Clinical Teacher最新文献

{"title":"Australian Paramedic Students' Reports of Clinical Placement Experiences: A Snapshot From two Cohorts","authors":"Lisa Hobbs,&nbsp;John Latham,&nbsp;Anita Westwood,&nbsp;Melainie Cameron,&nbsp;Jeremy Taylor,&nbsp;Scott Devenish,&nbsp;Dennis Walker","doi":"10.1111/tct.70097","DOIUrl":"https://doi.org/10.1111/tct.70097","url":null,"abstract":"<p>Clinical placements are a core requirement of paramedicine undergraduate degrees in Australia. Registered paramedics are expected to participate in teaching and mentoring of undergraduate students during placement. Additionally, universities and paramedic clinical placement providers are required to actively participate in providing 360° feedback to ensure ongoing quality of clinical placements. Most students look forward to attending clinical placement and experiencing what it is really like to be a paramedic; however, at times, students' expectations differ greatly to their experiences. In this study, we provide students' reporting of their experiences and feedback verbatim and, where possible, grouped into four themes of challenges common across placements: <i>staffing/supervisor challenges</i>, <i>clinical challenges</i>, <i>occupational hazards</i> and <i>balancing competing demands</i>. We welcome further discussion and recommend collaborations between universities, clinical placement providers and regulatory bodies to improve clinical placement experiences of paramedicine students on clinical placements, clinical supervision and, potentially, patient safety outcomes.</p>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.70097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857112","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":"Fostering Equity: Assessing Access to Transgender Health Education in US Medical School Curricula","authors":"Rebecca Arteaga,&nbsp;Samhita Mallavarapu,&nbsp;Maurice M. Garcia,&nbsp;Sandeep Sandhu,&nbsp;Shannon M. Smith","doi":"10.1111/tct.70071","DOIUrl":"https://doi.org/10.1111/tct.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Medical educators have increasingly advocated for the importance of training medical students in the care of transgender and gender diverse (TGD) patients, as the paucity of TGD-specific education among medical students may perpetuate inequities in care. However, little is known about medical students' current exposure to TGD care. The purpose of the study was to characterise the current exposure of TGD care within undergraduate medical education across the United States and Puerto Rico.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Medical students from accredited allopathic (160) and osteopathic (60) medical schools in the United States and Puerto Rico were invited to participate in an anonymous survey between January 2024 and April 2024. The survey included questions relating to student exposure to several components of TGD care and their perceived importance of receiving such training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 461 students from 20 medical schools submitted at least partial responses to the survey. Overall, 68.2% (311/456) of students reported that their school's curriculum had explicit didactic training in the care of TGD patients, and only 33.0% (150/455) reported that their school's curriculum had explicit clinical training. Additionally, 78.4% (344/439) of students perceived receiving such training as very important after starting medical school.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While many medical students reported having explicit didactic training inclusive of TGD patients, clinical exposure is overall lacking. Most medical students endorsed the importance of training in the care of TGD patients. Medical school curricula should incorporate more dedicated didactic and clinical training in the care of TGD patients to better serve the TGD population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849291","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}

{"title":"Surviving and Thriving in Medicine: Developing Theory-Based Interventions for Students From Widening Access Backgrounds","authors":"K. Gibson Smith,&nbsp;E. Ferguson,&nbsp;K. Gouveia,&nbsp;K. A. Walker,&nbsp;C. Lumsden,&nbsp;A. Poobalan,&nbsp;A. Laidlaw","doi":"10.1111/tct.70076","DOIUrl":"https://doi.org/10.1111/tct.70076","url":null,"abstract":"<p>The challenges facing students from widening participation (WP) backgrounds do not simply disappear upon entering medicine. Accordingly, it is imperative that in promoting equity in medicine, we understand how WP students may be best supported to thrive in their studies. This research aimed to develop an evidence-based and theory-informed intervention strategy to target student support amongst undergraduate WP students in medicine. Workshops were conducted with staff working in the medical school and students from WP backgrounds. Participants generated potential intervention ideas and critically considered the feasibility of implementation. Data analysis and intervention development were supported by the Theoretical Domains Framework (TDF) and Behaviour Change Wheel (BCW). The TDF and BCW were successfully conceptualised to structure an intervention strategy to enhance student support amongst WP students in medicine. Workshop participants identified support needs of students from WP backgrounds, and these were prioritised and used to drive intervention development. We outline two interventions that were developed from the research: adaptation of the existing personal tutor scheme and implementation of a WP peer network. The theory-based intervention strategy outlines a foundation that could be utilised to develop and evaluate interventions to support students from WP backgrounds in medicine. This study has demonstrated how an intervention development framework (BCW) using a theoretical base can be used to develop interventions for students from WP backgrounds. Two intervention ideas were developed from the research and were designed to promote support seeking, social connection and a sense of belonging in students from WP backgrounds.</p>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.70076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818434","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":"Utility of Portable Fundus Camera in Teaching Direct Ophthalmoscopy to Medical Students","authors":"Ching-Kit Tsui,&nbsp;Yuxian Zou,&nbsp;Zhenzhen Liu,&nbsp;Yiqing Li,&nbsp;Rongxin Chen","doi":"10.1111/tct.70093","DOIUrl":"https://doi.org/10.1111/tct.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Direct ophthalmoscopy (DO) an essential skill for junior doctors. DO allows for quick and effective fundus examinations to detect life- and vision-threatening diseases. However, medical students often find it difficult to master DO due to the challenges associated with fundus visualisation. Innovative and effective approaches are needed at the undergraduate level to improve the acceptance and proficiency of DO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>In 2023–2024, 79 fourth-year medical students participated in a study to evaluate the acceptance and effectiveness of a new teaching approach using a portable fundus camera (PFC) during weekly ophthalmology clerkships. This study compared the PFC-assisted teaching method with the traditional DO teaching method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p><b>The participants were allocated into two groups, with 40 in Group A and 39 in Group B.</b> They attended traditional DO and PFC-assisted modules separately in session one and then crossed over in session two. Questionnaires evaluated perceived ease of use (PEOU), perceived usefulness (PU), confidence and satisfaction at the end of the sessions. All students completed the DO performance using standard patient and fundus photointerpretation assessments and compared with previous non-intervention group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The integration of PFC-assisted teaching into the ophthalmology curriculum effectively addressed traditional barriers to learning DO, fostering confidence and skill acquisition in medical students. The blended approach of combining technology with traditional teaching facilitated a more comprehensive learning experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>PFC-assisted teaching provided an innovative and effective strategy for improving DO training. We would advocate for similar approach may help students to find out the zone of proximal development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.70093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818435","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":"Humility and Confidence in Medical Education: Can They Co-Exist?","authors":"Diantha Soemantri","doi":"10.1111/tct.70086","DOIUrl":"https://doi.org/10.1111/tct.70086","url":null,"abstract":"","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787270","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}

{"title":"Busy Bedsides and Virtual Visits: Early Clinical Experience Under Threat","authors":"James Fisher,&nbsp;Jonathon Foggin,&nbsp;Phillipa Davies,&nbsp;Paul Paes","doi":"10.1111/tct.70090","DOIUrl":"https://doi.org/10.1111/tct.70090","url":null,"abstract":"","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787269","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}

{"title":"Using PowerPoint and H5P to Create Interactive Animated Instructional Videos","authors":"Nazlee Sharmin,&nbsp;Shahram Houshyar,&nbsp;Thomas R. Stevenson,&nbsp;Ava K. Chow","doi":"10.1111/tct.70094","DOIUrl":"https://doi.org/10.1111/tct.70094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The advantages of animated videos in education are widely recognised, yet their use by educators is restricted by the technical skills and resources needed for their production.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>We have used the built-in animation and voice-over narration features of Microsoft PowerPoint to create full-fledged animated videos for students in the Doctor of Dental Surgery (DDS) program. H5P was used to add interactive self-assessment questions to the videos. Three interactive animated videos on oral epithelium and biofilms were posted in the learning management system (LMS) for the first and second year DDS students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>A descriptive study was conducted to demonstrate student interactions and perceptions of interactive animated videos. First and second-year DDS students were automatically enrolled in the study. Student engagement data, in the form of the number of interactions with the interactive animated videos, were collected from the LMS. They were also invited to participate in a voluntary survey. Although the interactive animated videos were posted as supplementary learning content, most students accessed the videos. Ninety-four percent of the survey respondents indicated that the videos helped clarify concepts and made learning enjoyable. They also positively valued the interactive self-assessment questions incorporated into the videos.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>PowerPoint can be a simple yet effective way to create animated videos. Although this study has a small number of participants, the findings highlight the potential of interactive animated videos as an effective teaching tool to enhance student engagement and learning experiences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.70094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787268","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":"Evaluation of a Direct Observation, Coaching and Assessment Model for the Internal Medicine Clerkship","authors":"Katherine C. Wrenn,&nbsp;Cancan Zhang,&nbsp;Amy R. Weinstein","doi":"10.1111/tct.70091","DOIUrl":"https://doi.org/10.1111/tct.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>With a trend towards competency-based assessment in medical education, there is a need for increased direct observation, feedback and coaching of medical students during clinical rotations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>To increase observation and provide more coaching and feedback, we designed a model in which a faculty coach met with students longitudinally during the internal medicine clerkship. The first session included an observed history and physical (H&amp;P), and the coach and student identified skill areas to focus on in remaining sessions. All sessions included a debrief with feedback.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>Students received a survey to rate the amount and quality of observation and feedback received, and we used ordinal logistic regression models to assess the intervention. We conducted thematic analysis to assess what students found most useful. Students in the intervention group reported more direct observation performing the H&amp;P (OR = 9.17, 95% CI [1.86, 70.05], <i>p</i> = 0.01) and found the personalized feedback and increased opportunities to discuss clinical reasoning valuable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>With a growing need for longitudinal observation of clinical skills to allow for competency-based assessments, at a time in which there is often insufficient continuity between students and supervising physicians, this model helps address needs for increased direct observation, coaching and feedback on skill development over time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793557","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}

{"title":"Quality Standards of Transitional Programmes for International Medical Graduates: An International Modified Delphi Study to Develop a Theory-Based Framework","authors":"Carlos Murillo-Zepeda,&nbsp;Mark Pearson,&nbsp;Amaya Ellawala","doi":"10.1111/tct.70092","DOIUrl":"https://doi.org/10.1111/tct.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Interventions aimed at supporting international medical graduates during the transition to host countries facilitate adjustment to these new workplace environments. Despite the progress made on clarifying the mechanisms operating behind successful interventions, there is still a theory-practice gap that stems in part from lack of guidance on their design and implementation. Therefore, this study sought to develop and validate a set of standards to enhance the quality of the design and implementation of programmes aimed at supporting the transition of international medical graduates to the host countries' healthcare and educational systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A modified e-Delphi method was applied for this study. Initially, a literature review was carried out to identify potential participants. Subsequently, a preliminary questionnaire was developed by adapting the key assumptions of a programme theory. Then, the consensus panel was assembled including researchers and programme directors with expertise in training international medical graduates. Participants' ratings were polled iteratively over two rounds, and items with a consensus agreement above 50% in the relevance criterion were included in the final set of standards.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The response rate was 16% (20/119). Most panellists were from European countries and the majority held professor positions in urban, university-based settings. This set of quality statements emphasise the importance of organisational culture and the responsibility of host-institutions to support the transition of IMGs to the new workplace environment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This project provides a validated theory-based framework to inform decisions on the design and implementation of programmes aimed at supporting the transition of international medical graduates to the host countries' healthcare and educational systems. Further research endeavours should evaluate the impact of this set of standards on adjustment outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787173","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}

{"title":"Student Perceptions of Narrative Feedback in Entrustable Professional Activities","authors":"Rebecca Lee,&nbsp;Neil Dhami,&nbsp;William Gibson,&nbsp;Deena M. Hamza,&nbsp;Anna E. Oswald,&nbsp;Mandy Moffat","doi":"10.1111/tct.70089","DOIUrl":"https://doi.org/10.1111/tct.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Entrustable professional activity (EPA) observations can be used to develop a holistic picture of trainee competency in professional tasks. Narrative feedback is an essential component of EPAs, but there is a lack of published literature capturing undergraduate student perceptions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Students who completed Year 3 of the MD programme in 2022–2023 at one institution in Canada were invited to participate in a survey designed to elicit their perceptions of narrative feedback in EPAs. Survey methods included closed-ended questions (analysed descriptively) and open-ended questions (analysed through thematic analysis).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The response rate to the survey was 23%. Over 60% of students reported that narrative comments in EPAs were specific and aligned with EPA scores, and 86% reported that the narrative feedback was individualised at least some of the time. However, 57% reported that they never or rarely received actionable feedback for growth. Students demonstrated mixed feelings as to whether EPAs help support their clinical development. Some noted that they can help students identify gaps and reinforce positives. Others reported preferring verbal feedback to written feedback and that EPAs resulted in an administrative burden. Over 90% of students reported barriers to obtaining EPAs, and almost 90% expressed the need for changes to EPAs. A predominant theme from students was the desire for a reduction in EPA requirements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Students perceived the narrative feedback to be individualized and specific but reported that the feedback rarely contained feedback for growth. Students identified several barriers to EPA completion and provided recommended changes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.70089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786803","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}