Competence In Clinical Care Research Articles

Innovative facultative seminar concepts regarding clinical teaching and preparing practice-oriented phases, such as medical clerkships and the final clinical internship from asurgical perspective

Practice-oriented phases, such as the mandatory clinical traineeships and the final clinical internship, are of great importance in the teaching curriculum and skilful learning of medical students. With respect to the practical phases, such as clinical clerkship and medical internship, the concept of two innovative courses to prepare and evaluate these crucial training sections is presented including initial experiences from teaching practice. A narrative review is given. A common aim of facultatively initiated lectures is a better qualification of medical students to fulfil the requirements of clerkship and the last practical year of the study of human medicine to facilitate taking first steps towards professional work as a clinical physician, in particular, the self-confidence of the medical students is to be substantially increased. The experiences obtained during clerkship and the last practical year influence interest, motivation and final choice for a certain medical speciality. In that respect, this period is of great importance for the whole professional career. The content of the preparation courses for the first medical clerkships and the final clinical internship provide a valuable contribution to prepare for challenging clinical work as a physician with sole responsibility. In particular, they aim to introduce students to the concept of a multiprofessional and extensive patient care. Taking into account the different practical experiences obtained in previous study sections, students are taught according to the overall aim to achieve an interdisciplinary competence in clinical care. The improvement of teaching and optimized preparation for practical phases in medical studies promotes a more successful learning process during the clerkship and last practical year.

A clinical care competency inventory for nurses in Traditional Chinese Medicine: Development and psychometric evaluation

The aims of this study were to develop a clinical care competence inventory for Traditional Chinese Medicine nurses and to test its psychometric properties. A cross-sectional survey was conducted in hospitals around Taiwan using a newly developed scale called Clinical Care Competency Inventory for Traditional Chinese Medicine Nurses. A total of 322 participants took the survey, and response rate was 95.7%. An exploratory factory analysis was used to analyze items and confirm the construct validity. Principal Component Analysis is an exploratory factor analysis used to identify the underlying dimension of the constructs of a particular scale. Six factors were determined from this study: evidence-based nursing capability, routine medical auxiliary behavior in acupuncture and moxibustion, medical auxiliary behavior in Traditional Chinese Medicine orthopedics, basic Traditional Chinese Medicine related knowledge and skills, diagnostic questioning and Traditional Chinese Medicine assessment in special conditions, and patient education about Traditional Chinese Medicine nursing which together explained 63.45% of the variance. The findings of this study can assist in the planning of in-service education for Traditional Chinese Medicine nurses. The nurse competence indicators are useful in planning nursing training and letting patients and their families know what to reasonably expect from nurses in relation to traditional Chinese medicine.

Community health nursing courses in baccalaureate nursing programs in China: A descriptive study based on website information

ObjectiveTo survey current community health nursing (CHN) courses offered in baccalaureate nursing programs in the mainland of China from the perspective on information available on websites of colleges and universities. MethodsA descriptive research design was used. Data were collected from the official websites of colleges and universities providing baccalaureate nursing programs in the mainland of China. A checklist was applied to identify academic year, type of course, credit, and class hours for both theory and practice teaching of CHN courses including Community Nursing, Geriatric Nursing, Rehabilitation Nursing, and Health Education. The prescribed textbooks were consulted for teaching content. ResultsColleges (n = 16) and universities (n = 26) offering baccalaureate nursing programs with accessible online information for curriculum setting were recruited. The results showed that most of the accessible educational institutions (92.86%) have offered three to four investigated CHN courses. Community Nursing, Geriatric Nursing and Rehabilitation Nursing are generally offered to juniors, while Health Education is offered in half of these institutions in different academic years. Community Nursing is mainly offered as a required course with 2 credits, while Geriatric Nursing, Rehabilitation Nursing and Health Education are provided as elective courses with fewer credits. Around half of the institutions have practice hours for Community Nursing, Geriatric Nursing and Rehabilitation Nursing courses. However, the proportion of practice hours in the courses is generally less than 50%. The teaching content focuses on clinical care competencies instead of complementary competencies. ConclusionIt was revealed that CHN education in China is still in its infancy from website information of colleges and universities. CHN courses should be included in curriculum design, and teaching reforms and innovations should be taken to prepare nursing students to practice in primary health care and community settings.

The Health of the Transgender Community: Out, Proud, and Coming Into Their Own

An introduction is presented in which the authors discuss various reports within the issue including the partial reprint of a 2001 article about transgender health care, a call for clinical care competence, and population-based data about the size of the transgender population in the U.S.

An experience applying the teaching strategies of cooperative learning and creative thinking in a mental-health nursing practicum for undergraduates at a technical college

Lack of knowledge and experience is prevalent in undergraduate students who are taking their clinical practicum for mental-health nursing. This issue negatively affects the learning process. This article shares an experience of implementing a practicum-teaching program. This program was developed by the authors to facilitate the cooperative learning and clinical care competence of students. A series of multidimensional teaching activities was designed by integrating the strategies of peer cooperation and creative thinking to promote group and individual learning. Results indicate that the program successfully encouraged the students to participate more actively in the learning process. Additionally, the students demonstrated increased competence in empathetic caring toward patients, stronger friendship relationships with peers, and improved self-growth. The authors hope this teaching program provides a framework to increase the benefits for students of participating in clinical practicums and provides a teaching reference for clinical instructors.

Guidance for the core content of a Curriculum in Special Care Dentistry at the undergraduate level

Given the rapidly changing demography of populations worldwide, dental professionals of the future need to be able to meet the challenge posed by the evolving landscape in health care needs. Leading institutions are now embedding teaching and learning in special care dentistry (SCD) within their curricula, to provide students with the knowledge, skills and attitudes to meet the oral health needs of vulnerable groups within their communities. The International Association for Disability and Oral Health (iADH) has initiated the development of undergraduate curriculum guidance in SCD through a consensus process. The curriculum in SCD is defined in statements of learning outcomes with many of the skills being transferable across the undergraduate course. This curriculum includes examples of teaching and assessment, designed to enhance critical thinking in relation to SCD and to promote positive attitudes towards disability and diversity. The learning outcomes are designed to be readily adapted to conform to the generic profiles and competencies, already identified in undergraduate frameworks by global educational associations, as well as meeting the requirements of professional regulatory bodies worldwide. Suggestions for teaching and learning are not intended to be prescriptive; rather, they act as a signpost to possible routes to student learning. Ideally, this will require that students have a sufficiently diverse patient case mix during their undergraduate studies, to achieve the required levels of confidence and competence by the time they graduate. Clinical care competencies in SCD emphasise the need for learners to broaden their theoretical knowledge and understanding through practical experience in providing care for people with special health care needs. It is crucial to the development of equitable dental services for all members of a community, that these learning outcomes are embedded into evolving curricula but most importantly, that they are evaluated and refined in a dynamic way with shared learning for all teachers.

The art of bedside rounds: a multi-center qualitative study of strategies used by experienced bedside teachers.

Medical educators believe bedside rounds are effective for the delivery of patient-centered care, and are necessary in helping trainees acquire competence in clinical care. Although recommendations for bedside rounds have been reported, a recent, systematic assessment of strategies used by current-day bedside teachers was needed to advance knowledge of this teaching method. To identify and understand bedside teachers' 1) preparatory steps, 2) patient selection, and 3) role allocation during the process of bedside rounds. A qualitative inductive thematic analysis using transcripts from audio-recorded, semi-structured telephone interviews. Internal medicine physicians (n = 34) who perform bedside rounds from ten academic US institutions (2010-2011). A purposive sampling strategy was utilized to identify physicians who were active inpatient attending physicians and met specific inclusion criteria for "bedside rounds." A total of 34 interviews were completed, and each was recorded and transcribed verbatim. A thematic analysis extracted key themes pertaining to the three objectives. Most respondents (51%) were associate or full professors, with an average of 14years of academic experience. Attending physicians prepared using trainee-specific, patient-specific and disease-specific information, while also mentally preparing for bedside rounds. They sought trainee buy-in and learning objectives, reviewed expectations and methods to ensure patient comfort, and provided early guidance with bedside encounters. Patients were selected if they required immediate care, were new to the service, or had a high educational value, while patients were deferred if unavailable, unwilling, or unable to communicate. The team members' roles during bedside rounds varied, with trainees being given graduated autonomy with increased experience. Bedside teachers' methods for preparation, patient selection, and role allocation during bedside rounds enhance trainees' education within the workplace. Strategies used by experienced bedside teachers can be used for faculty development efforts aimed at promoting this activity.

Building the Clinical Bridge to Advance Education, Research, and Practice Excellence

The University of Michigan School of Nursing and the Health System partnered to develop an undergraduate clinical education model as part of a larger project to advance clinical education, practice, and scholarship with education serving as the clinical bridge that anchors all three areas. The clinical model includes clusters of clinical units as the clinical home for four years of a student's education, clinical instruction through team mentorship, clinical immersion, special skills preparation, and student portfolio. The model was examined during a one-year pilot with junior students. Stakeholders were largely positive. Findings showed that Clinical Faculty engaged in more role modeling of teaching strategies as Mentors assumed more direct teaching used more clinical reasoning strategies. Students reported increased confidence and competence in clinical care by being integrated into the team and the Mentor's assignment. Two new full time faculty roles in the Health System support education, practice, and research.

Applying Non-synchronized E-learning to the Nursing Clinical Ladder System

The time and spatial constraints of face-to-face learning often affect nursing staff's inclination to enroll in ladder system training classes. Hence, their competence in clinical care may be unable to meet the requirements of the hospitals they work at. The e-learning mechanism offers a way to overcome such constraints. However, the differences in learners' achievement and satisfaction between traditional face-to-face and non-synchronized e-learning classes in the nursing clinical ladder system have not been thoroughly investigated. In this study, 155 nursing personnel serving at the case hospital, enrolled in N1/N2 ladder courses, were invited to participate as the subjects. The results showed that those who attended face-to-face learning classes reported higher satisfaction but achieved less in class than those in the e-learning class. The factors which influence the subjects' satisfaction with e-learning were investigated and summarized.

The ABC (and DE) of cultural competence in clinical care

Although the need for cultural competence in clinical care has been well articulated for over four decades, the goal of integrating and addressing cultural issues in care remains elusive. The challenges can be attributed to a lack of clarity on definitions and a lack of understanding of what constitutes cultural competence. What to know and what to do are questions that are frequently raised in discussions of cultural competence. Previous literature has described cultural competence in terms of affective, behavioural, and cognitive domains. The purpose of this paper is to build on this discourse by discussing key attributes within each domain and extending the framework to highlight the dynamics of difference, clarify the goal of equity, and recognise the importance of practice environments in the development of cultural competence in clinical care.