scholarly journals A Model for an Educational Virtual Ward Round

2021 ◽  
Author(s):  
Sarah Pauline Bowers ◽  
Philip J Dickson ◽  
Katharine Thompson
Keyword(s):  
Palliative Care ◽  
Medical Education ◽  
Medical Students ◽  
Healthcare Delivery ◽  
Ward Round ◽  
Clinical Placements ◽  
Care Teaching ◽  
Use Of Technology ◽  
Ward Rounds ◽  
Survey Responses

Abstract Background COVID-19 led to global disruption of both healthcare delivery and undergraduate medical education with suspension of clinical placements in alignment with government and university guidelines. To facilitate ongoing palliative care education, we aimed to develop a model for delivering virtual palliative care teaching and to assess the suitability of this as an alternative to in-person teaching. Method Basic technology (iPad and linked computer) were used to facilitate video conferencing, via the secure platform Microsoft Teams, between a consultant-led ward round in a specialist palliative care unit and fourth year medical students located in the education department of the unit. This was evaluated using electronic survey responses from patients, medical students and medical staff with generation of quantitative and qualitative data.Results Medical students greatly appreciated the opportunity to maintain attendance at clinical sessions during COVID-19. Quantitative and qualitative feedback demonstrated that the virtual ward round model effectively met medical students’ educational needs, particularly in relation to holistic assessment, pain management and communication skills. Only minor technological difficulties were noted. Feedback indicated that the use of technology to allow medical education was acceptable to patients, who were open and willing to adapt. Patients acknowledged that without medical students’ physical presence on ward rounds, there was an element of discretion; clinicians also found this to be beneficial. Conclusion COVID-19 has forced changes in the delivery of medical education. Virtual ward rounds are an effective method for delivering high quality palliative care teaching and are acceptable to patients, medical students and clinicians alike. Additional benefits beyond COVID-19 included allowing students to be present discretely during sensitive conversations whilst still meeting their learning outcomes.

scholarly journals Improving communication on medical ward rounds with patients who speak limited English with implementation of medical communication charts

2021 ◽  
Vol 10 (3) ◽  
pp. e001389
Author(s):  
Amrita Naomi D'Souza ◽  
Ana Canoso ◽  
Laura-Jane Smith
Keyword(s):  
Healthcare Delivery ◽  
Physical Symptoms ◽  
Ward Round ◽  
Medical Ward ◽  
Language Therapy ◽  
College Hospital ◽  
Medical Communication ◽  
Face To Face ◽  
High Satisfaction ◽  
Ward Rounds

AimTo improve communication on the medical ward round with patients with limited English through implementation of a medical communication chart.Local problemKing’s College Hospital (KCH), London, is situated in Southwark in which 11% of households have no members that speak English as a first language, 4.1% of London’s population report they do not speak English well. Language barriers impair healthcare delivery including during daily ward rounds. This has been exacerbated by the need for PPE during the SARS-CoV2 pandemic. Effective communication between healthcare teams and patients is essential for high quality, patient-centred care. Communication tools commonly used include online, telephone and face-to-face translation services but these have limitations.MethodsFace-to-face patient questionnaires were conducted in the pre-QIP (baseline) group to assess communication on medical ward rounds. Medical communication charts were designed by adapting pre-existing aids commonly used by speech and language therapy. Charts were translated into commonly spoken languages among KCH inpatients. Patients with limited English were selected from both COVID-19 and non-Covid wards. Preintervention and postintervention questionnaires were completed in three Plan–Do–Study–Act (PDSA) cycles.ResultsAt baseline, patients agreed or strongly agreed that the ward round addressed physical symptoms (8/8), concerns or anxieties (7/8), ongoing needs (7/8). Only two of eight doctors felt they could communicate effectively with patients. In PDSA 1, four of five patients reported high satisfaction in communicating physical symptoms, anxieties or concerns preintervention with five of five postchart implementation. Five of five patients reported high satisfaction in communicating ongoing needs preintervention but only three of five postintervention. In PDSA 2, two of five patients reported increased satisfaction in communicating physical symptoms, concerns or anxieties with four of four doctors reporting improved satisfaction in communication in PDSA 2 and two of three doctors reporting higher satisfaction in communication in PDSA 3.ConclusionUsing communication charts in patients with limited English can improve bidirectional communication on medical ward rounds.

11 Filling the void: preparing future junior doctors for challenging conversations

2018 ◽  
Vol 8 (3) ◽  
pp. 363.3-364
Author(s):  
Hannah Costelloe ◽  
Alice Copley ◽  
Andrew Greenhalgh ◽  
Andrew Foster ◽  
Pratik Solanki
Keyword(s):  
Palliative Care ◽  
Medical Education ◽  
Medical Students ◽  
Small Group ◽  
End Of Life ◽  
Communication Skills ◽  
Skills Training ◽  
Junior Doctors ◽  
List Type ◽  
The Impact

Evidence demonstrates that medical students have limited experience in developing ‘higher-order communication skills’ (Kaufman et al. 2000). Anecdotally many do not feel confident in their ability to conduct difficult conversations often due to a lack of exposure to such scenarios in practice or a pervasive notion that these scenarios are inappropriate for students and beyond the scope of a junior doctor’s role and thus not a focus of curriculums (Noble et al. 2007). There is however a correlation between level of clinical experience and improved confidence for medical students (Morgan and Cleave-Hogg 2002).We surveyed a group of final year medical students to assess their confidence using a 10-point Likert scale in tackling common palliative and end of life care scenarios. Our intervention comprised a study day of 10 practical small-group teaching simulation and OSCE-style stations designed to provide exposure to common experiences in a controlled setting. We reassessed the confidence of students after delivery and objectively explored the impact of the day by asking participants to complete a validated assessment before and after the course. All results showed significant improvement on t-testing: confidence in end of life communication in an OSCE setting improved by 42.2% and assessment marks improved by 24.7% (p=0.039).Palliative care is an area in which students approaching the end of undergraduate training feel underprepared. Our findings demonstrate that small group sessions improve confidence by facilitating communication practice in a controlled environment and providing crucial exposure to common palliative care scenarios they will face as doctors.References. Kaufman D, Laidlaw T, Macleod H. Communication skills in medical school: Exposure confidence and performance. Academic Medicine [online] 2000;75(10):S90–S92. Available at https://journals.lww.com/academicmedicine/Fulltext/2000/10001/Communication_Skills_in_Medical_School__Exposure.29.aspx [Accessed: 30 May 2018]. Morgan P, Cleave-Hogg D. Comparison between medical students’ experience confidence and competence. Medical Education [online] 2002;36(6):534–539. Available at https://doi.org/10.1046/j.1365-2923.2002.01228.x [Accessed: 30 May 2018]. Noble L, Kubacki A, Martin J, Lloyd M. The effect of professional skills training on patient-centredness and confidence in communicating with patients. Medical Education [online] 2007;41(5):432–440. Available at https://doi.org/10.1111/j.1365-2929.2007.02704.x [Accessed: 30 May 2018]

scholarly journals Validation of the Palliative Competency Tool: An Instrument To Qualify Medical Education (Validation of Palliative Competency Tool)

2020 ◽  
Author(s):  
Ursula Bueno do Prado Guirro ◽  
Carla Corradi Perini ◽  
Jose Eduardo de Siqueira
Keyword(s):  
Palliative Care ◽  
Medical Education ◽  
Factor Analysis ◽  
Medical Students ◽  
European Association ◽  
Alpha Coefficient ◽  
Excellent Performance ◽  
Statistical Validation ◽  
Delphi Methodology ◽  
Sphericity Test

Abstract Introduction: It is necessary to determine which competencies in Palliative Care (PC) have been acquired and which ones need to be improved. The aim was to develop and validate an instrument to assess the acquisition of competencies in PC care among medical students denominated Palliative Competency Tool (Pallicomp).Materials and methods: It were consisted of developing statements based on the competencies as described by the European Association for Palliative Care. The content was validated by experts, respecting the Delphi methodology. The instrument was applied to a group of medical students (n=71) enrolled at the final of 8th semester and statically validated.Results: Of the 30 questions developed, 24 were refined and approved by experts. The tool was applied to 71 medical students, only 12.7% had excellent performance and four out of ten competencies were underperformed. The statistical validation consisted of Bartlett's sphericity test, which showed adequate correlation for factor analysis (p <0.001); the Kaiser-Meyer-Olkin test for sample adequacy (0.7), and Conbach's alpha coefficient for the internal consistency (α = 0.7).Conclusions: Can be concluded that it was possible to construct and validate Palliative Competency Tool (PalliComp), an instrument of qualification of competencies acquisition of PC.

Respecting patient choices: using the ’Go Wish' cards as a teaching tool

2017 ◽  
Vol 8 (2) ◽  
pp. 194-197 ◽  
Author(s):  
Hibah Osman ◽  
Katia El Jurdi ◽  
Ramzi Sabra ◽  
Thalia Arawi
Keyword(s):  
Palliative Care ◽  
Medical Education ◽  
Medical Students ◽  
End Of Life ◽  
Thematic Analysis ◽  
Death And Dying ◽  
Teaching Tool ◽  
Student Reflection ◽  
Second Year ◽  
Self Discovery

BackgroundIndividuals have different values and priorities that can have an important impact on their medical management. Understanding this concept can help physicians provide medical care that is in line with the goals of their patients. Communicating this message effectively to students is challenging.ObjectiveTo report our experience with using Go Wish cards in the medical education setting.DesignA thematic analysis of student reflection papers using grounded theory.Setting/SubjectsSecond-year medical students participated in an activity using the Go Wish cards as part of a course module on palliative care. The activity aimed to encourage students to reflect on their own choices at the end of life and to highlight that different people have different priorities.ResultsForty-two students (42%) mentioned the Go Wish activity in their reflections on the module. They reported that the activity demonstrated the different priorities at the end of life, it illustrated the importance of providing personalised care, it promoted self-discovery, it transformed their view of death and dying, and it increased their appreciation of the importance of palliative care.ConclusionGo Wish cards can be used to help illustrate the variability in priorities of patients. They can be used as an effective to teach medical students about the importance of considering patient preferences when illness progresses.

scholarly journals Determining Factors Affecting the Acceptance of Medical Education eLearning Platforms during the COVID-19 Pandemic in the Philippines: UTAUT2 Approach

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 780
Author(s):  
Yogi Tri Prasetyo ◽  
Ralph Andre C. Roque ◽  
Thanatorn Chuenyindee ◽  
Michael Nayat Young ◽  
John Francis T. Diaz ◽  
...  
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Behavioral Intention ◽  
Structural Equation ◽  
The Philippines ◽  
Equation Modeling ◽  
Online Questionnaire ◽  
Factors Affecting ◽  
Use Of Technology ◽  
Instructor Characteristics

eLearning has been the medium of delivery of medical educational institutions to address the scarcity of medical professionals during the COVID-19 pandemic. In this study, the Unified Theory of Acceptance and Use of Technology (UTAUT2) was extended to determine the factors affecting the acceptance of eLearning platforms to medical education in the Philippines during the COVID-19 pandemic. A total of 360 medical students voluntary participated and answered an online questionnaire that consisted of 40 questions. Structural Equation Modeling (SEM) indicated that performance expectancy was found to have the highest effect on behavioral intention, which was followed by learning value and instructor characteristics. A high behavioral intention was found to affect the actual use of eLearning platforms. Interestingly, social influence and habit were found not to be significant to behavioral intentions. This study is the first study that has explored the acceptance of eLearning platforms among medical students in the Philippines during the COVID-19 pandemic. The findings can be a theoretical guideline of the Commission on Higher Education of the Philippines for eLearning platforms. Finally, the framework would be very valuable for enhancing the open innovation in eLearning platforms in medical fields worldwide.

scholarly journals Lessons from the COVID-19 pandemic for improving outpatient neuropalliative care: A qualitative study of patient and caregiver perspectives

2021 ◽  
pp. 026921632110173
Author(s):  
Zachary A Macchi ◽  
Roman Ayele ◽  
Megan Dini ◽  
Jensine Lamira ◽  
Maya Katz ◽  
...  
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Psychosocial Needs ◽  
Structured Interviews ◽  
Supportive Services ◽  
Care Needs ◽  
Survey Responses ◽  
The Impact

Background: COVID-19 has impacted persons with serious illness, including those with chronic, neurodegenerative conditions. While there are several reports on COVID-19’s impact on inpatient palliative care, literature is limited about the impact on outpatient care which may be more relevant for these patients. Aim: To generate a person-centered description of the impact of COVID-19 from the perspectives of patients living with neurodegenerative disease and caregivers to improve outpatient palliative care delivery. Design: This qualitative study used rapid analysis via matrix design to identify emergent themes related to participant perspectives on the challenges of COVID-19. Data sources included semi-structured interviews, open-ended survey responses, medical record documentation and participant-researcher communications. Setting/Participants: Data was collected from 108 patients with Parkinson’s disease, Alzheimer’s disease or related disorders and 90 caregivers enrolled in a multicenter, clinical trial of community-based, outpatient palliative care between March 20, 2020 and August 8, 2020 (NCT03076671). Results: Four main themes emerged: (1) disruptions to delivery of healthcare and other supportive services; (2) increased symptomatic and psychosocial needs; (3) increased caregiver burden; (4) limitations of telecommunications when compared to in-person contact. We observed that these themes interacted and intersected. Conclusions: Patients and caregivers have unmet care needs because of the pandemic, exacerbated by social isolation. While telemedicine has helped improve access to healthcare, patients and caregivers perceive clear limitations compared to in-person services. Changes in society and healthcare delivery in response to COVID-19 highlight ongoing and novel gaps that must be addressed to optimize future outpatient palliative care for neurologic illness.

scholarly journals Student’s Inventory of Professionalism (SIP): A Tool to Assess Attitudes towards Professional Development Based on Palliative Care Undergraduate Education

2019 ◽  
Vol 16 (24) ◽  
pp. 4925 ◽  
Author(s):  
Antonio Noguera ◽  
María Arantzamendi ◽  
Jesús López-Fidalgo ◽  
Alfredo Gea ◽  
Alberto Acitores ◽  
...  
Keyword(s):  
Professional Development ◽  
Palliative Care ◽  
Factor Analysis ◽  
Medical Students ◽  
Confirmatory Factor Analysis ◽  
Personal Growth ◽  
Goodness Of Fit ◽  
Self Report ◽  
Care Teaching ◽  
Confirmatory Factor

Introduction: Quality medical education, centered on a patient’s needs, is crucial to develop the health professionals that our society requires. Research suggests a strong contribution of palliative care education to professionalism. The aim of this study was to design and validate a self-report inventory to measure student’s professional development. Method: Sequential exploratory strategy mixed method. The inventory is built based on the themes that emerged from the analysis of four qualitative studies about nursing and medical students’ perceptions related to palliative care teaching interventions (see Ballesteros et al. 2014, Centeno et al. 2014 and 2017, Rojí et al. 2017). The structure and psychometrics of the inventory obtained is tested in two different surveys with two different groups of medical students. Inventory reliability and construct validity are tested in the first survey group. To verify the inventory structure, a confirmatory factor analysis is performed in a second survey group. Results: The inventory has 33 items and seven dimensions: a holistic approach, caring for and understanding the patient, personal growth, teamwork, decision-making, patient evaluation, and being a health care professional. Cronbach’s-alpha was 0.73–0.84 in all seven domains, ICC: 0.95. The confirmatory factor analysis comparative fit index (CFI) was 1 with a standardized root mean square Index 0.088 (SRMR) and obtained a 0.99 goodness-of-fit R-square coefficient. Conclusions: this new inventory is grounded on student’s palliative care teaching experiences and seems to be valid to assess student’s professional development.

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