Preparation For Clinical Practice Research Articles

Preparing undergraduate student paramedics to consider their mental health during clinical placement in Australia

IntroductionThis article explores the impact of mental health issues on paramedics in Australia, particularly Post-Traumatic Stress Disorder, caused by their exposure to high levels of stress. The prevalence of Post-Traumatic Stress Disorder is higher among paramedics than any other occupation, and this could be a cause for concern, especially for undergraduate student paramedics. The article examines the need to build resilience among student paramedics to help them handle the trauma they may experience during clinical placement. MethodsThis study conducted a two-step process to review literature and university handbooks to determine the level of education provided to paramedic students on Post-Traumatic Stress Disorder and resilience during clinical placement, due to the lack of research in this area. The first step involved a search for relevant articles, while the second step involved a search of the Australian Health Practitioner Regulation Agency website to identify paramedicine programs and a manual evaluation of each undergraduate pre-registration paramedicine curriculum in Australia. ResultsThis study conducted a systematic search of national and international literature and Australian undergraduate pre-registration paramedicine programs to identify any studies pertaining to the education of paramedic students in resilience and Post Traumatic Stress Disorder. The search found that only 15 (5.95 %) of the 252 reviewed subjects had reference to mental health, resilience or Post-Traumatic Stress Disorder, with only 4 (1.59 %) of them discussing these topics in preparation for clinical practice. The study highlights the lack of emphasis on student paramedic self-care as an essential underpinning for clinical placement preparation in the curriculum. ConclusionThis literature review concludes that appropriate training and support, teaching resilience, and promoting self-care are crucial in preparing paramedic students for the emotional and psychological demands of their work. Equipping students with these tools and resources can improve their mental health and well-being and enhance their ability to provide high-quality care to patients. Promoting self-care as a core value in the profession is essential in creating a culture that supports paramedics in maintaining their own mental health and well-being.

Proto-professionalism: Opportunities for student learning and service to homeless people

The concepts of professionalism including ethical practice, reflection, self-awareness, respect, teamwork and social responsibility are present in the healthcare curriculum but rarely learned in combination. The concepts can be combined when students receive practical experiences on the challenges of delivering health and social care to populations experiencing poverty and disadvantage. We report on work with homeless people in our local communities designed to align social accountability responsibilities with healthcare curricula through a student volunteering project; initially established in a medical school. Using an ethical approach we developed this learning through a staff-student-community partnership. The outcome was learning consisting of theoretical teaching, practice learning and the potential to volunteer. We report on the development phases over several years (2013-2017). The pedagogical evaluation used a sequential mixed methods approach. One hundred and ninety-five student participants scored pre- and post-questionnaires. Of these 75% completed reflective assignments and many went on to volunteer. Twenty of those who volunteered participated in one-to-one interviews. Scored data were analysed statistically and reflective written materials were analysed using content analysis. The interview data were analysed using thematic analysis. The learning was positively experience and students reported changed attitudes and understandings of homelessness. Practice-placements and volunteering further enhanced these insights and student’s perceptions of readiness for clinical practice. This can be described as proto-professionalism. The student-staff-community partnership offers an ethical platform on which to build sustainable local outreach projects. The students gained a deeper appreciation of social injustice for homeless people.

Heightened vigilance and perceived discrimination in dental trainees' readiness for clinical practice.

The aims of this study were to examine associations between heightened vigilance and perceived discrimination on readiness for clinical practice and to examine the mediating effects of social support and resilience. A survey was distributed to dental trainees (dental and dental hygiene students) enrolled at a US dental school located in the mid-Atlantic region. The survey assessed readiness for clinical practice and included measures of perceived discrimination, heightened vigilance, and the following wellness measures: perceived stress, resilience, anxiety, social support, and coping. Adjusted for gender, and race/ethnicity, we regressed heightened vigilance and perceived discrimination independently on students' readiness for clinical practice. To assess mediation, we computed the direct effects of heightened vigilance and perceived discrimination and potential indirect effects mediated through social support and resilience. A total of 250 students who completed the survey had complete data on all variables. Five percent identified as Black or African Americans, 34% as Asians, and 8% as Hispanic/Latino. Sixty-two percent were female and 91% were dental students. The overall mean (SD) heightened vigilance and perceived discrimination scores were 18.9 (4.9) and 10.5 (7.6), respectively. Only the mean score for heightened vigilance differed significantly by race/ethnicity (p=0.02). Higher heightened vigilance (odds ratio [OR]=0.75 95% confidence interval [CI]: 0.25, 2.23), and perceived discrimination (OR=0.52, 95% CI: 0.33, 0.88) scores were independently associated with lower adjusted odds of reporting high confidence in readiness for clinical practice even after adjusting for the mediating effects of social support and resilience, although the association for heightened vigilance was not statistically significant. Heightened vigilance and perceived discrimination appear to negatively impact dental trainees' career readiness. Intentional efforts to prioritize an anti-racism approach within dental education programs and patient care across the nation are warranted.

Mentoring the new third year internal medicine trainees.

In the United Kingdom, training for doctors specialising in general internal medicine (GIM) has been re-structured. The internal medicine training (IMT) programme replaced and lengthened core medical training (CMT), from 2 to 3 years. The intention is that trainees gain a further year of supervised experience before sub-specialism. From August 2021, the novel role of the “internal medicine trainee year 3 (IMT3) Doctor” has existed. As before, trainees rotate through varying medical specialities alongside on-call and out-of-hours GIM commitments. Hospital service provision demand has meant that many rotating IMT3 Doctors are still being expected to perform in less well-supervised specialist roles but are newly under the guise of still being trainees. This has created unique challenges from a learning and practice point of view. Mentorship in medical education has been found to be effective in supporting the transfer of learning needed to address ‘performance gaps’ in medical students becoming doctors.1 These gaps describe occasions in clinical practice where an individual exceeds their performance capacity. In the transition from student to doctor, mentorship programmes can increase individual confidence in preparation for clinical practice and allow new doctors to reflect on their professional development. Little is published on the use of mentorship in later stages of training. Our mentorship innovation aimed to address a new gap, which anecdotally exists for IMT3 doctors in the United Kingdom. Furthermore, mentors were able to give holistic support as the year progressed, supporting mentees to reflect on their educational and professional development. Through formal feedback before and after the first 10 months of this programme, we gained resoundingly positive responses. IMT3s felt particularly supported in professional examination and interview practice. They commented that by discussing issues in a non-threatening group environment and via the online chat forum, they could be reassured by their mentors on a regular basis that they were making safe and sensible clinical decisions, ultimately increasing their confidence in practice. Concerns raised by the mentees with regards the on-call/out-of-hours commitments were directly fed back to senior managers via the mentors and changes were made much to the satisfaction of IMT3s. A formal mentorship programme can be an adjunct to meeting the educational needs of doctors in training and help dictate which teaching methods and tools are of most value to learners. Mentors also benefited from the programme by developing their own teaching and leadership skills. Cerys A. Morgan, Murray A. J. Hudson, and Edward Hoy involved in concept of and implementation of mentorship programme. Murray A. J. Hudson involved in writing manuscript. Cerys A. Morgan and EH involved in revisions of manuscript.

Reimagining Gastroenterology Fellowship Training: The Third Year of the Future

Reimagining Gastroenterology Fellowship Training: The Third Year of the Future

Differences in perception of online anesthesiology between Thai medical students and teachers during the COVID-19 pandemic.

Traditional anesthesiology learning was disrupted by the coronavirus disease 2019 pandemic and replaced by online learning. Students and teachers did not prepare well for this change. Determining the differences in perceptions can close the gap and develop more effective curricula. Our study aims to compare students' and teachers' perceptions of online anesthesiology learning. We conducted a prospective descriptive study, a cross-sectional survey between July 2020 and January 2021 in the Anesthesiology Department, Faculty of Medicine, Khon Kaen University, Thailand. Our participants were fifth-year medical students and teachers participating in online anesthesiology. We compared the perception of the teaching process, support system, learning outcomes, satisfaction, and preference. Using an online structured questionnaire survey with a 4-point Likert scale to measure the degree of agreement with each item. We analyzed the difference between students' and teachers' perceptions by topic. We received responses from 174 students and 24 teachers. Students had a significantly higher proportion of positive perceptions than teachers on the teaching process (theoretical teaching, problem-based learning, feedback, and response system), on a support system (technological support, connectivity, and learning materials), on learning outcomes (clinical practice readiness, critical thinking, long-term memory, and enthusiasm), satisfaction score, and online learning preference (p<0.05). Differences in perception were high in many aspects of online anesthesiology learning. This perception gap was particularly evident in the teaching process, support system, and learning outcomes. And Thai students had more preference for online learning than teachers. Strategies to reduce the gap should focus on teachers' training and supporting online learning should be concerned.

Anemia in Neoplastic Disease: Current Treatment Options

Anemia is one of the most common complications of cancer. The severity of anemia depends on the severity of the disease and the course of its development. The review of the literature presents the causes and mechanisms of anemia in patients with malignant neoplasms, discussing its negative impact not only on the quality of life, but also on the effectiveness of chemotherapy, existing clinical recommendations for the treatment of anemia with the use of erythropoiesis stimulating agents. The attention is paid to the effectiveness of modern intravenous iron preparations. A brief overview of the literature data on the problem of use of intravenous iron preparations in clinical practice is presented. The review includes mainly the data of controlled randomized clinical studies, which are considered to be most informative in evidence. Recently, effective and safe intravenous iron preparations have appeared, the ways of their introduction, doses and formulas have been developed to calculate the overall deficit of iron in the organism. The data on the anemia importance, the incidence of which in tumor diseases, increases constantly, were found. In numerous randomized studies that have taken place over the open protocol, the value of hemoglobin (Hb) level for the quality of life of cancer patients receiving chemotherapy is demonstrated. Before recombinant human erythropoietins (rHuEPO) the transfusion of erythrocyte mass was used in cancer patients with anemia. However, hemotransfusion could be accompanied by the development of complications, transmission of transmissible infections, post-transfusion reactions, aloimmunization and the effect on the tumor clone with the possibility of stimulating tumor growth. The safety of iron parenteral preparations has increased because of the creation of a new generation of iron drugs.

Nursing Students' Caring Behavior Towards Clinical Learning Readiness

Aims: There was a high rate of psychological issues among students engaging in clinical practice. Students that focus on caring as their pedagogical foundation will be more equipped to provide nursing intervention in clinical situations. Objective: This research aimed to examine nursing students' caring behaviors as they relate to their readiness for clinical practice. Methods: A total of 122 nursing students from nursing schools in Bandung participated in this descriptive and cross-sectional study, with a response rate of 81.3%. Students' caring behavior and clinical readiness are assessed using the Casey-Fink Readiness for Practice Survey and the CBI-24 (Caring Behavior Instrument short form). Pearson correlation and linear regression tests in SPSS 26 were used to establish associations between the variables. Results: Findings demonstrated a statistically significant correlation between students' caring conduct and clinical preparation (sig 0.000; p0.05). The correlation between the two variables was 23.8% strong, which was statistically significant. Student readiness for clinical practice was only strongly related to the connection factor. Nursing students' caring attitudes and clinical readiness were not significantly influenced by students' age, gender, or work situation. Conclusions: The level of empathy and social connection among nursing students influenced how well they were prepared for clinical practice. The development of students' caring behaviors, including self-assurance, competency, and respect, should be a primary goal of nursing education.

INFLUENCE OF PROBIOTICS ON THE MESOTHELIN LEVEL IN WOMEN WITH ENDOMETRIOSIS ASSOCIATED WITH INFERTILITY IN COMPLEX PREPARATION FOR ASSISTED REPRODUCTIVE TECHNOLOGIES.

The aim: To study the determination of Mesothelin level in women with endometriosis associated with infertility and estimate influence of probiotic on endometriosis according of Mesothelin level in complex preparation before assisted reproductive technologies. Materials and methods: In this study, we conducted a retrospective analysis of the medical records of 40 infertile women who underwent assisted reproductive technologies while also using the probiotic "Femina Probiz." We divided the participants into two groups. The control group comprised 11 women who had tubal infertility due to a previous inflammatory condition but were otherwise found to be in good health through comprehensive clinical and laboratory assessments. These women, aged between 21 and 42 with an average age of 29.75 years, did not use the probiotic "Femina Probiz." The main group consisted of 29 women diagnosed with external genital endometriosis who were undergoing assisted reproductive technologies. Women in the main group received the probiotic "Femina Probiz" from Unic Biotech Ltd, India. They took one tablet twice a day for one month as part of their overall treatment before undergoing assisted reproductive technologies. We measured the Mesothelin levels before and after this preparation phase. This study was conducted at Bukovinian State Medical University and Centre of Reproductive Medicine. It's worth noting that the primary infertility incidence was significantly higher in the main group of patients. Results: In the main group, we observed that the Mesothelin level was 0.73±0.01, which was significantly higher than the post-preparation level (0.59±0.01). In contrast, the control group had a Mesothelin level of 0.49±0.01. Interestingly, we noted that the Mesothelin level in patients increased approximately twofold before preparation compared to those who had undergone preparation. This suggests that the use of the probiotic led to a sharp reduction in the elevated Mesothelin levels. Consequently, the significant decrease in Mesothelin levels after using the probiotic indicates its effectiveness and potential utility in the preparation phase of assisted reproductive technologies programs. Conclusions: The elevated Mesothelin levels indicate a strong association between the pathogenesis of endometriosis and inflammation, as well as damage to the peritoneum. The incorporation of a probiotic as part of a comprehensive preparation regimen prior to assisted reproductive technologies notably enhances the overall health of patients and leads to a reduction in Mesothelin levels. Based on our findings, we highly recommend the inclusion of this probiotic preparation in clinical practice.

The status of fermented preparations in clinical practice: A charaka samhita review

The status of fermented preparations in clinical practice: A charaka samhita review

Quantitative assessment of antioxidant potential of selected homeopathic preparations in clinical practice.

Antioxidant property like radical scavenging is a primary target to elucidate the efficacy mechanism of a drug against diseases linked to oxidative stress such as cancer, metabolic disorders, rheumatoid arthritis, etc. In alternative therapies, homeopathy is one of the preferred choices by patients and clinicians due to its potential to cure chronic and complex illnesses. However, the efficacy of homeopathic preparations at high diluted potencies attracts rational criticism due to insufficient scientific knowledge supporting the mechanism of action. Therefore, an attempt was made to estimate the total phenolic content (TPC) and radical scavenging activity of clinically prescribed homeopathic drugs. With gallic acid as a reference control, mother tinctures (MTs) and different potencies of Eucalyptus globulus (EG), Syzygium jambolanum (SJ), Ruta graveolens (RG), and Thuja occidentalis (TO) were used to perform Folin-Ciocalteu test, 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS), and 2,2-diphenyl-1-picrylhydrazyl (DPPH) assays. The results showed TPC of MTs equivalent to µg/mL of gallic acid viz; EG (4,872.5±133.2), SJ (8,840.5±14.8), RG (985.6±39.1), and TO (341.5±19.5) with significant ABTS and DPPH radical scavenging potential. Whereas 30C and 200C potencies of each homeopathic drug showed undetectable phenolic content and insignificant radical scavenging potential compared to vehicle control, i.e.,alcohol 90% (2.0±1.5). The reported efficacy of 30C and 200C potencies of homeopathic medicines against oxidative stress-related illnesses might be due to mechanisms other than radical scavenging. Furthermore, the assays studied can be helpful in drug standardization and quality control of MTs that are used as starting material in homeopathic preparations.

Effect of Multiple-Patient Simulation on Baccalaureate Nursing Students' Anxiety and Self-confidence: A Pilot Study.

Multiple-patient simulation (MPS) allows nursing students to develop leadership skills. Limited research examining student outcomes following MPS exists. This pilot study investigated the impact of MPS on (1) anxiety with transition to practice, (2) anxiety with clinical decision-making, (3) self-confidence with clinical decision-making, and (4) perceptions about MPS as a learning strategy. Twenty-two senior baccalaureate nursing students participated in this 2-group mixed-methods study. Data were collected before and after a leadership course using the State-Trait Anxiety Inventory, Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale, and a researcher-developed perceptions survey. Self-confidence with clinical decision-making significantly increased for all participants regardless of group assignment. Anxiety and anxiety with clinical decision-making decreased without significant changes. No significant differences were found between groups. Qualitative findings yielded 3 themes: preparation for clinical practice, overcoming anxiety, and confidence. Research investigating additional student outcomes after MPS with larger, more diverse samples is needed.

Students and simulation facilitators' experiences and perceptions of a distraction and interruption simulation: a mixed-methods study

BackgroundWhile distractions and interruptions are leading causes of errors during medication preparation, most nursing students are not taught how to manage distractions in a highly-interruptive environment. To help prepare nursing students to manage distractions and interruptions in clinical practice, we developed, implemented, and evaluated a medication preparation distraction and interruption simulation. ObjectivesTo explore student and simulation facilitators experiences and perceptions of a distraction and interruption simulation. DesignA sequential explanatory mixed-methods design was adopted including surveys, interviews, and focus groups. SettingA mid-sized research intensive western Canadian university. ParticipantsA total of 112 third year nursing students who engaged in the distraction and interruption simulation, and five simulation facilitators who facilitated the distraction and interruption simulation, participated in this study. MethodsStudents were invited to complete a cross sectional survey following the distraction and interruption simulation and were then invited to participate in focus groups. Simulation facilitators were invited to participate in one-on-one interviews following facilitating the distraction and interruption simulation. All data were collected between June and December 2020. ResultsData from surveys, interviews, and focus groups were delineated into 4 themes related to the phases of the simulation. The prebriefing provided an overview of the simulation and helped create psychological safety that was imperative for learning about potential medication errors when being distracted and interrupted. The simulation scenario had a high degree of fidelity and helped students implement strategies to manage distractions and interruptions. The structured debrief provided an opportunity for meaningful reflection. The impact of the simulation was apparent as students articulated the balance between speed versus safety and new strategies developed to manage distractions and interruptions in clinical practice. ConclusionThis study supports the use of simulation to develop key skills for managing distractions and interruptions during medication preparation in clinical practice.

The Scientific Rigor of the Objective Structured Examination for Competency Assessment in Health Sciences Education: A Systematic Review

Background and Purpose. The objective structured clinical examination (OSCE) is widely used as an assessment of competency in health sciences education. The aim of our systematic review was to appraise the scientific rigor of the OSCE as a competency-based assessment in health sciences education, including physical therapy. Methods. Our search was performed in 6 databases—Ovid MEDLINE(R), CINAHL, EMBASE, APA PsycINFO, ERIC, and Web of Science—to identify original data evaluating the OSCE in programs of education in physical therapy and related health sciences disciplines. Data were extracted as per the Utility Model to evaluate the validity, educational impact, reliability, acceptability, and costs of the OSCE in these programs. Results. The search identified 106 records, with 13 studies meeting our eligibility criteria. The OSCE is distinct from traditional clinical assessments, with low-to-fair concurrent validity between the 2 assessment types. The OSCE was used for instructional design, namely, curriculum development and alignment, and for educational practice, namely, making decisions on students' readiness for practice. Limitations of the OSCE include poor-to-low validity to predict practice readiness and low-to-acceptable reliability, with student-specific, domain-specific, and examiner-specific effects on outcomes identified. Strategies were provided which could improve the scientific rigor of the OSCE. Discussion and Conclusion. Based on current evidence, the scientific rigor of the OSCE may be insufficient to support its use to make academic decisions on students' standing in health sciences programs, including physical therapy, and readiness for clinical practice, with confidence. However, the OSCE can play an important role in instructional design and in guiding student learning. Protocol registration: PROSPERO, ID 162338.

Factors in integrating academic electronic medical records in nursing curricula: A qualitative multiple case studies approach

BackgroundAcademic electronic medical records are useful simulation-based educational tools that assist health professional students develop their skill sets for digital health practice. Despite this, their utilisation in pre-registration nursing curricula is uncommon in Australia and New Zealand. AimTo explore factors surrounding integration of academic electronic medical records into pre-registration nursing curricula in Australia and New Zealand. DesignExploratory qualitative multiple case studies approach with purposive sampling set within a larger research project. MethodsSemi-structured interviews conducted with course leaders from six nursing schools. Data were analysed in an iterative content-driven deductive and inductive process using open-coding and categories. Case analysis involved within case and cross-case analysis. ResultsFindings revealed different factors that impacted the utilisation of academic electronic medical records in nursing curricula including factors influencing adoption, barriers and challenges with implementation, enablers for integration and perceived benefits for students' clinical practice preparation. Reasons for not using academic electronic medical records, barriers for implementation, and preparation of students for clinical practice in the absence of these simulation tools were also highlighted. ConclusionOur findings suggest that use of academic electronic medical records in nursing curricula is still evolving and that their adoption and application within programs is not straightforward. While there are many factors unique to the schools using such resources, factors including decisions around curriculum incorporation, optimising available resources to support students' learning, and developing faculty capability to teach with academic electronic medical records were common considerations. Lack of funding and access to local educational tools were ongoing barriers for adoption. Further research examining curriculum timing and preparation, possibilities of partnerships to share resources, and evaluation in meeting students' needs is necessary.

Resident Physician “Moonlighting” for On-call in Transfusion Medicine: Educational Impact and Preparedness for Practice

Abstract Introduction/Objective Resident physician moonlighting is controversial and uncommon in Pathology, usually limited to anatomic pathology grossing support. Due to an acute staffing shortage in our department, we offered senior AP/ CP residents in our program a “moonlighting” opportunity involving partnership with attendings to supervise junior residents for transfusion medicine on-call (TMO) . Given the conflicting claims of educational benefit and detriment of moonlighting, we sought to evaluate impact of TMO moonlighting activities on residents' educational experience and preparedness for clinical practice. Methods/Case Report Residents selected for moonlighting TMO were PGY-3/4, “exceeded expectations” on their transfusion medicine rotation and had taken resident TMO. After initial “boot camp” exercises involving common TMO scenarios, they were added to the attending on-call schedule with a fair financial incentive. They were the first resource and provided in-person support for the TMO resident. Attendings were available for consultation via a secure communications platform (phone and text). After one year, residents were surveyed regarding overall experience, sense of graduated responsibility, impact of financial incentive, preparedness for future practice, and impact on day- time service commitment. "Resident In-Service Examination" (RISE) score was used to estimate impact of TMO on medical knowledge. Results (if a Case Study enter NA) NA. Conclusion Four out of the five residents took the survey. All 4 responded “definite” for positive experience, feeling of graduated responsibility and preparedness for practice. Financial incentive was assessed favorably. No resident reported an adverse impact on their daytime service responsibility. The group median score on RISE transfusion medicine 2022 was 75th percentile with median increase in 10 percentile points. As pathology moves towards sub- specialty practice, working fluency in some areas such as TMO remains a necessity for smaller group practices. Our experience (albeit with a small group of residents) suggests that TMO moonlighting activities may better prepare the residents for this unmet need.

Evaluation of online interprofessional simulation workshops for obstetric and neonatal emergencies.

To explore student perceptions of learning and interprofessional aspects of obstetric and neonatal emergencies through online simulation-based workshops. This qualitative study was conducted at Monash University, Australia. Data were obtained from six separate online Obstetric Neonatal Emergency Simulation workshops held between May 2020 and August 2021. A total of 385 students attended and were invited to participate in the study by completing an online survey two-three weeks later. Of the attendees, 144 students completed the survey (95 medical, 45 midwifery), equating to a response rate of 37%. Survey responses were downloaded from online survey platform and separated into medical and midwifery responses. Thematic analysis of data was performed using a coding framework, resulting in development of themes and subthemes. Main themes were adaptability, connectivism, preparedness for practice, experiential learning, learning through modelling and dynamics of online interaction. Students reported that online workshop was a useful alternative method to experience simulation-based learning, increase their readiness for clinical practice and foster positive interprofessional relationships. Consistent with existing literature evaluating similar in-person programs, midwifery students were most interested in interprofessional interaction (predominant theme: dynamics of online interaction), whilst medical students were more concerned with developing clinical skills (predominant themes: learning through modelling, experiential learning). Online learning may be a useful and convenient way of delivering interprofessional simulation-based education during the pandemic, in remote areas and as an adjunct to in-person teaching. Future studies should evaluate the impact of online learning with a mixed methods study and in comparison, to in-person programs.

Self-Reported Clinical Practice Skill Readiness of Final Year Nursing Students Studying in Bengaluru, Karnataka: An Institutional-Based Cross-Sectional Study

Abstract Introduction In recent few years, the production of nurses in both the public and private sectors has been growing rapidly to fill up the gap of health care staff. As there is a lack of data available on clinical practice readiness among final year nursing students in India, the question remains of how nursing students see themselves and what qualities and areas interest them are of great importance. Objectives This study was conducted to determine the clinical practice skill readiness among final year nursing students and also to explore the factors that show the significant difference with clinical practice skill readiness level. Methodology A nonexperimental institutional-based cross-sectional online survey was conducted from October 15 to November 15, 2020 using a simple random sampling technique. A total of 200 final year nursing students have participated in the study through the self-structured and prevalidated comprehensive nursing competencies questionnaire (CNCQ). Data was collected through Google Form and exported to SPSS version 20.0 for further analysis. To compare the nursing competencies score with selected demographic characteristics, a one-way analysis of variance and an unpaired t-test were applied at a 95% confidence interval (CI). The post hoc test was used to check for multiple comparisons. Results Results of the study revealed that the overall CNCQ mean score of basic nursing skills were reasonably high (39.08 ± 13.27) compared with advanced nursing care skills (13.03 ± 5.28). A significant difference (p < 0.05) was observed in overall clinical posting duration in both basic (p < 0.004) and advanced (p < 0.001) nursing skills with selected demographic variables. There is also a significant difference found in the overall level of qualification (p < 0.004) in basic nursing skills. It was observed that in basic nursing care skills half of the year clinical posting (minimum 6 months) duration had a significant difference with the improved performance skills (p < 0.005) (0.57; 95% CI 0.14–1.00). Whereas the results also show that, the advanced nursing skills will be greatly improved if the nursing students get an opportunity to practice in different specialty areas for at least 2 months (p < 0.013) (0.62; 95% CI 0.11–1.14) or half of the year (p < 0.001) (0.95; 95% CI 0.34–1.56). This result shows a clear indication of how important clinical posting for nursing students is. Conclusion Our data suggested that the final year nursing students are losing ground in clinical practice readiness and competency. The result also shows that the clinical competency score will greatly improve in both basic and advanced nursing skills if the students are exposed to the clinical areas at least for a few months. Our findings will support the stakeholders, authorities of nursing colleges, and policymakers to make a significant decision to enhance the clinical practice among final year nursing students.

Evaluation of Interprofessional Education on Effective Communication Between Pharmacy and Physician Assistant Students.

The purpose of this study was to assess the effect of Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) on student self-perceived competencies and perceptions of interprofessional (IP) communication and teamwork in a clinical case review activity. TeamSTEPPS is an evidence-based curriculum that is used to enhance and support IP healthcare communication. A repeated-measures, pretest/posttest study evaluated physician assistant students' and student pharmacists' perceptions of TeamSTEPPS. Students completed Performance Assessment for Communication and Teamwork (PACT) surveys, evaluating teamwork, knowledge, attitudes, and skills perceptions before and after a TeamSTEPPS lecture and associated activity with peer feedback. Overall, 87.4% (n = 429) completed pre- and post-PACT surveys. Apart from the Mutual Support domain (p = .898), all changes were significantly positive (p < .004), with the greatest improvements occurring in the Attitudes and Perceived Skills domains. TeamSTEPPS IP education, application, and peer feedback improved students' perceptions of multiple domains, including effective communication. Using TeamSTEPPS tools in IP formats enabled the students to safely practice and collaborate in preparation for clinical practice.

Readiness to enter the workforce: perceptions of health professions students at a regional Australian university

BackgroundPerceived readiness for practice can help mitigate the stress and uncertainty associated with transitioning from university into the workforce. This study aimed to identify factors influencing the readiness for clinical practice among final-year medical, dental, and pharmacy students at an Australian regional university.MethodsThe study utilised a sequential explanatory mixed-methods approach with surveys administered for the quantitative phase and interviews/focus groups for the qualitative phase. Descriptive statistics and inductive thematic analysis were utilised for the quantitative and qualitative data, respectively. Triangulation of findings from both phases facilitated in-depth understanding of the factors that influenced participants’ self-perceived readiness for clinical practice.ResultsFrom the three disciplines, 132 students completed the survey and 14 participated in the focus groups and interviews. Students felt most prepared in their patient-centred capabilities, core skills, and advanced consultation skills, and least prepared in their system-related capabilities and clinical care skills. Themes identified as essential enablers and confidence builders in relation to workforce readiness in all three disciplines were: gained knowledge and skills, value of clinical placement experiences, support from peers, family and staff. However, students felt their work-readiness was impaired by heavy academic workloads and poor knowledge of health care systems, which affected skills development. Participants suggested additional support in health care system and clinical governance, mental healthcare, and induction to placement sites to further improve their work readiness.ConclusionsThe findings of this study suggest that improving work-readiness of healthcare students requires alignment of learning needs to real-world practice opportunities, ensuring support systems are appropriate, and early familiarisation with the healthcare system.