Implementing innovative, learner-centered methods to teach oncology fellows how to face difficult conversations.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 27-27
Author(s):  
Andrew Shaw ◽  
Matthew Reilley ◽  
Jennifer Leigh McQuade ◽  
Walter F. Baile ◽  
Daniel E. Epner
Keyword(s):  
Communication Skills ◽  
Role Play ◽  
Narrative Medicine ◽  
Life Transitions ◽  
Average Score ◽  
First Year ◽  
Large Group ◽  
Learner Centered ◽  
Clinical Scenarios ◽  
Key Skills

27 Background: Oncologists engage in emotionally charged conversations with patients and families about prognosis, goals of care, and end of life transitions. Many oncologists lack key skills for guiding patients through such conversations. Key skills include posing open ended questions to elicit the patient’s perspective, using silence effectively, and responding to emotion with empathy. We previously described a communication skills curriculum for first year medical oncology fellows consisting of a series of one hour monthly seminars (Epner and Baile, Academic Medicine, 2014). We now describe improvements in the curriculum based on extensive feedback from learners and teaching assistants. Methods: Anonymous feedback from first year fellows indicated longer sessions would allow for sufficient warm up and more in depth reflection and opportunity to practice. We therefore consolidated the sessions into quarterly 4 hour workshops. Several fellows also expressed discomfort with participating in role play of clinical scenarios in front of colleagues, so we implemented small group learning in which 3-4 fellows practiced communication skills in facilitated role play scenarios. We also replaced large group role play with narrative medicine techniques, such as reading and discussing medically-themed short stories and reflective writing exercises to allow the greatest amount of participation among learners. Results: Fellows completed anonymous surveys on which they rated items on a 4 point scale, with 1 being best and 4 worst. The average score of the two survey items pertaining to large group role play was 2.6. After changes in the curriculum, items pertaining to narrative medicine averaged 1.3, which was very favorable. Items pertaining to relevance and value of the curriculum also averaged less than 1.5 for all years. Attendance was 100% with the exception of fellows who were on vacation. Conclusions: Learner-centered, interactive innovations to our previous communication skills curriculum were highly rated by fellows and addressed issues of enhanced participation in a learning environment in which fellows felt safe to actively participate, reflect, and interact extensively with their peers.

Responding to difficult emotions

2017 ◽  
Author(s):  
Jennifer Philip ◽  
David W. Kissane
Keyword(s):  
Communication Skills ◽  
Symptom Relief ◽  
Role Play ◽  
Skills Training ◽  
Active Listening ◽  
Narrative Approach ◽  
Communication Skills Training ◽  
Clinical Scenarios ◽  
And Coping ◽  
Difficult Situations

Patient distress can be acute or enduring, and contribute to the experience of a challenging consultation. Difficult emotions could include anger, resentment, morbid fear, intense grief, despair, or demoralization. A narrative approach is recommended involving active listening to the story, empathic acknowledgement of the emotions expressed, involvement of experienced clinicians, and reframing of the experience constructively to enable symptom relief and containment of the distress. When suffering persists, its further acknowledgement is warranted with efforts to promote adaptation and coping by exploration of the person and their life, sources of meaning, value and worth, and affirmation of these in the ill person. Role play in communication skills training involves the practice of a variety of empathic responses. Clinical scenarios for these difficult situations are provided in this chapter.

Pengembangan Bahan Ajar Matematika Bisnis Berbasis Komputer Untuk Mahasiswa Jurusan Akuntansi Politeknik Negeri Bali

Epigram ◽  
2019 ◽  
Vol 16 (2) ◽  
pp. 99-110
Author(s):  
I Made Wijana ◽  
Anak Agung Putri Suardani ◽  
I Gede Made Karma
Keyword(s):  
Small Group ◽  
Mathematics Teaching ◽  
Needs Analysis ◽  
Average Score ◽  
Teaching Materials ◽  
Initial Product ◽  
Large Group ◽  
Computer Based ◽  
Large Groups ◽  
Expert Validation

This research aims to produce prototype of computer-based business mathematics teaching materials to improve student achievement of Accounting Department, Politeknik Negeri Bali (PNB). In this research, to reach the target of teaching materials of computer-based business mathematics, the development using Borg and Gall method with some modifications into five steps: needs analysis and curriculum majoring in accounting, initial product development, education expert validation, small group trial , and large group trials. Trial of small group and large group by involving first semester student of Diploma IV Managerial Accounting Study Program, Accounting Department, PNB. Based on curriculum analysis and needs analysis, teaching materials are developed in the form of modules with Microsoft Excel application and the result of the initial product are five modules with topics of Formula, Linear and Non Linear Functions, Interest Calculation, Annuity, and Linear Programming. Education expert validation using five aspects resulted in an average score of 4.13 (good). Trial of the teaching materials by measuring student perceptions using three aspects for small groups resulted in an average score of 3.81 (good) and for large groups resulted in an average score of 4.23 (good). Furthermore, results of evaluation in large groups indicate a significant increase in mean of student scores from before and after using computer-based Business Mathematics teaching materials 

THE APPLICATION OF PREVIEW, READ, WRITE, AND RECITE (PRWR) METHOD TO IMPROVE STUDENT’S ACHIEVEMENT IN READING RECOUNT TEXT

2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Rahmat Nasution And Rahmah
Keyword(s):  
Secondary Data ◽  
Analysis Data ◽  
Primary Data ◽  
Average Score ◽  
First Year ◽  
Generic Structure ◽  
The Subject ◽  
Minimum Criteria ◽  
Main Ideas ◽  
Orientation Test

The objective of this research is to find out whether the application Preview, Read,Write, and Recite (PRWR) method improve student’s achievement in readingrecount text. This research applied classroom action research model. This studywas done in six meetings. The subject of this study was first year of SMAN 1Delitua. Primary data were collected by giving 20 questions of multiple-choicetest, the aspects contained in the tests focused on generic structure, main ideas,factual information, and Secondary data were collected by (interview, observationsheet, and questionnaire sheet. Based on analysis data, it was found that thestudent’s achievement improved. It could be seen from the comparison of result inthe orientation test and the cycle test I and II. There were only 9 students who hadpassed minimum criteria KKM in orientation test (75). The improvement showedthat in cycle I and II, based on the total average score it was 16 (42,4%) up to 26(78,7%) in cycle II, The secondary data gathered from interview, observationsheet, and questionnaire sheet, showed that students’ expression and enthusiasticalso improved. Thus, it was found that the applications of Preview, Read, Write,and Recite (PRWR) method in process of teaching improved students’achievement in reading recount text. It is suggested that English teachers applyPRWR method in teaching reading recount text.

A Cohort study to compare Admission criteria and Academic performance among preclinical students at The Copperbelt University School of Medicine: complete enumeration (Preprint)

2019 ◽  
Author(s):  
Andrew Mwila
Keyword(s):  
Academic Performance ◽  
Cohort Study ◽  
Clinical Medicine ◽  
Average Score ◽  
First Year ◽  
Admission Criteria ◽  
Biomedical Sciences ◽  
Dental Surgery ◽  
School Of Medicine ◽  
Better Than

BACKGROUND The Copperbelt University is the second public University in Zambia. The School of Medicine has four major programs namely; Bachelor of Medicine and Surgery, Bachelor of Dental Surgery, Bachelor of Clinical Medicine and Bachelor of Biomedical sciences. The Copperbelt University School of Medicine runs a five-year training program for both the BDS and the MBCHB programs. Students are admitted into the Medical school after successfully completing their first year at the Main campus in the School of Natural Sciences with an average of 4 B grades or higher (B grade is a mark of 65 to 74%). OBJECTIVE The study was done to determine the association between admission criteria and academic performance among preclinical students. Hence, the study compares the academic performance among preclinical students admitted into the Bachelor of Dental Surgery and Bachelor of Medicine and Surgery at the Copperbelt University School of Medicine. METHODS This is a retrospective cohort study conducted at Michael Chilufya Sata School of medicine Campus. A pilot study was conducted with 30 BDS and 30 MBCHB students and the obtained information helped determine the sample size. SPSS was used to analyze the data. The study period lasted approximately 7 weeks at a cost of K1621. RESULTS In 2014, there was an improvement in average performance between 2nd and 3rd year for each program. An average score of 15.4 (SD 4.2) was obtained in 3rd year compared to 12.8 (SD 4.9) in 2nd year (p<0.001). Meanwhile, 3rd MB ChB mean score was 12.6 (SD 3.7) compared to 10.7 (SD 3.6) in 2nd years (p<0.05). However, in 2016, both programs, 3rd year mean scores were lower than 2nd year (MB ChB 2nd year mean score was 12.0 (SD 4.3) compared to 3rd year with a mean score of 9.5 (SD 4.5), p<0.001; BDS 2nd year mean score was 10.6 (SD 4.0) compared to 3rd year mean score of 8.2 (SD 3.4), p<0.01. On average MB ChB students performed better than BDS students in all the years (p<0.05), except in 2016 when the results were comparable. CONCLUSIONS Results from the study shows that entry criteria has a correlation to academic performance as students admitted with higher grades perform much better than those with lower grades.

scholarly journals Twelve Years of the Italian Program to Enhance Relational and Communication Skills (PERCS)

2021 ◽  
Vol 18 (2) ◽  
pp. 439
Author(s):  
Lidia Borghi ◽  
Elaine C. Meyer ◽  
Elena Vegni ◽  
Roberta Oteri ◽  
Paolo Almagioni ◽  
...  
Keyword(s):  
Communication Skills ◽  
Repeated Measures ◽  
Behavioral Changes ◽  
Chi Square ◽  
Future Directions ◽  
Public And Private ◽  
Learner Centered ◽  
Difficult Conversations ◽  
Booster Sessions ◽  
Before And After

To describe the experience of the Italian Program to Enhance Relations and Communication Skills (PERCS-Italy) for difficult healthcare conversations. PERCS-Italy has been offered in two different hospitals in Milan since 2008. Each workshop lasts 5 h, enrolls 10–15 interdisciplinary participants, and is organized around simulations and debriefing of two difficult conversations. Before and after the workshops, participants rate their preparation, communication, relational skills, confidence, and anxiety on 5-point Likert scales. Usefulness, quality, and recommendation of the program are also assessed. Descriptive statistics, t-tests, repeated-measures ANOVA, and Chi-square were performed. A total of 72 workshops have been offered, involving 830 interdisciplinary participants. Participants reported improvements in all the dimensions (p < 0.001) without differences across the two hospitals. Nurses and other professionals reported a greater improvement in preparation, communication skills, and confidence, compared to physicians and psychosocial professionals. Usefulness, quality, and recommendation of PERCS programs were highly rated, without differences by discipline. PERCS-Italy proved to be adaptable to different hospital settings, public and private. After the workshops, clinicians reported improvements in self-reported competencies when facing difficult conversations. PERCS-Italy’s sustainability is based on the flexible format combined with a solid learner-centered approach. Future directions include implementation of booster sessions to maintain learning and the assessment of behavioral changes.

scholarly journals Tracking Active Learning in the Medical School Curriculum: A Learning-Centered Approach

2018 ◽  
Vol 5 ◽  
pp. 238212051876513 ◽  
Author(s):  
Lise McCoy ◽  
Robin K Pettit ◽  
Charlyn Kellar ◽  
Christine Morgan
Keyword(s):  
Active Learning ◽  
Medical School ◽  
School Curriculum ◽  
First Year ◽  
Group Instruction ◽  
Large Group ◽  
Curriculum Review ◽  
Learning Techniques ◽  
Learning Centered ◽  
Semistructured Interviews

Background: Medical education is moving toward active learning during large group lecture sessions. This study investigated the saturation and breadth of active learning techniques implemented in first year medical school large group sessions. Methods: Data collection involved retrospective curriculum review and semistructured interviews with 20 faculty. The authors piloted a taxonomy of active learning techniques and mapped learning techniques to attributes of learning-centered instruction. Results: Faculty implemented 25 different active learning techniques over the course of 9 first year courses. Of 646 hours of large group instruction, 476 (74%) involved at least 1 active learning component. Conclusions: The frequency and variety of active learning components integrated throughout the year 1 curriculum reflect faculty familiarity with active learning methods and their support of an active learning culture. This project has sparked reflection on teaching practices and facilitated an evolution from teacher-centered to learning-centered instruction.

scholarly journals A realist evaluation exploring simulated patient role-play in pharmacist undergraduate communication training

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aisling Kerr ◽  
Judith Strawbridge ◽  
Caroline Kelleher ◽  
James Barlow ◽  
Clare Sullivan ◽  
...  
Keyword(s):  
Focus Groups ◽  
Communication Skills ◽  
Role Play ◽  
Real Life ◽  
Skills Training ◽  
Realist Evaluation ◽  
Communication Training ◽  
Pharmacy Students ◽  
Simulated Patients ◽  
Rank Test

Abstract Background Effective communication between pharmacists and patients is essential and improves health outcomes. Simulated patients (SPs) are trained to reproduce real-life situations and can help pharmacy students to develop and adapt their communication skills in a safe, learner-centred environment. The aim of this research was to explore how SP and pharmacy student role-play supports communication training. Methods A mixed methods realist evaluation approach was adopted to test an initial theory relating to SP role-play for pharmacy students. The intervention tested involved complex communication cases in a men’s and women’s health module in year three of a new MPharm programme. This SP session was the first such session, of the programme which exclusively focused on complex communication skills for the students. Data collected comprised video-recordings of both training and mock OSCE sessions, and from student focus groups. Communication videos were scored using the Explanation and Planning Scale (EPSCALE) tool. Scores from SP and mock OSCE sessions were compared using the Wilcoxon-signed rank test. Focus groups were conducted with students about their experience of the training and analysed thematically, through a realist lens. Data was analysed for Context-Mechanism-Outcome configurations to produce modified programme theories. Results Forty-six students (n = 46/59, 78 %) consented to their video-recorded interactions to be used. Students identified contextual factors relating to the timing within the course and the setting of the intervention, the debrief and student individual contexts. Mechanisms included authenticity, feedback, reflection, self-awareness and confidence. Negative responses included embarrassment and nervousness. They distinguished outcomes including increased awareness of communication style, more structured communication and increased comfort. However quantitative data showed a decrease (p < 0.001) in communication scores in the mock OSCE compared with scores from training sessions. Modified programme theories relating to SP training for pharmacy students were generated. Conclusions SP role-play is a valuable communication skills training approach. Emphasis should be placed on multiple stakeholder feedback and promotion of reflection. Time limits need to be considered in this context and adjusted to meet student needs, especially for students with lower levels of communication comfort and those communicating in languages different to their first language.

scholarly journals Situation-Background-Assessment-Recommendation (SBAR) and Emergency Medicine Residents' Learning of Case Presentation Skills

2012 ◽  
Vol 4 (3) ◽  
pp. 370-373 ◽  
Author(s):  
Matthew C. Tews ◽  
J. Marc Liu ◽  
Robert Treat
Keyword(s):  
Emergency Medicine ◽  
Communication Skills ◽  
Comfort Level ◽  
Future Research ◽  
First Year ◽  
Clinical Environment ◽  
General Applicability ◽  
Good Reliability ◽  
First Case ◽  
Patient Handoffs

Abstract Background To date, no standardized presentation format is taught to emergency medicine (EM) residents during patient handoffs to consulting or admitting physicians. The Situation-Background-Assessment-Recommendation (SBAR) is a common format that provides a consistent framework to communicate pertinent information. Objective The objective of this study was to describe and evaluate the feasibility of using SBAR to teach interphysician communication skills to first-year EM residents to use during patient handoffs. Methods An educational study was designed as part of a pilot curriculum to teach first-year EM residents handoff communication skills. A standardized SBAR reporting format was taught during a 1-hour didactic intervention. All residents were evaluated using pretest/posttest simulated cases using a 17-item SBAR checklist initially, and then within 4 months to assess retention of the tool. A survey was distributed to determine resident perceptions of the training and potential clinical utility. Results There was a statistically significant improvement from the resident scores on the pretest/posttest of the first case (P  =  .001), but there was no difference between posttest of the first case and pretest of the second case (P  =  .34), suggesting retention of the material. There was a statistically significant improvement from the pretest and posttest scores on the second case (P  =  .001). The survey yielded good reliability for both sessions (Cronbach alpha  =  0.87 and 0.89, respectively), demonstrating statistically significant increases for the perceived quality of training, presentation comfort level, and the use of SBAR (P  =  .001). Conclusion SBAR was acceptable to first-year EM residents, with improvements in both the ability to apply SBAR to simulated case presentations and retention at a follow-up session. This format was feasible to use as a training method and was well received by our resident physicians. Future research will be useful in examining the general applicability of the SBAR model for interphysician communications in the clinical environment and residency training programs.

scholarly journals Agreement Between Parental Report and Clinician Observation of Infant Developmental Skills

2021 ◽  
Vol 12 ◽  
Author(s):  
Alexis Federico ◽  
Dexin Shi ◽  
Jessica Bradshaw
Keyword(s):  
Communication Skills ◽  
Motor Skills ◽  
Social Communication ◽  
Parent Report ◽  
First Year ◽  
Developmental Skills ◽  
Social Communication Skills ◽  
Young Infants ◽  
Strong Relation ◽  
First Year Of Life

Understanding the convergence between parent report and clinician observation measures of development is important and became even more critical during the COVID-19 pandemic as clinician contact with families was significantly limited. Previous research points to inconsistencies in the degree of agreement between parents and clinicians and very little research has examined these associations for infants within the first year of life. This study investigated the association between parent report and clinician observation measures of social communication and motor skills in 27 young infants who were assessed at 9 and 12 months of age. Results suggest a strong relation between clinician and parent rated motor skills, but weak to moderate associations between clinician and parent rated communication skills. Infant temperament played a significant role in parent ratings of infant communication. Together, these results provide support for data collection via parent report or clinician observation of infant motor skills, but suggest that multiple measures of infant communication may be helpful to obtain high-quality, perhaps more accurate, assessment social-communication skills. Specifically, multiple parent report measures along with an observation of parent-infant interactions will likely provide a more rich and accurate characterization of infant social-communication abilities.

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