Résumé
Background: Mentally fit preceptors may be more capable and flexible in providing students with system, emotional and cognitive support in the clinical learning environment (CLE) in the face of any life-threatening outbreaks. Existing professional development programmes for preceptors emphasise the development of preceptor competence in a normal CLE with minimal focus on their ability to engage with adverse events that challenge their mental health. Objective: The study sought insight from preceptors' experiences during the coronavirus disease 2019 (COVID-19) pandemic to identify their professional development programme needs while providing support to students during accompaniment. Method: A mixed methods convergent parallel design was used to collect data from 24 preceptors at a nursing education institution (NEI). Eleven preceptors responded to the survey that included the coronavirus disease 2019 (COVID-19) Stress Scale (CSS) and Burnout Assessment Tool (BAT) to collect quantitative data. Semi structured interviews were conducted with five purposively selected preceptors to collect qualitative data regarding their experiences while accompanying students during the COVID-19 pandemic. Results: Subscales within the CSS and BAT instruments were mapped against an existing preceptor support framework. Overall CSS data for each subscale indicated an average score varying from no stress to moderate stress, while BAT data shows that respondents rarely experienced burnout. However, some respondents experienced very high levels of stress and burnout. Qualitative data supplemented results. Conclusion: The COVID-19 pandemic influenced preceptors' role in supporting students and reflecting that they amended their functioning role. Existing preceptor professional development programmes should be reviewed to ensure that the necessary concepts that foster resilience are integrated to enhance the functional role of preceptors in adversity.
Sujets)
Enseignement infirmier , Pandémies , COVID-19Résumé
Background@#The effects of community immersion programs and other forms of community-based medical education on students have been highlighted in the literature. However, the driving factors that generate these outcomes are not emphasized by many authors. @*Objective@#This study aimed to identify and explain the important contextual factors and mechanisms considered as driving factors of the outcomes of community immersion programs. Methodology: An exploratory qualitative inquiry that employed focus group discussions, in-depth interviews, and reflection papers was utilized. The realist approach provided the structure in eliciting and analyzing medical students’ perspectives on the driving factors of the program outcomes of community immersion. Data were analyzed through thematic analysis. @*Results@#The outcomes generated by the community immersion program are consistent with the literature as well as relevant to the course and social outcomes as identified by De La Salle Medical and Health Sciences Institute. Uncovered major driving factors for these program outcomes include: “perceiving things from a different perspective”, and “positive attitude towards community health”. Various contextual factors that trigger these driving factors were further unpacked that provide a backdrop to the community immersion program. @*Conclusion@#Factors that bring about the program outcomes of community immersion are evident in the experiences of medical students. Focusing on these factors may allow community preceptors and administrators to have clearer perspectives on the factors to focus on in teaching community medicine through community immersion. It is recommended that preceptors and administrators consider and nurture these factors during community immersion to be effective in teaching medical students in the community setting and in the provision of primary health services to communities.
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Propõe-se a utilização de um instrumento sistematizado para avaliação da supervisão de casos por preceptores de Medicina de Família e Comunidade. Justifica-se por considerar que a qualidade da supervisão oferecida ao residente é uma dimensão importante na formação. A elaboração do instrumento contou com a observação de vídeo-gravações relacionadas a supervisão de casos como estratégia de qualificação dos preceptores. No cotidiano de trabalho, a supervisão ainda é, em grande parte, desenvolvida de acordo com experiência individual, sem considerar protocolos específicos. Nesse processo, discute-se o conceito de preceptor, a necessidade de alavancar a formação de médicos para atuação na Atenção Primária e de refletir sobre o uso de inovações tecnológicas na área da saúde. A utilização do instrumento e das vídeo gravações mostraram-se eficazes, servindo de subsídio para aprimorar tanto a técnica de observação, como a qualificação da supervisão.
Residency has been considered the best training system concerning the medical field. This paper discusses the use of an instrument to evaluate case supervision by preceptors in Family and Community Medicine. Due to the existing gap of family physicians working in Primary Health Care (PHC) and the urgency of opening new programs, there was a need for action to accelerate the training of preceptors. It is emphasized that one of the most important dimensions in the daily life of a medical residency program is the quality of the supervision that the preceptor offers. Daily in a PHC clinic, this activity is developed according to individual experience, without obeying protocols. In this process, the concept of preceptor is discussed, the need to leverage the training of PHC physicians and a reflection is made on technological innovations in the health area.
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Abstract: Introduction: Medical Residency is a specialization course characterized as in-service training, considered in Brazil as the gold standard in the development of specialist physicians' training. The medical residency preceptorship is an activity carried out by a specialist physician, responsible for monitoring resident physicians. However, there is neither a definition of the main requirements for such a preceptor, nor of his/her academic background to carry out the due teaching training, and it was possible to notice a relative lack of preparation regarding the pedagogical aspects. Methods: Descriptive study based on a quantitative approach, comprising 200 preceptors, of both genders, from medical residency programs in Maceió, state of Alagoas, Brazil. Results: The mean age was 43.31 ± 10.31 years, with a slight majority of female participants (52.5%). The mean time since graduation was 19.5 ± 10.58 years, and 83% of the participants had graduated in the state of Alagoas. Moreover, 78.5% said they had their Medical Residency certification, with an increased trend of public institution preceptors getting their degree at the stricto sensu level. The mean time of their completed postgraduate course was 12.63 ± 10.87 years and 7.07 ± 6.99 years being a preceptor. Only 19% mentioned they had some qualification for exercising the preceptorship, and 29.5% work as the teachers at the undergraduate level. The state of Alagoas has followed the expansion of the Residency programs, justifying the mean age found, similar to other studies. The majority of female participants can be associated with the feminization of health care professionals. The high percentage of preceptors with medical residency qualification is in accordance with Resolution n. 4/1978. We found experienced preceptors, but some authors differed. The low percentage of preceptors with qualification for exercising preceptorship indicates low interest and lack of available training. Conclusion: This study population is characterized as being young, and most are females. They have had long professional experience, and most have graduated in the state of Alagoas. There is a predominance of medical residency as their main qualification, and few of them have had training in the field. Finally, preceptors from public institutions have mostly got their degrees at the stricto sensu level.
Resumo: Introdução: A residência médica é uma modalidade de pós-graduação, caracterizada como treinamento em serviço, considerada no Brasil como padrão-ouro na formação de médicos especialistas. A preceptoria na residência médica é desenvolvida por um especialista que, além ser responsável pelo residente, prepara-o para a prática profissional. Como ainda não há definição dos principais requisitos para o preceptor, nem sobre a preparação para o exercício, percebe-se relativo despreparo quanto aos aspectos pedagógicos e de capacitação. Método: Trata-se de um estudo descritivo, de abordagem quantitativa, realizado com 200 preceptores de ambos os sexos, de programas de residência médica em Maceió, em Alagoas. Resultados: A média de idade encontrada foi de 43,31 ± 10,31 anos, com discreta maioria do sexo feminino (52,5%). O tempo médio de conclusão da graduação foi de 19,5 ± 10,58 anos, com 83% dos participantes graduados em Alagoas. Além disso, 78,5% possuem a certificação de residência médica, havendo maior tendência dos preceptores de instituições públicas em obter titulação em pós-graduações stricto sensu. O tempo médio da pós-graduação concluída foi de 12,63 ±10,87 anos; e o de exercício da preceptoria, de 7,07 ± 6,99 anos. Apenas 19% dos preceptores referiram capacitação para a preceptoria, e 29,5% atuam como docentes na graduação. Alagoas acompanhou a tendência nacional de ampliação da PRM, o que pode justificar a idade média encontrada, semelhante a outros estudos. A maioria do sexo feminino pode estar associada a um processo de feminização da saúde. A alta porcentagem de preceptores titulando a residência médica está em sintonia com a Resolução nº 4/78. Neste estudo foram encontrados preceptores experientes, constatação que diverge dos achados de alguns autores. A baixa porcentagem de preceptores com capacitação para a preceptoria indica baixo interesse, falta de estímulos e pouca oferta de treinamentos disponíveis. Conclusão: A população deste estudo é de preceptores predominantemente jovens, com maioria do sexo feminino, que possuem tempo elevado de experiência, e a maioria graduou-se em Alagoas. Houve predomínio da residência médica como principal titulação, e a maioria dos preceptores não recebeu capacitação pedagógica para a função. Por fim, os preceptores de instituições públicas possuem maior proporção de títulos de pós-graduação stricto sensu.
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Background: Students are not mere followers of teacher instructions, but fully aware and very observant of what differentiates a good clinical preceptor from a poor clinical preceptor and have expectations of how preceptors and clinical teachers should act. This study describes students’ perceptions on the effectiveness of clinical teaching practices of preceptors.Methods: A cross-sectional survey was conducted by using the Clinical Teaching Evaluation (CTE) Questionnaire to determine the level of effective clinical teaching by preceptors in the following areas: nursing expertise, teaching competence, and interpersonal relationship skills, and to identify characteristics (gender, age, program, and year level) associated with effective clinical teaching. The sample was composed of 158 randomly chosen students, Associate Degree Nurses and Associate Degree Midwives years 2 and 3, with clinical experience under preceptors at the 3 Referral Hospitals (Stung Treng, Kratie, and Ratanakiri) in Stung Treng region of Cambodia. Evaluations were ranked on a five-point scale with one being strongly disagree up to five being strongly agree.Results: The mean scores for all items were 0.739. Mean rating scores for effective clinical teaching of preceptors was 3.63, with nursing expertise at 3.72, teaching competence at 3.51, and interpersonal relationship skills at 3.65.Conclusions: The clinical teaching quality of preceptors can be improved by training with appropriate teaching methods with emphasis on effective clinical teaching practices to assist students in clinical competency.
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Background: Nursing education has evolved substantially in the last few decades. Preceptorship is important to nursing education for several reasons. The purpose of this study is to describe the effective nursing clinical preceptors in Phnom Penh National Hospitals. Both preceptors and students have reported experiencing constrained relationships, tension and anxiety, which led to failure result or frustrating experiences in clinical teaching and learning. Methods: The stratified sampling of 166 was invited. A cross-sectional design survey was used. The Cronbach’s Alpha Coefficient for all items was 0.945. Results: The findings were given as effective clinical preceptorship had a moderate (3.02, 0.85). The interpersonal relationship (3.51, 0.88), evaluation (3.39, 0.93), personal traits (2.80, 0.83), nursing competencies (3.39, 0.93), and teaching ability (2.70, 0.81). Conclusion: Interpersonal relationship, formative evaluation, giving suggestions and correcting mistakes without belittling was perceived to be important characteristic. It is necessary to integrate clinical teaching skills to clinical preceptors.
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To evaluate medical education at Kochi Medical School, a questionnaire survey was performed to assess the ability of residents who had graduated from Kochi Medical School.This project was managed by the Associate-Professor's Society of Kochi Medical School.1) Two preceptors (an internist and a surgeon) at each of 148 postgraduate clinical training hospitals other than Kochi Medical School Hospital were asked to answer a questionnaire concerning the objective or relative assessment of residents who had graduated from Kochi Medical School.<BR>2) Of the 108 questionnaires received from preceptors, 93 were considered to include effective assessments of residents who had graduated from Kochi Medical School.<BR>3) Twenty-one preceptors noted a deficiency of knowledge concerning community medicine.In addition, more than 15% of preceptors noted insufficient skills in performing laboratory examinations and making diagnoses with X-ray fi lms.In contrast, most preceptors were satisfied with skills in interviewing and performing physical examinations.<BR>4) Most preceptors judged residents who had graduated from Kochi Medical School to be superior to those who had graduated from other schools, whereas 8 preceptors thought that our graduates were inferior at acquiring medical knowledge or skills.<BR>5) Most preceptors encouraged residents from Kochi Medical School to be positive.