Final-year Education Research Articles

Career Choices and Decisions of Final-Year Education Students at the Rundu Campus of the University of Namibia

Career Choices and Decisions of Final-Year Education Students at the Rundu Campus of the University of Namibia

The RAST-NP Pilot: Preparing New Graduate Nurse Practitioners for Emergent Procedures in Remote Settings Using a Novel Training Program.

With more new graduate primary care nurse practitioners (NPs) practicing in remote locales than ever before, their preparation for performing emergency procedural skills (EPSs) is critical for safe and effective care. Emergency procedural skills are not uniformly taught in primary care academic programs but are easily imparted via additional training and practice. The purpose of this project was to develop and pilot an expert panel-validated training program specifically for NPs bound for remote practice and to evaluate how the participants rated their self-efficacy in performing specific EPSs before and after completing the training, called the Remote Advanced Skills Training for NPs (RAST-NP). A diverse expert panel rated EPSs to determine skills to be included in a pilot training program. After achieving consensus on skills to be taught, a hybrid online-in-person curriculum was developed using standards from the International Nursing Association for Clinical Simulation and Learning. This training was conducted for more than 2 days and delivered to a class of 15 primary care NP students in their final year of education. All participants completed a pre- and postparticipation survey to assess their self-efficacy using a validated questionnaire, modified to address the EPSs taught. The participants reported higher confidence following training on all EPSs taught, as indicated by an increase in difference in mean scores from 1 to 6.15 on an 11-point scale. For each EPS, the difference was statistically significant by both a paired t test and a Whitney-Mann U test with probability of 0.01 or less. Results indicate that the methods utilized (i.e., psychomotor practice) increased confidence in NP students, and they also suggest that the amount of time spent practicing skills is associated with interval increases in confidence. A combination of didactic and psychomotor methods was uniformly effective at increasing confidence, and thereby self-efficacy, and higher success is associated with more time practicing the kinesthetic skills in situ.

Swedish dental students’ clinical notes and reflections as part of a case-based examination – challenges for undergraduate education

Clinical records are the basis for clinical reasoning, diagnostics, treatment planning, and management as well as for management of the patient and the outcome of the treatment, and therefore an important aspect of health professionals’ work. Several articles emphasize the importance of adequate and correct content in these records. Previous research shows that even health professionals need to improve the content and structure of their clinical records, for them to give the information needed for various needs. The focus of this article are the clinical records of undergraduate dental students. The aim of the study was to explore patterns of adequate and inadequate content in clinical notes of undergraduate dental students in their final year of education. Secondly, whether these results could provide insights for development of health professions education. Data comprised of 33 cased-based examinations collected during January 2020 at the University Dental Clinic, Department of Dental Medicine, Karolinska Institutet, in Huddinge Sweden. Also, data included teachers’ assessment of these examinations. The texts were analyzed with thematic analysis. Analytical results showed three themes. The first theme, (i) Professional content knowledge, concerned information in patient history, status, diagnostics and treatment plan, and an information ambiguity. The theme also included the students' use of professional terminology and the choice of articles to support reflections. The second theme (ii) incomplete method of investigation involved the actual patient interview, but also students’ various misunderstandings of the template. The third theme was (iii) Academic formalities. This theme concerned students' understanding of the purpose of referencing and its function, but also a non-use of references, the use of irrelevant references, errors in the given citation style, and an incorrect structure of the text according to the template. In conclusion, results showed the need for continuous training in clinical note-taking and reflections during dental students' professional education. In this training, teachers’ assessment is important for students' development of professional literacy and professional judgment. Also, a continuous reminder of science and proven experience as the basis for the profession which is also made visible through academic formalities.

Skin barrier function in nursing apprentices during the coronavirus disease 2019 (COVID-19) pandemic.

BackgroundStudies investigating simultaneous influence of personal and work‐related factors on skin health during the coronavirus disease 2019 (COVID‐19) pandemic are missing.ObjectivesTo investigate the associations of skin hazards relevant for nursing apprentices with parameters of skin barrier function.MethodsA total of 238 nursing apprentices attending the final year of education (median age 19 years) from vocational schools in Zagreb, Croatia, were enrolled in this study. We administered a questionnaire based on the Nordic Occupational Skin Questionnaire to the nursing apprentices, performed clinical examination of skin on the hands, and evaluated transepidermal water loss (TEWL) and stratum corneum (SC) pH on the dorsum of the hand.ResultsAround half of nursing apprentices had compromised hand skin barrier function, as indicated by TEWL values >25 g/m2/h (48%) and SC pH >5.5 (57%). Skin barrier was compromised in around 40% of nursing apprentices without clinically observed skin symptoms. Elevated SC pH was independent of ambient conditions associated with skin symptoms and female sex.ConclusionsMeasurement of SC pH was shown to be less sensitive to field conditions than TEWL, and should be employed more in the field studies. Strengthening of skin health promotion in healthcare workers and apprentices is needed in pandemic conditions.

Exploring the pre-service teacher mentoring context: The construction of self-regulated professionalism short courses

During work integrated learning (WIL), pre-service mentoring helps prepare final-year education students for the workplace. The pre-service teacher is placed alongside a mentor teacher, and the higher education institution (HEI) stipulates the timeline and the requirements. This study follows a wide-ranging research project, identified by the acronym FIRE (Fourth-year Initiative for Research in Education). In this article we focus on pre-service teacher mentoring experiences, partnerships, roles, and teacher identity development concerning mentor teachers, not mentor lecturers. The results of 2 baseline exploratory research surveys are shared. The attitudes, beliefs, opinions and practices of Senior, Further Education and Training phase mentor teachers and pre-service teachers were gathered, measured and compared. The responses to 2 cross-sectional questionnaires in electronic format provided a competence-base for the design of curricula for 2 short courses about mentoring and self-regulated professionalism. The 2 short courses were created for mentor teachers and pre-service teachers.

Comparing Nursing Student Competence in CPR before and after a Pedagogical Intervention.

Nursing students must be able to initiate and perform effective cardiopulmonary resuscitation (CPR) when they start their career in nursing. Studies show that students' competency in CPR is deficient, indicating that better training is necessary during nursing education. This study reports on the differences in nursing students' competence in CPR before and after a longitudinal pedagogical intervention across the curriculum. Changes in the curriculum were relocation and added testing of CPR skills, inclusion of a course in defibrillation, a knowledge test as stimuli before simulation, and more simulation practice with deteriorating patients. This was a comparative study between two cohorts of students in the bachelor in nursing education. We measured knowledge and compression performance in the students' final year of education. Students in cohort 2, who received the pedagogical intervention, had a significant higher total knowledge score than students in cohort 1. Students' mean depth and number of correct compressions was similar. Students in cohort 2 had a significantly higher mean rate of compressions, number of compressions per minute, and mean number of compressions with incorrect hand positions. Although the new curriculum afforded more hands-on practice of CPR, it was not enough to improve the students' performance to match the demands set out in national and international guidelines.

Sleep as a topic in nursing education programs? A mixed method study of syllabuses and nursing students' perceptions

BackgroundSleep is a basic human need and is considered important for maintaining health. It is even more important during illness due to its impact for example on our immune system. Nurses have an important role in identifying sleep deprivation. They are also in a unique position to promote and address sleep among patients. However, it is essential that they are provided with the appropriate knowledge during training. AimTo explore and describe nursing students' perceptions of preparedness to adress and support patients' sleep during hospitalization and to apply sleep-promoting interventions in a clinical context. Furthermore, the aim was to investigate if, and how, the topic of sleep is explicitly incorporated in nursing education programs. DesignA descriptive study based on a mixed method approach. MethodsQuantitative and qualitative data were collected from program and course syllabuses and intended learning outcomes from three universities. Twenty-one nursing students from the same universities were interviewed during their final year of education. ResultsThe results of both quantitative and qualitative data consistently show that education regarding sleep and patients' sleep is limited and, in some respects, absent in the Bachelor of Science Nursing programs investigated. ConclusionThis study indicates that education about sleep and patients' sleep in the nursing programs studied is insufficient and limited. This gap in knowledge may lead to prospective registered nurses using their own experiences instead of evidence-based knowledge when assessing, supporting and applying sleep-promoting interventions.

Procena propisivanja - da li su studenti poslednje godine medicine kompetentni da racionalno propisuju antibiotike?

Introduction: The rational use of drugs, especially antibiotics, has been recognized as a serious problem worldwide. Aim: The purpose of this study was to evaluate the practical skills of Bulgarian medical students in their final year of education to prescribe antibiotics rationally as well as the impact of a training focused specifically on avoiding prescription errors. Materials/Methods: Medical students from the Medical University of Sofia in their 10th semester of education from two consecutive teaching cycles took part in this study. The students' participation was completely voluntary. The study was performed as academic study after having obtained a positive opinion from the Local Ethics Committee of the University Hospital 'Tsaritsa Joanna-ISUL', Medical University of Sofi a. The study was planned to be conducted in two separate parts: a pilot study aimed at receiving basic information about the self-assessment confidence of the medical students in prescribing drugs and especially antibiotics rationally and comparing this to their actual prescribing competence and a subsequent pivotal study after having performed a thorough analysis of the results of the pilot study with implementation of the respective corrective measures. The students' perception of their theoretical knowledge and practical skills to prescribe drugs and especially antibiotics rationally was assessed by means of a questionnaire containing 5 questions whereas their level of antibiotic prescribing competence was assessed by means of solving three simulated patient cases. The appropriateness of written therapeutic prescriptions was assessed independently by two clinical pharmacologists using a three-grade assessment scale: 'good', 'satisfactory' and 'unsatisfactory'. Results: The results of the pilot study showed that 50.35% of the prescriptions were rated as 'good', 21.64% as 'satisfactory' and 28.01% as 'unsatisfactory'. The results obtained from the subsequent pivotal study showed that 60.97% of the prescriptions were rated as 'good' (representing a 21.1% increase), 16.23% as 'satisfactory' (representing a 25% decrease) and 22.80% as 'unsatisfactory' (representing an 18.6% decrease). This was accompanied by an increase in the students' self-assessment confidence rated as 'good' - from 19.15% to 34.21%, while 'satisfactory' and 'unsatisfactory' ratings decreased - from 65.96% to 55.26% and from 14.89% to 10.53%, respectively. Conclusions: Medical students from the Medical University of Sofi a showed a level of competence to prescribe antibiotics rationally commensurable with the level report ed by foreign medical universities. Regardless of the observed discrepancy between the self-assessment rating and the practical antibiotic prescribing skills it was clearly shown that education specifically focused on prescription errors may contribute to the improvement of the students' antibiotic prescribing competence.

Academic boredom and the perceived course experiences of final year Education Studies students at university

This work explores the relationships between academic boredom and the perceived course experiences of 179 final-year Education Studies students attending a single university in England. Adopting a mixed-methods design, with data collection employing a combination of questionnaires and individual research interviews, findings suggest that all participants exhibited some measurable disposition towards academic boredom, with traditional lectures and work leading to the completion of assignments the main sites and triggers for the actual onset of academic boredom itself. Amid overwhelmingly encouraging responses from course expectations to course demands, reflecting the successful promotion of deep ways of working, as well as a clear sense of satisfaction with their teaching and learning environment overall, cluster analysis reveals the presence of five structurally related groups of students with profiles which help identify those typically more engaged and effective learners from others. Path analysis reveals a series of complex inter-connections, with academic boredom emerging as a strong predictor of surface approaches and organised effort as well as contributing indirectly towards degree outcome as a whole. The implications for boredom mitigation are considered.

Teaching Radiology to Medical Students—There Is a Need for Change to Better Prepare Students for Clinical Practice

Deriving maximum benefit from radiology rotations in medical schools is challenging. Lack of education on appropriate imaging renders students feeling unprepared. This study compares the ability of undergraduate medical students to identify appropriate radiological investigations, both at the beginning and end of their final year of education, to those of residents in their first year of clinical practice. Twelve scenarios were extracted from the American College of Radiology's Appropriateness Criteria (ACR-AC) and a questionnaire was generated. One topic was selected from each of the 10 sections in the diagnostic section and two from the interventional section. The questionnaire was distributed to three groups. Group A was composed of medical students at the beginning of final year. Group B was composed of medical students at the end of final year. Group C was composed of residents at the end of their first year of clinical practice. Radiology residents were surveyed to assess familiarity with the ACR-AC among trainees in Ireland. The total cohort included 160 participants. Group C (n = 35) performed significantly better than group A (n = 72) and group B (n = 53). There was no statistical difference in the mean scores achieved by group A and group B. Sixteen (73%) of 22 radiology trainees were familiar with the ACR-AC. A minimal improvement in the knowledge of medical students in requesting radiological investigations over the course of the final medical year, yet a significant impact of a relatively short period of "on-the-job" learning in the clinical setting, was indicated. Emphasis on education on appropriateness may offer an improvement in the utilization of radiology services and improve patient care.

Troubling the Blurred Boundaries of Online Professionalism

Recently, professional associations have issued new guidelines that apprehensively embrace the use of social media encouraging their members to use the medium ‘appropriately'. In the academic literature, a discussion has been taking place around ‘online professionalism' or ‘e-professionalism' with some in professional education beginning to ponder about how to facilitate the development of this extended form of professionalism. Within both of these discourses, the trope of boundary blurring is often invoked as an indication of the challenging potentials of social media to the professions and professional education. However, little regard is given to what these boundaries are and how they are formed. In this short paper reporting on research in progress, I seek not to blur the boundaries but to trouble them - to bring them more in focus and to treat them as an assemblage through an ANT analysis for the purpose of informing how we educate for professionalism. Theoretical approach: Employing an Actor Network Theory sensibility, this research reconceptualises boundaries as networks - heterogeneous assemblage of bodies, devices, technologies, algorithms, standards, representations etc. Thus, materials move from factors in boundary practices to actors constructing the boundaries in a process of generative materiality. As they are networks, boundaries are being made and re-made as the relations are constantly being performed (Latour, 2005). Moreover, networks are not inherently consistent. Parts of the network may be in conflict creating fissures and tensions. Applying this to boundaries, therefore, would allow for an analysis that explores, as Law (1992) has put it, "the precarious mechanics of organisation" (p. 389). It will inquire about what is invited and what is excluded in the boundary practices of online professionalism as well as tracing specific ways things are enacted - what enables or constrains these enactments. It will also explore what effects these assemblages produce. Methodology: The research will focus on two groups of pre-professional students in their final year of education, one from social work and the other from nursing. It will follow a three stage design. The initial stage is an individual interview where vignettes are employed to stimulate reflection on online professionalism and to draw out the boundaries of concern. The second stage is a group interview where participants discuss digital artefacts that may surprise or push boundaries. The last stage involves individual participants tracing their digital footprint with the research investigating the materialities that assemble into their notion of online professionalism.

Medical students are afraid to include abortion in their future practices: in-depth interviews in Maharastra, India.

BackgroundUnsafe abortions are estimated to cause eight per-cent of maternal mortality in India. Lack of providers, especially in rural areas, is one reason unsafe abortions take place despite decades of legal abortion. Education and training in reproductive health services has been shown to influence attitudes and increase chances that medical students will provide abortion care services in their future practice. To further explore previous findings about poor attitudes toward abortion among medical students in Maharastra, India, we conducted in-depth interviews with medical students in their final year of education.MethodWe used a qualitative design conducting in-depth interviews with twenty-three medical students in Maharastra applying a topic guide. Data was organized using thematic analysis with an inductive approach.ResultsThe participants described a fear to provide abortion in their future practice. They lacked understanding of the law and confused the legal regulation of abortion with the law governing gender biased sex selection, and concluded that abortion is illegal in Maharastra. The interviewed medical students’ attitudes were supported by their experiences and perceptions from the clinical setting as well as traditions and norms in society. Medical abortion using mifepristone and misoprostol was believed to be unsafe and prohibited in Maharastra. The students perceived that nurse-midwives were knowledgeable in Sexual and Reproductive Health and many found that they could be trained to perform abortions in the future.ConclusionsTo increase chances that medical students in Maharastra will perform abortion care services in their future practice, it is important to strengthen their confidence and knowledge through improved medical education including value clarification and clinical training.

Perceived stress at transition to workplace: a qualitative interview study exploring final-year medical students' needs.

ObjectivesThis study was designed to explore final-year medical students’ stressors and coping strategies at the transition to the clinical workplace.MethodsIn this qualitative study, semi-standardized interviews with eight final-year medical students (five male, three female; aged 25.9±1.4 years) were conducted during their internal medicine rotation. After verbatim transcription, a qualitative content analysis of students’ impressions of stress provoking and easing factors during final-year education was performed.ResultsStudents’ statements regarding burdens and dealing with stress were classified into four main categories: A) perceived stressors and provoking factors, B) stress-induced consequences, C) personal and external resources for preventing and dealing with stress, and D) final-year students’ suggestions for workplace improvement.ConclusionFinal-year medical students perceived different types of stress during their transition to medical wards, and reported both negative consequences and coping resources concerning perceived stress. As supervision, feedback, and coping strategies played an important role in the students’ perception of stress, final-year medical education curricula development should focus on these specifically.

Perceptions of final-year nursing students on the facilities, resources and quality of education provided by schools in Turkey

The purpose of this study is to determine the perceptions of final-year nursing students regarding the adequacy of education, resources and internships in preparation for graduation. The study design was a descriptive cross-sectional study of nursing students (n: 1804) in their final year of education and questionnaires were used to collect data. Information related to student-to-instructor ratios and internships was obtained from each institution. Most students reported receiving instruction or supervision by lecturers and clinicians who did not specialise in the field. Overall, students did not find the facilities, educational or technological resources and the quality of education offered by their respective schools adequate. The proportion of students who found the level of theoretical education, clinical practice and instructor support adequate was higher in state university colleges of nursing/faculties of health sciences than in state university schools of health sciences.

A solid grounding: prescribing skills training.

Prescribing is an error-prone process for all doctors, from those who are newly qualified through to those at consultant level. Newly qualified doctors write the majority of in-patient prescriptions and therefore represent an opportunity for safety improvement. Attention to prescribing as a patient-safety issue and potential educational interventions to help improve the situation have been published, but offer little to inform educators why and how any interventions may succeed. In order to identify areas of good practice, and to provide evidence of areas requiring further investigation and innovation, we aimed to ascertain the full range of prescribing practices for final-year medical students and newly qualified doctors across a large geopolitical region of the UK. A questionnaire methodology was used. One questionnaire was sent to those responsible for final-year education, and a further, different questionnaire was sent to those responsible for the training of newly qualified doctors, asking about prescribing education in their locality. Questionnaires were sent to 15 hospitals in total. Prescribing is an error-prone process for all doctors Twelve hospitals contributed to final-year medical student data: a response rate of 80 per cent. A variety of methods, including student assistantship, pharmacist-led skills sessions and practical assessment, were offered to varying degrees. Free-text responses identified opportunities for different prescribing education and support. All 15 hospitals provided data on doctors' education, with interventions including e-learning, assessment and support from ward-based pharmacists. Current education focuses on the technical and knowledge-based paradigm of prescribing. Human factors and the impact of electronic prescribing should play a part in future developments in prescribing education.

The impact of integrated team care taught using a live NHS contract on the educational experience of final year dental students.

To investigate the responses of the dental student body in the first three years of outreach education (2010-13) at the University of Portsmouth Dental Academy in the areas of integrated team work and use of a current NHS contact. Use of a questionnaire to allow both quantitative and qualitative data to be obtained, administered to the three cohorts of students at the end of their longitudinal attendance at the Academy in their final year of education at King's College London Dental Institute. Data were obtained from 227 students which represented a 95% return rate. Sixty-four percent of students strongly agreed with both statements: 'I am confident with working with a dental nurse' and 'I now understand properly the scope of practice of dental hygiene-therapists'. Sixty-seven percent strongly agreed with the statement 'I have had useful experience of working in NHS primary care during the final year'. Eighty percent either strongly agreed or agreed with the statement 'My experience of real Units of Dental Activity and Key Performance Indicators has encouraged me to positively consider NHS high street dentistry as a career option'. Within the limitations of this study the dental students reported having gained useful experience of working in integrated team care dentistry. They expressed strong support for the education that is being delivered in an outreach environment and, most importantly, the student body was looking forward to entering general dental practice in the UK.

Outclassed?: Undergraduates’ Perceptions of the Competition for Primary Teaching Jobs in England and Wales

This paper presents the results of a mixed-methods investigation into undergraduates’ perceptions of the competition for Newly Qualified Teacher positions within the primary sector in England and Wales. The study sample was a cohort of final-year Education Studies undergraduates at a post-1992 university in Wales. All of the participants aimed to become primary school teachers. The study's rationale lies in evidence that teaching is becoming more competitive while offering less security. The study revealed that the students had a realistic view of the labour market for NQT positions, showing awareness of the increasing demands placed upon the cultural, social and material resources of potential entrants. Although this knowledge did not deter the students, it is concluded that developments within teaching may ultimately deter working-class students. This has worrying implications for the composition of the teaching profession and, in turn, for wider issues of social justice within education.

Factors affecting burnout and work engagement in teachers when entering employment

When entering employment many beginning teachers experience a reality shock and a crisis of competence. These two factors, in combination with high levels of job demands and low levels of job resources, may lead to the development of burnout. The purpose of the study was to investigate how individual characteristics, the educational context, and the work context predicted levels of burnout and work engagement during this transition period. The sample consisted of 1290 beginning teachers from Sweden. Data were collected using surveys during the final year of education and during the initial period of employment. Data were analyzed using hierarchical regression. Job demands, job resources, and spillover between private life and work accounted for the largest amount of explained variance in both burnout and work engagement. Job demands were more strongly related to burnout, whereas job resources more strongly related to work engagement. The predictors with the greatest relative influence on both burnout and work engagement were unmet expectations and mastery of skills. The results support the importance of the work context's impact on burnout and work engagement. Additionally, the interaction between private life and work should be further studied in future studies.

Early-career burnout among new graduate nurses: A prospective observational study of intra-individual change trajectories

BackgroundNewly qualified and inexperienced nurses are at particular risk of suffering emotional exhaustion and burnout in unsupportive practice environments. Despite new nurses’ potential vulnerability, development of burnout after graduation has rarely been studied longitudinally and in relation to demographic and educational characteristics prior to working life entry, i.e. during education. ObjectivesTo identify and compare typical change trajectories (i.e. common patterns of intra-individual development) in burnout symptoms for new graduate nurses annually over a three-year period, during which there was reason to believe that this group was especially vulnerable. DesignA prospective longitudinal and national cohort of 1153 nurses within the population-based LANE study (Longitudinal Analyses of Nursing Education), where new graduate nurses were assessed four times annually, i.e. in their final year of nursing education and three times post graduation (after 1, 2 and 3 years). ParticipantsA longitudinal sample of 997 respondents was prospectively followed. MethodsWithin-group changes in burnout levels were analysed using a repeated-measures analysis of variance, and cluster analytic techniques were used to identify typical trajectories of burnout. ResultsAt group level, mean levels of burnout were rather stable across time. However, underlying these levels we identified eight change trajectories, explaining 74% of all individual variation; seven of them reflected significant changes across time. Almost every fifth nurse reported extremely high levels of burnout at some point during their first three years after graduation. Changes in burnout levels were accompanied by concurrent changes in depressive symptoms and intention to leave the profession. This study also showed that negative development of burnout was predicted by not feeling well prepared for a nursing job, lacking study interest, high levels of performance-based self-esteem and depressive mood in the final year of education. ConclusionsAn investigation of burnout symptoms over time disclosed numerous development patterns, some of which were stable while others changed significantly. Hence, this study gave a more nuanced picture of burnout development among new graduate nurses, highlighted by eight different trajectories. Regarding the time frame, nearly every second new graduate showed a significant increase in levels of burnout during their second year post graduation.

The prospective English language teacher's reflections of self efficacy

According to research based on teacher efficacy, experiences during student teaching influence the development of teacher efficacy mastery and that the student teacher's mentor and cooperating teachers’ role in their supervision also have a significant role in the development of their efficacy. The present study assessed teacher self-efficacy beliefs and the influences of the mentors and participating classroom teachers on their self efficacy among 67 undergraduate students in the final year of education in an English language teaching department at a faculty of education in Turkey.The study addressed the following two questions: 1-Do the students feel that they are prepared to enter the teaching workforce in terms of efficacy? And 2- What are the major mentor feedback factors influencing and hindering the students’ sense of self efficacy? These overarching questions framed the present research and provided an insight into the student teachers reflections of their teacher self-efficacy and the importance of their mentors and cooperating.