Systematic review: Predictors of students' success in baccalaureate nursing programs.

Nursing schools strive to select a diverse student population who are likely to succeed by ensuring timely student progression through the program and effective use of educational sources. The purpose of this systematic literature review is to explore the preadmission variables and selection criteria that predict student success in 4-year baccalaureate nursing programs in the U.S. Sixteen articles met the eligibility criteria, and six measures were used to define student success: (a) early academic success, particularly during the first and second year; (b) attrition; (c) timely completion of the program; (d) graduation; (e) performance in nursing courses; and (f) academic performance in other science courses. Typically, the core set of cognitive predictors used in the admission process in nursing schools were pre-nursing GPA, pre-nursing collegiate science GPA, and scores on standardized aptitude exams. This review suggests that it is challenging to isolate one single variable as the best predictor of student success; however, using a combination of variables can offer a reliable prediction method. More researchers should consider using a theoretical basis to guide their inquiry on this topic. Additionally, researchers should examine admission variables that are most relevant across programs.

Journeying to the White Coat Ceremony: A description of the people, situations and experiences that inform student visions of the physician they hope to become.

Little is known about the experiences that influence entering medical students' internal concepts of themselves as future physicians. During orientation to medical school, students were asked to write stories in response to the cue, "Tell a story about a person or experience that inspired you to consider a career of service in medicine." Qualitative methodology was employed to analyze 190 student stories. Thematic analysis identified descriptive details about content and allowed comparison between the students' and School's expectations. Inspirational settings, contexts, and individuals were identified. Nine different inspirational events were described. Student and School expectations for the kinds of physicians they hoped to become were generally consistent. The study demonstrates that students do indeed bring to medical school visions of the kinds of physicians they hope to become. Linking that vision with medical school activities including the White Coat Ceremony provides a bridge between medical school and students' earlier lives, thus explicitly linking orientation to professional formation.

Through patient eyes: Can third-year medical students deliver the care patients expect?

INTRODUCTION: Patient-centered approaches have a positive impact on adherence to treatment, self-management of chronic disease, and patient satisfaction. We seek to graduate physicians who provide effective Patient-Centered Care (PCC). The aims of this research were to (a) include the patients' perspectives in describing behaviors essential to effective PCC, (b) create an authentic, credible tool to assess these behaviors in third-year medical students, and (c) validate the assessment tool through the eyes of our patients. METHODS: To develop and validate PCC behaviors we (a) developed PCC descriptors that included patient perspectives, (b) developed scenarios for students to demonstrate PCC, (c) administered the PCC-Objective Structured Clinical Exam, and (d) used the patient perspective to validate results. RESULTS: Faculty and students found the PCC-OSCE to be an authentic experience. Students received abundant individualized feedback and demonstrated strong performance in communicating effectively, avoiding medical jargon, listening actively, demonstrating empathy, and leading critical conversations. Patient critiques of exemplary performances confirmed that the PCC-OSCE assesses elements the patients viewed as essential to PCC. CONCLUSION: Incorporating the patients' perspective aids in better understanding professional competencies and legitimizes the assessment.

Contextual tensions of the clinical environment and their influence on teaching and learning.

BACKGROUND: Academic medical centres face major challenges, and finding creative, effective strategies to support patient care and teaching are critical for survival. At the centre of these challenges is clinical teaching. AIM: To characterise how context influences clinical teaching. METHODS: Multiple embedded case-study design analysed 3 internal medicine in-patient teams. Direct observations, interviews and documents were data sources. Triangulated data, audit trails and member checks enhanced trustworthiness. RESULTS: Three tensions influenced clinical teaching: 1, patient census; 2, time sensitivity of the context; and 3, the multiple and conflicting commitments of participants. Patient census exhibited the greatest influence and was the catalyst for teaching, learning, and the allocation of total time. Time functioned as an important element influencing the pace of action, reflective and interpretative cognitive processes of the team, time available for action, and the general fatigue of the team. Conflicts among the multiple roles of ward team members disrupted individual and team teaching and learning. CONCLUSION: Clinical teaching is an open system influenced by multiple forces. Learning, teaching and patient care were very closely coupled, and learning knowledge and using knowledge were parts of the same process within the clinical context.