An exploration of the use of 3D printed foot models and simulated foot lesions to supplement scalpel skill training in undergraduate podiatry students: A multiple method study

Background Podiatrists regularly use scalpels in the management of foot pathologies, yet the teaching and learning of these skills can be challenging. The use of 3D printed foot models presents an opportunity for podiatry students to practice their scalpel skills in a relatively safe, controlled risk setting, potentially increasing confidence and reducing associated anxiety. This study evaluated the use of 3D printed foot models on podiatry students’ anxiety and confidence levels and explored the fidelity of using 3D foot models as a teaching methodology. Materials and methods Multiple study designs were used. A repeated measure trial evaluated the effects of a 3D printed foot model on anxiety and confidence in two student groups: novice users in their second year of podiatry studies (n = 24), and more experienced fourth year students completing a workshop on ulcer management (n = 15). A randomised controlled trial compared the use of the 3D printed foot models (n = 12) to standard teaching methods (n = 15) on students’ anxiety and confidence in second year students. Finally, a focus group was conducted (n = 5) to explore final year student’s perceptions of the fidelity of the foot ulcer models in their studies. Results The use of 3D printed foot models increased both novice and more experienced users’ self-confidence and task self-efficacy; however, cognitive and somatic anxiety was only reduced in the experienced users. All changes were considered large effects. In comparison to standard teaching methods, the use of 3D printed foot models had similar decreases in anxiety and increases in confidence measures. Students also identified the use of 3D foot models for the learning of scalpel skills as ‘authentic’ and ‘lifelike’ and led to enhanced confidence prior to assessment of skills in more high-risk situations. Conclusion Podiatry undergraduate programs should consider using 3D printed foot models as a teaching method to improve students’ confidence and reduce their anxiety when using scalpels, especially in instances where face-to-face teaching is not possible (e.g., pandemic related restrictions on face-to-face teaching).

Clinical supervisors’ perceptions of podiatry students’ preparedness for clinical placement and graduates’ preparedness for podiatry practice in Australia: An exploratory study

Introduction: Little is known about Australian podiatry students’ preparedness for clinical placement and graduates’ preparedness for clinical practice. This qualitative study explored clinical supervisors’ perceptions of podiatry students’ and graduates’ preparedness-related challenges and their recommendations for improvement.Methods: Eleven registered podiatrists who had supervised or were still supervising students were interviewed. Transcribed interviews were thematically analysed. Benner’s (1984) stages of clinical competence from novice to expert informed the study.Results: Clinical supervisors were divided about students’ preparedness for clinical placements, with their perceptions ranging from generally prepared (n = 2) to unsure (n = 5) to unprepared (n = 4). They commented on junior versus senior students, institutional differences and specific clinical skill deficiencies, e.g., scalpel debridement and patient communication skills. Perceived challenges for students on placement included poorly developed clinical skills and low self-efficacy, both stemming primarily from insufficient hands-on experience. Participants suggested that for improved placement preparedness, students required better quality clinical experiences and communication skills training. Being work-ready, which most graduating Australian podiatrists were reported to be, involved being safe and self-efficacious. Participants also suggested that a supportive clinical environment, an internship and more advanced interpersonal skills would facilitate preparedness. Conclusion: In terms of Benner’s (1984) framework, during training, podiatry students should be considered novices, and they should be considered advanced beginners on graduation. An entry-level graduate should not be expected to be competent across all areas of clinical practice. Hands-on clinical practice during placements was needed for moving successfully through Benner’s (1984) stages of clinical competence. While clinical supervisors believed that podiatry training generally prepared students for clinical practice immediately following graduation, they asserted that manual clinical and communication skills improvement is required for clinical placements.

Effect of a culturally safe student placement on students’ understanding of, and confidence with, providing culturally safe podiatry care

Background For university-based podiatry education there are little data available documenting the delivery method and impact of Aboriginal and Torres Strait Islander health curricula or the use of, and outcomes from, immersive clinical placements generally or specific to podiatry practice. Therefore, the primary aim of this study was to evaluate the effect of undertaking clinical placement in a culturally safe podiatry service for Aboriginal and Torres Strait Islander Peoples on podiatry students’ understanding of, and confidence with, providing culturally safe podiatry care. Methods Final year University of Newcastle undergraduate podiatry students attending a culturally safe Aboriginal and Torres Strait Islander student clinic at a local hospital were purposively recruited to participate. Students completed a custom-made and pilot-tested cultural awareness and capability survey before and after placement. Survey domains were determined from a principle component analysis. The Wilcoxon Signed Rank test was used to compare pre-placement scores on each domain of the survey to the post-placements scores. Effect sizes were calculated and interpreted as small (0.1–0.29), medium (0.3–0.49), and large (≥0.5). Results This study recruited 58 final year University of Newcastle podiatry students to complete baseline and follow-up surveys. For survey domain 1 (level of understanding of power relationships), domain 2 (level of understanding of the interrelationship between culture and self-perceived health), domain 3 (level of understanding of the importance of culture in clinical practice and access to health care), and domain 4 (level of confidence with providing culturally safe care) a statistically significant (p < 0.05) increase in scores was recorded post-placement. The effect sizes were medium to large. Conclusion This study demonstrated that an immersive student placement at a culturally safe podiatry clinic significantly improved students’ understanding of, and confidence with, providing culturally appropriate care to Aboriginal and Torres Strait Islander Peoples. This study provides foundation evidence of the role that such placements have on developing students’ cultural capability in a tertiary health care setting, and will help inform future curricula development at both educational institutions and health services, as well as form the basis for ongoing research.

Reliability and Repeatability of the Assessment of Stress in Nursing Students Instrument in Podiatry Students: A Transcultural Adaptation

Background: This study aimed to adapt the Spanish version of the Assessment of Stress in Nursing Students (ASNS) (shorter form) instrument for Spanish podiatry students, labeling the new tool as the Spanish version of Assessment of Stress in Podiatry Students (ASPS). The adaptation for reliability and repeatability included performing the transcultural adaptation process and examining the repeatability and reliability of ASPS when used in a different language. Methods: An internationally recommended translation procedure was used to adapt transculturally this tool. The instrument’s test–retest reliability was evaluated in two sessions that were 10 days apart. Results: After considering each domain’s total score, the reliability and internal consistency were analyzed with Cronbach’s α and intraclass correlation coefficient for a 95% confidence interval. Good internal consistency was reported according to total score (α = 0.8626) and each one of the six domains: (1) the practical activities performance domain showed a Cronbach’s α of 0.8684; (2) professional communication domain, α = 0.8765; (3) time management domain, α = 0.8832; (4) environment domain, α = 0.8974; (5) professional education domain, α =0.873; and (6) theoretical activity domain, α = 0.8787. Test–retest reliability, by paired test of Wilcoxon, was not significant, showing that there were not differences between domain scores (p ≥ 0.05). Lastly, visual distributions of Bland and Altman plots did not provide differences between domains and total scores. Conclusions: The Spanish version of the ASPS showed good repeatability, reliability and acceptability to measure stress parameters for podiatry students.

Do standard neurological assessments tell us more than we realise?

Background Neurological assessments are commonly performed by podiatrists as a screening tool for peripheral neuropathy, and to identify the risk of foot ulceration and amputation. Monofilament and tuning fork assessments are routinely used to assess peripheral sensation. Whilst these assessments are commonly used to monitor foot health, there is potential for neurological results to illuminate a broader and more holistic perspective of a person’s overall health status. Methods Recruitment of fifty participants (31 female, 19 male; 71.78±9.64 years) for foot health screening was associated with a foot health week promotional event at the Charles Sturt University Community Engagement and Wellness Centre. Under the guidance of registered podiatrists, fourth year podiatry students completed basic neurological assessments to determine each participant’s neurological status. Participants also completed a modified Foot Health Status Questionnaire (FHSQ). Age and monofilament results were analysed using Spearman’s rho, while correlations involving FHSQ data were identified using a Kruskal-Wallis test. Results For those participants who reported an excellent rating of their own health, there was a statistically significant relationship with adequate vibration sensation (p<0.01). A person’s ability to get up from a sitting position (p<0.01), lift and carry shopping (p=0.02) and climb a flight of stairs (p=0.03), was significantly correlated with more sites detected using monofilament assessment. Discussion Significant correlations were observed between basic neurological assessments and a number of activities of daily living. While the findings reflect a correlational relationship, not causational, this still provides an opportunity for clinicians to view neurological assessment results more holistically. Whilst the immediate focus for a practitioner will be tissue viability, neurological findings may be useful to stimulate further discussion about a patient’s functional capacity by exploring issues beyond the presenting condition.

Assessing the engagement rates and satisfaction levels of various clinical health science student sub-groups using supplementary eLearning resources in an introductory anatomy and physiology unit

Purpose Introductory anatomy and physiology provide a core knowledge base to students within clinical health science courses. Increased student numbers, as well as reduced access to laboratory-based cadaveric resources, have created a need for enhanced learning approaches to support learning. The streamlining of courses has also resulted in the need to effectively engage course sub-groups within large units. The purpose of this paper is to utilize the eLearning activities to investigate engagement and satisfaction levels within students undertaking an anatomy and physiology unit. Design/methodology/approach A total of 19 formative quizzes were made available to students. Online practical anatomy laboratories covered anatomical content, and physiology quizzes covered physiological content. Student engagement was compared using frequency analysis across students studying varying courses. Satisfaction was determined by analyzing student’s feedback using frequency analysis. Findings Students accessed the learning activities 29,898 times over semester, with the peak access (37 percent) prior to the closed book exams. The resources were utilized primarily as an exam preparation tool rather than consistently throughout semester. Out of the various courses, the Paramedicine, Physiotherapy and Podiatry students were the most engaged, with the highest percent of “engaged/highly engaged” students. Students from various courses shared very similar views of the perceived benefit of the eLearning activities. Practical implications These results indicated a difference in engagement levels between the students of various course sub-groups, and therefore suggests that the development of course-specific eLearning activities is necessary in large, streamlined units to achieve a more focused approach to support students’ learning, engagement and success, so that positive and beneficial learning experiences are ensured for all students. Originality/value These results suggest that in the future, development of eLearning activities is necessary to achieve a more focused approach to support students’ learning, engagement and success, so that positive and beneficial learning experiences are ensured for all.