Hospital Placements Research Articles

Student nurses' learning of practical skills in hospital placements: Perspectives of registered nurse mentors.

To gain insights into the perspectives of registered nurse mentors on the practical skill learning of second-year student nurses during hospital placement by examining the mentors' experiences and expectations. Clinical placement is a cornerstone of bachelor nursing programmes. It is a vital platform for students to transfer, apply, and enhance practical nursing skills learned. During clinical placement, registered nurse mentors play a crucial supervisory role in student nurses' practical skill learning. However, a gap exists in understanding the mentors' perspectives on practical skill learning during placements in hospital environments. We used a qualitative, exploratory, and descriptive research design. Ten registered nurse mentors responsible for student supervision at two hospitals in southern Norway were included. Ten individual interviews were conducted. Ten interviews were audio-recorded and transcribed. A systematic text condensation analysis was performed. The following four categories were identified: 'experiences vs. expectations in practical skill knowledge', experiences vs. expectations of engagement', 'experiences of attitudes' and 'experiences and expectations of emotions'. This study deepened our understanding of issues concerning student nurses' practical skill learning during clinical placement from the perspective of registered nurse mentors. The results emphasise the complexity of learning practical skills and are associated with categories including knowledge, attitudes, engagement, and emotions. These results underscore the multifaceted nature of practical skill learning and highlight the need for comprehensive strategies to effectively address these areas in nursing education, setting the stage for future investigations and potential policy changes in this domain. Registered nurse mentors' perspectives towards student nurses' practical skills.

Transforming field education in social work: A special issue on field education

Welcome to this special issue of Transformative Social Work, dedicated to social work field education. As we navigate a rapidly changing world, the need for dynamic and impactful field education has never been more crucial. This special issue brings together a diverse range of perspectives and innovative approaches, highlighting how field education can be transformative in both practice and theory. In this collection of thought-provoking articles, we explore the latest research and new practices that are reshaping the way social work students, field educators, and practitioners engage with the field. Articles include discussions on Indigenous field education, developmental and green social work approaches, and field models such as macro placements, self-directed placements, and rotational hospital placements. We also feature the experiences of practicum students during the COVID-19 pandemic and examine what motivates field instructors to engage in field education. As we look to the future, the aspirations and commitments articulated by our contributors in this special issue offer a hopeful vision. The articles in this issue illuminate the adaptability of social work students, field educators, researchers, and practitioners, particularly in the face of unprecedented global disruptions such as the COVID-19 pandemic. The innovations not only address current challenges but also lay the groundwork for more dynamic and responsive field education programs. There is a collective resolve to integrate lessons learned, foster interdisciplinary collaboration, and uphold the principles of social justice that underpin our profession. By doing so, we can ensure that social work field education continues to evolve in ways that are inclusive, effective, and aligned with the needs of our diverse communities. We invite you to explore these contributions, reflect on their insights, and consider how they might inspire and inform your own practice in field education.

The role of medical students in junior doctors’ strikes: A cross-sectional online survey

Objectives The British Medical Association announced a successful vote towards industrial action to achieve ‘pay restoration’ on 20 February 2023; with 11 walkout periods occurring in the following months. During industrial action, concerns arose about the role medical students would play and the pressure placed upon them to ‘act up’. The objective of this study was to assess the guidance issued by medical schools and local placement sites during industrial action. Design, setting and participants This cross-sectional study collected online survey data between 7 March 2023 and 7 April 2023 from medical students across England. Main outcome measures Reports about guidance issued by medical schools and hospital placements. Results 62% of the medical schools issued guidance stating they were not cancelling clinical placements; of these, 10% said attendance was a personal choice. 17% of medical schools cancelled all clinical placements and 7% did not issue guidance. 52% of medical schools monitored attendance on strike days. 1 medical school and 3 clinical placement sites advertised paid work for students during the industrial action. Conclusion The impact industrial action has on medical students has not been examined. Our results show mixed guidance from medical schools that can contradict local placement guidance. This lack of guidance is mirrored in the existing, yet limited, literature. If students feel pressured to perform tasks outside their remit, with inadequate supervision, it can impact patient safety and their license to practice. For the safeguarding of patients, and students, further work is needed to produce standardised guidance during industrial action.

A qualitative study exploring how undergraduate pharmacy students undertake a drug allergy history

Abstract Introduction If antimicrobial resistance (AMR) is not controlled, a post-antibiotic era could result in common infections and minor injuries becoming fatal. One way to combat AMR is the ‘de-labelling’ or removal of incorrect antibiotic allergy labels. At least 92% of labels corresponding to penicillin allergy are incorrect when tested.[1] This means that patients may not be receiving the correct antibiotic treatment and take longer to recover. Therefore, taking an accurate allergy history is important. Pharmacists routinely take drug allergy histories. From 2026, pharmacy students in England will graduate as prescribers, highlighting the importance of drug allergy knowledge and skills. Aim To explore how undergraduate pharmacy students undertake a drug allergy history. Methods A qualitative study utilising a constructivist approach involving a low-fidelity simulation followed by a one-to-one face-to-face semi-structured interview was conducted. Final year undergraduate Master of Pharmacy students of an English school of pharmacy were recruited via email and word-of-mouth to take part in this study. Following informed consent, participants simulated taking a drug allergy history with a student researcher. The simulation was audio-recorded and then played back to the participant as a cue for a subsequent audio-recorded semi-structured interview that explored their thought-process when taking a drug allergy history. All audio-recordings were transcribed verbatim. Transcripts were analysed using reflexive thematic analysis.[2] Results Nine participants took part in the study. The simulation and interview lasted seven minutes on average. Four themes were generated through the analysis. Theme 1: taking drug allergy history is learnt mainly through practice-based learning. Theme 2: nature, type and severity of allergic reactions information were deemed important for making clinical judgements. Theme 3: skills for taking drug allergy history are underdeveloped despite having knowledge. Theme 4: real patient contact exposure is needed to translate learning into practice. Most participants remembered learning about taking drug allergy history through practice-based learning sessions such as workshops, objective structured clinical examinations (OSCEs) and hospital placements. Participants seemed to follow a set of ‘rules’ when undertaking the simulation. For example, they stopped asking questions about allergies and decide not to dispense penicillin when they were informed that the patient was allergic to penicillin. Most participants recognised the risk of serious harm to patients if they made a mistake about patient allergies, and the need to have more real-world experiences to help translate their learning into practice. Conclusion Pharmacy students appeared to have the theoretical knowledge about drug allergies, but they were not yet able to make an appropriate clinical judgement in real-world situations. An increase in real-world clinical experience such as patient consultations in work-based placements can provide pharmacy students with valuable opportunities. By knowing how to undertake an accurate allergy history, fewer people will be inaccurately labelled as allergic, promoting antimicrobial stewardship. To our knowledge, this is the first study investigating how United Kingdom undergraduate pharmacy students undertake a drug allergy history. Our participants studied in one pharmacy school and undergraduate pharmacy students studying in other pharmacy schools may have different experiences around drug allergy history taking.

Diet and well-being of 1st year Medical Interns during hospital placement

Hospital placement is essential training for medical interns, involving shift work and high-pressure environments. This can increase physiological and psychological stress, which may be mediated by metabolites of microbial digestion(1). Nutrients of interest include those accessible to microbial digestion and associated with altered signalling within the microbiota-gut-brain axis (MGBA)(1). Fibre is fermented by gut microbes to produce short-chain fatty acids(2) and is associated with improved psychological outcomes(3). Tryptophan, a precursor to gut-derived serotonin(2), has been negatively associated with anxiety(4). Processed foods contain food additives, excess sugars, and saturated fats that may disrupt gut homeostasis(1) and impact psychological well-being(4). Lastly, total energy intake may determine the level of substrate available for microbial fermentation(2). Therefore, this research explores how microbiota-accessible food components interact with physical and psychological well-being in a cohort of medical interns undertaking their first-year of hospital placement. Participants were healthy medical interns, during first-year hospital placement (n = 21) from the Hunter New England Local Health District, NSW, Australia. Participants completed diet and wellbeing surveys at baseline and every 2 months over a 10-month period. 24-hour diet diaries were self-recorded from participants using a mobile application (Easy Diet Diary) and analysed using AusNut and the NOVA classification system of ultra-processed foods (ULP). Wellbeing surveys include depression, anxiety, stress scale (DASS), and PROMIS survey for mental (M), physical (P), and sleep well-being. Current data represents an ‘in-progress’ of the longitudinal data collection. This study utilised Spearman correlation and Tukey’s post hoc test for mixed methods analysis. From baseline to timepoint 3 (T3, 4 months) daily energy intake was consistent with cohort estimated energy requirements (EER). However, consumption ranged from 37% to 167% of EER, indicating a large variation of intakes. Energy consumed from ULP ranged from 30% to 34% (p = 0.6875). Baseline tryptophan intake (x¯ = 1139mg) was within the suggested target, whilst fibre intake (x¯ = 23g) was below the recommended intake. Neither saw significant changes from baseline to T3. Fibre intake was positively correlated with mental and physical well-being at baseline (x¯ = 23.1g, M: r = 0.474, p = 0.04, P: r = 0.608, p = 0.007), and timepoint 2 (x¯ = 31.5g, M: r = 0.647,p = 0.026, P: r = 0.780, p = 0.004) but not at T3. In addition, baseline consumption of sugar (x¯ = 18g) and poly-unsaturated fats (x¯ = 15g) were both negatively correlated with mental and physical well-being. Overall, no significant dietary changes were evident from baseline to mid-year collection in a first-year medical intern cohort during hospital placements. Fibre was significantly associated with mental and physical well-being, building on current understanding of fibre’s role in the MGBA. Planned metabolite analysis will explore the mechanisms of proposed microbiome-accessible nutrients alongside diet, well-being, and microbiota data. Findings from this study will identify how diet-microbiome interactions change under stress, with wider positive implications on intense workplace environments with the aim to preserve individual wellbeing.

Nursing students' experiences of the clinical learning environment at Hafr Al Batin University: A cross-sectional study

The clinical learning environment plays a crucial role in nursing education, significantly affecting student learning. This research aimed to examine the learning experiences of nursing students at the University of Hafr Al Batin, specifically within their clinical learning environments. The study used the Clinical Learning Environment, Supervision, and Nurse Teacher (CLES+T) scale to assess these experiences in hospital placements. Participants included nursing students in their second year and beyond who had completed at least one clinical placement in hospitals. The research adopted a quantitative approach, utilizing descriptive and inferential statistical methods for data analysis. Results indicated that final-year students were less satisfied with certain aspects, including the physical environment of the ward, supervisory relationships, and the involvement of nurse teachers. In contrast, second and third-year students generally viewed the clinical learning environment more positively. These outcomes are consistent with findings from international studies. The study suggests the importance of enhancing the roles of nurse teachers and supervisors to improve nursing students' learning experiences. Further qualitative research is recommended to gain a deeper understanding of these issues.

Work readiness of pharmacy graduates: An exploratory study.

IntroductionThe recent global pandemic of Covid-19 caused various disruptions. Among them were face-to-face teaching and learning activities being switched to virtual sessions in accordance with health authorities recommendations. The impact of these changes on work readiness of pharmacy graduates is unknown. AimThis study aims to determine the impact of pharmacy graduate's work readiness, particularly those that had their studies disrupted from the pandemic. MethodsPracticing pharmacists with supervisory experience were interviewed on their opinions on work readiness of early career and intern pharmacists. Specifically, they were asked to comment on work readiness of pharmacy graduates who had their later stage of pharmacy education impacted by the pandemic. Data was transcribed verbatim and thematically analysed. This was also supplemented with quantitative data from graduating students in 2020 and 2021 using the Work Readiness Scale. ResultsQualitative feedback showed four themes related to workforce readiness: work competence, social intelligence, personal characteristics, and organizational acumen. Preceptors interviewed noted differences in communication abilities when interacting with patients. However, this improved with time. Quantitative data collected from graduates via the validated Work-Readiness Scale also showed a more positive agreement towards perceived work readiness. These graduates were comfortable with using technology as they had used these extensively in their learning during the pandemic and thus was comfortable in adopting digital health tools in their practice. ConclusionAlthough graduates reported to be work ready, there were gaps in communication skills and confidence levels when interacting with patients, as reported by supervising preceptors. Graduates also described this sense of ‘missing out’ from not having the opportunity to attend face-to-face activities like their originally planned hospital placements and how it impacted their choice of career. As pharmacists continue to play vital roles as members of the broader healthcare workforce, both in clinical and nonclinical settings, learnings from this study should be considered in designing educational activities to train and develop the workforce of the future.

What influences on their professional development do general practice trainees report from their hospital placements? A qualitative study

BackgroundThe clinical learning environment is important in GP specialty training and impacts professional development. Uniquely for GP trainees, about half of their training periods occur in a hospital environment, which is not their final workplace. There is still little understanding of how hospital-based training influences GP's professional development.ObjectivesTo seek the views of GP trainees on how their hospital experience contributes to their professional development as a GP.MethodsThis international and qualitative study seeks the views of GP trainees from Belgium, Ireland, Lithuania, and Slovenia. Semi-structured interviews were performed in the original languages. A joint thematic analysis in the English language resulted in key categories and themes.ResultsFrom the four themes identified, GP trainees were found to experience additional challenges on top of the service provision/education tensions, which are common to all hospital trainees. Despite these, the hospital rotation component of GP training is valued by trainees. A strong finding of our study is the need to ensure that learning from the hospital placements is placed firmly in the context of general practice, e.g. GP placements prior or parallel with the hospital placements, educational activities resourced by GPs during their hospital experience, encouraging hospital teachers to have greater awareness of the educational needs of GPs, including an awareness of their training curriculum.ConclusionThis novel study highlights how hospital placements for GP trainees could be enhanced. Further study could be broadened to recently qualified GPs, which may uncover new areas of interest.

Enhancing employability through hospital placements for Biomedical Science students

Collaboration between Universities and hospitals has provided the National Health Service (NHS) with many excellent Biomedical Scientists through the placement year scheme. Here, we document the number of students joining the placement scheme and the number and type of hospital departments offering student placements over a 10-year period.
 Prior to 2012, students were able to join fully-funded placements through the Higher Education Funding Council for England (HEFCE). Since then, there has been a fluctuation in numbers completing a placement year at the University of Essex, but the employability of these graduates remains consistently higher than our 3-year graduates. We demonstrate the positive impact of completing a placement year in an NHS hospital laboratory for students, and the contribution to university metrics in good degrees and graduate outcomes as well as the provision of much needed, qualified biomedical science staff to hospitals.

‘We are the (simulation) champions – evaluating the role of simulation champions to enrich the diversity of simulation practice placements within higher education institutions undergraduate healthcare programmes’

Due to the COVID-19 pandemic, there has been a significant impact on undergraduate healthcare practice placement education [1]. In response, the Scottish Government, committed to ensuring Adult and Mental Health Nursing, Midwifery, and Paramedic Science students have adequate provision to student placements, awarded Higher Education Institutions (HEIs) funding to develop simulation placements. Within our HEI a Clinical Skills and Simulation Team (CSST) has been created comprising 3 Lecturers, a Simulation Technician, and a Digital Technologist. The team then built a Simulation Champions group (n=30) through fostering working relationships, to help promote simulation-based education (SBE) pedagogy across the HEI. The purpose of this study is to explore whether creating a simulation champions group has any impact on the delivery of simulated practice placements within undergraduate healthcare programmes. The Simulation Champions are a diverse group comprised of internal academic faculty and external National Health Service (NHS) partners (such as practice education facilitators) who are passionate educators in SBE. Each external partner has a contact within the HEI, aligned to their area of clinical expertise. Through an agreed Terms of Reference, their aim is to enhance, resource, and assist the delivery of high-quality, high-fidelity simulation placements to students by working collaboratively in line with the relevant professional body standards and proficiencies [2]. The CSST oversee the Simulation Champions, providing strategic direction, leadership, following the HEI strategy [3], and support the delivery of Simulation Placements. The group meets every quarter to discuss simulation practices, explore Continuous Professional Development (CPD) opportunities, and share knowledge and learning. The impact of this team will be measured through staff and student reflection using a framework to objectively analyse scenario diversity, achievement of learning outcomes, and alignment to professional body proficiencies. Following ethical approval, a group of Year 1 Adult Nursing students (n=60) will have completed a 40-hour Simulated Practice Placement designed and delivered by Simulation Champions (n=10). This study will then evaluate and conclude whether there is a need to create and develop a diverse, multi-professional Simulation Champions Group before successful Simulated Practice Placements can be achieved. It will also help determine if securing strong working relationships ensures a smooth transfer of knowledge and skills from clinical practice to the simulation setting within a HEI, and if all of this enhances the student experience. 1. Caplan J, Clements R, Chadwick C, Kadirgamar J, Morgan J, Rao A. Medical education in 2020: developing COVID secure undergraduate hospital placements. Medical Science Educator. 2020;30(4):1677–83. 2. NMC 2018a, 2018b, 2018c, 2018d: Nursing and Midwifery Council. The Code. Professional standards of practice and behaviour for nurses, midwives and nursing associates. Nursing and Midwifery Council. Realising professionalism: Standards for education and training. Part 3: Standards for pre-registration midwifery programmes. Nursing and Midwifery Council. Realising professionalism: Standards for education and training. Part 3: Standards for pre-registration nursing programmes. 3. University of the West of Scotland. Strategy 2025. 2020. uws-strategy-2025.pdf. [Accessed on 25/01/2022]

USING THE INDONESIAN MANCHESTER CLINICAL PLACEMENT INDEX (I-MCPI) TO ASSESS THE QUALITY OF HOSPITAL-BASED AND COMMUNITY-BASED CLINICAL LEARNING ENVIRONMENT

Background: Clinical placement is crucial to develop the fundamental competencies in providing patient care. Therefore, clinical learning environment (CLE) assessment is necessary to ensure its quality. The Indonesian Manchester Clinical Placement Index (I-MCPI) is an instrument for assessing the quality of the learning environment and the quality of training in both hospital and community placements. This study aimed to (1) measure the CLE quality of a school of medicine in Jakarta using I-MCPI and (2) explore the qualitative data resulted from the I-MCPI to draw a comprehensive conclusion about CLE.Methods: 155 respondents filled the online I-MCPI, and ten respondents participated in the in-depth interviews. The quantitative data were analyzed using the guideline provided by the original MCPI. The qualitative data analysis was performed using content analysis method.Results: Quantitative data resulted in ranks of the 18 clinical placements, including primary teaching hospital and its network clinical placements. Trends in Primary Health Care (PHC) placement showed lower rank on the CLE and the training quality. The primary teaching hospital was in the sixth position. The qualitative results identified issues of the supervisor’s role, students’ involvement, and learning facilities were identified as significant factors that influenced CLE.Conclusion: Most respondents were satisfied with the quality of learning in clinical rotation at the school. However, respondents suggested more support for students to be actively involved in clinical services, perform clinical skills, and encourage learning facilities to optimize the CLE.

P40 - Innovation in educating midwives at the University of Goroka in Papua New Guinea

It is estimated that at least 145 Papua New Guinean women die from pregnancy and childbirth for every 100,000 live births compared to six Australian women, and at least 21 Papua New Guinean babies die before 28 days of age for every 1000 live births compared to one Australian baby. One strategy that has been implemented to address these issues is an emphasis on midwifery education. In 2017 the University of Goroka (UOG) pioneered the 18-month postgraduate Bachelor of Midwifery course in PNG. The curriculum consists of 899 hours of theory and 1330 hours of clinical practice. Theory subjects cover clinical midwifery, care of the neonate, sexual health, public health and leadership. Clinical practice includes hospital, community clinic and rural placements. 80% of the population of Papua New Guinea (PNG) reside in rural areas, often very remote, and serviced by health centres, with few midwives employed in these areas. Rural practicum consists of eight weeks in a rural health centre. A group of students are accompanied by a university educator and apart from clinical practice, students provide in-services on evidenced-based practices to staff, and health promotion to school children and the community. Students also initiate and support community projects such as the building of maternity waiting houses and installation of COVID-19 hand basins in schools and health centres. Anecdotally, this has contributed to increased supervised births, reduced maternal and neonatal deaths in the facilities that accepted the students, created networks and collaboration with schools and health centres, and the communities have appreciated the input from the UOG team. The team of midwifery educators at UOG have worked hard to ensure their graduates are equipped with the skills and knowledge required to care for women and babies in PNG. This presentation aims to share their experiences of teaching midwifery at UOG.

Designing the learning of intraprofessional collaboration among medical residents

BackgroundTo preserve quality and continuity of care, collaboration between primary‐care and secondary‐care physicians is becoming increasingly important. Therefore, learning intraprofessional collaboration (intraPC) requires explicit attention during postgraduate training. Hospital placements provide opportunities for intraPC learning, but these opportunities require interventions to support and enhance such learning. Design‐Principles guide the design and development of educational activities when theory‐driven Design‐Principles are tailored into context‐sensitive Design‐Principles. The aim of this study was to develop and substantiate a set of theory‐driven and context‐sensitive Design‐Principles for intraPC learning during hospital placements.MethodsBased on our earlier research, we formulated nine theory‐driven Design‐Principles. To enrich, refine and consolidate these principles, three focus group sessions with stakeholders were conducted using a Modified Nominal Group Technique. Next, two work conferences were conducted to test the feasibility and applicability of the Design‐Principles for developing intraPC educational activities and to sharpen the principles into a final set of Design‐Principles.ResultsThe theoretical Design‐Principles were discussed and modified iteratively. Two new Design‐Principles were added during focus group 1, and one more Design‐Principle was added during focus group 2. The Design‐Principles were categorised into three clusters: (i) Culture: building collaborative relations in a psychologically safe context where patterns or feelings of power dynamics between primary and secondary care physicians can be discussed; (ii) Connecting Contexts: making residents and supervisors mutually understand each other's work contexts and activities; and (iii) Making the Implicit Explicit: having supervising teams act as role models demonstrating intraPC and continuously pursuing improvement in intraPC to make intraPC explicit. Participants were unanimous in their view that the Design‐Principles in the Culture cluster were prerequisites to facilitate intraPC learning.ConclusionThis study led to the development of 12 theory‐driven and context‐sensitive Design‐Principles that may guide the design of educational activities to support intraPC learning during hospital placements.

Development and Pilot Implementation of a Training Framework to Prepare and Integrate Pharmacy Students into a Multicentre Hospital Research Study.

A unique approach was introduced to integrate pharmacy students into a multicentre patient-centred research project predicting medication related harm (MRH) post-discharge. A training framework was developed to prepare students for research participation and integration. The framework aligned research project tasks with the pharmacists’ national competency standards framework. The framework was piloted on four research placement students from two local universities during three hospital placements, from October 2020 to August 2021. Following their initial orientation and training, students collected data from 38 patients and were involved in patient screening processes, interviewing, data collection and analysis. Patients’ MRH risk scores correlated with re-admission rates with 16/38 (42%) of patients re-admitted within eight weeks following discharge. Their participation in the research enabled students to obtain skills in (1) literature searching, (2) maintaining patient confidentiality, (3) interviewing patients, (4) obtaining data from medical records, (5) communicating with patients and clinicians, and (6) the use of clinical information to predict MRH risk.

A call to reform undergraduate nursing clinical placements

A call to reform undergraduate nursing clinical placements

Teaching Medical Students on Surgical Placement during the COVID-19 Pandemic, Lessons Learned so Far

Background: The COVID-19 pandemic has caused significant disruption to the teaching and progression of medical students. With no imminent end to the pandemic, it remains vital that medical students remain integrated into clinical environments to benefit from the teaching opportunities in the hospital setting. Aim: To offer advice on the teaching of medical students undertaking hospital placements within General Surgery during the COVID-19 pandemic. Method: We reflected on our experience as clinical medical educators working through the COVID-19 pandemic, supported by feedback from medical students and relevant contemporary educational guidelines and literature. Results: A review on how to optimise teaching medical students during the COVID-19 pandemic, balancing the need for safety and limiting viral transmission, while maximising clinical experience and learning. Conclusion: The COVID-19 pandemic has forced widespread changes to the way in which medical students receive teaching. We suggest ways to maximise learning opportunities, on hospital placements, during the pandemic. Maintaining quality medical education during the pandemic is key to producing the best doctors of tomorrow.

Exploring power dynamics and their impact on intraprofessional learning

BackgroundDuring postgraduate training, considerable efforts for intraprofessional education are in place to prepare primary care residents (PC residents) and medical specialty residents (MS residents) for intraprofessional collaboration (intraPC). Power dynamics are inherently present in such hierarchical medical contexts. This affects intraPC (learning). Yet little attention has been paid to factors that impact power dynamics. This study aims to explore power dynamics and their impact on intraPC learning between PC residents and MS residents during hospital placements.MethodsThis study expands on previously published ethnographic research investigating opportunities and barriers for intraPC learning among residents in five Dutch hospitals. We analysed transcripts of observations and in‐depth interviews using template analysis. A critical theory paradigm was employed. Discourse analysis additionally informed the data.ResultsWe defined five interrelated themes that describe characteristics of power dynamics in intraPC learning during hospital placements: beliefs; power distribution; interaction style; subjection; and fearless learning. Power dynamics operate both within and between the themes: power distribution between PC residents, MS residents and MS supervisors seemed to be an attribution affected by underlying beliefs about professional norms or about other professions; beliefs influenced the way PC residents, MS residents and MS supervisors interacted; power distribution based on inequity could lead to subjection of PC residents; power distribution based on equity could lead to fearless learning; and open interactions enabled fearless intraPC learning.ConclusionsPower dynamics have an impact on intraPC learning among residents in hospitals. Constructive power dynamics occur when power distribution is based on equity, combined with sincere open interactions, actively inviting each other into discussions and enlisting the support of MS supervisors to foster fearless learning. This can be achieved by creating awareness of implicit beliefs and making them explicit, recognising interaction that encourages intraPC learning and creating policies that support fearless intraPC learning.

Medical students\u2019 perception of simulation-based assessment in emergency and paediatric medicine: a focus group study

BackgroundAlthough simulation-based assessment (SBA) is being implemented in numerous medical education systems, it is still rarely used for undergraduate medical students in France. Objective structured clinical examinations (OSCEs) will be integrated into the national medical curriculum in 2021. In 2016 and 2017, we created a mannequin SBA to validate medical students’ technical and psychometric skills during their emergency medicine and paediatric placements. The aim of our study was to determine medical students’ perceptions of SBA.MethodsWe followed the grounded theory framework to conduct a qualitative study. A total of 215 students participated in either a paediatric or an emergency medicine simulation-based course with a final assessment. Among the 215 participants, we randomly selected forty students to constitute the focus groups. In the end, 30 students were interviewed. Data were coded and analysed by two independent investigators within the activity theory framework.ResultsThe analyses found four consensual themes. First, the students perceived that success in the SBA provided them with self-confidence and willingness to participate in their hospital placements (1). They considered SBA to have high face validity (2), and they reported changes in their practice after its implementation (3). Nevertheless, they found that SBA did not help with their final high-stakes assessments (4). They discussed three other themes without reaching consensus: stress, equity, and the structure of SBA. After an analysis with activity theory, we found that students’ perceptions of SBA underlined the contradictions between two systems of training: hospital and medical. We hypothesise that a specific role and place for SBA should be defined between these two activity systems.ConclusionThe students perceived that SBA would increase self-confidence in their hospital placements and emphasise the general skills required in their future professional environment. However, they also reported that the assessment method might be biased and stressful. Our results concerning a preimplementation mannequin SBA and OSCE could provide valuable insight for new programme design and aid in improving existing programmes. Indeed, SBA seems to have a role and place between hospital placements and medical schools.

The Journey of Saudi Male Nurses Studying within the Nursing Profession: A Qualitative Study

Background: Nursing is considered to be a primarily female profession, particularly in Saudi Arabia, despite the fact that male nurses have contributed to the advancement of the nursing profession in various specialties, such as military nursing, mental health, and critical care. Purpose: We explore the factors influencing Saudi male nursing interns to study within the nursing profession in Saudi Arabia. Methods: A descriptive qualitative study was conducted. A convenience sample of 12 Saudi male nursing interns from different nursing colleges were recruited, alongside four hospital internship coordinators. The data were collected by conducting two semi-structured focus group interviews and four individual interviews. All the interviews were analyzed using a comparative analytical approach. Results: Role models and the role of the internship year were identified as factors influencing Saudi male nurses’ decision to study nursing. However, hospital placements, cultural preferences, and the preferences of patients and their families for female nurses were the key challenges encountered. Importantly, this study demonstrated that social media plays a critical role in raising awareness regarding the importance of Saudi male nurses. Conclusion: Awareness needs to be raised of the nursing profession as a gender-diverse field through volunteering programs for the community. It is recommended that Saudi male nurses act as role models for students in the Academic Orientation Forum and on social media.

Medical education adaptation in South Korea during the COVID-19 pandemic

Introduction: We describe the circumstances and adaptations in the South Korean medical education during the COVID-19 pandemic and discuss areas in need of improvement in preparation of a worsening situation or for similar future public health crises. Methods: Literature reviews, focusing on research papers about medical educational changes in South Korea during the COVID-19 pandemic were performed. Selective data collected from a nationwide online survey by the Korean Association of Medical Colleges on the status of curricular changes in medical schools during the COVID-19 was presented. Results: All lectures have moved online, but clinical students continued their hospital placements during the pandemic, except for the first 3-5 weeks during the first surge in 2020. Initial technical naivety of the faculty and lack of technical resources were short-lived and the medical students settled well showing a much higher than expected student satisfaction level over online education. Practical skills sessions which benefit most from onsite hands-on experiences such as anatomy dissection, were delivered through a blended approach in some medical school. Student evaluation is the area of least change, mainly due to the students’ lack of trust in online assessments. Conclusion: South Korea' underwent major changes in medical education brought upon COVID-19 and the readiness of the technology adoption has been much increased. Student evaluation is the area of least transformation. Adoption of a programmatic assessment system should be considered to enhance not only learning but also improve trust among stakeholders of medical schools.