Community-based Clinical Experiences Research Articles

Addressing Challenges in Undergraduate Community Health Nursing Clinical: Kolb's Experiential Learning Theory.

The undergraduate nursing students enrolled in community health nursing clinical course must assess vulnerable populations impacted by social determinants of health and develop appropriate population-specific and evidence-based community interventions. However, students struggle to associate community-based experiences with learning and clinical course objectives. This article describes the experiential learning theory approach to guide and enhance student learning in the undergraduate community health nursing clinical course. Kolb's experiential learning theory was used to guide self-reflection process after clinical experience for undergraduate nursing students in their last semester of their education. The guided reflection helped nursing students translate experience into concepts and associate community-based clinical experience with their learning to meet clinical course objectives. Kolb's experiential learning theory is transformative in enhancing student learning in community health nursing care clinical education. The landscape of teaching and practice environment is evolving; therefore, teaching methods must follow suit. [J Nurs Educ. 2024;63(X):XXX-XXX.].

The fear of letting go and the Ivory Tower of dental educational training.

Clinical training in dental education is complex and happens mostly within a well-controlled environment such as a university dental clinic where oral health care services are delivered; it is mostly student-centered. While such training is important, it is also possible to augment and enhance it by training predoctoral dental students outside such a clinic within off-site community-based placements using a more person-centered approach. However, there seems to exist a reluctance in recognizing and utilizing the work produced in these off-site placements holistically as an integral part of students' clinical assessment. Community-based clinical experience adds value to the training of our predoctoral dental students. This perspective describes the benefits of community placements and recognizes their importance in the clinical and professional development of a future graduate. It also presents a way to assess students' performance that by-and-large mirrors that of the university dental clinic while striking a balance between student-centered education and person-centered care. In this perspective, we argue that the clinical work delivered at a community placement ought to be weighted equitably with the clinical work delivered at a university clinic when assessing students' competency as a whole. Our message is to keep a balance of student-centered education and person-centered care to the benefit of all those involved.

GSA and AGHE: 75 Years of Leading Innovative, Interdisciplinary, Intergenerational, and Engaging Education

The AGHE Symposium will highlight the many ways that education has advanced interdisciplinary work, innovative programs, intergenerational services and community engagement in the field of aging over the last decades. Presenters will reflect on how these educational modalities can inform the future of gerontology education. Educators have innovated over decades to develop a field characterized by a diversity of programs, including internships, applied learning experiences in research, policy and practice, and leadership. The history of AGHE and interdisciplinary education are linked, with AGHE serving as an incubator for the advancement of change in this area. Over the course of the last five decades, funding from federal and foundation initiatives have resulted in multi-disciplinary university based centers, interprofessional team training programs, and workforce development initiatives. These efforts have improved the health and well-being of older adults and contributed to the development of new collaborative care systems. AGHE members have also long been involved in intergenerational teaching and learning strategies, including service-learning and community activities. Intergenerational work in the field of aging has helped to shape the Age-Friendly University initiative which calls for colleges and universities to promote intergenerational learning through reciprocal sharing of expertise among learners of all ages. Finally, the AGHE community has long promoted engaged learning with opportunities for students to interact with community partners through programs such as community-based research and clinical experiences and local policy efforts. The ideas presented in the symposium will lead to reflection on how AGHE can expand its value as GSA’s educational arm.

Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso.

Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso.

Utilization of health and non-health major interdisciplinary teams in an undergraduate nursing faculty-student run community wellness clinic setting.

Lack of clinical placement sites in the community setting can pose a barrier to student learning in baccalaureate nursing education. Colleges and universities that have limited health-related majors are also challenged to create interdisciplinary learning opportunities in the community environment. Nursing faculty often address these issues with innovative teaching modalities. This article will introduce an innovative teaching modality, utilizing a constructivist teaching pedagogical approach, in a community-based learning environment. This modality addresses interdisciplinary community-based student learning related to health promotion and disease prevention in diverse communities.

Interprofessional education and practice guide: Developing interprofessional community-based clinical experiences

AbstractSubstantial interprofessional learning opportunities engaging with complex patients must be available to health professional students to prepare them with the necessary knowledge and experi...

A Reflection Curriculum for Longitudinal Community-Based Clinical Experiences: Impact on Student Perceptions of the Safety Net.

Community-based dental education (CBDE) allows dental students to be immersed in community settings and provide care to populations that are underserved. Exposure to those groups during training may impact provider attitudes, which may be strengthened by supporting students' reflection and exploration of their own attitudes. The aim of this study was to describe the implementation and preliminary results of a pilot longitudinal reflection curriculum integrated into a community-based clinical experience (CBCE) for senior dental students at one U.S. dental school and to report the impact of the reflection curriculum and CBCE on student experiences with populations that are underserved. In academic year 2015-16, all 35 senior dental students at one U.S. dental school were invited to complete an 11-item survey before and after completing a 12-week CBCE with integrated, longitudinal online reflections. Students received feedback from a faculty member after each reflection. All 35 students completed the survey, for a 100% response rate. After the CBCE, the students reported improved clinical efficiency and increased confidence in treatment planning and in treating dental emergencies and dentally anxious patients. They also reported improved understanding of the structure and relevance of community health centers, the role of different health care team members, and the impact of health policy. There was no significant difference in future plans to work with groups that are underserved. These results suggest that the CBCE and reflection curriculum had a positive impact on the students' clinical confidence as well as expanding their understanding of the broader oral health care delivery system. To address persistent oral health disparities, dental schools should continue to adopt CBDE programming that will prepare providers to effectively care for populations that are underserved.

Impact of Community-Based Clinical Training on Dental Students' Confidence in Treating Pediatric Patients.

With a significant need for more general dentists to provide care for pediatric patients, previous studies have found that community-based clinical training experience with children increased dental students' willingness to provide care to pediatric patients after graduation. The aim of our study was to determine the impact of community-based clinical training with pediatric patients on dental students' self-perceived confidence in treating pediatric patients, both overall and related to specific procedures. Of the total 105 fourth-year dental students at one U.S. dental school invited to participate in the study in academic year 2011-12, 76 completed the survey about their community-based dental education (CBDE), for a 72% response rate. Over half of the respondents (55%) reported feeling more confident in treating pediatric patients after their rotations. The increase in confidence was not associated with demographics. The placement of sealants (p=0.0022) and experience in giving local anesthesia (p=0.0008) were the two procedures most strongly associated with the increase in confidence. Also, these students received more experience in pulp therapy, extractions, and treating children up to three years of age during their community-based rotations than in the school-based clinic. In this study, greater exposure to pediatric dental clinical experiences during CBDE increased the students' confidence in treating pediatric patients. These results suggest that community-based experiences are useful in supplementing the school-based pediatric clinical experience, including increasing entry-level dentists' confidence in treating pediatric patients.

Clinical Experience in a Community Setting During Pediatric Emergency Medicine Fellowship Training.

The aim of this study is to explore current community emergency department (ED) experiences available to pediatric emergency medicine (PEM) trainees and estimate the proportion of graduates taking positions that involve working in a community ED setting. We conducted an e-mail-based survey among PEM fellowship directors and assistant directors. There were 55 program director respondents (74% response rate). Thirty-one percent of the surveyed PEM fellowship programs provide training exposure to a community ED setting. Twenty-nine percent of the surveyed programs reported that 25% to 49% of graduating trainees accepted positions that involve working in a community hospital ED setting, 13% responded 50% to 74%, and 4% report 75% to 100% from 2012 to 2016. There is an overall paucity of a dedicated community rotation for PEM trainees, yet many graduates are seeking employment in community-based EDs. Because the need for community-based PEM physicians continues to rise and to adequately prepare the PEM workforce, PEM fellowship training should consider a curriculum that includes community-based ED clinical experiences.

Achieving Clinical Competencies Through Community-Based Clinical Experiences.

Twenty-five percent of American adults experience a diagnosable psychiatric mental health (PMH) problem each year, and acute care medical-surgical nurses carry on average a five- to six-patient load per shift. Traditionally, U.S. PMH clinical experiences have occurred on inpatient units located within acute care hospitals or psychiatric hospital settings. However, many nursing programs are moving much of the PMH clinical experience to community-based settings. This study aims to investigate how prelicensure undergraduate baccalaureate (BSN) student nurses and their faculty perceive students' ability to achieve learning outcomes in community-based PMH clinical settings. This study's research questions include the following: (a) What are student nurses' perceptions of their abilities to achieve learning outcomes in community-based PMH clinical settings? (b) What are faculty's perceptions of the students' abilities to achieve learning outcomes in community-based PMH clinical settings? (c) What are student nurses' perceptions of their abilities to transfer knowledge gained in their community-based PMH clinical experiences to other health care settings? Qualitative descriptive study with data collected through semistructured interviews, questionnaires, focus groups, and campus and clinical site visits. Three student themes emerged from the data: meeting the challenges of developing PMH nursing skills, sharing multiple experiences of feeling competent, and empowering all nurses through PMH nursing skills. Three themes also emerged from the faculty data: seizing the day(s), sharing competency, and broadly empowering nursing students. Baccalaureate students are able to achieve PMH clinical competencies through the use of community-based experiences and to transfer PMH competencies to other clinical settings.

Host Agency Perspectives on Facilitating Community-Based Clinical Experiences for Nursing Students

Host Agency Perspectives on Facilitating Community-Based Clinical Experiences for Nursing Students

An Exploration of Dental Students’ Assumptions About Community‐Based Clinical Experiences

The aim of this study was to ascertain which assumptions dental students recalled feeling prior to beginning community-based clinical experiences and whether those assumptions were fulfilled or challenged. All fourth-year students at the University of Iowa College of Dentistry & Dental Clinics participate in community-based clinical experiences. At the completion of their rotations, they write a guided reflection paper detailing the assumptions they had prior to beginning their rotations and assessing the accuracy of their assumptions. For this qualitative descriptive study, the 218 papers from three classes (2011-13) were analyzed for common themes. The results showed that the students had a variety of assumptions about their rotations. They were apprehensive about working with challenging patients, performing procedures for which they had minimal experience, and working too slowly. In contrast, they looked forward to improving their clinical and patient management skills and knowledge. Other assumptions involved the site (e.g., the equipment/facility would be outdated; protocols/procedures would be similar to the dental school's). Upon reflection, students reported experiences that both fulfilled and challenged their assumptions. Some continued to feel apprehensive about treating certain patient populations, while others found it easier than anticipated. Students were able to treat multiple patients per day, which led to increased speed and patient management skills. However, some reported challenges with time management. Similarly, students were surprised to discover some clinics were new/updated although some had limited instruments and materials. Based on this study's findings about students' recalled assumptions and reflective experiences, educators should consider assessing and addressing their students' assumptions prior to beginning community-based dental education experiences.

Love.

On Being a Patient18 November 2014LoveJean-Noel Vergnes, DDS, PhDJean-Noel Vergnes, DDS, PhDFrom Toulouse Dental Faculty, Toulouse, France, and Division of Oral Health and Society, McGill University Montreal, Quebec, CanadaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-1076 Audio Reading - “Love” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Love," by J.N. Vergnes. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail At 86, I haven't got any teeth. Haven't for a long time. I wear false ones. With the special cream on the back every morning, they hold in well. It's more difficult for my wife, Angela, though. She had a stroke 3 years ago. We're the same age, but her health has gone downhill badly in the past few years. In fact, even before the stroke, we thought that Alzheimer's might be starting.I've become what they call her “informal carer.” After her stroke, I was completely lost. Everything had to be reorganized. It wasn't easy. I'd never have believed ... Author, Article, and Disclosure InformationAffiliations: From Toulouse Dental Faculty, Toulouse, France, and Division of Oral Health and Society, McGill University Montreal, Quebec, CanadaCorresponding Author: Jean-Noel Vergnes, DDS, PhD, Toulouse Dental Faculty, 3 Chemin des Maraîchers, 31062 Toulouse Cedex 9, France; e-mail, jn.[email protected]ca. PreviousarticleNextarticle Advertisement Audio Reading - “Love” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Love," by J.N. Vergnes. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics Cited byA Reflection Curriculum for Longitudinal Community-Based Clinical Experiences: Impact on Student Perceptions of the Safety NetWhat about narrative dentistry? 18 November 2014Volume 161, Issue 10Page: 758-759KeywordsCaregiversChildrenFoodMouthNursesNursing homesRunningStrokeTouchWheelchairs ePublished: 18 November 2014 Issue Published: 18 November 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Report card: an evaluation of a concept-based curriculum.

This article describes the evaluation of an innovative, concept-based baccalaureate nursing curriculum. Curriculum evaluation is an ongoing process that serves to ensure the delivery of quality education. Findings from surveys and focus groups identified strengths of the new curriculum as the conceptual approach, interactive small-group learning activities, clinical intensives, and early patient care experiences. Issues and challenges identified in the evaluation included perceived repetition of content in the Professional Nursing concept courses, coordination of community-based clinical experiences, a perceived need for greater age-span, pharmacology, and pathophysiology content, and NCLEX-RN preparation. Curriculum revisions based on these findings are described.

University of Virginia School of Medicine

University of Virginia School of Medicine

Incorporating Community-Based Clinical Experiences into a Maternal-Women's Health Nursing Course

Many barriers to increasing enrollment in nursing programs currently exist. One barrier is increased competition for clinical site placement from competing nursing and multidisciplinary programs. A critical component of nursing educational programs is providing clinical experiences that reinforce didactic learning. Incorporating women's health in a maternity course required clinical experiences to reflect this content. Faculty incorporated new strategies to help students integrate relevant theoretical concepts of maternity and women's health nursing by placing students in more community sites. Although labor and delivery and mother-baby units are located in the hospital, a wealth of community experiences for maternal and women's health nursing students exists. This article discusses strategies implemented by faculty at Youngstown State University to meet these challenges and promote appropriate clinical learning experiences for student nurses enrolled in a maternal-women's health nursing course.

Dentists' Comfort in Treating Underserved Populations After Participating in Community‐Based Clinical Experiences as a Student

The purpose of this project was to determine new dentists' comfort levels in treating traditionally underserved populations after participating in two consecutive five-week community-based clinical experiences while in dental school. A written survey was mailed to all known University of Iowa alumni (1992-2002; N=745). Respondents were asked to rank their comfort levels in treating twelve underserved populations on a five-point Likert type scale (5=no problem; 1=will not). Bivariate and logistic regression model analyses were performed to examine associations (p<0.05) among comfort and six predictor variables. Alumni (n=372) were most comfortable treating other ethnic, low-income, non-English-speaking, and HIV+/AIDS populations and least comfortable treating incarcerated and homebound populations. The following variables were significantly associated with comfort: 1) perception that the community experiences had great/much value; 2) practice located in larger communities; 3) non-solo practitioners; and 4) dentist's gender. As more dental schools utilize community-based clinical experiences to increase students' exposure to underserved populations, it is important that these experiences provide exposure to a variety of populations. Additionally, dental schools should continuously monitor the short- and long-term value of these programs for their students and recent graduates.

The High Clinic: a pilot project of a new model for an outpatient, community-based teaching clinic in rheumatology

The objectives were to develop an outpatient, community-based clinical education experience for second-year rheumatology fellows based on sound education principles, and to pilot the program to test its practicability and assess student perception of its educational efficacy. The outpatient clinical education experience consisted of four steps. In Step 1 second-year rheumatology fellows assessed patients and reviewed their cases with two supervisors. Step 2 entailed each fellow presenting a brief summary of each case to their colleagues and supervisors for discussion and analysis of learning issues. In Step 3 each fellow conducted a literature search of the learning issues identified in Step 2. Step 4 occurred in the days following the clinic and entailed a seminar discussion of the literature search results with fellow colleagues. At the end of this outpatient clinical education program, questionnaires were given to participating fellows to assess its effectiveness. All participants judged this new clinical education program to be practical and effective; outcomes were positive for all skills specified as objectives for the clinic. This model of outpatient community-based clinical teaching, named ‘The High Clinic’ is a new and effective model for a teaching clinic in rheumatology, featuring augmented patient exposure, increased interactions with supervisors and a case-based learning. The pilot test of the clinic was implemented successfully. Participants in the clinic were satisfied with their achievement of stated objectives. This model is applicable to other specialties.Practice points•This outpatient, community-based clinical education experience, based on sound education principles, features augmented patient exposure, increased interactions with supervisors and case-based learning.•A task-based, student-centered, community-based approach is an effective educational model in rheumatology and is applicable to other specialties.

Ethical Dilemmas Reported by Fourth‐Year Dental Students

Ethics education in dentistry is a requirement for accreditation. Despite universal adoption of ethics courses, there is ongoing discussion about the appropriate content of these courses and about methods to engage students. Faculty who teach ethics must select a limited set of topics from the broad fields of professional ethics, bioethics, and the humanities. The purpose of this article is to describe the ethical issues reported by fourth-year dental students during community-based extramural clinical experiences. Senior dental students (n=123) wrote essays describing an ethical issue they encountered during one of two extramural rotations. Ethical issues were categorized and coded by consensus between two faculty authors. Students most often reported perceived dilemmas related to patients' limited resources (25 percent), conflict between professionals (19 percent), clinic policy or procedures (15 percent), and decision making by patients' surrogates (13 percent). One student (<1 percent) reported encountering no ethical issues. Students' perceptions of ethical issues in clinical practice offer faculty a foundation for designing a dental ethics curriculum that is practical and immediately relevant to the experience of a dental student. Students' reports may also yield a method for systematic assessment of students' abilities to apply classroom ethics instruction to clinical practice.

Implementation and Delivery of an Intergenerational Community Learning Experience

The Family Home Visit Program (FHV) is part of the year-long 1st year Practice of Medicine course, and involves local multi-generational families and students from the schools of medicine and allied health. The FHV program differs considerably from more traditional community-based clinical practice experience: visits to an ill individual, community-based experiences designed for reminiscence by the “patient,” or multiple community-based agency courses/visits. The focus of the current intergenerational FHV is on interaction between families and students in a non-clinical setting (e.g., relating to patients as “people”), learning about the social and familial context in which health and illness occur and the healthcare priorities of family members. In year 1 of the program, 200 medical students, 40 OT/PT students and 68 families participated; 204 medical students, 70 OT/PT students and 70 families participated in year 2. The development, implementation, evaluation and outcomes of the program across two years are discussed.