Education for Health最新文献

Background: In India, orderlies are unlicensed hospital assistants instructed to perform delegated tasks under supervision by a licensed health-care giver. They receive on-the-job training, unlike certified nursing assistants. In this study, we have integrated a simulation session in our hospital orderly training program to promote the safe transfer of patients using a low-fidelity mannequin.

Methods: We conducted an interventional study with a mixed methodology in which 280 orderlies were immersed in a simulation session of transferring a mannequin from a bed to either a wheelchair or stretcher. An observer completed a prevalidated 18-item checklist assessing the team's performance on a 3-point global rating scale. Quantitative analysis of the data was done using a Paired t-test of the mean scores of the pre- and posttest. Posttraining, the participants completed a satisfaction questionnaire. Structured interviews with their ward in-charges were conducted 3-month posttraining, and the data were analyzed by thematic coding.

Results: The pre- and posttest scores of team performances for both groups were 33.22 and 45.3, respectively, indicating a statistically significant difference (P < 0.001). Posttraining, the session evaluation revealed that 100% of participants strongly agreed (mean score = 5) that the training was beneficial. The structured interviews revealed improvement in communication and patient interaction without much change in other skills. They found that, overall, this simulation-based training promoted the safe transfer of patients.

Discussion: Improvement in the team performance scores shows the effectiveness of this methodology in ensuring the secure transfer of patients, as well as better teamwork and communication. The results demonstrate that low-fidelity, low-cost simulation can be used effectively to create a formal training program for hospital orderlies.

Background: Very little attention has been given to the social accountability of conferences, either in action or in scholarship, in particular, of scientific conferences. Concerns that have been raised include: (1) Local communities and regions suffer from ecological pressure caused by conferences, (2) There is limited value to the local community, (3) International conferences take place at locations irrelevant to the topics discussed; hence there is no connection with locals, and (4) It has been the observation of the authors that <10% of participants may come from the region where the conference is organized, which makes it challenging to make a "positive societal impact" locally. We conducted a natural experiment investigating the interactions between academia, conference organizers, and community leaders.

Methods: We utilized a case study approach to report on the outcomes of two 2022 annual international conferences that seek to improve community health. We used a mixed-methods approach of surveys and interviews. Thematic analysis was conducted to identify the key themes.

Results: We obtained 358 responses from all six World Health Organization regions. Results from both conferences were split into two categories: the why and the how. A strong consensus among participants is that bi-directional learning between conference organizers and local communities leads to shared understanding and mutual goals. The data emphasize that including communities in academic conferences helps us progress forward from intentions toward demonstrating accountability and reporting impact.

Discussion: A diversity of perspectives is needed to advance socially accountable health system transformation. Five best practices from conference participants are laid out as a framework to assist in the change: (1) Build trust, (2) provide funding for community member participation, (3) appreciation of local community knowledge, (4) involve the local community in the planning stages, and (5) make the local community part of the conference and learning.

Background: Team-based learning (TBL) refers to the application of an active-learning method that has gained popularity across all health-care disciplines. This study aimed to assess nutrition students' perceptions of the roles of student versus faculty facilitators.

Methods: Participants in the study included, 117 2nd-year nutrition students registered in the "Introduction to Medicine" course in the 2022 academic year at a Japanese university. The first TBL session was faculty-led, whereas three students served as facilitators in the second. Upon completion of the course, learners and student facilitators completed a questionnaire on the student-led TBL. Responses to close-ended questions were analyzed using descriptive statistics, and those to open-ended questions were categorized into common themes.

Results: A total of 114 learners and 3 student facilitators responded to the questions. Learners found student-led TBL to be just as or more effective than faculty-led TBL in three respects: comprehension (93.0%), active participation (96.5%), and expectation of academic performance improvement (93.9%). According to student facilitators, it improved their knowledge, confidence, communication skills, and leadership abilities. Learners and facilitators indicated that student-led TBL was significantly more effective than faculty-led TBL. Thus, student-led TBL can enhance the ability of all students at different academic levels.

Discussion: Student-led TBL appears to be an effective learning strategy in higher education and further shifts toward student-centered learning in the course curriculum.

Background: The impact of conflict and war crisis on dental students is poorly understood. Given the prolonged conflicts and political instability in the Arabic-speaking countries, it is crucial to investigate the effect of these conditions on dental students. This study aimed to assess the impact of protracted war on dental students by comparing the personal, university, and wider context challenges they face across war-affected and unaffected countries.

Methods: A cross-sectional study was conducted including a convenience sample of dental students from 13 universities in 12 Arabic-speaking countries. Respondents were those at entry and exit points of their undergraduate dental training. A self-administered paper questionnaire collected anonymized data on sociodemographics, and personal, university, and wider context challenges that students were facing. Multivariable Poisson regression analyses were carried out.

Results: The overall response rate was 64.8%. The mean age was 21.2 (standard deviation = 2.1) years, with 68% of participants being female. After adjusting for age and sex, dental students in Arabic-speaking countries affected by protracted war crisis were significantly more likely to report wider context challenges compared to their counterparts in unaffected countries (n = 2448; beta = 1.12; 95% confidence interval: 1.10-1.13; P < 0.001).

Discussion: Dental students in Arabic-speaking countries affected by protracted war crisis were more likely to suffer from wider context challenges such as difficulties in attendance due to the deterioration of security and lack of flexibility of teaching time to accommodate the different circumstances induced by the war crisis. Supporting dental students in areas affected by protracted war crises is needed and may include developing online dental education programs.

Background: To better target rural background and rurally interested applicants during medical school admission, it is increasingly common for rural medical programs to include multiple mini-interview (MMI) scenarios designed to screen for rural interest. It remains unclear whether the inclusion of regionally/rurally focused MMI scenarios positively impacts the selection of rural background applicants and evidence is limited regarding why rural background applicants may perform worse on the MMI. Therefore, this study explored how rural and metropolitan applicants prepare for and perceive the MMI for admission to a regional medical pathway.

Methods: A mixed-methods survey was sent to provisional entry regional pathway medical school applicants who had completed an MMI. The survey was distributed before any offers of admission had been released.

Results: Rural applicants spent less time and money preparing for the MMI and felt less prepared (P < 0.05). However, time and money spent, and resources used to prepare were not associated with feeling more prepared (all P > 0.05). Respondents mostly felt that the MMI process aligned with their expectations (83%), is fair (64%), and helps a rural program select the most suitable applicants (61%). Rural applicants generally felt that they had an advantage over other applicants (61%) while most metropolitan applicants did not (23%; P = 0.002).

Discussion: Applicants to a regional medical pathway are generally supportive of the MMI process. It appears valuable for applicants to prepare for the MMI by understanding the format and requirements; however, investing substantial time and money does not underpin feeling better prepared. MMI scenarios which include a regional focus are perceived to advantage rural applicants.

Background: Direct observation is important, yet medical residents are rarely observed. We implemented and evaluated a direct observation program in resident clinics to increase the frequency of observation and feedback and improve perceptions about direct observation.

Methods: We assigned faculty as observers in our resident clinics between June 2019 and February 2020. We surveyed residents and faculty before and after the program. Faculty completed a form for each observation performed. We analyzed surveys to examine changes in barriers, frequency and type of observations and feedback, and attitudes toward observation. The analytical sample included 38 and 37 pre- and postresident surveys, respectively, and 20 and 25 pre- and postfaculty surveys, respectively.

Results: Resident survey response rates were 32.3% (40/124) pre- and 30.7% (39/127) postintervention. Most residents (76% [pre], 86% [post], P = 0.258) reported being observed in at least one of the four areas: history, examination, counseling, or wrap-up. We received observation tracking forms on 68% of eligible residents. Observed history taking increased from 30% to 79% after the program (P = 0.0010). Survey response rates for faculty were 64.7% (22/34) pre- and 67.5% (25/37) postintervention. Fewer faculty reported time (80% [pre], 52% [post], P = 0.051) and competing demands (65% [pre], 52% [post], P = 0.380) as barriers postintervention. Fewer faculty postintervention viewed observation as a valuable teaching tool (100% [pre], 79% [post], P = 0.0534). All faculty who did not view observation as valuable were the least experienced.

Discussion: Assigning faculty as observers can increase observation, especially in history taking, though data suggest an increase in negative perceptions of observation by faculty.

Background: The purpose of this study was to explore the use of a modified nominal group technique (mNGT) to inform the curriculum of a Short Learning Programme for peer mentors in the Bachelor of Clinical Medical Practice (BCMP) program.

Methods: An mNGT was used to achieve group consensus. Research participants included academic staff and students of the BCMP program called clinical associate (ClinA) students. Two sessions of the nominal group techniques (NGTs) were conducted. Two questions were presented: (1) what should be the learning outcomes of a Short Learning Programme for peer mentors for ClinA students? and (2) what learning activities should be included to achieve the intended learning outcomes?

Results: mNGT groups were both concluded in < 2 h and the costs involved were minimal. The priority outcomes of academic staff were to promote and encourage a positive, inclusive environment to enhance student morale; and to provide insight into the roles that peer mentors should fulfill. The primary objectives of academic staff were to foster and support a welcoming, inclusive atmosphere to boost student morale, as well as to offer guidance on the responsibilities that peer mentors should undertake. The top priorities of students were to provide insight into the role of a ClinA and the personal development of peer mentors. Learning activities suggested included time management and personal growth of peer mentors, "how to be an effective mentor," and leadership skills. The outcomes formulated by research participants reflected the graduate attributes listed by the University of Pretoria as well as generic attributes described by international scholars.

Discussion: A common NGT was an inexpensive and time-saving way to obtain rank-ordered data from research participants. This modified method ensured an equitable and inclusive approach, ensuring buy-in from all stakeholders, and is useful in the development of a curriculum for Short Learning Programmes. Both staff and students converged on common outcomes related to academic, psychosocial, and ClinA role support MeSH Terms: Consensus; Curriculum; Humans; Leadership; Mentors; Students.

Background: Feedback is a critical component of education but may not always be delivered in a useful manner. This study assessed surgical nursing students' perception of the feedback they received on a clinical rotation.

Methods: This is a sequential mixed-method study. The first stage surveyed surgical nursing students in surgical units about the feedback they received. In the second stage, participants' experiences receiving feedback were explored in interviews, and analyzed by a conventional content analysis approach.

Results: The majority of nurses found that feedback was not helpful, citing a lack of constructive feedback. Negative feedback was often delivered in a public setting. Comments were frequently based on secondary information rather than direct observation.

Discussion: Feedback to nurses on the surgical unit is not perceived by students as constructive. Clinical teachers did not appear to be aware of the educational effect of the feedback on the learning process of students. In addition, the setting for feedback often undermined its effectiveness. Staff development on effective feedback for teachers on the surgical unit is recommended.