Clinical Education Model Research Articles

Effect of intervention on humanistic care ability in internship nursing students

Objective To explore the intervention of improving nursing students′ humanistic care ability. Methods We selected 36 internship nursing students between May 2012 and April 2013 as control group (routine clinical teaching model) and 34 internship nursing students between May 2013 and April 2014 as intervention group (improved clinical teaching model that emphasizes the humanistic care). We compared the nursing students′ humanistic care ability and the patients′ satisfaction with them before and after intervention. Results There were no significant differences in the total score and the score of all dimensions of humanistic care ability between the intervention group and the control group before intervention (P>0.05). After the intervention, the total score and the dimension score of cognition, patience, encouragement in the intervention group was all higher than that in the control group (P<0.05). And patients′ satisfaction with nursing students′ overall quality and humanistic care was higher than that of the control group (P<0.05). Conclusions Strengthening the humanistic nursing education and training can improve the humanistic care ability, deepens the Patient centered concept and provides the higher quality nursing service. Key words: Internship nursing student; Care ability; Clinical teaching; Humanistic care

Patient Evaluation of Clerkship Learning and Teaching Within a “Learner-focused” Obstetrics and Gynecology Clinical Care Model

APGO Advisor: John Dalrymple, MD PURPOSE: To evaluate patients' perceptions of teaching provided by medical students and clinician-educators within a “Learner-focused” clinical care model. BACKGROUND: Clinician-educators balance competing demands: patients' evaluation of care against students' evaluation of learning experiences within constraints of quality and cost. “Patient-focused care” diminishes medical student learning. “Student-focused” teaching detracts from productivity. Ideal clinical teaching answers the needs of patient, student and clinician-educator: a “Learner-focused Clinical Care” model emphasizes the learning needs and informs a critical teaching role for each. METHODS: During obstetrics and gynecology rotations, exit questionnaires were administered to patients accepting medical student involvement. We assessed overall patient satisfaction and whether patients perceived that students, the clinician-educator, or themselves filled valuable teaching or learning roles or both. RESULTS: For 101 patients overall satisfaction with the visit was 4.86±.35 standard deviation (SD) (5 highest). Patients identified and valued the teaching provided by the clinician-educator (4.82±.44 SD, 4.92±.34 SD, respectively), expressing confidence in what the clinician-educator was teaching (4.95±.22 SD). Patients recognized and valued the teaching they received from the student (4.17±.73 SD, 4.00±.73 SD, respectively), expressing confidence in what the students taught (4.29±.72 SD). Within the model, patients least identified their own role as teacher (3.89±.99 SD). DISCUSSION: A clinical teaching model promoting active teaching and learning between patients, medical students and a clinician-educator, is associated with high patient satisfaction and suggests that valuable health education is provided both by students and clinician-educators.

Pilot study of a dedicated education unit: Lessons learned

Background and objective : Nursing programs in Australia, New Zealand, and the United States are implementing Dedicated Education Units (DEU) as an innovative approach to provide clinical experiences for undergraduate nursing students. In August 2014 a university in Texas received a state grant to institute a pilot implementation of a DEU as a means of increasing the number of pre-licensure nursing students in the BSN program. The following objectives were designed to provide structure to implement and evaluate the DEU project: (1) Develop and implement a DEU model for pre-licensure nursing clinical education in four medical-surgical courses, using two nursing units at a local regional hospital; (2) Test the effectiveness of the DEU model of clinical education for pre-licensure nursing students; and (3) Increase the number of BSN-prepared nurses serving as DEU Clinical Instructors who enroll in a MSN-Nurse Educator program by six in the first semester of the grant. Methods : A variety of methods were used to evaluate effectiveness of this project, including focus groups of participants; qualitative assessment of the project orientation process for students, faculty and staff; quantitative analysis of examination scores, course scores, competency evaluations, and enrollment data. Results : Project evaluation revealed some positive results; however, problems related to orientation and ongoing support were seen as a barrier to successful implementation. Work overload for the Clinical Instructors also negatively impacted the effectiveness of the project. The number of students involved in this project was dictated by the space available in the designated DEUs. Even though the small sample size was insufficient for a research study, the results of this project may be of interest to others implementing a DEU. Conclusions : This paper focuses on lessons learned from the implementation a DEU pilot project and provides a number of suggestions for addressing challenges. The analysis of the results of this pilot project and related recommendations to avoid or ameliorate the challenges may be instructive for other schools planning to initiate a DEU.

Campus‐Based, Community‐Based, and Philanthropic Contributions to Predoctoral Pediatric Dental Clinical Education: Two Years of Experiences at One Dental College

The aim of this study was to investigate the contribution of a tiered predoctoral pediatric dentistry clinical education model to competency achievement by dental students over a two-year clinical education. Retrospective data were obtained for academic years 2012-13 and 2013-14 from three sources: a campus-based, dental school-housed clinic; division-directed clinics in community-based pediatric and special needs clinics (DDC); and clinics affiliated with the dental college's community-based dental education (CBDE) program, the OHIO Project (OP). A fourth dataset was obtained for the same two-year period from a biannual clinic event held at the college in conjunction with Give Kids a Smile Day (GKAS). Procedures considered essential to the care of children were sorted by 12 dental codes from all services for patients 18 years of age and younger. The dental school clinic provided 11,060 procedures; the DDC, 28,462; the OP, 17,863; and GKAS, 2,028. The two-year total was 59,433 procedures. Numbers of diagnostic and preventive procedures were 19,441, restorative procedures were 13,958, and pulp and surgical procedures were 7,392. Site contribution ranged from 52.2 to 144.9 procedures per attending student, with the DDC yielding the highest per student average for each year (126.4 and 144.9) and the dental school clinic the lowest (52.2 and 53.1). This study found that a combination of school-based, community-based, and philanthropic pediatric dental experiences offered a large number of essential pediatric dentistry experiences for predoctoral dental students, with CBDE opportunities offering the largest contribution.

A clinical clerkship collaborative program inTaiwan: Acquiring core clinical competencies through patient care responsibility.

Traditionally, clinical clerkship training in Taiwan does not provide medical students with sufficient patient care responsibilities and often results in inadequate clinical skills. We implemented a pilot clerkship program at a comprehensive cancer center that emphasizes core clinical competency through direct patient care and dedicated faculty and mentors. Students were an integral part of the patient care team held accountable for providing coordinated and holistic care. Students' self-assessment of clinical competencies, faculty evaluation, and objective structured clinical examination were compared against their peers trained by traditional clerkship at a main teaching hospital. Fifty medical students completed the clerkship program in the first 3 years. At the end of the clerkship, participants rated themselves significantly higher than their peers in almost all patient care and clinical skill domains. The most significant areas included physical examination, clinical reasoning, developing management plan, holistic approach, handling ethical issues, and time management skills. The students rated their clerkship teachers significantly higher in time spent with students, skills and enthusiasm in teaching, as well as giving students appropriate patient care responsibilities. There was no significant difference in the end-of-clerkship objective structured clinical examination performance, but participants of the program achieved better grades in their subsequent internship. This pilot collaborative program presented a successful model for clinical education in the teaching of core clinical competencies through direct patient care responsibilities at the clerkship stage. It is hoped that the project will become a catalyst for medical education reform in Taiwan and regions with similar traditions.

India Legal Aid Clinics: Creating Service Learning Research Projects to Study Social Justice

Law school legal aid clinics serve two main purposes. The first is to provide a better legal education to students. The second is to provide access to justice in the community. This article will provide some background on the importance of both of these missions. We will then discuss the results of a study of legal aid clinics across India in 2012–13. Indian undergraduate law school students 4 designed and conducted this study under the direction of Dr Shailendra K. Gupta and Fulbright-Nehru Scholar David Tushaus at Banaras Hindu University. The research team obtained both quantitative and qualitative data from legal aid clinic directors for a view of the state of clinical legal education in India at this time. The service learning process of forming the team and conducting the research is described here. Findings show the global legal clinic movement has reached India. There are some excellent models for clinical legal education in India and abroad. However, there is great room for improvement. Some legal aid clinics provide excellent educational opportunities. Service learning, where students apply their knowledge in service to the community, is more effective in teaching analytical skills and critical thinking. Much more can be done in India’s clinics, where representation is more restrictive than in some countries. Providing legal education in the community through various means, including specialized advocacy, can be effective and educational. There are suggestions for reforms to improve clinical legal education in India, from providing elective credit to allowing direct representation.

The Benefits of Simulation-Based Education

Simulation-based education is an accepted teaching methodology within many disciplines, but has yet to be fully integrated into the clinical education models of speech-language pathology and audiology. Simulation-based education is an innovative opportunity to enhance clinical education in the fields of speech-language pathology and audiology. The approach provides a number of benefits that positively impact critical stakeholders, including training programs, faculty, students, clinical supervisors, and, most importantly, the clients requiring care. The benefits of simulation-based education will be reviewed relative to the existing literature both within and outside the professions.

Physiotherapy students and clinical educators perceive several ways in which incorporating peer-assisted learning could improve clinical placements: a qualitative study.

What are the experiences of students and clinical educators in a paired student placement model incorporating facilitated peer-assisted learning (PAL) activities, compared to a traditional paired teaching approach? Qualitative study utilising focus groups. Twenty-four physiotherapy students and 12 clinical educators. Participants in this study had experienced two models of physiotherapy clinical undergraduate education: a traditional paired model (usual clinical supervision and learning activities led by clinical educators supervising pairs of students) and a PAL model (a standardised series of learning activities undertaken by student pairs and clinical educators to facilitate peer interaction using guided strategies). Peer-assisted learning appears to reduce the students' anxiety, enhance their sense of safety in the learning environment, reduce educator burden, maximise the use of downtime, and build professional skills including collaboration and feedback. While PAL adds to the clinical learning experience, it is not considered to be a substitute for observation of the clinical educator, expert feedback and guidance, or hands-on immersive learning activities. Cohesion of the student-student relationship was seen as an enabler of successful PAL. Students and educators perceive that PAL can help to position students as active learners through reduced dependence on the clinical educator, heightened roles in observing practice, and making and communicating evaluative judgments about quality of practice. The role of the clinical educator is not diminished with PAL, but rather is central in designing flexible and meaningful peer-based experiences and in balancing PAL with independent learning opportunities. ACTRN12610000859088. [Sevenhuysen S, Farlie MK, Keating JL, Haines TP, Molloy E (2015) Physiotherapy students and clinical educators perceive several ways in which incorporating peer-assisted learning could improve clinical placements: a qualitative study.Journal of Physiotherapy61: 87-92].

An exploration of knowledge and practice of patient handling among undergraduate occupational therapy students

Purpose: To explore knowledge and practice relating to patient handling among final year occupational therapy students in the Republic of Ireland. Method: We conducted a survey of final year students in three out of four occupational therapy programs in the Republic of Ireland (n = 81). The survey measured students’ knowledge of manual handling principles and techniques and explored their experiences and ability to apply this knowledge to clinical situations. Results: All students (n = 81) had undertaken training in patient handling. Just under half of students (n = 35, 43.2%) had received additional training outside of the university setting. Overall knowledge of safe patient handling principles techniques and risk assessment was low (Mean Score = 15.71/28; SD = 3.81). Participants who received additional training achieved a lower mean total score (M = 13.89, SD = 3.54) than those who only undertook university-based training (M = 18.11; SD = 2.66; t(79) = −5.87; p < 0.05). The majority of participants reported intermittent use of taught principles while on clinical practice placements (n = 50, 61.8%) Reasons for not using taught principles included; selection of alternative technique by supervisor (n = 30, 56.6%); lack of available equipment (n = 13, 24.5%) and lack of time (n = 13, 24.5%). Conclusions: While occupational therapy students in Ireland receive training in safe patient handling they appear to have limited knowledge of best practice and experience difficulties in applying their learning to clinical situations. There is an urgent need to consider the effectiveness of current educational strategies in this area.Implications for RehabilitationSafe patient handling is a key component in preventing musculoskeletal injury among rehabilitation professionalsThe extent to which pre-professional training prepares rehabilitation professionals to practice safe patient handling is unclearOccupational therapy students in this study had limited knowledge of safe patient handling and had difficulty applying their learning to clinical practiceAlternative education models are required to support development of safe patient handling skills.Educators may wish to consider how safe patient handling can be embedded across curricula to avoid the challenges of once off instruction and massed practice.

Comparing Comprehensive Care and Departmental Clinical Education Models: Students’ Perceptions at the University of Tennessee College of Dentistry

In summer 2012, the University of Tennessee Health Science Center College of Dentistry transitioned from a departmental clinical education model to a comprehensive care/group leader model. The aim of this study was to investigate the perspectives of the fourth-year class of dental students who, because the transition took place during their training, had experienced treating patients under both educational models. To achieve this objective, a questionnaire was designed to assess the students' opinions on the efficiency of their effort, availability of specialty faculty, stress, collaboration with classmates, and availability of exposure to different practice styles and techniques under the two systems. The students were also given an opportunity to provide open-ended feedback on the shortcomings and advantages of the systems. The Class of 2013 had 81 students, 55 of whom participated in the survey for a response rate of 67.9%. The majority (86%) of the respondents preferred the comprehensive care model and reported feeling that, in it, they were able to accomplish more comprehensive dentistry with greater consistency of supervision from faculty in a more patient-centered environment than in the departmental model. However, 56 percent considered having the same group leader for two years a disadvantage and recommended rotation of at least one group leader every six months. The results of this survey can help this college and other dental schools that are seeking to optimize their educational model to best serve students' educational experience and the dental needs of their patient population.

A Description of Current Curricular Design Models Used In Physical Therapy Clinical Education and Their Relationship to Pass Rates on the National Physical Therapy Examination

Purpose. The purpose of this study was to develop descriptions and identify commonalities of current clinical education models used in physical therapy programs; then, using this information, to examine differences in first-time and ultimate pass rates among the derived formula from Commission on Accreditation in Physical Therapy Education (CAPTE) accredited programs in 2011-2013. Methods. This mixed methods study captured qualitative and quantitative data from the 204 PT programs located in the United States and Puerto Rico from 2011 to 2013. The data were coded into 11 different clinical education models which represented all programs. The models were then linked to first time and ultimate pass rates. Results. Twenty out of 204 (9.8%) PT programs reported first-time pass rates and 201/204 (98.5%) reported ultimate pass rates in the cited three-year cycle period stated in this study. The three most commonly occurring models make up 84% of all current existing models. All three frequently occurring models include both full time and clinical internship clinical experiences. Additionally, these models outperformed the national pass rate average by at least 3%. Conclusions. Our results are the first to provide an analysis of the various models in use in physical therapist education, as well as a preliminary outlook on how clinical education design is matched against a program’s pass rate on the national exam. Since pass rate is one of the few standardized, modifiable outcomes for CAPTE approved programs, it was selected as the outcome to allow comparison of clinical education models. One of the driving forces behind this study was to illustrate clearly the tremendous variety of clinical education models and a better understanding of the scope of the variances that is occurring.

実習形態の違いによる学生の気分・感情状態に関わる要因の検討─学生へのアンケート調査からの考察─

〔目的〕本研究の目的は，単独型と複数型の臨床実習形態の違いが学生の気分・感情状態に与える要因を，学生へのアンケート結果から示すことである．〔対象〕対象は2週間の検査・測定実習を実施した2年次生45名（平均年齢19.3±0.5歳，男性23名）とした．〔方法〕気分・感情状態をProfile of Mood States短縮版（POMS-SF）で測定するとともに，実習に関する15項目のアンケートを実施した．〔結果〕施設職員との関係，課題量などについてPOMS-SFと有意な相関が認められた．アンケート結果の比較では，施設職員との関係のみ，複数群が単独群よりも有意に低値を示した．〔結語〕複数型による実習形態は，単独型と比較して，施設職員との信頼関係が良好に築かれない可能性が示唆された．

Triple Ps and Cs to solve the trouble of transition: A new theoretical model

Aims: Aim of the study was to explore the experiences of interns and preceptors to develop a rich conceptual understanding of their experiences during the internship. Settings and Design: Purposeful sampling was used to recruit 22 interns and 11 preceptors during an internship program at a tertiary public hospital in Riyadh. Methods: We used qualitative research based on a phenomenological approach. data was collected through semi-structured interviews. Data Analysis: Interviews were transcribed verbatim and analysed concurrently using thematic analysis. Results: internship program had a positive impact on interns and their preceptors. However, both groups reported negative issues related to their preparations (training) and emphasised the need for better cooperation between education and practical healthcare services. Conclusions: findings lead the researchers to develop a new model for clinical education, future healthcare professionals and those who assist them during the internship, The Triple Ps and Cs to solve the trouble of transition.

The perspectives and perceptions of dental education in the West and an overview of dental education in India

The dental education forms the foundation of the professional lives of the dentists. In the context of the student, faculty and the curriculum constitute the main aspects of the dental education. The important perspectives of these three arena are analyzed with plausible suggestions for improvising them. The present technology-savvy Y generation has evolving educational needs and has to be provided with more diverse and interactive methodologies for learning and also involving information technology applications. The faculties both in terms of quality and number have profound impact on the outcomes of the dental education. The present dental curriculum needs to be reformed by correcting some inherent concerns and flaws such as inadequate clinical relevance of basic science concepts, lack of comprehensive patient care model for clinical education, and overcrowding of the curriculum. The dental education in India, despite its tremendous growth since the beginning, has some significant issues regarding the quality of dental education mostly in some private dental colleges. The Dental Council of India and the Union Government should be more stringent with reinforcing rules and regulations to assure adequate infrastructure and quality education in all the private dental colleges. More number of job postings for dentists should be created in the government hospitals, and the present inappropriately limited number of postgraduate seats should also be increased to assure the viability of the dental profession in future.

Evaluating Physical Therapist Students’ Clinical Performance in Acute Care: A Retrospective Analysis Comparing Student-Treated and Staff-Treated Patient Outcomes After Total Knee Arthroplasty

Introduction. The ultimate goal and primary responsibility of physical therapist (PT) education is to produce graduates who can function as competent practitioners. However, clinical effectiveness and efficiency of patient care provided by PT students are not well established. Subjects/Methods. We identified 160 patients who received primary unilateral total knee arthroplasty at a single acute care hospital in the Midwest between March 2009 and August 2010. Next, we used a retrospective cohort design to compare the outcomes for those treated by licensed PTs and physical therapist assistants (PTAs) (n = 80) to those treated by PT students (n = 80) in a collaborative clinical education model. Outcomes. Primary outcomes were the improvement in functional mobility at discharge as measured by the Functional Outcome Measure (FOM), and improvement of the provider's efficiency as measured by the change in FOM score from initial visit to final visit in relation to the number of therapy visits. Results: There were no significant differences between the functional gains achieved by each group (P = .955) or in provider efficiency (P = .594). Discussion and Conclusion: In the acute care setting, functional outcomes following primary total knee arthroplasty were similar for patients, whether treated by the physical therapy staff or PT students in a collaborative clinical education model. These results need confirmation with prospective randomized studies.

Models of physiotherapy clinical education in south-West Nigeria

The South-East Asian Journal of Medical Education (SEAJME) is the culmination of the SEARAME's vision to bring together medical educationists in the region to promote collaborative efforts toward uplifting the standards of medical education in the region and beyond through dissemination of knowledge. This journal will be the ideal platform to disseminate research findings and stimulate discussion among experts in the field. Open access policy of the journal will facilitate this ideal.From November 2019, The South-East Asian Journal of Medical Education (SEAJME) is indexed in EuroPub

Student-Assisted Services (SAS): An Innovative Clinical Education Model that Prepares Graduates for the Future, Contributes to Health Service Delivery, and Addresses Internship Shortages

The combination of an aging population profile and a rising prevalence of obesity and chronic disease increases the need for dietetics services.1 It is predicted that by the year 2020 only 75% of the demand for nutrition and dietetics practitioners in the United States will be met.2 A potential barrier to increasing the size of the dietetics workforce is the shortage of internships.3 Approaches such as team teaching have been trialed in hospitals,4 and although such initiatives provide some increase in student training capacity, they are unlikely to meet total placement demand.

Using a dedicated education unit clinical education model with second-degree accelerated nursing program students.

Rising health care costs have underscored the need for new graduates to effectively transition to professional practice. Effective academic-practice partnerships, such as dedicated education units (DEUs), can be useful in facilitating the transfer of knowledge from the classroom to the clinical setting. This randomized experimental study found the DEU clinical model to be valuable in facilitating the transfer of knowledge in second-degree accelerated program students as evaluated by course, simulation, and standardized assessment scores and self-evaluations. Successful transition to clinical practice is reported by practice partners; time allotted for orientation program requirements was reduced and retention on the unit of hire was improved. Additional research is needed to understand the effectiveness of second-degree accelerated nursing programs and how to revise the clinical education element of the program to meet the unique needs of these students.

Mentor Satisfaction Using a New Model of Clinical Education

Abstract AIM The aim of this descriptive study was to examine mentor satisfaction in an academic-practice partnership in Michigan. BACKGROUND New models of education, in which nurse faculty partner with practicing nurses to mentor and teach students, are being established to meet the demand for nurses. METHOD A survey was distributed via email list to examine mentor satisfaction according to the mentor's education level, experience, and clinical unit. Descriptive statistics were used to analyze the results. RESULTS Findings were analyzed with regard to satisfaction, understanding, student preparedness, comfort of giving feedback, faculty engagement, and the use of evidence-based practice. Mentors were found to be satisfied with the model. CONCLUSION Nurses with less experience were more satisfied with the model; level of education and unit were not found to be statistically significant. Future research to evaluate academic-practice partnerships is needed.

Medical Students’ Exposure to Bedside Teaching

The “One-Minute Preceptor” is a well-known and widely used clinical teaching model which consists of five primary microskills: (1) get a commitment, (2) probe for supporting evidence, (3) teach general rules, (4) reinforce what was right, and (5) correct mistakes. In order to obtain a baseline measurement of the use of these microskills in an established clinical department, we shadowed medical students during rounding experiences and clinical tutorials throughout an 8-week clinical rotation and recorded their exposure to the microskills; combining the latter two into a single domain of “feedback.” We recorded the presence or absence of each microskill within 15-min intervals. Overall, commitment, probing, teaching, and feedback occurred in 49.0, 20.2, 89.9, and 41.8 % of the 15-min intervals, respectively. This observational strategy was an innovative approach to observe the quality and quantity of clinical teaching and provides a baseline to determine the impact of faculty development programs to improve clinical teaching.