Undergraduate Clinical Training Research Articles

Developing mental health curricula and a service provision model for clinical associates in South Africa: a Delphi survey of family physicians and psychiatrists

BackgroundClinical associates are a health professional cadre that could be utilised in mental health task sharing in South Africa but this is training dependent. The objectives of the study were to identify the potential curricula content, training sites, and teaching modalities for undergraduate and potential postgraduate clinical associate mental health training and to identify the tasks that they should perform based on these curricula.MethodsWe utilised the Delphi method to reach consensus on items with the panel comprising psychiatrists and family physicians. The first round questionnaire of the Delphi survey was developed based on a literature review and the results from earlier phases of the overall study. The survey was administered electronically and consisted of three rounds. Following both the first and second rounds, an updated questionnaire was constructed omitting the items on which consensus was reached. The questionnaire consisted primarily of nine-point scales with consensus based on 70% of participants rating 1,2,3 or 7,8,9.ResultsThere were 26 participants in the first round with this number falling to 23 in later rounds. There was strong consensus on a training attachment to a mental health clinic at a community health centre (CHC) at undergraduate (96.2%) and postgraduate level (100%). Consensus was reached on the importance of training on the management of six categories of disorders at the undergraduate level and nine categories of disorders at the postgraduate level. Clerking patients as a teaching modality reached 100% consensus at both undergraduate and postgraduate levels. PHC clinics, CHCs and district hospitals reached consensus as appropriate settings for clinical associates to provide mental health services. In addition, GP practices and secondary hospitals reached consensus for those with postgraduate training. Consensus was reached on ten of the 21 listed tasks that could be performed based on undergraduate training and 20 of the 21 tasks based on a postgraduate qualification in mental health.ConclusionsThe Delphi panel’s recommendations provide a clear roadmap for enhancing mental health curricula for clinical associates, enabling their utilisation in mental health service provision. A future postgraduate mental health qualification for clinical associates would allow for expanded task sharing.

332 Improving Preparedness of Junior Doctors in Surgery Through Development and Implementation of an Induction Booklet

Abstract Aim Disruption to undergraduate clinical training during the COVID-19 pandemic caused a perceived lack of preparedness amongst newly qualified junior doctors. We aimed to improve junior doctor preparedness in surgery, through development and implementation of an induction booklet. Method An electronic survey distributed in December 2021 assessed junior doctors’ perceived preparedness for their surgical job and identified inadequacies in the existing induction programme. Through feedback and suggestions, we designed a 30-page induction booklet containing information for each surgical sub-specialty, on-call commitments, the rota, practical tips, and important contact numbers. The booklet was distributed to the subsequent two junior doctor cohorts, six weeks prior to them joining, in April and August 2022. They completed an electronic survey within their first week to assess the impact of the induction booklet. Results Survey response rate was 60% (n = 29) from the pre-intervention cohort and 55% (n = 28) from the post-intervention cohort. Prior to intervention, most junior doctors felt unprepared for their day-to-day surgical job (79%) or their first on-call shift (69%). Following the implementation of the booklet, only 11% of respondents felt unprepared for their day-to-day surgical job, more than a seven-fold improvement (p<0.0001). The proportion of respondents who felt unprepared for their first on-call shift significantly decreased to 32% (p = 0.0081). 93% of respondents reported that the induction booklet was useful in preparing them for their surgical job. Conclusions Development and implementation of a departmental induction booklet is a useful tool to improve preparedness amongst junior doctors in surgery.

Using standardized patients for undergraduate clinical skills training in an introductory course to psychiatry

BackgroundThe goal of this study was to assess the value and acceptance of Standardized or Simulated Patients (SPs) for training clinically inexperienced undergraduate medical students in psychiatric history taking, psychopathological assessment, and communication with psychiatric patients.MethodsAs part of a newly developed introductory course to psychiatry, pairs of 3rd year medical students conducted psychiatric assessments of SPs, including history and psychopathological state, under the supervision of a clinical lecturer. Prior to the assessment, students attended introductory lectures to communication in psychiatry and psychopathology but were clinically inexperienced. After the interview, the students’ summary of their findings was discussed with other students and the lecturer. Students, lecturers, and actors were invited to a survey after the course. Questions for the students included self-reports about perceived learning success and authenticity of the interviews.Results41 students, 6 actors and 8 lecturers completed the survey (response rates of 48%, 50%, and 100%, respectively). The survey results indicated that, despite their lack of clinical experience, students learned how to conduct a psychiatric interview, communicate in a non-judgmental and empathetic manner, take a psychiatric history and perform a psychopathological examination. SPs were perceived as authentic. The survey results suggested that this setting allowed for an enjoyable, non-distressful and motivating learning experience within a restricted time frame of just two afternoons.ConclusionThe results indicated that the SP approach presented is useful for teaching clinical skills in psychiatry to students with limited previous clinical experience and knowledge of psychiatry. We argue that SPs can be used to teach practical psychiatric skills already during an early phase of the curriculum. Limitations of our study include a limited sample size, a temporal gap between the course and the survey, reliance on self-reports, and lack of comparison to alternative interventions.

Clinical pharmacy undergraduate education in China: a comparative analysis based on ten universities’ training programs

BackgroundIn recent years, the scale of personnel training for clinical pharmacy professionals in China has expanded increasingly, however, the shortage of clinical pharmacists is still prominent. In 2018, the Ministry of Education of China released national standards for the teaching quality of undergraduate majors at regular colleges and universities, which has developed a core policy for undergraduate clinical pharmacy training. To explore the training methods for clinical pharmacy professionals in China and to promote the healthy and sustainable development of the clinical pharmacy education system. This study comparatively analyzed the training programs for clinical pharmacy undergraduates in China’s ten universities, discussed training programs suitable for clinical pharmacy professionals in China.MethodsThe clinical pharmacy education programs in these ten universities were obtained through official school websites or by interviewing relevant people, and then compared and analyzed.ResultsThe school with the largest number of courses and the most class hours in general courses is University A1 (34 courses, 1316 class hours), and the school with the most credits is University B1 (75.5 credits). The schools with the largest number of courses and the most class hours in the basic courses are University A1 (50 courses, 1997 class hours), and the schools with the most credits are University B3 and University B1 (105.5 credits). The schools with the largest number of courses in the core courses are University C1 (23 courses), and the school with the most credits and class hours is University B2 (51 credits, 914 class hours). The school with the most class hours in practical teaching is University B6 (1406 class hours), and the schools with the longest internship time are University A1 and University B6 (52 weeks).ConclusionsThere was substantial variation in programs. There remains a gap between the existing educational model and clinical training in pharmacy in China and developed countries. China should explore the most appropriate method for undergraduate education in clinical pharmacy based on studying foreign excellent educational models and the experience of China.

Starving for knowledge. Addressing the place of clinical nutrition within undergraduate and postgraduate clinical training: A national survey of practicing clinicians

Clinical Nutrition is finding its place within medical training. In response to IrSPEN's objectives and ESPEN's manifesto, IrSPEN distributed an electronic survey investigating attitudes to Clinical Nutrition and unmet educational needs. A 35-part questionnaire was designed and distributed to clinicians in Ireland. Questions elicited clinician demographics, education history and experience assessing and managing malnutrition. Descriptive statistics were reported, comparisons analysed using Chi-squared test and correlation between experience and confidence analysed with Spearman correlation coefficient. Of 168 respondents, 41% (n=58) were male and most practice medicine in an academic centre (87.5%). Fifty-eight (34.7%) were regularly involved in nutrition support. Despite 20% (n=33) of respondents regularly managing patients on parenteral nutrition (PN) and a fifth (n=34) regularly managing complications of obesity, few had confidence in assessment for artificial nutrition (15.7% (n=26), enteral nutrition; 8% (n=13), PN). Trainees were less confident than attending staff in assessing and managing artificial enteral feeding (p=0.022) and complications of PN (p=0.01). Over 70% respondents reported they received <2h clinical nutrition education. Only 32% (n=52) received any formal training within postgraduate training (PGT), more often GI trainees (p=0.01). A striking 98% felt additional focus on nutrition education in PGT is required. This survey elicits physician attitudes on nutrition education in undergraduate and postgraduate curricula in Ireland. Practicing physicians identify the need to increase clinical nutrition education. IrSPEN are actively engaging with Irish medical schools and training bodies to address these deficits with multidisciplinary engagement from expert physicians and allied dietetic colleagues.

Vision Bus Aotearoa: a platform for strengthening eye health teaching, research and community partnership

ABSTRACT Clinical Relevance Vision Bus Aotearoa is a fully equipped mobile eye health clinic designed to provide a novel platform for undergraduate optometry clinical training, community eye health research and deliver services to underserved communities. Background Aotearoa New Zealand has inequitable access to eye health care. Vision Bus Aotearoa aims to work in partnership with communities to provide comprehensive mobile primary eye health care services while training optometry students, and integrating community eye health research. Methods A description is provided of the governance model which has been involved throughout the project. Results The process of vehicle manufacture, clinical set-up, funding models and service delivery are described. The aims of the project are detailed in terms of optometry teaching, clinical services in partnership with communities, and research integration and implementation. Conclusion Vision Bus Aotearoa represents a valuable opportunity to deliver mobile eye health care to historically underserved communities, enhance undergraduate optometry teaching and to provide a unique platform for community eye health research.

Influence of Sparshanam, a Medical Humanities Module on Personal and Professional Development among the First Batch of Medical Graduates in Lalitpur, Nepal: A Cross-Sectional Study

Background: Medical humanities (MH) uses subjects like literature, music, drama, and painting for specific purposes in medical education. We aimed to assess its medium-term impact on medical alumni whose curriculum incorporated a module on MH which was named as Sparshanam. Methods: After approval from the Institutional Review Committee of KIST Medical College, this cross-sectional online survey was performed from December 2020 to January 2021on the 2008 batch medical alumni who had experienced Sparshanam in their medical education curriculum 10 years before. A mixed modal design (both qualitative and quantitative) was applied. The participants’ perception of the module, like its strengths, weaknesses, and its contribution to personal and professional development were assessed. Results: Out of the 75 first batch alumni, 39 (52%) participated. Most of them were working in the Kathmandu valley. The perceived strengths were teamwork, interactive group sessions, and imparting a holistic perspective of patients. The Sparshanam was perceived to enhance their teamwork, communication, leadership and clinical observation skills, and ability to empathize with patients. Participants perceived it to have an important influence on their development and recommended its introduction in the undergraduate and postgraduate clinical training. Conclusion: The Sparshanam was perceived to have a significant impact on their personal and professional development.

Enabling mental health task-sharing: a collective case study of undergraduate clinical associate training programmes in South Africa

BackgroundThere is a shortage of the human resources needed to deliver mental health services which is likely to be exacerbated by COVID-19. Due to mental health workforce shortages, task-shifting and task-sharing approaches have been implemented in a number of countries. Clinical associates, a mid-level cadre working under the supervision of medical practitioners, could play a role in delivering mental health services but it is not clear if they are adequately prepared. This study explored the mental health curriculum content of the undergraduate clinical associate training programmes in South Africa and the views of key informants of the adequacy of training in mental health.MethodsA qualitative collective case study approach was utilised for this multisite study at the three universities in South Africa offering clinical associate degrees. The study consisted of in-depth interviews utilising videoconferencing of individuals involved in each programme and a document review. Thematic analysis of the data was conducted.ResultsNineteen interviews were conducted. Mental health formed part of the curriculum in all three programmes with the bulk of the training taking place in the final year of the three-year degree. Facility-based training ranged from two weeks to four weeks with one university only using hospitals with mental health units while two universities used hospitals at which the students were based for the year regardless of potential mental health exposure they would receive. The list of curricula inclusions extended to seldom-seen conditions. The quality of training and supervision appeared site-dependant and only one university set minimum experiential targets.ConclusionThere is a basis on which to build the competencies and skills regarding mental health in this cadre. A training model that integrates mental health early in the undergraduate curriculum, focuses on common conditions and those with high disease burden, includes time in a mental health unit, provides facility-based trainers with detailed guidance to improve standardisation, and includes specific experiential targets that are monitored will enhance the potential utility of this cadre.

Students’ knowledge, attitudes and practices related to infection control in undergraduate dental clinical training during COVID-19 A report from one South African university

The COVID-19 pandemic has highlighted the need for renewed conversations in infection control in the context of dental undergraduate learning. This study set out to examine dental therapy and oral hygiene students’ knowledge, attitudes and practices related to infection control.This quantitative survey was conducted at one dental training site in South Africa. The study population comprised 156 full time enrolled students that was stratified into Year 1 (n=55), Year 2 (n=54) and Year 3 (n=47). An online, self-administered questionnaire with closed and open-ended questions was used to collect information. Data were analyzed using SPSS version 25.0 (IBM Corp., USA) and thematic analysis. The response rate for the study was 70.5% (n=111).Almost all participants (n=104) strongly agreed/agreed that COVID-19 is transmitted mainly through infected droplets. Most participants (Year 1: n=24, 22.5%; Year 2: n=28, 26.2%; Year 3: 22, 31.2%) strongly disagreed / disagreed that younger people were less susceptible to contracting COVID-19 disease. While 23 first (21.5%) and 16 second-year students (14.9%) strongly agreed/agreed that personal protective gear was sufficient protection against COVID-19, about 16 third-year students (14%) were unsure or disagreed. Almost all participants (n=105, 98.1%) strongly agreed/agreed to washing or sanitizing their hands regularly. The emergent themes from qualitative data analysis included: better access to resources and more coordinated planning for clinical and classroom-based learning. There were inconsistencies in participants’ knowledge and attitudes towards infection control. There is a need for ongoing awareness of infection control in both clinical and class-room based learning.

Embalming Procedures and Laboratory Practices for Cadaver‐Based Learning

IntroductionThe use of embalming chemicals, techniques, and laboratory practices for educational purposes is not well documented in Canada. While there is a preference for the use of hard‐fixation techniques, soft‐preservation techniques and unembalmed tissue for undergraduate learning, clinical training and research, the choice of tissue state in Canadian institutions remains unknown. Little has been reported on the effects of the introduction of clinical training programs on the choice of tissue state and on the effects that these choices have on human body donation programs. It is hypothesized that embalming procedures and laboratory practices will be highly variable across Canadian institutions, that a higher percentage of donors will be allocated to non‐hard‐fixation methods in institutions with a clinical training program, and that this shift in practices will require an increase in the number of donors needed from human body donation programs. This study aims to assess the use of embalming techniques and laboratory practices for education in Canada and to assess the impact of the integration of clinical training on human body donation programs.MethodsAn online questionnaire was distributed to 25 institutions in Canada that list an anatomy laboratory on their department website. A descriptive analysis was completed.ResultsA total of 23 embalming solutions were identified, and laboratory practices like sanitization, mold management, and health and safety measures were highly variable. This study confirmed that in Canadian institutions hard‐fixed donors are preferred for teaching, prosection and dissection, while soft‐preserved donors are preferred for clinical training, and unembalmed donors are preferred for research. Institutions with a clinical training program allocate a higher percentage of their donors to non‐hard‐fixed methods and require a higher number of donors from human body donation programs.ConclusionThis study confirms that the embalming procedures and laboratory practices used for cadaver‐based learning in Canadian institutions are highly variable. Furthermore, the introduction of a clinical training program leads to an increased need for soft‐preserved and unembalmed donors. This shift in practices requires a higher number of donors from human body donation programs.ImplicationThis study identifies 23 embalming solutions that can be tested for their efficacy and use in cadaver‐based learning to establish a best practice in embalming. Furthermore, this study sheds a light on the need to investigate the direct effects of clinical training sessions on human body donation programs and provides a perspective on the implementation of creative approaches to maximize the use of each donor received. This study opens a door to collaboration amongst the community of anatomists to establish the best embalming and safety practices to satisfy the need for donors in cadaver‐based learning, while minimizing the strain on human body donation programs.

Dental Students' Awareness After Clinical Training Between Dental Treatment and Systemic Health: A Questionnaire-Based Survey

Clinical training is an essential program for dental students to learn clinical skills. The aim of this study was to survey whether dental students who had undergone clinical training understood the clinical significance of dental treatment and its connection to systemic health. An awareness survey was conducted in dentistry students both before and after undergraduate clinical training. A total of 42 dental students were recruited before clinical training, and 32 dental students responded to the survey. In addition, all of the 42 dental students responded to the survey after clinical training. A total of 53 medical students were recruited as control subjects. Differences between the 2 groups were analyzed using Fisher's exact test. Before clinical training, a higher percentage of dental students felt the positive effects of periodontal treatment on systemic health. A higher percentage of dental students also recognized the positive effects of prosthetic treatment on geriatric conditions. After clinical training, no significant differences were found between periodontal and prosthetic treatment when surveyed about the positive effects of dental treatment on geriatric conditions. Undergraduate clinical training is essential for improving the students' understanding of the clinical significance of dental treatment. These surveys suggest that dental education supported by clinical experience contributes to understand the role of dental treatment.

Evaluation of an implemented Mini-CEX program for workplace-based assessment at Rehman Medical College, Peshawar, Khyber Pakhtunkhwa.

Objective: To evaluate the feasibility and acceptability of Mini-CEX as a formative WPBA tool at Rehman Medical College. To compare the annual exam short case scores of students with their internal Mini-CEX scores. Study design: Cross Sectional study. Setting: Rehman Medical College, Peshawar. Period: January to February 2016. Material &amp; Methods: Mini-CEX was implemented for the first time in a medical college of Khyber Pakhtunkhwa after training of faculty &amp; students on simulators. 100 MBBS students of Final Professional were included in the study through universal sampling. Completed Mini-CEX forms were collected weekly by Department of Medical Education (DME), and data entered in an Excel file. Mini-CEX scores of graduates were reviewed, compared and correlated with Khyber Medical University (KMU) practical exam scores in the same subjects for short cases. Results: 84 students were selected after data cleaning. Total required Mini-CEX were, 2338, submitted were 2563 with maximum mean submission/student of 5.32 in Obs/Gyn against a required mean of 3.32 (n=83, total rotation period = 04 weeks). The minimum requirement was 01 Mini-CEX/week. Total mean submission for all clinical disciplines was 7.67/student against a required mean of 6.27/student, showing ease and feasibility in implementation and student compliance. Significant correlation with KMU annual examination scores was observed only for Surgery (p=0.04). The correlation was insignificant for the other 03 disciplines of Medicine, Pediatrics and obstetrics and Gynecology with p &gt;0.05. Conclusion: Mini-CEX implementation is feasible and acceptable tool for formative WPBA in undergraduate clinical training. The student performance in Mini-CEX does not has a major effect on their annual exams scores.

Priming the Palliative Psychology Pipeline: Development and Evaluation of an Undergraduate Clinical Research Training Program.

Psychology adds value to palliative care research and practice, but palliative psychology training programs are underdeveloped, particularly prior to advanced graduate and post-doctoral training. The investigation aimed to examine the feasibility of developing an undergraduate clinical research training program focused on the application of palliative psychology to cancer care. Analyses described and examined predictors of trainee performance and post-graduate outcomes. Retrospective analyses of administrative data tracking trainee characteristics (degree programs and tracks, qualifications, and demographics), research trainee performance (satisfactory participation, training duration, scientific output, supervisor ratings, and overall performance), and post-graduate degree programs. The population included all undergraduate trainees in a cancer-focused palliative psychology research lab from inception in 2013 through 2020 at a US research-intensive university. Trainees (N = 25) typically majored in psychology (72.0%) or neuroscience (28.0%), often with second majors. The average participation in the lab was 3.4 semesters. Overall, 92.0% of trainees earned a conference abstract, 56.0% earned a publication, and 72.0% went on to a post-graduate degree program, most commonly psychology PhD, MD, or nursing programs. Trainees enrolling in psychology PhD programs were more likely than other trainees to have been on the pre-psychology PhD track (P < .001) and had higher overall research performance (P = .029), including higher supervisor ratings (P = .008) and higher scientific output (P = .019). This demonstration study provides evidence for the feasibility and beneficial impact of an undergraduate palliative psychology clinical research training program as an early component of cancer educational training. Findings support calls for the development and evaluation of novel palliative training programs worldwide.

A blended learning and teaching model to improve bedside undergraduate paediatric clinical training during and beyond the COVID-19 pandemic

The 2020 COVID-19 pandemic has severely disrupted paediatric undergraduate bedside clinical training. Facing an uncertain future, we need to be able to adapt to the variable effects of the pandemic on bedside training. During severe conditions, no bedside training is possible, while limited bedside training is possible during less severe conditions. We propose a learning and teaching model for undergraduate paediatric clinical training during and beyond the COVID-19 pandemic to facilitate bedside clinical training in order to maximise students’ acquisition of clinical competencies.

Preparing Graduates for Interprofessional Practice in South Africa: The Dissonance Between Learning and Practice.

With South Africa's tumultuous history and resulting burden of disease and disability persisting post-democracy in 1994, a proposed decentralization of heath care with an urgent focus on disease prevention strategies ensued in 2010. Subsequently a nationwide call by students to adapt teaching and learning to an African context spoke to the need for responsive health professions training. Institutions of higher education are therefore encouraged to commit to person-centered comprehensive primary health care (PHC) education which equates to distributed training along the continuum of care. To cope with the complexity of patient care and health care systems, interprofessional education and collaborative practice has been recommended in undergraduate clinical training. Stellenbosch University, South Africa, introduced interprofessional home visits as part of the students' contextual PHC exposure in a rural community in 2012. This interprofessional approach to patient assessment and management in an under-resourced setting challenges students to collaboratively find local solutions to the complex problems identified. This paper reports on an explorative pilot study investigating students' and graduates' perceived value of their interprofessional home visit exposure in preparing them for working in South Africa. Qualitative semi-structured individual and focus group interviews with students and graduates from five different health sciences programmes were conducted. Primary and secondary data sources were analyzed using an inductive approach. Thematic analysis was conducted independently by two researchers and revealed insights into effective patient management requiring an interprofessional team approach. Understanding social determinants of health, other professions' roles, as well as scope and limitations of practice in a resource constrained environment can act as a precursor for collaborative patient care. The continuity of an interprofessional approach to patient care after graduation was perceived to be largely dependent on relationships and professional hierarchy in the workplace. Issues of hierarchy, which are often systemic, affect a sense of professional value, efficacy in patient management and job satisfaction. Limitations to using secondary data for analysis are discussed, noting the need for a larger more comprehensive study. Recommendations for rural training pathways include interprofessional teamwork and health care worker advocacy to facilitate collaborative care in practice.

Long-term impact of undergraduate community-based clinical training on community healthcare practice in Japan: a cross-sectional study

BackgroundCommunity-based medical education (CBME) has been evolving globally. However, the long-term impacts of CBME programs on career intention are ambiguous. Therefore, this study aimed to reveal the long-term impact of community-based clinical training (CBCT) such as CBME programs in Japan on current community healthcare (CH) practice.MethodsThis cross-sectional study targeted physicians who had graduated from Kobe University School of Medicine between 1998 and 2004 and had over 15 years’ experience after graduation. Self-administered questionnaires were mailed to participants between September and November 2019. Of the 793 potential subjects, 325 questionnaires were undeliverable. A total of 468 questionnaires substantially sent to the subjects. The exposure was the undergraduate CBCT defined as clinical training about CH in a community. The primary outcome was the provision of current CH practice. The secondary outcome was rural retention. The odds ratios (ORs) and confidence intervals (CIs) were calculated, and the confounders (age, gender, and attitude toward CH at admission; primary outcome, and age, gender, attitude toward rural healthcare at admission, own and spouse’s hometown, and emphasis on child education; secondary outcomes) were adjusted using multivariate logistic regression analysis.ResultsA total of 195 (41.7%) questionnaires were analyzed. The mean (standard deviation [SD]) age of study participants was 43.8 (3.5) years and 76.4% were men. A total of 48 physicians (24.6%) experienced CBCT, of which the mean (SD) training period was 26.3 (27.3) days. As many as 148 (76.3%) physicians provided CH at the time of the study, and 12 (6.5%) worked in rural areas. There was no notable impact of undergraduate CBCT on current CH practice (OR, 1.24; 95% CI, 0.53–3.08; adjusted OR [aOR], 1.00; 95% CI, 0.43–2.30) and rural retention (OR, 0.59; 95% CI, 0.06–2.94; aOR, 0.59; 95% CI, 0.11–3.04).ConclusionsIt may be insufficient to use conventional CBCT in Japan to develop CH professionals effectively. Japanese CBME programs should be standardized through a review of their content and quality. They should continue to be evaluated for their medium- to long-term effects.

Undergraduate endodontic clinical training in Malaysia: A National survey.

Online survey was conducted to investigate the state of undergraduate endodontic clinical training in Malaysian dental schools. An online questionnaire and a cover letter were emailed to the deans of 13 Malaysian dental schools. The questionnaire covers various aspects of endodontic clinical training including teaching methods, endodontic clinical procedures, minimum requirements, clinical sessions and teaching staff. The response rate was 69%. Similarities in teaching methods were observed in all responding schools. All schools taught contemporary root canal treatment procedures, including the utilisation of radiograph and electronic apex locator for working length determination, the crown-down approach for canal preparation and the cold lateral compaction for obturation. Sodium hypochlorite solution and non-setting calcium hydroxide medicament were used in most dental schools. Variations were observed in terms of the number of clinical requirements, supervisor: student ratio, and availability of endodontic specialists. The use of engine-driven instruments was observed mainly in government-funded dental schools. The majority of dental schools in Malaysia are adopting the European Society Endodontology recommendation for undergraduate endodontic training, particularly in relation to the surveyed aspects. Most of the government-funded dental schools have progressed towards engaging contemporary endodontics with their increasing application of engine-driven Ni-Ti instruments and 3D imaging techniques. Appointments of full-time endodontic specialists would further enhance the quality of endodontic teaching and permit the utilisation of contemporary endodontic materials.

Satisfaction of optional pairing in clinical dental training.

The aim of this study was to investigate the perceived satisfaction of optional pairing in undergraduate clinical dental training of fourth- and fifth-year dental students and newly graduated intern dentists in the subject of conservative dentistry and endodontics. Data were collected through a paper-based 2-part questionnaire. The first part was made of 3 questions; gender, undergraduate dental year, and grade point average (GPA). The second part involved 9 questions about assistant student-year level preference, satisfaction of optional pairing and main advantages and disadvantages of pairing. Statistical analysis was performed using descriptive statistics and Chi-square test to investigate any statistically significant differences. A total of 92.4% were satisfied with optional clinical pairing. Satisfied respondents reported most prevalent advantages were speeding things up (88.5%) and helping in transferring instruments and materials (85.6%). Unsatisfied respondents reported the most prevalent disadvantages were like to work independently (56.8%) and the assistant was not always cooperative (32.4%). Students with low grade point averages (GPAs) felt incompetent to work in pairs compared with high GPA students (P=0.001). Only 32.4% of participants thought that the assistant student should be given an evaluation mark. About 75% of respondents reported that clinical pairing improved their diagnostic skills and treatment planning. Optional pairing in clinical dental training had a high satisfaction percentage. Allowing students to choose their own assistants may reduce pairing disadvantages and enhance its advantages. Students may gain a mentoring benefit from being encouraged to optionally pair with similar or higher study-year students.

Global curricular innovations at Rehman Medical College, Peshawar: the case for Mini-CEX

Background: Mini-CEX is a formative assessment tool that is implementable, feasible, and acceptable for undergraduate work place based assessment. It also impacts future practice outcomes for graduates who have undergone Mini-CEX assessment in undergraduate training. Objective: To evaluate the outcomes of undergraduate Mini-CEX training in graduates of Rehman Medical College (RMC) posted at two affiliated teaching hospitals of Peshawar, Khyber Pakhtunkhwa, Pakistan. Methodology: The cross sectional study was conducted at Rehman Medical College, Peshawar and its two affiliated teaching hospitals from January to February 2017 through universal sampling to include 96 house officers (48 RMC graduates having Mini-CEX experience, and 48 graduates of other medical colleges without Mini-CEX experience), and their 12 clinical consultants. Two questionnaire-based surveys (faculty and graduates), were conducted to evaluate clinical performance, utilizing Kirkpatrick’s model for evaluation. Data analysis was done by SPSS 22.0 for descriptive statistics. Results: The faculty survey for evaluating graduate performance yielded significant scores for attitude (p=0.02) and work ethics (p=0.002) of RMC graduates; 58.3% of the faculty regarded Mini-CEX as a valuable tool for improving clinical skills, attitude & perceptions during undergraduate clinical training. RMC graduates (p

Beyond the struggles: a scoping review on the transition to undergraduate clinical training.

ContextThe transition to clinical training within medical school is often seen as a struggle and students remain in distress despite numerous efforts to minimise threats. Efforts to change this may be misdirected if they are based on narrow conceptualisations of transitions. The authors conducted a scoping review to explore existing conceptual perspectives regarding the transition within medical school from pre‐clinical training to clinical training to suggest a research agenda and practical implications.MethodsBetween October 2017 and February 2018 the authors searched PubMed, MEDLINE, ERIC, PsycINFO, Web of Science and CINAHL for English language literature with no date limits and retrieved 1582 articles; 46 were included in this review. Two reviewers independently screened articles and extracted data. Data were then charted, analysed and discussed with the research team.ResultsThe transition to clinical training was often described negatively as ‘difficult’, ‘a problem’ and ‘a struggle’. Our analysis found that researchers in medical education conducted studies on the transition to clinical training from three conceptual perspectives: educational; social, and developmental. Most research approached the transition to clinical training as a problem to be addressed from an educational perspective through transition to clerkship courses and curriculum innovations. Some research was conducted from a social perspective, focusing on building relationships. Regarding development, authors found a few articles highlighting opportunities for personal and professional development by nurturing transferrable learning strategies and reflection.ConclusionsThis review provides an empirical base on which future research can be built to better understand and support medical students’ ability to navigate change. Finding new perspectives to approach the transition to clinical training could allow researchers to look beyond preparing students for struggles.