Medical interns’ reflections on their training in use of personal protective equipment

Background The current COVID-19 pandemic has demonstrated that personal protective equipment (PPE) is essential, to prevent the acquisition and transmission of infectious diseases, yet its use is often sub-optimal in the clinical setting. Training and education are important to ensure and sustain the safe and effective use of PPE by medical interns, but current methods are often inadequate in providing the relevant knowledge and skills. The purpose of this study was to explore medical graduates’ experiences of the use of PPE and identify opportunities for improvement in education and training programmes, to improve occupational and patient safety. Methods This study was undertaken in 2018 in a large tertiary-care teaching hospital in Sydney, Australia, to explore medical interns’ self-reported experiences of PPE use, at the beginning of their internship. Reflexive groups were conducted immediately after theoretical and practical PPE training, during hospital orientation. Transcripts of recorded discussions were analysed, using a thematic approach that drew on the COM-B (capability, opportunity, motivation - behaviour) framework for behaviour. Results 80% of 90 eligible graduates participated. Many interns had not previously received formal training in the specific skills required for optimal PPE use and had developed potentially unsafe habits. Their experiences as medical students in clinical areas contrasted sharply with recommended practice taught at hospital orientation and impacted on their ability to cultivate correct PPE use. Conclusions Undergraduate teaching should be consistent with best practice PPE use, and include practical training that embeds correct and safe practices.

Medical interns’ reflections on their training in use of personal protective equipment.

Background The current COVID-19 pandemic has demonstrated that personal protective equipment (PPE) is essential, to prevent the acquisition and transmission of infectious diseases, yet its use is often sub-optimal in the clinical setting. Training and education are important to ensure and sustain the safe and effective use of PPE by medical interns, but current methods are often inadequate in providing the relevant knowledge and skills. The purpose of this study was to explore medical graduates’ experiences of the use of PPE and identify opportunities for improvement in education and training programmes, to improve occupational and patient safety.Methods This study was undertaken in 2018 in a large tertiary-care teaching hospital in Sydney, Australia, to explore medical interns’ self-reported experiences of PPE use, at the beginning of their internship. Reflexive groups were conducted immediately after theoretical and practical PPE training, during hospital orientation. Transcripts of recorded discussions were analysed, using a thematic approach that drew on the COM-B (capability, opportunity, motivation - behaviour) framework for behaviour. Results 80% of 90 eligible graduates participated. Many interns had not previously received formal training in the specific skills required for optimal PPE use and had developed potentially unsafe habits. Their experiences as medical students in clinical areas contrasted sharply with recommended practice taught at hospital orientation and impacted on their ability to cultivate correct PPE use. Conclusions Undergraduate teaching should be consistent with best practice PPE use, and include practical training that embeds correct and safe practices.

Escape Room Blueprint: Central Orientation Contagion Crisis

Background: Turnover rate for new graduate nurses at a midwestern community hospital was 30% for the first two years. Central clinical orientation for new hire registered nurses and care assistants was heavily executed via didactic format. Feedback from instructors suggested boredom and disengagement of learners during these sessions. Post central orientation evaluations resulted in 49% of attendees feeling not “very confident” to apply skills in clinical practice. Methods: Clinical educators created an escape room to improve learner satisfaction, interprofessional communication, and confidence in applying skills in practice. A convenience sample of twenty-three (23) registered nurses and care assistants participated in an escape room, Contagion Crisis, covering basic knowledge of infection control, emergency response, restraints, and drug calculation. Results: Average Likert scores on the post survey for satisfaction and communication were 4.67 and 4.0 respectively. Confidence in applying skills to practice averaged 4.72. Subjective feedback from participants included enjoyment of a fun, non-pressure environment. Conclusion: Multiple clinical disciplines can use this escape room, as it covers topics from central hospital orientation. Learners preferred the escape room format versus a high-fidelity simulation, due to it being less “high stakes” and not a judgement of individual performance.

Are Australian medical interns adequately prepared for the optimal use of personal protective equipment?

BackgroundThe current COVID-19 pandemic has demonstrated that personal protective equipment (PPE) is essential, to prevent the acquisition and transmission of infectious diseases, yet its use is often sub-optimal in the clinical setting. Training and education are important to ensure and sustain the safe and effective use of PPE by medical interns, but current methods are often inadequate in providing the relevant knowledge and skills. The purpose of this study was to explore new graduates’ experiences of the use of PPE and identify opportunities for improvement in medical student education and training programmes, to improve occupational and patient safety. MethodsThis study was undertaken in 2018 in a large tertiary-care teaching hospital in XXXX, Australia, to explore medical interns’ self-reported experiences of PPE use, at the beginning of their first postgraduate year. Focus groups were conducted immediately after theoretical and practical PPE training, during hospital orientation. Transcripts of recorded discussions were analysed, using a thematic approach that drew on the COM-B (capability, opportunity, motivation - behaviour) framework for behaviour. Results 80% of 90 eligible interns participated. Many interns had not previously received formal training in the specific skills required for optimal PPE use and had developed potentially unsafe habits. Their experiences as medical students in clinical areas contrasted sharply with recommended practice taught at hospital orientation and impacted on their ability to cultivate correct PPE use. ConclusionsUndergraduate teaching should be consistent with best practice PPE use, and include practical training that embeds correct and safe practices.

Influence of Leadership, Remuneration and Organizational Culture on Health Madani Trough Performance of Public Hospital as Mediator

Health of Madani or Civil Society is "Healthy, Self-reliant and Equitable People”. The hospital as the spearhead of the leading health care services, whereas there are two kind of hospital in Batam, Public and Private Hospital. Orientation performance of hospitals is certainly influenced by the spirit and variable determiner of the hospital's performance, so this study aims to: "analyse of Leadership, Remuneration and Organizational Culture on Health Madani through Performance of Public Hospital”. The study population was all over the State Civil Administration, with a random sampling technique as the sample population, totally 220 respondents. The data were analyzed using SEM. The software used for the structural analysis is AMOS, and for a descriptive study using SPSS version 24.0. The research proves that: Leadership, Remuneration and Organizational Culture on Health Madani through Performance of Public Hospital as Mediator has significant effect. Pursuant to the result of this study is suggested that management of hospital in order to have a spirit of service as health care does not only embed oriented profit, the government also suggested to provide subsidized financing to hospital, so that health Madani which is "Healthy, Self-reliant and Equitable People” can be reached.

Effectiveness of a Preexternship Hospital Orientation Program for Graduate Students in Speech-Language Pathology

Purpose A preexternship hospital orientation program was developed in response to clinical externship supervisors providing feedback that students were not well prepared when entering the medical setting for the 1st time. This program aimed to introduce students to different medical settings where they could observe patients with a range of communication and swallowing disorders and their interactions with a speech-language pathologist. Method Students shadowed speech-language pathologists for a half-day at 4 different medical locations throughout the program. Forty-two students filled out pre- and postorientation surveys detailing their experiences and learning outcomes. Results An analysis of pre–post surveys indicates that students perceived a gain in working knowledge of several key areas, including assessment protocols, job demands, documentation, and interprofessional collaboration. Students also reported that the experience allowed them to make an informed choice regarding the type of externship or job they wished to pursue in the future. Conclusion Students reported favorable outcomes as a result of this observational experience. Clinical exposure programs should be considered as a modality for learning for speech-language pathology students.

Factors Related to Successful Transition to Practice for Acute Care Nurse Practitioners

The transition from student to acute care nurse practitioner (ACNP) has been recognized as a time of stress. The purpose of this descriptive, correlational-comparative design pilot study was to examine: (1) the relationships among personal resources, community resources, successful transition, and job retention; (2) the difference between ACNPs with 0 to 4 years and ACNPs with more than 4 years of prior experience as a registered nurse in an intensive care unit or emergency department; and (3) the skills/procedures that ACNPs found difficult to perform independently. Thirty-four participants were recruited from a social media site for nurse practitioners. Organizational support, communication, and leadership were the most important elements of successful transition into the ACNP role. This information can help ACNP faculty and hospital orientation/fellowship program educators to help ACNPs transition into their first position after graduation.