Clinical Competence Research Articles

Digital learning of clinical skills and its impact on medical students’ academic performance: a systematic review

BackgroundThe constraints imposed by the COVID-19 pandemic has led to the rapid development and implementation of digital methods for teaching clinical skills in medical education. This systematic review presents both the benefits, challenges, and effectiveness of this transition.MethodsA systematic search of six electronic databases (SCOPUS, Medline, CINAHL, PsycINFO, ERIC & Informit) was conducted on 1st October 2023 and updated on 1st April 2024 to identify peer- reviewed articles, from 2019 onwards, which used any type of digital tool (online or otherwise) to teach clinical skills to medical trainees (undergraduate or postgraduate) and were published in English language. The primary outcome synthesised was the reported effectiveness of these digital tools in the development of clinical skills. Risk of bias of included studies was assessed using the Quality Assessment With Diverse Studies (QuADS) tool.ResultsTwenty-seven studies involving 3,895 participants were eligible for inclusion in this review. The QuADS quality assessment scores ranged from 22 to 35, indicating medium quality and thirteen of the studies were randomized trials. Overall, digital teaching of clinical skills demonstrated improved or comparable outcomes to in-person teaching. There was a beneficial effect of digital learning tools on assessment outcomes, with meta-analysis showing a mean difference increase of 1.93 (95% CI 1.22 to 2.64), albeit with a high amount of statistical heterogeneity I2 97%, P < 0.001. Digital clinical skills teaching also resulted in improved student satisfaction scores in many situations and was also shown in one study to be cost effective.ConclusionTeaching of clinical skills using digital tools is an important alternative to the traditional format of face-to-face delivery, which is resource intensive and difficult to implement during a pandemic. This review demonstrates their potential efficacy in improving education outcomes, student satisfaction and potentially reducing costs. However, the integration of traditional and innovative digital teaching methods appeared to provide the most comprehensive learning experience. Future research could focus on longitudinal studies to assess the long-term impact and efficacy of different digital and blended learning modalities on the acquisition of clinical skills and professional competencies.

Educational outcomes of digital serious games in nursing education: a systematic review and meta-analysis of randomized controlled trials

BackgroundAdvancements in digital technologies and the coronavirus disease pandemic have rapidly shifted educational practices towards engaging digital methods, such as serious games, significantly influencing healthcare education. Digital serious games enhance nursing education by effectively overcoming limitations such as limited training time and inadequate resources, thereby improving knowledge and skills. Few high-quality systematic reviews and meta-analyses were focused exclusively on randomized controlled trials (RCTs) of digital serious games to determine their effects in nursing education.ObjectiveTo evaluate the effects of digital serious games on nursing education through a systematic review and meta-analysis using the Kirkpatrick model to evaluate learning and behavioral changes.MethodsA systematic review and meta-analysis of RCTs was performed. Six databases were searched for articles published before April 2024. Risk of bias was assessed using the Revised Cochrane Risk of Bias tool for randomized trials. A sensitivity analysis was performed. Outcome variables were categorized according to the Kirkpatrick model. Effect sizes were determined using Hedges’ g in a random-effects model. Subgroup analysis was performed.ResultsThe quality appraisal results revealed that all the studies exhibited a low risk of bias across these domains. Eleven studies were included in the systematic review, and eight studies, in the meta-analysis. The intervention group showed significant improvements in knowledge (Hedges’ g = 0.75, 95% confidence interval (CI) = [0.27, 1.22], p = .002, I² = 90.51%), confidence (Hedges’ g = 0.73, 95% CI = [0.23, 1.24], p = .005, I² = 82.71%), and performance (Hedges’ g = 0.49, 95% CI = [0.17, 0.80], p = .003, I² = 56.60%). Subgroup analysis showed a significant improvement in knowledge when the intervention period exceeded 2 weeks (Hedges’ g = 0.53, 95% CI = [0.32, 0.74], p < .001, I² = 25.41%).ConclusionThis study demonstrates that digital serious games significantly enhance knowledge, performance, and confidence of nursing students, offering a valuable alternative to traditional methods and equipping them with essential clinical competencies. However, the observed high heterogeneity and limitations like brief intervention durations necessitate caution in result interpretation and highlight the need for further research to explore long-term effects and behavioral changes in nursing education.

Assessment of clinical competencies of medical students in a simulated environment: a scoping review protocol

Simulation in scenarios representative of clinical practice is an innovative teaching-learning strategy. Performance evaluation in this scenario must be carried out using methods that are valid, reliable, equivalent, feasible, acceptable, have an educational impact and a catalytic effect. It is therefore necessary to understand the methods available for this purpose. The aim was therefore to outline a scoping protocol on the assessment methods used to analyze the clinical competencies of medical students in a simulated environment. This protocol was conducted according to the methods proposed by the Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The review question was defined based on the PCC (Population, Concept, Context) mnemonic: “What methods are used to assess the clinical skills of medical students in a simulated environment?”. The eligibility criteria are associated with publications in English, Portuguese and Spanish, available in full text, covering methodological approaches including qualitative, quantitative, mixed methods, primary research, systematic reviews, meta-analyses, letters, guidelines, published theses and dissertations, with no time frame. The searches will be carried out in the Scopus, CINAHL, Web of Science, Lilacs, PubMed and Scielo databases. The results will be presented in tables or diagrams, accompanied by explanatory text, according to the best use for the purpose of the review.

A THE HIGH-QUALITY OF CLINICAL PRACTICE EVALUATION FOR NURSING STUDENTS: A LITERATURE REVIEW

Background: Evaluation processes of clinical practice among nursing students can be less than optimal due to individual, organizational, and psychological factors. Improving clinical practice evaluations enhances student outcomes. Therefore, to measure quality in these evaluations, it is essential to identify standard components for evaluating clinical practice quality among nursing students. Purpose: This literature review aims to analyse what components influence the quality of clinical practice evaluation among nursing students. Methodology: The literature review is done by taking electronic database sources through e-book and journal search engines, such as Google Book, Google Scholar, Pro-Quest, PUBMED, and Science Direct. The criteria for published books are the last ten years (2013-2023) and journals for the last five years (2018-2023) using the keywords "component of quality evaluation of clinical practice among nursing students". Results: Based on a review of 12 journals that met the analysis criteria, various measurement components were identified and summarised into nine main components: validity, reliability, practicability, objectivity, feasibility, understandability, continuity, propriety, and efficiency, serving as the standard for measuring the quality of clinical evaluation in nursing students. Conclusion: The quality of clinical practice evaluation among nursing students must have standardized, effective, efficient, and sustainable components so that the clinical competence of nursing students can be achieved optimally.

The Effect of Emotional Intelligence, Caring Efficacy, and Social Support on Clinical Competency of Nursing Students

Aim The purpose of this study was to determine the effects of emotional intelligence, caring efficacy, and social support on the clinical competency of Korean nursing students. Methods We conducted a descriptive correlational study from 5th March to 10th June 10, 2020, among 257 nursing students in 3rd and 4th years who participated in clinical practice at four universities in two cities. We collected the data using a self-structured questionnaire that included 129 items from the Wong and Law Emotional Intelligence Scale (WLEIS), the General Self-efficacy (GSE) scale, and scales on social support and clinical competency. We analyzed the data using frequency analysis, t-test, ANOVA, Scheffe test, Pearson correlation coefficient, and stepwise multiple regression analysis. Results The majority of the students, i.e., 80.2%, were female, 57.6% were in their 3rd year, and the students’ average age ranged from 22.91 to 4.75. The participants’ clinical competency was linked to their emotional intelligence (r =.457; p&lt;.001), their ability to care for others (r =.516; p&lt;.001), and their social support (r =.515; p^.001). There was a statistically significant difference in clinical competency based on the participants’ religion, academic performance, and satisfaction with their major and clinical practice. Factors, such as care efficacy, social support, emotional intelligence, religion, and significant satisfaction, influenced clinical competency. Conclusion Overall, 39.3% of the participants demonstrated clinical competency. The results have highlighted the need for the development of an effective educational program that can enhance emotional intelligence, care efficacy, social support, and major satisfaction, thereby promoting the clinical competency of nursing students.

Effect of Video vs. Lecture/Demonstration in Improving Nursing Interns’ Knowledge and Skills Regarding External Ventricular Drain (EVD): A Quasi-Experimental Study

Background: Healthcare settings ought to consider creative strategies with regard to training nurses in clinical competencies, including trainee nurses and new nurses with limited resources. This study aimed to develop a high-quality educational video to gauge the effect of video instruction versus lecture demonstration in improving the skills and knowledge of nurse interns on the subject of external ventricular drain. Method: The study used a quasi-experimental post-test design and took place from June 2019 until May 2020. The 80 participants, all nurse interns, were randomly assigned to one of two teaching methods (video instruction or lecture demonstration). The data were gathered using a questionnaire prepared by the researchers. Results: The mean score of the lecture group was 68.2 +/-21.1, and in the video group, 78.5 +/-21.6. This means that the video group outperformed the lecture group in terms of skill (p=0.034). The findings showed no statistically significant difference in the groups’ overall knowledge and competence ratings. Conclusion: Video is a sound educational strategy, and the clinical education system can support the use of videos as a complementary method to teach clinical skills.

Effectiveness of Virtual Simulations Versus Mannequins and Real Persons in Medical and Nursing Education: Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials.

Virtual simulation (VS) is a developing education approach with the recreation of reality using digital technology. The teaching effectiveness of VSs compared to mannequins and real persons (RPs) has never been investigated in medical and nursing education. This study aims to compare VSs and mannequins or RPs in improving the following clinical competencies: knowledge, procedural skills, clinical reasoning, and communication skills. Following Cochrane methodology, a meta-analysis was conducted on the effectiveness of VSs in pre- and postregistration medical or nursing participants. The Cochrane Library, PubMed, Embase, and Educational Resource Information Centre databases were searched to identify English-written randomized controlled trials up to August 2024. Two authors independently selected studies, extracted data, and assessed the risk of bias. All pooled estimates were based on random-effects models and assessed by trial sequential analyses. Leave-one-out, subgroup, and univariate meta-regression analyses were performed to explore sources of heterogeneity. A total of 27 studies with 1480 participants were included. Overall, there were no significant differences between VSs and mannequins or RPs in improving knowledge (standard mean difference [SMD]=0.08; 95% CI -0.30 to 0.47; I2=67%; P=.002), procedural skills (SMD=-0.12; 95% CI -0.47 to 0.23; I2=75%; P<.001), clinical reasoning (SMD=0.29; 95% CI -0.26 to 0.85; I2=88%; P<.001), and communication skills (SMD=-0.02; 95% CI: -0.62 to 0.58; I2=86%; P<.001). Trial sequential analysis for clinical reasoning indicated an insufficient sample size for a definitive judgment. For procedural skills, subgroup analyses showed that VSs were less effective among nursing participants (SMD=-0.55; 95% CI -1.07 to -0.03; I2=69%; P=.04). Univariate meta-regression detected a positive effect of publication year (β=.09; P=.02) on communication skill scores. Given favorable cost-utility plus high flexibility regarding time and space, VSs are viable alternatives to traditional face-to-face learning modalities. The comparative effectiveness of VSs deserves to be followed up with the emergence of new technology. In addition, further investigation of VSs with different design features will provide novel insights to drive education reform. PROSPERO CRD42023466622; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=466622.

Student confidence in clinical competence during dental education

IntroductionDental education blends theoretical and practical training to prepare students for independent patient care. This study examines the confidence levels of dental students at Umeå University, Sweden regarding independent performance of general dentistry tasks, and whether this confidence changes after clinical training.Material and methodsSurveys were conducted before and after a summer clinical internship, with students rating their comfort levels on a scale from 0 to 10 for various procedures.ResultsResults from 64 initial surveys and 54 follow-up surveys showed no significant difference in confidence before and after the internship except for performing a tooth extraction (p = 0.010). However, confidence levels varied based on whether students had practiced specific tasks during the internship.DiscussionStudents felt least confident in managing acute dental trauma (mean 6.1–6.2) and treating cavities in young children (mean 6.2–6.7), while they were most confident in tasks like obtaining radiographic surveys (mean 8.5–8.6) and debriding periodontally compromised dentition (mean 8.2–8.3). Tooth extraction and dental fillings were the most practiced procedures during the internship.ConclusionsThe study concludes that the internship between the ninth and tenth semesters does not notably boost students’ confidence in specific dental procedures except for dental extractions. This result can possibly be explained due to the short duration of the training. Further exploration, including input from clinical supervisors, is suggested to optimise clinical training in dental education.

An international study of clinical, demographic, and competence-related determinants of communication with professionals.

This study aims to identify a combination of clinical, demographic, and patient competence determinants of patients' communication with doctors and nurses in an international sample of cancer patients. For our cross-sectional study, cancer patients assessed their communication with their doctors or nurses at the start of their treatment. Patients completed EORTC communication questionnaire QLQ-COMU26 to assess ten areas of communication with their doctor or nurses plus another item to assess how competent they felt when communicating with professionals. Bivariable analyses and multivariable linear regression models were performed separately for each QLQ-COMU26 area. Included in the study were 988 patients from 15 centres in 13 countries (five cultural areas). Higher age was related to higher level of communication in eight QLQ-COMU26 areas. Males reported higher level of communication in three areas. Lower levels of studies and higher level of perceived competence when communicating with professionals were related to higher level of communication in the ten QLQ-COMU26 areas. Communication was of a higher level with nurses than with doctors in four areas. Having received previous treatment with the same doctor or group of nurses was related to higher communication levels in seven areas. Lack of comorbidity was related to higher communication levels in two areas. Various differences in determinants were found among tumour sites. Our regression model has shown several relationships between communication and the demographic and clinical variables that may help identify patients at risk of poor communication. Future studies could focus on communication at diagnosis and in follow-up, and on areas such as assessing the particularities of communication between patient and professionals in relation to cancer type.

Research on Teaching Reform of Basic Medical Courses in Comprehensive Universities Oriented Towards “Clinical Competency”

Through this study, we aim to construct a teaching model for basic medical courses that enhances “clinical competency.” We explore the optimal methods and pathways for the organic integration of exam-oriented teaching and professional teaching, optimize teaching efficiency, improve teaching quality and educational effectiveness, and provide theoretical support for the cultivation of clinical medical talents in China. The goal is to establish a talent cultivation objective oriented towards “clinical competency,” promote the teaching reform of basic medical courses in comprehensive universities, facilitate the transition of basic medical course teaching from “teacher knowledge presentation” to “student knowledge construction,” and cultivate high-quality medical talents with clinical competency.

Perceived clinical competence and its related factors among registered nurses employed at selected outpatient clinics in Egypt.

Nurses' clinical competence is a significant concern in all healthcare settings due to the necessity of delivering high-quality patient care. Understanding and addressing the factors related to competence are crucial for promoting nurses' clinical competence and ultimately improving patient outcomes. Producing and maintaining a skilled nursing workforce is essential to protect communities. This study aimed to assess the level of self-evaluated clinical competence and its correlation with demographic and occupational variables among registered nurses employed at selected outpatient clinics in Egypt. The study utilized a descriptive cross-sectional design with a self-administered, two-part questionnaire that assessed participants' demographic and occupational variables as well as perceived clinical competence in various healthcare settings. It took place at outpatient clinics of two governmental hospitals and five primary healthcare centers in Mansoura City, Egypt between January, and June 2023. A purposive sample of 450 nurses took part in this study. The average score of nurses' clinical competence was 155.3±7.2 out of 230, indicating a "moderate level". In terms of professional behaviors and general performance, the average score for clinical competence was 48.4±3.6 and 40.7±4.1 respectively. Additionally, the average score for clinical competence regarding core and advanced nursing skills were 43.4±3.0 and 22.8±1.5 respectively. Among the domains of clinical competence, the highest average score was associated with "professional behaviors" as it forms the backbone of nursing practice. There was a highly significant relationship between the average score of clinical competence and the participant's age, sex, level of education, and years of clinical work experience (P<0.001). Nurses perceived their level of clinical competence as moderate. To enhance nurses' clinical competence, future studies and interventions should focus on promoting supportive work environments, providing ongoing education and training in advanced nursing skills, and the fostering development of critical thinking skills in nurses. Healthcare organizations should implement educational interventions to enhance nurses' clinical competence. These interventions should include continuous professional development opportunities, mentorship programs, inclusive training initiatives, and structured feedback mechanisms. These measures will help nurses stay up-to-date with the latest practices and technologies, create a supportive learning atmosphere, and address the unique needs and challenges faced by nurses of different genders and specialties.

Identifying Patient Safety Competencies for Healthcare Staff Treating Children and Young People With Intellectual Disability in Hospitals: A Delphi Study.

Children and young people with intellectual disability have poor healthcare and are at risk of patient safety events due to lack of staff training and consensus on competencies for safe and quality care. For the adoption of reasonable adjustments in mainstream paediatric healthcare clinical competencies needed to be adapted to an existing patient safety education framework. Thirteen experts in intellectual disability health and patient safety participated in an eDelphi survey aimed at reaching consensus on core competencies required of the paediatric healthcare workforce. Four rounds were completed with descriptive and thematic analyses undertaken. Consensus was achieved for 120 competencies across seven domains. Results highlighted the need for adaptations in all the domains, particularly communication, working safely and specific areas unique to this population. An adapted framework that addresses competencies for safe and quality care that included reasonable adjustments is critical for improving care for this population.

Does Physicians' Clinical Competence, Communication Ability, or Cultural Background Influence Potentially Inappropriate Prescribing of Benzodiazepines and Z-Drugs Among Older Adults With Insomnia?

The objective of this study is to estimate the association between physician's age, sex, clinical and communication competencies, and cultural background on benzodiazepines and Z-drugs (BDZ) prescribing to older adults with insomnia. A cohort of international medical graduates (IMGs) who completed their pre-residency licensure exam in 1998-2004 were linked to all U.S. Medicare patients they provided care to in 2014-2015. Their care records in Parts A, B, and D from all physicians were extracted. The first outpatient visit for insomnia to a study IMG was identified for each patient in that period. The outcome was incident BDZ prescribing by the study physician following the visit. Main exposures were physician age, sex, citizenship at birth, and clinical and communication competency as measured on the licensure exam. The association between physician characteristics and BDZ prescribing, adjusting for physician and patient covariates, was estimated using generalized estimating equations multivariable logistic regression. We analyzed 28 018 patients seen by 4069 unique physicians. IMGs born in all other regions of the world were less likely to prescribe BDZs compared to U.S.-born IMGs, with physicians from the United Kingdom being least likely (OR 0.54 [95%CI 0.34-0.85]). Neither physician's clinical competency nor communication ability were associated with BDZ prescribing (OR per 10% increase, respectively: 0.95 [95%CI 0.88-1.02] and 0.98 [95%CI 0.93-1.04]). Older physicians remain more likely to prescribe BDZ (OR per 5-year increase 1.04 [95%CI 1.00-1.08]). The associations between cultural background and physician's age on BDZ prescribing highlight the potential targets for remedial solutions to reduce the use of potentially inappropriate medications.

The Relationship Between Pediatric Nursing Students’ Clinical Practice Stress and Their Clinical Competence Regarding Gavage Feeding

The Relationship Between Pediatric Nursing Students’ Clinical Practice Stress and Their Clinical Competence Regarding Gavage Feeding

Simulation in podiatry teaching and learning: A scoping review.

In podiatry, there are a variety of clinical tasks that require precision and skill and it is expected that clinicians will obtain these skills during their training. Simulation is a dynamic teaching tool used in healthcare to enhance skill and knowledge acquisition. Currently, the extent and nature of the research on the use of simulation in podiatry teaching and learning are not clear. A scoping review was conducted to identify the extent and nature of research activity on the use of simulation in podiatry teaching and learning and identify gaps in the existing literature. Any research relating to simulation use in podiatry teaching including various designs and focusing on simulations aimed at improving podiatry teaching or learning were eligible for inclusion. A systematic search was conducted on February 14, 2024 of the following databases: Embase (via Embase.com), MEDLINE (via PubMed), CINAHL, and the Web of Science. Additional papers were identified via bibliographies of included studies. Content analysis of content relating to podiatry teaching and learning was performed and grouped into broad themes, then further narrowing to six themes. A total of 21 research studies were deemed eligible for inclusion focusing on diverse aspects of podiatry simulation utilized in high-income countries exclusively. Conducted between 1997 and 2023, these studies were categorized into six key themes: skill improvement, communication and professionalism, clinical competencies and patient safety, educational enhancement, and anatomy and histology education. The simulations, carried out by or assessed for podiatry professionals, staff, or students, ranged from high-fidelity medical mannequins to low-fidelity simulations such as a grapefruit model of a diabetes-related foot ulcer. Overall, the findings suggest that simulation teaching in podiatry, whether through direct skill enhancement or through educational impact assessments, holds potential in improving competency, confidence, and educational outcomes in podiatry practice. This scoping review identified a small yet diverse evidence base for simulation modalities in podiatry education, demonstrating gaps in long-term effects and comparative effectiveness studies. It highlights the urgent need for research focused on longitudinal impacts, evaluating various simulation technologies and standardizing best practices to improve podiatry education and align with clinical and patient care needs.

Validity evidence for endoscopic ultrasound competency assessment tools: Systematic review.

Background and study aims Competent endoscopic ultrasound (EUS) performance requires a combination of technical, cognitive, and non-technical skills. Direct observation assessment tools can be employed to enhance learning and ascertain clinical competence; however, there is a need to systematically evaluate validity evidence supporting their use. We aimed to evaluate the validity evidence of competency assessment tools for EUS and examine their educational utility. Methods We systematically searched five databases and gray literature for studies investigating EUS competency assessment tools from inception to May 2023. Data on validity evidence across five domains (content, response process, internal structure, relations to other variables, and consequences) were extracted and graded (maximum score 15). We evaluated educational utility using the Accreditation Council for Graduate Medical Education framework and methodological quality using the Medical Education Research Quality Instrument (MERSQI). Results From 2081 records, we identified five EUS assessment tools from 10 studies. All tools are formative assessments intended to guide learning, with four employed in clinical settings. Validity evidence scores ranged from 3 to 12. The EUS and ERCP Skills Assessment Tool (TEESAT), Global Assessment of Performance and Skills in EUS (GAPS-EUS), and the EUS Assessment Tool (EUSAT) had the strongest validity evidence with scores of 12, 10, and 10, respectively. Overall educational utility was high given ease of tool use. MERSQI scores ranged from 9.5 to 12 (maximum score 13.5). Conclusions The TEESAT, GAPS-EUS, and EUSAT demonstrate strong validity evidence for formative assessment of EUS and are easily implemented in educational settings to monitor progress and support learning.

A novel resident physician examination using clinical simulation video to assess clinical competence in Japan: a cross-sectional study

BackgroundThe general medicine in-training examination (GM-ITE) assesses physicians’ clinical knowledge. This study expanded on findings from a previous pilot study to assess the relationship between general medicine in-training examination (GM-ITE) scores and the diagnostic skills of resident physicians in Japan by employing an innovative clinical simulation video (CSV-IE).MethodsThis multicenter cross-sectional study included 4,677 resident physicians who took the GMITE between January 17 and 30, 2023. Participants watched the CSV-IE, depicting an emergency room scenario, and provided a diagnosis. The CSV-IE depicts an emergency case and provides a diagnosis. Discrimination indices were used to assess the CSV-IE’s effectiveness across clinical competence domains, and multilevel logistic regression was used to analyze physician- and hospital-level factors associated with correct diagnoses.ResultsCorrect diagnoses were provided by 470 participants (10.0%). The CSV-IE demonstrated high discriminatory power across all assessed domains, including basic clinical knowledge (DI = 0.44), symptomatology and clinical reasoning (DI = 0.31), physical examination and clinical procedure (DI = 0.35), and knowledge about the disease (DI = 0.25), supporting its utility as an effective assessment tool. In the multivariable analysis, factors associated with a higher likelihood of providing a correct CSV-IE diagnosis included a higher annual number of emergency outpatients (adjusted odds ratio: 1.025; 95% confidence interval [CI]: 1.003–1.047; P = .0230) and being in a higher postgraduate year (adjusted odds ratio: 1.387; 95% CI: 1.104–1.742; P = .005). Conversely, resident physicians at university hospitals were less likely to provide a correct CSV-IE response (adjusted odds ratio: 0.624; 95% CI: 0.435–0.896; P = .0107).ConclusionsCSV-IE modules may provide an integrative and realistic evaluation of clinical competence, addressing limitations of traditional MCQ-based assessments by offering contextualized, real-world scenarios that require dynamic decision-making and diagnostic reasoning.

The Development and Effects of Metaverse-based Core Nursing Skill Contents (CNSC) for Nursing Students: Drainage Management

Purpose: This study aimed to assess the impact of metaverse-based content for teaching core nursing skills (CNSC) to undergraduate nursing students. Methods: A non-equivalent control group was selected using a non-synchronized design. A total of 71 participants (34 in the experimental group and 37 in the control group) were recruited between May and June 2023 in Gwangju Metropolitan City. The CNSC included scenarios focused on drain management. Data analysis was conducted using SPSS version 25 for Windows. Results: Upon completing the CNSC, significant differences were observed between the groups in core nursing skills knowledge (t=7.97, &lt;i&gt;p&lt;/i&gt;&lt;.001), confidence in performing core nursing skills (t=5.79, &lt;i&gt;p&lt;/i&gt;&lt;.001), and clinical competency (t=2.26, &lt;i&gt;p&lt;/i&gt;=.003). Conclusion: The findings suggest that the CNSC designed for undergraduate nursing students was effective in enhancing their knowledge of core nursing skills, confidence in skill performance, and clinical competency.

Research on Core Competency Elements of Clinical Investigators.

To construct a competency model for clinical investigators involved in the process of new drug development, providing a reference for the training, selection and assessment of clinical investigators. The Behavioral Event Interview (BEI) method was used to interview 12 excellent clinical investigators and 8 clinical investigators of average performance. Each competency characteristic was extracted from the interview text by semantic coding. Total frequency, total score, average score and highest score were calculated for each competency element. Category agreement coefficient, coefficient of reliability and Spearman correlation coefficient were used to assess the consistency of two coders for coding and classification. Independent-samples Mann-Whitney U test was applied to compare the differences in competency elements between the group of excellent clinical investigators and the group of average investigators. The average coefficient of category agreement was 0.671, and the average coefficient of reliability was 0.803. No significant differences were observed between the two groups in the aspect of interview time (P = 0.190) and the interview words (P = 0.184), indicating comparability between the two groups. However, there was a clear performance difference between the excellent and average groups. In addition, we found that the competency model for clinical investigators contained 24 prominent competence elements and 8 benchmark competency elements. Clinical investigator is a medical professional who is involved in a highly research-intensive and practical job, where prominent competency element largely reflects clinical practice skills, innovation and awareness of Good Clinic Practice (GCP). Our results provide a reference for assessing clinical investigators' competencies, encouraging and guiding them to modify their behaviors according to the competency model, and also cultivating clinical investigators so as to improve the competence level of clinical investigators.

Perception of undergraduate medical students and examiners towards grand objective structured clinical examination

BackgroundThe assessment of undergraduate medical students consists of a written component and an advanced clinical competency test that evaluates the students’ skills. The Objective Structured Clinical Examinations (OSCE) were only implemented in most medical schools in the last ten years, similar in many developing countries. It was first used with other clinical assessment methods. This study was designed to investigate how medical students in the fourth and sixth grades and examiners perceived the unique format, features, and quality of the Grand Objective Structured Clinical Examinations (GOSCE), a novel method for assessing students. The aim was to understand how this innovative method, distinct from traditional assessment methods, prepares students for real-world scenarios where they encounter different specialty cases. Additionally, the study aimed to understand the significant role and challenges faced by the Faculty of General Medicine at Koya University in implementing this type of OSCE and to identify potential improvements to enhance the quality of the assessment process.MethodsFollowing the administration of two distinct GOSCE examinations for the fourth and sixth stages, feedback forms were created using Google Forms and distributed to students and examiners. The feedback forms covered all aspects of the examination process. The responses were then rigorously analyzed using the scientific tool SPSS, allowing for a comparison between students from both stages and the faculty and external examiners.ResultsIn the survey of 104 undergraduate students (78% of attendants), the majority (84n,80%) rated the fairness of the assessment as good, which is the primary goal of GOSCE. A large percentage (89n,85.6%) agreed that the examination covered a wide range of clinical skills. Eighty students (76.85%) believed the patients cooperated and found the findings precise; on the other hand, The obtained responses from 24 out of 33 faculty staff members (75%) and 29 out of 35 external examiners (82%) strongly agreed that the examination adequately covered a wide variety of clinical abilities. Only two of 68 examiners (2.9%) believed the examination needed more to provide a learning opportunity.ConclusionWith the insightful suggestions for improvement provided by the participants, GOSCE has a promising potential to evolve into a fair, objective clinical tool for assessing medical students, instilling a sense of optimism for its future development.