Competent Patient Care Research Articles

Mentor-mentee Relationship: A Win-Win Contract In Graduate Medical Education

Scholarly activities (i.e., the discovery of new knowledge; development of new technologies, methods, materials, or uses; integration of knowledge leading to new understanding) are intended to measure the quality and quantity of dissemination of knowledge. A successful mentorship program is necessary during residency to help residents achieve the six core competencies (patient care, medical knowledge, practice-based learning and improvement, systems-based practice, professionalism, interpersonal and communication skills) required by the Accreditation Council for Graduate Medical Education (ACGME). The role of the mentor in this process is pivotal in the advancement of the residents’ knowledge about evidence-based medicine. With this process, while mentees become more self-regulated, exhibit confidence in their performance, and demonstrate more insight and aptitude in their jobs, mentors also achieve elevated higher self-esteem, enhanced leadership skills, and personal gratification. As such, we may conclude that mentoring is a two-sided relationship; i.e., a 'win-win' style of commitment between the mentor and mentee. Hence, both parties will eventually advance academically, as well as professionally.

High-Fidelity Patient Simulation to Evaluate Student Nurse Patient Safety Competency

BackgroundThere is little evidence supporting the use of simulation to evaluate student nurse safety performance prior to entering the clinical environment. MethodsA High Fidelity Patient Simulation (HFPS) was created and tested that evaluated student nurse patient safety competency. Students were observed and evaluated on their ability to identify or perform six basic safe patient care competencies. A convenience sample (N = 52) of sophomore level students completing their initial semester in the Baccalaureate Nursing program were used to test the patient safety knowledge and skill evaluation. ResultsThe majority of the students complied with the safety competencies of communication and assuring call bell and personal items were within reach. Less than 60% of the students complied with hand hygiene and correct identification of the patient using two identifiers. Only 19% of the students were competent in all six patient safety competencies. ConclusionsHFPS provided a realistic patient care situation to evaluate basic safe patient care competencies. Future evaluation of student’s patient safety competency needs to include an orientation to the environment and clearer understanding of the student’s previous health care experience. Evaluation of the student’s patient safety competency will provide valuable information for faculty and clinical practice facilities.

Aligning In-Service Training Examinations in Plastic Surgery and Orthopaedic Surgery With Competency-Based Education.

In-service training examinations (ITEs) are used to assess residents across specialties. However, it is not clear how they are integrated with the Accreditation Council for Graduate Medical Education Milestones and competencies. This study explored the distribution of specialty-specific milestones and competencies in ITEs for plastic surgery and orthopaedic surgery. In-service training examinations were publicly available for plastic surgery (PSITE) and orthopaedics (OITE). Questions on the PSITE for 2014-2016 and the OITE for 2013-2015 were mapped to the specialty-specific milestones and the 6 competencies. There was an uneven distribution of milestones and competencies in ITE questions. Nine of the 36 Plastic Surgery Milestones represented 52% (341 of 650) of questions, and 3 were not included in the ITE. Of 41 Orthopaedic Surgery Milestones, 7 represented 51% (201 of 394) of questions, and 5 had no representation on the ITE. Among the competencies, patient care was the most common (PSITE = 62% [403 of 650]; OITE = 59% [233 of 394]), followed by medical knowledge (PSITE = 34% [222 of 650]; OITE = 31% [124 of 394]). Distribution of the remaining competencies differed between the 2 specialties (PSITE = 4% [25 of 650]; OITE = 9% [37 of 394]). The ITEs tested slightly more than half of the milestones for the 2 specialties, and focused predominantly on patient care and medical knowledge competencies.

Innovative Education of Patient Care Competencies in Lifestyle Medicine: a Collaborative Learning Activity for the Prevention of Cardiovascular Events

Essential components of lifestyle medicine (LM), nutrition and exercise, are not currently well addressed in medical education. This is an innovative session that could be implemented at medical institutions seeking to teach LM competencies, evidence-based medicine, and clinical decision making using active and collaborative learning in 2 hours of curricular time.

A correlative analysis of nursing competence and self efficacy of new nurses in a tumor hospital

Objective To describe the characteristics of nursing competence and self efficacy of new nurses in a tumor hospital and to explore the correlative relationship between them. Methods By convenience sampling method, a total of 303 new nurses who were employed in 2013 to 2015 from a tumor hospital were recruited in the study. A self-designed demographic questionnaire, the nursing competence scale (NCS) and the general self-efficacy scale (GSES) were used. Results The average score of nursing competence of new nurses was (83.80±10.35) points. Among the six dimensions of nursing competence, the interpersonal relation competence had the highest score of (86.74±10.55) points, while the nursing process applying competence had the lowest score of (81.41±11.02) points. The level of nursing competence and each dimensions were positively related with self-efficacy (r=0.443-0.557, P<0.01). Conclusions The level of nursing competence of new nurses in a tumor hospital is good, but the nursing process applying competence, critical patient care competence and the health education competence were still insufficient, so it is necessary to take corresponding measures to improve the overall quality of new nurses. Self efficacy can effectively predict the nursing competence of new nurses. The hospital can improve the nursing competence by intervene the self efficacy of new nurses, in order to improve the clinical nursing quality and promote the development of nursing. Key words: Tumor hospital; New nurses; Nursing competence; Self-efficacy

Clinical Simulation for Practicing Labor and Delivery Nurses: Advancing Competency through Simulated Nursing Practice

Nurses new to Maternal-Child units in hospital organizations need reality based in-service education in new employee orientation. Experienced nurses must have current, cutting edge staff development sessions that replicate practice scenarios to facilitate currency in practice. Annual clinical skills reaffirmation and new employee orientation commonly include clinical simulation activities that enhance critical thinking, assess clinical competency and reduce the potential for errors in practice. Practice repetition in the Education Department lab setting is a protected area to learn and refine clinical care skills and procedures. Case scenarios through use of clinical simulation are posed to provide current practice initiatives that enhance the nurses’ ability to provide safe, competent patient care. Keywords: Clinical Simulation, Nurse Educators, Nurse Practice, Staff Development

Discrepancies in Lesbian, Gay, Bisexual, and Transgender Patient Care and How Pharmacists Can Support an Evolved Practice

We live in an increasingly multicultural society with people from different ethnicities and beliefs. In recent years, we have witnessed a growing group of people who identify as having diverse sexual orientations and gender identities. Members of the lesbian, gay, bisexual, and transgender (LGBT) community have historically been marginalized by the health care industry. The disproportionate prevalence of LGBT health concerns and cultural prejudices may be overlooked by many practitioners. As pharmacists, we are in an optimal position to affect meaningful changes in how we treat, counsel, and interact with all our patients, including with those whose sexual orientation or gender identity differ from ours. It is important for student and practicing pharmacists alike to receive adequate education and training that identifies the role of a pharmacist in LGBT health and fosters culturally competent and equitable patient care. Clinical and cultural competence should be reflective of inclusive pharmacy programs that embrace and incorporate LGBT health. The objectives of this commentary are to identify the role of a pharmacist in LGBT health, recognize specific concerns with mental and sexual health, describe gender-transitioning pharmacotherapy, and discuss the current stance of LGBT health in pharmacy education.

Color-Blind Racial Beliefs Among Dental Students and Faculty.

Providing culturally competent patient care requires an awareness of racial and cultural norms as well as a recognition of racism. Yet, there is a paucity of research devoted to this problem. In dental education, increased attention has focused on eliminating oral health care disparities due to ethnicity and race. Further investigation to determine the relationship between color-blind attitudes (failing to recognize the impact of race and racism on social justice) and dental educators' cultural competence is needed. The aim of this study was to determine dental faculty and student baseline color-blind racial attitudes scale scores, using the color-blind racial attitudes scale (CoBRAS). This 20-item instrument that measures three subscales of color-blind racial attitudes (Unawareness of Racial Privilege, Institutional Discrimination, and Blatant Racial Issues) was administered to student and faculty groups at one U.S. dental school. Out of a total 245 students in three class years, 235 responded to all items, for a response rate of 96%; out of a total 77 faculty members invited to participate, 71 responded to all items, for a response rate of 92%. Underrepresented minority (URM) faculty scored significantly higher on the Institutional Discrimination subscale and lower on Unawareness of Racial Privilege compared to non-URM students. Males scored significantly higher on Institutional Discrimination and Blatant Racial Issues compared to females. Compared to white students, URM students scored lower on all three subscales. The findings were consistent with previous studies indicating that female and URM students were more sensitive to racism compared to male and majority students. The findings that white faculty had higher awareness of racial privilege than white students and that URM faculty were less aware of institutional discrimination than URM students provided new information. These findings suggest that dental faculty members need professional development opportunities that promote becoming color-conscious and understanding privilege and biases, that model instruction on discussing race and racism, and that extend beyond a brief workshop.

Integrating technical and non-technical skills coaching in an acute trauma surgery team training: Is it too much?

ObjectiveResearch on effective integration of technical and non-technical skills in surgery team training is sparse. In a previous study we found that surgical teachers predominantly coached on technical and hardly on non-technical skills during the Definitive Surgical and Anesthetic Trauma Care (DSATC) integrated acute trauma surgery team training. This study aims to investigate whether the priming of teachers could increase the amount of non-technical skills coaching during such a training. DesignCoaching activities of 12 surgical teachers were recorded on audio and video. Six teachers were primed on non-technical skills coaching prior to the training. Six others received no priming and served as controls. Blind observers reviewed the recordings of 2 training scenario's and scored whether the observed behaviors were directed on technical or non-technical skills. We compared the frequency of the non-technical skills coaching between the primed and the non-primed teachers and analyzed for differences according to the trainees' level of experience. SettingSurgical teachers coached trainees during the highly realistic DSATC integrated acute trauma surgery team training. Trainees performed damage control surgery in operating teams on anesthetized porcine models during 6 training scenario's. ParticipantsTwelve experienced surgical teachers participated in this study. ResultsCoaching on non-technical skills was limited to about 5%. The primed teachers did not coach more often on non-technical skills than the non-primed teachers. We found no differences in the frequency of non-technical skills coaching based on the trainees' level of experience. ConclusionPriming experienced surgical teachers does not increase the coaching on non-technical skills. The current DSATC acute trauma surgery team training seems too complex for integrating training on technical and non-technical skills. CompetenciesPatient care, Practice based learning and improvement.

A Multicenter Prospective Comparison of the Accreditation Council for Graduate Medical Education Milestones: Clinical Competency Committee vs. Resident Self-Assessment

The Accreditation Council for Graduate Medical Education requires accredited residency programs to implement competency-based assessments of medical trainees based upon nationally established Milestones. Clinical competency committees (CCC) are required to prepare biannual reports using the Milestones and ensure reporting to the Accreditation Council for Graduate Medical Education. Previous research demonstrated a strong correlation between CCC and resident scores on the Milestones at 1 institution. We sought to evaluate a national sampling of general surgery residency programs and hypothesized that CCC and resident assessments are similar. Details regarding the makeup and process of each CCC were obtained. Major disparities were defined as an absolute mean difference of ≥0.5 on the 4-point scale. A negative assessment disparity indicated that the residents evaluated themselves at a lower level than did the CCC. Statistical analysis included Wilcoxon rank sum and Sign tests. CCCs and categorical general surgery residents from 15 residency programs completed the Milestones document independently during the spring of 2016. Overall, 334 residents were included; 44 (13%) and 43 (13%) residents scored themselves ≥0.5 points higher and lower than the CCC, respectively. Female residents scored themselves a mean of 0.08 points lower, and male residents scored themselves a mean of 0.03 points higher than the CCC. Median assessment differences for postgraduate year (PGY) 1-5 were 0.03 (range: -0.94 to 1.28), -0.11 (range: -1.22 to 1.22), -0.08 (range: -1.28 to 0.81), 0.02 (range: -0.91 to 1.00), and -0.19 (range: -1.16 to 0.50), respectively. Residents in university vs. independent programs had higher rates of negative assessment differences in medical knowledge (15% vs. 6%; P = 0.015), patient care (17% vs. 5%; P = 0.002), professionalism (23% vs. 14%; P = 0.013), and system-based practice (18% vs. 9%; P = 0.031) competencies. Major assessment disparities by sex or PGY were similar among individual competencies. Surgery residents in this national cohort demonstrated self-awareness when compared to assessments by their respective CCCs. This was independent of program type, sex, or level of training. PGY 5 residents, female residents, and those from university programs consistently rated themselves lower than the CCC, but these were not major disparities and the significance of this is unclear.

Using Skeletal Outlines and Illustrative Diagrams as a Teaching/Learning Strategy in a Baccalaureate Nursing Pharmacology Course

Knowledge of pharmacology is an important aspect of safe, effective and competent clinical nursing practice, yet it can be challenging to teach. Many academics within the discipline of nursing are concerned that current nursing curricula may not be preparing nurses to accept responsibilities related to pharmacological management and are inadequately prepared for their role in medication administration. Nursing faculty who teach advanced clinical nursing practice courses also report that students lack the foundational knowledge of pharmacology needed and required in advanced clinical courses. These concerns have led to a call for additional focus that must be placed on student knowledge acquisition of pharmacology content due to poor student performance on standardized tests. Within a four-year undergraduate Bachelor of Science in Nursing (BScN) curriculum, pharmacology content was taught to first-term, second year students within a nursing praxis course, over a 13-week period. Students were required to understand the foundational principles, concepts and content of pharmacology and to integrate this knowledge in a critical reflective manner in clinical practice. A teaching/learning approach was implemented within the classroom that aligned with the work of Bui and McDaniel (2015). This method utilized outlines, illustrative diagrams and mental models aimed to enhance student note-taking in the development of content knowledge and to assist students to internalize critical cognitive learning processes. Consequently, student comprehension and critical thinking of pharmacology content was increased. Establishing a solid foundation of pharmacology that is integrated in a critically manner is a major component of providing safe and competent patient care.

Are We Ready to Implement Competence-Based Teaching in Pharmacy Education in Poland?

Pharmacists in Poland are responsible for the dispensing and quality control of pharmaceuticals. The education process in pharmacy is regulated and monitored at the national level. Pharmacy education at Jagiellonian University is organized in a traditional way based on input and content teaching. The aim of the study was to determinate whether the Jagiellonian University curriculum in the Pharmacy program meets the criteria of the European Competence Framework. The mapping of the intended curriculum was done by four academic teachers. The qualitative and quantitative analysis of the distribution of the European Competence Framework among a group of courses and study years was done. We observed that most of the personal competencies are offered to students in their senior years, while the patient care competencies are distributed equally during the cycle of the study, and only some of them are overrepresented at the senior years. We need a legislation change at the national level as well as organizational and mental change at the university level to move from learning outcome-based pharmacy education to competence-based.

Culturally competent library services and related factors among health sciences librarians: an exploratory study.

ObjectiveThis study investigated the current state of health sciences libraries’ provision of culturally competent services to support health professions education and patient care and examined factors associated with cultural competency in relation to library services and professional development.MethodsThis was a cross-sectional study. Data were collected with a survey questionnaire that was distributed via SurveyMonkey to several health sciences librarian email discussion lists.ResultsOut of 176 respondents, 163 reported serving clients from diverse cultural backgrounds. Various services were provided to develop or support initiatives in cultural competency in health professions education and patient care. A considerable number of respondents were unsure or reported no library services to support initiatives in cultural competency, although a majority of respondents perceived the importance of providing culturally competent library services (156, 89.1%) and cultural competency for health sciences librarians (162, 93.1%). Those who self-identified as nonwhites perceived culturally competent services to be more important than whites (p=0.04). Those who spoke another language in addition to English had higher self-rated cultural competency (p=0.01) than those who only spoke English.ConclusionsThese findings contribute to our knowledge of the types of library services provided to support cultural competency initiatives and of health sciences librarians’ perceived importance in providing culturally competent library services and cultural competency for health sciences librarians. The results suggest implications for health sciences libraries in fostering professional development in cultural competency and in providing culturally competent services to increase library use by people from a wide range of cultures and backgrounds.

The Implementation of Pharmacy Competence Teaching in Estonia.

Background: The PHAR-QA, “Quality Assurance in European Pharmacy Education and Training”, project has produced the European Pharmacy Competence Framework (EPCF). The aim of this study was to evaluate the existing pharmacy programme at the University of Tartu, using the EPCF. Methods: A qualitative assessment of the pharmacy programme by a convenience sample (n = 14) representing different pharmacy stakeholders in Estonia. EPCF competency levels were determined by using a five-point scale tool adopted from the Dutch competency standards framework. Mean scores of competency levels given by academia and other pharmacy stakeholders were compared. Results: Medical and social sciences, pharmaceutical technology, and pharmacy internship were more frequent subject areas contributing to EPCF competencies. In almost all domains, the competency level was seen higher by academia than by other pharmacy stakeholders. Despite on-board theoretical knowledge, the competency level at graduation could be insufficient for independent professional practice. Other pharmacy stakeholders would improve practical implementation of theoretical knowledge, especially to increase patient care competencies. Conclusions: The EPCF was utilized to evaluate professional competencies of entry-level pharmacists who have completed a traditional pharmacy curriculum. More efficient training methods and involvement of practicing specialists were suggested to reduce the gaps of the existing pharmacy programme. Applicability of competence teaching in Estonia requires more research and collaborative communication within the pharmacy sector.

Implementation of a Needs-Based, Online Feedback Tool for Anesthesia Residents With Subsequent Mapping of the Feedback to the ACGME Milestones.

Optimizing feedback that residents receive from faculty is important for learning. The goals of this study were to (1) conduct focus groups of anesthesia residents to define what constitutes optimal feedback; (2) develop, test, and implement a web-based feedback tool; and (3) then map the contents of the written comments collected on the feedback tool to the Accreditation Council for Graduate Medical Education (ACGME) anesthesiology milestones. All 72 anesthesia residents in the program were invited to participate in 1 of 5 focus groups scheduled over a 2-month period. Thirty-seven (51%) participated in the focus groups and completed a written survey on previous feedback experiences. On the basis of the focus group input, an initial online feedback tool was pilot-tested with 20 residents and 62 feedback sessions, and then a final feedback tool was deployed to the entire residency to facilitate the feedback process. The completed feedback written entries were mapped onto the 25 ACGME anesthesiology milestones. Focus groups revealed 3 major barriers to good feedback: (1) too late such as, for example, at the end of month-long clinical rotations, which was not useful because the feedback was delayed; (2) too general and not specific enough to immediately remedy behavior; and (3) too many in that the large number of evaluations that existed that were unhelpful such as those with unclear behavioral anchors compromised the overall feedback culture. Thirty residents (42% of 72 residents in the program) used the final online feedback tool with 121 feedback sessions with 61 attendings on 15 rotations at 3 hospital sites. The number of feedback tool uses per resident averaged 4.03 (standard deviation 5.08, median 2, range 1-21, 25th-75th % quartile 1-4). Feedback tool uses per faculty averaged 1.98 (standard deviation 3.2, median 1, range 1-25, 25th-75th % quartile 1-2). For the feedback question item "specific learning objective demonstrated well by the resident," this yielded 296 milestone-specific responses. The majority (71.3%) were related to the patient care competency, most commonly the anesthetic plan and conduct (35.8%) and airway management (11.1%) milestones; 10.5% were related to the interpersonal and communication skills competency, most commonly the milestones communication with other professionals (4.4%) or with patients and families (4.4%); and 8.4% were related to the practice-based learning and improvement competency, most commonly self-directed learning (6.1%). For the feedback tool item "specific learning objective that resident may improve," 67.0% were related to patient care, most commonly anesthetic plan and conduct (33.5%) followed by use/interpretation of monitoring and equipment (8.5%) and airway management (8.5%); 10.2% were related to practice-based learning and improvement, most commonly self-directed learning (6.8%); and 9.7% were related to the systems-based practice competency. Resident focus groups recommended that feedback be timely and specific and be structured around a tool. A customized online feedback tool was developed and implemented. Mapping of the free-text feedback comments may assist in assessing milestones. Use of the feedback tool was lower than expected, which may indicate that it is just 1 of many implementation steps required for behavioral and culture change to support a learning environment with frequent and useful feedback.

Standardized Assessment of Pharmacists' Patient Care Competencies:

Assessing the ongoing competence of practicing health care professionals requires regulators to balance complex demands of governments and the public, as well as interests and concerns of practitioners. A proliferation of models has evolved across professions and jurisdictions. In this article, we report on a model utilizing standardized assessment using best-practice measurement techniques and methods for evaluation of ongoing (i.e., post-registration) clinical competencies in the profession of pharmacy in Ontario, Canada. This model involves categorization of the profession into an active patient-facing and non patient-facing register, implementation of a learning portfolio requirement to replace mandatory continuing education credit accumulation, and the use of standardized assessment techniques, such as a multiple-choice test of clinical knowledge and an objective structured clinical examination (OSCE) of clinical reasoning and interpersonal skills. Lessons learned from the development, implementation and retrospective analysis of almost two decades of data from this program can provide regulators in diverse professions and different jurisdictions with tools for standardized assessment of patient care competencies.

Validation of weekly teaching activities of Emergency Medicine Residency Training Program, Qatar against the American Board of Emergency Medicine Curriculum

Introduction: The Emergency Medicine Residency Training Program (EMRTP) in Qatar conducts weekly didactic teaching activities based on syllabus from the Arab Board of Emergency Medicine, but with the accreditation by Accreditation Council for Graduate Medical Education International (ACGMEI) in 2013, we set out to validate the teaching activities against an internationally recognized curriculum of the American Board of Emergency Medicine (ABEM) known as the EM Model. Methods: We undertook a full review of all the teaching topics undertaken throughout the academic year of 2012–13 and found a moderate degree of compliance with the ABEM curriculum. Following this review, we identified developmental points addressed during the last three years. A further review was repeated for the academic year 2015–16 to ensure ongoing improvement. Results: The results show improved content delivery. The overall compliance increased by 16% (58% to 74%) in the domain of medical knowledge and patient care and a staggering 48% (46% to 94%) in the other competencies. Conclusion: On the whole the EMRTP annual curriculum has achieved a strong emphasis on the medical knowledge and patient care competencies (including procedures &amp; skills). Further improvement was noted in other core competencies.

Teaching leadership in trauma resuscitation: Immediate feedback from a real-time, competency-based evaluation tool shows long-term improvement in resident performance.

Limited data exist on how to develop resident leadership and communication skills during actual trauma resuscitations. An evaluation tool was developed to grade senior resident performance as the team leader during full-trauma-team activations. Thirty actions that demonstrated the Accreditation Council for Graduate Medical Education core competencies were graded on a Likert scale of 1 (poor) to 5 (exceptional). These actions were grouped by their respective core competencies on 5 × 7-inch index cards. In Phase 1, baseline performance scores were obtained. In Phase 2, trauma-focused communication in-services were conducted early in the academic year, and immediate, personalized feedback sessions were performed after resuscitations based on the evaluation tool. In Phase 3, residents received only evaluation-based feedback following resuscitations. In Phase 1 (October 2009 to April 2010), 27 evaluations were performed on 10 residents. In Phase 2 (April 2010 to October 2010), 28 evaluations were performed on nine residents. In Phase 3 (October 2010 to January 2012), 44 evaluations were performed on 13 residents. Total scores improved significantly between Phases 1 and 2 (p = 0.003) and remained elevated throughout Phase 3. When analyzing performance by competency, significant improvement between Phases 1 and 2 (p < 0.05) was seen in all competencies (patient care, knowledge, system-based practice, practice-based learning) with the exception of "communication and professionalism" (p = 0.56). Statistically similar scores were observed between Phases 2 and 3 in all competencies with the exception of "medical knowledge," which showed ongoing significant improvement (p = 0.003). Directed resident feedback sessions utilizing data from a real-time, competency-based evaluation tool have allowed us to improve our residents' abilities to lead trauma resuscitations over a 30-month period. Given pressures to maximize clinical educational opportunities among work-hour constraints, such a model may help decrease the need for costly simulation-based training. Therapeutic study, level III.

Diagnostic Reasoning Assessment Toolkit: Guided Reflection and Standardized Cases for At-Risk Final-Year Medical Students.

A failing diagnostic reasoning performance may represent student deficiency in a number of potential areas. However, many standard clinical skills assessments do not offer detailed assessments of diagnostic reasoning ability. This toolkit was designed to identify specific learner deficiencies with respect to diagnostic reasoning by focusing on individual student remedial work and by standardizing faculty evaluation. Educational objectives were derived from institutional patient care competency learning objectives at the Indiana University School of Medicine. Review of existing clinical skills remediation literature yielded a design that combined two learning methods: guided reflection and standardized patient cases. Over the 2014-2015 academic year, 12 final-year medical students used this resource to help develop an individual remedial learning plan prior to retaking a failed standardized assessment. Students were generally satisfied with the combined guided reflection and standardized case learning methods. Unique final-year medical student scheduling pressures, combined with a reporting time line for both institutional high-stakes OSCE remediation exams and the USMLE Step 2 Clinical Skills exam, incentivized failing students to schedule a retest on a short time line, often leaving little time for critical preparation. This resource offered an opportunity to efficiently spend limited preparation time to individualize exam preparation using a variety of faculty facilitators. The simplistic design was readily deployable to multiple faculty remediation mentors. Our institution can now provide a standardized diagnostic reasoning remedial evaluation using numerous clinical faculty based at any of our nine campuses.

Relationship between Staff Nurses’ Caring Behavior and Disposition Toward Critical Thinking

Background: Slums Background: Caring behavior is critical and crucial for nursing practice and the disposition toward critical thinking is required for an effective and competent quality patient care. Aim: examine the relationship between staff nurse’s caring behavior and disposition toward critical thinking in intensive care units. Design: descriptive correlational design was utilized in this study. Study was carried out in medical critical care units at new kaser El Ainy hospital. Subjects: Convenient sample of staff nurses (No=70) who were working in the selected critical care units was constituted the study sample. Tools: two tools were used for data collection: California critical thinking disposition Inventory and caring behavior inventory. Results: The study findings conclude that there was no correlation between total caring behavior and total critical thinking. Recommendations: It is recommended that nursing education should emphasize a curriculum related to caring behavior to enhance nursing student’s disposition toward critical thinking. The nurse leaders should act as a role model in demonstrating caring behavior, as well as using critical thinking skills including being a problem solver and decision maker