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2.
J Am Vet Med Assoc ; 260(15): 1911, 2022 Dec 01.
Article in English | MEDLINE | ID: covidwho-2198260
3.
J Educ Eval Health Prof ; 18: 23, 2021.
Article in English | MEDLINE | ID: covidwho-2198657

ABSTRACT

PURPOSE: It aimed to compare the use of the tele objective structured clinical examination (teleOSCE) with in-person assessment in high-stakes clinical examination so as to determine the impact of the teleOSCE on the assessment undertaken. Discussion follows regarding what skills and domains can effectively be assessed in a teleOSCE. METHODS: This study is a retrospective observational analysis. It compares the results achieved by final year medical students in their clinical examination, assessed using the teleOSCE in 2020 (n=285), with those who were examined using the traditional in-person format in 2019 (n=280). The study was undertaken at the University of New South Wales, Australia. RESULTS: In the domain of physical examination, students in 2020 scored 0.277 points higher than those in 2019 (mean difference -0.277, P<0.001, effect size 0.332). Across all other domains, there was no significant difference in mean scores between 2019 and 2020. CONCLUSION: The teleOSCE does not negatively impact assessment in clinical examination in all domains except physical examination. If the teleOSCE is the future of clinical skills examination, assessment of physical examination will require concomitant workplace-based assessment.


Subject(s)
Education, Medical, Undergraduate , Students, Medical , Australia , Clinical Competence , Educational Measurement , Humans , Physical Examination , Retrospective Studies
4.
AORN J ; 115(4): P10-P13, 2022 04.
Article in English | MEDLINE | ID: covidwho-2157692
8.
Curationis ; 45(1): e1-e10, 2022 Oct 27.
Article in English | MEDLINE | ID: covidwho-2110408

ABSTRACT

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. Semistructured 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.Contribution: 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.


Subject(s)
COVID-19 , Education, Nursing , Humans , Preceptorship , Pandemics , Education, Nursing/methods , Surveys and Questionnaires , Clinical Competence
9.
BMC Med Educ ; 22(1): 775, 2022 Nov 10.
Article in English | MEDLINE | ID: covidwho-2117192

ABSTRACT

BACKGROUND: Since COVID-19 limits safe clinical practice settings, virtual reality (VR) emerged as an alternative to practical education. Using VR simulation to learn mechanical ventilation is rare in nursing education. METHODS: This study developed a VR simulation program for mechanical ventilation care and evaluated its effects. We adopted a quasi-experiment design. Participants were fourth-year students across nursing colleges in South Korea. RESULTS: The interaction effect of the intervention time point and control group, to which the VR simulation program was applied, showed a significant difference in self-efficacy (F = 19.54, p < .001) and clinical reasoning capacity (F = 16.97, p < .001). Learning satisfaction of the experimental group was statistically significantly higher than that of the control group(F = 5.22, p = .026). The level of learning immersion (t = - 3.13, p = .003) and learning satisfaction (t = - 3.49, p = .001) were statistically significantly higher in the experimental group than in the control group. CONCLUSION: These findings confirmed that the VR stimulation program for nursing students had a positive effect on their self-efficacy, clinical reasoning capacity, and learning satisfaction. Furthermore, it was effective in improving their nursing competence.


Subject(s)
COVID-19 , Education, Nursing , Students, Nursing , Virtual Reality , Humans , Respiration, Artificial , Clinical Competence , COVID-19/epidemiology
10.
PLoS One ; 17(11): e0277525, 2022.
Article in English | MEDLINE | ID: covidwho-2116955

ABSTRACT

COVID-19 had a tremendous effect on medical education. Most teaching sessions had to be shifted online, posing additional stress and potential isolation on medical students. However, it also offered the promotion of innovative digital teaching concepts. In this article, an approach to undergraduate mental health training is presented and evaluated. The curriculum was designed according to Kern's six-step approach and consisted of asynchronous online material as well synchronous digital teaching and was accompanied by a plethora of newly developed teaching material (videos, fact sheets, etc.). Content covered the whole spectrum of diseases seen in a service of psychosomatic medicine and psychotherapy (i.e. anxiety, depression, trauma, somatoform and eating disorders, as well as motivational interviewing). Feedback from participants was collected, and exam results (written and practical) were compared to pre-COVID-19 times using t-tests for dependent and independent samples. Students were highly satisfied with the teaching (rating of 1.3 ± 0.6, n = 139 students). There was no significant difference from course evaluations before COVID-19 (1.5 ± 0.5, p > .05). The teaching also received an award in the students' competition "best digital teaching concept in summer term 2020". In the written exams, there was no significant difference between before COVID-19 (2.4 ± 0.45) and during COVID-19 times (1.6 ± 0.39; p > .05). In the practical objective structured clinical examination (OSCE), there was also no significant difference between students' judgement of the difficulty of the station (1.9 ± 0.22 vs 1.9 ± 0.31; p > .05) or how well-prepared they felt for the exam (2.0 ± 0.24 vs 2.0 ± 0.31; p > .05). However, there was a significant difference in terms of grades, with the pre-COVID-19 grades being significantly better (2.7 ± 0.37 vs 2.0 ± 0.44; p < .05), which reflects the difficulty of transferring practical skills training to an online setting. Students particularly valued the possibility of self-directed learning combined with personal guidance by departmental experts, reflecting the importance of wellbeing-centred medical education. The pandemic triggered overnight challenges for teaching mental health that may also offer the opportunity to think about worldwide teaching standards with easily accessible material and courses online. This may offer the opportunity to enthral medical students to become mental health specialists themselves.


Subject(s)
COVID-19 , Education, Medical, Undergraduate , Students, Medical , Humans , COVID-19/epidemiology , Mental Health , Clinical Competence , Education, Medical, Undergraduate/methods
11.
BMC Med Educ ; 22(1): 773, 2022 Nov 10.
Article in English | MEDLINE | ID: covidwho-2116331

ABSTRACT

BACKGROUND: The global spread of the COVID-19 virus caused unprecedented interruptions in medical education. This paper evaluates Relational Coordination (RC): communicating and relating for task integration; between the distinct stakeholders responsible for scheduling,delivering and receiving clinical teaching in the wake of the pandemic. METHODOLOGY: Using a cross-sectional design, the level of Relational Coordination was assessed between twelve groups within a Clinical Skills Program at a Medical School in the United Arab Emirates. It also measures three relevant mental health factors: namely, Job satisfaction, Work Engagement, and Burnout. RESULTS: Overall, RC scores were moderate (3.65 out of 5.00). Controlling for participants' position, RC was found to positively and significantly increase both job satisfaction (ß = 1.10, p < 0.001) and work engagement (ß = 0.78, p < 0.01)., Additionally, RC was significantly associated with lower burnout (ß = -0.56, p = 0.05). Fifty percent of participants experienced high job satisfaction, with a mean score of 5.0 out of 7.0, while 73% reported being enthusiastic about their job, with a mean score of 6.0 out of 7.0. About a third of participants (27%) reported feeling burnout. CONCLUSIONS: During times of disruption and crisis, medical education can benefit from higher levels of relational coordination. Our study shows the significant impact of relational coordination on mental health measures like job satisfaction and work engagement. To achieve the full potential and benefits of excellent levels of relational coordination in this program, we recommend six interventions focusing on improving communication, work processes, regular meetings, education innovations, capacity building, and the establishment of coaching and counseling programs for students and faculty.


Subject(s)
Burnout, Professional , COVID-19 , Humans , Mental Health , Pandemics , COVID-19/epidemiology , Clinical Competence , Cross-Sectional Studies , Job Satisfaction , Burnout, Professional/epidemiology , Burnout, Professional/prevention & control , Burnout, Professional/etiology , Students , Surveys and Questionnaires
12.
J Educ Eval Health Prof ; 19: 30, 2022.
Article in English | MEDLINE | ID: covidwho-2109729

ABSTRACT

PURPOSE: Coronavirus disease 2019 (COVID-19) restrictions resulted in an increased emphasis on virtual communication in medical education. This study assessed the acceptability of virtual teaching in an online objective structured clinical examination (OSCE) series and its role in future education. METHODS: Six surgical OSCE stations were designed, covering common surgical topics, with specific tasks testing data interpretation, clinical knowledge, and communication skills. These were delivered via Zoom to students who participated in student/patient/examiner role-play. Feedback was collected by asking students to compare online teaching with previous experiences of in-person teaching. Descriptive statistics were used for Likert response data, and thematic analysis for free-text items. RESULTS: Sixty-two students provided feedback, with 81% of respondents finding online instructions preferable to paper equivalents. Furthermore, 65% and 68% found online teaching more efficient and accessible, respectively, than in-person teaching. Only 34% found communication with each other easier online. 40% preferred online OSCE teaching to in-person teaching. Students also expressed feedback in positive and negative free-text comments. CONCLUSION: The data suggested that generally students were unwilling for online teaching to completely replace in-person teaching. The success of online teaching was dependent on the clinical skill being addressed; some were less amenable to a virtual setting. However, online OSCE teaching could play a role alongside in-person teaching.


Subject(s)
COVID-19 , Education, Medical , Students, Medical , Humans , Physical Examination , Clinical Competence
13.
BMC Med Educ ; 22(1): 753, 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2098332

ABSTRACT

BACKGROUND: The Coronavirus Disease-2019 (COVID-19) pandemic in South Africa compelled medical schools to switch to a purely online curriculum. The innovative changes transformed the standard clinical skills curriculum to increase learning transfer to bridge the theory-practice gap. The efficacy of this intervention remains unknown. This study aims to measure medical students' clinical competency in the affective, cognitive, and psychomotor domains by assessing clinical skills knowledge retention and transfer from the online platform compared to face-to-face and blended learning. METHODS: A non-random cross-sectional quasi-experimental study assessed third-year medical students' knowledge retention and learning transfer in three domains of clinical skills competence. Data were obtained using a score sheet during a directly observed formative and a trial online summative assessment. One hundred and one third-year medical students volunteered for the formative onsite assessment that tested the psychomotor domain. Two hundred and thirty-nine students were evaluated on the affective and cognitive domains in the summative online trial mini-objective structured clinical examination (tm-OSCE). The OSCE scores were analysed using descriptive statistics. The significance of the findings was evaluated by comparing OSCE scores with the pre-pandemic 2019 third-year medical students. RESULTS: Statistically significant differences were found between the two cohorts of medical students from both years (p < 0.05). The 2021 blended group's (n = 101) medians were 90%, 95%CI [86, 92], 82%, 95%CI [80, 85], and 87%, 95% CI [84, 90] for the psychomotor, affective, and cognitive skills, respectively. The e-learning group's affective and cognitive skills medians were 78%, 95%CI [73, 79] and 76%, 95%CI [71, 78], respectively. The 2019 face-to-face cohort (n = 249) achieved medians of 70%, 95% CI [69, 72] and 84%, 95%CI [82, 86] for the affective and psychomotor skills, respectively. CONCLUSION: Medical students demonstrated near and far transfer bridging the theory-practice gap in three clinical skills domains. The blended group performed significantly better than the e-learning and face-to-face groups. Medical schools and educators play a vital role in overcoming learning challenges and achieving higher transfer levels by adopting multiple student-centered teaching delivery approaches and arranging immediate application opportunities. This study offers medical educators suggestions that encourage the transfer of online learning to face-to-face practice, decentralising medical education with a revised blended learning strategy.


Subject(s)
COVID-19 , Students, Medical , Humans , Students, Medical/psychology , Clinical Competence , Cross-Sectional Studies , Cognition
14.
BMJ Open ; 12(11): e059487, 2022 11 02.
Article in English | MEDLINE | ID: covidwho-2097975

ABSTRACT

OBJECTIVES: The interim Foundation Year 1 (FiY1) post was created in response to the COVID-19 pandemic to help bolster the workforce and manage increased clinical pressures. This study aimed to assess the impact of the FiY1 post on medical graduates' self-reported confidence in common tasks, core skills, competencies and procedures prior to starting FY1, as a measure of increasing preparedness for practice. SETTING: A longitudinal survey was performed at a tertiary teaching hospital in the South East of England. FiY1 posts ran from June to July 2020. PARTICIPANTS: Questionnaires were sent to 122 medical graduates from a single medical school (recipients included FiY1s and non-FiY1s) and to 69 FiY1s at a single Teaching Hospital NHS Trust, irrespective of medical school attended. Initial and follow-up questionnaires had 86 and 62 respondents, respectively. Of these, 39 graduates were matched; 26 were FiY1s and 13 non-FiY1s. The 39 matched results were analysed. PRIMARY OUTCOME MEASURES: Confidence levels in common FY1 tasks, core procedures and competencies were gathered before and after the FiY1 post through online questionnaires. Change in confidence comparing FiY1s and non-FiY1s was measured and analysed using linear regression. RESULTS: On a 5-point scale, the FiY1 post increased overall confidence in starting FY1 by 0.62 (95% CI 0.072 to 1.167, p=0.028). The FiY1 post increased confidence in performing venepuncture by 0.32 (95% CI 0.011 to 0.920, p=0.045), performing intravenous cannulation by 0.48 (95% CI 0.030 to 1.294, p=0.041) and recognising, assessing and initiating the management of the acutely ill patient by 0.32 (95% CI 0.030 to 1.301, p=0.041). CONCLUSIONS: The COVID-19 pandemic FiY1 post improved confidence in core skills and competencies. These findings may help guide future educational interventions in conjunction with further larger scale studies, ultimately aiding to bridge the transition gap between being a medical student and a doctor.


Subject(s)
COVID-19 , Physicians , Students, Medical , Humans , COVID-19/epidemiology , Pandemics , Clinical Competence , Surveys and Questionnaires
16.
Surg Endosc ; 36(11): 8441-8450, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2085376

ABSTRACT

BACKGROUND: Worldwide, trauma-related deaths are one of the main causes of mortality. Appropriate surgical treatment is crucial to prevent mortality, however, in the past decade, general surgery residents' exposure to trauma cases has decreased, particularly since the COVID-19 pandemic. In this context, accessible simulation-based training scenarios are essential. METHODS: A low-cost, previously tested OSCE scenario for the evaluation of surgical skills in trauma was implemented as part of a short training boot camp for residents and recently graduated surgeons. The following stations were included bowel anastomosis, vascular anastomosis, penetrating lung injury, penetrating cardiac injury, and gastric perforation (laparoscopic suturing). A total of 75 participants from 15 different programs were recruited. Each station was videotaped in high definition and assessed in a remote and asynchronous manner. The level of competency was assessed through global and specific rating scales alongside procedural times. Self-confidence to perform the procedure as the leading surgeon was evaluated before and after training. RESULTS: Statistically significant differences were found in pre-training scores between groups for all stations. The lowest scores were obtained in the cardiac and lung injury stations. After training, participants significantly increased their level of competence in both grading systems. Procedural times for the pulmonary tractotomy, bowel anastomosis, and vascular anastomosis stations increased after training. A significant improvement in self-confidence was shown in all stations. CONCLUSION: An OSCE scenario for training surgical skills in trauma was effective in improving proficiency level and self-confidence. Low pre-training scores and level of confidence in the cardiac and lung injury stations represent a deficit in residency programs that should be addressed. The incorporation of simulation-based teaching tools at early stages in residency would be beneficial when future surgeons face extremely severe trauma scenarios.


Subject(s)
COVID-19 , General Surgery , Internship and Residency , Lung Injury , Simulation Training , Humans , Clinical Competence , Pandemics , Simulation Training/methods , General Surgery/education
18.
J Gen Intern Med ; 37(9): 2330-2334, 2022 07.
Article in English | MEDLINE | ID: covidwho-2075548

ABSTRACT

BACKGROUND: Vaccine hesitancy is challenging for clinicians and of increasing concern since COVID-19 vaccination rollout began. Standardized patients (SPs) provide an ideal method for assessing resident physicians' current skills, providing opportunity to practice and gain immediate feedback, while also informing evaluation of curriculum and training. As such, we designed and implemented an OSCE station where residents were tasked with engaging and educating a vaccine-hesitant patient. AIM: Describe residents' vaccine counseling practices, core communication and interpersonal skills, and effectiveness in meeting the objectives of the case. Explore how effectiveness in overcoming vaccine hesitancy may be associated with communication and interpersonal skills in order to inform educational efforts. SETTING: Annual OSCE at a simulation center. PARTICIPANTS: 106 internal medicine residents (51% PGY1, 49% PGY2). PROGRAM DESCRIPTION: Residents participated in an annual residency-wide, multi-station OSCE, one of which included a Black, middle-aged, vaccine-hesitant male presenting for a routine video visit. Residents had 10 min to complete the encounter, during which they sought to educate, explore concerns, and make a recommendation. After each encounter, faculty gave residents feedback on their counseling skills and reviewed best practices for effective communication on the topic. SPs completed a behaviorally anchored checklist (30 items across 7 clinical skill domains and 2 measures of trust in the vaccine's safety and resident) which will inform future curriculum. PROGRAM EVALUATION: Fifty-five percent (SD: 43%) of the residents performed well on the vaccine-specific education domain. PGY2 residents scored significantly higher on two of the seven domains compared to PGY1s (patient education/counseling-PGY1: 35% (SD: 36%) vs. PGY2: 52% (SD: 41%), p = 0.044 and activation-PGY1: 37% (SD: 45%) vs. PGY2: 59% (SD: 46%), p = 0.016). In regression analyses, education/counseling and vaccine-specific communication skills were strongly, positively associated with trust in the resident and in the vaccine's safety. A review of qualitative data from the SPs' perspective suggested that low performers did not use patient-centered communication skills. DISCUSSION: This needs assessment suggests that many residents needed in-the-moment feedback, additional education, and vaccine-specific communication practice. Our program plans to reinforce evidence-based practices physicians can implement for vaccine hesitancy through ongoing curriculum, practice, and feedback. This type of needs assessment is replicable at other institutions and can be used, as we have, to ultimately shed light on next steps for programmatic improvement.


Subject(s)
COVID-19 , Internship and Residency , COVID-19 Vaccines , Clinical Competence , Communication , Counseling , Curriculum , Humans , Male , Middle Aged , Trust
20.
J Contin Educ Nurs ; 53(10): 465-472, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2055508

ABSTRACT

During the COVID-19 pandemic, non-critical care nurses assisted in the provision of care to critically ill patients. Just-in-time education was needed for these nurses to effectively assist in the care of these patients. A 12-hour educational program was offered to non-critical care nurses. During this multi-modal program, instructors delivered information to participants through unique didactic classroom learning, simulation engagement, and hands-on experience in a critical care unit. After completing this innovative program, participants demonstrated a significant improvement in knowledge, confidence, and perception of competence in caring for critically ill patients. Participants were highly satisfied with the program. Implementation of a just-in-time, multi-modal critical care nursing program is an effective method of providing non-critical care nurses with basic levels of skills, knowledge, and competency during a crisis to enable them to assist with providing care to critically ill patients. [J Contin Educ Nurs. 2022;53(10):465-472.].


Subject(s)
COVID-19 , Critical Care Nursing , Nurses , Clinical Competence , Critical Care Nursing/education , Critical Illness , Humans , Intensive Care Units , Pandemics
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