Reasons why nurses decline influenza vaccination: a qualitative study

To explore reasons of non-vaccinated nursing staff for declining seasonal influenza vaccination. The annual influenza vaccination of healthcare workers reduces morbidity and mortality among vulnerable patients. Still, vaccination rates remain very low, particularly in nursing staff. While several studies have explored barriers for healthcare workers to get vaccinated, most have used a quantitative approach.; Data were collected by in-depth individual semi-structured interviews with 18 nurses from a range of fields, positions in organizational hierarchy, work experience and hospitals in two German-speaking cantons in Switzerland. Interviews were transcribed and analysed using conventional content analysis.; Three interconnected themes explaining why nurses decline influenza vaccination were identified: Firstly, the idea of maintaining a strong and healthy body, which was a central motif for rejecting the vaccine. Secondly, the wish to maintain decisional autonomy - especially over one's body and health. Thirdly, nurses' perception of being surrounded by an untrustworthy environment, which restricts their autonomy and seemingly is in opposition to their goal of maintaining a strong and healthy body.; Nurses tend to rely on conventional health beliefs rather than evidence based medicine when making their decision to decline influenza vaccination. Interventions to increase influenza vaccination should be tailored specifically for nurses. Empowering nurses by promoting decision-making skills and by strengthening their appraisal may be important factors to consider when planning future interventions to improve vaccination rates. The teaching of evidence-based decision-making should be integrated on different levels, including nurses' training curricula, their workspace and further education

Ten caveats of learning analytics in health professions education: A consumer’s perspective

A group of 22 medical educators from different European countries, gathered in a meeting in Utrecht in July 2019, discussed the topic of learning analytics (LA) in an open conversation and addressed its definition, its purposes and potential risks for learners and teachers. LA was seen as a significant advance with important potential to improve education, but the group felt that potential drawbacks of using LA may yet be under-exposed in the literature. After transcription and interpretation of the discussion's conclusions, a document was drafted and fed back to the group in two rounds to arrive at a series of 10 caveats educators should be aware of when developing and using LA, including too much standardized learning, with undue consequences of over-efficiency and pressure on learners and teachers, and a decrease of the variety of 'valid' learning resources. Learning analytics may misalign with eventual clinical performance and can run the risk of privacy breaches and inescapability of documented failures. These consequences may not happen, but the authors, on behalf of the full group of educators, felt it worth to signal these caveats from a consumers' perspective

Why are medical students so motivated to learn ultrasound skills? A qualitative study.

BACKGROUND The introduction of ultrasound (US) courses into medical undergraduate courses is usually met with a particularly high level of student motivation. The reasons for this are unclear. The aim of this study was to investigate the factors that contribute to undergraduate medical students' motivation to learn US skills. Understanding what motivates students to learn US will inform the efforts of faculty to foster students' motivation to learn. METHODS We carried out in-depth semi-structured one-to-one interviews with medical students participating in an optional US course at two Swiss universities. The interview guide consisted of 10 main questions. The content was informed by experts in the field of medical education and US, as well as by a literature review of motivation theories for learning, in particular by self-determination theory (SDT). SDT was used to guide the development of the interview guide and to reflect on the resulting themes in the discussion section. The interview guide was piloted with two medical students. The interviews lasted an average of 45 min and were audio recorded and transcribed. Thematic analysis was used to analyse the data. RESULTS Fourteen undergraduate medical students in their preclinical (year 3) and clinical studies (years 4 and 5) elaborated on a wide range of reasons for their high motivation to learn US. They were motivated for US training because of the positive nimbus of the US modality, emphasising the advantages of visualisation. Students acknowledged the potential professional benefits of learning US and described it as a fun, exciting group activity. CONCLUSIONS The four themes we found in our analysis can all be related to the three universal needs described in SDT. The strong focus on the visual aspect and the positive nimbus of the modality goes beyond that and reflects the visuo-centric Zeitgeist, which claims the superiority of visual information over other data. Educators should be aware that motivation to learn is affected by the Zeitgeist and ensuing preconceptions, such as the perception of the positive nimbus surrounding a topic. Other key elements that can be implemented to motivate students are just-in-time feedback, enabling group experiences and creating awareness of the clinical relevance of learning content

Förderung kommunikativer Fähigkeiten durch den Einsatz von Eigen- und Fremd-Videoannotationen simulierter Arzt-Patient-Gespräche im Rahmen von Kommunikationstrainings: Eine Implementierungsstudie

Background: The mandatory communication skills course for fourth-year medical students at the University of Bern Medical School aims to prepare students for challenging communication situations. Students role-play four different scenarios with simulated patients (SPs) and receive feedback from the patient's perspective. The scenarios are video-recorded and uploaded onto the University's virtual learning environment. Students can watch and annotate their own videos and give others access to view them. Project description: Although the course is well liked by students, we identified three areas for improvement: lack of faculty feedback; little active use of the video-recordings;lack of opportunity for students to discuss their experiences with each other. We aimed to address these shortcomings by introducing an additional learning task: students are asked to annotate a section of the video in which they had performed well, and one in which they thought they could have done better, in both their own and a colleague's videos. These video clips and annotations served as the basis of a subsequent two-hour small-group seminar with a physician tutor. The course was evaluated by a mandatory online questionnaire. Results: All 247 students completed the questionnaire. The annotation tool and task were deemed to be comprehensible. Students believed they had learnt more from annotating a peers' video than from their own and most thought being assessed by peers was acceptable. The physician tutors' comments were largely deemed as helpful. The mean mark for the course given by students was 4.6 (median 5) (1=very poor, 6=very good). Conclusion: A communication skills course expanded by video-annotations and group discussions with a physician tutor was shown to be feasible and was well received by students and faculty.Hintergrund: Der obligatorische Kommunikationskurs für Berner Medizinstudierende im vierten Jahr hat zum Ziel, die Studierenden auf herausfordernde Kommunikationssituationen vorzubereiten. Die Studierenden spielen vier verschiedene Szenarien mit Simulationspatienten (SP) und erhalten von diesen Feedback aus der Patientenperspektive. Die Szenarien werden auf Video aufgezeichnet und auf die virtuelle Lernplattform der Universität geladen. Die Studierenden können ihre eigenen Videos anschauen und annotieren und anderen den Zugang dazu erteilen.Projektbeschreibung: Obschon die Kommunikationskurse bei den Studierenden beliebt sind, identifizierten wir drei Verbesserungsmöglichkeiten:Fehlendes ärztliches FeedbackSpärliche Nutzung der Video-AufnahmenFehlende Möglichkeit für Erfahrungsaustausch unter den Studierenden Diesen Defiziten versuchten wir mit einer zusätzlichen Aufgabe entgegenzutreten: Die Studierenden erhielten den Auftrag, von ihren eigenen Videos und denjenigen eines Mitstudierenden jeweils eine gelungene Sequenz, sowie eine in ihren Augen verbesserungswürdige Sequenz zu annotieren. Diese Videosequenzen und Annotationen dienten als Grundlage für ein zweistündiges Kleingruppenseminar mit einem ärztlichen Tutor. Der Kurs wurde mittels eines obligatorischen Online-Fragebogens evaluiert.Ergebnisse: Alle 247 Studierenden füllten den Fragebogen aus. Das Annotations-Tool und die Aufgabenstellung wurden als verständlich beurteilt. Die Studierenden gaben an, mehr von der Annotation des Videos eines Mitstudierenden profitiert zu haben als von der Annotation ihrer eigenen Videos. Die meisten Studierenden störte es nicht, von Mitstudierenden beurteilt zu werden. Die Rückmeldungen durch die ärztlichen Tutoren wurden grösstenteils als hilfreich erachtet. Die Studierenden bewerteten den Kurs durchschnittlich mit der Note 4.6 (Median: 5), (1=sehr schlecht, 6=sehr gut). Fazit: Die Ergänzung des Kurses durch Video-Annotationen und Gruppendiskussionen mit ärztlichen Tutoren konnte erfolgreich implementiert und technisch umgesetzt werden. Der Kurs wurde sowohl von den ärztlichen Tutoren wie auch von den Studierenden gut aufgenommen

„Telefonische Notfallkommunikation“ – Entwicklung, Durchführung und Evaluation eines Kurses zur Erkennung und Behandlung von medizinischen Notfällen über das Telefon für Studierende des 5. Studienjahres

Objectives: Advising patients seeking medical guidance while communicating with them via telephone is a highly relevant skill in clinical daily life. However, telephone consultations differ from face-to-face interactions: clinical examination is nearly impossible and visual signals cannot be observed. Thus, telephone consultations require specific skills training. This article describes the development, implementation and evaluation of a course, "Telephone Consultation for Medical Emergencies", for 5th year medical students at the University of Bern, Switzerland. Methods: Following the evidence in the literature for telephone consultations, we developed guidelines for effective communication via telephone. After self-study of preparatory material, learners engaged in telephone consultations with simulated patients (SP) at the simulation center. They received multi-dimensional feedback regarding the encounter. Results: The course was successfully implemented in 2012. Evaluations showed the course to be well-received by students. In a survey, students agreed that they had learned many new skills and that they considered this learning as being important in their future employment. They felt that the SP feedback was helpful and that being observed by peer-students during the encounter or filling in a checklist while observing peer-students in other encounters added to their learning. During the debriefing of the simulation with a clinical expert, students judged the scenarios as realistic and relevant, praised the SP performances and identified that the most instructive aspect of the training was the opportunity to practice and to get feedback. Conclusion: Telephone consultations require specific skills that should be trained. The current Covid-19 pandemic and the recommendations of government institutions for patients to contact healthcare professionals primarily via telephone stress the importance of adequately training these skills. In this publication we describe a feasible and viable format for implementing this process.Zielsetzung: Patienten und Patientinnen, die medizinischen Rat suchen, mittels eines Telefongespräches zu beraten, ist eine sehr wichtige Fähigkeit in der täglichen klinischen Routine. Allerdings unterscheidet sich die Kommunikation über das Telefon von einer persönlichen Konsultation: eine klinische Untersuchung ist nahezu unmöglich und es können keine visuellen Signale beobachtet werden. Daher ist ein gesondertes Training der telefonischen Beratung erforderlich. Dieser Beitrag beschreibt die Entwicklung, Durchführung und Evaluation eines Kurses für „Telefonische Notfallkommunikation“ für Medizinstudierende im 5. Studienjahr an der Universität Bern, Schweiz. Methoden: Unter Berücksichtigung der Evidenz bezüglich telefonischer Beratungen in der Literatur haben wir Richtlinien für eine wirksame telefonische Kommunikation entwickelt. Nach dem Selbststudium vorbereitender Materialien, üben die Studierenden die telefonische Beratung mit Simulationspatienten (SP) im Simulationszentrum. Sie erhalten bezüglich der Simulation multi-dimensionales Feedback. Ergebnisse: Der Kurs wurde erstmals 2012 erfolgreich durchgeführt. Die Evaluationen zeigten, dass der Kurs von den Studierenden positiv aufgenommen wurde. In einer Umfrage stimmten die Studierenden zu, dass sie viele neue Fertigkeiten erlernt hätten und dass sie das Gelernte für ihre zukünftige Arbeit als wichtig erachteten. Sie hatten das Gefühl, dass das Feedback der SP für sie hilfreich war und dass die Beobachtung während der Simulation durch einen Peer-Studierenden oder das Ausfüllen einer Checkliste während der Beobachtung eines Peer-Studierenden in anderen Simulationen zusätzlich zu ihrem Lerneffekt beitrugen. Im Rahmen von Debriefings von Simulationen mit klinischen Experten beurteilten die Studierenden die Fallbeispiele als realistisch und relevant, lobten die Darstellung der Rollen durch die SP und benannten die Möglichkeit zum Üben und das Erhalten von Feedback als die lehrreichsten Elemente des Kurses. Schlussfolgerung: Die telefonische Beratung erfordert spezielle Fähigkeiten, die gesondert trainiert werden sollten. Die derzeitige Covid-19 Pandemie und die Empfehlungen der Behörden, dass Patienten Gesundheitspersonal bevorzugt über das Telefon kontaktieren sollten, betont die Wichtigkeit eines angemessenen Trainings dieser Fähigkeiten. In dieser Publikation beschreiben wir ein machbares und brauchbares Format für einen solches Training