expert analyzed 39 assessment units. The percentages considered for agreement were high (>80%), medium (70%-80%), or low (<70%), and each item was maintained or revised according to the percentage observed. There was high consensus in 74% of the assessment units (the corresponding items were maintained), medium consensus in 24% of them (the corresponding items were revised), and disagreement in 2% of them, namely as regards the "appropriateness" of item 5 ("Are there oral complications in sickle-cell disease?"), which was revised. The final version of the instrument had 16 items for different applications such as in the clinical care program, teaching program, or research program, with different cut-off scores for each application. In conclusion, the level of agreement among experts showed evidence of the content validity of the instrument.

Perceptions of Students of the Clinical Pathology Specialist Medical Education Program towards the Learning Environment: A Multi Methodology Study

Perceptions of Students of the Clinical Pathology Specialist Medical Education Program towards the Learning Environment: A Multi Methodology Study

Ethical issues experienced by otolaryngologists: a conventional content analysis.

To deliver effective medical services and establish trust and psychological security in patients, care providers must prioritize ethical principles. Developing a comprehensive clinical education program for learners, along with specific ethical guidelines, and implementing managerial and executive interventions necessitates a thorough understanding of the ethical challenges within this field. This qualitative study aimed to elucidate the ethical issues faced by otolaryngologists. Sixteen otolaryngologists participated in the study, selected through purposive sampling. Data were gathered through semi-structured interviews, and the analysis, conducted through conventional content analysis, revealed eight main categories and 38 subcategories encapsulating the identified ethical issues. The primary categories encompassed ethical issues faced by otolaryngologists concerning patients and companions, education, communication with the treatment team, physicians' rights, medical tourism, medical advertising, cultural considerations, and managerial challenges. resources and treatment approaches in alignment with Iranian cultural norms, address conflicts between treatment and education, and implement sound management plans to uphold rights of the treatment team. Additionally, the study suggests the necessity of ethical advertising programs and the strategic promotion of therapeutic tourism.

Evaluation of the preclinical hospital visit programme with students' feedback at the University of Nottingham, UK.

Background . The General Medical Council's publication Tomorrow's Doctors recommends that medical students should attain professional awareness at an early stage of their education. Accordingly, in the University of Nottingham, basic science teaching is integrated with clinical practice, by attaching medical students to hospital specialty teams and general practices in the community, as regular timetabled 'hospital visits' from the beginning of their medical education. We evaluated the feedback forms of the preclinical (1st and 2nd years) medical students retrospectively based on their experience of the hospital-based clinical teaching programme over 2 years. The hospital visit programme was modified based on the student feedback following which the effectiveness of the modified programme was revaluated post-test. Methods . This study was based on a quasi-experimental design in which comparisons of pre-test and post-test feedbacks with 337 feedback forms in each group were analysed in the study period. Quantitative response questions in the feedback were statistically analysed using independent t-test, and free text questions were qualitatively analysed and grouped into themes. Results . Data analyses showed significant difference (p<0.001) between the pre- and post-test groups. The main feedback themes identified were number of the patients examined, organization of the visit, patient selection, introductory talk, and briefing and debriefing before and after the visit. Conclusion . The structure of the hospital visit programme was influenced by the available infrastructure, flexibility of access and delivery of clinical teaching. The programme helped build professional attitudes in both staff and students and encouraged independent learning.

The use of the Delphi technique as part of the process of developing a tool to evaluate physiotherapy clinical education programmes

&#x0D; &#x0D; &#x0D; &#x0D; Objectively evaluating the quality and effectiveness of a physiotherapy clinical education programme has been unsuccessful to date, due to its complexity and the lack of a standardised tool. We undertook to develop a standardised programme evaluation tool and used the Delphi method to obtain consensus (set at 80%) to determine the face and content validity of the items and domains of the tool, the scoring system and a name for the tool. Academics, clinical physiotherapists and clinical physiotherapy educators participated in the Delphi rounds. Three Delphi rounds ensued: in Delphi round 1, a 71% response rate was obtained and 49 questions obtained 80% consensus. In Delphi round 2, a 91% response rate was obtained and 59 questions obtained 80% consensus. In Delphi round 3, a 42% response rate was obtained, several names were suggested, and the scoring system was established. The provisional tool of 85 items ultimately emerged as the Vaneshveri Naidoo Clinical Programme Evaluation Tool (VN-CPET).&#x0D; &#x0D; &#x0D; &#x0D;

ENGAGING WITH NURSING HOME SOCIAL WORKERS TO DEVELOP AND IMPLEMENT CLINICAL INTERVENTION TRAINING

Abstract PreLoss Group Support (PLGS) is a 10-session multi-modal therapeutic group intervention for dementia family care partners administered by nursing home social workers (NHSWs) to facilitate healthy death preparedness and eventual bereavement. In prior work, we used empirically validated procedures for developing psychosocial interventions, created PLGS participant and facilitator manuals, and implemented and evaluated PLGS in three cohorts of nursing home family care partners using research team LCSWs as facilitators and NHSWs as co-facilitator-trainees. Our present pragmatic trial will determine if telehealth-delivered PLGS reduces risk of poor bereavement outcome in family care partners, when delivered by NHSWs trained in PLGS via telehealth. We systematically engaged with nursing home stakeholders; administrators and NHSWs in rural, urban, and Veteran nursing homes to identify their perceptions of family care partner needs with respect to end-of-life care in residents living with dementia.NHSWs collaborated with our team to develop a full-day clinical education program. We incorporated their suggestions of family “characters” to script into our video modules using professional actors, addressed potential concerns with telehealth delivery of the training and intervention, participant identification and recruitment procedures, and requests for didactic content and interactive case examples of treatment element application. Current NHSWs who attended the full day training completed a 7-item satisfaction scale yielding a satisfaction rate of 95% (highly valuable), with 100% indicating they would recommend training to SWs in other facilities. Sustained collaboration with NH stakeholders optimizes commitment of NHSWs to PLGS participants, intervention delivery and informs later implementation strategies for translation and dissemination.

Caregiver condition management and family functioning after pediatric cancer treatment: Moderation by race and ethnicity.

End of pediatric cancer treatment requires family adjustment. Caregivers who struggle to incorporate the child's condition into family life have poorer family outcomes. To better understand factors that contribute to successful transition off active childhood cancer treatment, we sought to examine caregiver perceived management ability of the youth's condition and family functioning as predictors of caregiver distress, evaluate family functioning as a mediator between perceived ability and distress, and explore race and ethnicity as a moderator between perceived ability and family functioning. Caregivers (N=141) completed measures assessing family management (condition management ability; CMA), family functioning, and distress as part of a clinical education and screening program within 1year of the end of treatment. Bias-corrected bootstrap regression analyses examined mediation and moderated mediation models with patient race and ethnicity as the moderator. The overall mediation model was statistically significant for CMA→family functioning→distress. Race and ethnicity moderated the relationship between CMA and family functioning, but the full model was not significant. CMA was related to family functioning for caregivers of non-Hispanic white youth, but not caregivers of Hispanic youth. Family functioning was related to distress for all caregivers. Family functioning serves as an initial intervention target to reduce caregiver distress. Caregiver perceived management ability of their child's condition is a meaningful predictor of family functioning and distress for caregivers of non-Hispanic white youth, yet CMA may be limited as a screener of family management patterns for diverse populations, and other family management dimension may be more applicable.

Clinical yarning education: development and pilot evaluation of an education program to improve clinical communication in Aboriginal health care - participant, and health manager perspectives

BackgroundEffective communication between health care clinicians and Aboriginal patients is critical to delivering high quality, accessible, culturally secure health care. Despite this, ineffective communication is a well-documented barrier, and few studies have reported interventions to improve communication. Clinical Yarning is a patient centred communication framework for Aboriginal health care. Building on this framework, this study reports the development and evaluation of a Clinical Yarning education program.MethodsA Clinical Yarning education program was developed, underpinned by the principles of cultural security and adult learning, informed by a behavioural skills approach. The program was delivered in five health/education settings in one rural Western Australian region. Mixed-methods evaluation included a retrospective pre/post questionnaire to ascertain changes in participants’ knowledge, confidence, competence and their perceptions about communication in Aboriginal health care, and the program. Qualitative semi-structured interviews were undertaken with health service managers who oversaw each health care setting and who had not participated in the education program, to explore perceptions about the program and implementation considerations.ResultsTwenty-eight health care clinicians and six students completed training and the evaluation survey. There were significant improvements in self-rated communication skills, ability, confidence, knowledge, and perceived importance of communication training from pre to post-program. Participants strongly recommended the program to others, and most commonly valued the simulation/interactive learning activities. Health service managers acknowledged the limitations in most existing cultural training, and felt Clinical Yarning addressed a need; both the concept of Clinical Yarning and the education program provided were valued. Considerations identified for future implementation included: building multilevel partnerships within health services, offering alternate training options such as eLearning or train-the-trainer approaches, and integrating into existing development programs. Workforce transiency and availability were a barrier, particularly in remote areas.ConclusionsThis study offers preliminary support for the Clinical Yarning education program and provides a foundation for further development of this training approach. A future priority is implementation research to investigate the impact of the Clinical Yarning education program on health care and patient outcomes.

Examining the Status of Clinical Training of Undergraduate Students in the Operating Room at Hamadan University of Medical Sciences in 2023

Background: The operating room is a critical therapeutic area, accounting for approximately 60% of unintended hospital incidents. At times, due to insufficient staff experience, life-threatening issues may arise for patients. Thus, the role of clinical education for operating room students, who form a segment of future personnel stationed in the surgical team, is highly vital and impactful. The effectiveness of this education can be significantly improved by receiving feedback from these students. The aim of our study was to evaluate the effectiveness of clinical education from the viewpoint of operating room students. Methods: This descriptive cross-sectional study was conducted from February 2023 to April 2023. The research population included all Hamedan University of Medical Sciences operating room students. A sample of 47 individuals was selected by the census method. Data were collected using a demographic questionnaire and the Choo and Bowley effectiveness evaluation questionnaire. The data were analyzed using SPSS-25 and descriptive statistics. Results: Overall, 59.6% of the subjects were females, and the remaining 40.4% were males. No significant relationship was observed between the students’ age, gender, marital status, and academic semester and the average evaluation score of the effectiveness of clinical education (P &gt; 0.05). The average effectiveness score for clinical education programs was 35.50 ± 10.74, indicating that for most individuals (66%), the educational program was somewhat effective, and for 34% of individuals, the educational program was highly effective. Conclusion: The results revealed the relative effectiveness of the clinical education program for operating room students; thus, the satisfaction of clinical learners was somewhat satisfactory. However, further student satisfaction and more effective clinical education are necessary. Therefore, serious attention from managers and clinical instructors to implement innovative educational programs to enhance the level of clinical learners seems necessary.

The development of items for a physiotherapy clinical programme evaluation tool.

Evaluating a physiotherapy clinical education programme is challenging, given its complex and multidimensional nature, resulting in a paucity of research on the topic. The objective of our study, which was part of a larger study, was to identify items that could be included in a tool to evaluate a physiotherapy clinical education programme in South Africa. A qualitative study utilising focused group discussions including academics, clinical educators and clinicians was undertaken. A broad script that delved into clinical education experience was used. An inductive thematic content analysis using MaxQda version 2018.2 was undertaken; the data were coded, and similar foci were categorised and subcategorised. This process led to the identification of themes. Both triangulation of the data (member checks, field note comparison, observer reflection and verification of the data) and assuring the data's trustworthiness (credibility, dependability and confirmability) were undertaken. Fourteen focus group discussions were held countrywide. Three themes emerged from the data. A macro theme included all governance issues, a meso theme included all structural issues and a micro theme included all aspects related to clinical experience. The complex nature of clinical physiotherapy education and its diversity can be seen in these emerging themes. All the categories and subcategories making up these themes must now be considered in the next step of developing this tool. Quality assurance and minimal training standards may be ensured.

Standards of practice for clinical pharmacists

AbstractThis document sets forth ACCP's expectations for clinical pharmacists within the United States and countries around the world where clinical pharmacy is emerging or already well established. It is also intended to serve as a reference for those designing and assessing clinical pharmacy education and training programs. In addition to articulating the clinical pharmacist's process of care, the eight standards described within address the clinical pharmacist's involvement in collaborative team‐based, patient‐centered care; credentialing and privileging; professional development and maintenance of competence; professionalism and ethics; research and scholarship; and other professional responsibilities. The standards define for the public, healthcare professionals, and policymakers what they can and should expect of clinical pharmacists.

E-Learning Simulations for Teaching Clinical Decision-Making in an Audiology Training Program.

Clinical decision-making is an essential component of most clinical processes across the health sector and an ongoing challenge for clinical education programs to teach to students. The traditional methods of teaching these skills outside of lectures are mainly through clinical placements and problem-based learning (PBL) sessions, but availability and consistency can be variable and resource heavy. To address these challenges, an e-simulation module specific to pediatric infant diagnostic testing has been developed and implemented into the teaching program. We aimed to establish whether e-simulation resulted in student skill acquisition. Academic performance measures for 67 audiology students who used a traditional PBL and 108 students who used the e-simulation module were collected and analyzed. Student survey results generated both quantitative and qualitative data, which were analyzed using a thematic analysis with an inductive approach. Findings indicated that the e-simulation platform introduced in this study yielded learning outcomes similar to the traditional PBL format previously used. Participants experienced a significant in situ increase in understanding of infant diagnostic testing concepts following the use of the e-simulation and evaluated the e-simulation platform positively. The data support that an e-simulation-based approach in clinical education presents pedagogical benefits and can provide a meaningful sustainable inclusion in today's clinical teaching programs.

Paradoxical interventions: A meta-analysis.

This article outlines the evidence base for the use of paradoxical interventions (PIs) in individual psychotherapy. Often misunderstood, PIs have shown long-term (distal) impacts on clinical outcomes, yet a review of the existing literature on these interventions illustrates a trending decline in consideration and use within both research and applied settings. Definitions of PIs and their constituent elements are presented along with clinical examples. We conducted one meta-analysis comparing PIs with a placebo or control and another comparing PIs to other therapeutic methods. PIs demonstrated a large effect (d = 1.1, k = 17 studies) compared to controls and a medium effect size (d = .49, k = 17 studies) compared to other therapeutic methods. We included a review of several case studies using PIs as well. Among the salient findings, there is a lack of assessment measure to track the implementation of PIs in session or a method to track their in-session effects. Further, there is a dearth of contemporary quantitative experimental research and development of PIs. We further advocate for the development and integration of PI training and supervision into clinical education and posteducation programs, given the current data demonstrating clinical utility. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Development of a Tool to Determine Excellence in the Provision of Physical Therapist Clinical Education: A Modified Delphi Study.

The purpose of this study was to create a Site of Excellence in Clinical Education (SECE-PT) tool with the essential criteria used to determine excellence in the provision of physical therapist clinical education at a clinical site using a consensus-building approach. The development of the SECE-PT tool was divided into 2 parts. Part 1 involved the development of an initial set of proposed criteria, whereas part 2 employed a modified Delphi approach for consensus building. Purposive selection and snowball sampling techniques were used to recruit clinical instructors, recent graduates, site coordinators of clinical education, and directors of clinical education who met the inclusion criteria for the modified Delphi study. Three web-based survey rounds were used to achieve consensus, defined as a mean score of ≥7 on the 11-point Likert scale. The first round gathered demographic information on participants and collected information about clarity and redundancy in the criteria provided, the second gathered information once again about clarity and redundancy on the revised criteria provided, and the third asked participants to rate how essential it was for a site of excellence to demonstrate each of the final criteria. A total of 123 participants, equally representing clinical and academic perspectives, completed the demographic survey and round 1. Ninety-four participants completed round 2, and 80 participants completed the third and final round. Consensus revealed that 44 criteria were deemed essential for a SECE-PT to demonstrate. This study provides a measure to evaluate clinical sites providing clinical education. The SECE-PT tool should be widely adopted to evaluate the quality of the clinical site providing the education to student physical therapists. The SECE-PT tool can be used by clinical sites for self-assessment to examine aspects of their clinical education programs and determine whether parts of their program should be further developed. This can provide a framework for discussion and collaboration between clinical and academic partners, as well as regional consortia.

User-Centered Design of a Digitally Enabled Care Pathway in a Large Health System: Qualitative Interview Study.

Major depressive disorder (MDD) is a leading cause of disability worldwide. Management of chronic conditions such as MDD can be improved by enhanced patient engagement, measurement-based care (MBC), and shared decision-making (SDM). A user-centered design approach can improve the understanding of the patient journey and care team workflows and thus aid the development of digital health care innovations optimized for the needs of patients living with MDD and their primary care teams. This study aims to use qualitative research methods for the user-centered design of a digitally enabled MDD care platform, PathwayPlatform, intended to enhance patient engagement, MBC, and SDM. Insights were gathered through 2 stages of qualitative interviews by a study team with expertise in qualitative research and user-centered design methods. Thematic analysis was used to generate an overarching understanding of a set of shared experiences, thoughts, or behaviors across a broad qualitative data set, including transcripts of interviews, to allow both inductive and deductive insights to emerge. Thematic analysis of interviews was supported by Dedoose (SocioCultural Research Consultants, LLC), a qualitative data analysis software tool that enables systematized coding. Findings and insights were presented based on code frequency, salience, and relevance to the research project. In stage 1, interviews were conducted with 20 patients living with MDD and 15 health care providers from September 2018 to January 2019 to understand the experiences with and perceptions about the initial functionality of the Pathway app while also exploring the perceptions about potential additional features and functionality. Feedback about care team workflows and treatment approaches was collected in stage-2 interviews with 36 health care providers at 8 primary care sites. Inductive and deductive thematic analyses revealed several themes related to app functionality, patient-provider engagement, workflow integration, and patient education. Both patients and their care teams perceived the remote tracking of patient-reported outcomes via digital tools to be clinically useful and reliable and to promote MBC and SDM. However, there was emphasis on the need to enhance the flow of real-time data shared with the care team, improve trend visualizations, and integrate the data within the existing clinical workflow and educational programs for patients and their care teams. User feedback was incorporated into the iterative development of the Pathway app. Ongoing communication with patients living with MDD and their care teams provided an opportunity for user-centric developmental iterations of the Pathway Platform. Key insights led to further development of the patient-facing and care team-facing visit preparation features, collaborative goal-setting and goal-tracking features, patient-reported outcome summaries, and trend visualizations. The result is an enhanced digital platform with the potential to improve treatment outcomes and provide patients living with MDD additional support throughout their treatment journey.

Using equityXdesign to Develop Nursing Curricula : The Implicit Bias Clinical Teaching Program Case Study.

Using equityXdesign to Develop Nursing Curricula : The Implicit Bias Clinical Teaching Program Case Study.

Stroke clinical coding education program in Australia and New Zealand.

Accurate coded diagnostic data are important for epidemiological research of stroke. To develop, implement and evaluate an online education program for improving clinical coding of stroke. The Australia and New Zealand Stroke Coding Working Group co-developed an education program comprising eight modules: rationale for coding of stroke; understanding stroke; management of stroke; national coding standards; coding trees; good clinical documentation; coding practices; and scenarios. Clinical coders and health information managers participated in the 90-minute education program. Pre- and post-education surveys were administered to assess knowledge of stroke and coding, and to obtain feedback. Descriptive analyses were used for quantitative data, inductive thematic analysis for open-text responses, with all results triangulated. Of 615 participants, 404 (66%) completed both pre- and post-education assessments. Respondents had improved knowledge for 9/12 questions (p < 0.05), including knowledge of applicable coding standards, coding of intracerebral haemorrhage and the actions to take when coding stroke (all p < 0.001). Majority of respondents agreed that information was pitched at an appropriate level; education materials were well organised; presenters had adequate knowledge; and that they would recommend the session to colleagues. In qualitative evaluations, the education program was beneficial for newly trained clinical coders, or as a knowledge refresher, and respondents valued clinical information from a stroke neurologist. Our education program was associated with increased knowledge for clinical coding of stroke. To continue to address the quality of coded stroke data through improved stroke documentation, the next stage will be to adapt the educational program for clinicians.