scholarly journals Learning clinical reasoning in the workplace: a student perspective

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Larissa IA Ruczynski ◽  
Marjolein HJ van de Pol ◽  
Bas JJW Schouwenberg ◽  
Roland FJM Laan ◽  
Cornelia RMG Fluit
Keyword(s):  
Clinical Reasoning ◽  
Medical Center ◽  
Core Competency ◽  
Educational Interventions ◽  
Student Perspective ◽  
Clinical Environment ◽  
Clinical Rotations ◽  
Template Analysis ◽  
Complex Skills ◽  
Insight Into

Abstract Introduction Clinical reasoning is a core competency for every physician, as well as one of the most complex skills to learn. This study aims to provide insight into the perspective of learners by asking students about their own experiences with learning clinical reasoning throughout the medical Master’s curriculum. Methods We adopted a constructivist approach to organise three semi-structured focus groups within the Master’s curriculum at the medical school of the Radboud University Medical Center in Nijmegen (Netherlands) between August and December 2019. Analysis was performed through template analysis. Results The study included 18 participants who (1) defined and interpreted clinical reasoning, (2) assessed the teaching methods and (3) discussed how they used their context in order to learn and perform clinical reasoning during their clinical rotations. They referred to a variety of contexts, including the clinical environment and various actors within it (e.g. supervisors, peers and patients). Conclusion With regard to the process by which medical students learn clinical reasoning in practice, this study stresses the importance of integrating context into the clinical reasoning process and the manner in which it is learnt. The full incorporation of the benefits of dialogue with the practice of clinical reasoning will require additional attention to educational interventions that empower students to (1) start conversations with their supervisors; (2) increase their engagement in peer and patient learning; (3) recognise bias and copy patterns in their learning process; and (4) embrace and propagate their role as boundary crossers.

scholarly journals Clinical Reasoning as a Core Competency

2019 ◽  
Vol 95 (8) ◽  
pp. 1166-1171 ◽  
Author(s):  
Denise M. Connor ◽  
Steven J. Durning ◽  
Joseph J. Rencic
Keyword(s):  
Clinical Reasoning ◽  
Core Competency

scholarly journals Assessing Readiness for Clinical Practice: Students’ Perspectives of their Veterinary Curriculum

2016 ◽  
Author(s):  
L. Sanchez ◽  
Alison Kwiatkowski ◽  
Jeff Abbott ◽  
Dana Zimmel ◽  
Linda Behar-Horenstein
Keyword(s):  
Clinical Practice ◽  
Focus Group ◽  
Patient Involvement ◽  
Student Perspective ◽  
Veterinary Students ◽  
Clinical Rotations ◽  
Effective Feedback ◽  
Perceived Preparedness ◽  
Clinical Curriculum ◽  
Veterinary Curriculum

Studies describing the effectiveness of a veterinary curriculum from the student perspective are currently sparse. The overall purpose of this investigation was to describe students’ perceived preparedness for clinical practice. Three focus group meetings with fourth year veterinary students were conducted. Data were open-coded and categorized to identify themes. Four main themes emerged: Challenging communications, Un/appreciating curricular experiences, Documenting demands impede case involvement, and Hungering for timely, effective feedback. Overall students felt comfortable talking to clients about medicine but less comfortable discussing euthanasia or money; they appreciated the split clinical curriculum but questioned the value of the 1st/2nd year courses; they felt that paperwork on clinical rotations negatively impacted patient involvement; expressed the need for well-defined expectations regarding grading/assessment and autonomy on clinical rotations. Despite the reported issues, students expressed satisfaction with the split curriculum and readiness to enter their chosen field of study.

Influenza Vaccination Among Registered Nurses: Information Receipt, Knowledge, and Decision-Making at an Institution With a Multifaceted Educational Program

2008 ◽  
Vol 29 (2) ◽  
pp. 99-106 ◽  
Author(s):  
Cori L. Ofstead ◽  
Sharon J. Tucker ◽  
Timothy J. Beebe ◽  
Gregory A. Poland
Keyword(s):  
Influenza Vaccination ◽  
Registered Nurses ◽  
Educational Program ◽  
Medical Center ◽  
Vaccine Safety ◽  
Educational Interventions ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Vaccination Rates ◽  
To Receive

Objective.To evaluate the receipt of information and knowledge about influenza and vaccination, as well as influenza vaccination status and reasons for declining vaccination, among registered nurses.Design.Cross-sectional survey of registered nurses (RNs).Setting.A large tertiary medical center with a long-standing, multifaceted influenza vaccination program and relatively high vaccination rates among employees overall (76.5%).Participants.Randomly selected group of 990 RNs employed as inpatient staff nurses at the institution.Results.The survey was completed by 513 (51.8%) of 990 RNs. Most RNs (86.7%) had received an influenza vaccination in the past, and 331 (64.5%) intended to receive vaccination during the 2005-2006 influenza season. More than 90% of RNs acknowledged exposure to educational bulletins, and most had received information about influenza severity (383 [74.7%]), transmission (398 [77.6%]), vaccine safety (416 [81.1%]), and the time and location of free vaccination (460 [89.7%]). A majority (436 [85.0%]) felt they had received all the information they needed to make good decisions about vaccination. However, only 49 RNs (9.6%) gave correct answers to more than 85% of the knowledge questions on the survey. The reasons most frequently reported for declining vaccination were doubts about the risk of influenza and the need for vaccination, concerns about vaccine effectiveness and side effects, and dislike of injections.Conclusions.RNs exposed to a longstanding, multifaceted educational program had received information about influenza vaccination, but misconceptions were common and only 331 (64.5%) intended to receive vaccination. Strategies other than educational interventions are needed to increase influenza vaccination rates and thereby to ensure healthcare worker and patient safety.

Incivility

2019 ◽  
pp. 1-20
Keyword(s):  
Therapeutic Intervention ◽  
Nurse Educator ◽  
Clinical Environment ◽  
Academic Setting ◽  
Healthcare Facilities ◽  
Sole Purpose ◽  
Nursing Professionals ◽  
Insight Into

Nursing professionals experiencing incivility and bullying within the workplace are affected physically and emotionally. The sole purpose of the healthcare environment is to provide therapeutic intervention to the ill. Nurses should not anticipate going to work within healthcare facilities to be harassed, disrespected, and threatened. Be it a nurse working within a clinical environment or employed as a nurse educator in an academic setting, incivility and bullying can cause harm. Chapter 1 will provide an overview of the terms incivility and bullying. Uncivil conduct will be examined through a case study involving a perpetrator to provide insight into how a bully thinks and reacts with regard to their own behavior.

scholarly journals The student is key: A realist review of educational interventions to develop analytical and non‐analytical clinical reasoning ability

2020 ◽  
Vol 54 (8) ◽  
pp. 709-719 ◽  
Author(s):  
Anna Richmond ◽  
Nicola Cooper ◽  
Simon Gay ◽  
William Atiomo ◽  
Rakesh Patel
Keyword(s):  
Clinical Reasoning ◽  
Realist Review ◽  
Educational Interventions ◽  
Reasoning Ability

scholarly journals Case-Based Analogical Reasoning: A Pedagogical Tool for Promotion of Clinical Reasoning

2012 ◽  
Vol 7 (3) ◽  
pp. 129-136 ◽  
Author(s):  
Timothy E. Speicher ◽  
Alexandra Bell ◽  
Marijke Kehrhahn ◽  
Douglas J. Casa
Keyword(s):  
Athletic Training ◽  
Clinical Reasoning ◽  
Analogical Reasoning ◽  
Learning Transfer ◽  
Cognitive Learning ◽  
Primary Objective ◽  
Clinical Environment ◽  
Structural Principle ◽  
Multiple Case ◽  
Case Based

Context: One of the most common instructional methods utilized to promote learning transfer in health profession education is examination of a single patient case. However, in non-healthcare settings this practice has shown to be less effective in promoting learning than the examination of multiple cases with cueing. Objective(s): The primary objective of this article is to provide athletic training educators a rationale for implementing a multiple case-based analogical reasoning technique to improve students' learning transfer. Background: Case-based analogical reasoning is a pedagogical technique that improves problem solving by helping learners identify a common structural principle shared among multiple cases. Identification and transfer of the shared principle facilitates solving novel problems or patient cases. When cueing is coupled with the process, transfer of the structural principle to the problem is enhanced. Description: This article discusses cognitive learning theory and provides empirical evidence to support the use of case-based analogical reasoning to improve athletic training students' clinical reasoning. It also provides the educator practical tips for implementing the technique in classroom and clinical settings. Clinical Advantage(s): Improving the transfer of structural principles may improve solving novel problems in the clinical environment, which should also improve the quality of patient care. Conclusions: Clinical reasoning and learning transfer may be improved among health professional students during a case-based analogical reasoning process when cued to look for the shared structural principle among cases. Students who engage in multiple-case examination with cueing may be more apt to recall their learning and use it when faced with novel cases in the clinical environment.

Do patients and physicians perceive PSA screening discussions the same?

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 160-160
Author(s):  
James Austin Talcott ◽  
Gina Aharonoff ◽  
Maureen Bezuhly ◽  
Michael P. Osborne
Keyword(s):  
Decision Making ◽  
Randomized Trial ◽  
Primary Care Physicians ◽  
Medical Center ◽  
Academic Medical Center ◽  
Specific Antigen ◽  
Educational Interventions ◽  
Screening Methods ◽  
Psa Screening ◽  
Psa Testing

160 Background: Shared decision making is recommended for prostate-specific antigen (PSA) screening. We are performing a prospective randomized trial of educational interventions to improve screening compliance at an urban academic medical center. We hypothesize that patient and provider characteristics providers will affect compliance. We report the first results for PSA screening. Methods: In a cluster-randomized trial of educational supports for providers, we are recruiting an age- and sex-stratified sample of 216 patients aged 30 to 89 years undergoing an annual physical examination, 18 patients of each of 12 primary care physicians at two affiliated hospitals. Screening guideline format (color-coding) and academic detailing were randomly assigned in a 2 x 2 design. Surveys occurred immediately post-encounter to record recollections of screening discussions, recommendations and plans. Results: We report on the first 44 of 108 planned male participants. Most were white (77%), had a college degree (83%), and currently married (59%). When providers reported a PSA discussion, 13% of patients disagreed, while 23% of patients disagreed when their provider reported a PSA discussion. Discrepancies also occurred on additional elements of informed decision-making (data not shown). Reports also disagreed on physician recommendations: 2 of 8 patients (25%) disagreed with the physician’s report of recommending screening and 6 of 12 patients (50%) disagreed with the physician’s report of not recommending it. Half of patients (49%) reported distress at getting PSA results, but only 5% reported “a lot” of distress. Over half (58%) reported that PSA testing protected against prostate cancer “a lot.” No physician reported recommending PSA testing to men under age 50 or over age 70, but 1 of 6 men under 50 and 3 of 3 men over 70 reported that their physician had recommended testing. Conclusions: In a highly educated population of men and physicians surveyed immediately after their encounter, reports of whether PSA screening had occurred, the information that had been discussed and the recommendation had important discrepancies. Important differences may exist between patients and physicians in perceptions of PSA screening discussions. Clinical trial information: NCT02430948.

Interactive iBook-Based Patient Education in a NeuroTrauma Clinic

Neurosurgery ◽  
2017 ◽  
Vol 81 (5) ◽  
pp. 787-794 ◽  
Author(s):  
Ronald Sahyouni ◽  
Amin Mahmoodi ◽  
Amir Mahmoodi ◽  
Ramin R Rajaii ◽  
Bima J Hasjim ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Educational Interventions ◽  
The United States ◽  
Outpatient Setting ◽  
Educational Material ◽  
Patient Knowledge ◽  
Academic Medical ◽  
Baseline Knowledge

Abstract BACKGROUND Traumatic brain injury (TBI) is a leading cause of death and disability in the United States. Educational interventions may alleviate the burden of TBI for patients and their families. Interactive modalities that involve engagement with the educational material may enhance patient knowledge acquisition when compared to static text-based educational material. OBJECTIVE To determine the effects of educational interventions in the outpatient setting on self-reported patient knowledge, with a focus on iPad-based (Apple, Cupertino, California) interactive modules. METHODS Patients and family members presenting to a NeuroTrauma clinic at a tertiary care academic medical center completed a presurvey assessing baseline knowledge of TBI or concussion, depending on the diagnosis. Subjects then received either an interactive iBook (Apple) on TBI or concussion, or an informative pamphlet with identical information in text format. Subjects then completed a postsurvey prior to seeing the neurosurgeon. RESULTS All subjects (n = 152) significantly improved on self-reported knowledge measures following administration of either an iBook (Apple) or pamphlet (P < .01, 95% confidence interval [CI]). Subjects receiving the iBook (n = 122) performed significantly better on the postsurvey (P < .01, 95% CI), despite equivalent presurvey scores, when compared to those receiving pamphlets (n = 30). Lastly, patients preferred the iBook to pamphlets (P < .01, 95% CI). CONCLUSION Educational interventions in the outpatient NeuroTrauma setting led to significant improvement in self-reported measures of patient and family knowledge. This improved understanding may increase compliance with the neurosurgeon's recommendations and may help reduce the potential anxiety and complications that arise following a TBI.

scholarly journals Percepción y ansiedad de los estudiantes de Medicina en su rotación clínica en Obstetricia durante la pandemia por COVID-19

2021 ◽  
Vol 2 (1) ◽  
pp. 13-21
Author(s):  
Carlos Santiago Piñel Pérez ◽  
María José Gómez-Roso Jareño ◽  
Juan José López Galián
Keyword(s):  
Trait Anxiety ◽  
Participation Rate ◽  
Security Measures ◽  
Clinical Environment ◽  
State Trait Anxiety Inventory ◽  
Clinical Rotations ◽  
First Semester ◽  
Student Physician ◽  
Academic Year ◽  
De Medicina

Introducción.La pandemia por COVID-19 supuso la interrupción de las rotaciones clínicas en España y en el resto del mundo. En varias Universidades los estudiantes han vuelto al entorno clínico en el primer cuatrimestre del curso académico 2020/2021. Nuestro trabajo pretende evaluar la percepción y el nivel de ansiedad ante el riesgo de contagio por SARS-CoV-2 de los estudiantes de la asignatura de Obstetricia (Sexto de Medicina) en su rotación clínica en el servicio de Obstetricia y Ginecología en nuestro hospital. Métodos. Se diseñó un cuestionario basado en la versión breve de 6 ítems del cuestionario de ansiedad estado-rasgo (State-Trait Anxiety Inventory) para evaluar el nivel de ansiedad de los alumnos ante el riesgo de infección en cada uno de los puestos de rotación: consultas, paritorio, urgencias y planta de hospitalización. Resultados. La participación fue del 100% de los alumnos matriculados en la asignatura. El 73,69% de los estudiantes se sintieron bastante o muy seguros durante la rotación y el 89,48% consideraron que su aprendizaje durante las prácticas no se vio reducido por la situación de pandemia. El nivel medio de ansiedad mostrado en cada uno de los puestos de rotación fue bajo. Conclusiones. Las rotaciones clínicas en un entorno de pandemia, con las medidas de seguridad adecuadas y una relación alumno-médico 1:1 son posibles, seguras y necesarias para la correcta formación del estudiante de Medicina. Introduction. The COVID-19 pandemic led to clinical rotations disruption in Spain anth the resto of the world. In several colleges, students have returned to the clinical environment in the first semester of 2020/2021 academic year. We aim to evaluate the students´ perception and anxiety caused by the risk of infection by SARS-CoV-2 in their clinical rotation at the Obstetrics and Gynecology department of our Hospital. Methods. A survey was designed based on the 6-item version of de State-Trait Anxiety Inventory to assesss the students´ anxiety level at each place of rotation: delivery room, emergencies, consultations and hospitalization. Results: Participation rate was 100%. 73.69% felt quite or very safe during the rotation and 89.48% thought their learning was not reduced by the pandemic situation. The average level of anxiety shown was very low. Conclusions. Clinical rotations in a pandemic environment, with the appropriate security measures and a 1:1 student-physician ratio are possible, safe and necessary for the correct training of the medical student.

scholarly journals CATCH-ON Educational Interventions for Providers, Older Adults, and Caregivers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 497-497
Author(s):  
Erin Emery-Tiburcio ◽  
Robyn Golden ◽  
Michelle Newman
Keyword(s):  
Older Adults ◽  
Learning Community ◽  
Small Groups ◽  
Medical Center ◽  
Educational Interventions ◽  
Lessons Learned ◽  
Healthcare Team ◽  
Community Based ◽  
Community Based Organizations ◽  
Practical Recommendations

Abstract CATCH-ON, the collaborative GWEP led by Rush University Medical Center, is working to create Age-Friendly Communities by assuring that health systems, community-based organizations, and older adults and families are educated about the 4Ms. For providers, CATCH-ON offers a monthly Learning Community that focuses on one of the 4Ms each quarter. Each session provides practical recommendations for 4Ms implementation and opportunities to share experiences in small groups. CATCH-ON also partnered with Community Catalyst, older adults, and caregivers to develop a 4Ms educational brochure. The brochure is available electronically and by paper to educate older adults and caregivers about the 4Ms and discussing them with their healthcare team. Additionally, CATCH-ON created 4M online modules for older adults and families. This session will explore the success and lessons learned in developing educational interventions for diverse audiences and how this approach strengthens Age-Friendly Communities.

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