Practice-based Learning Research Articles

Implementation supports to promote fidelity within a flexible, presentation-responsive MHPSS intervention model: A case study of Baby Friendly Spaces in Cox’s Bazar, Bangladesh

IntroductionAs evidence has converged on the feasibility and effectiveness of focused, non-specialized, manualized interventions for treating mental distress in humanitarian settings, challenges persist in how to promote implementation fidelity and rigorously evaluate interventions designed to be more preventive or promotive in addressing risk and protective factors for poor mental health. One such intervention, Baby Friendly Spaces (BFS), is a psychosocial support program implemented for Rohingya mothers and their malnourished children living in refugee camps of Cox’s Bazar, Bangladesh. That follows a place-based intervention model in which various activities may be offered either individually or in groups with no specified sequence.Objectives This presentation describes the process of establishing standards for implementing optimal mental health and psychosocial support (MHPSS) interventions, training BFS workers, and building monitoring and supervision systems to promote implementation fidelity within this flexible support program.MethodsAs BFS services were already being offered as part of Action Against Hunger programming, we first conducted an audit of current services, determining that there was limited current standardization or support for implementation. Therefore, a manualized protocol was designed and covered the program curricula and self-care using didactic and practice-based learning. A series of online training sessions were conducted for 13 psychosocial workers and psychologists at centers delivering the enhanced intervention. Following the training, a baseline evaluation of attitudes, confidence, and knowledge for delivering BFS services was administered. We also collaboratively designed a systematic supervision process to meet the staff’s needs with a focus on capacity building and self-care.ResultsFollowing the initial training, BFS workers receiving the re-training showed similar levels of knowledge, but greater confidence (p=0.01) than MHPSS workers proceeding as usual. Participants reported that the training was useful for their field of work and for improving the quality of their work, and acknowledged they would be able to integrate the new learnings into their work and daily life. The follow-up with the supervision process confirmed their capacity to deliver the services and highlighted the need for workspace improvements, the lack of continuous motivation, their ability to identify specific issues for which they requested additional trainings.ConclusionsThere is a particular need for careful attention to implementation supports and supervision when offering flexible, place-based mental health and psychosocial support interventions. In that process, ensuring a continuity between the training and the supervision is essential for the quality of both the program and the research project.Disclosure of InterestNone Declared

A Culture of Inquiry: Practice-Based Knowledge for Nurse Leaders.

A culture of inquiry has not traditionally been associated with nursing leadership. As healthcare evolves, leaders must reevaluate barriers to improving healthcare outcomes. One noted barrier has been a need for more inquisitiveness to innovate. Through an American Organization for Nursing Leadership workgroup, the authors advanced the understanding of a "culture of inquiry," applying a practice-based learning approach for knowledge development. Three recommended foundational elements are psychological safety, building connections, and using design thinking at all organizational levels.

Nursing Students’ Clinical Competence and Decision-Making : Impact of a Multiple-components Practice-based Learning

Nursing Students’ Clinical Competence and Decision-Making : Impact of a Multiple-components Practice-based Learning

The power of collaboration as practice-based learning for student, tutor, and researcher.

The power of collaboration as practice-based learning for student, tutor, and researcher.

Advancing Preservice Science Teachers’ Skills to Assess Student Thinking On-the-Fly Through Practice-Based Learning

Teachers’ assessment of student thinking is both difficult to attain and essential for responsive teaching in ongoing interaction during science lessons. Principles of practice-based learning provide a basis for the design of learning environments which may equip prospective teachers for this challenging task. In an experimental study ( N = 104), we examined the extent that the use of different media types as representations of practice (video and written cases), the number of rehearsals, and the complexity of student thinking contribute to preservice teachers’ acquisition of assessment skills. Our findings indicated that participants benefited equally well from video and written cases. The number of necessary rehearsals depended on the complexity of student thinking to be assessed. This finding implies that specifics of the content to be assessed need to be taken into consideration when designing learning environments for practicing assessment skills.

Application of practice-based learning and improvement in standardized training of general practitioners

BackgroundIn the context of standardized training for general practitioners, the emphasis is still primarily on clinical skills, which does not fully encompass the overall development of general practitioners. This study implemented a practice-based learning and improvement (PBLI) project among students and evaluated its effectiveness based on indicators such as learning outcomes, students’ subjective experiences, and annual grades. This study offers recommendations for optimizing general practitioners’ teaching and residential training programs.Methods60 residents who participated in the regular training of general practitioners at the First Clinical College of Tongji Medical College of Huazhong University of Science and Technology from January 2019 to January 2022 were selected for this study. They were randomly divided into two groups, the PBLI group, and the control group, using a random number table method. Out of the 60 residents, 31 were assigned to the control group and 29 were assigned to the PBLI group. The participants in the PBLI group received additional PBLI training along with their daily residential training, while the participants in the control group only took part in the latter. The effectiveness of the PBLI program was analyzed by conducting a baseline survey, administering questionnaires, and evaluating examination results.ResultsAfter implementing the program, the PBLI group scored significantly higher than the control group (p < 0.05). Throughout the implementation process, students in the PBLI group expressed high satisfaction with the learning project, particularly with its content and alignment with the training objective. The teacher’s evaluation of the PBLI group students surpassed that of the control group in various areas, including literature retrieval, self-study, courseware development, speech ability, and clinical thinking.ConclusionsThe PBLI program aims to encourage resident-centered study in standardized residency training. This approach is beneficial because it motivates students to engage in active learning and self-reflection, ultimately enhancing the effectiveness of standardized residency training.

Effects of motor practice on the temporal coordination of articulatory movements for non-native onset clusters: Kinematic and acoustic evidence using electromagnetic articulography

Research on cross-language speech production has shown that part of the challenge of producing non-native clusters arises from difficulties with temporally coordinating the successive consonantal gestures within a cluster. However, it remains unclear whether the application of practice-based motor learning paradigms can improve or stabilize this aspect of non-native cluster production. This study uses electromagnetic articulography (EMA) to measure the effects of motor practice on the temporal coordination of articulatory movements for non-native onset clusters. Monolingual speakers of American English intensively practiced producing monosyllabic sequences containing non-native onset clusters (e.g., MGAT) over two consecutive days. EMA was used to capture lingual, labial, and jaw motion during successive repetitions. For properly-sequenced cluster repetitions, analysis of the EMA sensor trajectories showed that, over the course of practice, there was a general reduction in inter-gestural timing variability and increased overlap between adjacent consonantal gestures. Furthermore, some of these improvements were maintained to the second day, indicating that subjects started forming durable performance gains. Acoustic analyses also showed a reduction in the duration of epenthetic vowel errors (/mgæt/ → /məgæt/) produced throughout practice. Collectively, the findings suggest that motor practice can improve the temporal coordination of articulatory gestures affiliated with non-native clusters.

Implementasi ‘Petualangan Tani Kecil’ pada Siswa Sekolah Dasar untuk Keberlanjutan Pertanian di Masa Depan

As time goes by, the younger generation's interest in agriculture is decreasing. Therefore, agricultural learning needs to be carried out among elementary school students, because learning must be instilled from an early age. This activity aims to introduce the concept of sustainable agriculture to elementary school students through practice-based active learning. This service aims to provide an understanding of the importance of sustainable agricultural practices in order to achieve a more sustainable future economically, socially and environmentally. This service approach focuses on learning through simple agricultural practical activities that are relevant to the school environment and students' daily lives. The result of this activity is that elementary school students become more aware of the importance of agriculture in the future. Apart from that, they know how the agricultural process starts from planting, caring for and harvesting.

Challenges in engaging patients in feedback conversations for health care professionals' workplace learning.

Patient feedback is relevant information for improvement of health care professionals' performance. Engaging patients in feedback conversations can help to harness patient feedback as a powerful tool for learning. However, health care settings may prevent patients and health care professionals to effectively engage in a feedback dialogue. To advance our understanding of how feedback conversations may support learning in and from practice, we sought to explore patients' and health care providers' perspectives on engaging patients in feedback conversations as informal learning opportunities. For this qualitative study, we used a pragmatic approach and conducted semi-structured interviews with 12 health care providers and 10 patient consultants. We applied an inductive approach to thematic analysis to understand interviewees' perceptions regarding patient feedback for workplace learning. Participants attributed importance to patient feedback and described how the feedback may improve treatment relationships, professionals' performance and care processes on the team level and the organisational level. Participants experienced conflicting roles as patient and educator or expert and learner, respectively. Changing relationships, feelings of vulnerability and perceived power dynamics in treatment relationships would affect participants' engagement in feedback conversations. Patients and professionals alike saw a role for themselves in giving or inviting feedback but often missed the tools for engaging in feedback conversations. Patient feedback can contribute to professionals' practice-based learning but requires navigating tensions around conflicting roles and power dynamics in the treatment relationship. Both patients and health care professionals need to embrace vulnerability and may need facilitation and guidance to use patient feedback effectively. Attention to power dynamics, if not a shift towards collaborative relationships, is however crucial to engage patients in feedback conversations, thereby capitalising the power patients posses.

Practice-Based Learning in Aesthetic Medicine: Assessing Scientific Literacy Among Cosmetic Practitioners.

The field of aesthetic medicine has expanded substantially in the past decade, with significant practitioner diversification and departure from core-specialty supervision. The increased autonomy of nonphysician practitioners in a rapidly evolving field has raised accentuated the importance of scientific literacy and practice-based learning standards in the delivery of aesthetic medical care. To assess the degree of scientific literacy among aesthetic medicine practitioners of different educational and training backgrounds in the United States and abroad. A cross-sectional survey of 52 national and international aesthetic medicine practitioners employing a validated, 28-item, scientific literacy tool. The average score for all participants was 76% (SD = 18%, range = 43%-100%). Physician practitioners scored higher in all competencies compared non-physicians (86% vs 68%, p < 0.001), with a greater discrepancy among US practitioners (95% vs 71%, p < 0.001). Competencies relating to identification of bias/confounding variables, graphical data representation, and statistical inference/correlation showed the lowest proficiency. Practitioners with a doctorate or equivalent degree were significantly more likely to report frequent engagement with medical literature than non-physicians ( p = 0.02). There exists a significant disparity in scientific literacy between physician and nonphysician aesthetic medicine practitioners. This gap underscores the need for enhanced educational programs and continuous professional development to ensure safe and effective patient care in the evolving field of aesthetic medicine.

Learning About Resilience from Rural Interprofessional Healthcare Teams: Insights from the “First Wave” of COVID-19

Building resilience is a key concern for adult educators today as we face unprecedented global challenges such as the coronavirus disease-19 (COVID-19). Nowhere is this more apparent than in educational initiatives with health professionals who experience many stressors in their work, now amplified by the pandemic. This paper reports the results of focus groups with three interprofessional primary healthcare teams in rural Nova Scotia, Canada, in the fall of 2021. The aim was to learn about their lived experience during the first year of the pandemic, as a basis for considering how resilience could be nurtured and supported in rural team-based collaborative practices settings. Findings reveal that, while each collaborative team experienced recognized COVID-19 workplace stressors, they leveraged a store of collective resilience to navigate the pandemic. The trust, sense of purpose, and shared problem-solving skills they derived from working in collaborative structures over time enabled them to regain equilibrium and to adapt to new norms, and to transform thier practices. The study highlights the power of collaborative learning to strengthen overall ability for resilient performance, and the adaptive capacity that is required to deliver and sustain quality healthcare. The study highlights the need for continuing professional education that values naturally occurring practice-based learning. Adult educators are well positioned to support health professionals and health systems to nurture and support resilient action. They bring an understanding of effective collaborative tools and processes that foster dialogue and collective awareness that leads to a shared identity and understanding. As this study reveals, it is this shared identity and capacity arising within a group that enables them to draw on their collective sources of support to deal with adversity.

Practice tutors' readiness to support nursing students who require reasonable adjustments for clinical placement.

Preregistration nursing students (trainee nursing associates and student nurses) may have a disability or impairment that requires reasonable adjustments while they are on clinical placement. At The Open University, practice tutors support nursing students on clinical placement, which includes overseeing the facilitation of any such reasonable adjustments. However, they may not feel prepared to provide this support. A qualitative approach with a broad interpretivist paradigm was adopted. Data were collected from three focus groups that included a total of 10 nursing practice tutors. Audio data were transcribed and analysed using complete coding followed by thematic analysis. Three main themes were identified - it's complex; impact of engagement; and a cohesive approach - along with associated subthemes. Despite their clear interest in helping nursing students who require reasonable adjustments for practice-based learning, practice tutors can be hindered by barriers resulting from a lack of both training and guidelines. The complexity of the practice tutor role and student issues can compound this. Consistency in practice tutor training is recommended, as well as regular access to peer support to address these difficulties and develop the skills and knowledge.

Indigenizing and co-producing the ACGME anesthesiology milestone in Taiwan: a Delphi study and subgroup analysis.

To implement the ACGME Anesthesiology Milestone Project in a non-North American context, a process of indigenization is essential. In this study, we aim to explore the differences in perspective toward the anesthesiology competencies among residents and junior and senior visiting staff members and co-produce a preliminary framework for the following nation-wide survey in Taiwan. The expert committee translation and Delphi technique were adopted to co-construct an indigenized draft of milestones. Descriptive analysis, chi-square testing, Pearson correlation testing, and repeated-measures analysis of variance in the general linear model were employed to calculate the F values and mean differences (MDs). The translation committee included three experts and the consensus panel recruited 37 participants from four hospitals in Taiwan: 9 residents, 13 junior visiting staff members (JVSs), and 15 senior visiting staff members (SVSs). The consensus on the content of the 285 milestones was achieved after 271 minor and 6 major modifications in 3 rounds of the Delphi survey. Moreover, JVSs were more concerned regarding patient care than were both residents (MD = - 0.095, P < 0.001) and SVSs (MD = 0.075, P < 0.001). Residents were more concerned regarding practice-based learning improvement than were JVSs (MD = 0.081; P < 0.01); they also acknowledged professionalism more than JVSs (MD = 0.072; P < 0.05) and SVSs (MD = 0.12; P < 0.01). Finally, SVSs graded interpersonal and communication skills lower than both residents (MD = 0.068; P < 0.05) and JVSs (MD = 0.065; P < 0.05) did. Most ACGME anesthesiology milestones are applicable and feasible in Taiwan. Incorporating residents' perspectives may bring insight and facilitate shared understanding to a new educational implementation. This study helped Taiwan generate a well-informed and indigenized draft of a competency-based framework for the following nation-wide Delphi survey.

When a Toolkit Is Not Enough: A Review on What Is Needed to Promote the Use and Uptake of Immunization-Related Resources.

Evidence-based resources, including toolkits, guidance, and capacity-building materials, are used by routine immunization programs to achieve critical global immunization targets. These resources can help spread information, change or improve behaviors, or build capacity based on the latest evidence and experience. Yet, practitioners have indicated that implementation of these resources can be challenging, limiting their uptake and use. It is important to identify factors that support the uptake and use of immunization-related resources to improve resource implementation and, thus, adherence to evidence-based practices. A targeted narrative review and synthesis and key informant interviews were conducted to identify practice-based learning, including the characteristics and factors that promote uptake and use of immunization-related resources in low- and middle-income countries and practical strategies to evaluate existing resources and promote resource use. Fifteen characteristics or factors to consider when designing, choosing, or implementing a resource were identified through the narrative review and interviews. Characteristics of the resource associated with improved uptake and use include ease of use, value-added, effectiveness, and adaptability. Factors that may support resource implementation include training, buy-in, messaging and communication, human resources, funding, infrastructure, team culture, leadership support, data systems, political commitment, and partnerships. Toolkits and guidance play an important role in supporting the goals of routine immunization programs, but the development and dissemination of a resource are not sufficient to ensure its implementation. The findings reflect early work to identify the characteristics and factors needed to promote the uptake and use of immunization-related resources and can be considered a starting point for efforts to improve resource use and design resources to support implementation.

A patient follow-up intervention to improve medical decision making at an internal medicine residency program.

Practice-based learning and improvement (PBLI) is an ACGME (Accreditation Council for Graduate Medical Education) core competency. Learning and reflecting on patients through follow-up is one method to help achieve this competency. We therefore designed a study evaluating a structured patient follow-up intervention for senior internal medicine (IM) residents at the University of Colorado Hospital (UCH). Trainees completed structured reflections after performing chart review of prior patients during protected educational time. Two-month follow-up surveys evaluated the exercise's potential influence on clinical and reflective practices. Forty out of 108 (37 %) eligible residents participated in the exercise. Despite 62.5 % of participants lacking specific questions about patient outcomes before chart review, 81.2 % found the exercise at least moderately helpful. 48.4 % of participants believed that the review would change their practice, and 60.9 % felt it reinforced their existing clinical practices. In our qualitative data, residents learned lessons related to challenging clinical decisions, improving transitions of care, the significance of early goals of care conversations, and diagnostic errors/strategies. Our results indicate that IM residents found a structured patient follow-up intervention educational, even when they lacked specific patient outcomes questions. Our results underscore the importance of structured self-reflection in the continuous learning process of trainees and suggest the benefit of dedicated educational time for this process.

Penerapan Media KomunikasiLife-Sized-Game "Postcov" Pada TK Tunas Islam Semarang

Knowledge is one of the needs in education. Kindergarten Doa Ibu Semarang is an educational park that has problems related to the direct practice-based learning model which makes it easier for children to understand communication messages in the form of knowledge provided. So far, this school has not had any unique educational media that can provide learning to children through the process of learning while playing. The existing media is still in the form of practical media that are often found in other schools. Meanwhile, after the Covid-19 pandemic, memories still remain to provide lessons to be alert regarding pandemics and health themes. Through understanding and providing knowledge from an early age, it will have a good impact on preventing pandemics or diseases in the future. So there is a need for creative, educational media that can provide the development of learning concepts at Tunas Islam Kindergarten Semarang. This educational media in the form of a life-sized game with the name "Postcov" is the result of a research project by the implementing team as a new form of media which is expected to provide refreshment to the learning concept. The activities are carried out using the learning while playing method so that students increase their enthusiasm in absorbing the material while playing on game media. The final result of carrying out this service activity is to test the extent to which the "Poscov" learning media can be implemented with students at the Tunas Islam Kindergarten, Semarang.

EMBEDDING WORK-INTEGRATED LEARNING AT UNDERGRADUATE COLLEGE-LEVEL CURRICULUM TO ENHANCE EMPLOYABILITY SKILLS AMONG STUDENTS

Work-integrated learning (WIL) is a prominent, flourishing, educational phenomenon which has brought about numerous positive changes in the field of higher education globally. The corporate sector and the governments in the world are seeking ‘work-ready’ graduates. WIL as an umbrella term includes a variety of strategies and approaches that incorporate theory with practice of work within a purposefully designed curriculum. WIL makes meaningful, relevant connections to work throughout the curriculum in higher educational contexts which is intricately interwoven with employability skills and enhances these skill sets. Some of the pedagogical approaches adopted in WIL are Practice-based learning, Professional practices, Problem-based-learning, Experiential learning, Workplace learning, and Practice-based education. A study adopting an exploratory mixed-method was conducted in Middle East College, Oman including in-depth survey and interviews with faculty members, graduates, alumnus and students at undergraduate level to determine the efficacy of the contents of the curriculum enhancing Employability Skills of the students. Findings indicate that the curriculum enriched with WIL develops (a) General employability skills and respective requirements of a workplace, (b) Effective communication with colleagues across diverse roles, (c) Attitudes toward working effectively and competently, (d) Enhance academic knowledge and develop transferable skills, (e) Develop an understanding of ethical practices, (f) Build a professional identity and (g) Increase digital literacy skills. Students’ WIL experiences were taken into account in designing and implementing curricula related to WIL which are in line with enhancement of employability among students. The results of this research are valuable for practitioners in higher level educational contexts to integrate WIL and employability skills to contribute to global enhancement of these two flourishing phenomena.

Assessing Pediatric Rheumatology Fellow Competence in the Milestone Era: Past, Present, and Future.

Starting in 2015, pediatric rheumatology fellowship training programs were required by the Accreditation Council for Graduate Medical Education to assess fellows' academic performance within 21 subcompetencies falling under six competency domains. Each subcompetency had four or five milestone levels describing developmental progression of knowledge and skill acquisition. Milestones were standardized across all pediatric subspecialties. As part of the Milestones 2.0 revision project, the Accreditation Council for Graduate Medical Education convened a workgroup in 2022 to write pediatric rheumatology-specific milestones. Using adult rheumatology's Milestones 2.0 as a starting point, the workgroup revised the patient care and medical knowledge subcompetencies and milestones to reflect requirements and nuances of pediatric rheumatology care. Milestones within four remaining competency domains (professionalism, interpersonal and communication skills, practice-based learning and improvement, and systems-based practice) were standardized across all pediatric subspecialties, and therefore not revised. The workgroup created a supplemental guide with explanations of the intent of each subcompetency, 25 in total, and examples for each milestone level. The new milestones are an important step forward for competency-based medical education in pediatric rheumatology. However, challenges remain. Milestone level assignment is meant to be informed by results of multiple assessment methods. The lack of pediatric rheumatology-specific assessment tools typically result in clinical competency committees determining trainee milestone levels without such collated results as the foundation of their assessments. Although further advances in pediatric rheumatology fellowship competency-based medical education are needed, Milestones 2.0 importantly establishes the first pediatric-specific rheumatology Milestones to assess fellow performance during training and help measure readiness for independent practice.

Manajemen Pendidikan Entrepreneur dalam Meningkatkan Kompetensi Wirausaha Santri pada Pondok Pesantren Riyadlusharfiwalmantiq

This study aims to determine the implications of planning, implementing and evaluating entrepreneurial education on the entrepreneurial competence of students at the Riyadlusharfiwalmantiq Islamic Boarding School. The research method uses a qualitative approach with phenomenological methods, data collection techniques using observation, interviews and documentation techniques. The analysis technique uses SWOT analysis. The validity test used source training and technical triangulation methods. The results of the study indicate that the Entrepreneurship Education plan at the Riyadlusharfiwalmantiq Islamic Boarding School is set out in the form of an entrepreneur learning curriculum, which consists of theory-based learning planning and practice-based planning. Furthermore, it is described in the form of a learning syllabus that contains basic competencies, subject matter, indicators, learning activities, time allocation and assessment. Entrepreneurship education is implemented with two methods, namely theory-based learning and practice-based learning. Evaluation of the results of Entrepreneurship Education is carried out in 2 ways, directly (during the learning process) and post-learning. To examine the evaluation of entrepreneurial education learning using an evaluation model, namely the evaluation of the CIPP (Context, Input, Process, and Product) model. Entrepreneurial competence of students at Riyadlusharfiwalmantiq Islamic Boarding School was formed to have social entrepreneur and corporate entrepreneur competencies. Entrepreneurial education management has implications for students to gain knowledge, skills, and attitudes and aims to make students have the ability and ability to become beginners in entrepreneurship.

Pioneering Pathways: Founding Editors’ Perspectives on the 10th Anniversary of the Journal

Linda Martindale and Helen Buchanan, members of the editorial team for this Anniversary Issue of the International Journal of Practice-based Learning in Health and Social Care, undertook this interview with Lynn Clouder and Jill Thistlethwaite in May 2023. The interview was transcribed verbatim and subsequently edited for publication. In this, Lynn Clouder and Jill Thistlethwaite first reflect on the journal’s origins, and the gap it filled for publications about practice-based learning across health and social care professions. They discuss how the journal has developed over time, and what their hopes are for the next 10 years as the practice-based learning space continues to evolve and innovate.