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Evidence-based practice conversations with clinical supervisors during paramedic placements: an exploratory study of students' perceptions. 在护理人员实习期间与临床主管的循证实践对话:对学生认知的探索性研究。
Pub Date : 2020-05-29 DOI: 10.5455/jcme.20191219050921
Emma Bourke Matas, S. Maloney, M. Jepson, K. Bowles
Objective Paramedic education providers teach the latest evidence-based practice when students attend academic classes. Clinical placements are an important aspect of paramedic training, however, they can pose a potential area of conflict regarding approaches to practice, in particular when it comes to evidence-based practice knowledge and decision-making processes. To better understand the continuum between academic classes and clinical placement, this study explored students understanding of evidence-based practice conversations, determined the prevalence of these whilst on clinical placement, and considered whether students believe their future participation in evidence-based practice conversations could be improved. Methods An exploratory cross-sectional self-administered electronic questionnaire was conducted with paramedic students from an Australian university. The questionnaire was validity checked prior to implementation. Results One hundred and sixty-eight 2nd and 3rd year paramedic students completed the questionnaire (response rate = 66%). Although most students (82%) understood what constitutes an evidence-based practice conversation, only 23% reported learning about evidence-based practice conversations, and 18% reported practicing evidence-based practice conversations during their clinical placements. Regression analysis found that the gender of the supervisor and age of the student significantly affected the likelihood of learning about or practicing evidence-based practice conversations (p=0.029, p = 0.049 respectively) whilst on clinical placement. Students did not feel that evidence-based practice questioning would have possible negative repercussions, however most (83%) felt they needed to improve their evidence-based practice communication skills. Conclusions Paramedic students and clinical supervisors rarely engage in evidence-based practice conversations during clinical placement. Further research into evidence-based practice communication in the clinical placement setting is required to ensure a consistent approach to the training of future paramedics.
目的辅助医疗教育提供者在学生上学术课时教授最新的循证实践。临床实习是护理人员培训的一个重要方面,然而,在实践方法方面,尤其是在循证实践知识和决策过程方面,它们可能会造成潜在的冲突。为了更好地理解学术课程和临床实习之间的连续性,本研究探讨了学生对循证实践对话的理解,确定了这些对话在临床实习期间的普遍性,并考虑了学生是否相信他们未来对循证练习对话的参与度可以提高。方法对澳大利亚一所大学的护理专业学生进行了探索性的横断面自填电子问卷调查。问卷在实施前进行了有效性检查。结果168名护理专业二、三年级学生完成了问卷调查(应答率=66%)。尽管大多数学生(82%)理解什么是循证实践对话,但只有23%的学生报告学习了循证实践会话,18%的学生报告在临床实习期间练习了循证练习会话。回归分析发现,导师的性别和学生的年龄显著影响了在临床实习期间学习或实践循证实践对话的可能性(分别为p=0.029和0.049)。学生们并不认为循证实践提问会产生可能的负面影响,但大多数学生(83%)认为他们需要提高循证实践沟通技能。结论在临床实习期间,护理学生和临床督导很少参与循证实践对话。需要进一步研究临床安置环境中的循证实践沟通,以确保未来护理人员的培训方法一致。
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引用次数: 0
The use of mixed methods social network analysis to evaluate healthcare professionals' educator development: an exploratory study. 运用混合方法、社会网络分析评估医疗专业人员教育发展:一项探索性研究。
Pub Date : 2020-02-23 DOI: 10.5455/jcme.20191120122732
Charlotte O Callaghan, J. Sandars, Jeremy M. Brown, C. Sherratt
Introduction: Healthcare professionals’ educator development (HPED) is costly, both financially and in terms of clinicians’ time. However, there is little research into how HPED programmes can be evaluated. Research in other educational fields has demonstrated that the analysis of changes in learners’ social networks and the associated changes in social capital can reveal interesting and important effects of educational programmes which would otherwise be unknown. However, research on the social network impact of HPED is minimal. Aims: The authors present an innovative exploratory study of a new evaluation methodology, which considers the social network and social capital of a participant after completion of a HPED programme. To the best of the authors’ knowledge, this is the first time that such a method has been used in HPED. Method: Mixed methods social network analysis (MMSNA) was used to measure and further understand the social capital of the participant after completion of a HPED programme. Data collection was via a self-report template and a semi-structured interview. An exploratory case study of a medical doctor who completed a HPED programme at master’s level was conducted in October 2018 at Edge Hill University, Ormskirk, England. Results: Relationships made through the HPED programme provided the participant with access to social capital in the form of educational expertise, knowledge and information about job opportunities. These new relationships changed the social network structure, with reduced network constraint and increased number of structural holes in the network of the participant. Such access to resources unavailable to others within the network placed the participant at an ongoing advantage. Conclusion: MMSNA can reveal key benefits of HPED programmes which would not be apparent with other methodologies. The methodology produces results that can be transferred to other HPED programmes.
卫生保健专业人员的教育发展(HPED)是昂贵的,无论是在财政和临床医生的时间方面。然而,很少有关于如何评估HPED项目的研究。其他教育领域的研究表明,对学习者社会网络的变化和相关的社会资本变化的分析可以揭示教育计划的有趣和重要的影响,否则这些影响是未知的。然而,关于HPED对社会网络影响的研究很少。目的:作者提出了一种新的评估方法的创新探索性研究,该方法考虑了完成HPED计划后参与者的社会网络和社会资本。据作者所知,这是第一次在HPED中使用这种方法。方法:采用混合方法社会网络分析(MMSNA)来测量和进一步了解参与者在HPED计划完成后的社会资本。数据收集通过自我报告模板和半结构化访谈。2018年10月,英国奥姆斯科克边山大学对一名完成HPED硕士课程的医生进行了一项探索性案例研究。结果:通过HPED计划建立的关系为参与者提供了以教育专长、知识和就业机会信息形式获得社会资本的途径。这些新的关系改变了社会网络结构,减少了网络约束,增加了参与者网络中的结构漏洞。这种对网络内其他人无法获得的资源的访问使参与者处于持续的优势地位。结论:MMSNA可以揭示HPED规划的关键好处,而其他方法无法明显地显示这些好处。该方法产生的结果可以转移到其他HPED规划。
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引用次数: 0
Assessing community organization needs for medical school Community Service-Learning 评估医学院社区服务学习的社区组织需求
Pub Date : 2020-01-01 DOI: 10.5455/jcme.20191124110830
R. Boles, L. Benedict, Joyce H. L. Lui, Roxanne Wright, F. Leung
Objective While literature exists on student feedback to community service-learning (CSL), community organizations have played a small role in re-shaping CSL within medical curricula. The objective of this study was to analyze feedback from community supervisors involved in a CSL course at University of Toronto’s Faculty of Medicine. Methods Semi-structured one-to-one qualitative interviews were conducted with community supervisors (n = 9) between October 2018 and January 2019. Interviews were transcribed and thematic analysis was completed using Dedoose software. Researchers independently coded transcripts and developed an initial codebook. Once inter-rater reliability (Cohen's κ coefficient) > 0.80 was achieved, the remaining transcripts were coded deductively, and additional codes were developed inductively when existing code were unable to describe new data. Themes from the analysis were identified. Results Four overarching themes were identified. Perceived benefits to students by supervisors focused on their contributions to the development of future physicians through understanding community needs and exposure to organizations that may be resourceful to physicians. Among organizational benefits of CSL, extra hands, work-specific benefits, and medical student’s unique expertise were subthemes highlighted. CSL benefits were not without challenges. Scheduling difficulties, motivating students to understand their work’s value, and curriculum gaps identified were challenges supervisors faced. Three subthemes emerged under areas for improvement. Supervisors emphasized increasing flexibility to make experiences more meaningful for students. They also wanted more dialogue between organizations to gain insight from one another and a clearer understanding of CSL and its role in the curriculum. Conclusions Community supervisors viewed academic institutions to be in a unique position having established many partnerships with community organizations. Developing networking opportunities between organizations should be encouraged across CSL programs in medical education. As well, clearer understanding of CSL as part of the medical curriculum was important for supervisors to better understand their roles and responsibilities.
目的虽然已有文献报道学生对社区服务学习(CSL)的反馈,但社区组织在重塑医学课程中的社区服务学习方面发挥了很小的作用。本研究的目的是分析多伦多大学医学院一门CSL课程的社区主管的反馈。方法2018年10月至2019年1月,对社区主管进行半结构化一对一定性访谈(n = 9)。使用Dedoose软件对访谈进行转录并完成专题分析。研究人员独立地对转录本进行编码,并开发了一个初始密码本。一旦达到评分间信度(Cohen’s κ系数)> 0.80,剩余的转录本将被演绎编码,当现有编码无法描述新数据时,将被演绎编码。从分析中确定了主题。结果确定了四个主要主题。通过了解社区需求和接触可能对医生有资源的组织,导师对学生的感知利益集中在他们对未来医生发展的贡献上。在CSL的组织利益中,额外的双手、特定工作的利益和医学生独特的专业知识是突出的次主题。CSL的好处并非没有挑战。安排困难,激励学生了解他们工作的价值,以及确定课程空白是主管面临的挑战。在有待改进的领域下出现了三个分主题。主管们强调要增加灵活性,让学生的经历更有意义。他们还希望组织之间能有更多的对话,以获得彼此的见解,并更清楚地了解CSL及其在课程中的作用。社区管理者认为学术机构与社区组织建立了许多伙伴关系,具有独特的地位。应该鼓励在医学教育的CSL项目中开发组织之间的网络机会。此外,更清楚地了解CSL作为医学课程的一部分,对于主管更好地了解其作用和责任也很重要。
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引用次数: 1
Oral assessments; Knowledge and perception of faculty in undergraduate dentistry program 口头评估;牙科本科课程教师的知识和认知
Pub Date : 2020-01-01 DOI: 10.5455/jcme.20190430105713
V. D. Puttalingaiah, Poonam Agarwal
Objective: Medical education globally constitute formative and summative assessments. Oral examination is an integral part of assessment used to assess various learning domains, conventional oral assessment has been criticized for its reliability and validity. So with the changing trends, emphasis is given on structured oral assessments (SOE). The aim of this study is to know the knowledge and perception of faculty on oral assessments. Methods: A cross sectional questionnaire was designed, and faculty members of dentistry program participated. Result and statistical analysis: A total of n=45 faculty members participated in survey. Descriptive data was presented in the form of frequency, percentage, mean and standard deviation. Independent sample t test was used to compare the response scores between the genders. Chi square test was used to test the association between the gender and study responses. Conclusion: Structured oral assessment was the most preferred type, but time and student willingness was the major barriers. All five domains of Bloom’s taxonomy along with knowledge and interpersonal skills can be successfully assessed by SOE. There is a need for periodic faculty workshops to help them implement the newer trends in teaching and learning.
目的:全球医学教育构成形成性评估和总结性评估。口语考试是评估的重要组成部分,用于评估各个学习领域,传统的口语评估因其信度和效度而受到批评。因此,随着变化的趋势,重点是结构化口头评估(SOE)。本研究的目的是了解教师对口头评估的认知和感知。方法:采用横断面调查问卷,对口腔医学专业教师进行问卷调查。结果与统计分析:共有n=45名教师参与调查。描述性数据以频率、百分比、平均值和标准差的形式呈现。采用独立样本t检验比较性别间的应答得分。使用卡方检验来检验性别与研究反应之间的相关性。结论:结构化口头评估是最受欢迎的评估方式,但时间和学生意愿是主要障碍。Bloom分类法的所有五个领域以及知识和人际关系技能都可以通过SOE成功地进行评估。有必要定期举办教师研讨会,以帮助他们实施教学和学习的新趋势。
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引用次数: 1
Business Networking in Medicine: Medical Students' Perspectives on a Networking Assignment 医学中的商业网络:医学生对网络作业的看法
Pub Date : 2020-01-01 DOI: 10.5455/jcme.20190912121145
L. Benedict, Kevin Si, F. Leung
Objective: Networking in business is generally regarded as a highly valued skill. Few will disagree that networking in medicine has similar value. However, few medical school curriculums have included a formalized approach to teaching the skill of networking. In addition, there are limited studies that evaluate the use of a networking-focused curriculum in medicine. The objective of this study is to determine the perspectives of medical students on the use of a networking-based assignment titled �Personalized Resource List�. Methods: Participants were recruited from the class of first-year medical students whom had participated in the �Personalized Resource List� assignment. Participants (N=9) were recruited via e-mail and volunteered to complete a structured interview. Results: Thematic analyses of students� responses revealed that first-year medical students valued �networking� as a skill. Two major themes identified that were important to all participants were the �formation of a professional relationship� and the �formation of a professional identity�. Conclusions: Medical Students noted the importance of networking in medicine and found a formalized assignment within the medical school curriculum to be beneficial in their professional development.
目的:在商业中建立关系网通常被认为是一项非常有价值的技能。几乎没有人会不同意医学领域的网络具有类似的价值。然而,很少有医学院的课程包括一种正式的方法来教授社交技能。此外,评估以网络为重点的课程在医学中的应用的研究也很有限。本研究的目的是确定医学生对使用一项名为“个性化资源列表”的基于网络的作业的看法。方法:参与者从参与“个性化资源列表”分配的一年级医学生班级中招募。参与者(N=9)通过电子邮件招募,并自愿完成结构化面试。结果:学生回答的主题分析显示,一年级医学生重视“网络”作为一种技能。确定了对所有参与者都很重要的两个主要主题是“职业关系的形成”和“职业身份的形成”。结论:医学生注意到医学网络的重要性,并发现医学院课程中的正式作业有利于他们的专业发展。
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引用次数: 2
Patient-centred medicine: The use of expert patients in medical education 以病人为中心的医学:在医学教育中使用专家病人
Pub Date : 2020-01-01 DOI: 10.5455/jcme.20200129092612
K. Chan, G. Samoutis
Patient-centred medicine (PCM) involves looking at more than just a disease and how to treat it. It has evolved from the realisation that all patients are different physiologically, psychologically, emotionally, and socially, and it therefore encompasses all of these domains in its application. The mainstay of this approach is the promotion of a mutual relationship between patient and doctor that involves creating a secure environment to allow for open dialogue. By learning to listen to patients, and exploring other causes of disease other than physiological ones, doctors are able to provide a holistic approach to treatment. Patients are also actively encouraged to participate in the decision making process by adding their ideas, concerns and expectations. This negotiation allows for flexibility and individualisation of each treatment plan that is tailored to suit each individual patient. In essence, PCM encourages concordance: the agreement between doctor and patient on how to proceed towards a common goal. It is therefore important to teach medical students about PCM as early on in their medical education as possible. This will give them time to hone skills in communication so that they can better understand and explore their patient’s circumstances as well be aware of other domains that may require support. But how can medical schools effectively teach their students PCM? Here we suggest the use of expert patients as a beneficial method for promoting PCM in medical school curriculums as students have the opportunity to gain first hand knowledge of what a patient with a specific disease actually feels, what impact it has on their lives and those around them, and what support they find lacking or useful.
以病人为中心的医学(PCM)涉及的不仅仅是一种疾病以及如何治疗它。它是从认识到所有患者在生理、心理、情感和社会上都是不同的而发展起来的,因此它的应用涵盖了所有这些领域。这种方法的主要内容是促进患者和医生之间的相互关系,包括创造一个允许公开对话的安全环境。通过学习倾听病人的意见,探索除生理原因外的其他疾病原因,医生能够提供全面的治疗方法。患者也被积极鼓励参与决策过程,提出他们的想法、担忧和期望。这种协商允许每个治疗计划的灵活性和个性化,以适应每个患者。从本质上讲,PCM鼓励和谐:医生和病人之间就如何朝着共同的目标前进达成协议。因此,在医学生的医学教育中尽早向他们讲授PCM是很重要的。这将给他们时间来磨练沟通技巧,这样他们就能更好地理解和探索病人的情况,并意识到其他可能需要支持的领域。但是,医学院如何有效地教授学生PCM呢?在此,我们建议将专家患者作为在医学院课程中推广PCM的有益方法,因为学生有机会获得第一手知识,了解患有特定疾病的患者的实际感受,疾病对他们和周围人的影响,以及他们认为缺乏或有用的支持。
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引用次数: 0
Seasonality of medical student research: Does a pattern truly exist? 医学生研究的季节性:模式真的存在吗?
Pub Date : 2020-01-01 DOI: 10.5455/jcme.20200106084507
Y. Alamri, Mohamud Osman
Seasonal variation to manuscript submission and publication in the medical literature is yet to be carefully scrutinized. We report a lack of significant seasonal bias in relation to medical student submission to a prominent Australasian medical journal. Factors that contribute to when a manuscript is submitted may be predictable. Factors that contribute to when a manuscript is published, on the other hand, appear to be less predictable. These observations remain preliminary as the studies examining seasonal bias in the medical literature are too few and methodologically heterogeneous. A careful consideration of the implications will need to be taken into account to ensure a fair peer-review process.
医学文献中稿件提交和出版的季节变化还有待仔细审查。我们报告了在医科学生向澳大利亚著名医学期刊投稿方面缺乏显著的季节性偏倚。影响稿件何时提交的因素是可以预测的。另一方面,影响手稿发表时间的因素似乎更难以预测。这些观察结果仍然是初步的,因为在医学文献中检查季节性偏倚的研究太少,方法上也不一致。需要仔细考虑其影响,以确保公平的同行评审过程。
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引用次数: 0
A Four-Pronged Approach for Evaluating e-Learning Modules with a Newly Developed Instructional Design Scale 用新开发的教学设计量表评估电子学习模块的四管齐下方法
Pub Date : 2020-01-01 DOI: 10.5455/jcme.20190307082154
Kadriye O. Lewis, Erdem Demiroz, Haiqin Chen, Cheryll A. Albold, J. Mahan
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引用次数: 2
Towards an ethics of curiosity?The role of cinema in medical education on variations of sexual development 走向好奇的伦理?电影在性发展变化的医学教育中的作用
Pub Date : 2020-01-01 DOI: 10.5455/jcme.20191016125926
E. Clercq, Maddalena Favaretto, M. Luceri
Objective: Although it is not uncommon to be born with an intersex condition or DSD, it is a topic which is still relatively unknown. The aim of the present paper is to explore the extent to which fiction movies on DSD/intersex can be used to help medical students to gain more experiential knowledge, enhance their empathic abilities and facilitate self-reflection on this issue. Methods: A systematic film review was conducted to identify and critically review relevant fiction movies on intersex or DSD. For this purpose, an online database research was performed in the Internet Movie Database (IMDb). Results: Recent films refrain from conveying a stereotypical image of intersex persons (e.g. freaks, villains, criminals, femme fatale) but tend to focus on young adults’ journey to self-discovery. Still, the many close-ups of body of the character with DSD might be interpreted as a kind morbid curiosity for a body that is considered “different”. Conclusions: Although in some ways reductive, guided discussions on coming-to-age stories can be used in the medical curriculum to offer an insight in the lived experiences of DSD and to allow future healthcare professionals to turn the medical gaze upon themselves.
目的:虽然出生时患有双性人或双性人障碍并不罕见,但这是一个相对未知的话题。本论文的目的是探讨在何种程度上,关于双性人/双性人的虚构电影可以帮助医学生获得更多的经验知识,增强他们的移情能力,并促进对这个问题的自我反思。方法:采用系统的影评方法,对有关阴阳人或双性恋的小说电影进行识别和批判性评价。为此,在Internet Movie database (IMDb)中进行了在线数据库研究。结果:近年来的电影不再传达阴阳人的刻板形象(如怪胎、恶棍、罪犯、蛇蝎女),而是倾向于关注年轻人的自我发现之旅。尽管如此,DSD角色的许多身体特写可能会被解释为对被认为是“不同”的身体的一种病态的好奇心。结论:虽然在某些方面,关于成长故事的引导讨论可以在医学课程中使用,以提供对DSD的生活经验的见解,并允许未来的医疗保健专业人员将医学目光转向自己。
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引用次数: 3
How open minded medical students really are? A pilot study. 医科学生的思想到底有多开放?一项初步研究。
Pub Date : 2020-01-01 DOI: 10.5455/jcme.20191015115111
Vasiliki Spatoula, E. Panagopoulou
Objective: Despite the identified biases in the provision of health, no studies have so far compared stereotypes of medical students with students from other disciplines. The aim of this cross-sectional study was to compare attitudes of medical and social science students towards population groups of different ethnic background, age, and sexual orientation. Given the social desirability biases associated with explicit attitude assessment through self-report, and the feasibility issues of implicit attitude testing, the study also developed and piloted the Attitude and Opinion Scale, a self report instrument designed to assess attitudes and reduce social desirability. Method: Ninety third year students from the Medical School and the Social Sciences Department of Aristotle University of Thessaloniki, Greece, completed the Attitude and Opinion Scale. Results: Results showed statistical significant differences in attitudes towards groups of different sexual orientation (t=2.687, p=.009) and age (t=-2.554, p=.012). Conclusions: This pilot study indicated that medical students have more negative attitudes towards some population groups compared to students of social sciences. Increasing attention has to be paid in undergraduate medical courses to the knowledge, attitudes, and behaviors required for the effective and culturally safe practice of medicine in culturally and gender diverse settings.
目的:尽管在提供保健方面存在明确的偏见,但迄今为止还没有研究将医学生的刻板印象与其他学科的学生进行比较。本横断面研究的目的是比较医学和社会科学学生对不同种族背景、年龄和性取向人群的态度。考虑到通过自我报告进行外显态度评估的社会可取性偏差,以及内隐态度测试的可行性问题,本研究还开发并试点了一种旨在评估态度和降低社会可取性的自我报告工具——态度与意见量表。方法:对希腊塞萨洛尼基亚里斯多德大学医学院和社会科学系93年级学生进行态度与意见问卷调查。结果:结果显示,不同性取向人群的态度差异有统计学意义(t=2.687, p= 0.009),年龄差异有统计学意义(t=-2.554, p= 0.012)。结论:本初步研究表明,医学生对某些人群的负面态度比社会科学专业的学生多。在本科医学课程中,必须越来越多地关注在文化和性别不同的环境中有效和文化上安全的医学实践所需的知识、态度和行为。
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引用次数: 0
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Journal of contemporary medical education
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