4,558 research outputs found

    Patient safety in health care professional educational curricula: examining the learning experience

    Get PDF
    This study has investigated the formal and informal ways pre-registration students from four healthcare professions learn about patient safety in order to become safe practitioners. The study aims to understand some of the issues which impact upon teaching, learning and practising patient safety in academic, organisational and practice „knowledge? contexts. In Stage 1 we used a convenience sample of 13 educational providers across England and Scotland linked with five universities running traditional and innovative courses for doctors, nurses, pharmacists and physiotherapists. We gathered examples of existing curriculum documents for detailed analysis, and interviewed course directors and similar informants. In Stage 2 we undertook 8 case studies to develop an in-depth investigation of learning and practice by students and newly qualified practitioners in universities and practice settings in relation to patient safety. Data were gathered to explore the planning and implementation of patient safety curricula; the safety culture of the places where learning and working take place; the student teacher interface; and the influence of role models and organisational culture on practice. Data from observation, focus groups and interviews were transcribed and coded independently by more than one of the research team. Analysis was iterative and ongoing throughout the study. NHS policy is being taken seriously by course leaders, and Patient Safety material is being incorporated into both formal and informal curricula. Patient safety in the curriculum is largely implicit rather than explicit. All students very much value the practice context for learning about patient safety. However, resource issues, peer pressure and client factors can influence safe practice. Variations exist in students? experience, in approach between university tutors, different placement locations – the experience each offers – and the quality of the supervision available. Relationships with the mentor or clinical educator are vital to student learning. The role model offered and the relationship established affects how confident students feel to challenge unsafe practice in others. Clinicians are conscious of the tension between their responsibilities as clinicians (keeping patients safe), and as educators (allowing students to learn under supervision). There are some apparent gaps in curricular content where relevant evidence already exists – these include the epidemiology of adverse events and error, root cause analysis and quality assessment. Reference to the organisational context is often absent from course content and exposure limited. For example, incident reporting is not being incorporated to any great extent in undergraduate curricula. Newly qualified staff were aware of the need to be seen to practice in an evidence based way, and, for some at least, the need to modify „the standard? way of doing things to do „what?s best for the patient?. A number of recommendations have been made, some generic and others specific to individual professions. Regulators? expectations of courses in relation to patient 9 safety education should be explicit and regularly reviewed. Educators in all disciplines need to be effective role models who are clear about how to help students to learn about patient safety. All courses should be able to highlight a vertical integrated thread of teaching and learning related to patient safety in their curricula. This should be clear to staff and students. Assessment for this element should also be identifiable as assessment remains important in driving learning. All students need to be enabled to constructively challenge unsafe or non-standard practice. Encounters with patients and learning about their experiences and concerns are helpful in consolidating learning. Further innovative approaches should be developed to make patient safety issues 'real' for students

    Development of an evidence-based medicine mobile application for the use in medical education

    Full text link
    BACKGROUND: Evidence-based medicine (EBM) is a methodology that is being incorporated into more medical school curricula. Boston University School of Medicine was one of early adopters of Evidence Based Medicine in the United States. A growing concern in the medical community was that the complexities of applying EBM might be lost when students enter into their clinical rotations, thus there is a need for development of a tool to help reinforce the EBM principles. METHODS: The research team in collaboration with the designers of the Finding Information Framework, a custom-made EBM finding information tool, worked to develop a mobile application to help reinforce the framework for medical students. The app was designed with both Apple and PC operating systems in mind. Key features that were identified from current literature to provide the most user-friendly mobile application. Thus, the research team specifically utilized iOS and Android platforms as both platforms have a centralized app store, possess the highest volume of medical apps available, and are most widely used in the United States by medical students. RESULTS: The Finding Information Framework was a custom-made tool developed to guide new users of EBM, and help them to apply the principles in practice. The mobile application served an added convenience by allowing easy access and fast utilization of the EBM tools. The app was designed on an Android platform first due to its open-source OS and ease in app development to new programmers. Initially, the user-friendly web-based tool, App Inventor (AI), powered by Massachusetts Institute of Technology was evaluated to program the pilot Android app. Using both the AI Component Designer and the Block Editor, several problems were encountered in AI, such as the simplicity of the program and the lack of freedom in design. This moved the project to create the app natively and with a collaborative effort with the BU's Global App Initiative club. Initially, a wireframe was built using Balsamiq. Subsequently, the Android app was built using Android SDK and the iOS app was built in XCode with Objective C; both platforms had design sections prepared in Sketch, Adobe Photoshop and Illustrator. The last and final step was to obtain Boston University branding privileges for the app. CONCLUSION: The research team identified necessary features based on research to build a user-friendly, professional mobile application of an information mastery framework that can be used off-line. The app is called FIF as it is the title of the information mastery tool designed by BUSM EBM-VIG. With a clear mobile interface, it will be beneficial to the learning and training of medical students in EBM

    Does the inclusion of 'professional development' teaching improve medical students' communication skills?

    Get PDF
    Background: This study investigated whether the introduction of professional development teaching in the first two years of a medical course improved students' observed communication skills with simulated patients. Students' observed communication skills were related to patient-centred attitudes, confidence in communicating with patients and performance in later clinical examinations.Methods: Eighty-two medical students from two consecutive cohorts at a UK medical school completed two videoed consultations with a simulated patient: one at the beginning of year 1 and one at the end of year 2. Group 1 (n = 35) received a traditional pre-clinical curriculum. Group 2 (n = 47) received a curriculum that included communication skills training integrated into a 'professional development' vertical module. Videoed consultations were rated using the Evans Interview Rating Scale by communication skills tutors. A subset of 27% were double-coded. Inter-rater reliability is reported.Results: Students who had received the professional development teaching achieved higher ratings for use of silence, not interrupting the patient, and keeping the discussion relevant compared to students receiving the traditional curriculum. Patient-centred attitudes were not related to observed communication. Students who were less nervous and felt they knew how to listen were rated as better communicators. Students receiving the traditional curriculum and who had been rated as better communicators when they entered medical school performed less well in the final year clinical examination.Conclusions: Students receiving the professional development training showed significant improvements in certain communication skills, but students in both cohorts improved over time. The lack of a relationship between observed communication skills and patient-centred attitudes may be a reflection of students' inexperience in working with patients, resulting in 'patient-centredness' being an abstract concept. Students in the early years of their medical course may benefit from further opportunities to practise basic communication skills on a one-to-one basis with patients

    Nationwide introduction of a new competency framework for undergraduate medical curricula: a collaborative approach.

    Get PDF
    Switzerland recently introduced PROFILES, a revised version of its national outcomes reference framework for the undergraduate medical curriculum. PROFILES is based on a set of competencies adapted from the CanMEDS framework and nine entrustable professional activities (EPAs) that students have to be able to perform autonomously in the context of a predefined list of clinical situations. The nationwide implementation of such a competency- and EPA-based approach to medical education is a complex process that represents an important change to the organisation of undergraduate training in the various medical schools. At the same time, the concepts underlying PROFILES also have to be reflected at the level of the Federal Licencing Examination (FLE) and the national accreditation process. The vice-deans for education mandated a Swiss Working Group for PROFILES Implementation (SWGPI) to elaborate a guide presenting the principles and best practices based on the current scientific literature, to ensure the coherence between the future developments of the medical curricula and the evolution of the FLE, and to propose a coordinated research agenda to evaluate the implementation process. On the basis of the literature and analysis of our national context, we determined the key elements important for a successful implementation. They can be grouped into several areas including curricular design and governance, the assessment system and entrustment process, faculty development and change management. We also identified two dimensions that will be of particular importance to create synergies and facilitate exchange between the medical schools: a systematic approach to curriculum mapping and the longitudinal integration of an e-portfolio to support the student learning process. The nationwide collaborative approach to define strategies and conditions for the implementation of a new reference framework has allowed to develop a shared understanding of the implications of PROFILES, to promote the establishment of Swiss mapping and e-portfolio communities, and to establish the conditions necessary for ensuring the continuous alignment of the FLE with the evolving medical curricula

    A systematic approach to an integrated curriculum model for dental education

    Full text link
    The purpose of this quantitative study was to determine the degree of curriculum integration within dental schools in North America. The intent of the study was to determine how an adaptation of the Fogarty (1991) framework of integration exhibits itself in dental education; An electronic survey conducted of the Academic Deans of dental schools in the United States and Canada resulted in a response rate of 54.09% (33/61). Frequencies, chi-square and Spearman rho (p) correlation coefficient were used for the statistical analyses of data; All survey respondents reported that their curricula include all levels of integration which comprise the adapted integration framework. Six demographic variables were selected for analysis: (a) age of the school, (b) years of faculty teaching experience at that specific school, (c) faculty gender, (d) faculty employment status, (e) number of departments, and (f) average class size. Based on the data collected, statistically significant findings were indicated in only one level of integration. Within Level 4, within and across learners, significant findings were detected between genders; Additionally, the findings of this study indicated that there was very little, if any correlation, between the level of integration and the combined use of technology and research at responding schools

    Study on the use of mobile devices in schools: the case of Greece

    Get PDF
    This paper presents a reflection on the use of mobile technologies in the classroom in Greece, based on a review of relevant literature, PhD thesis and the case of the 1st Lyceum of Rhodes. Despite several developments, m-learning is far from being part of everyday educational practice. This is in accordance to the level of academic research on m-learning in Greece. Few PhD dissertations focus on mobile learning. However, most Greek universities have postgraduate programs on the use of ICT in education and mobile learning is part of their curriculum, giving hope for the future

    Use of information systems as tools to improve and measure leadership skills acquisition through medical simulation

    Get PDF
    Background & Aims In a context of health care rising demands, paired with a pressure to reduce costs, doctors are now expected to be leaders in clinical and non-clinical settings, with different levels of responsibility. However, the majority of medical curricula do not include formal training in management and leadership. Undergraduate medical curricula are integrating advanced clinical simulation as a safe and reliable learning method. It usually represents the first opportunity for students to act as a team managing a critical situation, during which leadership skills are crucial. Most of simulations do not use electronic health records system (EHR), thus not providing training in this important field. This study aims to demonstrate how an information system can assist medical simulations, both as learning and assessment tools, in terms of leadership skills acquisition. Thus, it is intended to show how can leadership and management be taught using simulation and prove if it’s possible to introduce an information system to manage this process. By doing so, it might be possible to suggest a model of an integrated information system for teaching management and leadership. Materials & Methods A mixed methodology was used where two main research initiatives were combined. These took place in the Clinical Skills Lab of the Faculty of Health Sciences (University of Beira Interior), in Portugal. First, the author designed and developed a tool to simulate an electronic health records system, in tight collaboration with the Clinical Skills Lab. Then, using a triangulation model, an experiment was designed in the context of the Leadership and Management subject. Several simulation-based classes took place, with the purpose of training medical students in leadership. Data was collected and integrated with two survey data sets, quantitative information extracted from the EHR simulated system, as well as other qualitative data obtained or assessed by the author with the help of a video recording system. Results There were 16 teams/groups assessed, in a total of 85 students (aged between 21 and 36 years, average age of 23.4, standard deviation of 2.21. An important part of the data used for this study was obtained from the simulated EHR system, without whom it would not be possible to gather this study results. On efficiency metrics, teams took between 0 and 8 minutes to make the first interaction with the simulated EHR, took between 7 and 22 minutes to establish the correct diagnosis and took between 9 and 27 minutes to execute the desired therapeutically procedure. There were 2 groups who didn’t establish the correct diagnosis and consequently didn’t performed the desired clinical attitudes and additional plus two groups that also didn’t made the corrective therapeutic procedure. In average, each team made four complementary diagnostic test requisitions, registered 2,44 clinical history entries and listed in the system 74,3% of the executed procedures. Teams spent in average € 55,01, stated as real costs, in diagnostic tests. Considering leadership and teamwork competencies self-assessment, groups obtained an average global rate between 2,83 and 4,28, out of a Likert scale of 5 degrees. In a global external assessment on leadership skills, a total average of 3,43 e 3,33 was obtained, respectively, in a scale parallel to the one used in the self-assessment and in an additional questionnaire applied only during external analysis. 7 groups were categorized as having a direct leadership style, 4 as alternate, 3 as shared and 2 as chaotic. From the 85 students, 35 filled a two month post simulation survey. All the 35 students (100% of the responses) feel this simulation was useful in terms of leadership skills acquisition. 88,6% are interested in having access to their own session’s video recordings and 82,9% showed interest in having these sessions frequently. Discussion/conclusion It was possible to establish an association with time-related efficiency metrics with the leadership style present in each group. Groups categorized as chaotic did not reach a final diagnosis neither treat the simulated patient at their responsibility. The higher number of system interactions, sometimes repeated, can support the attribution of this categories to the groups. These number of interactions, in a real situation, could have brought higher costs to the team when compared with other teams categorized with the remaining three leadership styles. In a growing context of higher responsibility in healthcare worker’s leadership, as with a crescent technological development and also with a broader use of simulation as a learning methodology, simulation based leadership learning becomes mandatory. Teamwork and leadership does not occur spontaneously. It has to be learned and rehearsed and simulation is an excellent tool for teaching, rehearsing and analyzing team performance. Training is associated with timelier decision making as teams recognize critical events earlier and initiated interventions in a time critical manner. In fact, students claim to have learned by these simulation sessions.It is possible to introduce an information system to manage this process, providing such amount of useful data used in this study. Information systems give us the ability to improve quality of data and capacity to work on that data, extracting useful metrics and analysis. Despite the small sample of this study, differences were found regarding self-assessment and external assessment for chaotic groups, who rated themselves higher than the external observer did. Previously published results by Rudy et al. (2001) and Bryan et al. (2005) demonstrated that student leaders consistently scored themselves lower than their peers on many aspects of leadership, including altruism, compassion, integrity, accountability, commitment to excellence, and self-reflection. Leadership learning must start early on, in the context of higher education, and it must settle in well-structured curricula. With this strategy it will be possible to provide students with the necessary skills to become the doctors of tomorrow, in charge of multiple management activities, being clinical or non-clinical, and exceeding the challenges posed by globalized healthcare. This study showed the urgent necessity for the creation of systems that analyze training activities, around the clock and with powerful analytics engines. Such could allow prospective and retrospective studies based on clinical outcomes on a medium and long term.Contexto e objetivos Num contexto de crescimento nos gastos com a saúde, acompanhado por uma pressão para redução desses mesmos custos, espera-se hoje dos médicos que sejam lideres em ambiente clínico e não clínico, com diferentes graus de responsabilidade. Contudo, a maior parte dos curricula médicos não inclui o ensino formal da Liderança e Gestão em Saúde. Por outro lado, estes curricula pré-graduados incluem cada vez mais a simulação biomédica enquanto método de ensino seguro e viável. Estes momentos representam muitas vezes a primeira oportunidade para os estudantes de atuarem enquanto equipa, gerindo uma situação de crise, durante a qual as competências de liderança são cruciais. No entanto, a maior parte das simulações não usa um sistema de registos clínicos eletrónicos que seja auxiliar nestes cenários. Assim, pretende-se através deste estudo demonstrar como é que a Liderança e Gestão em Saúde pode ser ensinada recorrendo à simulação e provar a possibilidade de introduzir um sistema de informação para gerir este processo. Ao fazê-lo, será possível sugerir um modelo de sistema de informação integrado para o ensino desta área de ensino. Materiais e métodos Foi utilizada uma metodologia mista, tendo sido combinadas duas experiências de investigação. Estas tiveram lugar no Laboratório de Competências da Faculdade de Ciências da Saúde da Universidade da Beira Interior, em Portugal. Em primeiro lugar, o autor concebeu e desenvolveu uma ferramenta para simular um software de registos clínicos eletrónicos. Depois, utilizando um modelo de triangulação, foi desenhada uma investigação no contexto do modulo de Liderança e Gestão em Saúde desta faculdade. Diversas sessões de simulação foram levadas a cabo, com o propósito de treinar as competências de liderança e trabalho em equipa. Foi recolhida e integrada informação de diversas fontes, nomeadamente de dois questionários, informação quantitativa do sistema de registos clínicos simulado, bem como de avaliação qualitativa dos vídeos gravados das sessões Resultados Foram avaliadas 16 equipas, num total de 85 estudantes (com idades compreendidas entre os 21 e os 36 anos, média de idades de 23,4, desvio padrão de 2,21). Uma componente importante da informação utilizada neste estudo foi obtida pelo sistema de registos clínicos simulado, sem o qual não teria sido possível recolher estes dados em qualidade e quantidade. Em termos de métricas de eficiência, as equipas levaram entre 0 a 8 minutos para interagirem pela primeira vez com o sistema, entre 7 a 22 minutos para estabelecer um diagnóstico correto para o paciente simulado e entre 9 e 27 minutos para executar o procedimento terapêutico de correção. Houve dois grupos que não estabeleceram o diagnóstico correto e consequentemente não efetuaram a terapêutica adequada. Em média, cada equipa fez quarto requisições de métodos complementares de diagnóstico, registou 2,44 entradas de história clínica e listou no sistema 74,3% dos procedimentos efetuados ao paciente. As equipas gastaram uma média de € 55,01 em métodos complementares de diagnóstico, quando traduzido em custo real. Considerando a autoavaliação de competências de liderança e gestão em equipa, os grupos obtiveram uma classificação média global entre 2,83 e 4,28, de uma escala de Likert de 5 graus. Numa avaliação externa global às competências de liderança dos grupos, obteve-se uma média de 3,43 e 3,33, respetivamente, recorrendo à mesma escala usada pelos estudantes e aplicando uma escalada adicional desenvolvida para o observador externo. 7 grupos foram classificados por este observador como tendo um estilo de liderança vertical, 4 foram classificados como alternantes, 3 com liderança partilhada e 2 como caóticos. Do total de 85 estudantes, 35 preencheram um inquérito dois meses após a simulação. Todos os 35 estudantes (100% das respostas) sentiram que a simulação foi útil em termos de aquisição de competências de liderança e gestão. 88,6% estão interessados em ver as suas gravações de vídeo e 82,9% gostariam de ter este tipo de sessões de forma regular e frequente. Discussão/conclusões Foi possível estabelecer uma associação entre as métricas de tempo/eficiência com os estilos de liderança presentes em cada grupo. Equipas categorizadas como caóticas não chegaram a um diagnóstico final nem foram capazes de efetuar o procedimento terapêutico adequado. O maior número de interações com o sistema de registos, algumas delas repetidas, poderão suportar a atribuição destas categorias às equipas. Este número de interações, num contexto real, poderia ter sido traduzido em custos superiores, quando comparado com outros estilos de liderança que não o caótico. Numa realidade de responsabilização dos profissionais de saúde em funções de liderança, pareado com um crescente desenvolvimento tecnológico, bem como com uma utilização global da simulação enquanto ferramenta de ensino, o ensino da liderança recorrendo à simulação torna-se emergente e necessário. Liderança e trabalho de equipa não se adquirem espontaneamente. Estes devem ser aprendidos e treinados, sendo a simulação uma ferramenta crucial para tal. A prática está associada a melhores e mais rápidas decisões, dado que as equipas passam a reconhecer mais cedo os eventos críticos e iniciam ações em resposta a estes. De facto, os estudantes indicam ter desenvolvido competências de liderança através destas simulações. É possível introduzir um sistema de informação para gerir este processo, providenciando um enorme conjunto de dados, como os que foram utilizados neste estudo. Os sistemas de informação possibilitam a melhoria da qualidade dos dados e a capacidade para os analisar, extraindo métricas e análises relevantes, que não seriam obtidas de outra forma. Apesar da amostra pequena deste estudo, foram encontradas diferenças relativamente à autoavaliação e heteroavaliação de grupos caóticos, que atribuíram classificações superiores a si próprios, quando comparados com a heteroavaliação efetuada por observador externo. Como sugerido por Rudy et. Al (2001) e Bryan et al. (2005), está demonstrado que estudantes com boas capacidades de liderança tendem a ser mais autocríticos na altura de se autoavaliarem. A aprendizagem da liderança deve começar cedo, em ambiente universitário, e deve assentar em programas curriculares bem estruturados. Com esta estratégia, será possível enriquecer os estudantes com as competências necessárias para se tornarem os médicos do futuro, a cargo de múltiplas tarefas de gestão — clínicas ou não clínicas — ultrapassando os desafios colocados por uma saúde globalizada. Este estudo demonstra a necessidade urgente de criar sistemas de informação integrados para monitorizar tais atividades de ensino, em tempo real, com potentes ferramentas de análise. Tal poderá permitir estudos retrospetivos e prospetivos, baseados em resultados clínicos ou outros, de médio e longo termos

    Competence-driven engineering education: A case for T-shaped engineers and teachers

    Get PDF
    The demand for engineering education and graduates is increasing daily because the current service and technological designs are unable to meet the needs of the society and the expected dramatic increase in the future. The emerging skill gap requires a shift in the type of expertise required of young professionals that will be needed to successfully lead organizations in the new economy. Researchers have identified various ‘shapes’ for the engineering professionals to make them relevant to the 21st century challenge, especially in the industry where their expertise is much needed. T-shaped professionals have skills that make them to be more preferred among others. The purpose of this paper is to present the need to upgrade engineering education curriculum to produce more T-shaped graduate engineers required in the changing industrial world. The potential benefits of T-shaped professionals to organizational performance are quite significant; hence, the demand for T-shaped professionals in knowledge-intensive, service-oriented economies is increasing. Unfortunately, the challenges associated with creating more T-shaped professionals are also significant. National regulatory bodies for engineering education in Nigeria are beginning to move towards integrated curriculum to break down discipline silos and produce T-shaped graduate engineers for the fast-changing industrial world. Service Science Management and Engineering (SSME) is an emerging discipline with over 250 programmes in 50 nations seeking to create more T-shaped professionals

    From Faculty Development to the Classroom: A Qualitative Study of How Nurse Educators Turn Faculty Development into Action

    Get PDF
    The purpose of this qualitative study was to better understand the transfer of learning by uncovering how various factors supported the integration of knowledge and skills gleaned from the Faculty Development: Integrated Technology into Nursing Education and Practice Initiative (ITNEP) programs into nursing education curricula. Through interviews with 20 participants from four ITNEP programs, this study confirmed the importance of learner characteristics, program design elements, and factors in the work environment for supporting successful transfer of learning and supports a variety of other transfer of learning research findings. New or seldom discussed supportive individual characteristics were found, including: leadership abilities, lifelong learning, ability to recognize limitations, persistence, creativity, and risk-taking. Study findings suggest that proactive personality may support transfer of learning. Participants maintained motivation from pre-training through post-training at a high enough level to successfully transfer learning. The importance of networking opportunities, a diversity of perspectives, post conference support, and teams in programs designs were found to positively influence transfer and were discussed in relation to social influence. The variety of supportive factors in the participants' work environments, including strategic alignment, strengthens the assertions that transfer may be individually context dependent. Barriers to transfer efforts in the work environment were also addressed. Additionally, while patterns of specific characteristics emerged, interacting findings were found threaded throughout
    corecore