Investigating the degree of self-efficacy perception and role performance of nursery and midwifery college instructors in practical education

چکیده: زمینه و هدف: اگر سلامتی یک جامعه را در گرو خدمات پرستار و ماما بدانیم، شناخت و حل موانع و مشکلات ایفای نقش و خودکارآمدی در آموزش بالینی، می تواند شرایط لازم جهت ایفای نقش بهتر و خودکارآمدتر بودن مربیان را فراهم نماید. از این رو این مطالعه با هدف تعیین احساس خودکارآمدی و ایفای نقش مربیان دانشکده پرستاری و مامایی و ارایه راه‌کارها انجام شده است. روش بررسی: این پژوهش، یک مطالعه توصیفی است که با روش حل مسأله انجام شده است. نظرات کلیه مربیان دانشکده پرستاری و مامایی شهرکرد متمایل به شرکت در پژوهش (29 نفر) با استفاده از ابزارهای بررسی که شامل پرسشنامه ایفای نقش و احساس خودکارآمدی بود مورد بررسی و ارزیابی قرار گرفت. داده ها با استفاده از آزمون آمار توصیفی تجزیه و تحلیل شد. یافته‌ها: در ارتباط با مشکلات مربوط به ایفای نقش، شاخص‌ترین مشکل از دیدگاه این مربیان «فراهم نبودن محیط مناسب برای ایفای نقش مربیان در بالین» با امتیاز 57/127 از 145 بود. در ارتباط با مشکلات مربوط به احساس خودکارآمدی شاخصی که کمترین امتیاز را به خود اختصاص داد و در واقع ضعیف‌ترین احساس خودکارآمدی را در بر داشت، احساس مربوط به «من جهت افزایش اعتماد بنفس خودم، قادر هستم در ارتباط با ایده‌ها و نظریات خودم در صورت لزوم با مسئولین دانشکده در طول ترم تحصیلی بحث علمی نمایم.» بود که با امتیاز 90 از 116 در آخرین رده قرار گرفت. عوامل موثر در ایفای نقش مربیان شامل تاهل، سن، سابقه کار و میزان تحصیلات و عوامل موثر بر خودکارآمدی مربیان شامل سن و نوع استخدام بود. نتیجه‌گیری: با توجه به نتایج حاصل از پژوهش حاضر و دانش، تاهل، سن، سابقه کار و میزان تحصیلات، مهارت و قدرت ایفای نقش یک مربی پرستاری و مامایی را تحت تاثیر قرار داده و توانمندی وی را ارتقاء می بخشد. به هر میزان که این مقوله ها قوی تر باشد، احساس خودکارآمدی مربی پرستاری و مامایی نیز افزایش یافته و تاثیر شگرفی بر کیفیت ایفای نقش وی خواهد گذاشت

Malaysian pharmacy educators’ view of the role of non-pharmacy trained educators in teaching pharmacy students

The common statement “…Pharmacy students should only be taught by pharmacists…” is a norm among many pharmacy educators in countries such as Malaysia. It is not, per se, a confronting statement but could indicate alarming attitudes not favorable to the current pharmacy education framework. Pharmacy education in the third millennium is transformed to contain and reflect on the innovations of the modernization era in which, globalization in health education, public health, development of the new facets of professionalization and professionalism, interprofessional and interdisciplinary teaching and learning activities are among the most talked about topics.1-6 Interestingly, these innovative ideas are the result of extremely cautious, vigilant, accurate, and continuous observations and contemplations which have undergone thorough examinations and experimentations before being presented as novice ideas and/or theories. For example, the notion of interdisciplinary learning dates back to late 1970s7 and today, there is concrete evidence of its effectiveness and usefulness in delivery of better health care.6,8 Hence, to contest such ideas and/or theories, one needs to be able to provide reliable evidence(s), as agreements or disagreements should be borne with a full sense of responsibility and accountability

Relationship-centred care in health: A 20-year scoping review

Relationship-centred care (RCC) is a framework for conceptualizing health care which recognizes that the nature and quality of relationships in health care influence the process and outcomes of health care. Our goal was to undertake a scoping review of the peer-reviewed and grey literature on RCC in health. Using Arksey and O’Malley’s scoping review methodology we identified literature about RCC in teaching, learning and clinical practice. Electronic databases were searched, and targeted searches were also conducted for grey literature to capture unpublished material. Subsequently, data abstraction tools were used with eligible studies for analysis. Sixty-nine publications originated mainly from the United States and the United Kingdom by authors from various academic disciplines, of which medicine and nursing were dominant. Thematic analysis revealed that the most commonly cited definition of RCC emerged from the Pew-Fetzer report and focused on the central role of relationships between practitioners and their patients, the community and other practitioners in providing quality care and improving outcomes. The concept of RCC was found to be influenced by theories of sociology, social psychology and psychiatry. The practice of RCC was demonstrated through organizational environments that model RCC, practice settings that focus on the patient or family in care planning, and health professional education that is based on RCC principles. RCC is important to: humanize health care and improve patient care. Our review identified three sub-categories that could add to the relational dimension of the practitioner-organization: practitioner–education, practitioner–profession, and practitioner–practice. Recommendations for future research include: outcome and process studies of health professions education and health care that focuses on RCC. The RCC approach provides a paradigm to move beyond the patient-centred care model by focusing on the central role of all relationships in the delivery and outcomes of care

Medical student experiences in clinical reproductive medicine: dual-cohort assessment of a new learning module at the Royal College of Surgeons in Ireland

Aims: Exposure to a structured curriculum in reproductive medicine during medical school is helpful given the high frequency of fertility and pregnancy-related issues that future physicians will encounter. This study sought to evaluate a new reproductive medicine module for medical students. Study Design: Prospective cohort study. Place and Duration of Study: Dublin, Ireland; 2008-2010. Methodology: A new educational module in reproductive medicine for upper-level medical students was initiated in 2008 at the Royal College of Surgeons in Ireland (RCSI). The module included reproductive endocrinology lectures, laboratory sessions, and direct observation of clinical consultations as a required component of an obstetrics and gynaecology rotation. Students were assigned to this module on the basis of random allocation by departmental administration. The current investigation used an anonymous questionnaire and a MCQ exam to measure academic performance and student acceptance of this module, at launch and again two years later. The first sampling was from the pilot class in 2008 and a second group was evaluated in 2010. No student was in both groups. Results: 42 of 66 students completed the evaluation in 2008, and 71 of 98 did so in 2010. Mean±SD medical student age and average examination scores were comparable for the two groups. In both samples, most students (95.5%) had no prior lectures on reproductive endocrinology, and most indicated improvement in their level of understanding after the module. Both laboratory and clinical features were scored highly by students. Conclusion: At present, there is no standardised medical student curriculum for reproductive medicine in Ireland. This report is the first to describe a structured learning experience in this subspecialty area for medical students in Ireland. Additional studies are planned to track knowledge acquisition and career impact specific to reproductive medicine based on this module

Teaching Culturally Sensitive Care to Dental Students: A Multidisciplinary Approach

Dental schools must prepare future dentists to deliver culturally sensitive care to diverse patient populations, but there is little agreement on how best to teach these skills to students. This article examines this question by exploring the historical and theoretical foundations of this area of education in dentistry, analyzes what is needed for students to learn to provide culturally sensitive care in a dental setting, and identifies the discipline-specific skills students must master to develop this competence. The problems associated with single-discipline, lecture-based approaches to teaching culturally sensitive care are outlined, and the advantages of an interdisciplinary, patient-centered, skills-based approach to teaching culturally sensitive care are described. The authors advocate for an approach to teaching culturally sensitive care that builds upon learning in the behavioral sciences, ethics, and public health. Component skills and perspectives offered by each of these curriculum areas are identified, and their contributions to the teaching of culturally sensitive care are described. Finally, the need to consider the timing of this instruction in the dental curriculum is examined, along with instructional advantages associated with an approach that is shared by faculty across the curriculum

Attitudes of medical students to medical leadership and management: a systematic review to inform curriculum development.

BACKGROUND: There is a growing acknowledgement that doctors need to develop leadership and management competences to become more actively involved in the planning, delivery and transformation of patient services. We undertook a systematic review of what is known concerning the knowledge, skills and attitudes of medical students regarding leadership and management. Here we report the results pertaining to the attitudes of students to provide evidence to inform curriculum development in this developing field of medical education. METHODS: We searched major electronic databases and citation indexes within the disciplines of medicine, education, social science and management. We undertook hand searching of major journals, and reference and citation tracking. We accessed websites of UK medical institutions and contacted individuals working within the field. RESULTS: 26 studies were included. Most were conducted in the USA, using mainly quantitative methods. We used inductive analysis of the topics addressed by each study to identity five main content areas: Quality Improvement; Managed Care, Use of Resources and Costs; General Leadership and Management; Role of the Doctor, and Patient Safety. Students have positive attitudes to clinical practice guidelines, quality improvement techniques and multidisciplinary teamwork, but mixed attitudes to managed care, cost containment and medical error. Education interventions had variable effects on students' attitudes. Medical students perceive a need for leadership and management education but identified lack of curriculum time and disinterest in some activities as potential barriers to implementation. CONCLUSIONS: The findings from our review may reflect the relatively little emphasis given to leadership and management in medical curricula. However, students recognise a need to develop leadership and management competences. Although further work needs to be undertaken, using rigorous methods, to identify the most effective and cost-effective curriculum innovations, this review offers the only currently available summary of work examining the attitudes of students to this important area of development for future doctors.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Teaching Resident Self-Assessment Through Triangulation of Faculty and Patient Feedback

Problem: To accurately determine one\u27s ability in any clinical competency, an individual must be able to self-assess performance and identify personal limitations. Existing research demonstrates that physicians of all levels are unreliable self-assessors. This poses a concern in medical practice, which requires continuous updates to clinical competencies and awareness of personal limitations. Few published studies examine graduate medical education curricula designed to develop self-assessment skills. Intervention: Conceptual models, such as self-determination theory, suggest that self-assessment is most effectively learned through reflective processes. The Family Medicine Residency Program at Lehigh Valley Health Network developed a learner-centered competency assessment process that integrates advising and performance review. The multisource, observable behavior-based process encourages conversation between resident and advisor. Utilizing feedback from clinical preceptors and patient surveys, advisors guide residents in determining individual learning needs in core competency areas, including relationship-centered care. Development of medical learners\u27 capacity to form relationships is one means to improving the patient experience. Context: This retrospective case study evaluates the accuracy of senior residents\u27 self-assessment in relationship-centered care compared with that of junior residents. The study population includes the 34 residents enrolled from AY 2009–2012. Data sets represent specific 6-month periods and have 3 component scores—Self, Faculty, and Patient—which were triangulated to determine concordance rates by postgraduate year level. Outcome: The concordance rate among first-years was 26.7%, whereas third-years saw 60.0% concordance. A discordance analysis found the Patient score most often deviated from the other 2 scores, whereas the Faculty score was never the sole dissenter. When all 3 scores differed, the Self score frequently fell between the other 2 scores. Lessons Learned: The principles of self-determination theory provide a valuable framework for understanding the development of residents\u27 intrinsic motivation to become lifelong learners. The trend in improved concordance rates among senior residents suggests that prompting learners to triangulate feedback from multiple sources can lead to a shift in perspective about competency. Further study is needed to determine whether our results are generalizable to other competencies and educational setting

Experienced Quality of Post-Acute and Long-Term Care From the Care Recipient's Perspective-A Conceptual Framework

This article aims to conceptualize experienced quality of post-acute and long-term care for older people as perceived by care recipients. An iterative literature review and consultations with stakeholders led to the development of the INDividually Experienced QUAlity of Long-term care (INDEXQUAL) framework. INDEXQUAL presents the process of an individual care experience consisting of a pre (expectations), during (experiences), and post (assessment) phase. Expectations are formed prior to an experience by personal needs, past experiences, and word-of-mouth. An experience follows, which consists of interactions between the players in the caring relationships. Lastly, this experience is assessed by addressing what happened and how it happened (perceived care services), how this influenced the care recipient's health status (perceived care outcomes), and how this made the care recipient feel (satisfaction). INDEXQUAL can serve as a framework to select or develop methods to assess experienced quality of long-term care. It can provide a framework for quality monitoring, improvement, and transparency. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine

The International Charter for Human Values in Healthcare: An interprofessional global collaboration to enhance values and communication in healthcare

Objectives: The human dimensions of healthcare—core values and skilled communication necessary for every healthcare interaction—are fundamental to compassionate, ethical, and safe relationship-centered care. The objectives of this paper are to: describe the development of the International Charter for Human Values in Healthcare which delineates core values, articulate the role of skilled communication in enacting these values, and provide examples showing translation of the Charter’s values into action. Methods: We describe development of the Charter using combined qualitative research methods and the international, interprofessional collaboration of institutions and individuals worldwide. Results: We identified five fundamental categories of human values for every healthcare interaction—Compassion, Respect for Persons, Commitment to Integrity and Ethical Practice, Commitment to Excellence, and Justice in Healthcare—and delineated subvalues within each category. We have disseminated the Charter internationally and incorporated it into education/training. Diverse healthcare partners have joined in this work. Conclusion: We chronicle the development and dissemination of the International Charter for Human Values in Healthcare, the role of skilled communication in demonstrating values, and provide examples of educational and clinical programs integrating these values. Practice implications: The Charter identifies and promotes core values clinicians and educators can demonstrate through skilled communication and use to advance humanistic educational programs and practice

Understanding Patient Trust in the Athletic Setting through Interviews

Trust is a vital component of the patient-clinician relationship yet little is known about trust in the athletic training (AT) profession. Purpose: The purpose of this qualitative study was to define and understand trust in an athletic training setting. Methods: Interviews with Division I student-athlete patients (n=9) and athletic trainers (n=3) were conducted to collect data about participant views and definitions of trust. Data were analyzed using classical and constant comparison techniques; the trustworthiness of findings were assessed via peer debriefing, member checks, and reflexive journaling. Results: The analyses yielded 21 codes and four themes described to promote trust: (1) athletic trainers’ attributes, (2) interactions between athletic trainers and athletes, (3) the quality of this relationship and (4) the overall experience. Conclusion: A working definition of trust in the athletic training setting was developed via this work; furthermore, athletic trainers and patients agreed that trust is a complex construct but is vital to developing a productive therapeutic relationship