Technology Complements Physical Examination and Facilitates Skills Development among Health Sciences Clerkship Students: An Integrative Literature Review.

Background: Technology is increasingly present in the clinical environment. There is a dearth of investigation of the relationship between technology and touch concerning student learning of physical examination practices. Method: Integrative review methods were used to synthesise empirical literature to provide a comprehensive understanding of the relationship between physical examination, learning and technology in the context of health professional student clerkships. Results: Three databases including MEDLINE, CINAHL and Eric were searched for all articles published from 2014 to 2021 using terms relating to (i) physical examination, (ii) technology, and (iii) student clerkships. Thirty-three studies met the inclusion criteria. From the analysis, it is evident that technologies that intersect with learning of physical examination may broadly be apportioned into two categories: 1) technologies that mediate physical examination practices; and 2) technologies that mediate the learning of physical examination. Conclusions: This review indicates that technologies may have multiple roles in the student learning of physical examination, including technology mediating increased diagnostic accuracy and access to supplementary learning material relating to physical examination that is integrated for the clinical clerkship environment. It highlights a need to further understand the touch versus technology relationship and explore the dynamic intersection.

Working with underperformance in surgical training: Educational strategies for supervisors.

Underperformance is a significant challenge for surgical educators. This paper outlines some educational strategies to manage the very complex demands presented by underperformance during training in the workplace. Preventative approaches include: setting expectations with early conversations; conscious attention to the workplace curriculum; and building trainee evaluative judgement through assessment and feedback. Once underperformance has been identified, other approaches including: developing a joint action plan; reducing or increasing feedback opportunities; and ensuring the trainee remains motivated. While these strategies cannot prevent failure, they offer the trainee opportunities to succeed.

Attributes of the complete dental record: a Delphi approach to standards.

BACKGROUND: Adherence to the Dental Board of Australia Guidelines on dental records is not universal and remediation of deficient practise requires clarity in the practical application of standards. The aim of this research is to clarify practical requirements of dental record keeping in New South Wales. METHODS: Seventeen experts were invited to participate in an electronically administered series of Delphi questionnaires. Concepts were refined until consensus was reached. RESULTS: Two rounds were required to achieve a satisfactory level of consensus (>80%). A high level of consensus was obtained across the two rounds, with 72% and 86% agreement on propositions in the first and second rounds, respectively. Consensus criteria were established in 14 domains to establish attributes of the complete dental record (ACDR). CONCLUSIONS: The ACDR may supplement existing national guidelines and are likely to be useful in a remediation context in which clear, unambiguous expectations for conduct are paramount.

Comparing student attitudes to different models of the same virtual patient.

AIMS: Two types of virtual patient designs can be distinguished - a 'narrative' structure and a 'problem-solving' structure (1). This study assesses attitudes of students with respect to learning communication skills via a virtual patient; and compares acceptability of the two different types of virtual patient designs. METHODS: Two virtual patients were constructed around the same case, each emphasising a narrative or problem-solving model. Undergraduate medical students used the simulations as part of a communication skills program. A computer-based survey was used to assess attitude. RESULTS: There was general acceptance of the use of the computer-based simulated patient. Students who generally performed better at communication skills, were more positive towards the virtual patient. There was no quantitative difference in acceptability between the two designs, but there were clear qualitative differences. CONCLUSIONS: While students were moderately positive about both simulations, qualitative data indicated that their were clear differences in attitude between the two different designs.

Random comparison of 'virtual patient' models in the context of teaching clinical communication skills.

AIMS: Two types of virtual patient designs can be distinguished: a 'narrative' structure and a 'problem-solving' structure. This study compares the same virtual patient with two different structures within the domain of communication skills. METHODS: Two virtual patients were constructed around the same case, one emphasizing a narrative and one a problem-solving model. Use of these packages was trialled with undergraduate medical students over 2 years. Students were randomly assigned to tutorials using the virtual patients, and their communication skills were compared with baseline performance by a separate group. Outcome was assessed by evaluation of an interview with a simulated patient. RESULTS: There was no significant difference between the three groups in overall communication skills. However there was a significant improvement in the communication skills of the narrative group when compared only with the problem-solving group. Additionally, various aspects of communication skills, such as use of open-ended questions and appropriate language, showed significant differences between the three groups. CONCLUSION: There is some evidence to support the value of a narrative design for virtual patients which are to be used to teach communication skills, which encourages further investigation.

Methodology for developing educational hypermedia systems.

Hypermedia has the potential to greatly enhance teaching. It can, however, be difficult to develop hyperdocuments which provide medical students with the full benefit of the technology. We wish to resolve this problem by providing a methodology for creating educational hypermedia systems with specific emphasis on the medical domain, but applicable across disciplines. This paper examines some of the specific issues involved in educational hypermedia, and outlines a series of practical guidelines, drawing together the disparate disciplines necessary to the development process. We illustrate the methodology with our own experience in creating and updating the HIV Hypermedia Medical Education Software over a period of two years.

Designing interfaces for medical information management systems.

Poor interface design has adversely affected the integration of technology into medical environments. This paper discusses the importance of good interface design in medical information management systems. We will illustrate the advantages of approaching interface design in a user-centered manner, by describing the interface design process of the Curriculum Database for the Faculty of Medicine, Monash University. We believe that a consultative design process can make the difference between software success and failure.