Clinical Training Fields Research Articles

Collaborative Learning Experiences of Nursing Students in the Clinical Learning Setting: A Qualitative Study

Introduction: Collaborative learning encourages students to work with peers and leads to the development of problem-solving and communication skills, and the transfer of knowledge learned in the classroom to be used in the clinical setting. This study aims to explain the role of collaborative learning experiences of nursing students in the field of clinical training. Methods: In this qualitative study, 20 nursing students who experienced specialist clinical training were selected using object-based sampling. The data were collected using semi-structured and focus group interviews. The interviews were transcribed verbatim and the relevant themes were extracted and categorized using content analysis. Results: The results revealed that group interactions lead to useful experiences in clinical works. It was also shown that collaborative learning affects the clinical success of nursing students. The participants stated that group work in clinical settings is the most important learning experience in the training course. While contributing to learning development, group participation helps the students to deal with the assigned tasks more efficiently and support each other by sharing their knowledge and establishing friendly relations. The themes derived from the data included 1) peer support, 2) clinical reasoning, and 3) group capabilities. Conclusion: Collaborative learning is an important factor in improving clinical work. The results of the present study underlined the weakness of educational programs in terms of collaborative learning. Therefore, educators and education professionals are recommended to support the development of a suitable context for active and collaborative education and learning.

Psychometric properties of the Persian version of the Anesthetic Trainee Theatre Educational Environment Measure (ATEEM).

Background: The quality improvement of medical education programs and the ongoing reform of the curriculum should be done in the light of clinical training fields and identifying the strengths and improving the weaknesses. Therefore, this study was conducted to evaluate the validity and reliability of ATEEM (Anesthetic Trainee Theatre Educational Environment Measure) questionnaire for assessing learning environment of anesthesiology residents in educational centers affiliated to 3 main medical schools in Tehran, Iran. Methods: This study was conducted on first to fourth year anesthesiology residents using a questionnaire. Validity (face, content, construct) and reliability of ATEEM questionnaire was investigated. Construct validity was measured by confirmatory factor analysis, stability of reliability by test-retest, and internal consistency by Cronbach's alpha. Results: A total of 156 questionnaires out of 190 were fully answered, returned by residents of anesthesiology, and analysis were performed (82% response rate; 44.5% male (n=69); 55.5% female (n=86)). The age range of respondents was 26 to 48 years. The mean total ATEEM score was 114.03 out of 160. Face and content validity of the questionnaire was approved. Content validity ratio (CVR) and content validity index (CVI) were 0.63 and 0.88, respectively. Fitness indices in confirmatory factor analysis were greater than 0.9, and RMSEA (root mean square error of approximation) index was less than 0.08 (0.07). This indicator measures the acceptability of fitness and it is an appropriate measurement model. The average reliability coefficient was 0.73 and the overall Cronbach's alpha coefficient was 0.959. Conclusion: The results of this study showed that the Persian version of the ATEEM questionnaire, with appropriate psychometric properties, can be used to evaluate the anesthetic trainee theatre learning environment used in hospitals.

Knowledge on ionizing radiation among non-radiologist clinicians at Kenyatta National Hospital- Kenya.

Background: Low dose ionizing radiation used in diagnostic imaging has the potential to cause detrimental health effects. Knowledge of the requesting clinician on ionizing radiation will deter inappropriate and unjustifiable imaging requests.Objective: To document the knowledge of ionizing radiation (IR) among the teaching hospital non-radiologist clinicians.Design: Cross-sectional survey.Setting: Kenyatta National Hospital (KNH), the largest teaching and referral hospital in Nairobi, Kenya.Subjects: A total of 170 non-radiology hospital clinicians were recruited into the study after ethical approval and informed consent using simple random sampling method over a six-week period in August -October 2013.Results: Health workers with ionizing radiation (IR) training were more likely to correctly identify all the imaging modalities that use IR compared to those without IR training (50.9% versus 27.5%; OR = 2.83, 95% CI 1.35-5.91). There was significant heterogeneity in knowledge across the cadres (p < 0.0001). Those with formal IR training were able to identify that an abdominal CT has the highest radiation dose compared to those with no formal training (69.8% vs 37.1% p= < 0.001). Length of professional experience, field of clinical training, and formal training in IR of the clinicians had no influence on their knowledge of IR doses. With respect to organ sensitivity only 42% of participants correctly rated bone marrow as a very sensitive organ.Conclusions: The results from this study show that health workers lack the basic knowledge on ionizing radiation doses and its harmful effects. This is likely to impact negatively on their attitude and practice. The implications here are serious for the patient as they are possibly being exposed to unnecessary radiation and its attendant risks which include carcinogenesis.Recommendations: To bridge this knowledge gap, there is need to increase awareness about ionizing radiation through continuous medical education,development of imaging referral guidelines and incorporating modules on medical radiation and its risks during the clinicians’ training programs.

Haptics-equiped interactive PCI simulation for patient-specific surgery training and rehearsing

Despite the long history of medical simulations, suffering from the patient-specific heterogeneous heart physiological structure and complex intravascular procedures, it is still challenging for patient-specific percutaneous coronary intervention (PCI) surgery simulation. In this paper, we advocate a haptics-equiped interactive prototype system towards PCI surgeons training and patient-specific surgery rehearsing, which can afford trainees the opportunity to approximately experience the entire PCI procedures and customized emergency cases that might occur in common clinical settings. The full simulation covers tissue deformation, catheter and wire simulation, X-ray simulation, haptic feedback, and 3D realistic rendering, which in all give rise to the integrated physical, visual, haptic, and procedural realism. Our system can accommodate various comprehensive operations involved in PCI-related procedures, including feeding wires, releasing stents, injecting contrast medium, simulating X-ray, bleeding, etc. Moreover, our system framework is fully built upon CUDA, and thus can achieve real-time performance even on a common desktop. The high-fidelity, real-time efficiency and stableness of our system show great potentials for its practical applications in clinical training fields.

Appreciative clinical training.

This article presents a training model that has been used for 4 years in a graduate program in clinical psychology. The specific goal of the training model is to encourage beginning supervisors to identify their character strengths, refocus their attention and memory on the origin of these strengths, and cultivate their character strengths in the service of the supervision relationship. The most common character strengths of a group of clinical psychology graduate students are explored and compared with the general population, because an understanding of the strengths of your students has implications for education and training. Qualitative data are also presented that reveals the following themes: the power of focusing on one's strengths, the value of a strength-based approach, the complexity of strength-based work, and the notion of strengths born from challenge. The purpose of this article is to present a model of supervision training that enhances effective supervision and encourages the use of character strengths in the service of the supervision relationship. Appreciative clinical training values affirm and highlight strengths in supervision relationships. The intention of appreciative clinical training is to facilitate the cultivation of strengths through a refo- cusing of attention and memory using assessment, reflective dia- logue, and appreciative inquiry. Refocusing of attention and mem- ory are key ingredients of positive interventions (Rashid, 2009), and in this model the shift is from a deficit-based to a strength- based focus of clinical inquiry or intervention. Appreciative clinical training is informed by the principles of Appreciate Inquiry (AI) (Cooperrider & Srivastva, 2000; Cooper- rider & Whitney, 1999; Whitney & Trosten-Bloom, 2010), insofar as it is an inquiry into supervision at its best, and suggests that if you want to transform a situation or a relationship, focusing on strengths is often more effective than focusing on problems. Ap- preciative clinical training questions what you want more of in your supervision relationships and assumes that you will move in the direction of the questions you ask. We use strength-based questions as the focus of our inquiry—for example, When therapy or supervision is going really well, which of your strengths shine through? What creates nourishing, connected, and focused therapy and supervision relationships? What facilitates independence and self-sufficiency in your clinical relationship?—in contrast to a deficit-based focus of clinical inquiry, for example, What is the problem you are having with your client? Where are you stuck? Can you tell me what is giving you the most trouble in this case? Strength-based approaches to supervision are a growing part of the field of clinical training. Falender and Shafranske (2004) note that one half of a professional psychologist's formal training comes in the form of supervision and propose a competency-based approach to enhance the skills of the supervisor and supervisee. Empirical evidence suggests that the use of strengths helps make progress toward goals and increases relationship proficiency (Lin- ley, Nielsen, Gillett, & Biswas-Diener, 2010), both of which are core competencies in the supervision relationship. In a study of law school students, Peterson and Peterson (2009) found that the use of one's top strengths leads to a decrease in depression and an increase in work-related satisfaction. Sheldon and Lyubomirsky (2006) found that visualizing one's best possible self leads to an

Outcome analysis of accreditacion processes for chilean nursing programs

The National Undergraduate Accreditation Commission has been taking care of the accreditation process in several Nursing Schools, whose results are analyzed in this article, given the limited evidence of strengths and weaknesses. The objective is to analyze the first results obtained by that commission about the current development of Nursing in the country. The strengths obtained are: experience, qualification, commitment of teaching staff; well-defined study programs; adequate clinical training fields and infrastructure. Weaknesses are: reduced number of teachers; a curricular approach emphasizing biomedicine over nursing, low use of participative teaching methods; increasing difficulty to access exclusive clinical areas, and insufficient bibliographic resources. Conclusion: It is urgent that all Nursing Schools submit to universal criteria and standards, establishing minimum graduation levels for students, as well as the real state of the quality of nursing education in the country.

Einschätzung der Strahlenbelastung radiologischer Thorax-Verfahren: Was ist Nichtradiologen bekannt?

Assessment of the knowledge of non-radiological physicians concerning radiation exposure during radiological procedures on the thorax. 124 non-radiological physicians from the departments of surgery, internal medicine, anesthesiology, and neurology at a university hospital were questioned during a four-week period using a standardized questionnaire as to the effective dose (ED) of different radiological procedures on the thorax. The interviewees were asked to estimate the ED of chest X-rays and CT examinations and to compare these with the ED of other radiological methods. Length of professional experience, field of clinical training, and hierarchical position were also documented. The T-test and chi-square test were used for statistical analysis. 119/124 (96.0 %) physicians with an average work experience of 8.2 years (0.3-32 years) were willing to participate. 47/119 (39.5 %) correctly estimated the ED of conventional chest X-ray (0.01-0.1 mSv), and 40/119 (33.6 %) correctly gauged the ED of adult chest CT (1-10 mSv). The ED of cardiac CT and pediatric chest CT without dose reduction (10-100 mSv) were correctly judged by 31/119 (26.1 %) and 32/119 (26.9 %), respectively. The correct ratio of the ED of chest X-ray to that of chest CT (factor 100-1000) was given by 28/119 (23.5 %), while 86/119 (72.3 %) underestimated the ratio. 50/119 (42.0 %) and 35/119 (29.4 %) correctly stated that the ED of pediatric chest CT without dose reduction and that of cardiac CT are greater than that of adult chest CT. 24/119 (20.2 %) and 10/119 (8.4 %) thought that the ED of low-dose chest CT is smaller than that of chest X-ray or chest MRI, respectively. The length of professional experience, field of clinical training, and hierarchical position of the participants did not have a significant influence on the test results. Correct estimation of the ED of radiological chest examinations, especially that of CT examinations with a high ED, poses substantial difficulties for non-radiologists regardless of the length of professional experience and field of clinical training. In light of the increase in ordered radiological exams, targeted adaptation of medical school teaching content and promotion of pertinent continuing radiological education seem pressing.