{"title":"There's more to surgery than scalpels","authors":"Lachlan Dick","doi":"10.1111/tct.13744","DOIUrl":"10.1111/tct.13744","url":null,"abstract":"","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"21 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673779","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}
Maria Bajwa, Anne Herx-Weaver, Shannon Baily, Jessica Ray, Yoon Soo Park, Janice Palaganas, Rami Ahmed
{"title":"Human factors considerations in distance simulation: A nominal group technique application","authors":"Maria Bajwa, Anne Herx-Weaver, Shannon Baily, Jessica Ray, Yoon Soo Park, Janice Palaganas, Rami Ahmed","doi":"10.1111/tct.13724","DOIUrl":"10.1111/tct.13724","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The pandemic-driven surge in global distance simulation (DS) adoption highlighted the need for effective educator training. A literature search identified the gap regarding human factors (HF) considerations for the professional development of DS practitioners. This study addresses this gap by applying HF principles to guide educators in developing and delivering evidence-based DS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a consensus-gathering, three-phase study using the nominal group technique (NGT) in the first phase, qualitative thematic analysis with member checking in the second phase and external expert opinion in the third. A dichotomised approach was used to divide the <i>post-consensus discussion survey</i> results into an agreement and non-agreement for quantitative analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results of the quantitative analysis identified the following needs: developing a conceptual framework for DS, tailoring the technical aspect to the educational objectives, investigating learner engagement, training faculty at an earlier stage and identifying at-risk students. Qualitative results identified primary themes of <i>technology</i>, <i>people</i> and <i>outcome measurements</i>. Key aspects of <i>technology</i> were identified as system- and programme-fit and resource considerations. <i>Outcome measurement</i> highlights the need for increased measurement and research at all levels of DS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Specific HF focal points include human–technology interaction and learning outcome assessment within the DS context. Incorporating HF principles throughout the DS process, from inception to outcome evaluation, promises substantial benefits for both learners and educators. This approach empowers both learners and educators, fostering a dynamic and enriched educational environment and improved learning experiences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"21 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673778","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}
Emily Buckley, John Cooke, Helen Whelton, Aileen Barrett
{"title":"‘Rules of engagement’: Does competition drive engagement in faculty development","authors":"Emily Buckley, John Cooke, Helen Whelton, Aileen Barrett","doi":"10.1111/tct.13737","DOIUrl":"10.1111/tct.13737","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Faculty development (FD) is integral to the implementation of educational programmes. However, attracting new faculty is challenging. Competition is a motivator for learning at an undergraduate level; however, incorporating competition to engage faculty in continued FD has not been explored. In the context of a new strategy to embed in situ simulation in postgraduate education across our healthcare group, and drawing on motivational theory, we asked ‘does competition drive engagement in new FD initiatives?’</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted semi-structured interviews with nine healthcare professionals (HCPs) who had participated in an in situ simulation ‘SimStars’ competition. Guided by thematic analysis and borrowing from constructivist grounded theory, we explored participants' motivations for entering a competition, their experiences of competition throughout their education and how this process impacted on their engagement in FD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three overarching concepts arose and challenged our understanding of the role of competition as a motivator: (1) ‘Competition is a necessary evil’; (2) ‘It really is the taking part that counts’; and (3) ‘Teamwork makes the dream work’. In contrast to previously published work, our results suggest participants view competition negatively and as a means to career progression. However, the opportunity to work as part of an (interprofessional) team towards a goal, and to develop a new skill (i.e. the process), was more motivating for participants than ‘winning’ a competition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Competition may not provide a motivation for HCPs to engage in FD and may be a barrier. Providing collaboration opportunities, faculty coaching and the chance to develop new skills could enhance engagement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"21 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.13737","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643590","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":"A pilot initiative to enhance quality improvement teaching with simulation","authors":"Mankeeran Dhanoa, Sachin Trivedi, Mark Sheridan","doi":"10.1111/tct.13723","DOIUrl":"10.1111/tct.13723","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Quality Improvement and Patient Safety (QIPS) is a recognised competency across residency programmes. Although a variety of teaching modalities exist, many do not represent the multifaceted clinical environment that trainees work in. Residents have reported challenges in linking QIPS classroom-based learning with their clinical duties. High-fidelity simulation has been used to bridge this gap within clinical skills teaching and therefore has potential to address this issue in QIPS learning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>We developed and piloted four high-fidelity simulation scenarios with 15 surgical residents (Orthopaedics, General Surgery, Gynaecology and Neurosurgery). Each scenario contained elements of both latent and active safety errors. Residents were provided with a short pre-reading from an open-access resource on basic QIPS methodology and underwent a debriefing by a trained QIPS faculty. Residents were then tasked to apply their learning to their scenario to develop a QIPS-focused solution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>Objective knowledge acquisition was assessed with the Quality Improvement Knowledge Assessment Tool—Revised (QIKAT-R) in conjunction with a survey based upon the Kirkpatrick Model of Learning. Overall, residents agreed that the simulation was helpful in learning QIPS methodology and agreed that they could perform fundamental QIPS tasks. The average QIKAT-R score demonstrated a trend towards improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>High-fidelity simulation is a potential means to provide residents with hands-on experience in QIPS knowledge acquisition and application. Future directions should aim to compare the efficacy of simulation with other teaching modalities and evaluate the long-term impact of QIPS teaching on resident behaviours and motivation to take part in QIPS initiatives.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"21 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139572294","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}
Carl Gustaf S. Axelsson, Michael G. Healy, Subha Ramani, Traci Wolbrink, Elizabeth Armstrong, Roy Phitayakorn
{"title":"Virtual training for small group facilitators","authors":"Carl Gustaf S. Axelsson, Michael G. Healy, Subha Ramani, Traci Wolbrink, Elizabeth Armstrong, Roy Phitayakorn","doi":"10.1111/tct.13731","DOIUrl":"10.1111/tct.13731","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In addition to providing patient care, interprofessional health care teams work collaboratively on a variety of projects. These projects often benefit from using facilitated small group project discussion sessions, such as the Harvard Macy Institute's (HMI) Step Back Process (SBP). Although having a trained facilitator is an important component of the SBP, only a limited number of health care professionals can attend HMI courses in person or virtually, limiting its impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>We developed three video-based education (VBE) modules to deliver facilitator training on the SBP, informed by principles of Mayer's cognitive theory of multimedia learning. For module development, we used a five-step approach. We evaluated effectiveness of the modules as a self-directed method to enhance SBP facilitator training. An initial survey collected demographic data and module feedback, a follow-up survey collected feedback on the modules' impact on facilitation and interviews focused on the participants' overall experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>Survey results indicated that the modules were positively received and helped to improve participant confidence in facilitating. We identified four themes from the interviews: challenges of facilitating, value of group feedback, value of modules for experienced facilitators and the modules as part of a multi-modal approach to train new facilitators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>This innovation provides insight on delivering facilitator training on the SBP using VBE. Health professions educators developing online facilitator training could adapt our development process and modify implementation guided by our results. Future work should evaluate the best methods to integrate VBE modules into a longitudinal virtual community and assess facilitation techniques.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"21 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565124","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}
Stacey Kassutto, Caitlin Clancy, Sean Harbison, Suzana Tsao
{"title":"A virtual simulation-based clinical skills course","authors":"Stacey Kassutto, Caitlin Clancy, Sean Harbison, Suzana Tsao","doi":"10.1111/tct.13727","DOIUrl":"10.1111/tct.13727","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Advancements in technology continue to transform the landscape of medical education. Virtual reality (VR) and remote simulation represent unique approaches to teaching students clinical skills through experiential learning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>We developed, implemented and evaluated a virtual simulation-based course modelled on Kolb's Learning Cycle. A 5-day, 15-h virtual clerkship clinical skills curriculum designed to help students recognise a patient requiring urgent or emergent care was piloted in May 2020. VR and remote simulations facilitated concrete experiences, reflective observation, concept formation, and active experimentation. Curricular evaluation included analysis of usage, performance, self-assessment, and perceptions of educational value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>One hundred and fifty-six students completed 436 VR sessions (median 3 per student). Students repeated virtual cases, on average, 75% of the time, demonstrating improvement in average performance scores from 59% (attempt 1) to 72% (attempt 2). Post-course evaluations, completed by 109 (69.9%) students, demonstrated significant improvements in mean scores in all domains of a self-assessment based on emergent care skills.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>We developed and implemented a virtual clinical skills course that allowed students to progress through all four stages of Kolb's Learning Cycle. VR and remote simulations represent an opportunity for educators to reimagine and expand opportunities for experiential learning. The number of students accommodated, total virtual simulations completed, and positive student feedback suggests that this may be a feasible, acceptable, and scalable method for increasing opportunities for progression through Kolb's Learning Cycle. Further investigation into impact on educational outcomes is needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"21 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565045","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}
Nicolette Codispoti MD, MS, MPH, Elizabeth Southworth MD, Sarah A. Wagner MD, Scott C. Graziano MD, MS, Gregory Gruener MD, MBA, MHPE
{"title":"Bridge to M4 (B2M4): An innovative residency application preparation curriculum","authors":"Nicolette Codispoti MD, MS, MPH, Elizabeth Southworth MD, Sarah A. Wagner MD, Scott C. Graziano MD, MS, Gregory Gruener MD, MBA, MHPE","doi":"10.1111/tct.13728","DOIUrl":"10.1111/tct.13728","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The medical residency application process is daunting, time-consuming, and variable, making mentorship in preparation for this process important. In light of changes to the residency application process due to the COVID-19 pandemic, medical students identified a need to create a formal residency application preparation curriculum. The curriculum focused on reflection, while also furthering professional development and preparing for the nuances of the residency application cycle through structured advising.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>Bridge to M4 (B2M4) included reflective activities to help guide curriculum vitae (CV) refinement, personal and professional values clarification, residency program exploration, elevator pitch formation, personal statement development, mentor identification, guidance on requesting letters of recommendation, and virtual residency interview preparation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>The B2M4 elective first took place in June 2020 with 36 rising fourth year students enrolled. Perceived effectiveness of the curriculum was assessed by having student cohorts evaluate the importance of the CV, personal statement, general preparation, and residency program selection before and after the course. Student feedback was reviewed with content analysis, which highlighted the usefulness of a structured residency preparation course that was rooted in reflection and incorporated faculty mentorship and feedback.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>This student-driven, innovative curricular design provided students the opportunity to prepare for the residency application process through reflective activities including values clarification, strengths identification, and goal setting. B2M4 demonstrates a process that can be used not only during the Residency Match process, but also throughout graduate medical education and future career decisions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"21 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565101","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":"Clinical educator expertise: A scoping review","authors":"Gretel Evans, Merrolee Penman, Kate Thomson","doi":"10.1111/tct.13729","DOIUrl":"10.1111/tct.13729","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Allied health clinicians supervising healthcare students in workplace learning play a key role in a learner's progression to autonomous practice, yet expert educator practice is not well understood. How expert clinical educators in allied health professions are defined, enact their role, develop educational expertise and bring value to workplace learning is unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A scoping methodology was chosen to understand what is known about clinical educator expertise in allied health, focusing on definitions, characteristics, impacts and development. Searching seven databases, the authors used an iterative, systematic approach to the selection, collation and analysis of peer-reviewed and grey literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Within 21 included papers, diverse terms and definitions were used to describe expert clinical educators across 9 allied health professions and 5 countries. Expert educator characteristics included advanced skills in facilitating learning, the ability to build positive relationships with learners and a proactive attitude to developing personal supervision skills through reflection. Impacts were identified for learners and educators, and the few sources examining educator development found that expert practice grows in a dynamic, multi-mode, non-linear fashion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A comprehensive picture of the expert clinical educator in allied health is not yet conceptualised, despite some characteristics being associated with expertise. The differences between expert and less proficient educators are unclear with little examination of the impacts, value or development of expert educator capabilities. We offer a framework for future research and advocate for focused studies that examine clinical educator expertise, to enhance approaches to professional development and recognition of excellence in clinical educator practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"21 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565169","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":"Informal peer-assisted learning amongst medical students: A qualitative perspective","authors":"Timothy J. Morris, Sarah Collins, Joanne Hart","doi":"10.1111/tct.13721","DOIUrl":"10.1111/tct.13721","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Peer-assisted learning (PAL) can occur informally as part of a medical programme and complements the formal curriculum. However, little is known about the mechanisms and processes of how informal peer-assisted learning (IPAL) is enacted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This paper presents data from an ethnographic and semi-structured interview study with Year 1 and 2 undergraduate medical students at a UK university.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Peers were observed assisting each other informally: a process that developed as part of the integrated, group-based approach to undergraduate medical education at a UK university. IPAL took place both within and outside of formal teaching sessions and included explanation/clarification of particular points, sharing resources, guiding pronunciation and demonstrating skills. Students placed a high value on IPAL and believed that it was beneficial. When IPAL broke down, this led to negative emotions that presented obstacles to learning, such as resentment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>IPAL is an important part of academic support for medical students, and this work shows both its scope, extending from formal to informal teaching, and how it is enacted. This understanding can help educators situate IPAL within student education.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"21 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.13721","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565171","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}