Student Clinical Skills Research Articles

Comparing the impact of different transfusion medicine teaching methods—A mobile application versus task-based learning—On two dimensions of clinical competence among nursing students: A quasi-experimental study

AimTo evaluate and compare the impact of a transfusion medicine training course delivered via two different teaching methods—a mobile application and task-based learning—on nursing students' knowledge and clinical decision-making skill. BackgroundTo advance nursing education and clinical competence, it is crucial to integrate innovative methods, such as mobile applications and task-based learning, that promote active and competency-based learning. Evaluating these methods provides educators with insights to enhance nursing students' knowledge and clinical decision-making skill, ultimately improving patient care and supporting professional development. DesignA quasi-experimental study using a pretest-intervention-posttest design with a control group. MethodsThis study included 82 nursing students from the 6th to 8th semesters, selected through convenience sampling and randomly assigned to three groups—mobile application (n=30), task-based learning (n=30) and control (n=30). The first group received educational content through a mobile application, the second group through task-based learning and the control group received no intervention. Data were collected using a valid and reliable three-part researcher-made tool, including a demographic/educational checklist and questionnaires on knowledge and clinical decision-making skill, administered before and two weeks after the intervention. Analysis was done using paired t-test, analysis of covariance and Bonferroni post hoc test, with a significance level set at p<0.05. ResultsFollowing the intervention, both intervention groups showed a significant increase in knowledge and clinical decision-making skill scores (p<0.05). Although both groups had higher knowledge scores than the control group, the differences were not significant (p>0.05). In contrast, clinical decision-making scores were significantly higher in both intervention groups compared with the control (p<0.05). No significant differences were observed between the intervention groups regarding the mean post-test knowledge and clinical decision-making skill scores (p>0.05). ConclusionBoth teaching methods effectively improved nursing students' knowledge and clinical decision-making skills in transfusion medicine. To leverage these findings effectively, educational authorities should integrate mobile applications and task-based learning into nursing curricula, test these methods in various settings to assess their impact and use the findings to update curricula in line with current educational needs.

Impact of Teaching Methods on Clinical Reasoning in Forensic Medicine: A Quasi-Experimental Study.

To compare the effectiveness of flipped classroom and video-assisted learning techniques with didactic lectures in promoting clinical reasoning skills in Forensic Medicine. Quasi-experimental study. Place and Duration of the Study: Department of Forensic Medicine, Dow International Medical College and Dow University of Health Sciences, Karachi, Pakistan, from May to October 2023. The study included 114 third-year medical students divided into three predefined tutorial groups. Over four weeks, within the Forensic Medicine respiratory module, each group was taught one topic per week using a distinct teaching strategy: Traditional lectures (TL) for the first group, flipped classroom (FC) method for the second group, and video-assisted teaching (VAT) for the third group. Students' learning achievements and clinical reasoning skills were assessed through a pre-test, post-test, and revision post-test. Pre-test scores showed no significant differences among the groups (p = 0.655). However, post-test scores differed significantly (F2:111 = 11.93, p <0.001). Tukiye's test indicated that the mean score for the FC group was significantly different from the TL group (p = 0.003) and the VAT group (p <0.001), but there was no significant difference between the TL and VAT groups (p = 0.422). The revision post-test indicated a significant decrease in mean scores across all groups, regardless of the instructional approach (p <0.001). The FC approach for teaching clinical reasoning in Forensic Medicine shows promising results, effectively improving student performance and learning experience. Flipped classroom, Video-assisted teaching, Clinical reasoning, Forensic Medicine teaching.

Assessment of Clinical Reasoning in Undergraduate Medical Education: A Pragmatic Approach to Programmatic Assessment.

Clinical reasoning, a complex construct integral to the practice of medicine, has been challenging to define, teach, and assess. Programmatic assessment purports to overcome validity limitations of judgments made from individual assessments through proportionality and triangulation processes. This study explored a pragmatic approach to the programmatic assessment of clinical reasoning. The study analyzed data from 2 student cohorts from the University of Utah School of Medicine (UUSOM) (n = 113 in cohort 1 and 119 in cohort 2) and 1 cohort from the University of Colorado School of Medicine (CUSOM) using assessment data that spanned from 2017 to 2021 (n = 199). The study methods included the following: (1) asking faculty judges to categorize student clinical reasoning skills, (2) selecting institution-specific assessment data conceptually aligned with clinical reasoning, (3) calculating correlations between assessment data and faculty judgments, and (4) developing regression models between assessment data and faculty judgments. Faculty judgments of student clinical reasoning skills were converted to a continuous variable of clinical reasoning struggles, with mean (SD) ratings of 2.93 (0.27) for the 232 UUSOM students and 2.96 (0.17) for the 199 CUSOM students. A total of 67 and 32 discrete assessment variables were included from the UUSOM and CUSOM, respectively. Pearson r correlations were moderate to strong between many individual and composite assessment variables and faculty judgments. Regression models demonstrated an overall adjusted R2 (standard error of the estimate) of 0.50 (0.19) for UUSOM cohort 1, 0.28 (0.15) for UUSOM cohort 2, and 0.30 (0.14) for CUSOM. This study represents an early pragmatic exploration of regression analysis as a potential tool for operationalizing the proportionality and triangulation principles of programmatic assessment. The study found that programmatic assessment may be a useful framework for longitudinal assessment of complicated constructs, such as clinical reasoning.

Albuterol off-label use in the management of hyperkalemia and students survey

This study aimed to explore the evidence in the off-label use of albuterol in the acute management of hyperkalemia. It also aims to explore the knowledge and opinion of first-year pharmacy students related to this topic. Based on the literature survey, it shows a lack of awareness among first-year pharmacy students regarding albuterol, hyperkalemia, and the use of albuterol for hyperkalemia. Demographic factors, such as income and years of work experience, were shown to influence students' understanding of the topic. Regarding the survey, a total of forty participants completed an online survey, providing information on demographic factors such as age, gender, residency state, employment status, income, education, and work experience. Results revealed a predominantly female and younger student population, with diverse geographic representation and varied employment and income levels. Most participants selected the wrong answer to questions related to albuterol and hyperkalemia, suggesting potential knowledge gaps in this area. These findings highlight the need for targeted educational interventions to enhance student understanding and clinical decision-making skills in pharmacotherapy-related concepts. Further research could evaluate the effectiveness of such interventions in improving student knowledge and patient care outcomes.

Liverpool dental student wins clinical skills grand final

Liverpool dental student wins clinical skills grand final

Investigating dyads in nursing education

Background: Nursing education faces challenges due to a shortage of nurse educators and nurses in the workforce, prompting programs to expedite training, impacting student and nurse well-being. While standards are high, studies reveal many students feel unprepared. Self-confidence is crucial, affecting clinical performance, as is effective communication, which is pivotal for safe patient care. Dyadic education, involving pairs, is gaining traction for its potential to enhance teamwork and reduce stress.Methods: This study explored dyadic teaching's impact on nursing students' self-confidence, communication, and clinical skills in the context of nursing practicums. A convenience sample of nineteen undergraduate nursing students participated in a survey assessing their experiences in dyads.Results/Conclusions: Findings suggest dyadic teaching fosters greater confidence, reduces stress, and enhances communication. However, limitations, including small sample size and retrospective data collection, underscore the need for further research. Introducing dyadic approaches in nursing curriculums holds promise for optimizing student learning and patient care outcomes.

Use of a clinical reasoning scaffolding document improves student performance

ObjectiveClinical reasoning is an essential skill set for practicing pharmacists to possess. Given its complex nature, optimal pedagogies for teaching clinical reasoning are largely unknown. The use of scaffolding to expand a student's zone of proximal development and improve clinical reasoning performance was assessed in this study. MethodsThis prospective, observational cohort study of second professional year (P2) students compared performance of those who were exposed to a clinical reasoning scaffolding tool (CRST) to historic control P2 students (No CRST) on FARMR notes in alignment with the Pharmacists' Patient Care Process. Student performance was assessed using an entrustment-like scale for each of 5 sections (Findings, Assessment and goals, Recommendations, Monitoring, and Rationale) of the FARMR to link classroom and experiential education settings. ResultsIn total, 141 CRST students from 28 groups were compared to 77 No CRST students from 13 groups. CRST students performed significantly higher in Assessment and goals of therapy, Recommendations, Monitoring, Rationale sections but no difference in Findings. ConclusionsScaffolding has been utilized successfully in other health professions education. This study provides evidence of it successfully improving student pharmacist clinical reasoning skills, an essential ability for successful pharmacy practitioners.

Evaluation of Medical Students' Satisfaction With Using a Simulation-Based Learning Program as a Method for Clinical Teaching.

Objectives This cross-sectional analytical study aims to evaluate medical students' awareness and satisfaction regarding the utilization of simulation-based learning (SBL) as a method for clinical teaching at King Saud University (KSU) over the past 12 months. It seeks to understand how such learning methods enhance students' self-satisfaction and clinical skills, facilitate the application of learned knowledge, and assess the role of instructors in providing ample practice opportunities in the skills laboratory. Furthermore, the study aims to assess the satisfaction levels of students in both preclinical and clinical years regarding the time allocated for skills laboratory sessions and the integration of high-fidelity technology in simulation-based training programs at KSU. Methods In this cross-sectional study, a total of 306 male and female medical students from the College of Medicine at KSU participated, comprising 196 preclinical students (first, second, and third years) and 110 clinical students (fourth and fifth years). Quantitative data was collected through a structured questionnaire on a 5-point Likert scale that showed degrees of satisfaction. The satisfaction was measured based on a 5-point Likert scale that shows the degree of satisfaction from (very dissatisfied, dissatisfied, neither dissatisfied nor satisfied, satisfied, and very satisfied), and we calculated the p-value based on an independent t-test, and the percentage represented the percentage of students who chose satisfied and very satisfied. Results The results showed overall satisfaction with SBL (mean: 3.98, 71.10%), and it was recognized as a useful and effective method of learning skills. It is reported that it helped the students implement what they learned. At the same time, lower satisfaction was identified in areas with less allocated time for skill labs. Moreover, lack of accessibility and lack of trained staff were reported, and they should be addressed by providing staff with proper training. Conclusion The results of the study will help to understand how students' learning needs should be addressed. Moreover, providing simulation-based training is a pathway compliant with the best educational standards that should be adapted according to each institution's singularities. Besides offering further results, the study presents suggestions for further research.

Increased Perceived Confidence in Professional Role Skills among Undergraduate Dietetic Students Following Simulation-Based Learning Experiences

Simulation-based learning experiences (SBLEs) are effective for teaching healthcare students clinical and communication skills. The current study assessed self-perceived clinical and communication confidence among dietetics students completing a series of four SBLEs (3 group, 1 individual) across nine months. Dietetics students were recruited in February 2023 prior to their first SBLE. Simultaneously through the academic year, students completed clinical and communication courses. Students were invited to complete an online, anonymous self-reported survey regarding confidence with nutrition care and communication prior to their first SBLE (Time 1), prior to their third SBLE (Time 2), and following their final SBLE (Time 3). The survey measured healthcare work experience and self-perceived confidence. Student confidence increased among 30 of the 38 indicators (p &lt; 0.05). At Time 2 (following two group SBLEs), those with healthcare experience had higher confidence among 12 of the 39 items (p &lt; 0.05). At Time 3 (following four simulation experiences) those with healthcare experience had higher confidence among just four of the 39 total items (p &lt; 0.05). Cohort increases in confidence suggest that SBLEs, along with dietetics coursework, were critical in increasing confidence and students’ perceived ability to carry-out entry-level tasks of a dietitian. While student confidence increased across the cohort, SBLEs were particularly beneficial in leveling confidence between those with prior clinical experience and those without.

Evaluation of Student Expectations and Clinical Competence Skills Performance during Surgery Clerkship Programme: A Comprehensive Study

The existence of a good clerkship system and quality lecturers will undoubtedly enhance the medical students’ knowledge and skills that align with their competencies. This study aimed to evaluate the achievement of surgical competence based on the expectations of students following clinical clerkships in a surgical department. This study included medical students who participated in a clinical clerkship in the surgical department using a mixed method with a sequential explanatory design as a quantitative approach. Pre- and post-tests were also used to assess changes in student knowledge, qualitative results were obtained from focus group discussions (FGD), and standardised questionnaires were used to assess student skills expectations and achievements. The results showed a significant increase in students’ knowledge after participating in a clinical clerkship, with a mean difference of 3.94 [standard deviation (SD) = 10.67]. However, only three of the skills met students’ expectations during clinical clerkship. This was attributed to a lack of opportunities to practice the skills that students had acquired, the presence of too many students, limited time, and a shortage of practical placements in regional hospitals. Most students perceived the majority of lecturers as nurturing and proficient. However, some lecturers are often occupied with their commitment, resulting in infrequent student interactions. The clinical clerkship system for the Department of Surgery at the Faculty of Medicine, Hasanuddin University effectively enhanced student knowledge, but it needs to be improved to meet their skill expectations.

Development and implementation of a high-fidelity simulation training course for medical and nursing collaboration based on the Fink integrated course design model.

The purpose of this study is to examine the design and implementation of a high-fidelity simulation training course for medical and nursing collaboration, based on the Fink integrated course design model. Additionally, the study aims to validate the teaching effectiveness of the course. Previous empirical studies have highlighted the effectiveness of collaborative healthcare education in institutional teaching and hospital training. However, the development of healthcare collaborative education in China has been slow to develop in China. In recent years, Chinese nursing educators and researchers have shown interest in utilizing high-fidelity simulators for healthcare collaborative education. These simulators help address the limitations of traditional nursing teaching and healthcare separation simulation. Nevertheless, a standardized simulation interprofessional education curriculum is still lacking. Therefore, nursing educators need to develop a standardized high-fidelity simulation training curriculum for healthcare collaboration, guided by established science curriculum development theories. A high-fidelity simulation training course on healthcare collaboration was designed based on the Fink integrated curriculum design model. The course was taught to 14 nursing students and 8 clinical medicine students from March to July 2022. To comprehensively evaluate the effectiveness of the healthcare collaboration high-fidelity simulation training course, several assessment tools were used. These included course grades, satisfaction and self-confidence scales, simulation teaching practice scales, healthcare collaboration attitude scales, critical thinking skills scales, and semi-structured interviews. After the course was implemented, students demonstrated high overall scores (79.19 ± 5.12) and reported high satisfaction ratings (4.44 ± 0.37). They also exhibited increased self-confidence (4.16 ± 0.33). Additionally, students evaluated all four dimensions of the course teaching practice scale positively. Furthermore, the study demonstrated significant improvements in various aspects, such as attitudes toward medical and nursing collaboration (t = -7.135, P < 0.01), shared education and teamwork (t = -3.247, P = 0.002), job autonomy for nurses (t = -1.782, P = 0.000), and reduced physician dominance (t = -6.768, P = 0.000). The critical thinking skills of the students showed significant improvement, with higher scores in truth-seeking (t = -3.052, P = 0.004), analytical ability (t = -2.561, P = 0.014), systematic ability (t = -3.491, P = 0.001), self-confidence in critical thinking (t = -4.024, P = 0.000), and curiosity (t = -5.318, P = 0.000) compared to their scores before the course (all P < 0.05). The interviews showed that the course's student-centered approach enabled active learning. Students suggested enhancing teaching cases and allocating more time for reflection and summarization. The study successfully designed a high-fidelity simulation training course for healthcare collaboration by utilizing the Fink integrated curriculum design model. The findings provide valuable insights for the development of standardized curricula and healthcare collaboration education in China. Moreover, the course adheres to best practice principles, fostering improved attitudes toward healthcare collaboration and enhancing students' healthcare collaboration and clinical thinking skills.

A virtual simulation-based clinical skills course.

Advancements in technology continue to transform the landscape of medical education. Virtual reality (VR) and remote simulation represent unique approaches to teaching students clinical skills through experiential learning. We developed, implemented and evaluated a virtual simulation-based course modelled on Kolb's Learning Cycle. A 5-day, 15-h virtual clerkship clinical skills curriculum designed to help students recognise a patient requiring urgent or emergent care was piloted in May 2020. VR and remote simulations facilitated concrete experiences, reflective observation, concept formation, and active experimentation. Curricular evaluation included analysis of usage, performance, self-assessment, and perceptions of educational value. One hundred and fifty-six students completed 436 VR sessions (median 3 per student). Students repeated virtual cases, on average, 75% of the time, demonstrating improvement in average performance scores from 59% (attempt 1) to 72% (attempt 2). Post-course evaluations, completed by 109 (69.9%) students, demonstrated significant improvements in mean scores in all domains of a self-assessment based on emergent care skills. We developed and implemented a virtual clinical skills course that allowed students to progress through all four stages of Kolb's Learning Cycle. VR and remote simulations represent an opportunity for educators to reimagine and expand opportunities for experiential learning. The number of students accommodated, total virtual simulations completed, and positive student feedback suggests that this may be a feasible, acceptable, and scalable method for increasing opportunities for progression through Kolb's Learning Cycle. Further investigation into impact on educational outcomes is needed.

Exploring Undergraduate Nursing Students' Perceptions on Clinical Learning Environment in the UAE: A Focus on Perceived Benefits and Challenges.

Establishing a supportive clinical environment is paramount for enhancing nursing students' engagement in clinical practice, their clinical proficiencies, and satisfaction. The increase in nursing student enrollment at the Nursing College, driven by the collaborative efforts between Abu Dhabi Health Services Company (SEHA) and universities, has given rise to concerns regarding the quality of education and clinical instruction. These concerns are primarily due to the increased student-to-instructor ratio. Furthermore, the unsupportive clinical settings and learning tensions underscore the need to understand students' learning experiences and address research gaps within the field of clinical learning in the United Arab Emirates (UAE). The purpose of this study is to investigate the undergraduate nursing students' perceptions of their clinical learning environment, with a focus on perceived benefits and challenges. This study used a cross-sectional survey design. The researchers administered a five-point Likert scale questionnaire, which had been adapted and contextualized, to a convenience sample of 217 third and fourth-year nursing students who willingly participated in this study. Despite the presence of positive aspects, such as diverse clinical experiences and strong support from both clinical instructors and peers, several challenges affect the students' clinical learning. These challenges encompass disparate perceptions of supervision among staff nurses, learning tensions related to student academic workload, insufficient clinical supervision, and difficulties in finding assistance when needed. There is a clear need to enhance the overall ward learning environment to optimize students' academic motivation and clinical skills. Several measures can be taken to achieve this goal, including incentivizing and reducing the workload of staff nurses, investing in the professional development of clinical instructors, promoting peer interactions and group learning, and adopting a block pattern of education in years three and four for better clinical knowledge assimilation and reduced theoretical workload.

Los Estilos de aprendizaje y su importancia en el desarrollo de habilidades clínicas de los estudiantes de Odontología: Un estudio transversal

Introduction.Professional schools of dentistry must generate and guarantee the learning and development of clinical skills in students in order to achieve an adequate graduate profile. This challenge implies the need to know the learning styles of students in order to generate strategies and improve learning.Objective: This study aims to analyse the importance of learning styles in the development of clinical skills of dental students at a private university in Cusco.Methodology: A descriptive and cross-sectional study was carried out, the population consisted of 215 students in the seventh, eighth and ninth semesters of the clinical area of the School of Stomatology, with a sample of 139 students, using the survey technique and the questionnaire as an instrument for the variables under study, as well as data processing using SPSS software, v. 26.Results: it is known that 70.5% of the students' learning styles have a high level of management of their learning styles, with 41.7% in the reflective style, 67.6% in the theoretical style and 56.1% in the pragmatic style, which implies that according to their educational experience their style predominates; in addition to the importance of learning styles in the development of clinical skills.Conclusion: clinical skills are significantly associated with the learning style possessed by the students.

The power to help or harm: student perceptions of transgender health education using a qualitative approach

BackgroundLack of transgender health education among health professional education programs is a limitation to providing gender-affirming care. Educational interventions have advanced in the past decade using a variety of pedagogical approaches. Although evidence supports that educational interventions can significantly improve student knowledge, comfort levels, preparedness, and clinical skills, few studies have addressed student perceptions of or receptiveness towards transgender health education. The study purpose was to explore student perceptions of transgender health education using a qualitative approach.MethodsWe utilized a basic qualitative design to explore student perceptions of transgender health education at a Catholic, Jesuit institution. Participants were medical students (n = 182), medical family therapy students (n = 8), speech, language and hearing sciences students (n = 44), and dietetic interns (n = 30) who participated in an Interprofessional Transgender Health Education Day (ITHED) in partnership with transgender educators and activists. Participants completed an online discussion assignment using eight discussion prompts specific to the ITHED sessions. Data were analyzed using the constant comparative method and triangulated across four medical and allied health programs.ResultsA total of 263 participants provided 362 responses across eight discussion prompts. Three major themes resulted: (1) The Power to Help or Harm, (2) The Responsibility to Provide Health Care, and (3) A Posture of Humility: Listen and Learn. Each theme was supported by three to four subthemes.ConclusionsHealth professional students were highly receptive towards transgender health education delivered by transgender community members. First-person accounts from session facilitators of both positive and negative experiences in healthcare were particularly effective at illustrating the power of providers to help or harm transgender patients. Reflection and constructive dialogue offers students an opportunity to better understand the lived experiences of transgender patients and explore their identities as healthcare providers at the intersection of their religious and cultural beliefs.

An effectiveness evaluation of a community-based course for medical students: a randomized controlled trial in the teaching of epidemiology

BackgroundEpidemiology is considered to be the fundamental science of public health and plays an important role in clinical competence and professional development. The objective of this study is to evaluate the effectiveness of a short-term course for the teaching of epidemiology, which was designed as a community-based class for medical students.MethodThis course was designed according to Kern’s six-step approach to curriculum development. A total of 75 undergraduates were recruited. Forty-one students were assigned to an experimental group engaged in theoretical teaching and practical courses, while 34 students were assigned to the control group only taking theoretical courses. All participants were asked to complete a pre- and post-course survey and to take a test after completing the course. The scores between the experimental and control groups were compared using the Wilcoxon test.ResultThe experimental group showed significantly higher self-assessment scores in course understanding (p = 0.0126) and clinical practice skills (p = 0.0005) after completing the course, while no significant difference was observed in the control group. In addition, students in the experimental group reported significantly higher interest (p = 0.0015), stronger learning motivation (p = 0.0113) and a better mastery of epidemiology (p = 0.0167) after completing the course than those in the control group. However, test scores (p = 0.0859) and pass rates (p = 0.1755) demonstrated no statistical significance between the two groups.ConclusionThe short-term practical course in epidemiology exerted significantly positive effects on the improvement of student learning enthusiasm, course understanding and clinical practice skills. These findings provide new ideas and statistical evidence for the development of epidemiological instruction. Future studies should explore how to more widely and optimally apply community-based courses to the teaching of epidemiology.

Assessment of quality improvement of simulation-based learning using an evidence-based framework in dental education.

Simulation-based education is of paramount importance in a dental pre-clinical setting. Hence, continuous quality improvement is crucial to optimize students' knowledge and clinical skills. This study aimed to evaluate the impact of evidence-based simulation learning (EBSL) compared with traditional-based simulation learning (TBSL) using Plan-Do-Study-Act (PDSA) model. This quality improvement project was undertaken at a private university. Guided by the PDSA model, rubber dam application tasks were conducted in the simulation lab in 2 phases. Phase 1 included TBSL and phase 2 included EBSL comprising of 2 PDSA cycles. 'Plan' stage involved obtaining feedback from students and the concerned staff. 'Do' stage included implementation of EBSL in eight steps adopted from Higgins's framework. 'Study' stage evaluated the outcomes and in 'Act' stage amendments were made to the first EBSL cycle. In the second PDSA cycle re-implementation and evaluation of the rubber dam application exercises were carried out. Descriptive data were presented as percentages and mean scores were compared using paired t-test. Thirty-seven year 2 students participated in this study. A significant improvement in the mean scores was observed between TBSL and EBSL (3.02 + 0.16 and 3.91 + 0.27, respectively, p < .001) using PDSA model with the highest mean score for rubber dam application in the second PDSA cycle for EBSL (4.00 + 0.01). Ninety-five per cent of the students provided positive feedback pertaining to EBSL. EBSL was effective in achieving high student satisfaction, desired knowledge, and skills required during simulation-based exercises. The PDSA cycle can be considered to optimize pre-clinical skills learning.

Evaluation of a pilot to introduce simulated learning activities to support speech and language therapy students' clinical development.

Speech and language therapy (SLT) education must meet the needs of the future workforce, training enough students who are competent practitioners able to meet the workforce demands. Increasing student numbers and the impact on placement providers mean students must be equipped for learning on placement. Simulation is a way of supporting students to develop their clinical skills and decision-making in a safe, supportive environment. To explore the perspectives of SLT students who were introduced to simulation during their undergraduate degree at a UK university as part of a pilot study. The aim of the pilot was to listen to the students' voices to begin to understand their lived experiences of simulation and to gather views on how simulation can support their clinical learning. Focus groups and semi-structured interviews were carried out with second-year BSc SLT students in semester 2 following the simulated learning activities and clinical placement. Qualitative data were gathered and thematic analysis was applied to the data to identify the barriers and enablers to students' clinical learning in simulation. A total of 11 students responded out of a cohort of 38. Three key themes were identified from the analysis: individual learning needs, facilitator skill and programme-level organization. Student experience of simulation was positive. One of the key elements students found to support their clinical skills was the importance of the safe space; support for learning instead of correction led them to engage in active learning. Key barriers to simulation related to having sufficient prior knowledge, the skills of the facilitator, group size and the wider learning landscape of the programme. In response to this pilot, there are plans to continue developing this model of simulation and embed simulation across the programme, led by a sound pedagogical approach with clear preparation and planning and building the necessary infrastructure. Other SLT programmes and practice educators developing simulation as part of their programmes or placement may wish to consider some of these findings to support the use of simulation in their workplace. What is already known on this subject Simulation as a teaching methodology is widely used in medicine and nursing programmes. It is now used in various allied health professions and in some SLT programmes. There is evidence to suggest simulation increases student confidence and clinical skills without increasing the capacity on those offering clinical placements in practice. What is already known on this subject This study offers a practical example of introducing simulation in an established undergraduate programme for SLT students. It explains the background to this innovative way of teaching clinical skills and explains why this approach could be beneficial for the future speech and language therapist. What are the clinical implications of this work? This study gives practical examples of how simulation can work to facilitate student clinical learning and knowledge. It may offer ideas to those working in clinical practice to organize placements differently or add simulation elements to improve the student experience. Other educational establishments and placement educators may find the recommendations helpful in developing their own simulation approach.

Perception of Quiet Students in Emergency Medicine: An Exploration of Narratives in the Standardized Letter of Evaluation.

The Standardized Letter of Evaluation (SLOE) is designed to assist emergency medicine (EM) residency programs in differentiating applicants and in selecting those to interview. The SLOE narrative component summarizes the student's clinical skills as well as their non-cognitive attributes. The purpose of this qualitative investigation was to explore how students described in the SLOE as quiet are perceived by faculty and to better understand how this may impact their residency candidacy. This retrospective cohort study included all SLOEs submitted to one EM residency program during one application cycle. We analyzed sentences in the SLOE narrative describing students as "quiet," "shy," and/or "reserved." Using grounded theory, thematic content analysis with a constructivist approach, we identified five mutually exclusive themes that best characterized the usage of these target words. We identified five themes: 1) quiet traits portrayed as implied-negative attributes (62.4%); 2) quiet students portrayed as overshadowed by more extraverted peers (10.3%); 3) quiet students portrayed as unfit for fast-paced clinical settings (3.4%); 4) "quiet" portrayed as a positive attribute (10.3%); and 5) "quiet" comments deemed difficult to assess due to lack of context (15.6%). We found that quiet personality traits were often portrayed as negative attributes. Further, comments often lacked clinical context, leaving them vulnerable to misunderstanding or bias. More research is needed to determine how quiet students perform compared to their non-quiet peers and to determine what changes to instructional practices may support the quiet student and help create a more inclusive learning environment.

Child Health Essential Skills Stations (CHESS): Development, Implementation, and Evaluation of an Undergraduate Child Health Clinical Skills Course

Background: Teaching undergraduate medical students clinical skills in a child health setting is a particular challenge for clinical educators. Students spend less time with pediatric patients and have fewer opportunities to practice clinical skills. The coronavirus (COVID-19) pandemic further reduced students’ opportunities to observe and practice skills in the workplace. This has necessitated a greater shift towards teaching skills in a "skills lab" setting, which allows for simulated practice in a safe environment. This study reports the design, implementation, and evaluation of a standardized course that utilizes the "skills lab" to train undergraduate medical students in five clinical skills important to child health. Objectives: This study aimed to implement and evaluate a standardized undergraduate clinical skills course for child health and improve students' confidence in performing child health clinical skills. Methods: Evaluations were carried out over approximately one academic year, with a total of 174 participants from a single medical school in the United Kingdom. Qualitative and quantitative data were collected, examining students' self-reported confidence (pre- and post-course) along with free-text course evaluations. A paired t-test was used to calculate the mean difference in students' pre- and post-course confidence scores. Qualitative evaluations were analyzed for themes using framework analysis. Results: The students had greater confidence in all measured learning outcomes following the course. Qualitative data, examined using framework analysis, suggested that the course was valued by students, who felt it was relevant to their future practice. Numerous written comments suggested particular content and teaching methods that were strengths of the course, including practical elements, small group teaching, and feedback from tutors. Conclusions: Implementing a child health clinical skills course in a skills lab setting is feasible and valued by students. The course increased the self-reported confidence of the studied cohort and might therefore support them in practicing these skills with actual patients. Further studies are required to determine whether these effects demonstrate longevity and whether they translate to increased competence in performing the taught skills.