Oncology nursing training: A blended teaching approach in resource-limited countries.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19189-e19189
Author(s):  
Mehrunnissa Taj ◽  
Benish Lalani ◽  
Nurani Madhani ◽  
Cornelia Ouma ◽  
Lydia Njumwa ◽  
...  

e19189 Background: Although cancer is a global health concern, resource-limited countries (RLCs) experience higher mortality and morbidity compared with high-income countries. Knowledge gaps and inadequate training are some of the many barriers to safe and effective patient care in RLCs. Oncology nursing as a subspecialty does not readily exist in many RLCs, such as Kenya and Tanzania; many of the nursing staff learn essential clinical skills on the job with no structured training. Advanced practitioners are critical in identifying knowledge deficits and elevating oncology nurses’ clinical skills for positive patient outcomes. Methods: We used a blended teaching approach (a combination of computer-led sessions and face-to-face interactions) to impart cancer education to the nursing staff working in the oncology departments at four hospitals in Kenya and Tanzania. The training focused on cancer biology, epidemiology, pharmacology, safe chemotherapy administration, side effect management, and patient education. Computer-based modules and face-to-face skills training on chemotherapy administration were conducted over a four-month period. Pre- and post-assessments were held for each training session, and clinical skills were evaluated in-person at the completion of the course. Finally, a comprehensive post-assessment was conducted immediately after the training, and again at 3- and 6-month intervals to evaluate knowledge gain and retention over time. Results: Of 21 participants across four sites, the mean scores for the first pre- and post-test were 71.43% and 90.48%, respectively ( p = .01), showing a significant improvement in knowledge. The post-tests after course completion and again at the 6-month interval showed mean values of 88.28% and 89.30%, respectively ( p = .36), indicating a sustained effect of our intervention and no diminution of knowledge at 6 months. The initial face-to-face skills’ training was followed by 3- and 6-month sessions via video chat. At the final 12-month face-to-face visit, we confirmed recommended policy and clinical practice changes in effect and developed a plan for sustainability measures. Conclusions: Blended teaching is an effective tool in improving knowledge, skills, and self-efficacy for clinicians practicing in RLCs. Advanced oncology practitioners can play an important role in assessing, designing, and implementing similar training courses in other areas of oncology, such as survivorship, and palliative care. The corresponding improvement in knowledge and skillsets could ultimately improve patient outcomes .

2007 ◽  
Vol 30 (4) ◽  
pp. 59
Author(s):  
H. Carnahan ◽  
E. Hagemann ◽  
A. Dubrowski

A debate is emerging regarding the efficacy of proficiency based versus duration based training of technical skills. It is not clear whether the performance level attained at the end of practice (i.e., proficiency criteria), or the overall amount of practice performed during learning will best predict the retention of a technical clinical skill. The skill learned was the single-handed double square-knot. Forty two trainees learned the skill through video-based instruction and were divided into three groups (14 participants per group) each with a specific criterion time to tie the knot (10, 15, and 20 seconds). Practice continued until participants completed the knot within their criterion time. The total number of trials, and the overall practice time required to obtain each respective criterion were recorded during practice. Participants returned one-week later for a timed retention test consisting of one trial of the knot tying skill with no video instruction. A multiple regression analysis tested whether the amount of practice, the total practice time, or the criterion reached at the end of practice was the best predictor of the time taken to perform the skill during retention. This analysis showed that the number of practice trials was highly correlated with total practice time (r = .82, p = .01), therefore total practice time was withdrawn as a predictor variable from the subsequent analysis. The regression showed that the only significant predictor of retention performance was the criterion reached at the end of practice (p = .03). The number of practice trials was not found to significantly predict the retention performance (p = .87). The results support the notion that proficiency based training results in better retention of a technical clinical skill in comparison to duration based approaches. This provides evidence for the introduction of proficiency based educational approaches in technical skills curricula. Jowett N, LeBlanc V, Xeroulis G, MacRae H, Dubrowski A. Surgical skill acquisition with self-directed practice using computer-based video training. Am J Surg. 2007; 193(2):237-42. Gallagher AG, Ritter EM, Champion H, Higgins G, Fried MP, Moses G, Smith CD, Satava RM. Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training. Ann Surg. 2005; 241(2):364-72. Van Sickle KR, Ritter EM, McClusky DA, Lederman A, Baghai M, Gallagher AG, Smith CD. Attempted establishment of proficiency levels for laparoscopic performance on a national scale using simulation: the results from the 2004 SAGES Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) learning center study. Surg Endosc. 2007; 21(1):5-10.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S369-S370
Author(s):  
Alison M Beieler ◽  
Alison M Beieler ◽  
Leah H Yoke ◽  
Leah H Yoke ◽  
Catherine Liu ◽  
...  

Abstract Background Applicants entering Infectious Disease (ID) fellowships are declining and shortages of ID physicians is a challenge recognized by the clinical workforce and Infectious Diseases Society of America (IDSA). There is increased awareness of more Advanced Practice Providers (APPs) being used within ID to expand and extend existing practices. However, little is known about APP utilization, APP clinical scope of practice, specific roles, and opportunities for education. Methods To evaluate physician perspectives on APP utilization in ID, we created an anonymous and voluntary survey using the REDCap data tool that was distributed by social media, key stakeholder emails, and IDSA online community forum between 12/1/2019-1/31/2020. In addition to collecting geographic information and the type of ID practice, participants were also surveyed about the use of APPs and any perceived barriers that may limit their use. Results 218 practicing ID physicians responded to the survey (Figure 1). 155 (71%) physicians work with APPs in their current practice (Figure 2); specifically, 56 (27%) with 1 APP, 62 (30%) with 2-4 APPs, 28 (13%) with 5-9 APPs, and 11 (5%) with > 10 APPs. Of respondents, 104 (48%) practiced at University/Medical schools, 80 (37%) in hospitals/clinics, and 28 (13%) in private practice (Table 1); most work in adult inpatient/outpatient ID. The main reasons selected by respondents for not using APPs in their practice included concerns around a lack of formal ID training 22 (15%), lack of time/lack of ability to assist with APP training 29 (20%), practice is already sufficiently staffed 19 (13%), and concern for physician revenue loss 16 (11%) (Table 1). Figure 1. Physician Responses by Region, n = 218 Figure 2. Physicians Utilizing APPs in Practice, n = 210 (*no response, 8) Table 1. Physician ID Practice Type, Setting, and Concerns Conclusion Results suggest that while collaboration between ID physicians and APPs exists to meet current needs, a lack of ID training is a limiting factor. Our findings demonstrate there is an opportunity for formal ID education and resource development both to enhance APPs clinical skills and address perceived knowledge gaps. Inclusion of APPs in the ID workforce may allow physicians to expand ID care into more resource limited areas to continue to provide high quality patient care. Disclosures Steven A. Pergam, MD, MPH, Chimerix, Inc (Scientific Research Study Investigator)Global Life Technologies, Inc. (Research Grant or Support)Merck & Co. (Scientific Research Study Investigator)Sanofi-Aventis (Other Financial or Material Support, Participate in clinical trial sponsored by NIAID (U01-AI132004); vaccines for this trial are provided by Sanofi-Aventis)


2013 ◽  
Vol 88 (2) ◽  
pp. 192-197 ◽  
Author(s):  
David Topps ◽  
Joyce Helmer ◽  
Rachel Ellaway

2012 ◽  
Vol 32 (3) ◽  
pp. 261-266 ◽  
Author(s):  
Kajiru Gad Kilonzo ◽  
Sudakshina Ghosh ◽  
Siya Anaeli Temu ◽  
Venance Maro ◽  
John Callegari ◽  
...  

Data on the burden of acute kidney injury (AKI) in resource-poor countries such as Tanzania are minimal because of a lack of nephrology services and an inability to recognize and diagnose AKI with any certainty. In the few published studies, high morbidity and mortality are reported. Improved nephrology care and dialysis may lower the mortality from AKI in these settings. Hemodialysis is expensive and technically challenging in resource-limited settings. The technical simplicity of peritoneal dialysis and the potential to reduce costs if consumables can be made locally, present an opportunity to establish cost-effective programs for managing AKI. Here, we document patient outcomes in a pilot peritoneal dialysis program established in 2009 at a referral hospital in Northern Tanzania.


2021 ◽  
pp. bmjstel-2020-000814
Author(s):  
Natasha Houghton ◽  
Will Houstoun ◽  
Sophie Yates ◽  
Bill Badley ◽  
Roger Kneebone

The COVID-19 pandemic has prompted the cancellation of clinical attachments and face-to-face teaching at medical schools across the world. Experiential learning—through simulation or direct patient contact—is essential for the development of clinical skills and procedural knowledge. Adapting this type of teaching for remote delivery is a major challenge for undergraduate medical education. It is also an opportunity for innovation in technology enhanced learning and prompts educators to embrace new ways of thinking. In this article, the authors explored how educators from different disciplines (medicine, music and performing arts) are using technology to enhance practical skills-based learning remotely.The authors, five experienced educators from different fields (surgery, medicine, music and magic), jointly documented the transition to technology enhanced remote teaching through a series of five structured conversations. Drawing from literature on distance learning in medicine and professional experience in education, the authors identified seven practice-enhancing recommendations for optimising teaching of procedural knowledge and skills. These are: (1) make a virtue out of necessity; (2) actively manage your environment; (3) make expectations clear; (4) embrace purposeful communication; (5) use digital resources; (6) be prepared for things to go wrong and (7) personalise the approach. The authors argue that widening the discourse in technology enhanced learning to include cross-disciplinary perspectives adds richness and depth to discussions. This article demonstrates a cross-disciplinary approach to addressing challenges in technology-enhanced medical education.


2021 ◽  
pp. e20210043
Author(s):  
Sarah Baillie ◽  
Annelies Decloedt ◽  
Molly Frendo Londgren

Flipped classroom is an educational technique in which content is delivered online for students to study at their own pace in preparation for in-class learning. Benefits include increased flexibility, enhanced student engagement and satisfaction, and more effective use of time spent during face-to-face teaching. However, the development and implementation of flipped classroom teaching are also associated with challenges, including time required to develop learning materials and getting students to engage with the preparatory work. This teaching tip describes a structured approach to designing and implementing the flipped classroom approach for clinical skills to allow a greater focus on practicing the hands-on skills and the provision of feedback during the laboratory session. First, the rationale for flipping the classroom and the expected benefits should be considered. On a practical level, decisions need to be made about what to include in the flipped component, how it will complement the face-to-face class, and how the resources will be created. In the design phase, adopting a structured template and aligning with established pedagogical principles is helpful. A well-designed flipped classroom motivates learners by including different elements such as quality educational media (e.g., videos), the opportunity to self-assess, and well-defined connections to relevant knowledge and skills. Student engagement with the flipped material can be promoted through different strategies such as clear communication to manage student expectations and adapting the delivery of the face-to-face component. Finally, gathering feedback and evaluating the initiative are important to inform future improvements.


Author(s):  
Martine Pellerin ◽  
Carlos Soler Montes

The study explores the effectiveness of the implementation of blended teaching (BT) by combining the Spanish online resource Aula Virtual de Español (AVE) with the face-to-face (F2F) delivery approach in second language Spanish programs in two high schools in Alberta, Canada. Findings demonstrate the effectiveness of combining the online resource AVE to the F2F teaching approach to promote BT in the Spanish language classroom. The use of BT approach in the language classroom had a positive impact on the students’ attitudes towards the study of the language, the students’ motivation and their participation levels in class, as well as their use of the target language in the classroom. Moreover, the multimodal experiences provided by the use of the online AVE resource combined with the F2F delivery approach responded more to the different learners learning styles and specific needs. Finally, the use of online AVE in conjunction with F2F teaching was also perceived as an effective tool in the preparation for the International Spanish Diplomas (DELE) taken by the students in the more advanced Spanish classes. La présente étude explore l’efficacité de l’enseignement hybride combinant l’utilisation de la ressource espagnole en ligne Aula Virtual de Español (AVE) et l’interaction face à face dans les programmes d’enseignement de l’espagnol, langue seconde, dans deux écoles secondaires de l’Alberta (Canada). Les résultats démontrent l’efficacité de la combinaison de la ressource en ligne AVE à la prestation face à face pour favoriser l’approche de l’enseignement hybride dans les cours d’espagnol. L’utilisation de l’approche de l’enseignement hybride dans le cours de langue a eu une incidence positive sur l’attitude des élèves relativement à l’apprentissage de la langue, la motivation des élèves et leur taux de participation en classe, ainsi que leur utilisation de la langue d’apprentissage dans la classe. En outre, les expériences multimodales fournies par l’utilisation de la ressource en ligne AVE et l’interaction face à face correspondaient mieux aux styles d’apprentissage et aux besoins particuliers des apprenants. Enfin, l’utilisation de la ressource en ligne AVE et de l’interaction face à face a aussi été perçue comme un outil efficace de préparation aux Diplômes internationaux d’espagnol (DIE) entrepris par les élèves des cours d’espagnol plus avancés.


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