Kirkpatrick Level Research Articles

Faculty development for strengthening online teaching capability: a mixed-methods study of what staff want, evaluated with Kirkpatrick's model of teaching effectiveness.

Globally, tertiary teachers are increasingly being pushed and pulled into online teaching. While most developments in online education have focused on the student perspective, few studies have reported faculty development (FD) initiatives for increasing online teaching capability and confidence from a staff perspective. We designed and evaluated FD workshops, using five datasets, and the use of H5P software for interactive online teaching. We used educational theory to design our FD (Mayer multimedia principles, active learning) and evaluated our FD initiatives using the Best Evidence Medical Education (BEME) 2006 modified Kirkpatrick levels. Teaching staff reported that Communities of Practice were important for their learning and emotional support. Uptake and deployment of FD skills depended on the interactivity of FD sessions, their timeliness, and sufficient time allocated to attend and implement. Staff who applied FD learning to their online teaching created interactive learning resources. This content was associated with an increase in student grades, and the roll-out of an institutional site-wide H5P license. This paper demonstrates an effective strategy for upskilling and upscaling faculty development. The use of H5P as a teaching tool enhances student learning. For successful FD, we make four recommendations. These are: provide just-in-time learning and allocate time for FD and staff to create online teaching material; foster supportive communities; offer personalized support; and design hands on active learning.

Using Simulation to Develop Clinical Reasoning Skills for Registered Practical Nurses New to Acute Care

BackgroundTo address the nursing workforce shortage, registered practical nurses (RPNs) were introduced to acute care areas at The Ottawa Hospital. MethodsThe Kirkpatrick levels were used to evaluate the RPN simulation-based education session. A paired T-test was used to assess statistical significance of patient safety data. ResultsGreater than 81% of RPNs found the simulations to be extremely effective at preparing them for their new role. Patient safety data showed a statistically significant decrease in rapid-response team calls (p = .0431) and a decrease in patient falls that was not quite statistically significant (p = .0506). ConclusionThrough the simulation sessions, the RPNs mastered the fundamentals of being able to assess, construct, implement, and evaluate a plan of patient care, setting the framework for clinical reasoning.

The Value of the Pediatric Urgent Care in Pediatric Resident Education.

Pediatric urgent care (UC) is a growing field and may provide unique learning opportunities for pediatric residents. We aimed to assess whether a UC rotation could be feasible and meaningful and help fill educational gaps. Within our current X+Y rotational model, we used Kern's 6-step approach for curriculum development to create a longitudinal UC educational experience for postgraduate year 2 (PGY2) pediatric residents. We assessed progress towardachieving our aim by using a mixed-methods approach matched to Kirkpatrick's levels of learning, including program annual evaluations, self-assessed UC competencies, and 360 milestone evaluations. A total of 14 PGY2s participated in our yearlong longitudinal rotation without duty hour violations or deviations from well childcare. Thematic analysis revealed concepts of autonomy, procedural access, and intentionality of education. Residents showed statistical improvement in 4/10 milestones and 26/27 self-assessed performance items. Of 14 residents, 6 scored ≥4 on all milestones by the end of the year. Our curriculum demonstrates a valuable role for the pediatric UC in the procedural and clinical education of pediatric residents. Practical implications and assessment tools of such a curriculum may be valuable for others interested in integrating this learning experience into their current educational model.

Effectiveness of an Online Preceptor Development Program Across Health Professions.

An online Preceptor Development Program (PDP) was developed to meet the needs of geographically dispersed preceptors across health professions. We aimed to measure the audience, their engagement, and effectiveness of an online PDP developed and implemented amid the COVID-19 pandemic. The mixed methods study included survey and attendance data for live and asynchronous formats. T-tests compared overall session perception to self-reported session impact. Objective alignment and self-reported measures of impact were analyzed around Kirkpatrick's levels of reaction, learning, and behavior. Participants engaged in live and/or asynchronous PDP sessions from various professions, specialties, and geographical locations. Quantitative findings indicated significant associations between overall session perception and knowledge (session 2), competence (sessions 1, 2), and performance (session 1). Objectives were met, and key learning takeaways were reported. While most participants indicated no barriers to implementation, two barriers identified were a lack of time and uninterested students. Participants were afforded flexibility and choice and likely benefitted in the areas of knowledge, competence, and behavior. This online PDP effectively addressed preceptor needs in common areas, including feedback. Future program development may include advisory group input and interactive learning opportunities.

Student Evaluation of a Learning Enhancement in Anatomy Program (LEAP) during the COVID-19 Pandemic: A Retrospective Study.

The pandemic acted as an accelerator for the development of online teaching formats in anatomy and histology worldwide. The authors introduce a bridging program that reinforces the knowledge and understanding of gross and correlative anatomy and histology acquired in a virtual environment in preparation for its future clinical application. The study aims to evaluate the Learning Enhancement in Anatomy Program (LEAP) conducted among first-year medical students at the College of Medicine, University of the Philippines Manila. This descriptive cross-sectional study aims to determine the initial experience of implementing a learning enhancement program and assess areas for its improvement. An internally validated questionnaire was given to students after the program to gauge students' reactions (Kirkpatrick Level 1 evaluation). Pre- and post-tests were administered to evaluate knowledge acquisition (Kirkpatrick Level 2 evaluation). Short-term behavioral peer evaluation (Kirkpatrick Level 3 evaluation) was also instituted. One hundred fifty-two (152) students participated in the study. General reactions from students to the LEAP were consistently positive, with a steady majority of the students rating '5' or a 'Strongly Agree' to positive statements regarding the program. Higher ratings for more traditional teaching methods, such as cadavers, formalinized specimens, and bones, compared to virtual systems were apparent. However, inter-student variation in preference for teaching modalities was observed. All stations of the LEAP were evaluated satisfactorily, with most gross anatomy stations rated higher than histology stations. A significant increase was noted in the total post-test scores compared to pre-test scores. This improvement in test scores was observed in the anatomy and histology subcategories and in six of the seven organ system modules. Perceived behavioral outcomes were also generally positive. The LEAP is a worthwhile endeavor, garnering overwhelmingly positive reactions and a significant improvement in test scores. Future studies are necessary to fine-tune teaching and training in a blended learning environment.

Measuring the Impact of Augmented Reality Surgical Training; A Kirkpatrick Level Approach.

Measuring the Impact of Augmented Reality Surgical Training; A Kirkpatrick Level Approach.

EKSPLIKASI KIRKPATRICK LEVEL 1 DAN 2 PADA PELATIHAN JARAK JAUH DI BALAI DIKLAT KEAGAMAAN BANDUNG

The objective of this study is to conduct an evaluative analysis of the Religious Harmony Distance Training Batch III using the Kirkpatrick evaluation methodology. The training was conducted by the Bandung Religious Training Center, and the assessment will focus on the reaction and learning levels. The employed research methodology entails a descriptive approach that incorporates quantitative techniques. The study's sample consisted of all individuals who had participated in the third batch of the training program. Data for the study was obtained via questionnaires. The findings of this study indicate that the Kirkpatrick level 1 reaction model demonstrated trainees' satisfaction and positive response towards the training implementation. Additionally, at level 2, the learning outcomes effectively met the training objectives. Consequently, the application of the Kirkpatrick model at the reaction and learning levels successfully addressed issues in the third batch, yielding positive outcomes. Keywords: Evaluation; Religious Harmony Training; Kirkpatrick Model

Assessing the Merits and Effectiveness of Peer Teaching in Small Groups through the Employment of Different Learning Media.

Background Peer teaching is a well-acknowledged method to facilitate teaching and learning among medical students. The objective of the study was to assess the merits and effectiveness of peer teaching in small groups using a student-centered approach through the employment of different learning media. Methods This was a cross-sectional descriptive study conducted among a group of 34 students from third professional year. Purposive sampling was used, wherein students were subdivided into five small groups. At the beginning, a pretest consisting of 10 multiple-choice questions was conducted on the topic "Epidemiology of Hypertension." This topic was further subdivided into five subtopics, and five separate learning media (viz., video, PowerPoint, white board, chalk-and-talk, and chart) were allocated using the lottery method. Each group discussed the allotted topic and then presented their findings in the large group using the assigned learning media, while other groups gave feedback, and the best group was decided through multivoting. Posttest was administered and the results were compared with the pretest. Data entry was done in Microsoft Excel and analysis was done using SPSS 16. Descriptive statistics and paired t -test was used to compare the results in pretest and posttest at p level < 0.05. Results This innovative session of peer teaching featured 34 students, with a mean age of 22 ± 1.3 years. While carrying out the Kirkpatrick Level 1 evaluation, almost 90% students liked the role of the facilitator in stimulating interest in the topic. There was a mean average increase of 1.7 marks on comparing the scores of posttest with pretest (Kirkpatrick Level 2), and the reported difference was statistically significant. Joyful learning 24 (66.7%) and group discussion 23 (63.9%) emerged as the most liked aspects of the session. Conclusion In conclusion, peer teaching through learning media is an effective method as it promotes active learning, improves communication skills, and improves the academic performance of students. Peer teaching using different learning media proved to be quite effective in improvement of knowledge about epidemiology of hypertension, the pros and cons of different learning media, and encouraged creativity among students.

Simulation-Based Training in Emergency Obstetric Care in Sub-Saharan and Central Africa: A Scoping Review.

Every day approximately 810 women die from complications related to pregnancy and childbirth worldwide. Around two thirds of these deaths happen in sub-Saharan Africa. One of the strategies to decrease these numbers is improving the quality of care by emergency obstetric simulation-based training. The effectiveness of such training programs depends on the program's instructional design. This review gives an overview of studies about emergency obstetric simulation-based training and examines the applied instructional design of the training programs in sub-Saharan and Central Africa. We searched Medline, Embase and Cochrane Library from inception to May 2021. Peer-reviewed articles on emergency obstetric, postgraduate, simulation-based training in sub-Saharan and Central Africa were included. Outcome measures were categorized based on Kirkpatrick's levels of training evaluation. The instructional design was evaluated by using the ID-SIM questionnaire. In total, 47 studies met the inclusion criteria. Evaluation on Kirkpatrick level 1 showed positive reactions in 18 studies. Challenges and recommendations were considered. Results on knowledge, skills, and predictors for these results (Kirkpatrick level 2) were described in 29 studies. Retention as well as decay of knowledge and skills over time were presented. Results at Kirkpatrick level 3 were measured in 12 studies of which seven studies demonstrated improvements of skills on-the-job. Improvements of maternal and neonatal outcomes were described in fifteen studies and three studies reported on cost-estimations for training rollout (Kirkpatrick level 4). Instructional design items were heterogeneously applied and described. Results of 47 studies indicate evidence that simulation-based training in sub-Saharan and Central Africa can have a positive impact across all four levels of Kirkpatrick's training evaluation model. However, results were not consistent across all studies and the effects vary over time. A detailed description of instructional design features in future publications on simulation-based training will contribute to a deeper understanding of the underlying mechanisms that determine why certain training programs are more effective in improving maternal and neonatal healthcare outcomes than other.

Evaluation of arts and humanities programs in surgery education: a systematic review

Purpose This systematic review seeks to understand what outcomes have been reported for arts and humanities programs in surgery education. Methods Authors searched Medline ALL (Ovid), Embase.com, Web of Science, and Academic Search Ultimate to identify articles on evaluated arts and humanities programs in surgery education. The search identified 1,282 titles and abstracts, of which 55 underwent independent full-text review. The authors identified 10 articles that met inclusion criteria, from which they collected and analysed data. Results Medical students were the identified learners in most studies (6/10; 60%). Reflective writing was the arts and humanities activity in half of the studies (5/10; 50%); activities based on film, visual art other than film, literature, or social media in the remaining studies (5/10; 50%). Most studies (8/10; 80%) featured a non-controlled, non-randomized design. Authors categorised 5 studies (50%) as Kirkpatrick Level 1, 4 (40%) as Level 2, and 1 (10%) as Level 3. Conclusion Integration of the arts and humanities into surgery education may promote increased levels of learner reflection and empathy, in addition to improved acquisition of surgical skills. More rigorous evaluation of these programs would clarify the impact of arts and humanities programs on surgery learners.

Faculty development for strengthening online teaching capability: a mixed-methods study of what staff want, evaluated with Kirkpatrick’s model of teaching effectiveness

Background: Globally, tertiary teachers are increasingly being pushed and pulled into online teaching. While most developments in online education have focused on the student perspective, few studies have reported faculty development (FD) initiatives for increasing online teaching capability and confidence from a staff perspective. Method: We designed and evaluated FD workshops, using five datasets, and the use of H5P software for interactive online teaching. We used educational theory to design our FD (Mayer multimedia principles, active learning) and evaluated our FD initiatives using the Best Evidence Medical Education (BEME) 2006 modified Kirkpatrick levels. Results: Teaching staff reported that Communities of Practice were important for their learning and emotional support. Uptake and deployment of FD skills depended on the interactivity of FD sessions, their timeliness, and sufficient time allocated to attend and implement. Staff who applied FD learning to their online teaching created interactive learning resources. This content was associated with an increase in student grades, and the roll-out of an institutional site-wide H5P license. Conclusion: This paper demonstrates an effective strategy for upskilling and upscaling faculty development. The use of H5P as a teaching tool enhances student learning. For successful FD, we make four recommendations. These are: provide just-in-time learning and allocate time for FD and staff to create online teaching material; foster supportive communities; offer personalized support; and design hands on active learning.

Educational Interventions for Medical Students to Improve Pharmacological Knowledge and Prescribing Skills: A Scoping Review.

Medication-related errors place a heavy financial burden on healthcare systems worldwide, and mistakes are most likely to occur at the stage of prescribing. Junior doctors are more likely to make prescribing errors, and medical graduates also lack confidence and preparedness towards prescribing. Thus, this review aimed to evaluate the existing educational approaches to improve pharmacological knowledge and prescribing skills among medical students. CENTRAL, CINAHL, ERIC, Ovid Embase, Ovid MEDLINE, Ovid PsycINFO, and Scopus were searched with keywords related to "pharmacological knowledge", "prescribing skills", "educational interventions" for articles published since 2016. 3595 records were identified, and 115 full-text articles were assessed for eligibility. Eighty full-text articles were eligible and included in this review. Thirty-seven studies focused on improving prescribing skills, whilst 43 targeted pharmacological knowledge. A broad range of interventions was implemented, including e-learning, case-based, interprofessional, and experiential learning. Pharmacological knowledge and prescribing skills were measured in various ways, and all studies reported one or more positive findings at Kirkpatrick level 1 or 2. No study reported outcomes at Kirkpatrick levels 3 and 4. The World Health Organisation's Good Guide to Prescribing was the foundation of the development of prescribing educational interventions. Emerging interventions such as experiential and interprofessional learning should be incorporated into the prescribing curriculum. Innovative approaches such as game-based learning can be considered for clinical pharmacology teaching. However, there was a lack of outcomes at Kirkpatrick levels 3 and 4. Robust methodology and reliable outcome measures are also needed in future studies.

Emergency Medicine Obstetrics and Gynecology: A Case-Based Curriculum for Residents.

Millions of patients present to US emergency departments every year with OB/GYN concerns. Emergency medicine trainees must be adequately prepared to care for this population, regardless of how commonly they appear in the training environment. We used active learning and gamification principles in this curriculum to increase learner engagement and participation in the material. We chose OB/GYN topics based on review of Tintinalli's OB/GYN content and the American Board of Emergency Medicine's Model of Clinical Practice. Each session comprised a case-based lecture and review questions using the game-based Kahoot! online software. Pre- and postcurriculum surveys assessed residents' confidence in caring for emergent OB/GYN pathologies on a 5-point Likert scale. We designed survey questions assessing the first level of Kirkpatrick's levels of training evaluation; these questions were reviewed and revised by the department's Medical Education Scholarship Committee for validity. A mean of 18 residents attended each session. Seventy-six percent of residents (26 of 34) completed the precurriculum survey, 67% (23 of 34) completed the postcurriculum survey, and 44% (15 of 34) completed both. For all respondents, mean reported confidence with curriculum topics increased from 3.5 to 4.0 (p < .05). For residents completing both surveys, confidence increased from 3.4 to 4.0 (p < .01). Application of this curriculum significantly improved learner confidence in targeted OB/GYN topics. Future directions could include evaluating curricular impact at higher levels in the Kirkpatrick model, extending sessions to include more time for interaction, and adding suggested readings.

We Need to Do Better: A Scoping Review of Wellness Programs In Surgery Residency

Burnout, depression, and fatigue are common among surgical residents. Most published wellness studies in surgery only focus on a cross-sectional view of attitudes and perceptions around wellness in training. While much of this literature calls for interventions and presents strategies for improving resident well-being, there is a paucity of published wellness initiatives, and even fewer with programmatic evaluation. A scoping review was designed to address: (1) What wellness initiatives are used in surgery residency programs? (2) Which wellness domains do these programs address? and (3) How are program outcomes evaluated? A formal literature search was conducted using PubMed, Embase, and Scopus databases to identify English-language studies conducted in the United States that described wellness-focused initiatives for surgery residents. Two authors independently screened all abstracts and full texts for inclusion. Data were extracted including wellness domain(s) and outcomes evaluation methods with associated Kirkpatrick level(s) (1-reaction, 2-learning, 3-behavior, 4-results). Study quality was examined using the medical education research study quality index (MERSQI) score. A total of 2237 abstracts were screened with 115 full texts reviewed for eligibility. Fifty-one studies were included in the final analysis, representing 39 distinct wellness programs. The most common domains of wellness addressed were emotional (19/39, 48.7%), occupational (17/39, 43.6%), and physical (16/39, 41.0%). Of the 51 studies reviewed, 8 (15.7%) did not conduct any program evaluation, 27 (52.9%) evaluated level 1, 30 (58.8%) evaluated level 2, 3 (5.9%) evaluated level 3, and none evaluated level 4 outcomes. The mean MERSQI score was 9.16 (SD 1.8). Wellness is an established problem in surgical training. This review reveals a small number of published wellness interventions and even fewer that incorporate programmatic evaluation at the level of behavior and results change. Effective change will require rigorous and deliberate programming that addresses multiple domains and evaluation levels.

Models of pre-registration student supervision in allied health: a scoping review

Introduction: The aim of this scoping review was to identify, organise and synthesise existing evidence in relation to the supervision of allied health students on clinical placement.Methods: Five databases were searched for peer reviewed articles published from 2000 onwards. Data were extracted and analysed according to approaches to supervision, and student and/or educator outcomes for different models used. Each outcome was aligned to modified Kirkpatrick levels of evaluation.Results: 39 articles were reviewed. The terms models and approaches were poorly defined and used interchangeably in the clinical placement literature. Studies varied in the methods employed and were typically of low to moderate methodological quality with a dominance of Kirkpatrick level 2a outcomes reported.Conclusions: This review has proposed a definition of supervision models to enable future research comparisons between models and to provide clarity to placement providers’ decision making. Overall evidence for reported outcomes is mixed and not strong enough to draw conclusions in favour of any one model. Approaches to supervision, not student ratio, may well be the catalyst for positive outcomes for all stakeholders and therefore should be the focus of future research.

Feasibility of Including Hands-On Microteaching in the Medical Faculty Development Program in India: A Mixed-Methods Study.

Background Medical faculty development programs (FDPs) often lack hands-on training in teaching skills. Microteaching, a short, focused teaching practice, could be a feasible way to bridge this gap. This study aimed to explore the feasibility of including hands-on microteaching in a medical FDP in India. Methodology This mixed-methods study involved fresh medical faculty members who never attended FDP on the basics of medical education technologies, stakeholders, and students from a recently established autonomous medical institute of national importance in India. Participants completed a pre-test survey on their teaching skills and received a hands-on microteaching session during an FDP. After the session, participants completed a post-test survey and provided feedback on the feasibility and acceptability of hands-on microteaching in the program. Program evaluation was done by application of Kirkpatrick's Model levels one, two, and three. Results According to the Kirkpatrick Model of Evaluation level one (Reaction), the participants reported improved teaching skills and greater confidence in their ability to teach after the microteaching session. They also reported that hands-on microteaching was an effective way to learn teaching skills and receive feedback. Stakeholders opined that microteaching is a very effective tool for improving teaching skills and should be a part of FDP. Evaluation at level two (Learning) shows that there was a significant improvement in the mean score of post-tests. As per level three (Behaviour Change) evaluation, the majority of the students informed that there is observable improvement in the effectiveness of teaching of faculties in the past two months, i.e., since the participation of faculty in hands-on microteaching in FDP. Conclusions Hands-on microteaching could be a feasible and effective way to enhance the teaching skills of medical faculty members in India. The study findings suggest that including hands-on microteaching in FDPs could help bridge the gap between theoretical knowledge and practical teaching skills.

Twine virtual patient games as an online resource for undergraduate diabetes acute care education

BackgroundVirtual patients provide a safe way to simulate authentic clinical practice. Twine is an open-source software that can be used to create intricate virtual patient games, including elements like non-linear free text history taking and time-related changes to the game’s narrative. We evaluated the incorporation of Twine virtual patient games into a diabetes acute care online learning package for undergraduate medical students at the University of Glassgow, Scotland.MethodsThree games were developed using Twine, Wacom Intuous Pro, Autodesk SketchBook, Camtasia Studio, and simulated patients. Online material included three VP games, eight microlectures, and a single best answer multiple choice question quiz. The games were evaluated at Kirkpatrick Level 1 with an acceptability and usability questionnaire. The entire online package was evaluated at Kirkpatrick Level 2 with pre- and post-course multiple choice and confidence questions, with statistical analysis performed using paired t-tests.Results122 of approximately 270 eligible students provided information on resource utilisation, with 96% of these students using at least one online resource. 68% of students who returned surveys used at least one VP game. 73 students provided feedback on the VP games they had played, with the majority of median responses being “agree” on positive usability and acceptability statements. The online resources were associated with a mean multiple choice score increase from 4.37 out of 10 to 7.96 out of 10 (p < 0.0001, 95% CI + 2.99 to + 4.20, n = 52) and a mean total confidence score increase from 4.86 out of 10 to 6.70 out of 10 (p < 0.0001, 95% CI + 1.37 to + 2.30, n = 48).ConclusionsOur VP games were well-received by students and promoted engagement with online material. The package of online material led to statistically significant increases in confidence and knowledge in diabetes acute care outcomes. A blueprint with supporting instructions has now been created to facilitate rapid creation of further games using Twine software.

Anesthesia in medical school: A simulation-based curriculum proposal

Introduction: Most medical students are not familiar with Anesthesiology, as it is infrequently addressed properly in medical school curricula. However, anesthesiology skills are widely practiced across specialties and commonly performed by general practitioners. Currently, anesthesia curricula are often based on shadowing and lectures without emphasizing relevant skills, behaviors, and attitudes, whereas simulation-based curricula enable a holistic evaluation of the trainee.&#x0D; Objective: To implement and assess the perceptions of students and professors of a novel simulation-based anesthesiology curriculum.&#x0D; Methods: A descriptive study was planned for evaluating the new proposal. A simulation-based 3-week curriculum was organized using a blended course with skill laboratories. We designed flipped classroom-based lectures (2 weeks) combined with activities using standardized patients, manikins, and hybrid scenarios (1 week). After each activity, feedback was given by an anesthesiologist, as well as individual grading and a survey based on the Kirkpatrick levels.&#x0D; Results: From June to November 2020, 53 students were enrolled in the clerkship. Each week, every group of 6-8 students was assigned to the same specialist to perform the activities and track individual progress. The response rate of the survey was 83%. Across the levels of Kirkpatrick, there was an excellent opinion of the activities, as well as a high similarity between the perception of both students and professors.&#x0D; Conclusion: Our simulation-based curriculum, which was highly appraised by students and professors, was found to be feasible, appealing, and offered a good introduction to the principles and practices of anesthesiology to medical students.

A systematic review of intellectual and developmental disability curriculum in international pre-graduate health professional education

BackgroundDespite the increasing global population of individuals with intellectual and developmental disabilities (IDD), this population remains especially vulnerable to health disparities through several factors such as a lack of access to sufficient medical care and poor determinants of health. To add, numerous studies have shown that healthcare professionals are still insufficiently prepared to support this population of patients. This review synthesizes the literature on current pre-graduate IDD training programs across healthcare professions with the goal of informing the creation of evidence-based curricula.MethodsFour major databases were searched for current pre-graduate IDD training interventions for healthcare professionals. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis flow diagram and the Best Evidence Medical Educations systematic review guide were used to frame our collection and analysis.ResultsOf the 8601 studies screened, 32 studies were identified, with most studies involving medical students (50%). Of note, 35% of studies were interprofessional. Most interventions utilized multiple pedagogical methods with a majority including clinical experiences (63%) followed by theoretical teaching (59%). Kirkpatrick levels showed 9% were level 0, 6% were level 1, 31% were level 2A, 31% were level 2B, 19% were level 3, 3% were level 4A, and none were level 4B.ConclusionsThere is a paucity of formally evaluated studies in pre-graduate health professional IDD education. As well, there are a lack of longitudinal learning opportunities and integration into formal curriculum. Strengths identified were the use of multimodal approaches to teaching, including interprofessional approaches to optimize team competencies.

Simulation-Based Breast Biopsy Training Using a Low-Cost Gelatin-Based Breast Model in Rwanda.

An interdisciplinary team of healthcare providers and simulation specialists adopted and modified a protocol for the creation of a low-cost, gelatin-based breast model for teaching ultrasound-guided breast biopsy and assessed first-time user experience. An interdisciplinary team of healthcare providers and simulation specialists adopted and modified a protocol for the creation of a low-cost, gelatin-based breast model for teaching ultrasound-guided breast biopsy for approximately $4.40 USD. Components include medical-grade gelatin, Jell-O™, water, olives, and surgical gloves. The model was used to train two cohorts comprising 30 students total during their junior surgical clerkship. The learners' experience and perceptions on the first Kirkpatrick level were evaluated using pre- and post-training surveys. Response rate was 93.3% (n = 28). Only three students had previously completed an ultrasound-guided breast biopsy, and none had prior exposure to simulation-based breast biopsy training. Learners that were confident in performing biopsies under minimal supervision rose from 4 to 75% following the session. All students indicated the session increased their knowledge, and 71% agreed that the model was an anatomically accurate and appropriate substitute to a real human breast. The use of a low-cost gelatin-based breast model was able to increase student confidence and knowledge in performing ultrasound-guided breast biopsies. This innovative simulation model provides a cost-effective and more accessible means of simulation-based training especially for low- and middle-income settings.