The teaching of clinical skills at a postgraduate hospital

1981 ◽  
Vol 11 (2) ◽  
pp. 391-399 ◽  
Author(s):  
Francis Creed ◽  
Robin M. Murray

SynopsisThe teaching of ‘clinical skills’ is generally held to be central to postgraduate training in psychiatry, but the term itself has so far escaped exact definition. In an effort to study some of the component clinical abilities, their inter-relationships, and the factors promoting their transmission, all junior psychiatrists at the Maudsley Hospital were surveyed for their views on the clinical training they had received. Three hundred and seventy three assessments on 43 units were made. Trainees perceived the academic instruction and advice on formulating cases which they had received as being quite unrelated to the quality of help with interview skills and instruction in practical management, but feedback from the consultant to the trainee on the latter's performance was necessary for a high standard of both academic and practical instruction. Encouragement to do research was transmitted independently of other clinical teaching. Over a 3-year period the standard of multidisciplinary teamwork appeared to improve, but there was a decline in the standard of academic instruction and in encouragement to do research. These overall differences were due to changes in the teaching staff, rather than alterations in teaching methods. Surveys such as this may help to define the goals of postgraduate clinical training, and also monitor the extent to which an institution is achieving these goals.

2008 ◽  
Vol 11 (2) ◽  
pp. 56-60 ◽  
Author(s):  
Jill K. Duthie

Abstract Clinical supervisors in university based clinical settings are challenged by numerous tasks to promote the development of self-analysis and problem-solving skills of the clinical student (American Speech-Language-Hearing Association, ASHA, 1985). The Clinician Directed Hierarchy is a clinical training tool that assists the clinical teaching process by directing the student clinician’s focus to a specific level of intervention. At each of five levels of intervention, the clinician develops an understanding of the client’s speech/language target behaviors and matches clinical support accordingly. Additionally, principles and activities of generalization are highlighted for each intervention level. Preliminary findings suggest this is a useful training tool for university clinical settings. An essential goal of effective clinical supervision is the provision of support and guidance in the student clinician’s development of independent clinical skills (Larson, 2007). The student clinician is challenged with identifying client behaviors in the therapeutic process and learning to match his or her instructions, models, prompts, reinforcement, and use of stimuli appropriately according to the client’s needs. In addition, the student clinician must be aware of techniques in the intervention process that will promote generalization of new communication behaviors. Throughout the intervention process, clinicians are charged with identifying appropriate target behaviors, quantifying the progress of the client’s acquisition of the targets, and making adjustments within and between sessions as necessary. Central to the development of clinical skills is the feedback provided by the clinical supervisor (Brasseur, 1989; Moss, 2007). Particularly in the early stages of clinical skills development, the supervisor is challenged with addressing numerous aspects of clinical performance and awareness, while ensuring the client’s welfare (Moss). To address the management of clinician and client behaviors while developing an understanding of the clinical intervention process, the University of the Pacific has developed and begun to implement the Clinician Directed Hierarchy.


Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Pritesh Mistry ◽  
James Bateman ◽  
Helen Foss ◽  
Muhamad Jasim

Abstract Background/Aims  Medical students need to gain patient contact to develop their skills in history taking and examinations. In year three, undergraduate students typically rotate across various hospitals and specialties and are expected to have dedicated rheumatology exposure for history and examination competencies. Rheumatology as an out-patient specialty can limit opportunities for medical students to have broad exposure to rheumatological conditions. Methods  In January 2018, we designed an annual rheumatology half-day teaching workshop (‘Rheumatology Carousel’) using a combination of lecture-based teaching and small group based guided clinical history and examination stations, aimed at third-year medical students from the University of Birmingham. This covered key presentations in rheumatology: axial spondyloarthropathy, rheumatoid arthritis, systemic sclerosis (connective tissue disease), osteoarthritis, and vasculitis. Each station required a Clinical Teaching Fellow or Rheumatology ST trainee, overseen by one consultant facilitator. We designed patient proforma’s incorporating consent, demographics, key clinical history, therapy, and examination findings. We produced a written patient guide, and consultants invited appropriate patients to volunteer for the day. We designed a one-hour lecture-based tutorial. A lesson plan and schedule were created outlining faculty requirements; including time, roles, and faculty numbers. We invited five to six patients to each session, with a plan of four to five focussed examinations. We designed the carousel to accommodate up to 40 students, split into two groups running over a day. Focussed examinations involved students in groups of four, with each student being a lead examiner in at least one station, each station lasting 20 minutes. Best practice examination techniques for each condition were assessed and emphasised. Following a debrief, we collected feedback from students, faculty, and patients (online and written feedback), using Likert scores for teaching content, and quality of the session delivery. Results  The carousel ran in February 2018, 19, and 20. The sessions were positively evaluated by students, faculty, and patients. In total, 93 students attended, 89/93 completed feedback. Satisfaction scores (mean; SD; range) were high (1-strongly disagree, 5-strongly agree) for content (4.8; 0.49, range 3-5) and quality of delivery (4.7; 0.54; 3-5). All patients who participated volunteered to return for future teaching sessions, with several patients attending all three years. Free text feedback indicated students valued structured exposure to core conditions and called for more sessions of this nature. Conclusion  This sustainable reproducible intervention ensures students have structured exposure to important rheumatological conditions. The methodology allows reproducible sessions that are positively evaluated despite rotating clinical teaching staff. We have made all our teaching materials, logistical plan, and scheduling tools available as open access resources under a Creative Commons license for free re-use and adaptation by any healthcare professional, via a web link. We plan to record an electronic version to distribute post the COVID-19 pandemic. Disclosure  P. Mistry: None. J. Bateman: None. H. Foss: None. M. Jasim: None.


1997 ◽  
Vol 28 (3) ◽  
pp. 195-212 ◽  
Author(s):  
Ellen M. Kelly ◽  
Jane S. Martin ◽  
Kendra E. Baker ◽  
Norma I. Rivera ◽  
Jane E. Bishop ◽  
...  

One-hundred-fifty-seven Indiana school speech-language pathologists responded to a survey regarding their educational and clinical preparation and their current clinical practices with people who stutter. Respondents described and evaluated the quantity and quality of their academic coursework and clinical experiences, as well as their current clinical procedures for diagnosing and treating stuttering. Speech-language pathologists also estimated their clinical competence with their clients who stutter at two junctures in their careers: (a) following completion of academic/clinical training, and (b) currently. Respondents reported receiving insufficient academic and clinical preparation to work with people who stutter. In addition, nearly half of those surveyed reported that their current clinical skills are inadequate for managing stuttering. Findings are interpreted as confirming and extending the growing body of literature that documents the need for the improvement and expansion of educational and clinical opportunities in stuttering for speech-language pathologists in training and those in professional practice.


2019 ◽  
Vol 74 (5) ◽  
pp. 333-341
Author(s):  
Dmitriy O. Ivanov ◽  
Yury S. Aleksandrovich ◽  
Olga S. Kulbakh ◽  
Elena R. Zinkevich ◽  
Liliya V. Ditkovskaya ◽  
...  

Background: The introduction of Federal state standards of higher education has caused the need to study the quality and condition of specialists postgraduate training in the field of health. In 20172019 at St. Petersburg state pediatric medical university a study aimed at examining the satisfaction of residents with educational training at the faculty of postgraduate and additional professional education was hold, the results of which allowed to identify the problem areas of training in order to further adjust the content and organizational aspects of the quality of training of highly qualified specialists in the field of health protection of citizens of Russia. Aims: The estimation of the quality of postgraduate training of specialists in the field of health care based on the pedagogical reflection of their satisfaction with the process of training during the residency. Methods: The study was conducted by means of a questionnaire consisting of a number of questions stated in the form of appeals aimed at obtaining information illustrating the content, organizational, operational and personal resources of postgraduate education of residents. The respondents were asked to rank their responses according to their satisfaction with the quality of education on the scale that ranged from excellent to very poor. The object of the study was 125 graduates completed their professional training at the stage of postgraduate education in residency at various clinical departments. The duration of the study, including the preparation of analytical materials, the organization, and conduct of the survey, the subsequent analysis of the data, totally amounted to two years. The analysis of the survey results allowed to identify the targets of possible correction of informative, organizational, operational and personal aspects of postgraduate training of doctors. Results: The participants of the study were 125 respondents-resident physicians who completed the educational trajectory in various areas of professional training on the basis of clinical departments of pediatric medical university. It should be noted that the distribution of participants in the questionnaire by graduate clinical departments was characterized as uneven, due to the peculiarities of the plan of admission to the residency, social order from the health care institutions of Russia, and finally, individual educational needs and needs of students. The average age of residents is 26 years. As a result of the study, it was possible to identify informative, organizational and personal problem areas of training of residents. In particular, there were problems in the content of professional education, in the level of pedagogical skills of the teaching staff of clinical departments, in the development of professional competencies of residents, in the content of test tasks in certain specialties. Due to the factor analysis of the results, a semantic space was built that reflects the analysis of the satisfaction of graduates of Spbsmu with the quality of training at the stage of residency. Conclusions: Based on the results of the study, it was possible to identify the targets of correctional work, involving the improvement of organizational, informative, technological and personal resources of the educational program of postgraduate training of residents.


2021 ◽  
Author(s):  
Sarra Shorbagi ◽  
Nabil Sulaiman ◽  
Ahmad Hasswan ◽  
Mujtaba Kaouas ◽  
Mona M. Al-Dijani ◽  
...  

Abstract Background: The emergence of coronavirus disease 2019 (COVID-19) and its quick progress to a global pandemic has urged medical schools to shift from didactic to distance learning and assessment approaches. The quality of clinical training and assessment have been jeopardized due to the regulatory restrictions and potential hazards to human lives. The aim of this paper is to evaluate the feasibility and effectiveness of an electronic Objective Structured Clinical Examination (e-OSCE), which attempted to transform the format of a face-to-face OSCE to an e-OSCE.Methods: We conducted three end of clerkship e-OSCEs for final year medical students in Surgery, Medicine and Family Medicine using teleconferencing application of Microsoft Teams (MST). The e-OSCE blueprint included the assessment of all clinical skills except physical examination and procedural skills. Examiners supervised e-OSCE from the college campus while all students were remotely assessed through the MST channels. During the exam, the students stayed in their specified MST channels, examiners rotated across all students. The feasibility and effectiveness of e-OSCE was evaluated using a self-administered questionnaire to students, examiners and e-OSCE team. Results: The data analysis showed that 93.4% students and 92.2% examiners agreed with the quality and process of e-OSCE. Similarly, 83.6% students and 98% examiners agreed with the fairness, smoothness and organization of e-OSCE. As many as 45.9% students and 74.5% examiners agreed that e-OSCE was close to real life practice. Approximately one fifth of students and one third of examiners preferred e-OSCE over the face-to-face OSCE. The analysis of qualitative data generated themes of e-OSCE structure and technology. While majority of participants were satisfied with e-OSCE, students were concerned about examiners’ training and e-OSCE contents. Examiners and e-OSCE team recognized the paper-less, tech-savy, fast and reliable e-OSCE format. Conclusion: During and beyond COVID- 19 era, e-OSCE is a feasible and effective modality for assessing clinical competence except for physical examination and procedural skills. The planning and implementation of e-OSCE reflects an ingenuity in assessment of clinical competencies of medical students.


2020 ◽  
Vol 3 (1) ◽  
pp. 45
Author(s):  
Jie Chen

With the emergence of development of international integration, the domestic education also attaches great importance to English discipline. The hospitality management of application-oriented undergraduate universities demands high standard for English. The hospitality management of some domestic undergraduate universities has reformed the traditional English teaching mode and adopted the Full English Teaching mode. However, due to the lack of high-quality English teachers, the single teaching methods, and the lack of support from university for Full English Teaching, the actual effect of Full English Teaching is not ideal. Through investigation and analysis of an undergraduate university, this paper finally puts forward countermeasures against the deficiencies in the Full English Teaching mode so as to improve the professional quality of the teaching staff, adopt diversified teaching means and enhance the school’s support for English teaching.


2019 ◽  
Author(s):  
Chang-yuan ZHANG ◽  
Fa Chen ◽  
Shan-Zhi Wang ◽  
Hao Yu ◽  
Hui Cheng ◽  
...  

Abstract Objective In order to standardize the teaching criterion and improve the quality of clinical training between different dental trainees, an integrated clinical curriculum was developed since September 2014 in the Hospital of Stomatology, Fujian Medical University of China. This article aimed to introduce the development of this curriculum and evaluate the dental trainees’ view on the curriculum. Methods and analysis A six-step approach was used to develop the curriculum. Dental trainees (n=142) rated the curriculum with satisfaction scores on a Likert-type scale and answered several open-ended questions. One-way ANOVA and Fisher's exact probabilities were utilized to analyzed satisfaction scores among four types of dental trainees. Results The mean satisfaction scores was 7.96 (out of 10). There was no significant difference in satisfaction scores among four types of dental trainees (P=0.209) and between the two genders (P=0.233). 91.55% of the dental trainees reckoned that the curriculum was valuable to their clinical training. There was no significant differences among the four types of dental trainees in terms of helpfulness to promote and standardize their clinical skills training (P=0.828). Conclusions The present findings suggest that the dental trainees appreciated the integrated clinical curriculum. This integrated curriculum is considered suitable for current condition of dental clinical training in China.


2010 ◽  
Vol 18 (1) ◽  
pp. 94-101 ◽  
Author(s):  
Verónica Guerra Guerrero ◽  
Olivia Sanhueza Alvarado

The National Undergraduate Accreditation Commission has been taking care of the accreditation process in several Nursing Schools, whose results are analyzed in this article, given the limited evidence of strengths and weaknesses. The objective is to analyze the first results obtained by that commission about the current development of Nursing in the country. The strengths obtained are: experience, qualification, commitment of teaching staff; well-defined study programs; adequate clinical training fields and infrastructure. Weaknesses are: reduced number of teachers; a curricular approach emphasizing biomedicine over nursing, low use of participative teaching methods; increasing difficulty to access exclusive clinical areas, and insufficient bibliographic resources. Conclusion: It is urgent that all Nursing Schools submit to universal criteria and standards, establishing minimum graduation levels for students, as well as the real state of the quality of nursing education in the country.


Perfusion ◽  
1998 ◽  
Vol 13 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Louis Brownstein ◽  
Candice S Rettie ◽  
Catherine M George

Clinical staff perfusionists are responsible for training perfusion students to perform tasks and manage patients in the clinical setting. They are often the least prepared to assume this teaching role. To address this need, a modular programme has been developed to provide the teaching staff with instructional skills. Adult learning theory specifies that an effective learning environment addresses issues of saliency, motivation, retention and transfer. Adults have different expectations, so this programme is designed to maximize this process. The programme is comprehensive and may be used for didactic instruction as well. Derived from a model designed for physicians as teachers, five modules provide theoretical support for teaching techniques, learning tools and management techniques for giving feedback and evaluating performance. Specifically, the topics address the following subjects: managing and motivating learners; teaching medical problem solving; teaching clinical skills; giving feedback and evaluating performance. The short curriculum is based on teaching principles that apply to adult learners with diverse learning styles. While presenting techniques to use with different types of learners, the programme itself incorporates these techniques in teaching the teachers. The modules use lectures, demonstrations, role playing and video taping to challenge teachers and learners in the cognitive, psychomotor and affective domains. The success of this programme is its ability to engage each participant in the learning process.


2016 ◽  
Vol 26 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Marianne Meng-Ann Ong ◽  
Mimi Yow ◽  
Jestina Tan ◽  
Scott Compton

Background: The National Dental Centre Singapore (NDCS) has collaborated with the National University of Singapore’s Division of Graduate Dental Studies to provide supervised clinical training in the five dental specialties for residents since the early 1990s. Faculty were first introduced to the one-minute preceptor (OMP) in microskills through in-house workshops held from May to August 2014. Purpose: The aim of this study was to assess if a OMP faculty workshop impacts residents’ perceptions of clinical teaching in NDCS. Methods: First- and second-year residents were asked to rate their perceptions of the quantity and quality of clinical teaching, and the adequacy of the five OMP microskills performed by faculty before and one month after the OMP workshops. Data were analysed using descriptive statistics and non-parametric statistical tests. Results: A total of 37 NDCS clinical faculty participated in the OMP workshops and 34 residents participated in the pre- and post-workshop survey. The short-term impact of the OMP faculty workshop revealed minimal effect on residents’ perceptions of the clinical teaching in both quantity and quality. Conclusion: A one-time OMP workshop for faculty members does not substantially improve residents’ perceptions of the quality or quantity of clinical teaching. The results of this study indicate that the effort to improve clinical teaching by faculty must be a sustained effort. Future studies should investigate the barriers to faculty members’ performance of the OMP microskills.


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