scholarly journals Development of a clinical skills remediation program for chiropractic students at a university

2018 ◽  
Vol 32 (2) ◽  
pp. 152-158
Author(s):  
Suzanne D. Lady ◽  
Leslie A.K. Takaki
Keyword(s):  
Student Performance ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Acceptable Level ◽  
Educational Institutions ◽  
Important Goal ◽  
Assessment Measures ◽  
Consistent Assessment ◽  
Remediation Plan ◽  
Chiropractic Students

Objective: An important goal of chiropractic educational institutions is to ensure that all graduates reach an acceptable level of clinical competency and thus institutions are equipped to offer traceable remediation when skills fall below certain benchmarks. Methods: Working with key individuals in the faculty, administration, and assessment department, a process of remediation was created and materials were produced that could be used by faculty and assessment staff to focus on a student's lack of knowledge, technique, or documentation in specific clinical skill areas. The primary goal was to create an individualized remediation plan that suits the specific needs of the student. Results: Utilization of the remediation center continues to increase. Referrals to the center for fiscal years 2015, 2016, and 2017 were 60, 125, and 126 students, respectively. Retesting rates after remediation continue to be high, with 98.3%, 95.2%, and 95.8% for fiscal years 2015, 2016, and 2017, respectively. Conclusion: We developed and implemented a chiropractic remediation program to satisfy the need for objectively identifying and remediating clinical skill deficiencies. This remediation program experienced an increase in use in its initial 3 years of operation, indicating more inclusion of the program across the departments, clinics, and assessment. The outcome of remediation is still not clear because there are no consistent assessment measures in place to determine pre- and postremediation student performance.

scholarly journals Comparison of ‘Mental training’ and physical practice in the mediation of a structured facial examination: A quasi randomized, blinded and controlled study 

2021 ◽  
Author(s):  
Arne Nelskamp ◽  
Benedikt Schnurr ◽  
Alexandra Germanyuk ◽  
Jasmina Sterz ◽  
Jonas Lorenz ◽  
...  
Keyword(s):  
Student Performance ◽  
Clinical Examination ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Maxillofacial Surgery ◽  
Training Group ◽  
Controlled Study ◽  
Oral And Maxillofacial Surgery ◽  
Mental Training ◽  
Physical Practice

Abstract Background: The correct performance of a structured facial examination presents a fundamental clinical skill to detect facial pathologies. However, many students are not adequately prepared in this basic clinical skill. Many argue that the traditional ‘See One, Do One’ approach is not sufficient to fully master a clinical skill. ‘Mental Training’ has successfully been used to train psychomotor and technical skills in sports and other surgical fields, but its use in Oral and Maxillofacial Surgery is not described. We conducted a quasi-experimental to determine if ‘Mental Training’ was effective in teaching a structured facial examination. Methods: 67 students were randomly assigned to a ‘Mental Training’ and ‘See One, Do One’ group. Both groups received standardized video instruction on how to perform a structured facial examination. The ‘See One, Do One’ group then received 60 minutes of guided physical practice while the ‘Mental Training’ group actively developed a detailed, stepwise sequence of the performance of a structured facial examination and visualized this sequence subvocally before practicing the skill. Student performance was measured shortly after (T1) and five to ten weeks (T2) after the training by two blinded examiners (E1 and E2) using a validated checklist. Results: Groups did not differ in gender, age or in experience. The ‘Mental Training’ group averaged significantly more points in T1 (pE1 = 0.00012; pE2 = 0.004; dE1 = 0.86; dE2 = 0.66) and T2 (pE1 = 0.04; pE2 = 0.008, dE1 = 0.37; dE2 = 0.64) than the ‘See One, Do One’ group. The intragroup comparison showed a significant (pE1 = 0.0002; pE2 = 0.06, dE1 = 1.07; dE2 = 0.50) increase in clinical examination skills in the ‘See One, Do One’ group, while the ‘Mental Training’ group maintained an already high level of clinical examination skills between T1 and T2.Discussion: ‘Mental Training’ is an efficient tool to teach and maintain basic clinical skills. In this study ‘Mental Training’ was shown to be superior to the commonly used ‘See One, Do One’ approach in learning how to perform a structured facial examination and should therefore be considered more often to teach physical examination skills.

scholarly journals Comparison of ‘Mental training’ and physical practice in the mediation of a structured facial examination: a quasi randomized, blinded and controlled study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arne Nelskamp ◽  
Benedikt Schnurr ◽  
Alexandra Germanyuk ◽  
Jasmina Sterz ◽  
Jonas Lorenz ◽  
...  
Keyword(s):  
Student Performance ◽  
Clinical Examination ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Maxillofacial Surgery ◽  
Training Group ◽  
Controlled Study ◽  
Oral And Maxillofacial Surgery ◽  
Mental Training ◽  
Physical Practice

Abstract Background The correct performance of a structured facial examination presents a fundamental clinical skill to detect facial pathologies. However, many students are not adequately prepared in this basic clinical skill. Many argue that the traditional ‘See One, Do One’ approach is not sufficient to fully master a clinical skill. ‘Mental Training’ has successfully been used to train psychomotor and technical skills in sports and other surgical fields, but its use in Oral and Maxillofacial Surgery is not described. We conducted a quasi-experimental to determine if ‘Mental Training’ was effective in teaching a structured facial examination. Methods Sixty-seven students were randomly assigned to a ‘Mental Training’ and ‘See One, Do One’ group. Both groups received standardized video instruction on how to perform a structured facial examination. The ‘See One, Do One’ group then received 60 min of guided physical practice while the ‘Mental Training’ group actively developed a detailed, stepwise sequence of the performance of a structured facial examination and visualized this sequence subvocally before practicing the skill. Student performance was measured shortly after (T1) and five to 10 weeks (T2) after the training by two blinded examiners (E1 and E2) using a validated checklist. Results Groups did not differ in gender, age or in experience. The ‘Mental Training’ group averaged significantly more points in T1 (pE1 = 0.00012; pE2 = 0.004; dE1 = 0.86; dE2 = 0.66) and T2 (pE1 = 0.04; pE2 = 0.008, dE1 = 0.37; dE2 = 0.64) than the ‘See One, Do One’ group. The intragroup comparison showed a significant (pE1 = 0.0002; pE2 = 0.06, dE1 = 1.07; dE2 = 0.50) increase in clinical examination skills in the ‘See One, Do One’ group, while the ‘Mental Training’ group maintained an already high level of clinical examination skills between T1 and T2. Discussion ‘Mental Training’ is an efficient tool to teach and maintain basic clinical skills. In this study ‘Mental Training’ was shown to be superior to the commonly used ‘See One, Do One’ approach in learning how to perform a structured facial examination and should therefore be considered more often to teach physical examination skills.

scholarly journals Comparison of ‘Mental Training’ and Physical Practice in the Mediation of a Structured Facial Examination

2020 ◽  
Author(s):  
Arne Nelskamp ◽  
Benedikt Schnurr ◽  
Jasmina Sterz ◽  
Jonas Lorenz ◽  
Robert Sader ◽  
...  
Keyword(s):  
Student Performance ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Maxillofacial Surgery ◽  
Training Group ◽  
Oral And Maxillofacial Surgery ◽  
Mental Training ◽  
Physical Practice ◽  
Significant Difference ◽  
High Level

Abstract Background: The correct performance of a structured facial examination presents a fundamental clinical skill to detect facial pathologies. However, many students are not adequately prepared in this basic clinical skill. Many argue that the traditional ‘See One, Do One’ approach is not sufficient to fully master a clinical skill. ‘Mental Training’ has successfully been used to train psychomotor and technical skills in sports and other surgical fields, but its use in Oral and Maxillofacial Surgery is not described. We conducted a fully randomized experiment to determine if ‘Mental Training’ was effective in teaching a structured facial examination.Methods: 67 students were randomly assigned to a ‘Mental Training’ and ‘See One, Do One’ group. Both groups received standardized video instruction on how to perform a structured facial examination. The ‘See One, Do One’ group then received 60 minutes of guided physical practice while the ‘Mental Training’ group actively developed a detailed, stepwise sequence of the performance of a structured facial examination and visualized this sequence subvocally before practicing the skill. Student performance was measured shortly after (T1) and five to ten weeks (T2) after the training by two blinded examiners (E1 and E2) using a validated checklist.Results: Groups did not differ in gender, age or in experience. The ‘Mental Training’ group averaged significantly more points in T1 (pE1 = 0.00012; pE2 = 0.004) and T2 (pE1 = 0.04; pE2 = 0.008) than the ‘See One, Do One’ group. The intragroup comparison showed a significant (pE1 = 0.0002; pE2 = 0.06) increase in knowledge in the ‘See One, Do One’ group, while the ‘Mental Training’ group maintained an already high level of knowledge between T1 and T2. Gender analysis showed a significant difference in favor of female students at T1 for Rater 1 (pE1 = 0.03).Discussion: ‘Mental Training’ is an efficient tool to teach and maintain basic clinical skills. In this study ‘Mental Training’ was shown to be superior to the commonly used ‘See One, Do One’ approach in learning how to perform a structured facial examination and should therefore be considered more often to teach basic surgical skills.

56. Proficiency at the end of practice predicts retention of a technical clinical skills

2007 ◽  
Vol 30 (4) ◽  
pp. 59
Author(s):  
H. Carnahan ◽  
E. Hagemann ◽  
A. Dubrowski
Keyword(s):  
Virtual Reality ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Technical Skills ◽  
Skills Training ◽  
Retention Performance ◽  
Specific Criterion ◽  
Practice Trials ◽  
Practice Time ◽  
Criterion Time

A debate is emerging regarding the efficacy of proficiency based versus duration based training of technical skills. It is not clear whether the performance level attained at the end of practice (i.e., proficiency criteria), or the overall amount of practice performed during learning will best predict the retention of a technical clinical skill. The skill learned was the single-handed double square-knot. Forty two trainees learned the skill through video-based instruction and were divided into three groups (14 participants per group) each with a specific criterion time to tie the knot (10, 15, and 20 seconds). Practice continued until participants completed the knot within their criterion time. The total number of trials, and the overall practice time required to obtain each respective criterion were recorded during practice. Participants returned one-week later for a timed retention test consisting of one trial of the knot tying skill with no video instruction. A multiple regression analysis tested whether the amount of practice, the total practice time, or the criterion reached at the end of practice was the best predictor of the time taken to perform the skill during retention. This analysis showed that the number of practice trials was highly correlated with total practice time (r = .82, p = .01), therefore total practice time was withdrawn as a predictor variable from the subsequent analysis. The regression showed that the only significant predictor of retention performance was the criterion reached at the end of practice (p = .03). The number of practice trials was not found to significantly predict the retention performance (p = .87). The results support the notion that proficiency based training results in better retention of a technical clinical skill in comparison to duration based approaches. This provides evidence for the introduction of proficiency based educational approaches in technical skills curricula. Jowett N, LeBlanc V, Xeroulis G, MacRae H, Dubrowski A. Surgical skill acquisition with self-directed practice using computer-based video training. Am J Surg. 2007; 193(2):237-42. Gallagher AG, Ritter EM, Champion H, Higgins G, Fried MP, Moses G, Smith CD, Satava RM. Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training. Ann Surg. 2005; 241(2):364-72. Van Sickle KR, Ritter EM, McClusky DA, Lederman A, Baghai M, Gallagher AG, Smith CD. Attempted establishment of proficiency levels for laparoscopic performance on a national scale using simulation: the results from the 2004 SAGES Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) learning center study. Surg Endosc. 2007; 21(1):5-10.

scholarly journals Self-Regulated Learning Microanalysis For The Study Of The Performance Of Clinical Examinations By Physiotherapy Students

2020 ◽  
Author(s):  
Raquel Medina ◽  
Daniel David Álamo-Arce ◽  
Felipe Rodríguez de Castro ◽  
Dario Cecilio Fernandez ◽  
John Sandars ◽  
...  
Keyword(s):  
Pilot Study ◽  
Strategic Planning ◽  
Student Performance ◽  
Clinical Skill ◽  
Potential Usefulness ◽  
Rater Reliability ◽  
Self Monitoring ◽  
Self Regulated Learning ◽  
Regulated Learning ◽  
Physiotherapy Students

Abstract Background Students require feedback on their self-regulated learning (SRL) processes to improve the performance of clinical examinations. The key SRL processes used by students can be identified by SRL-micro-analysis but, this method has not been previously applied to physiotherapy students. The aim of this pilot study was to test a research design that might allow the evaluation of the potential usefulness of SRL microanalysis for the identification of key SRL processes used by physiotherapy students during the performance of a clinical examination skill.. The objectives of the pilot study were: 1) to evaluate whether SRL-microanalysis could identify differences in the use of SRL processes between successful and unsuccessful students; 2) to evaluate the reliability of SRL microanalysis ratings produced by different assessors.Methods SRL-microanalysis was used with second year physiotherapy students of a Spanish university (n= 26) as they performed a goniometric task. The task required students to obtain a goniometric measurement of the shoulder joint of a peer. Two assessors evaluated student performance and conducted the SRL- microanalysis with all students. An analysis of inter-rater reliability was performed to evaluate the degree of agreement between assessors. Results The SRL-microanalysis revealed differences in the use of key SRL processes between successful (n= 15: 57.0%) and unsuccessful performers (n= 11: 43.0%): The differences were particularly evident in strategic planning and self-monitoring skills. There was good inter-rater reliability for scoring of strategic planning (k=0.792), self-monitoring (k=0.946) and self-evaluation (k=0.846).Conclusion The use of SRL microanalysis characterized the key SRL processes of physiotherapy students performing a clinical skill with reliability between the assessors. This pilot study supports the potential usefulness of SRL-microanalysis for the identification of key SRL processes in physiotherapy education. Therefore, this study paves the way to the development of a full study, with a larger number of students and more diverse clinical tasks, to evaluate the SRL processes in successful and unsuccessful students.

scholarly journals Clinical Medical Students’ Preferred Teaching Methods: A Study at the National Defense University of Malaysia

2021 ◽  
Vol 3 (2) ◽  
pp. 74-78
Author(s):  
Sheikh Salahuddin Ahmed ◽  
Sagili Chandrasekhara Reddy
Keyword(s):  
Medical Students ◽  
Teaching Methods ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Simulated Patient ◽  
National Defense ◽  
Undergraduate Medical Students ◽  
Teaching Materials ◽  
Real Patient ◽  
National Defense University

Background: Providing appropriate teachings in the curriculum have a great impact on learning by the students. Objectives: The aim of this study was to determine the clinical undergraduate medical students’ preferred teaching methods provided by the medical educators. Material and Methods: This study was conducted on 89 medical students in the 4th and 5th year of the Faculty of Medicine and Defense Health, National Defense University of Malaysia, from 1st November 2019 to 31st July 2020. Each of the students was approached with a structured questionnaire for their responses to determine their preferred teaching methods. Results: Out of 89 students, 46 were male (51.7%); the mean age of the study students was 23.5 years. Among the various teaching methods, bedside teaching was the most preferred (76.4%) one followed by lectures (14.6%), tutorials (7.9%) and seminars (1.1%). 66.3% of students would use e-learnings’ uploaded teaching materials, whereas the remainder would not. Bedside demonstrations of clinical skills by the tutors were preferred by 77.5% of students. Practicing clinical skills by the students on a real patient rather than on a mannequin or a simulated patient was preferred by 94.4% of students. Regarding case discussions, problem-based learnings (PBL) were preferred by 80% of students. Conclusions: Bedside teachings, demonstrations of clinical skill by a teacher, practicing skills by the students on a real patient rather than on a simulated patient or a mannequin, and PBLs are highly preferred by the students. Adequate teaching materials uploaded in the e-learning management system provide a good source for the teachings and learnings.

scholarly journals Nephrology Fellows’ and Program Directors’ Perceptions of Hospital Rounds in the United States

2020 ◽  
Vol 15 (4) ◽  
pp. 474-483
Author(s):  
Suzanne M. Boyle ◽  
Keshab Subedi ◽  
Kurtis A. Pivert ◽  
Meera Nair Harhay ◽  
Jaime Baynes-Fields ◽  
...  
Keyword(s):  
United States ◽  
Patient Care ◽  
Training Programs ◽  
Clinical Skills ◽  
Care Delivery ◽  
Clinical Skill ◽  
Program Directors ◽  
The United States ◽  
Early Morning ◽  
Attending Rounds

Background and objectivesHospital rounds are a traditional vehicle for patient-care delivery and experiential learning for trainees. We aimed to characterize practices and perceptions of rounds in United States nephrology training programs.Design, setting, participants, & measurementsWe conducted a national survey of United States nephrology fellows and program directors. Fellows received the survey after completing the 2019 National Board of Medical Examiners Nephrology In-Training Exam. Program directors received the survey at the American Society of Nephrology’s 2019 Nephrology Training Program Directors’ Retreat. Surveys assessed the structure and perceptions of rounds, focusing on workload, workflow, value for patient care, and fellows’ clinical skill-building. Directors were queried about their expectations for fellow prerounds and efficiency of rounds. Responses were quantified by proportions.ResultsFellow and program director response rates were 73% (n=621) and 70% (n=55). Most fellows (74%) report a patient census of >15, arrive at the hospital before 7:00 am (59%), and complete progress notes after 5:00 pm (46%). Among several rounding activities, fellows most valued bedside discussions for building their clinical skills (34%), but only 30% examine all patients with the attending at the bedside. Most directors (71%) expect fellows to both examine patients and collect data before attending-rounds. A majority (78%) of directors commonly complete their documentation after 5:00 pm, and for 36%, after 8:00 pm. Like fellows, directors most value bedside discussion for development of fellows’ clinical skills (44%). Lack of preparedness for the rigors of nephrology fellowship was the most-cited barrier to efficient rounds (31%).ConclusionsHospital rounds in United States nephrology training programs are characterized by high patient volumes, early-morning starts, and late-evening clinical documentation. Fellows use a variety of prerounding styles and examine patients at the beside with their attendings at different frequencies.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_03_17_CJN.10190819.mp3

Postnatal depression: Can visual media and dramatisation of a young woman's experiences, enable student health care professionals develop knowledge to enhance clinical practice skills?

2017 ◽  
Vol 41 (S1) ◽  
pp. S675-S675
Author(s):  
A. Lyons ◽  
S. Church
Keyword(s):  
Mental Health ◽  
Health Education ◽  
Postnatal Depression ◽  
Healthcare Professionals ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Visual Media ◽  
Perinatal Mental Health ◽  
Mental Health Education ◽  
Senior Student

IntroductionSince the presentation of the symptoms of postnatal depression (PND) can vary; healthcare professionals must receive the appropriate level of training to develop the knowledge required for the effective assessment and referral of women. Yet, healthcare professionals may have limited knowledge in perinatal mental health and students may lack practice opportunities to develop the knowledge and clinical skills. For these reasons, the use of alternative learning resources within perinatal mental health education is vital.ObjectivesTo explore the use of visual media in perinatal mental health education.AimsAgainst the background of increasing concerns about the ability of professionals to assess women with PND, this paper will consider how using dramatisation as a teaching approach can enable students to develop their knowledge and guide clinical skill development.MethodsThree separate groups of senior student midwives and health visitors were asked to evaluate a dramatisation developed from women's lived experience of PND. Pre and post verbal evaluation of the drama were undertaken with the use of focus groups guided by semi-structured questions. Ethical approval was granted by the university.ResultsFollowing thematic analysis three issues were identified:–the role of the healthcare professional;–improvements needed in care;–issues of education and training.ConclusionsAgainst the background of limited placement experience and opportunity for assessment of PND, the use of visual media can improve student healthcare professionals’ learning; with the use of structured facilitation, there is a great potential for multidisciplinary learning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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