Teaching Of Clinical Skills Research Articles

Thinking and exploration of formative assessment in the clinical practice skills teaching of laboratory medicine

To combine more than 20 years of experience in clinical practice skills teaching of laboratory medicine, with the characteristics of laboratory medicine, the theory system of formative assessment has been constructed, to guide the clinical practice of the students. Based on the construction of network question bank, students make use of the network question bank self testing, to know whether they had got the stage goal, existing problems and future plan through self testing, so as to mobilize their enthusiasm and initiative to enhance their self-confidence. Under the formative assessment teaching system, students establish internship file information, including practice notes, weekly practice, group discussion, self testing results, the teacher and peer assessment information. Teachers set up QQ group, WeChat group with their students, the timely to get the question from students and to take appropriate measures improve teaching. Teachers had established and improved the long-term after graduation feedback mechanism, and formative assessment improved the teaching quality of the whole practice teaching benefits teachers as well as students.(Chin J Lab Med, 2017, 40: 552-554) Key words: Formative assessment; Laboratory medicine; Teaching system

Pharmacists’ perceptions of their emerging general practice roles in UK primary care: a qualitative interview study

BackgroundUK general practice is experiencing a workload crisis. Pharmacists are the third largest healthcare profession in the UK; however, their skills are a currently underutilised and potentially highly valuable resource for primary health care. This study forms part of the evaluation of an innovative training programme for pharmacists who are interested in extended roles in primary care, advocated by a UK collaborative ‘10-point GP workforce action plan’.AimTo explore pharmacists’ perceptions of primary care roles including the potential for greater integration of their profession into general practice.Design and settingA qualitative interview study in UK primary care carried out between October 2015 and July 2016.MethodPharmacists were purposively sampled by level of experience, geographical location, and type of workplace. Two confidential semi-structured telephone interviews were conducted — one before and one after the training programme. A constant comparative, inductive approach to thematic analysis was used.ResultsSixteen participants were interviewed. The themes related to: initial expectations of the general practice role, varying by participants’ experience of primary care; the influence of the training course with respect to managing uncertainty, critical appraisal skills, and confidence for the role; and predictions for the future of this role.ConclusionThere is enthusiasm and willingness among pharmacists for new, extended roles in primary care, which could effectively relieve GP workload pressures. A definition of the role, with examples of the knowledge, skills, and attributes required, should be made available to pharmacists, primary care teams, and the public. Training should include clinical skills teaching, set in context through exposure to general practice, and delivered motivationally by primary care practitioners.

Teaching Veterinary Anesthesia: A Survey-Based Evaluation of Two High-Fidelity Models and Live-Animal Experience for Undergraduate Veterinary Students.

In veterinary medical education, reduction, replacement, and refinement (the three Rs) must be considered. Three clinical skills in anesthesia were identified as challenging to students: endotracheal intubation, intravenous catheterization, and drug dose calculations. The aims of this project were to evaluate students' perception of their level of confidence in performing these three clinical skills in veterinary anesthesia, to document the extent of students' previous experience in performing these three tasks, and to describe students' emotional states during this training. Veterinary students completed a series of four surveys over the period of their pre-clinical training to evaluate the usefulness of high-fidelity models for skill acquisition in endotracheal intubation and intravenous catheterization. In addition, practice and ongoing assessment in drug dose calculations were performed. The curriculum during this period of training progressed from lectures and non-animal training, to anesthesia of pigs undergoing surgery from which they did not recover, and finally to anesthesia of dogs and cats in a neutering clinic. The level of confidence for each of the three clinical skills increased over the study period. For each skill, the number of students with no confidence decreased to zero and the proportion of students with higher levels of confidence increased. The high-fidelity models for endotracheal intubation and intravenous catheterization used to complement the live-animal teaching were considered a useful adjunct to the teaching of clinical skills in veterinary anesthesia. With practice, students became more confident performing drug dose calculations.

Medical students’ communication skills in clinical education: Results from a cohort study

ObjectiveTo assess students’ communication skills during clinical medical education and at graduation. MethodsWe conducted an observational cohort study from 2007 to 2011 with 26 voluntary undergraduate medical students at Hamburg University based on video-taped consultations in year four and at graduation. 176 consultations were analyzed quantitatively with validated and non-validated context-independent communication observation instruments (interrater reliability ≥0.8). Based on observational protocols each consultation was also documented in free-text comments, salient topics were extracted afterwards. Results26 students, seven males, were enrolled in the survey. On average, graduates scored higher in differential-diagnostic questioning and time management but showed deficiencies in taking systematic and complete symptom-oriented histories, in communication techniques, in structuring consultations and in gathering the patients’ perspectives. Patient-centeredness and empathy were rather low at graduation. Individual deficiencies could barely be eliminated. ConclusionMedical students were able to enhance their clinical reasoning skills and their time management. Still, various communication deficiencies in final year students became evident regarding appropriate history taking, communication skills, empathy and patient-centeredness. Practice implicationsThe necessity of developing a longitudinal communication curriculum with enhanced communication trainings and assessments became evident. A curriculum should ensure that students’ communication competencies are firmly achieved at graduation.

Explicating Filipino student nurses' preferences of clinical instructors' attributes: A conjoint analysis

The role of clinical instructor in student nurses' preparation for the professional nursing practice cannot be underestimated. The extent to which such role is achieved depends highly on the instructors' ability to realize the desired qualities expected of them. While a number of empirical studies have qualitatively explored the attributes of an effective clinical instructor, no attempt has ventured yet on the power of experimental vignettes for conjoint analysis in explicating the preferences of a select group of Filipino student nurses relative to their clinical instructors' attributes. Junior and senior nursing students (n=227), recruited from one of the comprehensive universities in the Philippines, were asked to sort out orthogonal cards generated by Sawtooth Software. As shown, the full-profile conjoint analysis was considerably fit for this study: Pearson's R=0.988, (p<0.05) and Kendall's t=0.944, (p<0.05). Results indicated that the student nurses are one in terms of their most preferred clinical instructor attribute, which was clinical teaching capacity (38.14%) followed by interpersonal relationship and caring behavior (33.17%). In regard to the clinical teaching capability, a clinical instructor who parallels clinical teaching skills with the students' understanding and experience (0.089) was the highest part-worth. As for the interpersonal relationship and caring behavior, the highest part-worth was a clinical instructor who respects a student nurse as an individual and cares about him/her as a person (0.114). Findings of this study can be a basis for clinical instructors as to which qualities to cultivate best to facilitate a first-rate clinical nursing instruction. Likewise, the results of this study can inform current practices of clinical instructors by making them aware of how they can nurture a pedagogical approach consistent with the student nurses' preferences.

Supporting Nurse Practitioner Preceptor Development

Abstract Increases in the number of nurse practitioners (NPs) completing their educational programs create a challenge for universities as well as health care organizations. More clinical preceptors are needed to support students and new professionals transitioning to clinical practice. Although preceptors are critical in the evolution from new NP to competent provider, there is a lack of information available to NP preceptors related to developing effective clinical teaching skills. This comprehensive literature review evaluates current, evidence-based strategies for preceptor development. The findings in the literature show improvement in clinical reasoning when structured preceptor methods are incorporated into clinical practice.

Assessment of “YouTube” Content for Distal Radius Fracture Immobilization

Distal radius fractures (DRFs) are the most common orthopedic fractures, with >70% of cases treated by closed immobilization using a short arm cast or a sugar tong splint. However, inadequate immobilization is a risk factor for loss of reduction requiring repeat reduction or surgical treatment. Therefore, education of clinical skills for appropriate immobilization of DRFs is important. With the increasing use of web-based information by medical learners, our aim was to assess the quality and quantity of videos regarding closed immobilization of DRFs on YouTube. Retrospective review of YouTube videos on distal radius fracture immobilization using specific search terms. Identified videos were analyzed for their educational value, quality of the technical skill demonstrated, and overall metrics. Educational value was scored on a 5-point scale, with "1" indicative of low quality and "5" of high quality. Not applicable. Among the 68,366 videos identified, 16 met our inclusion criteria of being in English; performed by a health care professional or institution; and with casting being the major theme of the educational information provided. Of these 16 videos, 6 had an educational value score of 4 or 5, with the remaining 10 having a score ≤3. Although immobilization was demonstrated by cast technician specialized in orthopedics, skills were also performed by orthopedic attendants, urgent care physicians, orthopedic residents, and nurse practitioners. The credentials of the performer in 3 videos were not identified. There is a need to promote high-quality educational videos produced by established medical school faculty members on open, web-based, portals.

Effect analysis of PDCA management applied in the teaching of the operation of spinal surgery practice nurses to reduce nursing errors

Objective To study the application effect of PDCA management mode in the teaching process of practice nurses in spine surgery to reduce the occurrence of nursing errors. Methods A total of 35 practice nurses in spine surgery from March 2014 to March 2015 received the routine teaching mode were set as control group, and 35 practice nurses from April 2015 to April 2016 implemented PDCA management mode were set as intervention group. The occurrence rate of nursing adverse events in two years was observed, and the interns for clinical teaching evaluation model of quality and satisfaction and the intern examination results were summarized. Results The incidence of nursing adverse events was 22.86% (8/35) in control group, and 2.86% (1/35) in intervention group, the difference was statistically significant (χ2= 17.85, P= 0.00). The intern teacher for clinical teaching content arrangement, teaching attitude, detail guidance and skills training indicators evaluation score were (15.46±1.03), (14.18±1.06), (14.61±1.11), (13.30±1.07) points in control group, and (18.26±1.00), (18.48±0.51), (19.43±0.21), (19.16±0.28) points in intervention group, the differences were statistically significant (t= 11.54-31.34, P < 0.01). The interns given theory and skills examination results were (80.15±1.61), (85.16±1.02) points in control group, and (93.10±2.01), (91.06±2.03) points in intervention group, the difference was statistically significant (t=29.75, 15.36, all P=0.00). The clinical teaching satisfaction was 57.14% (20/35) in control group, and 80.00% (28/35) in intervention group, the difference was statistically significant (χ2= 12.12, P=0.00). Conclusions PDCA management model applied to clinical practice in department of orthopedics teaching process, can effectively improve the intern theory knowledge and skills to master the ability, most of the interns examination results are more optimistic, and for this kind of management pattern for the process of teaching evaluation of higher satisfaction, the teachers care under the guidance of intern nursing mistake, nursing adverse events is low, this method is worthy of promotion. Key words: PDCA management mode; Spinal surgery; Practice teaching; Nursing operation error

We Can Teach How to Bend the Cost Curve: Lessons in Pediatric High-Value Health Care.

* Abbreviations: PPI — : Prepare, Process, Initiate SOAP-V — : Subjective, Objective, Assessment, Plan, Value “We have really good data that show when you take patients and you really inform them about their choices, patients make more frugal choices. They pick more efficient choices than the health care system does.” Donald Berwick, MD In continuing the series of articles by the Council on Medical Student Education in Pediatrics, we focus on the great clinical teacher’s responsibility to both deliver and explicitly teach about high-value health care. Medical students entering clinical rotations have been introduced to the concept of “too much care” in their coursework, including overdiagnosis, overtreatment, excessive testing, and poor care coordination and communication.1,2 As pediatricians committed to eliminating practices and associated expenditures that are not evidence-based and that lack direct patient benefit, we can improve our clinical teaching skills by making our role-modeling of such behaviors explicit. This paper reviews ways to incorporate teaching about common examples of pediatric care of limited or no value by using accessible teaching tools, such as the Choosing Wisely lists.3 We also introduce 2 efficient teaching aids to help learners incorporate the concept of value into their clinical reasoning and presentations: Prepare, Process, Initiate (PPI), and Subjective, Objective, Assessment, Plan, Value (SOAP-V).4 Despite the modest deceleration in the … Address correspondence to Alison Volpe Holmes, MD, MPH, 1 Medical Center Dr, Rubin 525, Lebanon, NH 03756. E-mail: alison.v.holmes{at}hitchcock.org

Enhancing technical skill learning through interleaved mixed-model observational practice.

A broad foundation of behavioural (Hayes et al. in Exp Brain Res 204(2): 199-206, 2010) and neurophysiological (Kohler et al. in Science 297(5582): 846-848, 2002) evidence has revealed that the acquisition of psychomotor skills, including those germane to clinical practice (Domuracki et al. in Med Educ 49(2): 186-192, 2015), can be facilitated through observational practice. Interestingly, research also reveals that learning via observation is greatest when the learner has the opportunity to view both error-free expert demonstrations and flawed novice demonstrations (Rohbanfard and Proteau in Exp Brain Res 215: 183-197, 2011). In this study, we explored whether the learning that results from the combined viewing of experts and novices is greater when the demonstrations are presented under observation schedules characterized by higher levels of contextual interference. To do so, we engaged participants in an observational learning study of the Fundamentals of Laparoscopic Surgery pots-and-beans task: a simulated procedure in which performers must move objects under precision constraints in the minimal access surgery environment. Each participant was randomized to one of three groups that engaged in identical physical and mixed-model observational practice of this skill, with the only difference being that one group's observation was presented in blocked fashion (low interference) while the other two groups' observations were presented in semi-interleaved (medium interference) and interleaved (high interference) fashions. Total errors and time-to-complete measures taken during physical practice blocks revealed that all three groups improved over the intervention. Further analyses revealed that the low interference group performed better immediately following the physical and observational practice intervention, but that the medium- and high-interference groups were conveyed a performance advantage in a transfer test conducted after a period of retention that challenged participants to perform in the opposite direction. The results are discussed with respect to the classic contextual interference effect (Shea and Morgan in J Exp Psychol 5(2): 179-187, 1979) and with particular relevance to clinical skills education.

Teaching and assessment of clinical communication skills: Lessons learned from a SWOT analysis of Portuguese Angolan and Mozambican Medical Education

BackgroundThe importance of clinical communication skills (CCS) teaching and assessment is increasingly recognized in medical education. There is a lack of outcome-based research about CCS teaching and assessment processes in Portuguese medical education. Our goal is to conduct a SWOT analysis of this process in Portugal, Angola and Mozambique in order to contribute to the establishment of an action plan for more effective CCS teaching and assessment in medical curricula. MethodsBetween 2010 and 2012, semi-structured interviews focused on the state of the art of teaching and assessment of clinical communication skills were conducted with key stakeholders of medical courses in Portugal, Angola and Mozambique. The design corresponds to an exploratory, descriptive and cross-sectional study, with the analysis of the recorded interviews. Interview transcripts were analyzed to identify salient themes/coding template in their discussions of the CCS teaching process. The coding and analysis of the surveys is qualitative. Results87 interviews were performed at the 8 Portuguese, 1 Angolan and 1 Mozambican medical schools. Results indicate that the teaching and assessment process of CCS is in the beginning stages with these commonalities noted: (i) Variability amongst faculty in the teaching and assessment methods, (ii) disconnection of CCS between basic and clinical cycles, (iii) content and process skills and (iv) faculty development. ConclusionsCCS training lacks a formal structure with considerable variation of the CCS teaching process in these countries. The interviews promoted a rise in awareness of this situation and how these skills can enhance the quality of curricular change. Some important opportunities for the development and implementation of a framework of an integrated communication skills curriculum such as curricular reforms and well-established cooperation and networks were identified. The acknowledgement of the importance of integrating these skills in ME by key stake-holders and students in institutions and the identification of champions motivated to commit to the effort are strengths that should be considered to integrate and enhance CCS in the medical curricula.

Residency evaluation and adherence design study: Young ophthalmologists' perception of their residency programs - Clinical and surgical skills.

Background:Residency training is the basis of good clinical and surgical practice.Purpose:The aim is to know the demographics, training experience, and perception of young ophthalmologists to improve the present residency programs in India.Setting:Young ophthalmologists trained in India.Methods:A survey was conducted by the Academic and Research Committee of the All India Ophthalmology Society, in 2014–2016 of young ophthalmologists (those trained between 2002 and 2012, with 2–10 years' postresidency experience) to gauge teaching of clinical and surgical skills during the postgraduate residency program.Statistical Analysis:Statistical Package for Social Sciences version 16.Results:Of the 1005 respondents, 531 fulfilled inclusion criteria. Average age was 32.6 years (standard deviation [SD] 4). On a scale of 0–10, clinical skills teaching was graded as (mean, SD): Slit lamp examination (7.2, SD 2.8), indirect ophthalmoscopy (6.2, SD 3.3), gonioscopy (5.7, SD 3.4), perimetry (6.2, SD 3.2), optical coherence tomography (4.6, SD 4), and orthoptic evaluation (4.3, SD 3.1). The mean (SD) and median of surgeries performed independently was intracapsular cataract extraction 3.0 (14.9), 0; extracapsular cataract extraction 39.9 (53.2), 18; small incision cataract surgery 75.3 (64.4), 55; phacoemulsification 30 (52.6), 1; pterygium excision 31.5 (43.5), 15; dacryocystectomy 20.3 (38.1), 4; dacryocystorhinostomy 11.7 (26.2), 2; chalazion 46.4 (48.3), 30; trabeculectomies 4 (14.9), 0; strabismus correction 1.4 (4.9), 0; laser-assisted in situ Keratomileusis 1.5 (12.2), 0; retinal detachment 1.5 (12.5), 0; vitrectomy 3.0 (17.0), 0; keratoplasty 5.2 (17.8), 0; eyelid surgery 8.6 (18.9), 2 and ocular emergencies 41.7 (52.4), 20. Observed and assisted surgeries were more common. However, the range of grading was 0–10 in all categories.Conclusion:Residency training in India varies considerably from program to program. Standardization is needed to assure all graduates are competent and render consistent quality of service.

A survey of senior medical students’ attitudes and awareness toward teaching and participation in a formal clinical teaching elective: a Canadian perspective

ABSTRACTBackground: To prepare for careers in medicine, medical trainees must develop clinical teaching skills. It is unclear if Canadian medical students need or want to develop such skills. We sought to assess Canadian students’ perceptions of clinical teaching, and their desire to pursue clinical teaching skills development via a clinical teaching elective (CTE) in their final year of medical school.Methods: We designed a descriptive cross-sectional study of Canadian senior medical students, using an online survey to gauge teaching experience, career goals, perceived areas of confidence, and interest in a CTE.Results: Students at 13 of 17 Canadian medical schools were invited to participate in the survey (4154 students). We collected 321 responses (7.8%). Most (75%) respondents expressed confidence in giving presentations, but fewer were confident providing bedside teaching (47%), teaching sensitive issues (42%), and presenting at journal clubs (42%). A total of 240 respondents (75%) expressed interest in participating in a CTE. The majority (61%) favored a two week elective, and preferred topics included bedside teaching (85%), teaching physical examination skills (71%), moderation of small group learning (63%), and mentorship in medicine (60%).Conclusion: Our study demonstrates that a large number of Canadian medical students are interested in teaching in a clinical setting, but lack confidence in skills specific to clinical teaching. Our respondents signaled interest in participating in an elective in clinical teaching, particularly if it is offered in a two-week format.

A qualitative evaluation of scalpel skill teaching of podiatry students

BackgroundDegrees in health disciplines need a balance of theoretical knowledge and sufficient clinical practice to meet registration requirements, in particular those requiring specialist skills such as the use of scalpels and other small instruments, such as podiatry. However, despite this requirement there is a scarcity of literature and research to inform teaching of these particular manual clinical skills. Therefore, the aims of this study were to determine the current approaches being used to teach manual skills, in particular scalpel skills, in university podiatry programs in Australia and New Zealand, and to explore what issues, challenges and innovations exist.MethodsA qualitative study, consisting of semi-structured interviews with staff at eight university podiatry programs in Australia and New Zealand was undertaken to determine how these skills are taught and evaluated, and how poor performers are managed. A conventional content analysis technique was used to analyse and code interview data, with the resultant categories reported.ResultsApproaches to teaching manual clinical skills, in particular scalpel skills, appear to be consistent between university programs in Australia and New Zealand in utilising didactic-style content, demonstration, physical practice on inanimate objects and real skin, and often the use of supplementary audio-visual material. The main reported differences between programs were in methods and processes of practice, with controversy regarding the use of inanimate objects versus real skin for practice.ConclusionsDespite a lack of research and literature surrounding this topic, the approach to teaching is relatively consistent between programs with greatest disparity being the structure and duration of practice. Key issues for teaching staff in teaching manual skills were students’ clinical exposure, motivation, levels of anxiety and dexterity.

Hybrid simulation for integrated skills teaching

Background: Classroom teaching of communication and clinical skills in the pre-clinical years does not reflect authentic practice in the clinical workplace. This paper describes an innovative hybrid simulation teaching session on male urinary catheterisation to large cohorts of undergraduate medical students, which aims to achieve a holistic approach to integrated skills acquisition. Evaluation of the session is described. Method: Undergraduate students (n=1221) took part in a 1-hour workshop, delivered over four years to consecutive cohorts. Evaluation forms (n=1042) captured students’ rating of the session and impact on their levels of confidence. Free text comments were explored using content analysis. Results: The majority (91%) of students evaluated the sessions as excellent or good, with students who performed the procedure rating the session significantly higher. They did not feel more confident about their skills than students who merely observed. Free text comments illustrate perceived benefits of practising integration of clinical and communication skills. Discussion: Teaching male catheterisation using hybrid simulation is effective, feasible and sustainable over time for large cohorts of undergraduate medical students. Students recognise benefits of learning communication and procedural skills in an integrated manner, and report increased levels of confidence in their ability to catheterise, provide explanations and build rapport with the patient

A Five-Year Review of Enhanced Learning through Integration: Anatomy and Clinical Practice

Many medical schools have undergone curricula revisions and attempted to integrate basic and clinical sciences. In 2012, our program at the University of Florida College of Medicine underwent significant curricular reform, transitioning from the standard medical curriculum to a systems-based approach. The teaching of anatomy, clinical skills, radiology, ethics, population health, human behavior, and evidence-based medicine was integrated into one class, “Introduction to Clinical Medicine”, which spans 68 weeks in the pre-clerk- ship curriculum. As a result, there was a reduction of anatomy teaching from 166 to 120 hours. Our curriculum integration demonstrates opportunities for enhanced teaching including increasing peer learning, incorporating multidisciplinary case presentations, and allowing for a deliberate overlap and layering of anatomy education across two years of medical school. This paper describes our reflection on the effect of the curriculum change on student learning. Five years after implementation of these changes shows that our efforts also illustrate the challenges inherent to curricular integration including scheduling constraints, unclear sources of financial support, apprehension about the effect on future National Board of Medical Examiners (NBME) scores, and difficulty assessing which areas a student needs to remediate within a failed integrated course. Overall, the integration of anatomy with other classes into a revised course at our College of Medicine has been well received and successful.

Using video podcasting to enhance the learning of clinical skills: A qualitative study of physiotherapy students' experiences

BackgroundVideo podcasts, or vodcasts are increasingly used by a range of healthcare professions in the mastery of new skills. Little is known about the experiences of using vodcasts in physiotherapy education. Traditional pedagogic strategies have been employed in order to master those skills required for physiotherapy practice. There have been advances in the use of technology in medical education in the nursing, dentistry and medical fields. Vodcasts offer great versatility and potential when used as a pedagogical tool, embedded within a physiotherapy curriculum. AimTo explore students' experiences of using technology enhanced learning, namely vodcasts, in the Physiotherapy curriculum to develop the learning of clinical skills. MethodA series of focus groups were carried out with undergraduate and pre-registration physiotherapy students (n=31). FindingsStudents valued the versatility and audio-visual nature of vodcasts; helpful in revising for practical examinations and practising their skills prior to, during and after taught skills classes. Watching and practising simultaneously allowed students to practice repeatedly and formulate a process for each skill. When learning a new skill, a combination of teaching and learning approaches was favoured, marrying traditional approaches with those that utilise technology. ConclusionsThis study's findings add to the existing body of evidence in skills based teaching and support a multi-media, blended approach in those disciplines involved in the learning and teaching of clinical skills.

Twelve tips for educating tomorrow’s clinical educators today: A proactive approach to clinical education (PACE)

Teaching the next generation of health workers is considered a core role for all clinicians, yet in practice it is often regarded as an optional activity. While health professionals are expected to teach, many are reluctant to attend faculty development initiatives that provide the training. There are many and varied reasons for this: lack of personal motivation or support from managers to undertake additional education in clinical education, staff shortages and, perhaps, a misunderstanding of the expectations of today’s professionals. Moreover, position descriptions of clinicians seldom include a role and responsibility to educate. Thus clinicians who do undertake additional formal education to provide clinical education may have limited opportunities for promotion after making such an effort. An adjustment to pre-registration clinical curricula that highlights the importance of and focuses on developing competence, capacity and capability in clinical education may be the key. This paper presents a “12 tips” framework to embed a proactive approach to learning clinical education skills (PACE) into a program of study. The 12 tips of PACE propose how, from the beginning of their undergraduate practicum experiences, pre-registration learners can be prepared to take up their professional responsibilities as clinical educators. The PACE framework can also be applied to the post-registration curriculum. The PACE model has the potential to both strengthen the skill base and increase the size of the clinical education workforce by including clinical education skills as an integral part of all clinical training.

Application effect of nursing students as standardized patients in teaching practice of Emergency Nursing

Objective Taking Standardized Patients (SP) technique as basis, combining situational simulative teaching method, SP, as an attempt, is introduced to clinical nursing skill teaching in practice of the course of Emergency Nursing. Effect of this introduction would be explored, and new ideas and new methods in teaching practice of the course Emergency Nursing would also be explored. Methods By teaching the unit of Wound Hemostasis and Bandaging, training of nursing students as SP and compilation of Practice Handbook of Simple SP for Emergency Nursing were completed. 50 undergraduate students, majoring in Nursing and admitted in 2011, were selected and divided randomly into experimental group and control group, each with 25 students. Traditional model patient was used as teaching tool for operation demonstration and practice in the control group, while in the experimental group, operation and practice were done with combination of model patients and situational simulative teaching method basing on SP technique. Before and after the experiment, students in the two groups were asked to fill in the Scale of professional attitude measurement of nurses. Results Practice Handbook of Simple SP for Emergency Nursing was completed. According to the evaluation of simple SP and nursing teachers, this training material was practical in content and operable in reality; 5 SSP have received the training and won approval; after the experiment, scores of nurses in the experimental group in the Scale of professional attitude measurement of nurses were higher than those in the control group (P<0.05); in the experimental group, scores of SSP teaching practice after the experiment were higher than that before the experiment (P<0.05). Conclusions Introducing nursing students as SP in teaching practice of the course of Emergency Nursing can improve professional attitude of undergraduate students majoring in Nursing in universities of Chinese Medicine and increase their professional identity. Key words: Standardized patients; Emergency Nursing; Situational simulative teaching method

ADEQUACY OF NURSING STUDENTS' KNOWLEDGE AND SKILLs ABOUT INTRAMUSCULAR INJECTION

Background For the last two decades, there have been concerns about the adequacy of clinical skills education of nursing students in terms of content and competency. Intramuscular injection (IM) is one of the common methods of drug administration technique. Administering an IM injection is a complex psychomotor task that requires skill and knowledge on the part of the healthcare professional that is performing the procedure. The aim of the present study is to assess adequacy of nursing students' knowledge, and skills about intramuscular injection. The study was conducted at Faculty of Nursing at Benha University. Descriptive design was used. Two tools were filled by 80 nursing students from first year from the above mentioned setting. (1) Knowledge questionnaire contains 23 questions and (2) Observation checklist contain 27 items about intramuscular injection .Results revealed that high percent (80%&70%) of nursing students have adequate skills and knowledge about intramuscular. There is positive significant correlation between nursing students' skills and knowledge about intramuscular injection at P<0.0001. It can be concluded that nursing students from first year at Faculty of Nursing at Benha University have adequate knowledge, and skills of intramuscular injection. So, it was recommended that prime importance for nursing educators pays further attention to nursing students’ training about intramuscular injection.