Clinical Learning Research Articles

A thematic content analysis of the structure and effects of good doctor abilities in China

BackgroundThe efforts to explore and build the structure of good doctor abilities are important because they help improve the quality of education for medical students and better standardize the working performance of doctors. However, at present, no worldwide standards for such a structure have been established. In this study, we endeavoured to map the structure of good doctor abilities and identify their effects.MethodsWith a focus on China, a thematic content analysis was adopted in this study to analyse the personal profiles of 50 widely recognized good doctors. NVivo11 software was used.ResultsThe Structure and Effects of Good Doctor Abilities in China model was proposed, and interpretations were made based on AMO theory. Good doctor abilities fall within six categories: rigorous clinical thinking, skilled in diagnosis and therapy, clinical empathy, continuous learning and innovation, enhancing and sharing experiences, and communication and coordination. These abilities have positive impacts on doctors’ work performances and social benefits by encouraging good behaviours, ultimately promoting the sustainable development of the hospitals where they serve.ConclusionsIn this study, we established a model of the structure and effects of good-doctor abilities in China and interpreted its mechanism, innovation and theory diversification in “good-doctor” research. Moreover, this study has practical significance because it provides systematic and well-targeted criteria for improving the professionalism of doctors, promoting more good doctor behaviours, providing guidance for regulating doctors’ conduct and providing a reference for medical education and working performance reviews worldwide.

Tailored leadership training in emergency medicine: qualitative exploration of the impact of the EMLeaders programme on consultants and trainees in England

BackgroundEmergency medicine (EM) consultants are expected to provide leadership to facilitate optimal clinical results, effective teamwork and learning. To foster leadership skills, the Emergency Medicine Leadership Programme (EMLeaders) was launched...

“A life-changing experience and the beginning of a lifelong commitment”: experiences and impact of Global Health Community Service-Learning in undergraduate dental curriculum in Canada

BackgroundGlobal Health Community Service-Learning (GHCSL) can have a profound professional and personal impact on learners. This pedagogy provides understanding of unfamiliar environments and challenges learners to step out of their comfort zones, adapt to new cultures, and navigate unique situations. Yet, there are relatively few studies exploring the experiences of learners participating in community service-learning placements in global regions as part of undergraduate dental curriculum. This study aimed to explore the experiences and impact of the GHCSL program in East Africa among undergraduate dental learners at the Schulich School of Dentistry.MethodsEight undergraduate dental learners were enrolled in GHCSL pilot placements. Placement agreements were established with Makerere University in Kampala, Uganda, and the University of Rwanda in Kigali, Rwanda for the summer of 2022. Stakeholders from both institutions were engaged in the development and implementation of these placements. Learners were required to engage in weekly reflection through a ‘storytelling and incident-based narrative’ while carrying out their placement. A qualitative study design was employed, and an inductive interpretive approach was utilized to thematically analyze the learners’ reflective essays.ResultsFive major themes emerged from the learners’ reflective essays: (1) experiential clinical learning; (2) cultural humility and social awareness; (3) awareness of contrasting healthcare systems; (4) commitment to service; and (5) personal and professional growth. Most learners reflected on their engagement with diverse communities, being exposed to unique patient cases, and witnessing the adaptability exuded in resource-constrained environments. These experiences presented the learners with an opportunity to develop cultural humility and gain a newfound motivation to mitigate global oral health disparities in populations beyond that of their local communities. Learners also reflected on enhanced social awareness experiences and the awareness of contrasting healthcare systems in Canada and their placements, which encouraged the development of empathy, communication, and compassion skills, as well as an understanding of the disproportionate burden of conditions in low-resource settings.ConclusionThe reflective essays concluded that the GHCSL placements had a positive impact on the learners, encouraging many to develop a heightened desire for lifelong learning to address oral health disparities within a global context.

Factors influencing nursing student satisfaction in aged care placements: An Australian cross-sectional study

AimThis study aimed to investigate factors influencing nursing students’ satisfaction with aged care placements. BackgroundProviding positive clinical experiences in aged care is crucial for students to learn safe, quality care and to foster a sustainable workforce. DesignCross-sectional study MethodsNursing students in nursing degrees participated in the national placement evaluation survey. A total of 2378 responses were extracted from the national clinical placement evaluation survey in 2023. Using multinomial logistic regression, demographics, academic, placement characteristics and placement education quality (clinical environment and learning support) were investigated in relation to three different levels of students' overall satisfaction (low, moderate, high). ResultsStudents reported overall satisfaction with their clinical placement, with a mean score of 7.9 (SD=2.1) on a 10-point scale. While most students agreed that they had achieved their learning objectives (90.0 %), they reported limited opportunities to interact with the multidisciplinary team (80.0 %). Further, students reported a relatively negative experience with staff, such as willingness to work with students (78.9 %) and being positive role models (78.9 %). Comparing the low satisfaction group to the moderate satisfaction group, male gender, identifying as an indigenous student and higher academic years increased the odds of being ‘least satisfied’, whereas international students, whose first language was not English and those with higher perceived placement education quality scores had lower odds of low satisfaction group membership. Conversely, compared with the moderate satisfaction group, those with the highest satisfaction with their clinical placement had a greater odds of being older, an international student and having higher scores in placement quality for the clinical environment and learning support. This model predicted 58.7 % of students' overall satisfaction. ConclusionsPositive learning experiences in aged care may promote the importance of practice in this area to new graduates. Despite students’ overall positive satisfaction with aged care placements, it is clear there are areas to address: a need to develop a structured approach to enhance aged care clinical experiences, progressive development of learning objectives, enhancing student career preparation and increasing participation in interprofessional collaboration may be useful approaches.

Framework for managing inappropriate behavior in clinical dental learning environments.

Workplace violence (WPV), such as physical violence, harassment, intimidation, or other threatening behavior, commonly occurs within healthcare settings including dentistry. The objective of this study was to analyze the behavioral and environmental factors contributing to WPV, determine its prevalence within one dental institution, and develop a WPV prevention and management protocol that is dental specific. To identify factors that impact WPV occurrence, the PRECEDE-PROCEED planning model was employed. A pilot cross-sectional survey was then conducted among faculty, staff, and dental learners (students/residents) to evaluate the prevalence of WPV incidents experienced and witnessed over the past year. The survey also assessed the locations where incidents took place, their type, and the strategies employed to manage them. A comprehensive protocol aimed at preventing and managing WPV in dental settings was subsequently developed. Multiple factors influence the occurrence of WPV. The prevalence of experienced and witnessed WPV incidents was 22% and 24% among faculty/staff and 7% and 5% among learners, respectively. Verbal aggression was the most common type of WPV. Most respondents lacked awareness of the available reporting mechanisms for WPV. A WPV prevention and management protocol was developed, consisting of five steps: intervene, report, document, access support services, and resolve (IRDAR). Administrators must have a comprehensive understanding of the prevalence of violence in their workplace and the underlying factors that contribute to it in order to take appropriate action. IRDAR is a clearly defined and easily implemented protocol designed for preventing and managing WPV in dental learning environments.

Analyzing pain patterns in the emergency department: Leveraging clinical text deep learning models for real-world insights

ObjectiveTo determine the incidence of patients presenting in pain to a large Australian inner-city emergency department (ED) using a clinical text deep learning algorithm. Materials and methodsA fine-tuned, domain-specific, transformer-based clinical text deep learning model was used to interpret free-text nursing assessments in the electronic medical records of 235,789 adult presentations to the ED over a three-year period. The model classified presentations according to whether the patient had pain on arrival at the ED. Interrupted time series analysis was used to determine the incidence of pain in patients on arrival over time. We described the changes in the population characteristics and incidence of patients with pain on arrival occurring with the start of the Covid-19 pandemic. Results55.16% (95%CI 54.95%–55.36%) of all patients presenting to this ED had pain on arrival. There were differences in demographics and arrival and departure patterns between patients with and without pain. The Covid-19 pandemic initially precipitated a decrease followed by a sharp, sustained rise in pain on arrival, with concurrent changes to the population arriving in pain and their treatment. DiscussionApplying a clinical text deep learning model has successfully identified the incidence of pain on arrival. It represents an automated, reproducible mechanism to identify pain from routinely collected medical records. The description of this population and their treatment forms the basis of intervention to improve care for patients with pain. The combination of the clinical text deep learning models and interrupted time series analysis has reported on the effects of the Covid-19 pandemic on pain care in the ED, outlining a methodology to assess the impact of significant events or interventions on pain care in the ED. ConclusionApplying a novel deep learning approach to identifying pain guides methodological approaches to evaluating pain care interventions in the ED, giving previously unavailable population-level insights.

Leveraging social media for resident training in developing countries: A case study of Libya.

Social media platforms have emerged as invaluable tools for remote training in resource-constrained countries. This study presents the development, implementation, and preliminary assessment of a remote intensive care unit (ICU) training program conducted in Libya utilizing social media platforms. This educational initiative was based on the Checklist for Early Recognition and Treatment of Acute Illness and iNjury (CERTAIN) program, targeting Libyan resident physicians. The initiative comprised a series of live-streamed pulmonary/critical care lectures and asynchronous discussion of clinical cases via a private messaging chat. Participant engagement, satisfaction, and learning outcomes were evaluated using social media analytics and surveys. A total of 323 learners joined the Libyan ICU training program chat group, and two tele-education sessions were broadcast, accumulating a total of 749 views. The majority (72.6%) of learners had graduated from medical school within the past five years and were in residency training. Clinical cases and learning materials were shared through 2,991 messages in the chat group. Learners' objective and subjective clinical knowledge improved after each tele-education session, and 88% of survey respondents rated the remote ICU training program as excellent. This study highlights the potential of using widely available social media platforms for remote ICU education in resource-limited settings.

Bridging School and Practice? Barriers to the Integration of 'Boundary Objects' for Learning and Assessment in Clinical Nursing Education.

In clinical health professions education, portfolios, assignments and assessment standards are used to enhance learning. When these tools fulfill a bridging function between school and practice, they can be considered 'boundary objects'. In the clinical setting, these tools may be experienced as time-consuming and lacking value. This study aimed to investigate the barriers to the integration of boundary objects for learning and assessment from a Cultural-Historical Activity Theory (CHAT) perspective in clinical nursing education. Nineteen interviews and five observations were conducted with team leads, clinical educators, supervisors, students, and teachers to obtain insight into intentions and use of boundary objects for learning and assessment. Boundary objects (assessment standards, assignments, feedback/reflection/patient care/development plan templates) were collected. The data collection and thematic analysis were guided by CHAT. Barriers to the integration of boundary objects included: a) conflicting requirements in clinical competency monitoring and assessment, b) different application of analytical skills, and c) incomplete integration of boundary objects for self-regulated learning into supervision practice. These barriers were amplified by the simultaneous use of boundary objects for learning and assessment. Underlying contradictions included different objectives between school and practice, and tensions between the distribution of labor in the clinical setting and school's rules. School and practice have both convergent and divergent priorities around students' clinical learning. Boundary objects can promote continuity in learning and increase students' understanding of clinical practice. However, effective integration requires for flexible rules that allow for collaborative learning around patient care.

Prioritisation of clinical trial learning needs of musculoskeletal researchers: an inter-disciplinary modified Delphi study by the Australia & New Zealand musculoskeletal clinical trials network

BackgroundThere is a need to increase the capacity and capability of musculoskeletal researchers to design, conduct, and report high-quality clinical trials. The objective of this study was to identify and prioritise clinical trial learning needs of musculoskeletal researchers in Australia and Aotearoa New Zealand. Findings will be used to inform development of an e-learning musculoskeletal clinical trials course.MethodsA two-round online modified Delphi study was conducted with an inter-disciplinary panel of musculoskeletal researchers from Australia and Aotearoa New Zealand, representing various career stages and roles, including clinician researchers and consumers with lived experience of musculoskeletal conditions. Round 1 involved panellists nominating 3–10 topics about musculoskeletal trial design and conduct that they believe would be important to include in an e-learning course about musculoskeletal clinical trials. Topics were synthesised and refined. Round 2 asked panellists to rate the importance of all topics (very important, important, not important), as well as select and rank their top 10 most important topics. A rank score was calculated whereby higher scores reflect higher rankings by panellists.ResultsRound 1 was completed by 121 panellists and generated 555 individual topics describing their musculoskeletal trial learning needs. These statements were grouped into 37 unique topics for Round 2, which was completed by 104 panellists. The topics ranked as most important were: (1) defining a meaningful research question (rank score 560, 74% of panellists rated topic as very important); (2) choosing the most appropriate trial design (rank score 410, 73% rated as very important); (3) involving consumers in trial design through to dissemination (rank score 302, 62% rated as very important); (4) bias in musculoskeletal trials and how to minimise it (rank score 299, 70% rated as very important); and (5) choosing the most appropriate control/comparator group (rank score 265, 65% rated as very important).ConclusionsThis modified Delphi study generated a ranked list of clinical trial learning needs of musculoskeletal researchers. Findings can inform training courses and professional development to improve researcher capabilities and enhance the quality and conduct of musculoskeletal clinical trials.

Psychometric properties of the Arabic version of PHEEM applied on a sample of medical residents in Syria

BackgroundThe clinical learning environment (CLE) plays a crucial role in shaping the learning experiences and professional development of medical professionals. Understanding and optimising this environment is essential for improving doctors’ knowledge acquisition, clinical skills, and overall well-being. The development of the Postgraduate Hospital Educational Environment Measure (PHEEM) and its translation to numerous languages has been a milestone in clinical education. Even though PHEEM was recently translated into Arabic, its psychometric properties in this form remain unevaluated. Therefore, this study aims to conduct a comprehensive psychometric analysis of the Arabic version of the PHEEM questionnaire.MethodsThis is a cross-sectional questionnaire survey validation study. The defined population were medical residents in Damascus, Syria. A paper-based survey as well as an online-based one were conducted using several non-probability sampling methods namely, convenience, river and, snowball sampling between June 15, 2023, and June 21, 2023. Both exploratory (EFA) and confirmatory (CFA) factor analyses were conducted. Several psychometric criteria were applied including scree plot, eigenvalue > 1.5 and the ‘proportion of variance accounted for’ criterion.ResultsA total of 543 participants completed the questionnaire (56.9% female). Kaiser-Meyer-Olkin measure for sample adequacy was high (0.937) and the P-value for Bartlett’s test was < 0.001. EFA revealed five meaningful factors which were labelled: perception of teachers, learner’s engagement and social participation, external regulation, work culture, and living conditions. These factors had the following eigenvalues: 12.6, 2.18, 2.03, 1.86, and 1.41 respectively, with a total explained variance of 43.45%. Cronbach’s Alpha was 0.938. CFA confirmed the model structure of EFA (SRMR = 0.067 and RMSEA = 0.066). The Average Variance Explained (AVE) value of any given factor was > 0.7.DiscussionThe Arabic PHEEM inventory demonstrated satisfactory psychometric properties. The extracted domains are of theoretical relevance to the psychosocial-material conceptual framework for learning environment. Nonetheless, this validation was performed in the Syrian context; therefore, future studies in other Arabic countries are recommended to support the applicability of Arabic PHEEM in the wide Arab World.

Linking nursing students' professional identity, clinical learning environment, financial incentives, and career opportunities with migration intent: Structural equation modeling.

To investigate how nursing students' professional identity, clinical learning environment, financial incentives, and career opportunities influence their intention to migrate. There is a preponderance of studies about nurse migration and its impact on the global nursing workforce. However, a critical gap remains about nursing students' intentions to migrate, particularly among developing countries like the Philippines. Using a cross-sectional design, third- and fourth-year nursing students (n=316) from the largest comprehensive university in Manila were conveniently recruited. Data were collected from November to December 2023 using five validated self-report scales. Descriptive (e.g., mean, standard deviation) and inferential statistics (e.g., Spearman rho, covariance-based structural equation modeling) were used to analyze data. The emerging model demonstrated acceptable model fit indices. Nursing students' professional identity (β=0.18, p=0.043) and financial incentives (β=0.10, p=0.046) significantly and positively influence the intention to migrate. The satisfaction with future career opportunities (β=-0.12, p=0.038) and clinical learning environment perception (β=-0.15, p=0.048) negatively influence the intention to migrate. These four predictors accounted for 4.60% of the total variance of intention to migrate. Nursing students' professional identity and financial incentives directly impact intent to migrate, whereas future career opportunities satisfaction and clinical learning environment inversely affect intent to migrate. This study underscores the imperative for nursing colleges and faculty to promote positive professional identity and provide a conducive clinical learning environment to develop sustainable nurses' migration policies.

The influence of supervisory support on clinical learning as experienced by Czech Nursing and health professional students in the context of patient safety events: A qualitative study

AimTo explore the influence of supervisory and mentoring relationships on the clinical learning experiences of Czech Nursing and health professional students in the context of patient safety events BackgroundClinical experience is integral to healthcare education, shaping skills, behaviours, values and professional identity. During clinical placements, students may encounter memorable patient safety events and experience varied reactions from mentors/supervisors/others. Some research has highlighted challenges faced by students on clinical placement. Few studies involve multiple professions, most emanating from Western Europe, the UK, the USA and Australia with little relating to central European countries such as the Czech Republic. DesignTwo stage interpretivist qualitative study based in social constructionism MethodsConvenience sample across 13 undergraduate and 18 postgraduate health professions courses. Stage 1 (2022): using SLIPPS Learning Event Recording Tool translated into Czech. 20 students’ (Midwifery=11, Nursing=1, Paramedic=1, Occupational therapy =7) submitted 21 patient safety learning event narratives. Stage 2 (2022): Focus group with 2 nursing and nine midwifery students. Phased thematic analysis involving multiple researchers. ResultsThree themes illustrate the circumstances and impact of placement mentoring/supervision experiences, conceptualised as: ‘Clinical and Emotional Companionship’, ‘Clinical and Emotional Abandonment’ and ‘Sense of agency - Professional and personal growth’. ‘Companionship’ reflected the students’ feelings of being welcomed, respected, heard, trusted and supported. Conversely ‘abandonment’ emerged from feelings of being unheard, vulnerable, humiliated, afraid, leaving students feeling abandoned, lonely and ‘useless’. Notwithstanding these conditions, students showed the ability to identify patient safety issues with agency evident in reactions such as stepping-in to try to ameliorate a situation, rather than speaking-up. Professional and personal growth was also apparent in their narratives and a conceptual diagram illustrates the students’ learning journeys in a patient safety context. ConclusionThe findings and new conceptualisations around abandonment and companionship emerging from this study expand the evidence base regarding the profound impact of clinical experience and mentorship/supervision on learning and students’ emotional wellbeing. A sense of companionship appears to play a buffering role even in challenging circumstances of involvement in or witnessing compromised patients’ safety. Allowing students a sense of belonging, to vent, grow, feel supported and safe to ask/learn - contributing to ‘emotional safety for learning’, promotes students’ behaviour that may prevent/minimize hazards or ameliorate the aftermath. However, we must not simply blame mentors/supervisors, staff, or the students themselves- they are simply part of a much larger complex environment of professional education encompassing hidden curriculums, power dynamics and professional socialisation.

All hands on deck during the COVID-19 pandemic. Maintaining face-to-face medical education and clinical placements.

Medical students must have robust educational experiences, graduate and commence timely employment. Here, we describe how the Royal College of Surgeons in Ireland (RCSI) delivered clinical placements in medical programmes over the first three waves of the COVID-19 pandemic in Ireland, including a student-centred, holistic approach to students' educational, social and health needs with strong student involvement, re-organising the university's primary care team, developing COVID-19 PCR testing on site and re-focusing communications and student services. This resulted in re-arranging the students into learning communities, and students and staff electronically recorded their COVID-19 symptom status daily. In-person observed structured clinical examination and other clinical exams progressed. No lockdown of any campus occurred. Over the two senior years, 693 students completed 15,000 weeks of clinical and experiential learning across 104 sites, similar to previous years, including anatomy practicals, procedural skills training, simulated ward rounds and patient encounters, case-based presentations and small group tutorials. The compliance rate with the daily symptom tracker was 91%. The percentage response rate and the number of students providing feedback from October 2020 to April 2021 was as high as 50%. The overall response rate was 33%. By mid-May, 93-95% of students in the two senior years had had at least one dose of the SARS-CoV-2 vaccine, with 99% fully vaccinated by the start of the next academic year in autumn 2021. Over the period of testing for SARS-CoV-2, just over 22,000 samples were processed, of which 0.79% were positive; no medical student acquired COVID-19 or was associated with nosocomial transmission. The total investment by the RCSI in Dublin, was €9.3m (€1.2 in capital expenditure and €8.1 in operational expenses). Continuing face-to-face clinical placements during a pandemic was possible through a multi-model approach that prioritised two-way communication, compliance with national public health advice and student screening.

Fully Automatic Deep Learning Model for Spine Refracture in Patients with OVCF: A Multi-Center Study.

The reaserch of artificial intelligence (AI) model for predicting spinal refracture is limited to bone mineral density, X-ray and some conventional laboratory indicators, which has its own limitations. Besides, it lacks specific indicators related to osteoporosis and imaging factors that can better reflect bone quality, such as computed tomography (CT). To construct a novel predicting model based on bone turn-over markers and CT to identify patients who were more inclined to suffer spine refracture. CT images and clinical information of 383 patients (training set = 240 cases of osteoporotic vertebral compression fractures (OVCF), validation set = 63, test set = 80) were retrospectively collected from January 2015 to October 2022 at three medical centers. The U-net model was adopted to automatically segment ROI. Three-dimensional (3D) cropping of all spine regions was used to achieve the final ROI regions including 3D_Full and 3D_RoiOnly. We used the Densenet 121-3D model to model the cropped region and simultaneously build a T-NIPT prediction model. Diagnostics of deep learning models were assessed by constructing ROC curves. We generated calibration curves to assess the calibration performance. Additionally, decision curve analysis (DCA) was used to assess the clinical utility of the predictive models. The performance of the test model is comparable to its performance on the training set (dice coefficients of 0.798, an mIOU of 0.755, an SA of 0.767, and an OS of 0.017). Univariable and multivariable analysis indicate that T_P1NT was an independent risk factor for refracture. The performance of predicting refractures in different ROI regions showed that 3D_Full model exhibits the highest calibration performance, with a Hosmer-Lemeshow goodness-of-fit (HL) test statistic exceeding 0.05. The analysis of the training and test sets showed that the 3D_Full model, which integrates clinical and deep learning results, demonstrated superior performance with significant improvement (p-value < 0.05) compared to using clinical features independently or using only 3D_RoiOnly. T_P1NT was an independent risk factor of refracture. Our 3D-FULL model showed better performance in predicting high-risk population of spine refracture than other models and junior doctors do. This model can be applicable to real-world translation due to its automatic segmentation and detection.

Nurses, midwives and students' reports of effective dedicated education units in five European countries: A qualitative study.

To investigate nursing/midwifery students, Clinical Mentors, Link Teachers and Head Nurses experiences within "Dedicated Education Unit" model in 6 European clinical placements and analyse the necessary elements for a powerful clinical learning environment. A multi-country, phenomenological, qualitative study. Focus group interviews were performed to identify the personal and organizational factors of importance for students and nurses/midwives. Data analysis produced 4 main themes (1) Clinical placement organization, (2) students' clinical knowledge and skill acquisition, (3) students, and nurses/midwives' experiences within the DEU model and (4) factors for creating an effective learning environment. A close educational-service collaboration, a realistic clinical placement planning, a focus on student learning process and an investment in professionals' education and development among others, are elements to set up a powerful clinical learning environment. It is considered advisable and urgent to improve the working conditions of nurses/midwives and the learning environments of students as a strategy to alleviate the global shortage of nurses and respond to the increasingly demanding health needs of the population. Due to the close relationship between students' learning and features of the clinical environment nurse educators seek innovative models which allow students to manage patient care and their transition to professional practice. To implement new learning strategies, identifying students, nurses and midwives perceptions and suggestions is a powerful information to evaluate implementation process and outcomes. Our findings could help academic and clinical managers to meet the human and organizational requirements to create a successful learning environment in every student placement.

Comparing Effectiveness of Online Text-based and Video-based Material in Anesthesia with Jet Ventilation and Microlaryngeal Surgery: A Multicenter Randomized Trial

Objective: Effective clinical training is essential for healthcare personnel with clinical skill requirements. This studyaimed to identify an effective learning medium for anesthesia residents by comparing text-based and video-based online training. Materials and Methods: This online, randomized, multicenter study was conducted between October 2020 and March 2021. Three Thai institutions were involved: the Faculty of Medicine Siriraj Hospital, Mahidol University; the Faculty of Medicine, Ramathibodi Hospital, Mahidol University; and the Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University. In all, 126 anesthesia residents were randomized into a “text group” and a “video group.” Four residents were excluded due to contamination of their learning material. The 122 eligible students undertook 3 knowledge and skill assessments (“Pretest,” “24-hour posttest,” and “3-month posttest”). The primary outcome was the gain score after training. This was measured in 2 ways: the difference between the 24-hourposttest and Pretest scores and the difference between the 3-month posttest and Pretest scores. Results: The mean gain scores for Pretest and 24-hour posttest were higher in the text group with no significant difference (P = 0.347). The mean differences between the 3-month posttest and Pretest scores were higher in the text group without a significant difference (P = 0.488). The mean satisfaction score was higher in the video group. Conclusion: Video-based e-learning training provided better satisfaction without significantly improving gain scores compared to text-based e-learning training. Online video-based was beneficial over text-based for ease of understanding in clinical learning points.

“This should be a compulsory placement for all nursing students”: An evaluation of pre-registration nursing students’ perceptions of learning on a mental health clinical placement

AimTo conduct a longitudinal exploration of pre-registration nursing students’ perceptions of their learning on an immersive mental health clinical placement grounded in learning from people with a lived experience of mental illness (otherwise known as consumers). BackgroundEnriching mental health clinical learning environments are crucial for positive mental health nursing outcomes. Though non-traditional clinical placement (i.e. non-hospital-based) models effectively increase student learning in a range of domains, little is known about the specific features of contemporary non-traditional placement settings that may be supporting student learning over time. DesignA survey design in the form of a standardised evaluation tool with additional qualitative response questions was used to examine nursing students’ perceptions of learning whilst on a non-traditional clinical placement over a 5-year period. Non-traditional placement settings are alternative placement options to traditional inpatient/community mental health settings. The TREND Statement Checklist was adhered to. MethodsSecond- and third-year students studying a Bachelor of Nursing (N = 753) from eight Australian Universities completed a Student Placement Feedback Survey between 2019 and 2023. Data were collected via an evaluation survey including 7-items (rated on a 5-point agreement scale) and three free-response questions. Quantitative and qualitative responses were analysed over all observations and compared between the five years of student evaluations. ResultsAcross five years, the immersive mental health placement was consistently rated by students as a highly valuable learning experience. Utilizing a Multivariate Analysis-of-variance (MANOVA) for the quantitative component revealed that student ‘learning from lived experience’ remained uniformly high and steady throughout 2020–2023. This was despite disrupted learning that ceased face-to-face tuition caused by the COVID-19 pandemic. An increase in ‘student enthusiasm for nursing’ was identified after the return to face-to-face learning. Qualitative analysis identified a greater need for preparedness prior to attending the placement and wellbeing support amongst students. ConclusionsOver the five years, pre-registration nursing students report clinical skill improvement and enhanced knowledge following the immersive mental health placement alongside an increased desire for further skill development. Learning from people’s lived experience of mental illness and specialised facilitators was valuable for student learning outcomes. Increased support is needed for student mental health vulnerabilities and wellbeing ahead of clinical placements. Further research is recommended on the aspects of non-traditional clinical placements that may be protective for student learning.

Clinical learning experiences of healthcare professional students in a student-led clinical learning environment (SLCLE) – A mixed methods evaluation

AimTo evaluate healthcare professional (HCP) students clinical learning experiences’ whilst undertaking placements in a student-led clinical learning environment (SLCLE) and any changes in self-reported ratings of confidence. BackgroundThe English NHS Long Term Workforce Plan (2023) highlights the need to expand domestic education of HCPs to meet workforce shortages. The demand for quality clinical placements to support the preparation of HCP students remains a challenge globally. A creative solution has been the development of student-led learning clinical environments in healthcare settings. SLCLEs provide high-quality learning experience, increase clinical placement capacity whilst maintaining patient care standards. A multisite NHS Trust adopted this model as evidence suggests HCP students will be better prepared on qualification to adopt registered practitioner professional responsibilities. This model has been integrated across three hospital sites within a large teaching hospital, providing care for a diverse population and designed to accommodate students from a range of HCP disciplines and higher educational institutions. DesignA mixed methods convergent design. MethodsAn online survey was administered to SLCLE allocated nursing and allied health profession (AHP) undergraduate and graduate-entry first, second and third-year students (n=132). Face to face focus groups/individual interviews were undertaken with a purposive sample of student participants (n=80) to evaluate their experiences of clinical learning in SLCLEs. Survey data were analysed using descriptive statistics and paired t-tests, interviews using framework method. ResultsUndergraduate and graduate-entry students from four UK universities completed the survey (n=132), 103 students (78 %) responded. Most were year 2 students (n=43/42 %), pursuing nursing programmes (n=82/80 %). Most considered the SLCLE met their expectations (n=76/74 %), reported increased confidence post-placement (n=84/82 %), felt supported by staff (n=80/78 %), peers (n=93/90 %) and clinical educators (n=93/90 %). Self-reported confidence scores post-SLCLE were significantly higher than pre-SLCLE. On-line pre-placement information was infrequently accessed yet identified as an omission. Four themes were identified: (i) preconceptions and initial anxiety; (ii) empowerment, growth and a unique learning experience; (iii) collaborative inter-professional learning and support; and (iv) insights and anticipations. ConclusionsThe SLCLE allocation enhanced students’ confidence and knowledge. Support from clinical educators, ward staff and doctors was perceived as invaluable for creating a positive learning culture. Peer support and opportunities to lead care delivery contributed to students’ professional development. The format and method for providing pre-placement information needs review as do strategies for avoiding delays in completing assessment documentation. Overall, the SLCLE experience offers much potential as a nurturing and effective learning environment for HCP students.

Pengaruh Pelatihan Preceptor Mentor terhadap Kepuasan Mahasiswa dalam Bimbingan Praktik Klinis

Clinical practice learning is a learning activity held in practice settings such as hospitals, clinics, health centers and communities. Phenomenological studies state that the duties and responsibilities as a preceptor cannot be carried out optimally. Surveying student perceptions regarding the role of preceptors in practice areas, 12% stated that preceptors were less cooperative, less friendly, and less guiding; 11.3% stated that preceptors were busy with other tasks, and 15.3% stated that preceptors were busy with patients. The aim of the research was to determine the effect of preceptor mentor training on student satisfaction at the Padang DII Midwifery Study Program, Padang Ministry of Health Polytechnic. This research is quantitative research with a cross-sectional approach. The research population was clinical practice supervisors in hospitals, community health centers, and midwives' independent practice in West Sumatra. The sampling technique used total sampling with a total of 80 respondents. The research instrument is a questionnaire. The research results showed that out of a total of 80 respondents, 47 respondents (58.75%) had participated in preceptor mentor training and 38.75% of them had received student satisfaction ratings in the high category in guiding students. Conclusion : The Chi-square test result is 0.000, preceptor mentor training has an influence on student satisfaction at the DIII Midwifery Study Program, Padang Health Polytechnic, Ministry of Health, Padang in guiding clinical practice in the practice area. Recommended that the institution to collaborate with the hospital so that preceptorship training can be carried out jointly and complement each other between clinical and academic supervisors.

Impact of Clinical Learning Environment and Incivility on Professional Self-Concept in Dental Hygiene Students

Impact of Clinical Learning Environment and Incivility on Professional Self-Concept in Dental Hygiene Students