scholarly journals P138 What are medical students’ perceptions of human factors in simulated learning events: a thematic analysis

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Alex Tebbett ◽  
Jo Jennings ◽  
Chris Bannon ◽  
Mike Brown ◽  
Qasim Khan ◽  
...  

Abstract Introduction Human factors, such as communication skills, are imperative to good patient care. In post-simulation debriefs we discuss these non-technical skills with medical students regularly, but do we have a good appreciation of what the terms mean to them, or what aspects of behaviour, good or bad, they focus on? Method Six human-factor sheets were developed to guide the students in their analysis of events in simulated scenarios. The sheets focused on one of: communication, teamwork, decision making, task management, situational awareness, or a final overview. A brief introduction to each factor was given as well as examples of good practice. The students were encouraged to record in writing what aspects of the scenario went well, and what could be improved, for a chosen skill. These sheets were then collected at the end of the session, with the students’ consent, for anonymous analysis. Data collection commenced last month and will run until December, with an estimated inclusion of about 100 students from two universities. The data will be analysed using thematic analysis performed by multiple researchers. Discussion If we can understand what aspects of these non-technical skills are considered important to our students early on in their career we can better tailor our teaching, both in simulation and in the clinical environment, to foster better performance throughout their training. By understanding what our students perceive, analyse, and internalise we can also reflect on our own practice and interactions to consider how we project as role models to our future colleagues.

Author(s):  
Saba Hoobehfekr ◽  
Fariba Asghari ◽  
Azadeh Sayarifard ◽  
Maliheh Kadivar ◽  
Shayan Kashefinejad

Medical professionalism has a crucial role in educating medical students. The role of professionalism in the clinical environment is therefore an important factor in medical education. This study attempts to evaluate the opinions of medical students in the teaching hospitals of Tehran University of Medical Sciences (TUMS) about the professionalism environment in this university. A sample of 165 students filled out the Persian translation of UMKC-SOM (Climate of Professionalism Survey) questionnaire. This instrument evaluates students’ perspectives on the degree of adherence to professionalism by faculty, residents and other students. The results of the study revealed that the total score of professionalism climate was 53.9 for faculty, 42.09 for residents, and 50.76 for students and the difference between these three groups was statistically significant (p-value < 0.01). Results of further analysis through post-hoc tests for multiple comparisons among the groups revealed that the students found their fellow students and faculty more professional than residents. The study also showed that the medical ethics course had no impact on perceptions observations (p-values > 0.05). The study results also revealed that the students found their fellow students and faculty more professional than residents. This finding demonstrates the importance of teaching professionalism to residents since they serve as role models for students. Further multicenter studies are needed to improve the professionalism climate in the medical teaching environment.


Author(s):  
Dian Puspita Sari ◽  
Yoga Pamungkas Susani

Background: Medical students’ transition to clinical clerkship has been shown to be challenging. Students need to effectively adjust to the new learning environment. This study aims to explore the role of senior peers in students’ experiences during transition to clinical clerkships.Methods: A qualitative methodology was adopted for this study. Eight 4th year medical students (5 female, 3 male) submitted audio diaries during their first 12 weeks of clinical clerkships. 73 audio diaries were collected in total. Data were analyzed thematically. Twenty-five out of the 73 audio diaries contained interactions with senior peer students and these interactions were captured in 38 excerpts. These excerpts were analyzed further to understand the role of senior peer students during the transition.Results: Senior peer students helped to ease out transition to clinical clerkship by serving three roles: (1) transferring information on ways of working in a clinical environment, on social aspects of clinical environments and on learning issues; (2) providing exemplars in performing clinical tasks as well as learning tasks; (3) as co-workers who provided access and support students’ participation. Conclusions: Senior peer students in a clinical clerkship helped newcomers to navigate themselves in a clinical environment by helping them to build situational awareness, by supporting vicarious learning and supporting students’ participation in a clinical environment.


2021 ◽  
Author(s):  
Yoshihiro Kataoka ◽  
Takami Maeno ◽  
Takashi Inaba ◽  
Sayaka Ninn ◽  
Masatsune Suzuki ◽  
...  

Abstract Evidence-based medicine (EBM) has become increasingly widespread over the last 30 years. However, the ideal curriculum for undergraduate EBM education has yet to be developed. To establish an EBM curriculum suitable for the educational environment in Japan, we conducted a qualitative study to identify the elements needed to facilitate undergraduate EBM learning among Japanese medical students. Participants were supervising physicians working in teaching hospitals or clinics. Six physicians were interviewed individually from October 2019 to January 2020. The interviewees were asked about their own EBM learning and teaching experiences, what they kept in mind when teaching EBM to medical students and what they felt was needed to improve current undergraduate EBM education. Interview transcripts were analyzed using thematic analysis. Thematic analysis extracted five themes: awareness of foreground questions in clinical practice, motivating learning through observation of role models, awareness of the role of medical students and active learning, understanding patient background as a starting point for practicing EBM, and prioritizing understanding “why” rather than “how” in EBM. Japanese medical students with limited clinical experience may first need to observe their supervisors practice EBM to develop the motivation to learn and grasp the bigger picture of EBM. It is important for medical students to develop an interest in their patients through conversations. Focusing on learning the rationale rather than the skills for practicing EBM may be the key to facilitating initial interest in undergraduate EBM education for subsequent continuous learning.


Author(s):  
Paul Olszynski ◽  
Mackenzie Russell ◽  
Adam Neufeld ◽  
Greg Malin

We created a clinical ultrasound (CUS) elective in clerkship, which gave medical students the opportunity to enhance their knowledge and technical skills while refining their CUS-related clinical decision making. This elective uniquely allowed medical students to integrate their CUS knowledge and skills into real patient care within the clinical environment (discipline) of their choice. As such, beyond supporting increasing technical competence, students learned to advocate for appropriate use of CUS, an important skill for trainees to develop. 


2020 ◽  
Vol 7 ◽  
pp. 238212052096807
Author(s):  
Andrés Martin ◽  
Julie Chilton ◽  
Cecilia Paasche ◽  
Nicole Nabatkhorian ◽  
Hilary Gortler ◽  
...  

Introduction: Medical culture can make trainees feel like there is neither room for mistakes, nor space for personal shortcomings in the makeup of physicians. A dearth of role models who can exemplify that it is acceptable to need support compounds barriers to help-seeking once students struggle. We conducted a mixed-methods study to assess the impact of physicians sharing their living experiences with medical students. Methods: Second-year medical students participated, through synchronized videoconferencing, in an intervention consisting of 3 physicians who shared personal histories of vulnerability (e.g. failure on high-stakes exams; immigration and acculturation stress; and personal psychopathology, including treatment and recovery), followed by facilitated, small-group discussions. For the quantitative component, students completed the Opening Minds to Stigma Scale for Health Care Providers (OMS-HC) before and after the intervention. For the qualitative component, we conducted focus groups to explore the study intervention. We analyzed anonymized transcripts using thematic analysis aided by NVivo software. Results: We invited all students in the class (n = 61, 46% women) to participate in the research component. Among the 53 participants (87% of the class), OMS-HC scores improved after the intervention ( P = .002), driven by the Attitudes ( P = .003) and Disclosure ( P < .001) subscales. We conducted 4 focus groups, each with a median of 6 participants (range, 5-7). We identified, through iterative thematic analysis of focus group transcripts, active components before, during, and after the intervention, with unexpected vulnerability and unarmored mutuality as particularly salient. Conclusions: Sharing histories of personal vulnerability by senior physicians can lessen stigmatized views of mental health and normalize help-seeking among medical students. Synchronous videoconferencing proved to be an effective delivery mechanism for the intervention in a ‘virtual wellness’ format. Candid sharing by physicians has the potential to enhance students’ ability to recognize, address, and seek help for their own mental health needs.


2019 ◽  
Author(s):  
Sneha Barai

UNSTRUCTURED The UK General Medical Council (GMC) explicitly states doctors have a duty to ‘contribute to teaching and training…by acting as a positive role model’. However, recent studies suggest some are not fulfilling this, which is impacting medical students' experiences and attitudes during their training. As such, doctors have a duty to act as role models and teachers, as specified by the GMC, which it seems are not currently being fulfilled. This would improve the medical students’ learning experiences and demonstrate good professional values for them to emulate. Therefore, these duties should be as important as patient care, since this will influence future generations.


2020 ◽  
Vol 163 (5) ◽  
pp. 1000-1002
Author(s):  
Ahmad K. Abou-Foul

On December 14, 1799, 3 prominent physicians—Craik, Brown, and Dick—gathered to examine America’s first president, George Washington. He was complaining of severe throat symptoms and was being treated with bloodletting, blistering, and enemas. Dick advised performing an immediate tracheotomy to secure the airway. Both Craik and Brown were not keen on trying tracheotomy and overruled that proposal. Washington was not involved in making that decision. He most likely had acute epiglottitis that proved to be fatal at the end. If Dick had prevailed, a tracheotomy could have saved Washington’s life. Human factors analysis of these events shows that his physicians were totally fixated on repeating futile treatments and could not comprehend the need for a radical alternative, like tracheotomy. That was aggravated by an impaired situational awareness and significant resistance to change. Leadership model was also based on hierarchy instead of competency, which might have also contributed to Washington’s death.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L E Murchison ◽  
R Anbarasan ◽  
A Mathur ◽  
M Kulkarni

Abstract Introduction In the already high-risk, high-stress environment of the operating theatre, operating during Covid-19 has brought its own unique challenges. Communication, teamwork and anxiety related new operating practices secondary to Covid-19 are hypothesised to have a negative impact on patient care. Method We conducted a single-centre online survey of operating theatre staff from 22nd June–6th July 2020. Respondents completed 18 human factors questions related to COVID-19 precautions including communication, teamwork, situational awareness, decision making, stress, fatigue, work environment and organisational culture. Questions consisted of yes/no responses, multiple choice and Likert items. Kruskall-Wallis tests, Chi-Squared, Mann Whitney U tests, Spearman’s correlation coefficient, lambda and Cramer’s V tests were used. Free-text responses were also reviewed. Results 116 theatre staff responded. Visual (90.5%), hearing/ understanding (96.6%) difficulties, feeling faint/lightheaded (66.4%) and stress (47.8%) were reported. Decreased situational awareness was reported by 71.5% and correlated with visors (r = 0.27 and p = 0.03) and FFP2/3 mask usage (r = 0.29 and p = 0.01). Reduced efficiency of theatre teams was reported by 75% of respondents and 21.5% felt patient safety was at greater risk due to Covid-19 precautions in theatre. Conclusions Organisational adjustments are required, and research focused on development of fit-for-purpose personal protective equipment (PPE).


BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Alex Tebbett ◽  
Ian Purcell ◽  
Shereen Watton ◽  
Rathinavel Shanmugham ◽  
Alexandra Tebbett

Abstract Introduction During Covid-19 many staff members were redeployed to the Intensive Care Unit (ICU) with little opportunity to train in the new skills they would require. One such skill was the transfer of a critically ill, and contagious, patient from ICU; a risky and complicated procedure which requires planning, preparation, risk assessment, situational awareness and, ideally, experience. To assist our colleagues in this skill an existing ICU transfer course has been adapted to cover the Covid-19 situation, or any similar contagious pandemic, in patient transfer. Methods An in-situ simulation method was chosen as the most realistic method of immersing our participants into the environment of ICU and to highlight real-life complexities and issues they may face. A multidisciplinary training session was devised so that novice anaesthetists, ACCPs and nurses could learn together, reflective of the usual team. Human factors such as communication, team leadership, task management and situational awareness are the focus of the post-simulation debrief, and human factors sheets have been created to guide the participants in analysing these skills. Pre- and post-simulation confidence, knowledge and attitudes will be assessed using validated appraisal tools and questionnaires to gather both quantitative and qualitative data about the experience. Discussion Multidisciplinary training is often difficult to arrange, due to the different requirements, processes, and procedures each department demands. A hidden blessing of Covid-19 is the realisation that this barrier can be broken, for the benefit of our patients and colleagues alike, and training sessions like this implemented.


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