Impact of the SB AR model combined with case-scenario simulation teaching model on intermedical communication and critical thinking in obstetrics and gynecology clinical clerkship students / 现代医院

Objective To explore the effects of SB AR(Situation,Background,Assessment and Recommendation)com-munication combined with case-scenario simulation teaching model on intermedical communication and critical thinking of medical students in obstetrics and gynecology clerkship.Methods A total of 156 undergraduate clinical medical students who participa-ted in clinical clerkship training in obstetrics and gynecology from November 2022 to May 2023 were randomly divided into the ex-perimental and control groups.The medical students in the experimental group were trained with SB AR communication model combined with case scenario simulation model when they were admitted to the department,and the rest of the training was the same as that of the control group.In the control group,the traditional training mode was applied,and the teaching of intermedial communication was carried out in the form of lectures and bedside observation.We compared the discharge assessment scores(theoretical knowledge and clinical skills),critical thinking ability and satisfaction with the clinical training teaching of the two groups.Results The experimental group trainees'grades in history taking and intermedial communication were better than those of the control group,with significant difference(P＜0.05).However,there was no significant difference in the theoretical knowledge grades between the two groups(P＞0.05).The score of critical thinking in the experimental control group was signifi-cantly higher than that in the control group(P＜0.05).The scores of analytical ability,systematization ability,self-confidence in critical thinking and cognitive maturity were higher in experimental group(P＜0.05),while the scores of truth-seeking,open-mindedness and curiosity were similar between the two groups(P＞0.05).Students in the experimental group were more satis-fied with training model than that in the control group(P＜0.05).Conclusion The implementation of SBAR communication model combined with case scenario simulation teaching model in the trainee stage of obstetrics and gynecology for undergraduate students of clinical medicine is conducive to students'interest in learning,enhancement of critical thinking ability,and improve-ment of inter-doctoral communication ability,respecting that it can be popularized in trainee teaching of all kinds of disciplines.

Attitude Survey toward Palliative Medicine in Medical Students Starting Clinical Clerkship

Purpose: Few surveys have demonstrated that medical students’ understanding of palliative care in Japan. This study’s aim is to examine whether medical students prior to beginning clinical clerkship are ready to learn palliative care. Methods: Prior to the commencement of participatory clinical training, approval was obtained from the Kagawa University Faculty of Medicine Research Ethics Committee for the execution of this study. A questionnaire survey was conducted on 105 students enrolled in the Faculty of Medicine at our university, focusing on their confidence in achieving the learning objectives for “Palliative Care” outlined in the Medical Education Model Core Curriculum. Participants rated the confidence to the nine learning objectives related to palliative care (ranging from 0 points indicating no confidence to 100 points indicating full confidence). A comparison of the nine items was conducted using the Kruskal–Wallis test, followed by Scheffe’s multiple comparison test. A significance level of P<0.05 was applied. Results: The response rate was 62.9% (66 out of 105 students). Confidence in achieving the learning objectives varied, with item 6, “Understanding the concept and definition of death and the biology of organismal death,” being significantly higher than the other five items (P<0.05). No significant differences were observed among the other items. Conclusion: The need for systematic preparatory education on palliative care for medical students who are about to enter clinical practice is suggested.

Designing a Clinical Clerkship Program with the 4C/ID Model / 医学教育

Clinical clerkships in medical school requires an educational approach that integrates medical students into the medical team and progressively assigns medical tasks to them based on their competencies. However, it is challenging for supervisors to delegate tasks to medical students gradually while considering medical safety. This paper outlines the design of an emergency department clinical clerkship program based on the Four Component Instructional Design (4C/ID) model. This model enables students to learn complex task performance skills in stages while developing a schema, considering the cognitive load involved in learning complex tasks. The 4C/ID model is anticipated to be an effective instructional design for constructing clinical clerkship programs.

5. The 2022 Revision of the Model Core Curriculum for Medical Education in Japan and the Common Achievement Test Being Made an Official Requirement / Participatory Clinical Clerkship / 医学教育

Following the revision of the structure and content of the Model Core Curriculum for Medical Education to be more outcome-based and the legal status of the medical practice performed by medical students in the clinical clerkship, we have revised the Guideline for Participatory Clinical Clerkship. The following items were revised or newly described : significance of enhancing the participatory clinical clerkship, scope of medical practice, confidentiality, patient consent, patient consultation and support service, objectives of the clinical clerkship, simulation education, departments where the clinical clerkship is conducted, assessment in the clinical practice setting, CC-EPOC, and entrustable professional activities. A foundation has been established to promote seamless undergraduate and postgraduate medical education. However, future work is needed to examine the specific level of performance expected at the end of the clinical clerkship and department-specific clinical practice goals and educational strategies.

Research progress on moral distress of nursing interns / 中国实用护理杂志

Moral distress generally exists in the nursing interns and has a far-reaching impact. This paper analyzed and summarized the current situation, influencing factors and coping strategies of the nursing interns at home and abroad, in order to provide reference for promoting the professional development of nursing students, strengthening their professional beliefs and stabilizing the nursing team.

Reform and exploration of teaching methods for eight-year program medical students' early exposure to clinical practice / 中华医学教育探索杂志

Objective:To explore the effect of early clinical clerkship training in the early exposure to clinical practice of eight-year program medical students.Methods:Experimental control method was used in this study. A total of 120 eight-year program medical students in the third year of Batch 2014 to 2016 from the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were selected as the research objects. The students of each grade were randomly selected by computer and divided into experimental group and control group, with 20 students in each group. Before early clinical exposure, the experimental group received 16 class hours of early clinical clerkship training, while the control group did not receive early clinical clerkship training. After the early clinical exposure, the clinical diagnosis and treatment ability of the two groups of students was compared. SPSS 24.0 software was used for t test. Results:The scores of medical history inquiry of experimental group and control group were [(17.45±1.96) points and (15.95±1.93) points; (18.30±1.03) points and (16.75±1.86) points; (17.95±1.36) points and (16.40±1.60) points, respectively]. The physical examination scores were [(17.75±1.65) points and (16.05±1.64) points; (17.85±1.18) points and (16.80±1.47) points; (18.25±1.16) points and (16.85±1.63) points, respectively]. The clinical judgment scores were [(18.15±1.42) points and (16.35±2.41) points; (18.20±1.24) points and (16.65±1.53) points; (18.35±1.35) points and (16.25±1.83) points, respectively]. Diagnosis and treatment scheme scores were [(17.15±1.57) points and (14.55±2.56) points; (17.30±1.42) points and (15.90±1.48) points; (17.80±1.06) points and (16.35±1.87) points, respectively]. The scores of communication skills were [(17.95±1.15) points and (17.00±1.19) points; (18.55±0.83) points and (17.45±1.50) points; (18.45±1.00) points and (17.45±1.23) points, respectively], with statistically significant differences (all P<0.05). Conclusion:The application of early clinical clerkship training in the early exposure to clinical practice of eight-year program medical students can improve the quality of students' clerkship.

Application study of outcome-based education teaching model in practice teaching of clinical medical laboratory / 中华检验医学杂志

Objective:Application study of outcome-based education teaching model in practice teaching Of clinical medical laboratory.Methods:According to the teaching model, A total of 60 interns from the First Affiliated Hospital of the University of South China from June 2021 to May 2022 were selected as the research objects and they were randomly number table method divided into two groups, the traditional teaching group is 30 cases and the OBE group is 30 cases.The Self-regulated Learning Effectiveness Evaluation Scale is used to evaluate the effectiveness of self-regulated learning. The assessment scores (skill operation, case analysis, clinical communication, exit examination,each 50 points) and teaching model satisfaction were compared between the two groups.Results:The results of the two groups were compared to find out the score of the examination ( P>0.05).After practice, the OBE group was significantly better than the traditional teaching group in skill operation test, morphological recognition test, case analysis test aspects ( P<0.05). According to the evaluation of students′ independent learning effectiveness, it can be seen that the OBE group has independent learning ability, self-confidence, ability to acquire knowledge, and logical thinking ability etc. The OBE group scored higher than the traditional teaching group ( P<0.05). There was no significant significance in teachers′ teaching enthusiasm effect score ( P>0.05). Scoring teaching content, teaching difficulties, teaching design, teaching satisfaction etc, the OBE group was significantly higher than the traditional teaching group ( P<0.05). Conclusion:Application study of outcome-based education teaching model in practice teaching of clinical medical laboratory. It can effectively improve the clinical practice and clinical communication ability of students, so as to more effectively improve the social adaptability and post competence of clinical medical laboratory graduates.

Obstetric simulation for undergraduate medical education: how to improve students' self-confidence and expectation according to gender

SUMMARY OBJECTIVE: The aim of this study was to evaluate the effects of obstetric simulation training on undergraduate medical students to improve their self-confidence. METHODS: Fifth-year undergraduate medical students were invited to a 2-week course of simulation in obstetrics during their clerkship. The sessions included were as follows: (1) care for the second and third periods of childbirth, (2) partograph analysis and pelvimetry, (3) premature rupture of membranes at term, and (4) diagnosis and management of third-trimester bleeding. Before the first session and at the end of the training period, a questionnaire about self-confidence in obstetric procedures and skills was applied. RESULTS: A total of 115 medical students were included, of whom 60 (52.2%) were male and 55 (47.8%) were female. Comparing initial and final scores, the median results of the subscales "comprehension and preparation" (18 vs. 22, p<0.001), "knowledge of procedures" (14 vs. 20, p<0.001), and "expectation" (22 vs. 23, p<0.01) were significantly higher at the end of the training period in all items of the questionnaire than in the beginning. Differences were found based on the students' gender, i.e., female students had a significantly higher sum of scores than the male students in the initial subscale for "expectation" (median, 24 vs. 22, p<0.001) and "interest" (median, 23 vs. 21, p=0.032), and a higher sum of scores in the subscale for "expectation" (median, 23 vs. 21, p=0.010) in the final questionnaire. CONCLUSION: Obstetric simulation enhances the improvement of students' self-confidence in understanding both the physiology of childbirth and the obstetric care procedures. Further studies are needed to understand the influence of gender on obstetric care.

Segurança do paciente na prática clínica dos estudantes de enfermagem: conhecimentos e atitudes / Seguridad del paciente en la práctica clínica de los estudiantes de enfermería: conocimientos y actitudes / Patient safety in clinical practice of nursing students: knowledge and attitudes

Objetivos: mensurar os conhecimentos e atitudes de estudantes de enfermagem sobre segurança do paciente em campos de prática desenvolvido em unidades hospitalares. Método: pesquisa transversal e quantitativa, realizada em um centro universitário privado da capital paranaense. Foi aplicado o Latino Students Patient Safety Questionnaire a 26 estudantes entre os meses de junho e agosto de 2022. Os dados foram analisados por estatística descritiva. Itens/questões com escore ?4 pontos indicam resultado satisfatório Resultados: das 21 afirmativas, 57,1% foram consideradas insatisfatórias. A consciência do erro individual, das normas de segurança adotadas pela instituição e da impossibilidade de evitar a maioria dos erros clínicos obtiveram as menores médias (2,7 cada). Os itens da dimensão atitude proativa para evitar risco à segurança apresentaram-se satisfatórios (≥4 pontos). Conclusão: os estudantes apresentam atitude proativa para evitar risco à segurança, embora haja lacunas de conhecimento acerca da segurança do paciente em campos práticos.

Objetivos: medir los conocimientos y actitudes de estudiantes de enfermería sobre seguridad del paciente en campos de práctica desarrollado en unidades hospitalarias. Método: investigación transversal y cuantitativa, realizada en un centro universitario privado de la capital paranaense. Se aplicó el Latino Students Patient Safety Questionnaire a 26 estudiantes entre los meses de junio y agosto de 2022. Los datos fueron analizados por estadística descriptiva. Ítems/cuestiones con puntaje ?4 puntos indican resultado satisfactorio Resultados: de las 21 afirmativas, 57,1% fueron consideradas insatisfactorias. La conciencia del error individual, de las normas de seguridad adoptadas por la institución y de la imposibilidad de evitar la mayoría de los errores clínicos obtuvieron las menores medias (2,7 cada una). Los ítems de la dimensión actitud proactiva para evitar riesgo a la seguridad se presentaron satisfactorios (≥4 puntos). Conclusión: los estudiantes presentan actitud proactiva para evitar riesgo a la seguridad, aunque hay lagunas de conocimiento acerca de la seguridad del paciente en campos prácticos.

Objective: to measure the knowledge and attitudes of nursing students about patient safety in fields of practice developed in hospital units. Method: cross-sectional and quantitative research, conducted in a private university center in the capital of Paraná. The Latino Students Patient Safety Questionnaire was applied to 26 students between June and August 2022. Data were analyzed by descriptive statistics. Items/questions with ?4 points score indicate satisfactory result. Results: of the 21 statements, 57.1% were considered unsatisfactory. Awareness of individual error, safety standards adopted by the institution and the impossibility of avoiding most clinical errors obtained the lowest averages (2.7 each). The items of the proactive attitude dimension to avoid safety risk were satisfactory (≥4 points). Conclusion: students present a proactive attitude to avoid safety risk, although there are gaps in knowledge about patient safety in practical fields.

História do Centro Docente Assistencial de Fonoaudiologia da Universidade Federal da Bahia / History of the Speech-Language Pathology Teaching Assistance Center at the Federal University of Bahia / Historia del Centro de Asistencia Docente de Logopedia de la Universidad Federal de Bahía

Introdução: As clínicas-escolas de fonoaudiologia exercem papel fundamental na formação dos futuros profissionais. O Centro Docente Assistencial de Fonoaudiologia (CEDAF) foi criado com o intuito de ser uma clínica-escola do Curso de Graduação em Fonoaudiologia da Universidade Federal da Bahia. Objetivo: Descrever a história do CEDAF, a fim de contextualizar as mudanças pelas quais passou, destacando os principais acontecimentos a partir do olhar de atores que fazem parte desse percurso. Método: Trata-se de um estudo qualitativo, caracterizado como exploratório e descritivo, realizado na clínica CEDAF. Foram utilizadas fontes de dados orais, coletadas por meio de entrevistas e grupo focal, gravadas em áudio, transcritas e analisadas conforme categoria temática, buscando identificar os núcleos de sentido. Resultados: Foi possível perceber a intensa transformação pela qual o CEDAF passou ao longo dos seus vinte anos de história. Entre as mudanças mais significativas estão a ampliação do espaço físico, aumento do número de alunos do curso e a contratação de novos docentes, a admissão de fonoaudiólogas na clínica e o convênio firmado com a rede municipal de saúde. Conclusão: Deixar registrada uma primeira versão da história do CEDAF pode contribuir para fazer deste local um campo de pesquisa em contínuo aperfeiçoamento na formação dos futuros profissionais de fonoaudiologia e na prestação de serviço.

Introduction: Speech therapy clinic-schools play a fundamental role in the training of future professionals. The Speech-Language Pathology Teaching Assistance Center (CEDAF) was created with the intention of being a clinic-school of the Graduation Course in Speech Therapy at the Federal University of Bahia. Purpose: Describe the history of CEDAF, to contextualize the changes it has gone through, highlighting the main events from the perspective of actors who are part of this path. Method: This is a qualitative study, characterized as exploratory and descriptive, carried out at the CEDAF clinic. Oral data sources were used, collected through interviews and focus groups, recorded in audio, transcribed, and analyzed according to thematic category, seeking to identify the core meanings. Results: It was possible to perceive the intense transformation that CEDAF has undergone throughout its twenty years of history. Among the most significant changes are the expansion of the physical space, the increase in the number of students in the course and the hiring of new professors, the admission of speech therapists in the clinic and the agreement signed with the municipal health network. Conclusion: Registering a first version of the history of CEDAF can contribute to making this place a field of research in continuous improvement in the training of future professionals in speech therapy and service provision.

Introducción: Las clínicas-escuelas de logopedia juegan un papel fundamental en la formación de los futuros profesionales. El Centro de Asistencia Docente de Logopedia (CEDAF) se creó con la intención de ser clínica-escuela del Curso de Graduación en Logopedia de la Universidad Federal de Bahía.Objetivo: Describir la historia del CEDAF, con el fin de contextualizar los cambios que ha atravesado, destacando los principales hechos desde la perspectiva de los actores que forman parte de este camino. Método: Se trata de un estudio cualitativo, caracterizado como exploratorio y descriptivo, realizado en la clínica CEDAF. Se utilizaron fuentes de datos orales, recolectadas a través de entrevistas y grupos focales, grabadas en audio, transcritas y analizadas según categoría temática, buscando identificar los significados centrales. Resultados: Se pudo percibir la intensa transformación que ha experimentado CEDAF a lo largo de sus veinte años de historia. Entre los cambios más significativos se encuentran la ampliación del espacio físico, el aumento del número de alumnos en el curso y la contratación de nuevos profesores, la admisión de logopedas en la clínica y el convenio suscrito con la red municipal de salud. Conclusión: Registrar una primera versión de la historia del CEDAF puede contribuir a hacer de este lugar un campo de investigación en mejora continua en la formación de los futuros profesionales en logopedia y prestación de servicios.

Two thumbs up! A review of the “PULMOSERYE: Pulmonary patient miniseries… Dead or Alive: The saga of Mang Jose”- a clerkship learning activity during the pandemic

@#The World Health Organization declared Covid 19 a pandemic in March 2020, disrupting medical education and creating a significant void in the hospital rotation of the clinical clerks. Alternative methods of teaching and learning had to be instituted, and since face-to-face encounters were still not allowed, all these activities had to be online. While the various activities were able to challenge critical analysis and thinking, the Section on Pulmonary Medicine felt that the clerks would benefit most from activities that would most closely simulate an actual patient encounter. And so, the PulmoSerye was born: a miniseries that followed the patient from initial consultation in the emergency room resulting in admission, events that happened in the ward, formulation of the Master Problem List, progress notes, giving discharge orders, writing the discharge summary, and finally a follow up via Telemedicine. This is what the clerks would have experienced if they had been in hospital. Activities such as the Pulmoserye should be highly considered as a viable option should clerkship hospital rotations once again be put on hold.

A cross-sectional study on the knowledge in musculoskeletal medicine of undergraduate medical students in a national university

OBJECTIVES@#This study aimed to compare the evaluation results of University of the Philippines - College of Medicine (UPCM) Learning Unit VI (LU VI) students in their Musculoskeletal (MSK) year-end module examination and final module grade to their results in the MSK 30 examination. It likewise sought to assess the adequacy of the institution’s current curriculum on the basis of the most clinically relevant MSK topics included in the MSK 30.@*METHODS@#The knowledge of the students in Musculoskeletal medicine was determined using the MSK 30 validated exam and this was compared to their results in the various evaluation tools of the present MSK curriculum. The results were subjected to statistical analysis using (1) the Pearson correlation coefficient and (2) item analysis. @*RESULTS@#Despite exhibiting above average performance in the MSK module, the performance of the 66 (N=187) LU VI students in the MSK 30 showed otherwise with a passing rate of only 48.48%. There was no statistically significant correlation between the MSK 30 and the year-end module examination (p value = 0.77, CI 90%, ME 8%), and the final module grade (p value = 0.92, CI 90%, ME 8%). It was noted that the students did poorly in the following topics: Environmental Injury, Head Injury, Infection, Pediatrics, Spine, and Sports Injuries.@*CONCLUSION@#Undergraduate medical students of the University of the Philippines - College of Medicine performed poorly in the MSK 30 despite a generally good performance in the prescribed MSK module. Whether this is indicative of inadequacies in the existing MSK curriculum or is due to the MSK 30 not being appropriate to the local setting will need to be determined.

Practice of online clinical clerkship teaching mode based on "3P" model / 中华医学教育探索杂志

In order to construct the online teaching mode of clinical clerkship course and improve the online clerkship teaching system of clinical medicine in China, based on the "3P" model, a complete set of online clinical clerkship mode has been constructed from three links of teaching, pre-class preparation, classroom teaching and after-class evaluation, and applied to clinical teaching practice of Internal Medicine. The practice suggests that students are highly satisfied and the teaching effect is good, which provides a new idea for the reform of online clerkship teaching of clinical medicine.

Practice of organ system integration education in the clerkship teaching of digestive system / 中华医学教育探索杂志

The integration education is organized around "an organ system" of the body, and integrates multiple medical disciplines orderly, which is the main trend of medical education reformation at home and abroad. Digestive diseases are diverse and complicated, so that it is of great significance to apply integration education mode in the clinical teaching of digestive system. Taking the clinical clerkship teaching of digestive system in The First Affiliated Hospital of Chongqing Medical University as an example, through reasonably integrating the course content, fully applying problem-based learning (PBL) method, taking multiple teaching methods, combing ideological and political education, and paying more attention to improving the teachers' training, the learning enthusiasm of students could be stimulated, their independent thinking ability and holistic medical view could be cultured, and the teaching effect would be effectively improved.

Application of Rain Classroom combined with situational teaching in clinical clerkship of internal medicine / 中华医学教育探索杂志

Objective:To explore the effect of Rain Classroom combined with situational teaching in clinical clerkship of internal medicine.Methods:A total of 72 undergraduate students with clinical majors of Batch 2015 were selected and randomly divided into a control group and an experimental group using computer scrolling pause method, with 36 students in each group. The control group adopted traditional teaching methods, and the research group adopted Rain Classroom combined with situational teaching. The teaching effect evaluation was carried out through a 10-point questionnaire based on the internal medicine theory examination, clinical skill assessment and learning interest, knowledge mastery and application, and clinical thinking and practical ability. SPSS 20.0 was used to conduct t-test. Results:The average scores of the students in the experimental group including the theoretical test (87.94±5.68) and the skill test scores (88.08±5.73) were significantly higher than those in the control group (83.00±5.89) and (83.86±4.80)( P<0.01). The results of the questionnaire showed that students' interest in learning improvement, self-learning ability, new knowledge acquisition, application of knowledge, clinical thinking, clinical practice, problem solving, self-expression, teamwork, doctor-patient communication ability in the study group were better than those in the control group ( P < 0.01). Conclusion:The Rain Classroom combined with situational teaching method is helpful to improve students' knowledge mastery and application, improve clinical thinking and practical ability, improve learning interest and clinical clerkship teaching effect.

Application of situation video feedback combined with problem-based learning in clinical clerkship teaching of cardiac surgery for medical students in class of organ-systems-based curriculum / 中华医学教育探索杂志

Objective:To study the application effects of situation video feedback combined with problem-based learning (PBL) on the clinical clerkship teaching of cardiac surgery for medical students in experimental class of organ-systems-based curriculum (OSBC).Methods:Medical students of Batch 2016 and 2018 OSBC reform experimental class of Jianghan University were selected as the research objects. The study group used situation video feedback combined with PBL teaching method to conduct cardiac surgery clerkship teaching, and the control group used conventional teaching method. At the end of the clerkship, the self-made "Clerkship Satisfaction Questionnaire" was distributed for questionnaire survey and the theoretical test was carried out at the same time. After the course, the theoretical examination was conducted, and the results were compared. SPSS 17.0 was used for t-test and Chi-square test. Results:The clerkship satisfaction investigation results showed that the study group was more satisfied than the control group in such 10 aspects as improving the interest of learning, learning efficiency, the ability of teamwork, clinical thinking, interpersonal communication, combining theory with practice, active knowledge acquirement, language expression, understanding knowledge point, and confidence to become a real doctor. Moreover, there were significant differences in improving the interest of learning, the ability of clinical thinking, and combining theory with practice ( P<0.05). The two theoretical test scores of the study group [(77.46±4.73) points and (79.80±7.53) points] were significantly higher than those of the control group [(70.68±5.16) points and (75.94±8.16) points] ( P<0.05). Conclusion:Situation-based video feedback combined with PBL can improve the clinical clerkship teaching effect of cardiac surgery for medical students under the teaching mode of OSBC.

Application of flipped classroom combined with online interactive teaching in clinical clerkship of cardiology / 中华医学教育探索杂志

Objective:To explore the application effect of flipped classroom combined with online interactive teaching in clinical clerkship of cardiology.Methods:The study collected 56 students from Batch 2017 five-year clinical medicine undergraduate class of Medical College of China Three Gorges University and they were randomly divided into experimental group and control group in average. The control group adopted the traditional teaching method while the experimental group adopted the combined teaching method. The differences of test scores after teaching were compared between the two groups and the feedback of students on the two methods was also analyzed. SPSS 12.0 was used for t test and chi-square test. Results:The final score of clinical thinking in the experimental group (84.38±3.18) was significantly higher than in the control group (75.43±5.85) ( P<0.05), and the satisfaction of the experimental group to the teaching mode was [86% (24/28)], which was significantly higher than that of the control group [50% (14/28)]. More than 80% of the students in the experimental group regarded that the combined teaching method was helpful to promote the interaction between teachers and students, master relevant knowledge, and improve learning interest and learning efficiency. Conclusion:This combined teaching method can enhance students' clinical thinking ability, learning enthusiasm and efficiency, and finally effectively improve the effect of clerkship.

3. Learner Support for Medical Students Who Can't Communicate Well in Clinical Clerkship / 医学教育

In this paper, as support for “student who is not good at communication”, a fictional case of a pharmaceutical student will be examined from the followingthree perspectives. The first, from a developmental and social psychological perspective, is the possibility of “unlearning or mislearning of communication” and “discrepancy between the actual self, the ideal self, and the ought self.” In support, learning assertion skills can be effective. The second is from a clinical psychological perspective, in terms of “social anxiety disorder” and “narcissism”. In support, pharmacotherapy and cognitive behavioral therapy will be discussed. Third, from the perspective of neurodevelopmental syndrome, the possibility of “autism spectrum disorder” is considered. In this case, involvement that enhances self-understanding and self-affirmation will be important. Educators and supporters are required to make an accurate assessment of the cause of the difficulty.

Patient Safety Incidents and the second victim phenomenon among nursing students / Los incidentes de seguridad del paciente y el fenómeno de la segunda víctima entre estudiantes de enfermeira / Incidentes de segurança do paciente e o fenômeno da segunda vítima entre estudantes de enfermagem

ABSTRACT Objective: To map the factors involved in incidents that harm patient safety and contribute to the second victim phenomenon among nursing students. Method: Qualitative, exploratory-descriptive study addressing 23 nursing students attending a Federal University in the South of Brazil. The interviews were analyzed using text and discoursive analysis. The Iramuteq software supported the processing of texts. Results: Communication failures within the health staff, a lack of protocols and equipment that prioritize patient safety, and factors related to the teaching-learning process favor the occurrence of patient safety incidents and the second victim phenomenon among nursing students. Conclusion: Addressing the topic concerning patient safety in nursing programs can promote the patient safety culture by encouraging reporting and admitting the possibility of errors and learning from them, strategies that can mitigate second victim effects.

RESUMEN Objetivo: mapear los factores que participan en incidentes que fragilizan la seguridad de los pacientes y que colaboran para el fenómeno de la segunda víctima entre los estudiantes de enfermería. Método: estudio de abordaje cualitativo, de carácter exploratorio y descriptivo, realizado en 23 estudiantes de enfermería de una Universidad Federal del sur de Brasil. Las entrevistas fueron analizadas a través del análisis textual discursivo. El software Iramuteq auxilió en el procesamiento de los textos. Resultado: las fallas en la comunicación entre el equipo de la salud; la ausencia de protocolos y de equipamientos que den prioridad a la seguridad del paciente; y, los factores relacionados al proceso de enseñanza y aprendizaje, favorecen la ocurrencia de incidentes de seguridad del paciente y corroboran el fenómeno de la segunda víctima entre estudiantes de enfermería. Conclusión: la incorporación de la temática sobre seguridad del paciente, en el curso de enfermería, puede auxiliar a desarrollar una cultura de seguridad del paciente al incentivar la cultura del relato, admitir la posibilidad del error e incentivar el aprendizaje; y, partiendo de este, crear estrategias que puedan auxiliar a mitigar los efectos de la segunda víctima.

RESUMO Objetivo: mapear os fatores envolvidos em incidentes que fragilizam a segurança dos pacientes e que colaboram para o fenômeno da segunda vítima entre os estudantes de enfermagem. Método: estudo de abordagem qualitativa, de caráter exploratório-descritivo, realizado com 23 estudantes de enfermagem de uma Universidade Federal do Sul do Brasil. As entrevistas foram analisadas através da análise textual discursiva. O software Iramuteq auxiliou no processamento dos textos. Resultado: falhas na comunicação entre a equipe de saúde, ausência de protocolos e de equipamentos que priorizem a segurança do paciente e os fatores relacionados ao processo de ensino-aprendizagem favorecem a ocorrência de incidentes de segurança do paciente e corroboram para o fenômeno da segunda vítima entre estudantes de enfermagem. Conclusão a incorporação da temática sobre segurança do paciente no curso de enfermagem pode auxiliar o desenvolvimento de uma cultura de segurança do paciente, ao incentivar a cultura do relato, admitir a possibilidade do erro e o aprendizado a partir dele, estratégias que podem propiciar na mitigação dos efeitos da segunda vítima.

Support provided to nursing students in the face of patient safety incidents: a qualitative study / Soporte a los estudiantes de enfermería delante de incidentes de seguridad del paciente: investigación cualitativa / Suporte aos estudantes de enfermagem diante de incidentes de segurança do paciente: pesquisa qualitativa

ABSTRACT Objectives: to identify the support provided to nursing students after a patient safety incident. Methods: qualitative study developed with 23 students attending an undergraduate nursing program in southern Brazil. Data were collected between September and November 2021 and submitted to textual discursive analysis using the Iramuteq software. Results: the students reported that mainly classmates and professors of the practical courses provided support. The students showed no knowledge of organizational support or protocols available to students who become second victims of such incidents. Final Considerations: the primary support sources available to nursing students involved in patient safety incidents were identified. Note that support provided to nursing students is still incipient both in Brazil and internationally. Hence, further studies are needed to address potential victims and support resources to mitigate this phenomenon.

RESUMEN Objetivos: conocer el soporte ofrecido al estudiante de enfermería después de un incidente de seguridad del paciente. Métodos: investigación cualitativa, desarrollada en el curso de licenciatura de enfermería en el Sur de Brasil, con 23 estudiantes. Los datos fueron recolectados entre septiembre y noviembre de 2021 y sometidos al análisis textual discursivo, con la utilización del software Iramuteq. Resultados: los estudiantes relataron que recibieron apoyo principalmente de los compañeros y profesores de las materias del campo de práctica; también, ellos demostraron no conocer ningún tipo de soporte organizacional, protocolo o apoyo cuando son por segunda vez víctimas de esos incidentes. Consideraciones Finales: se identificaron las principales fuentes de apoyo, cuando el estudiante de enfermería se envuelve en incidentes de seguridad del paciente. Se destaca la insipiencia de los recursos de soporte ofrecidos al estudiante de enfermería, tanto en el ámbito nacional como internacional; así, es necesario realizar más investigaciones dirigidas a esas potenciales víctimas e proporcionar recursos de soporte para mitigar ese fenómeno.

RESUMO Objetivos: conhecer o suporte ofertado ao estudante de enfermagem após um incidente de segurança do paciente. Métodos: pesquisa qualitativa, desenvolvida com 23 estudantes de um curso de bacharelado de enfermagem do Sul do Brasil. Os dados foram coletados entre setembro e novembro de 2021 e submetidos à análise textual discursiva, com a utilização do software Iramuteq. Resultados: os estudantes relataram que receberam apoio principalmente dos colegas e professores das disciplinas do campo de prática, mas demonstraram desconhecer qualquer tipo de suporte organizacional, protocolo ou apoio quando se encontram na condição de segunda vítima desses incidentes. Considerações Finais: foram identificadas as principais fontes de apoio quando o estudante de enfermagem se envolve em incidentes de segurança do paciente. Destaca-se a incipiência dos recursos de suporte oferecidos a esse estudante, tanto nacional como internacionalmente, sendo prementes mais pesquisas direcionadas a essas potenciais vítimas, bem como recursos de suporte para mitigar esse fenômeno.