Anesthesia Education Research Articles

Competency based anesthesia education: A welcome step.

Competency based anesthesia education: A welcome step.

Mock Oral Board Examination in Nurse Anesthesia Education.

Despite its widespread use in anesthesia residency training, mock oral board examinations (MOBEs) are not included in the pedagogy of most nurse anesthesia programs (NAPs). A small-scale study was conducted to assess the use of MOBEs in this setting. The investigational cohort consisted of 10 second-year students in a master's program in nurse anesthesia. MOBEs were scored according to a common rubric, and final scores were reconciled by raters. Responses from pretest and posttest questionnaires, as well as scoring data, were analyzed. MOBEs were administered in a problem-free manner to nurse anesthesia students and was perceived by these students as a valuable addition to their curriculum. There was pass-fail agreement among the raters related to clinical analysis, fund of knowledge, and communication skills, and the scoring was characterized by elements of internal consistency. MOBEs are feasible in an NAP, and well accepted by students. MOBEs have significant evaluative potential in this setting. [J Nurs Educ. 2021;60(4):229-234.].

Analysis of Confidence Levels and Application Success Rates in Simulator-Based Dental Anesthesia Education Among Undergraduate Dental Students

We investigated the confidence levels of undergraduate dental students who used dental anesthesia simulators and patient reports of undergraduate dental students' confidence levels in delivering anesthesia injections, in comparison with undergraduate dental students who did not use dental anesthesia simulators. We also investigated application success rates. The study was carried out in the dental anesthesia simulator laboratory and in the faculty clinics of the Faculty of Dentistry of Ankara University. One-hundred volunteer undergraduate dental students who had completed the third year of the 5-year undergraduate education program and who had not performed local anesthesia on a patient participated in the study. Seventy and 30 undergraduate dental students did and did not receive training on dental anesthesia simulators, respectively, before performing procedures on patients. Using a questionnaire, undergraduate dental students conducted a self-assessment of preparedness and confidence, educators assessed the application success rates, and patients evaluated the undergraduate dental students' confidence levels. Patients reported that the undergraduate dental students trained using the simulators were more confident. The self-reported confidence and success rates in providing anesthesia did not differ significantly as per the use of dental anesthesia simulators. Although use of simulators did not enhance self-reported confidence, patients reported that undergraduate dental students who used the simulators were more confident and reassuring. Use of simulators did not increase the undergraduate dental students' self-reported confidence or preparedness. However, we recommend using such simulators to overcome the ethical and moral issues associated with other teaching methods.

Pedagogical development in local anaesthetic training in paediatric dentistry using virtual reality simulator.

PurposeWith the advancements in technology, dental pedagogy has also evolved, and new learning technologies have emerged. Virtual reality (VR) as an education tool in dentistry is underutilised. VR as an adjunct in local anaesthesia (LA) teaching in paediatric dentistry has not been investigated. The study aimed to investigate dental student’s perception of dental LA VR simulation on a paediatric patient and to determine whether this can improve students learning experience.MethodsSeventy-one students participated in a self-administered questionnaire before and after the use of dental LA VR simulator. Descriptive analysis was performed to determine the perceptions of experience gained through VR. The data were tabulated, graphed, and analysed using SPSS and GraphPad Prism software.ResultsThe study noted that 89.9% of participants perceived that it would improve their LA skills. After using dental LA VR, 83.1% of participants experienced more engaged in the learning activity, and 55.0% of participants agreed/strongly agreed that it improved their understanding of anatomical landmarks. Around 56.4% of participants agreed/strongly agreed that it added value compared with traditional LA teaching methods.ConclusionIt can be concluded that the use of VR simulation can enhance students engagement and learning experience in paediatric dentistry settings and can be used as an additional means of LA training.

ImPACT: Achieving Equity in Anesthesia Education for East Africa

Features| February 2021 ImPACT: Achieving Equity in Anesthesia Education for East Africa Bantayehu Sileshi, MD; Bantayehu Sileshi, MD Search for other works by this author on: This Site PubMed Google Scholar Mahelet Tadesse, MD; Mahelet Tadesse, MD Search for other works by this author on: This Site PubMed Google Scholar Haftom Berhane, MSc; Haftom Berhane, MSc Search for other works by this author on: This Site PubMed Google Scholar J. Matthew Kynes, MD J. Matthew Kynes, MD Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor February 2021, Vol. 85, 20–21. https://doi.org/10.1097/01.ASM.0000733840.53042.e3 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Search Site Citation Bantayehu Sileshi, Mahelet Tadesse, Haftom Berhane, J. Matthew Kynes; ImPACT: Achieving Equity in Anesthesia Education for East Africa. ASA Monitor 2021; 85:20–21 doi: https://doi.org/10.1097/01.ASM.0000733840.53042.e3 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: africa, eastern, equity, impact A major contributor to the surgical access and outcomes deficit experienced by vulnerable populations worldwide is the lack of trained anesthesia clinicians in low- and middle-income countries (LMICs). The World Federation of Societies of Anesthesiologists Global Anesthesia Workforce Survey revealed large gaps in both physician and non-physician anesthesia provider density, including 70 countries with a total anesthesia provider number <5 per 100,000 population (Anesth Analg 2017;125:981-90). Closing these gaps will require high-level investment, partnership, and innovation for education capacity in these settings. The Improving Perioperative Anesthesia Care and Training (ImPACT) Africa program is making strides to close this anesthesia education gap in East Africa. Founded in 2014 by a team at Vanderbilt University Medical Center (VUMC) with a grant from the GE Foundation, the program has focused on four key areas of capacity-building: learning resource development, training educators, health care simulation, and data collection. ImPACT was initially launched... You do not currently have access to this content.

Editorial introductions.

Editorial introductions.

Anesthesiologists Have an Important Role in Preclinical Nurse Anesthesia Education.

Anesthesiologists do not participate regularly in the preclinical portion of nurse anesthesia training programs (NAPs). This practice is predicated on a historical separation of the early educational tracks of physicians and advanced practice nurses whose professions ultimately came to occupy overlapping niches within the field of anesthesia. The state of affairs has been bolstered by territorial friction between professional organizations, and by the lack of a perceived need for anesthesiologists to become involved at an early stage of nurse anesthesia education given the large number of qualified certified registered nurse anesthesia instructors available to perform this role. Anesthesiologists, however, have significant pedagogical assets to offer NAPs, including expertise in critical analysis and decision-making skills related to perioperative adverse events. In addition, introduction of anesthesiologists into preclinical NAP education has the potential to inject added academic rigor into NAPs currently transitioning to Doctor of Nursing Practice programs. Likewise, NAPs offer a professional haven for those anesthesiologists seeking new challenges in education, and a unique opportunity to shape the future of anesthesia. Most importantly, introducing anesthesiologists into the initial educational phases of the nurse anesthesia profession provides an opportunity to grow trust and understanding between these two professions that are critical for safe, healthy, and lasting partnerships in future years.

Preoperative communication with anesthetists via anesthesia service platform (ASP) helps alleviate patients\u2019 preoperative anxiety

Female gender has been identified as one of the risk factors closely linked to perioperative anxiety and a lower level of satisfaction. A successful preoperative anesthesia education may improve such negative outcomes. The aim of this study was to investigate whether preoperative anesthesia education via an Anesthesia Service Platform (ASP) could reduce the anxiety levels in female patients scheduled for laparoscopic cholecystectomy under general anesthesia, and accelerate rehabilitation. A total of 222 patients scheduled for elective laparoscopic cholecystectomy were randomly assigned to the control group and the ASP group. Patients’ baseline and post-intervention psychological status was measured by the State-Trait Anxiety Inventory and General Well-Being Schedule. Pain management and recovery were assessed by VAS every 12 h for 48 h after surgery; length of stay (LOS) and postoperative analgesic consumption were also assessed. Patients in the control group experienced higher anxiety levels before surgery and had longer LOS than those in the ASP group. Patients in the ASP group had a higher general well-being score; however, they suffered more pain and consumed more analgesics after surgery. ASP is effective for preventing anxiety in female patients before laparoscopic cholecystectomy, improving patients’ general well-being levels, and shortening their LOS, but negatively influences patients’ postoperative pain levels.

Advances in anesthesia education: increasing access and collaboration in medical education, from E-learning to telesimulation.

The landscape of medical education continues to evolve. Educators and learners must stay informed on current medical literature, in addition to focusing efforts on current educational trends and evidence-based methods. The present review summarizes recent advancements in anesthesiology education, specifically highlighting trends in e-learning and telesimulation, and identifies possible future directions for the field. Websites and online platforms continue to be a primary source of educational content; top websites are more likely to utilize standardized editorial processes. Podcasts and videocasts are important tools desired by learners for asynchronous education. Social media has been utilized to enhance the reach and visibility of journal articles, and less often as a primary educational venue; its efficacy in comparison with other e-learning platforms has not been adequately evaluated. Telesimulation can effectively disseminate practical techniques and clinical knowledge sharing, extending the capabilities of simulation beyond previous restrictions in geography, space, and available expertise. E-learning has changed the way anesthesiology learners acquire knowledge, expanding content and curricula available and promoting international collaboration. More work should be done to expand the principles of accessible and collaborative education to psychomotor and cognitive learning via telesimulation.

Anaesthesia nursing competence: Self-assessment of nursing students

BackgroundThe importance of competence assessment in anaesthesia nursing education has increased since nurse educators and anaesthesia care employers have identified the gap between nursing education and nursing practice. In order to ensure nursing students' preparedness for entry into anaesthesia nursing practice, it is necessary to measure whether nursing students have achieved the required competence to practice as anaesthesia care providers. ObjectivesTo assess the anaesthesia nursing competence of nursing students and to describe factors related to their anaesthesia nursing competence. This study will provide new knowledge to support the curricula of nursing education and new nurses' practice in anaesthesia care. DesignCross-sectional survey design. MethodsData from a sample of Finnish nursing students (n = 205) were collected by using an on-line/paper and pencil survey (the Anaesthesia Nursing Competence Scale, 7 categories) in 2017. The assessment was based on self-assessment and used a Visual Analogue Scale (0−100). Descriptive statistics, a Pearson correlation coefficient, independent sample t-tests and a multivariable regression were used to analyse the data. ResultsThe self-assessed overall competence of graduating nursing students was 59 (range 43–73). Approximately half of the students reached an acceptable level (60≤) and half did not. The highest self-assessed category was collaboration within patient care, and the lowest was knowledge of anaesthesia patient care. The number of credits, anaesthesia courses, and experience of clinical practice in anaesthesia nursing were significantly related to anaesthesia nursing competence. ConclusionsCompetence development in the knowledge of anaesthesia patient care should be considered in general nursing education. Student nurses' competence could be developed by providing more opportunities for theoretical studies and clinical practice in anaesthesia nursing. A specialised post-registration education in anaesthesia nursing might be one solution to overcome the limitations in the competence that general nursing education is not fully able to cover for anaesthesia nursing.

Education and training in ultrasound-guided regional anaesthesia and pain medicine.

Effective and safe regional anaesthesia and pain medicine procedures require clinicians to learn and master complex theoretical knowledge and motor skills. This review aims to summarize articles relevant to education and training in these skill sets in the previous 2 years. Twenty-two articles were identified, investigating nine out of the 13 top-ranked research topics in education and training in regional anaesthesia. Research topics addressed by these articles included prerotation simulation, deliberate practice combined with formative assessment tools, validation of assessment tools, three-dimensional-printed models, and knowledge translation from simulation to clinical practice. Emerging concepts investigated for their applications in regional anaesthesia included eye-tracking as a surrogate metric when evaluating proficiency, and elastography aiding visual salience to distinguish appropriate perineural and inappropriate intraneural injections. Research into education and training in regional anaesthesia covered multiple and diverse topics. Methodological limitations were noted in several articles, reflecting the difficulties in designing and conducting medical education studies. Nonetheless, the evidence-base continues to mature and innovations provide exciting future possibilities.

The Fine Art of Health Care: Visual Thinking Strategies for Interprofessional Skills Development in Graduate Nurse Anesthesia Education.

Visual Thinking Strategies (VTS) is a methodology designed to teach critical thinking, communication, and visual literacy. The Fine Art of Health Care is a VTS-based educational program that brings students from various health-care disciplines to the Lowe Art Museum at the University of Miami in Florida. Twenty-six nurse anesthesia, medical, physical therapy, nursing, and psychology students participated in the workshop during the 2016 fall semester. The students completed an anonymous survey to evaluate their experience. All participants agreed or strongly agreed that VTS helped them understand how to hone their observational and listening skills; 92% agreed that looking at and discussing art has merit with regards to collaborative practice; 96% agreed that VTS helped them improve their communication skills; and 93% found value in the VTS workshop because it provided opportunity to meet and have discussions with students from other disciplines. The arts and humanities have long been recognized as important tools for building multidisciplinary collaboration in health education. There is growing evidence that integrating the arts into the nursing curriculum can have powerful outcomes. These capabilities proved useful in the nurse anesthesia curriculum by allowing skillful conceptualization, and originality and leveling of the playing field for all health-care students.

Anesthesia Teaching for Undergraduates; Bringing the Operating Theatre to the Simulation Lab: A Pilot Study

Background: Simulation-based education has become more prominent in recent years. In our university, we have begun to use simulation at various levels in the curriculum. Objectives: We decided to utilize simulation to meet the challenges of teaching medical students in the operating theatre, which have slowly risen over the years at our place of practice. Methods: A total of 120 final year medical students posted to anesthesia were divided into two groups and exposed to two different operating theatre (OT) teaching environments: Group I: Actual OT and group 2: Simulated OT. The performance of the two groups on 25 MCQs was compared using the chi-square test and independent t-test. Results: The chi-square test showed no significant difference between the groups in the number of students who passed the test at the end of the posting [χ2 (2, N = 119) = 2.375, P &gt; 0.05]. An independent t-test carried out on the test scores showed that the actual OT group (M = 10.15, SD = 2.284) performed better than the simulated OT group (M = 9.04, SD = 2.528), and it was statistically significant [t (112) = 3.265, P = 0.001]. Conclusions: There was no difference in terms of pass or fail between the two groups suggesting that OT learning could be simulated. However, the actual OT group had overall better scores statistically. Thus the depth of learning may be better with actual OT teaching, especially because the teaching and learning occur in the real environment. Until further research suggests that simulated OT can replace actual OT learning for undergraduates, we plan to use the simulated OT as a bridge towards actual OT learning.

Critical Care Medicine Practice: A Pilot Survey of US Anesthesia Critical Care Medicine-Trained Physicians.

This survey assessed satisfaction with the practice environment among physicians who have completed fellowship training in critical care medicine (CCM) as recognized by the American Board of Anesthesiology (and are members of the American Society of Anesthesiology) and evaluated the perceived effectiveness of training programs in preparing fellows for critical care practice. A cross-sectional online survey composed of 39 multiple choice and open-ended questions was administered between August and December 2018 to all members of the American Society of Anesthesiologists (ASA) who self-identified as being CCM trained. The survey instrument was developed and revised in an iterative fashion by ASA committee on CCM and the Society for Education in Anesthesia (SEA). Survey results were analyzed using a mixed-method approach. Three hundred fifty-three of the 1400 anesthesiologists who self-identified to the ASA as having CCM training (25.2%) completed the survey. Most were men (72.3%), board certified in CCM (98.7%), and had practiced a median of 5 years. Half of the respondents rated their training as "excellent." A total of 70.6% described currently working in academic centers with 53.6% providing care in open surgical intensive care units (ICUs). Most anesthesiologist intensivists (75%) spend at least 25% of their clinical time providing ICU care (versus clinical anesthesia). A total of 89% of the respondents were involved in educational activities, 60% reported being in administrative leadership roles, and 37% engaged in scholarly activity. Areas of dissatisfaction included fatigue, lack of collegiality or respect, lack of research training, decreased job satisfaction, and burnout. Analysis suggested moderate levels of job satisfaction (49%), work-life balance (52%), and high levels of burnout (74%). A significant contributor to burnout was with a perception of lack of respect (P = .005) in the work environment. Burnout was not significantly associated with gender or duration of practice. Qualitative analysis of the open-ended responses also identified these 3 variables as major themes. This survey of CCM-trained anesthesiologists described a high rate of board certification, practice in academic settings, and participation in resident education. Areas of dissatisfaction with an anesthesia/critical care practice included burnout, work/life balance, and lack of respect. These results may increase recruitment of anesthesiologists into critical care and inform strategies to improve satisfaction with anesthesia critical care practice, fellowship training.

Application of an education model using the WeChat public platform in the standardized training of anesthesiology residents.

Standardized training of clinical residents is an important way to train high-level clinicians and is an important step to ensure quality clinical work. WeChat facilitates efficient information dissemination and feedback, convenient communication. In the new media era, the influence of WeChat has inspired changes in educational methods, to explore the role of an education model using the WeChat public platform in the standardized training of anesthesiology residents. A total of 40 anesthesiology residents undergoing standardized training in our department from January 2016 to August 2017 were selected as subjects and randomly divided into 2 groups: traditional group (n=20) and WeChat group (n=20). In the WeChat group, in addition to the traditional clinical teaching model (lectures), the residents also received push information from the WeChat public platform for anesthesia education. The residents in the traditional group did not receive the push information and only received traditional clinical teaching. Three months later, assessment scores of and teaching quality in the 2 groups were evaluated. Teaching quality was evaluated using peer assessment and self-assessment questionnaires. Residents in the WeChat group performed significantly better on assessments than those in traditional group regarding theoretical knowledge of anesthesiology, understanding mechanisms, operation ability, current knowledge, case analyses and use of professional English (P<0.05). The questionnaire results indicated that the degree of satisfaction of the residents and teachers in the WeChat group was significantly higher than that in the traditional group (P<0.05). The theoretical knowledge scores, operational skill scores and overall scores in the WeChat group were significantly higher than those in the traditional group (P<0.05). Applying an education model based on the WeChat public platform in standardized training of anesthesiology residents can significantly improve teaching efficacy and satisfaction, enhance comprehensive assessment results, and improve teaching quality.

Analysis of teaching methods in anaesthesia in the undergraduate curriculum of four veterinary universities

ObjectiveTo design a holistic audit tool to assess the effectiveness of anaesthesia teaching strategies, and thereby to study veterinary undergraduate teaching methods in different geographical areas. Study designQualitative study using interviews of university staff and students to identify common themes and differences in teaching veterinary anaesthesia. MethodsAn audit was performed using an audit tool in four veterinary universities (École Nationale Vétérinaire d'Alfort, France; Royal Veterinary College, UK; University of Buenos Aires, Argentina; and Alma mater studiorum - Università di Bologna, Italy). First, an open-question interview of anaesthesia head of service (60–90 minutes) identified the pedagogical strategies in order to conceive a subsequent semi-directive interview formulated as a SWOT analysis (Strength/Weaknesses/Opportunity/Threats). Second, the SWOT reflection was conducted by a second staff member and focussed on: 1) general organization; 2) topics for pre-rotation teaching; 3) teaching methods for clinical rotation; and 4) assessment methods. Qualitative analysis of the interview responses was performed with semi-structured interviews. Finally, the students evaluated their teaching through a students’ questionnaire generated from the output of both interviews. ResultsA group of nine lecturers and 106 students participated in the study at four different sites. Preclinical teaching ranged from 13 to 24 hours (median 15 hours). Clinical teaching ranged from 4 to 80 hours (median 60 hours). Overall, all faculties perceived time as a limitation and attempted to design strategies to achieve the curriculum expectations and optimize teaching using more time-efficient exercises. Large animal anaesthesia teaching was found to be a common area of weakness. Internal feedback was delivered to each university, whereas generalized results were shared globally. ConclusionsThis preliminary study proved the generalizability of the protocol used. Recruiting a larger pool of universities would help to identify and promote efficient teaching strategies and innovations for training competent new graduates in an ever-expanding curriculum.

Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise

BackgroundMedical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction, teaching styles, entry criteria and institutional factors.MethodAggregated data were collected for 50 measures across 29 UK medical schools. Data include institutional history (e.g. rate of production of hospital and GP specialists in the past), curricular influences (e.g. PBL schools, spend per student, staff-student ratio), selection measures (e.g. entry grades), teaching and assessment (e.g. traditional vs PBL, specialty teaching, self-regulated learning), student satisfaction, Foundation selection scores, Foundation satisfaction, postgraduate examination performance and fitness to practise (postgraduate progression, GMC sanctions). Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail.ResultsMedical school differences are stable across time (median alpha = 0.835). The 50 measures were highly correlated, 395 (32.2%) of 1225 correlations being significant with p < 0.05, and 201 (16.4%) reached a Tukey-adjusted criterion of p < 0.0025.Problem-based learning (PBL) schools differ on many measures, including lower performance on postgraduate assessments. While these are in part explained by lower entry grades, a surprising finding is that schools such as PBL schools which reported greater student satisfaction with feedback also showed lower performance at postgraduate examinations.More medical school teaching of psychiatry, surgery and anaesthetics did not result in more specialist trainees. Schools that taught more general practice did have more graduates entering GP training, but those graduates performed less well in MRCGP examinations, the negative correlation resulting from numbers of GP trainees and exam outcomes being affected both by non-traditional teaching and by greater historical production of GPs.Postgraduate exam outcomes were also higher in schools with more self-regulated learning, but lower in larger medical schools.A path model for 29 measures found a complex causal nexus, most measures causing or being caused by other measures. Postgraduate exam performance was influenced by earlier attainment, at entry to Foundation and entry to medical school (the so-called academic backbone), and by self-regulated learning.Foundation measures of satisfaction, including preparedness, had no subsequent influence on outcomes. Fitness to practise issues were more frequent in schools producing more male graduates and more GPs.ConclusionsMedical schools differ in large numbers of ways that are causally interconnected. Differences between schools in postgraduate examination performance, training problems and GMC sanctions have important implications for the quality of patient care and patient safety.

Adaptation and Validation of the Situation Awareness Global Assessment Technique for Nurse Anesthesia Graduate Students

BackgroundEndsley's Situation Awareness Global Assessment Technique (SAGAT) is accepted as a valid and reliable situation awareness (SA) measurement tool in event-driven domains, including health care specialties. This study validated an adapted SAGAT to quantify anesthesia providers' SA in a simulation. MethodUsing exploratory sequential mixed methods, SAGAT items were adapted and validated using qualitative techniques and further validated by quantitative approaches. The study used 2 samples of CRNA, nurse anesthesia educators. ResultsContent analysis of identified and validated SA requirements elicited SAGAT items, with the final item list demonstrating I-CVIs of 0.83 to 1.0 and S-CVI/Ave of 0.92. Conclusion(s)An anesthesia providers' competence is directly related to clinical decision making and thus SA, necessitating the importance of its measurement.

The Future of Anesthesia Education: Developing Frameworks for Perioperative Medicine and Population Health.

The Future of Anesthesia Education: Developing Frameworks for Perioperative Medicine and Population Health.

The operating room as a learning arena: Nurse anaesthetist and student nurse anaesthetist perceptions.

To examine which competencies mentors and student nurse anaesthetists perceive as important in a clinical anaesthesia education practice. Mentoring during clinical placement in the operating room can be challenging from the viewpoint of both a nurse anaesthetist and their students. The operating room is a work environment with many restrictions, and the nurse anaesthetist's work requires prompt decisions and actions. Simultaneously, the mentor is tasked with guiding and supporting the student. A qualitative approach including two focus group interviews was used. The analysis was conducted using systematic text condensation. The COREQ checklist for qualitative studies was applied. The analysis yielded two main categories, including two sub-categories for each. The first, "Mentoring in the operating room," contained sub-categories "Application of knowledge and expectations" and "Mentoring experiences," and the second, "Creating a good climate for learning," contained sub-categories "Impact on mentoring: human factors" and "Impact on mentoring: obstacle factors." The mentor's knowledge of human relationships and learning strategies emerged as an important factor with the potential to influence the students' learning and self-confidence. Another valuable consideration was the ability to give constructive feedback, from the perspective of both. However, production pressure was a negative factor for effective knowledge transition. The ability to give constructive feedback and having an awareness of one's own attitude-which should ideally be positive and inclusive-are crucial mentoring skills. Mutual expectations must be clearly communicated before the clinical placement period, including learning assumptions, a progression plan and learning outcomes. This will facilitate the planning and help to direct the optimal course of learning. This study highlights that an awareness of the student's vulnerability and the mentor's pedagogical competence and learning strategy are crucial factors to take into account.