Peer-assisted learning (PAL) can occur informally as part of a medical programme and complements the formal curriculum. However, little is known about the mechanisms and processes of how informal peer-assisted learning (IPAL) is enacted.
Materials and Methods
This paper presents data from an ethnographic and semi-structured interview study with Year 1 and 2 undergraduate medical students at a UK university.
Results
Peers were observed assisting each other informally: a process that developed as part of the integrated, group-based approach to undergraduate medical education at a UK university. IPAL took place both within and outside of formal teaching sessions and included explanation/clarification of particular points, sharing resources, guiding pronunciation and demonstrating skills. Students placed a high value on IPAL and believed that it was beneficial. When IPAL broke down, this led to negative emotions that presented obstacles to learning, such as resentment.
Conclusions
IPAL is an important part of academic support for medical students, and this work shows both its scope, extending from formal to informal teaching, and how it is enacted. This understanding can help educators situate IPAL within student education.
{"title":"Informal peer-assisted learning amongst medical students: A qualitative perspective","authors":"Timothy J. Morris, Sarah Collins, Joanne Hart","doi":"10.1111/tct.13721","DOIUrl":"10.1111/tct.13721","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Peer-assisted learning (PAL) can occur informally as part of a medical programme and complements the formal curriculum. However, little is known about the mechanisms and processes of how informal peer-assisted learning (IPAL) is enacted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This paper presents data from an ethnographic and semi-structured interview study with Year 1 and 2 undergraduate medical students at a UK university.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Peers were observed assisting each other informally: a process that developed as part of the integrated, group-based approach to undergraduate medical education at a UK university. IPAL took place both within and outside of formal teaching sessions and included explanation/clarification of particular points, sharing resources, guiding pronunciation and demonstrating skills. Students placed a high value on IPAL and believed that it was beneficial. When IPAL broke down, this led to negative emotions that presented obstacles to learning, such as resentment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>IPAL is an important part of academic support for medical students, and this work shows both its scope, extending from formal to informal teaching, and how it is enacted. This understanding can help educators situate IPAL within student education.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.13721","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
James Schuster-Bruce, Eleanor Crossley, David Peters, Ananth Sathyanath, Daghni Rajasingam, Venu Shylaja, Irfan Syed, Raj Lakhani
Background
A surgical team works in a high-performance environment and is exposed to stress. Mindfulness practice is evidenced to reduce symptoms of stress, as well as burnout, which is high amongst health workers. The operating theatre is unique, with many job-roles, needs and time-critical tasks. It is plausible that group mindfulness may benefit the surgical team. This evaluates the take-5 theatre brief, consisting of a ‘check-in’ and short breathwork, when used by two surgical teams as part of the regular theatre team brief.
Approach
The take-5 theatre brief was evaluated using domains of acceptability and implementation. Data were collected at two district general hospitals in the United Kingdom using 5-point Likert scales hosted on electronic surveys Thematic analysis was performed of participant voice notes, strategic meeting notes and transcripts of interviews between key informants.
Evaluation
There were 17 participants. Ten were from site A (59%), with the remainder being from site B (41%) and covered a range of roles within the theatre team. Participants found the take-5 theatre brief helpful (median Likert 5) and felt that it would benefit themselves (median Likert 5) as well as the team (median Likert 5) and that it fitted into the day easily (median Likert 4). There was a high demand, no financial investment was required and overall it was easy to implement; however, it became challenged in theatre lists that were late to start.
Implication
The take-5 theatre brief is an acceptable initiative for these two operating theatre teams.
{"title":"The ‘take-5 theatre brief’: Group mindfulness practice for operating theatre teams","authors":"James Schuster-Bruce, Eleanor Crossley, David Peters, Ananth Sathyanath, Daghni Rajasingam, Venu Shylaja, Irfan Syed, Raj Lakhani","doi":"10.1111/tct.13735","DOIUrl":"10.1111/tct.13735","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A surgical team works in a high-performance environment and is exposed to stress. Mindfulness practice is evidenced to reduce symptoms of stress, as well as burnout, which is high amongst health workers. The operating theatre is unique, with many job-roles, needs and time-critical tasks. It is plausible that group mindfulness may benefit the surgical team. This evaluates the take-5 theatre brief, consisting of a ‘check-in’ and short breathwork, when used by two surgical teams as part of the regular theatre team brief.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>The take-5 theatre brief was evaluated using domains of acceptability and implementation. Data were collected at two district general hospitals in the United Kingdom using 5-point Likert scales hosted on electronic surveys Thematic analysis was performed of participant voice notes, strategic meeting notes and transcripts of interviews between key informants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>There were 17 participants. Ten were from site A (59%), with the remainder being from site B (41%) and covered a range of roles within the theatre team. Participants found the take-5 theatre brief helpful (median Likert 5) and felt that it would benefit themselves (median Likert 5) as well as the team (median Likert 5) and that it fitted into the day easily (median Likert 4). There was a high demand, no financial investment was required and overall it was easy to implement; however, it became challenged in theatre lists that were late to start.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implication</h3>\u0000 \u0000 <p>The take-5 theatre brief is an acceptable initiative for these two operating theatre teams.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emotional intelligence (EI) of physicians significantly impacts their personal well-being and professional success with broad implications in health care. A focused training on EI is often lacking in medical curricula. We sought to understand the impact of improvisation training on clinicians' EI.
Approach
Four online medical improv workshops were offered to a diverse group of physicians with varied levels of practice experience including medicine-paediatric residents, paediatric educators, practising paediatricians and internal/family medicine clinicians. The improv training was thoughtfully curated and remained consistent for all four cohorts, lasting 2 h. Self-reported EI scales (pre and post) were captured using an online survey tool. The overall EI score and the scores of three EI components were compared before and after training.
Evaluation
Out of 64 participants, 41 participants (64%) completed both the pre- and post-surveys and were included in the final analysis. Participant's pre-training score (mean:123.9, range: 121.1–126.7) was compared to their post-training score (mean:128.9, range: 126.3–131.3). The t tests comparing EI scores showed that compared to pre-intervention, participants on average scored 4.9 points higher (95% CI: 3.1–6.7; p < 0.01) on the overall scale, 2.2 points higher (95% CI: 1.2–3.2; p < 0.01) on the appraisal score, 1.4 points higher (95% CI: 0.8–2.0; p < 0.01) on the regulation score and 1.2 points higher (95% CI: 0.4–2.1; p = 0.01) on the utilisation score.
Implications
Improv training is an innovative method to fill the crucial gap in EI curricula. There was a statistically significant improvement in average score for clinicians' EI after a pilot improv training programme.
背景：医生的情商（EI）对他们的个人幸福和职业成功有重大影响，并对医疗保健产生广泛影响。医学课程中往往缺乏对情商的集中培训。我们试图了解即兴表演培训对临床医生情商的影响：方法：我们为具有不同执业经验的医生提供了四个在线医学即兴表演讲习班，这些医生包括儿科住院医师、儿科教育工作者、儿科执业医师和内科/家庭医学临床医师。即兴表演培训经过精心策划，四组学员的培训时间保持一致，均为 2 小时。对培训前后的总 EI 分数和三个 EI 要素的分数进行了比较：在 64 名学员中，有 41 名学员（64%）完成了培训前后的问卷调查，并被纳入最终分析。学员的培训前得分（平均值：123.9，范围：121.1-126.7）与培训后得分（平均值：128.9，范围：126.3-131.3）进行了比较。比较 EI 分数的 t 检验显示，与干预前相比，参与者的平均得分高出 4.9 分（95% CI：3.1-6.7；P 暗示）：即兴表演培训是一种创新方法，可以填补情商课程的重要空白。在试点即兴表演培训课程后，临床医生的情商平均得分有了统计学意义上的显著提高。
{"title":"Intelligent play: How improv can improve clinician's emotional intelligence","authors":"Ankit Mehta, Brett Hendel-Paterson, Nilesh Shah, Jesse Hemphill, Nell Adams, Mary Fredrickson","doi":"10.1111/tct.13730","DOIUrl":"10.1111/tct.13730","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emotional intelligence (EI) of physicians significantly impacts their personal well-being and professional success with broad implications in health care. A focused training on EI is often lacking in medical curricula. We sought to understand the impact of improvisation training on clinicians' EI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>Four online medical improv workshops were offered to a diverse group of physicians with varied levels of practice experience including medicine-paediatric residents, paediatric educators, practising paediatricians and internal/family medicine clinicians. The improv training was thoughtfully curated and remained consistent for all four cohorts, lasting 2 h. Self-reported EI scales (pre and post) were captured using an online survey tool. The overall EI score and the scores of three EI components were compared before and after training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>Out of 64 participants, 41 participants (64%) completed both the pre- and post-surveys and were included in the final analysis. Participant's pre-training score (mean:123.9, range: 121.1–126.7) was compared to their post-training score (mean:128.9, range: 126.3–131.3). The <i>t</i> tests comparing EI scores showed that compared to pre-intervention, participants on average scored 4.9 points higher (95% CI: 3.1–6.7; <i>p</i> < 0.01) on the overall scale, 2.2 points higher (95% CI: 1.2–3.2; <i>p</i> < 0.01) on the appraisal score, 1.4 points higher (95% CI: 0.8–2.0; <i>p</i> < 0.01) on the regulation score and 1.2 points higher (95% CI: 0.4–2.1; <i>p</i> = 0.01) on the utilisation score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>Improv training is an innovative method to fill the crucial gap in EI curricula. There was a statistically significant improvement in average score for clinicians' EI after a pilot improv training programme.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.13730","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kathleen L. Mulligan, Elina Kurkurina, Rahul Anand
{"title":"From concept to clinical application: The importance of including trust in low-value care curricula","authors":"Kathleen L. Mulligan, Elina Kurkurina, Rahul Anand","doi":"10.1111/tct.13736","DOIUrl":"10.1111/tct.13736","url":null,"abstract":"","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katherine Neff, Erin McKean, Madison Miller, James T. Fitzgerald, Lauren Owens, Helen K. Morgan
Background
As the gender demographics of medical students have evolved over the past decades, it is important to understand potential stressors and challenges that may affect clinical learning experiences. This study investigated the prevalence of prior sexual assault (SA) and interpersonal violence (IPV) in medical students and how these affect their clinical clerkship experiences.
Methods
A survey was distributed to third- and fourth-year medical students at a single institution in August 2022 querying respondents on demographics and prior experiences with SA/IPV at any point in their lives. Respondents who indicated they had previously experienced SA/IPV were directed to questions about how these experiences affected clerkships.
Findings
Of 419 students, 125 responded to the survey (30.8% response rate). Forty (31.1%) reported a history of SA/IPV—32 (80.0%) women, five (12.5%) men, and three (7.5%) who did not report gender or identified as non-binary. Of the 40 respondents with a history of SA/IPV, 20 (50.0%) reported that their prior history affected their overall clinical experience, and nine (22.5%) felt that it affected their performance. Only seven (17.5%) reported using any resources, such as counselling, during their clerkships. Narrative responses discussed significant effects on performing physical exams, taking a history, interacting with team members, and engaging during clerkships.
Discussion
This work demonstrates the high number of students affected by SA/IPV and how these prior experiences affected core components of their clerkship experiences.
Conclusions
Institutions must be proactive to create better supports for learners with histories of trauma, including SA/IPV.
{"title":"How medical students' trauma histories affect their clinical clerkship experiences","authors":"Katherine Neff, Erin McKean, Madison Miller, James T. Fitzgerald, Lauren Owens, Helen K. Morgan","doi":"10.1111/tct.13734","DOIUrl":"10.1111/tct.13734","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>As the gender demographics of medical students have evolved over the past decades, it is important to understand potential stressors and challenges that may affect clinical learning experiences. This study investigated the prevalence of prior sexual assault (SA) and interpersonal violence (IPV) in medical students and how these affect their clinical clerkship experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A survey was distributed to third- and fourth-year medical students at a single institution in August 2022 querying respondents on demographics and prior experiences with SA/IPV at any point in their lives. Respondents who indicated they had previously experienced SA/IPV were directed to questions about how these experiences affected clerkships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Of 419 students, 125 responded to the survey (30.8% response rate). Forty (31.1%) reported a history of SA/IPV—32 (80.0%) women, five (12.5%) men, and three (7.5%) who did not report gender or identified as non-binary. Of the 40 respondents with a history of SA/IPV, 20 (50.0%) reported that their prior history affected their overall clinical experience, and nine (22.5%) felt that it affected their performance. Only seven (17.5%) reported using any resources, such as counselling, during their clerkships. Narrative responses discussed significant effects on performing physical exams, taking a history, interacting with team members, and engaging during clerkships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This work demonstrates the high number of students affected by SA/IPV and how these prior experiences affected core components of their clerkship experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Institutions must be proactive to create better supports for learners with histories of trauma, including SA/IPV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephen Billett, Christy Noble, Nancy Sturman, Megan O'Shannessy, Kay Brumpton, Anh Hai Le
Background
Securing access to sufficient and focussed learning experiences is a perennial challenge for medical trainees. This challenge was accentuated during the COVID-19 pandemic lockdowns and with physical isolation processes that decreased in-person patient presentations and a shift to telehealth consultations. This situation has prompted the need to optimise the available experiences and educational responses to overcome the limitations in the number, quantum and range of available clinical learning experiences.
Methods
Semi-structured interviews were conducted with medical practice teams in four rural general practices to understand how medical trainees' education in rural general practices can be sustained in such circumstances.
Findings
Key considerations included optimising the available experiences to assist medical trainees to generate the kinds of mental models needed by trainees to conduct medical work, and particularly, when it became even more restricted through remote or physically distanced consultations. It also identified lessons learnt during COVID-19 pandemic lockdowns to inform and improve the provision of trainees' experiences in such practices.
Discussion
Providing experiences for trainees to participate fully in clinical activities is imperative. A sequenced set of experiences was proposed to incrementally prepare trainees to engage in and conduct clinical consultations remotely using digital technologies.
Conclusion
Such an approach may not always be easy or possible to enact but offers a pathway of experiences most likely to lead to positive outcomes for the trainees whilst maintaining patient care and safety considerations.
{"title":"Reimagining rural clinical education from lessons learnt during COVID","authors":"Stephen Billett, Christy Noble, Nancy Sturman, Megan O'Shannessy, Kay Brumpton, Anh Hai Le","doi":"10.1111/tct.13732","DOIUrl":"10.1111/tct.13732","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Securing access to sufficient and focussed learning experiences is a perennial challenge for medical trainees. This challenge was accentuated during the COVID-19 pandemic lockdowns and with physical isolation processes that decreased in-person patient presentations and a shift to telehealth consultations. This situation has prompted the need to optimise the available experiences and educational responses to overcome the limitations in the number, quantum and range of available clinical learning experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted with medical practice teams in four rural general practices to understand how medical trainees' education in rural general practices can be sustained in such circumstances.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Key considerations included optimising the available experiences to assist medical trainees to generate the kinds of mental models needed by trainees to conduct medical work, and particularly, when it became even more restricted through remote or physically distanced consultations. It also identified lessons learnt during COVID-19 pandemic lockdowns to inform and improve the provision of trainees' experiences in such practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Providing experiences for trainees to participate fully in clinical activities is imperative. A sequenced set of experiences was proposed to incrementally prepare trainees to engage in and conduct clinical consultations remotely using digital technologies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Such an approach may not always be easy or possible to enact but offers a pathway of experiences most likely to lead to positive outcomes for the trainees whilst maintaining patient care and safety considerations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.13732","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Harry Carter, Sally Hanks, Robert Johnson, Thomas Gale
Capability is the ability to perform clinical skills in ever-changing real world contexts, adapting to challenges and integrating technical and non-technical skills and competencies, for example, cannulating an uncooperative patient at night. Going beyond teaching competency and ensuring capability is imperative, as recommended by the national outcomes for medical graduates. A course on intravenous cannulation was developed with e-learning modules and high-fidelity complex simulation scenarios, aiming to promote capability in practice. The course delivered an intravenous cannulation e-learning package between two practical simulations to 10 final-year medical students. The hybrid simulation design consisted of an actor with a bespoke cannulation part-task trainer strapped to their arm. Each simulation delivered a challenging scenario, requiring the integration of procedural and behavioural skills to succeed. Simulations were video recorded, and participants reviewed their performances before completing semi-structured interviews. Transcribed interviews were thematically analysed. Interview analysis demonstrated two overarching themes: ‘Impact on Capability’ and ‘Preparedness for Practice’. There was consistent recognition of improved capability from the interviews. Simulation exercises were described as the most valuable tool for developing capability. The e-learning helped with structure, facilitating students' adaptation to scenarios. Participants felt that training in medical school was largely competency-based and did not tackle complex interactions. Following e-learning and simulations, students felt more prepared for clinical practice. The course structure has value for medical professionals in developing capability and preparing for clinical practice, helping to reach standards expected of graduates. Plans to assess capability across multiple undergraduate programmes through Entrustable Professional Activities are in progress.
{"title":"Educating for capability and preparing for practice: Integrating theory and skills","authors":"Harry Carter, Sally Hanks, Robert Johnson, Thomas Gale","doi":"10.1111/tct.13725","DOIUrl":"10.1111/tct.13725","url":null,"abstract":"<p>Capability is the ability to perform clinical skills in ever-changing real world contexts, adapting to challenges and integrating technical and non-technical skills and competencies, for example, cannulating an uncooperative patient at night. Going beyond teaching competency and ensuring capability is imperative, as recommended by the national outcomes for medical graduates. A course on intravenous cannulation was developed with e-learning modules and high-fidelity complex simulation scenarios, aiming to promote capability in practice. The course delivered an intravenous cannulation e-learning package between two practical simulations to 10 final-year medical students. The hybrid simulation design consisted of an actor with a bespoke cannulation part-task trainer strapped to their arm. Each simulation delivered a challenging scenario, requiring the integration of procedural and behavioural skills to succeed. Simulations were video recorded, and participants reviewed their performances before completing semi-structured interviews. Transcribed interviews were thematically analysed. Interview analysis demonstrated two overarching themes: ‘Impact on Capability’ and ‘Preparedness for Practice’. There was consistent recognition of improved capability from the interviews. Simulation exercises were described as the most valuable tool for developing capability. The e-learning helped with structure, facilitating students' adaptation to scenarios. Participants felt that training in medical school was largely competency-based and did not tackle complex interactions. Following e-learning and simulations, students felt more prepared for clinical practice. The course structure has value for medical professionals in developing capability and preparing for clinical practice, helping to reach standards expected of graduates. Plans to assess capability across multiple undergraduate programmes through Entrustable Professional Activities are in progress.</p>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.13725","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amanda Godoi, Charlotte Casteleyn, Farazi Virk, Mia McDade-Kumar, Matthew H. V. Byrne, Ahmed Moussa, Patrice Baptiste, Michal Tombs
Background
Medical students' preparedness for clinical practice is well researched, yet little is known on the extent to which students are being prepared for a medical career. This paper reports the construction of a short medical inventory titled eXploring medical sTudents' caReer reAdiness (XTRA) to measure students' career readiness based on Super's theory of career maturity.
Approach
We designed an instrument consisting of a series of 5-point Likert-scale to identify participants competencies regarding career exploration and planning during their undergraduate studies. The instrument was completed by 348 medical students from 41 universities in the United Kingdom. We examined the validity and reliability of the instrument through Exploratory Factor Analysis, Cronbach's coefficient α and Pearson correlation.
Evaluation
Exploratory Factor Analysis revealed that 16 of the 20-items survey were aligned with the exploration stage of Super's theory: Crystallisation (Career goals), Specification (Career pathways) and Implementation (Career accomplishments). The four items that formed two separate statistical factors were specific to a current medical career in the UK. Internal reliability for Super's factor subscales were acceptable (α = 0.71 to α = 0.81). A significant positive relationship was found between students' overall rating of career readiness and the three factors, indicating construct validity.
Implications
The XTRA Inventory is a short instrument with construct and content validity specifically designed to measure career readiness of medical students. Further work on its psychometric properties will help establish this inventory to be used as a guidance and career counselling tool by medical educators and educational institutions in developing career development programmes.
{"title":"Construction and validation of a medical career readiness inventory","authors":"Amanda Godoi, Charlotte Casteleyn, Farazi Virk, Mia McDade-Kumar, Matthew H. V. Byrne, Ahmed Moussa, Patrice Baptiste, Michal Tombs","doi":"10.1111/tct.13733","DOIUrl":"10.1111/tct.13733","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Medical students' preparedness for clinical practice is well researched, yet little is known on the extent to which students are being prepared for a medical career. This paper reports the construction of a short medical inventory titled eXploring medical sTudents' caReer reAdiness (XTRA) to measure students' career readiness based on Super's theory of career maturity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>We designed an instrument consisting of a series of 5-point Likert-scale to identify participants competencies regarding career exploration and planning during their undergraduate studies. The instrument was completed by 348 medical students from 41 universities in the United Kingdom. We examined the validity and reliability of the instrument through Exploratory Factor Analysis, Cronbach's coefficient <i>α</i> and Pearson correlation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>Exploratory Factor Analysis revealed that 16 of the 20-items survey were aligned with the exploration stage of Super's theory: Crystallisation (Career goals), Specification (Career pathways) and Implementation (Career accomplishments). The four items that formed two separate statistical factors were specific to a current medical career in the UK. Internal reliability for Super's factor subscales were acceptable (<i>α</i> = 0.71 to <i>α</i> = 0.81). A significant positive relationship was found between students' overall rating of career readiness and the three factors, indicating construct validity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>The XTRA Inventory is a short instrument with construct and content validity specifically designed to measure career readiness of medical students. Further work on its psychometric properties will help establish this inventory to be used as a guidance and career counselling tool by medical educators and educational institutions in developing career development programmes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.13733","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Virtual-first care: Opportunities and challenges for the future of diagnostic reasoning","authors":"Katharine Lawrence, Devin Mann","doi":"10.1111/tct.13720","DOIUrl":"10.1111/tct.13720","url":null,"abstract":"","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139467397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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