Exploring preparation practices of nursing and midwifery educators for in situ simulation-based education: A qualitative study in a large healthcare service.

AIM: This study aimed to explore nursing and midwifery clinical educators' preparation practices related to in situ simulation-based education, at a tertiary health service in Australia. BACKGROUND: Simulation-based education is routinely used in healthcare education and training. A key mechanism to optimise simulation-based education is learner preparation. While diverse pre-simulation preparation approaches are described in the literature, these are predominantly focused on activities that are undertaken in either university and/or skills centre contexts. In contrast, the learner preparation practices for simulation-based education that is delivered insitu in healthcare facilities by clinical nurse and midwifery educators are underexplored. DESIGN: This study used an exploratory qualitative design. METHODS: Participants were recruited using purposive sampling from a potential study group of thirty. Twelve individuals from the nursing and midwifery education group met selection criteria and agreed to participate in the study. Each individual participated in a semi-structured interview. Interview data were then transcribed and analysed using qualitative descriptive methods. RESULTS: Data analysis resulted in the development of four themes related to the preparation of participants for insitu simulation-based education sessions. Each theme informs the choices of clinical nurse/midwifery educators' preparation practices: 1) responsivity to workplace and clinical priorities; 2) clinical educator objectives; 3) preparedness for learning and clinical practice; and 4) evolving educational expertise. CONCLUSION: This study explored the preparation practices of nurse and midwifery clinical educators engaged in the delivery of insitu simulation-based education. Findings indicate a depth of experiences and a willingness to share practice insights, suggesting that insitu simulation-based education is an integral part of the in service repertoire and a key component of departmental education strategies, designed to support practice and hone skills required to deliver quality patient care.

Historical trends and current experiences of anatomical body donation in two Zimbabwean medical schools.

BACKGROUND: Body donation is integral to anatomy education, but procurement can be ethically fraught. While voluntary donation is preferred, the use of unclaimed bodies, although considered unethical, is a primary means for body procurement in some countries. This mixed methods study examined historical trends and anatomy technical staff perspectives on body donation in two Zimbabwean medical schools. METHODOLOGY AND MAIN FINDINGS: In Phase 1, 194 cadaver paper records from January 1984 to January 2021 were reviewed. Unclaimed bodies accounted for 67% while 33% (all white Zimbabweans) were voluntarily donated. Most cadavers were black Africans (62.4%) followed by white Zimbabweans (34.0%). Race was not indicated in seven (3.6%) records. In Phase 2, semi-structured interviews were conducted with seven technicians responsible for sourcing cadavers at the two institutions. Data were thematically analysed resulting in the development of eight themes, arranged into three domains. Cadaver procurement themes related to (1) cadaver source, (2) adherence to procurement guidelines, (3) screening for suitability, and (4) cultural and religious beliefs. Cadaver embalmment focused on (5) embalming practices, and (6) hospital mortuary-based embalming. Finally, (7) disposal processes and (8) resource constraints were found to influence cadaver disposal practices. CONCLUSIONS: Contrary to best practice, there is continued reliance on the use of unclaimed bodies to support anatomy education in the two Zimbabwean medical schools. Improving the ethical sourcing of bodies requires increased efforts to educate all Zimbabweans, especially the black majority, about the role and importance of voluntary body donation in medical education. Additionally, well-structured, and well-resourced body donation programs could enhance ethical procurement.

Twelve tips for designing and implementing an academic coaching program.

Coaching has become increasingly popular as a mechanism to support learning across the health professions education (HPE) continuum. While there is a growing body of literature in this area, there is minimal guidance related to the design and implementation of academic coaching in health professional courses. This paper seeks to contribute to this literature by presenting guidance for academic developers who are considering introducing academic coaching into a health professional course. The 12 tips are based on the authors' collective experiences of designing and implementing academic coaching in university medical courses in Australia and the UK. Although focused on medical education, this paper is intended to have applicability across the health professions, and potentially across university and postgraduate training contexts. Together, the tips offer a strategic and operational framework to guide the design and implementation of academic coaching initiatives in health professions education.

"Pet things" and "penny drops"-Factors influencing clinicians' teaching of pelvic anatomy.

Pelvic anatomy is considered challenging to teach and learn, partly because its complexity can make it difficult to conceptualize. Educational researchers recognize the value of a spiraling curriculum to develop clinically orientated anatomy knowledge for health professionals, but most studies have focused on the preclinical years. It is unclear how the complexities of pelvic anatomy are taught in the clinical setting by clinician educators. Understanding pelvic anatomy teaching from the perspectives of clinician educators is important because of their critical role in supporting medical students to become knowledgeable, safe practitioners. This study sought to examine factors that influence clinician educators' teaching of pelvic anatomy to medical students during clinical placement. Using established qualitative research methods, this exploratory study used semi-structured interviews with 10 participants from obstetrics/gynecology (n = 4) and urology (n = 6) in Australia. Interviews were transcribed, and data were analyzed using a reflexive thematic analysis framework. Two overarching factors were identified as influencing clinician educators' teaching: (1) how they defined the scope of knowledge, and (2) pedagogical understanding. Scope of knowledge was underpinned by patient safety considerations and guided by past experience and student aspirations. Pedagogical understanding also relied on experience and encompassed multiple teaching strategies, including approaches informed by sensitivities surrounding pelvic anatomy. Multiple factors influence how clinician educators define the scope of pelvic anatomy knowledge required of medical students. Clinician educators' awareness of syllabus and teaching approaches can enable them to support students to attain threshold concepts such as three-dimensional spatial relationships and sociocultural sensitivities associated with pelvic anatomy.

Informal faculty development in health professions education: Identifying opportunities in everyday practice.

INTRODUCTION: Faculty development (FD) supports health professions educators to develop knowledge, skills, and expertise. Whilst formal FD is a focus in the health professions education (HPE) literature, little is known about how FD occurs informally. We sought to identify opportunities and constraints for informal FD amongst health professions educators in the academic (university) setting and understand how they engage with these opportunities. METHODS: This exploratory study was conducted in one Australian university. Interviews and focus groups were conducted with undergraduate and postgraduate teachers and assessors (teachers) (n = 10); teaching team and program leaders (mid-level leaders) (n = 8); and senior (university-level) leaders (n = 2). We analysed data thematically and applied situated cognition theory. RESULTS: We identified three everyday educational practices that provide opportunities for informal FD in the academic setting: (1) applying evidence to; (2) evaluating; and (3) sharing, educational practice. Engaging with these opportunities was shaped by individuals' motivation and proactivity to engage in professional learning (effectivities) and organisational culture and structures (constraints). CONCLUSION: Applying evidence to, evaluating, and sharing educational practice provide valuable contexts for ongoing learning in the academic setting. Assisting educators and organisations to recognise and leverage these 'in situ' FD opportunities is vital in fostering a continuous learning culture.

Knowledge to action: a scoping review of approaches to educate primary care providers in the identification and management of routine sleep disorders.

STUDY OBJECTIVES: The referral burden on health care systems for routine sleep disorders could be alleviated by educating primary care providers (PCPs) to diagnose and manage patients with sleep health issues. This requires effective professional education strategies and resources. This scoping review examined the literature on existing approaches to educate PCPs in sleep health management. METHODS: A comprehensive literature search was conducted across 8 databases to identify citations describing the education of PCPs in diagnosing and managing sleep disorders, specifically insomnia and sleep apnea. A conceptual framework, developed from the knowledge-to-action cycle, was used to analyze citations from a knowledge translation perspective. RESULTS: Searches identified 616 unique citations and after selection criteria were applied, 22 reports were included. Reports spanning 38 years were analyzed using components of the knowledge-to-action cycle to understand how educational interventions were designed, developed, implemented, and evaluated. Interventions involved didactic (32%), active (18%), and blended (41%) approaches, using face-to-face (27%), technology-mediated (45%), and multimodal (5%) delivery. Educational effectiveness was assessed in 73% of reports, most commonly using a pre/post questionnaire (41%). CONCLUSIONS: While this scoping review has utility in describing existing educational interventions to upskill PCPs to diagnose and manage sleep disorders, the findings suggest that interventions are often developed without explicitly considering the evidence of best educational practice. Future interventional designs may achieve greater sustained effectiveness by considering characteristics of the target audience, the pedagogical approaches best suited to its needs, and any environmental drivers and barriers that might impede the translation of evidence into practice. CITATION: King S, Damarell R, Schuwirth L, Vakulin A, Chai-Coetzer CL, McEvoy RD. Knowledge to action: a scoping review of approaches to educate primary care providers in the identification and management of routine sleep disorders. J Clin Sleep Med. 2021;17(11):2307-2324.

Assessment of clinical reasoning: three evolutions of thought.

Although assessing clinical reasoning is almost universally considered central to medical education it is not a straightforward issue. In the past decades, our insights into clinical reasoning as a phenomenon, and consequently the best ways to assess it, have undergone significant changes. In this article, we describe how the interplay between fundamental research, practical applications, and evaluative research has pushed the evolution of our thinking and our practices in assessing clinical reasoning.

Five Principles for Using Educational Theory: Strategies for Advancing Health Professions Education Research.

Health professions education (HPE) research often involves examining complex phenomena. Theory provides a means for better understanding the mechanics of these phenomena and guiding health professions researchers and educators as they navigate the practical implications for teaching, learning, and research. Engaging with educational theory is, therefore, critical to facilitating this understanding. However, this engagement presents a key challenge for HPE researchers and educators without a background in social science. This article outlines 5 key principles of engaging with theory and offers integration strategies to assist HPE researchers and educators who wish to apply theory to their HPE scholarship and practice. The article concludes with a practical example of how these principles were applied to an HPE research project, demonstrating the value of theory in enhancing research quality. Existing theories can facilitate opportunities for individual researchers to better understand complex phenomena while simultaneously moving forward the field of HPE.