The clinical teacher最新文献

{"title":"A remote access mixed reality teaching ward round.","authors":"Laksha Bala,&nbsp;James Kinross,&nbsp;Guy Martin,&nbsp;Louis J Koizia,&nbsp;Angad S Kooner,&nbsp;Gideon J Shimshon,&nbsp;Thomas J Hurkxkens,&nbsp;Philip J Pratt,&nbsp;Amir H Sam","doi":"10.1111/tct.13338","DOIUrl":"https://doi.org/10.1111/tct.13338","url":null,"abstract":"<p><strong>Background: </strong>Heterogeneous access to clinical learning opportunities and inconsistency in teaching is a common source of dissatisfaction among medical students. This was exacerbated during the COVID-19 pandemic, with limited exposure to patients for clinical teaching.</p><p><strong>Methods: </strong>We conducted a proof-of-concept study at a London teaching hospital using mixed reality (MR) technology (HoloLens2™) to deliver a remote access teaching ward round.</p><p><strong>Results: </strong>Students unanimously agreed that use of this technology was enjoyable and provided teaching that was otherwise inaccessible. The majority of participants gave positive feedback on the MR (holographic) content used (n = 8 out of 11) and agreed they could interact with and have their questions answered by the clinician leading the ward round (n = 9). Quantitative and free text feedback from students, patients and faculty members demonstrated that this is a feasible, acceptable and effective method for delivery of clinical education.</p><p><strong>Discussion: </strong>We have used this technology in a novel way to transform the delivery of medical education and enable consistent access to high-quality teaching. This can now be integrated across the curriculum and will include remote access to specialist clinics and surgery. A library of bespoke MR educational resources will be created for future generations of medical students and doctors to use on an international scale.</p>","PeriodicalId":74987,"journal":{"name":"The clinical teacher","volume":"18 4","pages":"386-390"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/tct.13338","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25547615","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":"Spirituality in medical education and COVID-19.","authors":"Seyed-Hasan Adeli,&nbsp;Morteza Heidari,&nbsp;Akram Heidari","doi":"10.1111/tct.13331","DOIUrl":"https://doi.org/10.1111/tct.13331","url":null,"abstract":"","PeriodicalId":74987,"journal":{"name":"The clinical teacher","volume":"18 4","pages":"372-373"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/tct.13331","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38834858","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":"The paradox of teaching wellness: Lessons from a national obstetrics and gynaecology resident curriculum.","authors":"Abigail Ford Winkel,&nbsp;Laura E Fitzmaurice,&nbsp;Stacie A Jhaveri,&nbsp;Sigrid B Tristan,&nbsp;Mark B Woodland,&nbsp;Helen Kang Morgan","doi":"10.1111/tct.13360","DOIUrl":"https://doi.org/10.1111/tct.13360","url":null,"abstract":"<p><strong>Background: </strong>In response to high rates of burnout among trainees, educators in obstetrics and gynaecology introduced a six-session wellness curriculum that improved professional fulfilment and resident burnout in participants with greater attendance. The implementation of the curriculum varied based on local variables and contextual factors.</p><p><strong>Objective: </strong>To analyse the reactions of participants and curriculum leaders across the diverse settings of the pilot experience in order to identify the best practices for implementation of a wellness curriculum.</p><p><strong>Methods: </strong>Twenty-five US OBGYN residency programmes completed the curriculum in the 2017-2018 academic year. OBGYN residents in all the years of training participated. Faculty members and fellows were workshop facilitators and course leaders. All participants completed post-intervention surveys. A qualitative, descriptive thematic analysis explored free-text responses from residents and workshop facilitators.</p><p><strong>Results: </strong>Among 592 eligible resident participants, 387 (65%) responded to the post-intervention survey. Workshop facilitators submitted 65 surveys (47% response) on curriculum elements, rating the activities as 'good' or 'excellent' in 90.8% of cases. Qualitative analysis of workshop facilitators' and resident comments pointed to three themes, namely disagreement about the purpose of the curriculum, the social value of the curriculum in the residency programme and the need to open a broader discussion and take action to address structural barriers to wellness.</p><p><strong>Conclusions: </strong>Residents and faculty members involved in a wellness curriculum pilot had polarised reactions. While participants found value in learning skills and connecting to colleagues, efforts to promote wellness skills should be accompanied by communication and action to address drivers of burnout.</p>","PeriodicalId":74987,"journal":{"name":"The clinical teacher","volume":"18 4","pages":"417-423"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/tct.13360","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38885814","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":"Teaching data science to medical trainees.","authors":"Ryan Wee,&nbsp;Ernest Soh,&nbsp;Dominic Giles","doi":"10.1111/tct.13391","DOIUrl":"https://doi.org/10.1111/tct.13391","url":null,"abstract":"Data science broadly refers to the endeavour of extracting knowledge from data. There is currently an explosion of data in health care, from the use of electronic health care record systems to complex datasets such as genomics. These scenarios present tremendous opportunities for health professionals— including doctors, nurses, medical students and allied health staff— to innovate their practice by harnessing, analysing and extracting insights from data. Furthermore, understanding data science will allow health professionals to be critical users of the literature. Reflecting the need for future doctors to be familiar with data science methods, our university (University College London) recently introduced a module titled ‘Doctor As Data Scientist’. This programme aims to educate medical students about critical appraisal and data science in medicine, and there are calls for more universities to implement a similar approach.1 There is also an increasing demand amongst medical students for data science skills to be incorporated into their training.2 However, several challenges remain in teaching data science to medical students:","PeriodicalId":74987,"journal":{"name":"The clinical teacher","volume":"18 4","pages":"384-385"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/tct.13391","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39073068","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":"The chicken dance technique for teaching the instrument tie.","authors":"Shaan Sadhwani,&nbsp;Anna Cho,&nbsp;NamHee Kim,&nbsp;Syeda B Owais,&nbsp;Antonio Bernardo,&nbsp;Alexander I Evins","doi":"10.1111/tct.13319","DOIUrl":"https://doi.org/10.1111/tct.13319","url":null,"abstract":"Suturing and knot tying are essential skills and a mainstay of medical education, however, there remains a lack of detailed literature on effective methods for teaching new learners.1,2 Over the previous decade of teaching suturing, our team of surgical educators, led by an experienced academic neurosurgeon, has noticed a typical pattern of errors made by new learners, characterized by rigidity and a narrow working area, that result in wasted motions, pulling out the tail of the suture, and loosely tied knots. To combat this, we developed a novel teaching technique using the Chicken Dance that emphasizes visuospatial awareness and the importance of the elbows in knot tying while allowing students to learn the fundamental motions in an unconstricted space. Students are divided into small instructor-led groups, spaced 1 meter apart and positioned perpendicular to the wound. The suture needle is advanced through each end of the wound using a needle driver and forceps, with supination of the wrist, and the suture is pulled leaving a 2–3 cm tail. The needle is removed from the driver, the forceps are palmed, and the long end of the suture is grasped by the non-dominant hand, securing the needle. The Chicken Dance technique is then taught using the following steps. 1. Starting Position: Start by imitating chicken wings—abduct the arm at the shoulder to bring the elbows to 75–90° and flex the elbow to bring the wrists to the sternum while holding the suture with the non-dominant hand behind the needle driver in the dominant hand (Figure 1A). Place the hands approximately 10 cm in front of the chest and at least 10 cm above the wound to maximize the working area. 2. Wing Flapping: With the suture held behind the needle driver, begin the wrapping of the suture around the driver by flapping your “chicken wings”—moving both elbows superiorly from the starting position (Figure 1B-C) and then inferiorly below the starting position (Figure 1C), wrapping the suture around the driver once. Repeat to wrap the suture around the driver a second time (Figure 1D-E), keeping both wrists relatively still and each arm moving in concert so that one arm is not moving more than the other. The flapping motion of the elbows results in the suture wrapping around the needle driver without creating tension on the suture. 3. First Square Knot: Once the suture is wrapped around the needle driver, supinate the dominant hand to prevent the suture from slipping off and grasp the tip of the tail with the driver (Figure 1F). The non-dominant hand is then extended to pull the suture off the driver and create and tighten a knot (Figure 1G). This is performed with minimal movement of the driver to prevent elongation of the tail during tightening. Perpendicular force should then be applied using both hands. 4. Additional Throws: Repeat steps 1–4 with one wrap of the suture around the needle driver, alternating the direction of the wrap with each throw of the knot until the desired number ","PeriodicalId":74987,"journal":{"name":"The clinical teacher","volume":"18 4","pages":"365-366"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/tct.13319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38733151","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":"Inequalities of pandemic proportions.","authors":"Esther Dami Okhiria,&nbsp;Katherine Roxanne Rahnejat","doi":"10.1111/tct.13361","DOIUrl":"https://doi.org/10.1111/tct.13361","url":null,"abstract":"","PeriodicalId":74987,"journal":{"name":"The clinical teacher","volume":"18 4","pages":"379-380"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/tct.13361","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38959561","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":"The CREDE framework through clinical cases.","authors":"Juan Pablo Scarano Pereira,&nbsp;Inés Bedmar Gómez,&nbsp;Carmen Navas Jiménez","doi":"10.1111/tct.13356","DOIUrl":"https://doi.org/10.1111/tct.13356","url":null,"abstract":"","PeriodicalId":74987,"journal":{"name":"The clinical teacher","volume":"18 4","pages":"442"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/tct.13356","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38887798","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":"Learning and satisfaction in a student-led clinic.","authors":"Laura Niwa,&nbsp;Crystal L MacLellan","doi":"10.1111/tct.13339","DOIUrl":"https://doi.org/10.1111/tct.13339","url":null,"abstract":"<p><strong>Background: </strong>Student-led clinics (SLCs) offer unique clinical placement experiences and address unmet community rehabilitation needs. There is growing evidence that SLCs provide high-quality experiential practice and adequate quality of patient care. The purpose of this study was to evaluate patient satisfaction with student-led care and students' perception of their learning experiences in a student-led physiotherapy clinic.</p><p><strong>Methods: </strong>Eight participants with total hip arthroplasty attended 6 weeks of student-led group exercise classes. As a marker of quality of care, we assessed key outcomes including walking speed and endurance, lower extremity function, falls risk and self-reported quality of life after 3 and 6 weeks. Patients completed a satisfaction survey at the end of the program. Ten students who completed a placement during this time shared their perception of learning in the SLC.</p><p><strong>Results: </strong>Student-led group exercise class was associated with improvements in walking speed and endurance, lower extremity function, a decrease in falls risk and improved quality of life. Patients were satisfied with their care. The SLC was a safe learning environment in which students felt well-supported to develop confidence and independence, were encouraged to reflect on performance and take responsibility for care provided.</p><p><strong>Conclusion: </strong>Patients are largely satisfied with the quality of care provided. High-quality authentic clinical learning opportunities provided in the SLC may offer pedagogical benefits over traditional practicums, and students are generally satisfied with their learning experiences. SLCs may provide a setting to expose students to research and gain appreciation for evidence-based practice.</p>","PeriodicalId":74987,"journal":{"name":"The clinical teacher","volume":"18 4","pages":"391-397"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/tct.13339","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25428559","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":"The student perspective of a staff-student partnership scheme.","authors":"Yuri Yin-Moe Aung","doi":"10.1111/tct.13358","DOIUrl":"https://doi.org/10.1111/tct.13358","url":null,"abstract":"The Imperial College StudentShaper program is a student partnership scheme created to encourage staff– student collaboration on educational research. 1 Its core tenet is for staff and students to be equally valued and mutually benefit, with the overall aim of improving student experience. This approach aligns with the concept of ‘students as partners’, proposing that involving students in their own education processes improves their engagement, agency and enhances higher education programs. 2 While similar schemes exist elsewhere, 3,4 the StudentShaper program is to my knowledge unique in providing a ded-icated platform for student partnership, supported by Imperial College strategy and a student bursary. my I em-ployed twice as a StudentShaper in two year- long research projects concerning student for and the of pre- performance in medicine respectively.","PeriodicalId":74987,"journal":{"name":"The clinical teacher","volume":"18 4","pages":"377-378"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/tct.13358","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38947447","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":"Video-assisted reflection: improving OSCE feedback.","authors":"Oliver Mitchell,&nbsp;Natalia Cotton,&nbsp;Kathleen Leedham-Green,&nbsp;Salem Elias,&nbsp;Brent Bartholomew","doi":"10.1111/tct.13354","DOIUrl":"https://doi.org/10.1111/tct.13354","url":null,"abstract":"<p><strong>Background: </strong>Objective Structured Clinical Examinations (OSCEs) are commonly used to provide feedback to students on their performance in formative examinations. However, students are often unable to act independently on the feedback they receive. This study explored how the use of video-assisted reflection in OSCEs can enhance students' ability to reflect and engage in sustainable feedback.</p><p><strong>Methods: </strong>Twenty-one students undertaking a mock-final OSCE consented to have one of their examination stations filmed. Participants completed a series of reflective forms immediately after the OSCE, after verbal feedback from an examiner and finally, after watching the video of their own performance. Students were asked to predict their overall grade as well as list areas for improvement. Pearson r correlations examined the relationship between the examiners' grades and the candidates' self-predicted grades. Wilcoxon signed-rank tests were used to compare the length of reflections at each stage. Semi-structured interviews were conducted to explore students' beliefs on self-efficacy and how the video-assisted reflection altered their ability to act on feedback.</p><p><strong>Results: </strong>The students' ability to self-assess and gauge their own performance improved significantly after undertaking the video-assisted reflection (p < 0.01). Furthermore, video-assisted reflection significantly increased the length of the student's reflections. In interviews, participants described multiple ways in which the video-assisted reflection improved their confidence and ability to act on feedback, highlighting a clear enhancement in self-efficacy.</p><p><strong>Discussion: </strong>Video-assisted reflection of recorded OSCE stations represents an effective approach to increase student self-efficacy and subsequently improve engagement in sustainable feedback practice.</p>","PeriodicalId":74987,"journal":{"name":"The clinical teacher","volume":"18 4","pages":"409-416"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/tct.13354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38875906","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}