Development Of Clinical Skills Research Articles

Which practice is best to manage the Hidden curriculum for the best use of mobile devices in clinical practice? A systematic review.REVIEW

Objective: To evaluate the literature regarding the practices to manage the hidden curriculum for the best use of mobile devices in clinical practice. Study Design: Systematic Review. Setting: Articles selected for review from Canada, United Kingdom, Japan, Ireland and Saudi Arabia. Period: July to Dec 2023. Methods: Following databases were searched: PubMed (12,579), the Cochrane Library (348), scopus (84), PsycInfo (21), CINAHL (220), Google Scholar (1,414). Primary variable (Evaluation of the development of clinical skills made possible by mobile devices) and secondary variable (to determine how satisfied students are with their mobile learning experience). The quality of study was critically appraised according the Critical Appraisal Skills Programme (CASP) scale. Results: The research findings indicate that using mobile devices into medical education has a variety of effects. Positive instructor perspectives, more student involvement, and higher learning outcomes were frequently reported by participants. Medical students' growth of technological competency and readiness for the changing healthcare landscape have been found to be accelerated by mobile devices. The integration of virtual simulations and applications that are interactive has had a positive impact on the development of clinical abilities. Positive effects included themes of individualization, collaborative learning communities, and a better understanding of patient-centered care. On the other hand, issues including the digital divide, diversions, and security threats were recognized as obstacles that called for a careful strategy to reduce any negative effects. When everything is considered, the findings confirm the revolutionary potential of mobile device incorporation in medical education and highlight how it helps to create a dynamic, technologically advanced learning environment for prospective medical professionals. Conclusion: This study provides insight on how adding mobile devices into medical education has a revolutionary effect. The research indicates enhanced learning outcomes, increased student involvement, and altering faculty perspectives through insightful stories and compelling arguments.

Impact of an International Training on Interventionists' Expertise in Cleft Palate Speech: Results From Oaxaca, Mexico.

International cleft lip and palate surgical charities recognize that speech therapy is essential for successful care of individuals after palate repair. The challenge is how to ensure that cleft speech interventionists (i.e., speech-language pathologists and other speech therapy providers) provide quality care. This exploratory study investigated effects of a two-stage cleft training in Oaxaca, Mexico, aimed at preparing speech interventionists to provide research-based services to individuals born with cleft palate. Changes in the interventionists' content knowledge and clinical skills were examined. Twenty-three cleft speech interventionists from Mexico, Guatemala, and Nicaragua participated in a hybrid two-stage training, completing an online Spanish cleft speech course and a 5-day in-person training in Oaxaca. In-person training included a didactic component and supervised clinical practice with 14 individuals with repaired cleft palates. Testing of interventionists' content knowledge and clinical skills via questionnaires occurred before the online course (Test 1), immediately before in-person training (Test 2), and immediately after in-person training (Test 3). Qualitative data on experience/practice were also collected. Significant increases in interventionists' overall content knowledge and clinical skills were found posttraining. Knowledge and clinical skills increased significantly between Tests 1 and 2. Clinical skills, but not knowledge, showed further significant increases between Tests 2 and 3. Posttraining, interventionists demonstrated greater expertise in research-based treatment, and fewer reported they would use nonspeech oral motor exercises (NSOME). Findings provide preliminary support for such two-stage international trainings in preparing local speech interventionists to deliver high-quality speech services to individuals born with cleft palate. While content knowledge appears to be acquired primarily from the online course, the two-stage training incorporating in-person supervised practice working with individuals born with cleft palate may best enhance continued clinical skill development, including replacement of NSOME with evidence-based speech treatment. Such trainings contribute to building capacity for sustainable quality services for this population in underresourced regions.

Audio podcast and procedural video use in anaesthesiology and intensive care: A nationwide survey of Swedish anaesthetists.

Digital modalities which enable asynchronous learning, such as audio podcasts and videos demonstrating procedures, may benefit acquisition and retention of knowledge and clinical skills. The main objective of this nationwide cross-sectional survey study was to evaluate key aspects and factors related to usage of audio podcasts and procedural videos in anaesthesiology and intensive care. A 20-item multiple-choice-question online survey was created through a consensus process including pilot testing among residents and consultants. Data were collected over a 3-month period, September-November 2023. The survey was completed by 466 anaesthetists. More than a third reported using procedural videos ≥1 time per week, whereas fewer than one in four participants used audio podcasts at least once per week. Multivariable logistic regression analysis showed that working at a university hospital, male sex, and younger age were independently associated with podcast use ≥1 time per week, with the highest odds ratio (OR) for younger age (<40 years vs. ≥40 years old; OR 5.86 (95% confidence interval 3.55-9.67), p < .001). Younger age was also significantly associated with higher frequency of video use (OR 1.71 (1.13-2.58), p = .011), while working predominantly in intensive care was associated with a lower frequency of video use. Podcasts were often used during commuting (42.3%), household work (30.7%), and exercise (24.9%), indicating a role in multi-tasking. Approximately half of respondents expressed that audio podcast-based learning has a moderate to very large positive impact on acquisition of theoretical knowledge, as well as practical skills. A vast majority, 85.2%, reported that procedural videos have a moderate to very large impact on development of clinical skills. Audio podcasts and procedural videos are appreciated tools with potential to supplement more traditional didactic techniques in anaesthesiology and intensive care. Procedural video use is common, with perceived large effects on development of clinical skills. Further data are needed to fully understand learning outcomes, quality of peer-review processes, and potential sex-differences.

Experiences of Allied Health Clinicians Accessing a Pilot Project ECHO® Program to Support Learning in Pediatric Feeding.

Pediatric feeding disorder is increasing in prevalence, yet low clinician confidence regarding its management is a barrier to care. Targeted clinician training is needed as traditional didactic training programs are limited in both their accessibility and capacity to provide opportunities for the application of theory-based learning. This study examined the experiences of a group of clinicians involved in a multidisciplinary PedFeed ECHO® network, a virtual community of practice established to support speech pathologists, occupational therapists, dieticians, and psychologists in Queensland, Australia, working with children with pediatric feeding disorder. Sixteen clinicians (34% of the total PedFeed ECHO network) from different professional backgrounds, clinical settings, and locations participated in semistructured interviews three months post completion of eight ECHO sessions. Inductive thematic analysis revealed three themes: (1) broad-ranging outcomes of PedFeed ECHO, (2) participant experiences of PedFeed ECHO, and (3) facilitators for future success. PedFeed ECHO was viewed very positively and provided participants with a valuable opportunity for information sharing and collaboration as a multidisciplinary team. Participants described impacts on their professional practice, knowledge, confidence, and professional isolation, as well as service and patient-level impacts. Several facilitators for the success of future PedFeed ECHO cohorts were provided. Insights from participants will serve to improve the design and delivery of ECHO training for future cohorts. Monitoring clinical skill development over a longer period of time and exploring clinician perceptions regarding direct impact on patient care are needed to further validate the impact of ECHO.

Barriers to clinical learning skills development among midwifery students and newly qualified midwives in Morocco: A qualitative study.

In Morocco, despite various initiatives to improve the quality of reproductive healthcare, the indicators remain unfavorable. To strengthen the skills of midwives and support the achievement of Millennium Development Goals (MDGs) 4 and 5 by 2030, Morocco has developed and implemented a competency-based training framework. However, there is a lack of information on the successful implementation of this program and its impact on the quality of student midwives' preparation for practice. This study aimed to gain a deeper understanding and explore the barriers affecting the development of clinical learning skills among midwifery students and newly qualified midwives. This study employed a descriptive, exploratory qualitative approach. Data were collected through nine focus group discussions with 30 midwifery students and 24 newly graduated midwives between April and June 2023 from six higher education institutions in northern and central Morocco. Inductive content analysis was used to analyze the transcribed discussions. The barriers varied between locations. Overall, the internship design was inadequate, and the clinical environment was insufficient. Participants highlighted limited opportunities to experience the full range of midwifery skills. However, most midwifery students and new graduates had deficient competencies in managing high-risk situations and emergencies. This work provides an overview of the nature and extent of the challenges faced by many student midwives in Morocco, resulting in newly graduated midwives being poorly prepared for the full range of midwifery practice. These findings can inform various initiatives to strengthen midwifery education at the global, regional, and national levels.

Learning clinical reasoning skills during the transition from a medical graduate to a junior doctor

Introduction: The literature confirms the challenges of learning clinical reasoning experienced by junior doctors during their transition into the workplace. This study was conducted to explore junior doctors' experiences of clinical reasoning development and recognise the necessary adjustments required to improve the development of clinical reasoning skills. Methods: A hermeneutic phenomenological study was conducted using multiple methods of data collection, including semi-structured and narrative interviews (n=18) and post-consultation discussions (n=48). All interviews and post-consultation discussions were analysed to generate themes and identify patterns and associations to explain the dataset. Results: During the transition, junior doctors’ approach to clinical reasoning changed from a ‘disease-oriented’ to a ‘practice-oriented’ approach, giving rise to the ‘Practice-oriented clinical skills development framework’ helpful in developing clinical reasoning skills. The freedom to reason within a supportive work environment, the trainees’ emotional commitment to patient care, and their early integration into the healthcare team were identified as particularly supportive. The service-oriented nature of the internship, the interrupted supervisory relationships, and early exposure to acute care settings posed challenges for learning clinical reasoning. These findings highlighted the clinical teachers' role, possible teaching strategies, and the specific changes required at the system level to develop clinical reasoning skills among junior doctors. Conclusion: The ‘Practice-oriented clinical skills development framework’ is a valuable reference point for clinical teachers to facilitate the development of clinical reasoning skills among junior doctors. In addition, this research has provided insights into the responsibilities of clinical teachers, teaching strategies, and the system-related changes that may be necessary to facilitate this process. Keywords: Clinical Reasoning, Medical Decision Making, Medical Graduates, Junior Doctor Transition, Hermeneutic Phenomenology, Qualitative Research

Evaluation of a Simulation Based Training Course for Non-Consultant Hospital Doctors (NCHDS) in Psychiatry

IntroductionSimulation-based training (Sim) is an established method of teaching in medical education and can help bridge the gap between medical theory and clinical practice. While sim is well-established in medical and surgical specialties, it is less well developed in psychiatry. Psychiatric emergencies often occur out of hours when there are fewer senior staff available on-site. Sim offers a safe setting for development of essential clinical skills with carefully delivered feedback.Sim can be high-cost involving specialized simulation facilities, especially when utilising high-fidelity equipment. Even lower-fidelity techniques requiring standardized patients (SPs) require funding for actors and this can be a barrier to utilising Sim.ObjectivesWe piloted a Sim course to NCHDs working in psychiatry in a tertiary university hospital with the aim of improving trainee skills and confidence in managing psychiatric emergencies on-call including risk assessment, involuntary admission and acute behavioural disturbance. A low-fidelity approach was taken with minimal use of SPs.MethodsA sim handbook developed by Irish Centre for Applied Patient Safety and Simulation (ICAPSS) was used for reference in developing the simulation modules. Three modules were delivered in a structured manner over three hours; involuntary admission, risk assessment and management of acute behavioural disturbance. Each module involved the simulation exercise (20 minutes) followed by debrief (20 minutes). The facilitated debrief involved open discussion and prompted reflective learning. Anonymous, paper-based questionnaires were used to collect feedback on participants’ experience of the training.ResultsThere were 12 attendees and ten participants completed the feedback. All participants (100%, n=10) agreed or strongly agreed that sim helped them to learn and all agreed that the topics covered were relevant to their clinical role. All participants (100%, n=10), indicated that they enjoyed the workshop. Eighty percent (n=8) agreed or strongly agreed that they would like to do more sim-based workshops. The supportive environment and debrief sessions were reported as the most enjoyable aspects of the workshop.ConclusionsParticipants unanimously agreed that the training was useful to them in their clinical roles and helped them to learn. Sim was effective in teaching high risk complex psychiatric cases to psychiatry NCHDs and consideration should be given to expand this teaching method within postgraduate psychiatry training in Ireland.Disclosure of InterestNone Declared

Practice makes perfect: The learner-doctor blueprint for proficient physicians.

In the process of producing competent and efficient medical graduates, clinical teaching is an integral component of undergraduate training. Even though clinical training has been linked with multiple benefits and plays a defining role in transforming a medical student into a competent doctor, it has some inherent challenges. The learner-doctor method emphasizes learning by doing and has the potential to counter the identified challenges in the traditional mode of clinical training. The learner-doctor method places emphasis on collaborative learning, wherein students learn by experiential learning and active participation in patient care. This method not only fosters the development of clinical skills but also cultivates critical thinking, teamwork, empathy, and effective communication. A number of activities or strategies must be planned and implemented to ensure that the set objectives of the learner-doctor method are accomplished by the medical institutions. In conclusion, as medical education continues to evolve, the learner-doctor method of clinical training is a dynamic approach to bridging the gap between theoretical knowledge and practical skills. As this method enables medical students to actively engage in patient care and improve their critical thinking, it becomes the need of the hour that every medical institution should explore the opportunity to effectively implement the same in their settings.

Investigating LGBTQ affirmative attitudes and needs for better practice among Hungarian healthcare professionals

AbstractIntroduction: LGBTQ (lesbian, gay, bisexual, transgender, queer) people often do not seek health care and do not identify as LGBTQ people because of fear of judgment, stereotyping, and discrimination by health professionals. All of this is a particularly worrying phenomenon, because various mental difficulties, risky behaviors, and certain types of somatic and psychosomatic diseases may appear in a higher proportion among them.Objectives Attitudes related to LGBTQ people were examined in several areas in Hungary. Most of our data comes from psychologists, however, a comprehensive examination of health professionals’ attitudes towards LGBTQ people has not yet been carried out.MethodsIn a cross-sectional online survey, we ask healthcare professionals (medical doctors, nurses, other graduate healthcare professionals and medical university students) to fill out our questionnaire. The participants complete the Modern Homonegativity Scale and the Lesbian, Gay, Bisexual and Transgender Clinical Skills Development Scale.Results We assume that the majority of Hungarian healthcare professionals have a neutral or positive attitude towards LGBTQ people, but they struggle with a significant lack of affirmative skills. We will present our results in detail in the presentation of the symposium.ConclusionsThere is an urgent need to provide the appropriate affirmative knowledge material to Hungarian healthcare workers.Disclosure of InterestNone Declared

Correlation Between Health Assessment and RLE 2 Courses at Tobruk University

Health Assessment (HA) and Related Learning Experience 2 (RLE 2) are foundational courses for nursing students at Tobruk University. This study aimed to investigate the potential correlation between student performance in HA and RLE 2 to enlighten curriculum adjustments and improve student preparation for clinical practice. This study employed quantitative methodology consisting of three batches from the school year endings 2021, 2022, and 2023. A total of 263 student records were selected for this study. The collected data were measured using the Pearson product-moment correlation coefficient based on the final grades in both HA and RLE 2, together with the semester grade average (SGA). As for the mean, RLE was higher than HA in all batches. The highest correlation between HA and RLE2 belonged to batch 2021, with r=0.6197. Correlation for batch 2023 was the highest between HA and SGA with r=0.8777. Batch 2021 tops in RLE2 and SGA correlation with r=0.73119. Other study findings were also presented in terms of variation and graphical presentation. Limitations and suggestions for further research were addressed. This study sought to inform the relationship between theoretical knowledge and clinical skill development in nursing students. The research findings can contribute to decision-making potential for possible curriculum development at the University, and consequently, bring about continuous improvement in the area of nursing education and practice.

Mechanisms of Near-Peer Learning in a Longitudinal Clerkship: A Grounded Theory Study.

Many medical schools incorporate longitudinal clerkships, which promote continuity and may offer early clinical exposure during the preclinical curriculum. However, the mechanisms of near-peer learning and how it contributes to the development of clinical skills in longitudinal clinical experiences are less clear. The authors explored how peer-to-peer interactions among medical students influenced their developmental trajectories from nascent clinicians to more seasoned practitioners capable of juggling dual roles of clinical care and clinical supervision within longitudinal clerkships. The Education-Centered Medical Home (ECMH) at Northwestern University Feinberg School of Medicine is a longitudinal clerkship that represents an ideal setting to explore peer learning. At ECMH, continuity is established across all 4 years of medical school among small groups of students from each year, a preceptor, and a panel of outpatients. The authors conducted 6 focus groups and 9 individual interviews between March 2021 and February 2023 with medical students from all years. Using constructivist grounded theory, the authors collected and analyzed data iteratively using constant comparison to identify themes and explore their relationships. Within ECMH, peer relationships fostered an informal learning culture that enabled meaningful peer interactions while reinforcing the established culture. The authors identified 3 essential learning practices between senior and junior medical students: preparing for patient encounters, shifting roles dynamically during the joint encounter, and debriefing encounters afterward. These practices strengthened learning relationships and supported students' developmental trajectories. Longitudinal peer learning relationships enabled meaningful peer interaction that influenced medical students' clinical development and capability for clinical supervision. Mutual trust, familiarity, and continuity facilitate targeted feedback practices and growth at the edge of junior students' capabilities. Optimizing this peer learning environment and seeking new opportunities to use longitudinal peer learning in clinical environments could promote psychological safety and professional identity formation for medical students.

Clinical skills development for healthcare practitioners working with patients with persistent physical symptoms (PPS) in healthcare settings: a systematic review and narrative synthesis

BackgroundThe complexity and uncertainty around Persistent Physical Symptoms (PPS) make it difficult to diagnose and treat, particularly under time-constrained consultations and limited knowledge. Brief interventions that can be utilised in day-to-day practice are necessary to improve ways of managing PPS. This review aimed to establish (i) what training primary and secondary healthcare practitioners have undertaken to develop their clinical skills when working with PPS, (ii) what training techniques or theoretical models have been used within these interventions, and (iii) how effective was the training.MethodA systematic literature search was undertaken on eight databases to identify professional development interventions for healthcare practitioners working with PPS, were of any study design, and at a minimum were single measure studies (i.e., training outcome alone). Studies were assessed using the Mixed Methods Appraisal Tool (MMAT) and narratively synthesised.ResultsDespite high methodological heterogeneity across the six included studies, they all aimed to improve healthcare practitioners’ communication skills through educational (theory, awareness, attitudes, assessment, treatment, and management of PPS) and experiential (role play) learning.ConclusionsThe review findings demonstrate that developing healthcare practitioners’ communicative behaviours led to increased confidence and self-efficacy when working with PPS, which facilitated improved consultations and improvements on some patient outcomes. Barriers to the uptake of training programmes and implementation into daily clinical practice are discussed, including the need for PPS to be formally implemented into undergraduate teaching and post-qualification continuous professional development.Trial registrationThis review was registered at PROSPERO [CRD42022315631] prior to the review starting.

Using Technology-Supported Approaches for the Development of Technical Skills Outside of the Classroom

The COVID-19 pandemic, and the subsequent lockdown, had a significant and disproportionate impact on subjects that required the development of clinical technical skills due to the lack of access to simulation classrooms and patients. To directly address this impact, we developed a conceptual framework for the design and implementation of a progressive simulation approach from the perspective of a teacher. This conceptual framework integrates and draws from key theories of simulation design, curriculum integration, learner motivation, and considerations of the facets of good assessment, including modern approach validity. We used the conceptual framework to inform and develop a progressive simulation design to support the development of essential intra-oral suturing skills outside of the classroom, at home, while still being able to provide external feedback as if learners were in the classroom or clinic. Moreover, the approach described significantly extended the available opportunities for deliberate practice, assisting with the automation of essential skills and aiming to better support learner development during face-to-face patient opportunities. Although further work is needed, we believe that our conceptual framework could be applied to any situation where progressive simulation is seen as beneficial, especially if there are elements of key skills that could initially be developed using a simple take-home simulator.

INTERDISCIPLINARY INTEGRATION OF MICROBIOLOGY, VIROLOGY, AND IMMUNOLOGY IN THERAPEUTIC STOMATOLOGY

Introduction: This article examines the potential for integrating Therapeutic Stomatology with Microbiology, Virology, and Immunology. It highlights the significance of studying key concepts in these disciplines, which underpin various methods of microbiological diagnostics utilized in dentistry. Practical skills and theoretical knowledge essential for the study of Therapeutic Stomatology are exemplified. The aim of this paper is to underscore the significance of interdisciplinary integration between Microbiology, Virology, and Immunology with Therapeutic Stomatology in the education and training of future dental practitioners.&#x0D; Results and Discussion: A solid grasp of microbiology is crucial for fostering the clinical acumen of future dental professionals. The integration of disciplines should be systematically woven into all phases of the educational curriculum. By merging fundamental and clinical disciplines, a multidimensional approach to problem-solving is facilitated, highlighting the interconnectedness between fields. This integration enhances students' intellectual, cognitive, and communicative abilities, broadening their educational horizons and enabling the application of foundational knowledge in novel contexts. Consequently, this approach nurtures the development of clinical reasoning skills among aspiring dental practitioners.&#x0D; Conclusions: The interdisciplinary integration of Microbiology, Virology, and Immunology with Therapeutic Stomatology in professional training ensures educational coherence, enhances the organization and refinement of knowledge and skills, and lays the groundwork for cultivating professionals characterized by versatile thinking and comprehensive expertise in their field.

Enhancing gerontological social work education: curriculum insights from offering a clinical gerontology certificate

ABSTRACT With the increasing aging population there is a need for more gerontological social work practitioners; however, such training for social workers in Canada is limited. To help address this gap, one faculty of social work developed a graduate level clinical social work practice certificate with a specialization in gerontology. In this paper we explore students’ and instructors’ perspectives about the curriculum, delivery, and impact of this certificate, and provide recommendations for improvement, particularly with respect to the clinical nature of the courses. Eight students and four instructors participated in the study. Strengths and opportunities for enhancement were identified for curriculum and delivery. Study findings also indicated that further curriculum development should focus on enhancing clinical skill development and providing more practice experience. Implications arising from these findings included developing clinical skills through experiential learning, interprofessional education, and service learning.

IDEAL: Maintaining PHC-focused training in a MBChB programme through a COVID-induced innovation.

Responding to the need for authentic clinical training for students in the context of coronavirus disease 2019 (COVID-19), the Stellenbosch University Faculty of Medicine and Health Sciences developed an innovative 12-week longitudinal, integrated rotation for pre-final-year medical students, the Integrated Distributed Engagement to Advance Learning (IDEAL) rotation. This saw 252 students being placed across 30 primary and secondary healthcare facilities in the Western and Northern Cape provinces. With a focus on service learning, the rotation was built on experiences and research of members of the planning team, as well as partnership relationships developed over an extended period. The focus of student learning was on clinical reasoning through being exposed to undifferentiated patient encounters and the development of practical clinical skills. Students on the distributed platform were supported by clinicians on site, alongside whom they worked, and by a set of online supports, in the form of resources placed on the learning management systems, learning facilitators to whom patient studies were submitted and wellness supporters. Important innovations of the rotation included extensive distribution of clinical training, responsiveness to health service need, co-creation of the module with students, the roles of learning facilitators and wellness supporters, the use of mobile apps and the integration of previously siloed learning outcomes. The IDEAL rotation was seen to be so beneficial as a learning experience that it has been incorporated into the medical degree on an ongoing basis.Contribution: Longitudinal exposure of students to undifferentiated patients in a primary health care context allows for integrated, self-regulated learning. This provides excellent opportunities for medical students, with support, to develop both clinical reasoning and practical skills.

IMPACT OF PUNCTUALITY AND REGULARITY ON LEARNING BEHAVIORS AND CLINICAL SKILLS IN POST-GRADUATE RESIDENTS AT NISHTAR HOSPITAL MULTAN

: Punctuality and regularity are crucial traits in medical education that can significantly impact learning behaviors and clinical skills development. However, there is a lack of empirical evidence investigating their impact on postgraduate residents in the Pakistani healthcare system. This qualitative study aims to explore the experiences and perceptions of doctoral residents regarding punctuality and regularity in their clinical and learning activities at Nishtar Hospital Multan. The study also seeks to identify the perceived effects of punctuality and regularity on residents' learning behaviors and clinical skills development, highlight any barriers or facilitators to maintaining punctuality and regularity in the residency program, and provide insights to inform future interventions or policies aimed at promoting punctuality and regularity among postgraduate residents. The study found that punctuality and regularity significantly enhance postgraduate residents' learning behaviors and clinical skills. Punctual and regular residents reported better time management skills, increased exposure to different cases, and improved academic performance in their clinical and learning activities. However, some residents faced barriers to maintaining punctuality and regularity, such as long working hours and inadequate supervisor support. The study suggests that interventions aimed at promoting punctuality and regularity should consider the unique challenges and opportunities of the Pakistani healthcare system and prioritize the needs and experiences of postgraduate residents.

Critical Clinical Competencies (CCC) Curriculum for Clinical Reasoning Skills Development

Critical Clinical Competencies (CCC) Curriculum for Clinical Reasoning Skills Development

An early-curricular team learning activity to foster integration of biochemical concepts and clinical sciences in undergraduate medical education.

The ability to connect key concepts of biochemistry with clinical presentations is essential for the development of clinical reasoning skills and adaptive expertise in medical trainees. To support the integration of foundational and clinical sciences in our undergraduate health science curricula, we developed a small group active learning exercise during which interprofessional groups of students use clinical cases to explore the biochemistry, diagnostic strategy, and evidence-based treatment options of inborn errors of metabolism (IEM). We designed multistage learning modules consisting of (1.) low-fidelity case simulations of pediatric patients presenting with IEMs, (2.) guided group discussions on clinical biochemistry, differential diagnoses, and diagnostic strategies, (3.) oral presentations of clinical reasoning strategies, and (4.) discussion of relevant evidence-based medicine topics related to the cases. These modules Scientific Knowledge Integrated in Patient Presentations (SKIPPs) were added to a first-semester foundational sciences course serving five health professions programs. The assessment of learning outcomes by students and faculty shows that SKIPPs sessions are well-received activities that significantly improve trainees' ability to integrate foundational science concepts into clinical scenarios, to practice interprofessional teamwork and to develop clinical reasoning skills.

CLINICAL INTERNSHIP PROGRAM DEVELOPMENT IN AN ACADEMIC CARDIOPULMONARY EXERCISE LAB

https://youtu.be/L4guyGQnFdQ BACKGROUND Programs in exercise physiology, exercise science, kinesiology, sports sciences, and human performance encompassing both undergraduate and graduate studies are increasingly popular, providing education for a growing career field. Preparing students for healthcare careers requires adequate exposure and hands-on learning using experiential internship and practicum opportunities. An initiative to formalize the exercise science academic requirements for university programs is already in place and requires institutional program CAAHEP accreditation by 2027. Participation in a clinical internship and the hours required vary among college programs. This retrospective study performed on the cardiopulmonary internship program at a large Midwest pediatric hospital provides insight to clinical education and research skill development for undergraduate and graduate exercise science students. METHODS A retrospective review of program metrics and outcomes was analyzed regarding university affiliations with the internship program, number of students accepted into the internship program, completion rate, training and competencies, student academic level and associated culminating student presentations, and program satisfaction surveys for students completing their internship experience. RESULTS Between 2012 to 2023, the program grew from 3 to 40 university affiliation agreements/institutions. 143 students participated in the internship program: 32 fulfilled shadowing experiences, 90 were undergraduate interns and 21 were graduate interns. Internship hour requirements varied from 100 to 600 hours, with most students completing 350-450 hours. In 2012, the program enrolled 1 student per year, and by 2013 the capacity expanded to 4 student positions per semester (each spring, summer, fall). Internship students have presented 38 poster/abstract presentations at regional conferences and seminars. Students achieved 99% completion of site-specific sign-off competencies in cardiopulmonary exercise testing, including expanded requirements for cardiac rehabilitation starting in 2018. 98% of the student interns completed the program. CONCLUSIONS The cardiopulmonary internship program has continued to expand additional affiliate universities from both local and out of state institutions referring students to the pediatric internship program. Secondary to our cardiology program’s growth to include pediatric and now adult congenital patients, our outreach sites, and the expansion into cardiac rehabilitation and exercise prescription, the lab team members and allocated space have increased to accommodate increasing patient volumes. This has led to the ability to increase student interns per semester and expand their preparation for transition into the healthcare workforce. Understanding of the skills and competencies obtained during the practicum experience may help to enhance academic curriculum to transition students into clinical opportunities.