Objective Structured Clinical Examination Research Articles

Qualitative Exploration of Nursing Students' Perceptions of the Implementation of Objective Structured Clinical Examination (OSCE)

ABSTRACT Introduction: The current method of measuring the clinical competency ability of nursing students is not only through CBT-based exams. One of the methods used to evaluate students' clinical skills is Objective Structured Clinical Examination (OSCE). The purpose of this study is to explore student perception of implementation (OSCE) as a method of evaluating student skills. Methods: This study uses qualitative exploration studies with a phenomenological approach to explore into students' experiences with the OSCE. The population in this study is nursing students (2019–2020) at private University at Surabaya. A total of nine students participated in this study according to the established inclusion criteria. The data collection was conducted through in-depth interviews through Zoom with semi-structural interviews and recorded by the researchers according to the participant's consent. The study was conducted from January 14th to February 1st, 2024. Data were analyzed using the Colaizzi method to determine themes and sub-themes. Results: According to the results of the study, five themes related to student perceptions of the implementation of the OSCE covered the level of knowledge, stressors, implementation management, coping mechanisms, and advantages of OSCE methods. Conclusion: These findings are expected to serve as a basis for the strategy of implementing OSCE as a method of clinical evaluation, especially in the scope of the College of Nursing Sciences. Keywords: Perception, Students, Nursing, OSCE.

Changes in the Professional Identity and Self-Efficacy of Nursing Students Engaged in the Objective Structured Clinical Examination Using Simulation Learning.

The Objective Structured Clinical Examination (OSCE) is widely adopted in nursing education to enhance clinical skills and professionalism. With OSCE, the learning process is important, and students who underwent OSCE felt more confident and better prepared for their next clinical training. This study aims to clarify how the self-efficacy and professional identity of nursing students change after learning through simulation education and OSCE. Clarification of these issues will allow an OSCE design utilizing simulation-based education as will be discussed. This study used a pre-post study design, and the participants were 74 nursing university students at one university in Japan who agreed to participate in the study. The total scores and subscale scores for professional identity and self-efficacy were compared before and after the OSCE using the Wilcoxon signed-rank test. Spearman's rank correlation coefficient was calculated to examine the relationship between professional identity and self-efficacy. There were significant increases in self-efficacy scores (p<0.05) after OSCE, but there were no significant changes in the total scores of professional identities before and after the OSCE. Professional identity scores, such as choosing nursing again and desire to improve nursing skills, increased. Simulation-based OSCE effectively enhances nursing students' self-efficacy and certain aspects of professional identity, indicating its potential for nursing education.

The potential for using entrustable professional activities in assessing optometric clinical competence.

Qualifications required to practise optometry seek to provide assurance that those completing them have the necessary competencies to be safe and effective clinicians. Often, this assurance is gained via high stakes assessments such as objective structured clinical examinations. This paper introduces entrustable professional activities (EPAs) as a potential alternative approach to assessing optometric clinical competence. Entrustable professional activities are defined in the context of optometric practice and the potential advantages and challenges of using them are outlined.

The Relationship between Anxiety Level and Cognitive Function of Students Class of 2022 Medical Faculty of Universitas Palangka Raya in Dealing with OSCE

Anxiety is a feeling that is often felt in dealing with various life situations that occur to a person. This can also happen to new students taking the Objective Structured Clinical Examination (OSCE). Anxiety that is continuously experienced by students will disrupt their sleep patterns, and lack of sleep results in poor sleep quality which can affect the cognitive and psychomotor aspects of medical students. This study aims to determine the relationship between anxiety levels and students' cognitive function in dealing with OSCE. This research is a cross-sectional study, where the research subjects are students from the class of 2022 who meet the exclusion and inclusion criteria. The research was conducted in June 2023 at the Faculty of Medicine, University of Palangka Raya. This research was conducted on 135 subjects consisting of 41 men and 94 women with an average age of 19(17-21) years. The highest anxiety level before the OSCE exam in the study was a moderate anxiety level of 75.5%. There is no significant relationship between anxiety level (ZSAS score) and cognitive function (Moca-Ina) with p=0.680. In conclusion, there is no relationship between anxiety level and students' cognitive function in dealing with OSCE.

An online training and feedback module enhances the musculoskeletal examination performance of medical interns

BackgroundPathologies of the locomotor system are frequent and can cause disability and impact the quality of life of the people affected. In recent years, online training and feedback have emerged as learning tools in many fields of medicine.ObjectiveThis study aims to evaluate medical interns’ musculoskeletal examination performance after completing an online training and feedback module.MethodsThis study employed a quasi-experimental design. Medical interns were invited to complete a 4-week musculoskeletal physical examination training and feedback module via an e-learning platform. The course included written and audiovisual content pertaining to medical history, physical examination, and specific tests for the diagnosis of the most common knee, spine, shoulder, ankle, and foot conditions. Before and after completing the module, their ability to perform the physical examination was evaluated using an objective structured clinical examination (OSCE) with simulated patients that took place face-to-face. A control group of experts was assessed using the OSCE, and their performance was compared to that of the interns before and after the training. At the end of the module feedback on the OSCE was provided to participants through the platform asynchronously and two evaluation questions about the user experience were conducted at the end of the study.ResultsA total of 35 subjects were assessed using the OSCE, including 29 interns and 6 experts. At the beginning of the training module, the group of interns obtained an average score of 50.6 ± 15.1. At the end of the module, 18 interns retook the OSCE, and their performance increased significantly to an average of 76.6 ± 12.8 (p < 0.01). Prior to the training, the experts performed significantly better than the interns (71.2 vs. 50.6; p = 0.01). After the interns received the training and feedback, there were no significant differences between the two groups (71.2 vs. 76.6; p = 0.43). Two evaluation questions were conducted at the end of the study, revealing that 93% of the participants affirm that the training module will be useful in their clinical practice, and 100% of the participants would recommend the training module to a colleague.ConclusionThe online training and feedback module enhances the musculoskeletal examination performance of medical interns.

The objectively structured clinical examination for safe nursing care: a scoping review

Introduction: The Objective Structured Clinical Examination (OSCE) has been utilized as an educational strategy in the training of health professionals. Its application in this context can enhance the development of both technical and non-technical skills, as well as safety in care.Objective: To map the patient safety skills developed by nursing professionals through the Objective Structured Clinical Examination as found in the literature.Method: This is a scoping review structured according to the JBI framework and guided by the Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. The review is registered in the Open Science Framework with the DOI number 10.17605/OSF.IO/MESC3. A search was conducted in the following databases: PubMed, Scopus, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), the CAPES Catalog of Theses and Dissertations, and Google Scholar, between February and April 2023.Results: Twenty-five studies were selected, demonstrating that the OSCE is used to train nursing teams with a focus on safety skills such as communication, teamwork, decision-making, clinical care, and situational safety awareness.Conclusion: The OSCE has been used as an educational strategy to improve the quality and safety of care. It is applied from primary care to high-complexity settings to evaluate professional skills that are technical, attitudinal, or behavioral in nature. The use of OSCE aids in the development of professional skills related to patient safety.

Designing, Implementing, and Evaluating a Basic Surgical Skills Bootcamp: An Effective Approach to Enhance Competency in Surgical Residency Training

IntroductionRecent technological advances have facilitated the development of new educational methods, such as simulation-based learning, in specialized bootcamps to enhance the learning of surgical residents. This study aimed to design, implement, and evaluate a basic surgical skills bootcamp for residents in general surgery, orthopedics, neurosurgery, and gynecology based on the learning gap in the current educational program. MethodsThis intervention study focused on the design, implementation, and evaluation of a basic surgical skills bootcamp in a simulated operating room for first-year surgical residents in general surgery, orthopedics, neurosurgery, and gynecology. ResultsThe study resulted in the creation of a comprehensive course plan and the execution of a 6-day training program. Evaluation of educational outcomes confirmed high learner satisfaction, improvement in Multiple Choice Questions (MCQ) exam scores, and acceptable scores in the Objective Structured Clinical Examination (OSCE). ConclusionThe findings of this study suggest that surgical bootcamps, when designed based on needs assessment and in line with scientific bootcamp design principles, play a crucial role in enhancing the satisfaction, knowledge, and skills of surgical residents.

Development and Evaluation of Interprofessional High-Fidelity Simulation Course on Medication Therapy Consultation for German Pharmacy and Medical Students-A Randomized Controlled Study.

Recently, there has been a remarkable move towards interprofessional collaboration in response to the COVID-19 pandemic and the care of comorbidities. In Germany, there has been a gradual increase in interprofessional learning in medical and pharmacy education, aiming to enhance patient care. To adapt the pharmacy curriculum for collaborative practice between pharmacy and medical students, we developed an immersive interprofessional collaboration course for pharmacy students using adult and pediatric high-fidelity simulators (HFS) to assess and train medication consultation skills. In a randomized controlled trial, we investigated whether interprofessional training between pharmacy and medical students results in differences in pharmacy students' performance of medication therapy consultation compared to the case of mono-professional training of pharmacy students only. Before and after inter/mono-professional training, each pharmacy student performed an objective structured clinical examination (OSCE) and completed a self-assessment questionnaire. Additionally, an attitude survey towards interprofessional learning was completed by pharmacy and medical students at the end of the training. As expected, interprofessional as well as mono-professional training showed a statistically significant increase in medication consultation skills. Of importance, the performance in the interprofessional training group was significantly better than in the mono-professional group, particularly in drug therapy counselling and consultation behaviors. There was a significant difference between the intervention and control groups in self-assessment scores, and all study participants had positive attitudes toward interprofessional collaboration and training. Therefore, interprofessional training using HFS has been shown to appropriately train pharmacy students for collaborative practice and consultation skills.

Station Numbers and Duration: Factors Affecting the Validity of OSCE - A Review Article

Context: Objective structured clinical examination (OSCE) is one of the student assessment methods currently used in both undergraduate and postgraduate medical education. This paper reviews evidence related to key factors influenced by the number and duration of OSCE stations. The aim of our study was to broaden current knowledge of the effective components of OSCE design. Although many OSCE designers have doubts about the optimal number and duration of OSCE stations, this issue has not been adequately addressed so far. Methods: The search was conducted through the databases of ScienceDirect, Eric, PubMed, Scopus, Ovid, and Google Scholar. English language papers, including original and review articles, without a time limit until 2022, were included. This review was conducted on papers selected using the keywords: Objective structured clinical examination, OSCE, duration of station, number of stations, utility, validity, reliability, cost, budget, finance, skill, competency. Results: The findings have been validated by scrutinizing OSCE-related skills, reliability, validity, and cost evaluations incorporating OSCE design. These results revealed that key factors to consider in OSCE design include skills, reliability, validity, and cost. Conclusions: Our findings could have a profound impact on the design of OSCE structures in medical education worldwide.

Kampo diagnostic ability is specific in post‐clinical clerkship objective structured clinical examination: An observational study

AbstractBackgroundThe Japanese medical educational model core curriculum requires an understanding of the characteristics of Kampo medicine. However, there are few reports on the methods of evaluating the skill levels of Kampo medicine practitioners.ObjectiveThis study investigated the utility of objective structured clinical examination (OSCE) for evaluating the skills of Kampo medicine practitioners, exploring its relationship with other medical skills.MethodsThe 2022 post‐clinical clerkship OSCE assessed the accuracy of Kampo‐related tasks, specifically abdominal examinations. In addition, correlation coefficients and factor analysis were used to analyze the relationship of Kampo tasks with other tasks (three clinical‐reasoning tasks, electrocardiogram attachment task, joint examination task).ResultsMedical students showed significant variation in their ability to accurately assess different abdominal regions. The epigastric region had the highest accuracy (92.0%), while the para‐umbilical region had the lowest (45.1%). Correlation analysis between Kampo tasks and other clinical tasks (clinical reasoning, electrocardiogram attachment, joint examination) yielded coefficients ranging from 0.10 to 0.19, suggesting a low relationship. Factor analysis confirmed the independence of Kampo skills from other assessed medical skills across four distinct factors.ConclusionsSince Kampo diagnostic skills are highly unique, it is possible that Western medicine OSCE tasks alone may not sufficiently assess competency in Kampo medicine. Therefore, it is necessary to consider incorporating Kampo tasks into the OSCE.

‘Having skin in the game’: guiding principles for incorporating moulage into OSCEs

BackgroundDermatological conditions are a common reason for patients to seek healthcare advice. However, they are often under-represented in Objective Structured Clinical Examinations (OSCEs). Given the visual nature of skin conditions, simulation is suited to recreate such skin conditions in assessments such as OSCEs. One such technique often used in simulation is moulage—the art and science of using special effects make-up techniques to replicate a wide range of conditions on Simulated Participants or manikins. However, the contextual nature of OSCEs places additional challenges compared to using moulage in more general forms of simulated-based education.Main bodyOSCEs are high-stakes assessments and require standardisation across multiple OSCE circuits. In addition, OSCEs tend to have large numbers of candidates, so moulage needs to be durable in this context. Given the need to expand the use of moulage in OSCE stations and the unique challenges that occur in OSCEs, there is a requirement to have guiding principles to inform their use and development.ConclusionInformed by evidence, and grounded in experience, this article aims to provide practical tips for health profession education faculty on how best to optimise the use of moulage in OSCEs. We will describe the process of designing an OSCE station, with a focus on including moulage. Secondly, we will provide a series of important practice points to use moulage in OSCEs—and encourage readers to integrate them into their day-to-day practice.

Effectiveness of a pediatric critical care pilot preceptor program: Improved confidence and competency outcomes among a cohort of professional nurses in Blantyre, Malawi

BackgroundAvailability of high-level pediatric training for nurses in Malawi is limited. To address this gap, a novel pediatric critical care nurse preceptor program was developed and implemented by pediatric nurse specialists. AimEvaluate the effectiveness of a pediatric critical care nurse preceptor program, via change in nurses' knowledge, skills, confidence, and precepting competence. DesignA 12-month pediatric critical care nurse preceptor program with assessments at baseline, end of intensive (3 months), and end of program (6 months). SettingBlantyre, Malawi. ParticipantsNurses with two or more years of pediatric nursing experience (N = 20) nominated by unit managers. MethodsQuantitative data were collected throughout program implementation. Assessments included: (1) multiple choice knowledge test, (2) Objective Structured Clinical Examinations in two areas (vital signs and airway, breathing, circulation, disability, exposure assessments; and blood gas and electrolyte analysis), (3) group simulations (cardiopulmonary resuscitation or respiratory distress), (4) Likert-scale clinical confidence survey, and (5) Likert-scale precepting competence survey. Data were analyzed using repeated measures ANOVA with pairwise comparisons. For Likert-scale surveys, median confidence scores were compared using a Friedman test with post hoc pairwise comparisons using Wilcoxon signed-rank tests. ResultsParticipants demonstrated significant improvement in clinical knowledge (p < .001), vital signs and airway, breathing, circulation, disability, exposure assessment (p = .001), blood gas and electrolyte analysis (p = .001), CPR (p < .001) and respiratory distress (p < .001) simulations, clinical confidence (p = .002), and precepting competence (p = .041). ConclusionThis pediatric critical care nurse preceptor program was effective in improving participants' confidence and competence (knowledge and skills) in pediatric critical care nursing and precepting. Results suggest the program's potential to address the shortage of highly trained pediatric critical care nurses in Malawi. This lays groundwork for refining and expanding preceptorship, ultimately improving pediatric critical care nursing education in resource-limited settings.

Development and Integration of Models for Teaching Ram Breeding Soundness Examinations in Veterinary Education.

Proficiency with ram breeding soundness examinations requires competency with palpation, a skill that can be difficult to teach and assess. There are limited small ruminant clinical skills models available, despite the advantages they offer in veterinary education. We developed reusable models for teaching ram breeding soundness examinations, focusing on scrotal assessment and palpation. Then we integrated these models into a practical session where multiple clinical aspects were included. We created anatomically normal ("sound") testes using 3D modeling software before editing these to display common abnormalities ("unsound" testes). Then, we 3D printed two-part molds and cast the silicone testes. Testes were inserted into siliconized, lubricated stockings facilitating free movement during palpation. Scrotal sacs were sewn from polar fleece and suspended to mimic natural orientation in a live, standing ram. As well as for scheduled classes, we used the models as a station in our course's Objective Structured Clinical Examination (OSCE) assessment. Our models offer advantages in the veterinary education context. Their relatively low cost and durability facilitates their classification as "open access" within our skills lab for student deliberate practice outside scheduled classes. They provide a uniform student learning experience that does not rely on live animals or clinical case load and aligns with best-practice recommendations from accrediting bodies. Student engagement and OSCE outcomes were good, but going forward it would be ideal to collaborate with a program that uses live rams for teaching and assessing this skill to directly examine the impact of our models on confidence and competence.

Rôle des médecins hospitalo-universitaires de médecine interne dans la formation aux métiers de la santé et au sein des institutions en France : enquête du Collège National des Enseignants de Médecine Interne (CEMI)

RationaleOn the occasion of the General stage meeting of Internal Medicine, the National College of Internal Medicine Teachers (CEMI) conducted a survey on teaching activity among all French university hospital (HU) internal medicine specialists. MethodThe survey was carried out in September 2023 by sending an email to 101 hospital practitioners university professors (PU–PH) and 18 hospital practitioners assistant professors (MCU–PH) of internal medicine in subsection 53-01 of the National council of universities (CNU), as well as to the 11 HU internists working in immunology (subsection 47-01) or therapeutics (subsection 48-04). ResultsSeventy-three HUs (56.1%) responded to the survey, including 65 PU–PH, 7 MCU–PH and 1 university hospital practitioner (PHU). Internal medicine HUs participate in faculty teaching: 80% are responsible for teaching, 30% are responsible for the year or cycle or lead committees and 40% have had or have an elected mandate at the faculty or at university. Internal medicine HU are involved in the teaching of semiology during the first cycle of medical studies, but also in pharmaceutical sciences, dentistry, midwifery and in paramedical training. They are very invested in the implementation of the second cycle reform and 80% are involved in the preparation of Objective Structured Clinical Examinations (ECOS), mainly as examiners (90%). They also participate in teaching using simulation (60%), teaching advanced practice nurses (IPA) (25%), and writing CEMI books (75%). For ECOS, 90% participate as examiners, 60% participate in teaching using simulation, 25% are involved in teaching advanced practice nurses (IPA), 75% participated in the writing of CEMI works. Eight (12%) internal medicine HUs co-facilitate training with patients and 26 (38%) participate in master's courses at the Faculty of Sciences. Finally, 94% are affiliated with a research unit and 48% supervise university theses students. ConclusionInternal medicine universities teachers have a strong educational commitment, particularly in semiology and in the reform of the second cycle of medical studies with ECOS and simulation.

Team-based learning (TBL) curriculum combined with video vignettes improves performance of undergraduate medical students on OSCE compared with TBL alone

BackgroundClinical practitioners think of frequent causes of diseases first rather than expending resources searching for rare conditions. However, it is important to continue investigating when all common illnesses have been discarded. Undergraduate medical students must acquire skills to listen and ask relevant questions when seeking a potential diagnosis.MethodologyOur objective was to determine whether team-based learning (TBL) focused on clinical reasoning in the context of rare diseases combined with video vignettes (intervention) improved the clinical and generic skills of students compared with TBL alone (comparator). We followed a single-center quasi-experimental posttest-only design involving fifth-year medical students.ResultsThe intervention group (n = 178) had a significantly higher mean overall score on the objective structured clinical examination (OSCE) (12.04 ± 2.54 vs. 11.27 ± 3.16; P = 0.021) and a higher mean percentage score in clinical skills (47.63% vs. 44.63%; P = 0.025) and generic skills (42.99% vs. 40.33%; P = 0.027) than the comparator group (n = 118). Success on the OSCE examination was significantly associated with the intervention (P = 0.002).ConclusionsThe TBL with video vignettes curriculum was associated with better performance of medical students on the OSCE. The concept presented here may be beneficial to other teaching institutions.

A study on the impact of open source metaverse immersive teaching method on emergency skills training for medical undergraduate students

BackgroundIn recent years, the traditional simulation-based medical teaching approach has faced challenges in meeting the requirements of practical emergency medicine education. This study utilized open-source tools and software to develop immersive panoramic videos using virtual reality technology for emergency medical teaching. It aims to investigate the efficacy of this novel teaching methodology. This transformation shifted the focus from physical simulation to virtual simulation in medical education, establishing a metaverse for emergency medical teaching.MethodsIn accordance with the curriculum guidelines, the instructors produced panoramic videos demonstrating procedures such as spinal injury management, humeral fracture with abdominal wall intestinal tube prolapse, head and chest composite injuries, cardiopulmonary resuscitation, and tracheal intubation. Using Unity software, a virtual training application for bronchoscopy was developed and integrated into the PICO4 VR all-in-one device to create a metaverse teaching environment. Fourth-year medical undergraduate students were allocated into either an experimental group (n = 26) or a control group (n = 30) based on student IDs. The experimental group received instruction through the metaverse immersive teaching method, while the control group followed the traditional simulation-based medical teaching approach. Both groups participated in theoretical and practical lessons as usual. Subsequently, all students underwent a four-station Objective Structured Clinical Examination (OSCE) to assess the effectiveness of the teaching methods based on their performance. Additionally, students in the experimental group provided subjective evaluations to assess their acceptance of the new teaching approach.ResultsBefore the training commenced, there were no significant statistical differences in the first aid test scores between the experimental and control groups. Following the training, the experimental group outperformed the control group in the four-station OSCE examination, with all P-values being less than 0.05. The satisfaction rate among the experimental group regarding the new teaching method reached 88.46%, reflecting levels of satisfaction and extreme satisfaction.ConclusionThe open-source metaverse immersive teaching method has demonstrated a positive impact on enhancing the emergency skills of medical undergraduate students, with a high level of acceptance among students. In comparison to traditional simulated medical teaching methods, this approach requires less time and space, incurring lower costs, and is deemed worthy of wider adoption.

Substitution of a Traditional Face-to-Face Workshop With Virtual Escape Room in Higher Education: A Cost-Effectiveness Analysis.

Online education games are gaining ground in health profession education, yet there is limited literature on its costs. This study is an economic evaluation of the substitution of a face-to-face (F2F) workshop with an online escape room game teaching the same content. A traditional F2F workshop on hepatitis management was conducted with 364 students in 2021 and was compared with a virtual self-run escape room game called Hepatitiscape™, which was used by 417 students in 2022. The outcomes were final examination and objective structured clinical examination (OSCE) scores for hepatitis stations. An incremental cost-effectiveness ratio was used to compare costs and outcomes. Student perceptions of the delivery of Hepatitiscape™ were also captured using an online questionnaire. Delivering the hepatitis case workshop via Hepatitiscape™ yielded an additional 4.77% increase in the final examination score and a 21.04% increase in the OSCE score at an additional cost of AUD $4212 in the first year compared with F2F delivery. This equated to an incremental cost-effectiveness ratio of AUD 883 per additional score of final examination and AUD 200 per additional score of OSCE for hepatitis stations. Hepatitiscape™ became cost saving from the second year onward. Student perception data revealed their recall of content was higher owing to the iterative design of the gaming elements. Hepatitiscape™ is likely to be a cost-effective strategy to deliver workshops that are routinely delivered F2F to test knowledge-based constructs. In addition, virtual gaming has a logistical advantage over F2F delivery in that it enhances student participation from remote locations and allows for better control and flexibility of content delivery with increasing or decreasing cohort sizes, and can have potential long-term sustainable savings.

Strengthening the planning and design of Objective Structured Clinical Examinations.

Although Objective Structured Clinical Examinations (OSCEs) offer innovative, objective, and fair methods of clinical assessment, their quality is compromised by poor planning and design. This study aimed to describe the development and present evidence-based recommendations on strengthening the planning and design of OSCEs for a South African public College of Nursing. A South African public College of Nursing. Recommendations were developed based on synthesising two sets of qualitative data. Set 1 included two main themes with each of the four sub-themes related to barriers and facilitators towards quality in OSCE designs from 14 nurse educator interviews and 15 external moderator reports. Set 2 included 12 quality measures to be adopted in the quality design of OSCEs derived from an integrative literature review. The draft recommendations were reviewed by eight experts to be finalised. Seven recommendations were developed for strengthening OSCEs' planning and design, related to: (1) policy framework, standard operating procedures and stakeholder code of conduct; (2) blueprinting and mapping of the OSCE content; (3) developing a bank of OSCE stations; (4) scoring rubric and standard-setting method selection; (5) examiners and standardised patients' recruitment and training; (6) venue selection; and (7) station piloting. The seven developed recommendations can strengthen the quality of OSCEs in the South African public College of Nursing context. The developed recommendations can assist nurse educators in planning and designing to conduct quality OSCEs following piloting and implementation.

In situ simulation educational intervention in emergency care nursing: from identifying learning needs to developing clinical and transferable skills

Introduction: The nursing team is crucial in emergency care (EC) settings, serving as patients’ first point of contact. However, gaps in their training have been hindering the effectiveness of care and patient survival. In situ simulation (ISS) has been recognized as a valuable tool in EC education, uncovering hidden risks in clinical care areas. This study aimed to analyse how an ISS educational intervention in the EC department impacted participants’ clinical and transferable skills. Methods: To assess the effectiveness of an educational intervention on the 37 EC nursing professionals, a 12-month study quasi-experimental study was conducted. The study consisted of a survey to identify participants’ learning needs and four workshops tailored to meet the team’s specific needs, culminating in an ISS session. Knowledge levels were evaluated using pre- and post-tests administered before (T0) and after (T1) the workshops, along with a formative assessment with an Objective Structured Clinical Examination (OSCE) holistic marking guide to measure the clinical and transferable skills acquired during the ISS. Results: The primary participant’s learning needs centred around cardiopulmonary arrest caused by acute myocardial infarction, including interpreting electrocardiogram and teamwork. These topics were used to develop the workshop and the simulation scenario. A significant difference (p &lt; 0.001) was observed in the levels of learning between T0 and T1, indicating a marked improvement in the participants’ performance. The nursing professionals displayed proficient clinical and transferable skills during the ISS, successfully completing over 80% of the OSCE items. Discussion: These findings suggested that a customized educational intervention incorporating participatory learning and ISS effectively enhances clinical and transferable skills among nursing professionals. The positive outcomes observed in post-tests and OSCE holistic assessment highlighted the effectiveness of this intervention for the EC nursing team. The results of this study demonstrate that active participation in workshops facilitates knowledge acquisition. Furthermore, the OSCE results illustrate the practical application of clinical and transferable skills during the ISS.

CALMER Conflict: A Novel Curriculum for Graduating Medical Students to Manage and Defuse Patient-Provider Conflict.

Workplace violence disproportionately affects healthcare workers and verbal aggression from patients frequently occurs. While verbal de-escalation is the first-line approach to defusing anger, there is a lack of consistent curricula or robust evaluation in undergraduate medical education. To develop a medical school curriculum focused on de-escalation skills for adult patients and evaluate effectiveness with surveys and an objective structured clinical examination (OSCE). We implemented this curriculum in the "Get Ready for Residency Bootcamp" of a single large academic institution in 2023. Forty-four fourth-year medical students PROGRAM DESCRIPTION: The curriculum consisted of an interactive didactic focused on our novel CALMER framework that prioritized six evidence-based de-escalation skills and a separate standardized patient practice session. The post-curriculum survey (82% response rate) found a significant increase from 2.79 to 4.11 out of 5 (p ≤ 0.001) in confidence using verbal de-escalation. Preparedness improved with every skill and curriculum satisfaction averaged 4.79 out of 5. The OSCE found no differences in skill level between students who received the curriculum and those who did not. This evidence-based and replicable de-escalation skill curriculum improves medical student confidence and preparedness in managing agitated patients.