Clinical supervisors' experiences of using an interprofessional clinical supervision model in an acute care setting.

Often, students converge on the acute healthcare setting in professional silos, focusing solely on key learning objectives specific to their profession. The use of an Interprofessional Clinical Supervision (IPCS) model may enable students from medicine, nursing, pharmacy, and allied health to develop profession-specific skills, provide opportunities to improve communication skills within an interprofessional team and enhance student understanding of other health professionals' contributions to care delivery. Clinical supervision of these students within an IPCS model presents a number of logistical and interprofessional challenges. Through the use of two semi-structured group interviews, we sought to understand interprofessional clinical supervisors' (n = 4) perspective of implementing the IPCS model. Thematic analysis revealed emerging themes of planning, interprofessional supervisor utilization, role clarity and perceived professional limitations from the data. This study found that the IPCS model can provide an innovative alternative to traditional profession specific supervision models and interprofessional education activities, particularly given the climate of increasing student numbers and reduced resources.

Introducing a laparoscopic simulation training and credentialing program in gynaecology: an observational study.

BACKGROUND: Simulation training in laparoscopic surgery has been shown to improve surgical performance. AIMS: To describe the implementation of a laparoscopic simulation training and credentialing program for gynaecology registrars. MATERIALS AND METHODS: A pilot program consisting of protected, supervised laparoscopic simulation time, a tailored curriculum and a credentialing process, was developed and implemented. Quantitative measures assessing simulated surgical performance were measured over the simulation training period. Laparoscopic procedures requiring credentialing were assessed for both the frequency of a registrar being the primary operator and the duration of surgery and compared to a presimulation cohort. Qualitative measures regarding quality of surgical training were assessed pre- and postsimulation. RESULTS: Improvements were seen in simulated surgical performance in efficiency domains. Operative time for procedures requiring credentialing was reduced by 12%. Primary operator status in the operating theatre for registrars was unchanged. Registrar assessment of training quality improved. CONCLUSIONS: The introduction of a laparoscopic simulation training and credentialing program resulted in improvements in simulated performance, reduced operative time and improved registrar assessment of the quality of training.

A protocol for evaluating progressive levels of simulation fidelity in the development of technical skills, integrated performance and woman centred clinical assessment skills in undergraduate midwifery students.

BACKGROUND: Simulation as a pedagogical approach has been used in health professional education to address the need to safely develop effective clinical skills prior to undertaking clinical practice. However, evidence for the use of simulation in midwifery is largely anecdotal, and research evaluating the effectiveness of different levels of simulation fidelity are lacking.Woman centred care is a core premise of the midwifery profession and describes the behaviours of an individual midwife who demonstrates safe and effective care of the individual woman. Woman centred care occurs when the midwife modifies the care to ensure the needs of each individual woman are respected and addressed. However, a review of the literature demonstrates an absence of a valid and reliable tool to measure the development of woman centred care behaviours. This study aims to determine which level of fidelity in simulated learning experiences provides the most effective learning outcomes in the development of woman centred clinical assessment behaviors and skills in student midwives. METHODS/DESIGN: Three-arm, randomised, intervention trial.In this research we plan to:a) trial three levels of simulation fidelity - low, medium and progressive, on student midwives performing the procedure of vaginal examination;b) measure clinical assessment skills using the Global Rating Scale (GRS) and Integrated Procedural Performance Instrument (IPPI); andc) pilot the newly developed Woman Centred Care Scale (WCCS) to measure clinical behaviors related to Woman-Centredness. DISCUSSION: This project aims to enhance knowledge in relation to the appropriate levels of fidelity in simulation that yield the best educational outcomes for the development of woman centred clinical assessment in student midwives. The outcomes of this project may contribute to improved woman centred clinical assessment for student midwives, and more broadly influence decision making regarding education resource allocation for maternity simulation.

Improving pain management of abdominal pain in children presenting to the paediatric emergency department: a pre-post interventional study.

BACKGROUND: In 2007, the Mater Children's Hospital Emergency Department participated in the Emergency Care Pain Management Initiative funded by the National Health and Medical Research Council National Institute of Clinical Studies (NHMRC-NICS). The findings of this NHMRC-NICS research across eleven paediatric emergency departments highlighted deficits in pain management of abdominal pain. Specifically pain assessment, timeliness of analgesia, and pain management guidelines were found to be lacking. METHODS: In response to the NICS report local practice was reviewed and a pilot research project undertaken to develop a clinical guideline for the pain management of abdominal pain in children presenting to the emergency department. The guideline was developed by an expert panel and trialled using a pre and post intervention design. RESULTS: The results demonstrated improved compliance to assessment and documentation of pain scores and assimilation of the best practice principles recommended in the guideline. CONCLUSIONS: This project raised local awareness in the pain management of abdominal pain and provides baseline information for future improvement. The guideline has been trialled in the clinical setting of paediatric emergency and has the potential to improve pain management practices in children presenting to the emergency department with abdominal pain.