The Impact of COVID-19 on the Clinical Experience and Training of Undergraduate Student Radiographers internationally: The Clinical Tutors' perspective.

INTRODUCTION: The impact on the clinical training and education of healthcare students by COVID-19 has been documented. However, the thoughts and experiences of clinical tutors (CTs) about radiography students attending for clinical training and education during this now elongated period beyond first recognition of the virus has not been explored. This paper will discuss data collected from CTs in the UK Devolved Nations (UKDN) and the United Arab Emirates (UAE) who were compared because of their similarities in delivery based on individual 'rules of engagement' devised by their various health departments. AIM: The purpose of this study was to examine the clinical tutors' thoughts and experiences of supervising radiography students attending clinical placement during the COVID-19 pandemic. METHODS: The UK Devolved Nations (UKDN) and the United Arab Emirates (UAE) were selected for comparison on an international level as they are geographically distinct with a comparable population and education accredited/acknowledged by the Society and College of Radiographers (SCoR). Data was collected data from CTs across the UKDN and the UAE. The study used an online questionnaire (Google Forms) with closed questions in four themes including: students' experiences, impact on students' clinical placement, attitude of the clinical staff and the potential effects of COVID-19 on future graduates' skills and competencies. Further data was gathered on the experience of CTs mentoring students during the COVID-19 pandemic. RESULTS: Data were collected from 59 CTs (81%, n = 48) from UKDN and (19%, n = 11) UAE. Twenty-seven (46%) respondents reported that COVID-19 had a negative impact on clinical practical experience. However, 32 (54%) identified that COVID-19 had no impact on student supervision/feedback or on clinical achievements. Eleven (19%) respondents thought that students should not have been on clinical placement during the pandemic but a further 51% (n = 30) were happy with the students on placement and expressed willingness to delegate work to students. Interestingly, 58% (n = 34) of CTs suggested that future graduates may need a longer preceptorship after they graduate due to receiving decreased clinical experience during the pandemic. Overall, 78% (n = 46) of respondents thought that students improved their clinical confidence by working directly with COVID-19 positive patients. CONCLUSION: The current study has identified conflicting opinions across CTs in different clinical departments. Whilst some felt that students should not be in the hospital during the pandemic, others reported that working directly with COVID-19 patients had a positive impact on students as it improved their clinical confidence. Despite the challenges presented by COVID-19, CTs were able to provide direct clinical supervision and feedback to students on clinical placement throughout the pandemic. Nevertheless, future graduates may need a longer preceptorship period due to decreased clinical experience during the pandemic. IMPLICATIONS FOR PRACTICE: Clinical placements should continue during subsequent COVID-19 waves of infection or future pandemics to ensure development of skills in resilience and adaptability. Underdeveloped skills due to a decreased range of examinations can be rectified when any wave of the infection subsides by providing tailored training based on individual student's needs.

Tutor Uncertainty in Dealing with Unprofessional Behaviours of Medical Students and Residents: a Mixed Methods Study.

BACKGROUND: Despite acknowledgement of medical students' expected professional behaviours and attitudes, there remains widespread reluctance to report students that behave inappropriately. Existing literature focuses on why faculty fail to fail, overlooking the tutors who deal with students day to day. We investigated how tutors address inappropriate behaviours and attitudes in students and residents. METHODS: A mixed methods study was carried out consisting of a survey and two focus groups with tutors. Seventeen tutors from the University of Limerick School of Medicine, Ireland, took part in the survey (n = 22%) and eight tutors participated in two focus groups during the 2018-2019 academic year. RESULTS: Findings suggested that 59% of tutors would take a different approach to addressing unprofessional behaviours witnessed in medical students and residents. A total of 88% of tutors said they intervened on a professionalism issue with 52% saying 'once in a while'. In contrast to the survey, tutors in the focus groups expressed a lack of confidence in addressing some behaviours due to a lack of time, not seeing the outcome of process/remediation etc. Tutors indicated a strong preference for case-based training on assessing professional identity formation (PIF). CONCLUSIONS: We found tutors typically work closely with students on a day-to-day basis managing unprofessionalism issues. Tutors valued regular communication about policies and procedures about appropriate conduct as well as support, advice, and/or oversight from independent members of university staff. This research highlights the need for training designed for busy tutors as a distinct type of medical teacher. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-021-01429-1.

Necesidades de formación docente: ¿qué perciben los tutores de Fisioterapia? / Teaching training needs: what do physiotherapy tutors perceive?

Introducción: La docencia clínica se diferencia de la docencia de aula en que está más estrechamente vinculada al desarrollo del perfil de egreso de los profesionales de la salud y ocurre en espacios de atención directa al paciente. Por ello, requiere formación y competencias específicas de los tutores clínicos que guían ese momento formativo. Material y método: Se realizó un estudio cuantitativo, donde se encuestó a 70 tutores clínicos de Fisioterapia. A éstos se les aplicó el cuestionario de necesidades de formación docente, previo consentimiento informado. Resultados: Los tutores clínicos perciben como prioridad la formación en el desarrollo integral de los estudiantes en un 89%. Conclusión: Los resultados muestran que los tutores clínicos enfatizan sus necesidades del perfeccionamiento docente en el desarrollo de competencias clínicas y en el desarrollo integral de los estudiantes. Sin embargo, las percepciones de otras áreas de formación docente presentan menor relevancia para el período clínico.(AU)

Introduction: The clinical teaching differs from classroom teaching in that it is more closely linked to the development of the graduation profile of health professionals and occurs in areas of direct patient care. For the same, requires training and specific skills of the clinical tutors who guide this formative moment. Material and method: A quantitative study was carried, where 70 clinical tutors were surveyed. To these, the teacher training needs questionnaire was applied, with prior informed consent. Results: The clinical tutors perceive training in the integral development of students as a priority 89%. Conclusion: The results show that clinical tutors emphasize their needs for teacher improvement in the development of clinical skills and in the comprehensive development of students. However, the perceptions of other areas of teacher training are less relevant for the clinical period.(AU)

El perfil del tutor clínico en los escenarios actuales / The profile of the clinical tutor in current settings

Actualmente, uno de los objetivos de la educación médica es proporcionar a los estudiantes la oportunidad de desarrollar habilidades clínicas y competencias profesionales. Por lo cual el docente tutor generador de aprendizaje debe poseer las herramientas necesarias para ello. La tutoría clínica, es una estrategia fundamental en la enseñanza de los saberes de las ciencias médicas. Considerada como educación "no formal" en contraste con la educación tradicional de las aulas, la enseñanza en los ambientes clínicos tiene su propia estructura o formas de enseñanza. En este sentido, el docente tutor debe reconocer cuáles son las funciones de la tutoría clínica, para así, establecer objetivos claros que respondan al programa de formación de un profesional y que permita la conducción de la tutoría de manera óptima, generando en el estudiante aprendizaje significativo. Esta revisión tiene por objetivo entregar información actualizada respecto al abordaje actual de la tutoría clínica en las carreras del área de salud y describir las competencias pedagógicas que debe tener un tutor clínico.

Currently, one of the goals of medical education is to provide students with the opportunity to development clinical skills and professional competencies. Therefore, the tutor generator learning must have the necessary tools to do. Clinical tutoring is a fundamental strategy in the teaching of knowledge of medical sciences. Considered as "non-formal" instruction in contrast to traditional classroom instruction, teaching in clinical settings has its own structure or forms of teaching. Therefore, the tutor teacher must recognize what are the functions of clinical tutoring, in order to establish clear objectives that respond to the training program of a professional and that allow the conductivity of the tutoring in an optimal way, generating meaningful learning in the student. This review aims to provide updated information regarding the current approach to clinical tutoring in health careers and to describe the pedagogical competencies that should have a clinical tutor.

Resultados de una capacitación sobre retroalimentación efectiva para tutores clínicos de internado de universidades chilenas / Results of a training activity about effective feedback for internship clinical preceptors in Chilean universities

Introducción: La retroalimentación es una competencia docente central en los procesos evaluativos, porque favorece aprendizajes de mejor calidad. Sin embargo, es necesario formar a los docentes para que logren desarrollarla. El presente estudio buscó analizar los resultados de una capacitación en línea en retroalimentación efectiva a tutores clínicos de internado de universidades chilenas pertenecientes a la Red Nacional de Unidades de Educación Médica y Ciencias de la Salud. Sujetos y métodos: Estudio cuantitativo, preexperimental, de corte transversal y con alcance analítico relacional. Los 29 participantes fueron elegidos con una estrategia de muestreo no probabilística y por voluntarios. Participaron en una capacitación en línea sobre retroalimentación efectiva. Antes y después de la capacitación, sus desempeños en retroalimentación se observaron con un estudiante simulado en una entrevista por videoconferencia. Para calificar su desempeño, se empleó la rúbrica de observación directa de retroalimentación de habilidades clínicas. Al final, también respondieron una encuesta de satisfacción de capacitación. Resultados: Todos los participantes mejoraron su desempeño realizando retroalimentación tanto en general como en ocho de los nueve criterios evaluados. Sólo el ítem de retroalimentación no presentó diferencias significativas y fue bien valorado en ambas evaluaciones. Además, los participantes evidenciaron un alto nivel de satisfacción con la intervención. Conclusiones: Una capacitación acotada en retroalimentación efectiva a tutores clínicos de internado, bien planificada, con objetivos de aprendizaje claros y utilizando diversas estrategias de enseñanza mejora su desempeño entregando retroalimentación y con un alto nivel de satisfacción de los participantes.(AU)

Introduction: Feedback is a central teaching competence in evaluation processes because it favors better quality learning. However, teachers need to be trained to develop it. This study aims to analyze the results of an online training in effective feedback to tutors of clinical practices of Chilean universities belonging to the National Network of Units of Medical Education and Health Sciences. Subjects and methods: A quantitative, pre-experimental, cross-sectional study with a relational analytical scope. The 29 participants were chosen with a non-probability sampling strategy and by volunteers. They participated in an online training on effective feedback. Before and after the training, their performance in feedback was observed with a simulated student in a video conference interview. The Direct Observation of Clinical Skills Feedback rubric was used to rate their performance. At the end, they also answered a Training Satisfaction Survey. Results: All participants improved their performance by providing feedback, with statistically significant results in 8 items (p < 0.001), only the item ‘Feedback was carried out in a respectful manner’ did not present significant differences (p = 0.569), being well valued in both evaluations. Furthermore, the participants showed a high level of satisfaction with the intervention. Conclusions: A limited training in effective feedback to clinical internship tutors, well planned, with clear learning objectives and using various teaching strategies, improves their performance by providing feedback and with a high level of satisfaction of the participants.(AU)

Optimal clinical setting, tutors, and learning opportunities in medical education: A content analysis.

INTRODUCTION: As an integral and the most important part of medical education, clinical education provides the opportunity to prepare medical students as professionals. This study explores the standpoints of informants concerning the optimal conditions for clinical education and its components, including learning opportunities, clinical settings, and clinical tutors, with the aim to improve clinical teaching and standards. METHODS: The study design is built on qualitative content analysis with the directed approach. The participants were selected using purposive sampling with maximum variation, and the data were collected through online focus group discussion (FGD) and semi-structured individual interviews conducted either face-to-face or on the telephone. RESULTS: Twenty vice-chancelleries of education and medical education planners from across the country participated in this study. Concepts resulted in four main categories: educational settings, tutors, creating learning opportunities, and learning situations. The concepts were sorted into 15 subcategories, also 21 subclass 1 and 14 subclass 2. The most extensive subcategories comprised variety of educational settings, teaching team conditions, and learning strategies. CONCLUSION: Optimal conditions for clinical education are associated with the use of educational settings close to the real workplace of general practitioners such as general inpatient settings, outpatient settings, and emergency department. Moreover, optimal conditions require the provision of learning opportunities by organized team of tutors and team member empowerment along with policy-making and planning on the national scale by the Ministry of Health in consideration of local conditions.

Percepción de las competencias docentes del tutor clínico según estudiantes de odontología de universidad chilena / Perception of the teaching competencies of the clinical tutor according to dentistry students of a Chilean university

Introducción: La etapa clínica de la carrera de Odontología involucra la atención de pacientes bajo la supervisión de tutores clínicos, los cuales no solo deben ser instructores de técnicas, sino que además, demostrar habilidades del saber, saber hacer y saber ser. Actualmente, no se cuenta con un instrumento específico para medir competencias docentes en tutores de odontología en la Universidad de Concepción. Objetivos : Evaluar la validez y confiabilidad de un instrumento de medición de competencias docentes del tutor de Odontología. Determinar la percepción de las competencias docentes que exhibe el tutor clínico según los estudiantes del ciclo clínico de la carrera de Odontología de una universidad tradicional chilena. Métodos: Estudio no experimental de alcance analítico relacional y corte transversal en muestra no probabilística de 70 estudiantes de ciclo clínico de Odontología de la Universidad de Concepción. Se determinaron propiedades psicométricas del Cuestionario de Evaluación de Docentes Clínicos de Odontología (CEDC-O) y se aplicó para analizar la percepción de las competencias docentes. Resultados: CEDC-O presentó propiedades psicométricas adecuadas para evaluar competencias docentes de tutores de Odontología, encontrándose tres factores. Los estudiantes consideraron que sus tutores asignaron autonomía y tareas clínicas acorde a su nivel de experiencia, pero consideraron que no los estimularon a pensar en cómo potenciar sus fortalezas. Conclusión: El CEDC-O presenta evidencia de validez para utilizarlo en tutores de Odontología. Los estudiantes de este estudio tienen una percepción moderada de las competencias docentes de sus tutores, haciendo énfasis en la falta de feedback efectivo(AU)

Introduction: The clinical phase of dental career involves real patients treatment under the supervision of clinical tutors, who mustn´t be just instructors of techniques, but also demonstrate skills of "to know, to know how and to know how to be". Currently, there is no specific instrument that measures teachers competencies in tutors of dentistry at the University of Concepcion. Objectives : Evaluate the validity and reliability of an instrument of measurement of teaching competences of the tutor of dentistry. Establish the perception of the teaching competences that the clinical tutor shows according to students of the clinical cycle of the dental career of a traditional Chilean university. Methods : Cross-sectional study in a non-probabilistic sample of 70 students from the clinical cycle of dentistry of the University of Concepción. The psychometric properties of the Evaluation Questionnaire for Clinical Teachers of Dentistry (CEDC-O) were determined and applied to analyze the perception of teaching competencies. Results: CEDC-O presented adequate psychometric properties to evaluate teacher competences of tutors of dentistry, with three factors. The students considered that their tutors assigned autonomy and clinical tasks according to their level of experience, but considered that they didn´t stimulate them on how to increase their strengths. Conclusion: The results showed that CEDC-O presents evidence of validity for use in dental tutors, and that students of this study have a moderate perception of the teaching competencies of their clinical tutors, emphasizing the lack of effective feedback(AU)

Percepción de los estudiantes de la especialización en enfermeras sobre tutpría clínica en áreas críticas / Perception of the students of the specialization in nurses on clinical tutpría in critical areas / Percepção dos estudantes da especialização em enfermeiros em tutpría clínica em áreas críticas

La presente investigación es un acercamiento al fenómeno de la tutoría clínica en áreas críticas, el objetivo fue analizar la percepción que tienen los estudiantes de la especialización en enfermería que realizan prácticas en áreas críticas respecto a la forma que se lleva a cabo y la función que cumple la tutoría. Se trata de una investigación cualitativa en el marco dela fenomenología interpretativa. Para la obtención de datos se diseñó una entrevista semi estructurada con preguntas tema, se aplicó a seis estudiantes que cursaron el segundo semestre de la especialización en enfermería del adulto en estado crítico. El análisis de datos se realizó de acuerdo al análisis de contenido; surgieron cinco categorías: percepción del estudiante, fortalezas y debilidades vividas, mediación para el aprendizaje, entorno situacional de la tutoría y función y finalidad. La percepción del estudiante permitió identificar los aciertos y faltas en la dinámica establecida en este proceso: correlacionado con lo revisado en la literatura se cumplen los objetivos del estudio por lo que se considera que la tutoría clínica es el proceso pedagógico que contribuye a la formación de especialistas en enfermería, los conocimientos y actividades que logran vincular de acuerdo a su función forman un plan programado orientado a apoyar y asesorar el proceso de aprendizaje, indispensable en determinados momentos o en situaciones específicas de la práctica clínica.

This research is an approach to the phenomenon of clinical tutoring in critical care, the objetive was to analyze the students´ perception of specialization in nursing who practice in critical care as to how that is donde and the role meets tutoring. This is a qualitative research within the framework of interpreve phenomenology. To obtain design data is a semi-structured interview with questions theme was applied to six students who completed the second half of specialization in Adult Nursing in critical condition. Data analysis was performed according to content analysis, five categorires emerged: Perceptions of student strengths and weaknesses experienced, mediation for learning, situational environment of mentoring and role and purpose. The perception of the student identified the successes and failures in the dynamics established in this process correlated with the literatura reviewed in compliance with the objectives of the study so it is considered that the clinical mentoring is the pedagogical process that contributes to the formation of nurse specialists, knowledge and activities that link does according to its function and form of a plkan designed to support an assist the learning process, essential at certain time or in specific situations, in cllinical practice.

Esta pesquisa é uma abordagem ao fenômeno de tutoria clínica em áreas críticas, o objetivo foi analisar a percepção dos estudantes que se formam nas práticas de desempenho de enfermagem em áreas críticas a respeito de como ele é realizado e função ele conhece a tutoria. Trata-se de uma pesquisa qualitativa no âmbito da fenomenologia interpretativa. Para coleta de dados a entrevista semi-estruturada com perguntas destinadas tema, seis estudantes que tenham concluído no segundo semestre de especialização em enfermagem gravemente doente adulto foi aplicado. A análise dos dados foi realizada de acordo com a análise de conteúdo; Eles emergiram cinco categorias: percepção dos pontos fortes e fracos dos alunos experientes, a mediação para a aprendizagem, ambiente situacional mentoring e função e finalidade. A percepção do aluno identificou os sucessos e fracassos nas dinâmicas estabelecidas neste processo correlacionado com objetivos do estudo da literatura revista por isso é considerado que a orientação clínica é o processo pedagógico que contribui para a formação de met especialistas de enfermagem, conhecimentos e atividades que não conseguem ligar a sua função de acordo com um plano programado são projetados para apoiar e aconselhar o processo de aprendizagem, que é essencial em determinados momentos ou em situações específicas de prática clínica.

Influence of Clinical Tutors' Personality on Medical Ethics Formation of Medical Interns / 中国医学伦理学

Clinical tutors' personality manifesting during the process of clinical practice and daily communication with medical interns has a series of influences on medical ethics formation of medical interns,including influences of direction,demonstration,contraction,and halo effect.Thus,clinical tutors should pay attention to cultivating a decent moral personality,and hospitals should value the proper combination of moral evaluation and supervision for medical staff in order to achieve the unity of heteronomous morality and self discipline,and effectively promote the formation of decent morality and personality of clinical tutors.