Teaching Clinical Skills During Pandemic Times

2022 ◽  
pp. 249-273
Author(s):  
Maria Fernanda Chaparro ◽  
José Alberto Herrera ◽  
Miriam Lizzeth Turrubiates ◽  
Silvia Lizett Olivares Olivares
Keyword(s):  
Medical Students ◽  
Clinical Competence ◽  
Clinical Skills ◽  
Teaching Strategy ◽  
Faculty Members ◽  
Online Resources ◽  
Clinical Simulation ◽  
Healthcare Simulation ◽  
Controlled Environments ◽  
Facilitated Learning

Clinical simulation is a teaching strategy that replicates medical situations in controlled environments. The COVID-19 pandemic created disruptions for healthcare simulation centers. As a response, the Universidad Anáhuac designed online clinical simulation practices and assessments. The pre-intervention survey showed skeptical medical students (59.15%) to continue this learning format. The intervention included neurology, cardiology, and gynecology topics supported by five faculty members and staff. Instruments were examination checklists to evaluate the clinical competence based on a 100 score and the Debriefing Assessment for Simulation in Healthcare (DASH) with a 1 (extremely ineffective) to 7 (extremely effective) score. Students received individual training by Zoom, including simulation practices, debriefing, and assessment. Even though it seemed impossible to address clinical skills by distance, simulation practices continued with online resources. Collaborative participation between faculty, students, and staff facilitated learning during the COVID-19 conditions.

USEFULNESS OF CONVENTIONAL KNOWLEDGE BASED CLINICAL EXAMINATION (SHORT CASE) VERSUS OBJECTIVE STRUCTURED CLINICAL EXAMINATION (OSCE) IN ACQUIRING CLINICAL COMPETENCE IN FINAL YEAR MBBS STUDENTS

2021 ◽  
pp. 56-58
Author(s):  
Rajesh Rajagopalan ◽  
V. Mohankumar ◽  
K. Revathi ◽  
K. G. Srinivasahan ◽  
B. R. Balamurugan
Keyword(s):  
Medical Students ◽  
Clinical Examination ◽  
Clinical Competence ◽  
Clinical Skills ◽  
Case Method ◽  
Examination System ◽  
College Hospital ◽  
Case Assessment ◽  
Score Pattern ◽  
The Way

Introduction: The way medical students learn is largely determined by the way they are assessed. There is a need to rationalize the examination system by giving due emphasis on internal assessment, and supplementing the traditional short case examination with more valid and reliable instruments for the assessment of clinical skills. To compare the Aims And Objectives: marks/score pattern between short case and OSCE and to study the students and faculty feedback about short case method of assessment versus OSCE. This study was conducted on 60 nal year MBBS students at the end of thei Methodology: r clinical posting in skin department of IRT Perundurai Medical College Hospital, Erode. Clinical assessment was rst done on short case and then by administering OSCE. The results were analyzed using ANOVA. Two scenarios were chosen namely Hansen's disease and psoriasis. Marks obtained by the students were only Results: marginally higher in OSCE than short case assessment. Students performed better in OSCE leprosy. 26 out of 60 students scored 70% or above by short case method whereas 32 out of 60 scored 70% or above by OSCE method. The student's feedback regarding both in general was positive. Students preferred short case assessment in terms of method and time. Logistical difculties were noted in OSCE. The practical Conclusion: clinical examinations are of key importance in the assessment of clinical competence of medical students. Students perform better in OSCE because it is objective, fair, unbiased, without examiners marking variability, without fear of examiner and anxiety. Students and faculty sensitization regarding nuances of OSCE is the need of the hour.

scholarly journals Desenvolvimento de habilidades em ambientes controlados e simulação para segurança dos usuários SUS na graduação

2020 ◽  
Vol 4 (1) ◽  
pp. 45
Author(s):  
João Carlos Da Silva Bizario ◽  
Gabriela Furst Vaccarezza ◽  
Carolina Felipe Soares Brandão
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Medical School ◽  
Deliberate Practice ◽  
First Semester ◽  
Clinical Simulation ◽  
Academic Activities ◽  
Health Care Network ◽  
Controlled Environments ◽  
Different Levels

INTRODUCTION: The insertion of Medical Students since the beginning of Medical School in applied professional reality practices provides a potential and necessary opportunity for performance and competence development driven by the National Curricular Guidelines from 2014. The familiarity of students with professional practices in controlled environments contributes to reality comprehension, guaranteeing the development of skills, which contributes and maintain the patients’ safety. OBJECTIVE: Describing the insertion of the curriculum performed of the professional skills and Clinical Simulation as a controlled learning environment, concurring with developed activities in different levels of health care attention, such as non-controlled environments. METHODOLOGY: Experience report of the academic activities of Medical Course at Universidade Municipal de São Caetano do Sul from its conception. RESULTS: Skills and simulations throughout the semesters contain several activities with Simulated Patient Actors, Task Trainers, Hybrid Simulation, Rapid Cycle Deliberate Practice (RCDP), and Standardized Simulation as a path to the development of medical competences since the first semester of the course. CONCLUSION: Medical Students’ insertion in health care network (RAS) since the beginning of Medical School linked to Clinical Simulation, have played an important role and complement the curricula, preserving the main objective of promoting better practices aiming the patients’ safety.

scholarly journals Resident Evaluations: The Use of Daily Evaluation Forms in Rheumatology Ambulatory Care

2009 ◽  
Vol 36 (6) ◽  
pp. 1298-1303 ◽  
Author(s):  
SUSAN HUMPHREY-MURTO ◽  
NADER KHALIDI ◽  
C. DOUGLAS SMITH ◽  
ELZBIETA KAMINSKA ◽  
CLAIRE TOUCHIE ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Clinical Competence ◽  
Clinical Skills ◽  
Faculty Members ◽  
Objective Structured Clinical Examination ◽  
Validity And Reliability ◽  
Point Scale ◽  
Good Reliability ◽  
Evaluation Report ◽  
Internal Medicine Residents

Objective.The in-training evaluation report (ITER) is widely used to assess clinical skills, but has limited validity and reliability. The purpose of our study was to assess the feasibility, validity, reliability, and effect on feedback of using daily evaluation forms to evaluate residents in ambulatory rheumatology clinics.Methods.An evaluation form was developed based on the Royal College of Physicians and Surgeons of Canada CanMEDS roles. There were 12 evaluation items including overall clinical competence. They were rated on a 5-point scale from unsatisfactory to outstanding. All internal medicine residents rotating on rheumatology were strongly encouraged to provide the form to their preceptor at the end of each clinic. A questionnaire was administered to residents and faculty.Results.Seventy-three internal medicine residents completed a 1-month rotation at University of Ottawa (n = 26) and McMaster University (n = 47). Faculty members completed a total of 637 evaluation forms. The number of evaluation forms ranged from 2 to 16 (mean 8.73) per resident. At an average of 8.73 forms per resident the reliability was 0.71 for the composite score. Fourteen forms would be required for a reliability of 0.8. The correlation between the objective structured clinical examination scores and the forms was 0.48 (p = not significant). Faculty and residents reported increased feedback following implementation of the forms.Conclusion.The use of daily evaluation forms is feasible and provides very good reliability. Use of the evaluation forms increases feedback to residents on their performance. The forms were well received by faculty and residents.

State Medical Board Disciplinary Hearings as Tools for Teaching Professionalism in Medical Education

2011 ◽  
Vol 97 (3) ◽  
pp. 8-12
Author(s):  
Onelia G. Lage ◽  
Sydney F. Pomenti ◽  
Edwin Hayes ◽  
Kristen Barrie ◽  
Nancy Baker
Keyword(s):  
Medical Students ◽  
Ethics Education ◽  
Faculty Members ◽  
Specific Method ◽  
Pilot Studies ◽  
Medical Board ◽  
Medical Institutions ◽  
State Medical Boards ◽  
State Medical Board ◽  
The Impact

ABSTRACT This article proposes a partnership of state medical boards with medical schools to supplement professionalism and ethics education for medical students, residents, physicians and faculty members of medical institutions. The importance of professionalism has been recognized by several studies, but a specific method of teaching and developing professionalism has yet to emerge. Studies suggest that there is an association between a lack of professionalism in medical school and future disciplinary actions by medical boards. However, there has been little collaboration between these institutions in addressing unprofessional behaviors. One collaborative concept that holds promise, however, is the idea of inviting medical students to attend physician disciplinary hearings. Students and physicians alike report that watching a hearing can significantly impact attitudes about professionalism as a part of medical practice. While formal research is scarce, the positive response of individual students who experience disciplinary hearings firsthand suggests that further pilot studies may be useful. Presented in this paper are the perspectives of three individuals — a medical student, a faculty member and a medical board chair — who discuss the impact and potential of attending disciplinary hearings in developing professionalism and ethics. Also included is a review of the current literature.

Inter-rater Reliability of Preceptors on Clinical Pharmacy Competency Evaluation

2020 ◽  
Vol 15 ◽  
Author(s):  
Dixon Thomas ◽  
Sherief Khalifa ◽  
Jayadevan Sreedharan ◽  
Rucha Bond
Keyword(s):  
United Arab Emirates ◽  
Clinical Pharmacy ◽  
Clinical Competence ◽  
Assessment Tool ◽  
Clinical Skills ◽  
Group Discussion ◽  
Pharmacy Students ◽  
Rater Reliability ◽  
Quasi Experimental ◽  
Competency Evaluation

Background:: Clinical competence of pharmacy students is better evaluated at their practice sites. compared to the classroom. A clinical pharmacy competency evaluation rubric like that of the American College of Clinical Pharmacy (ACCP)is an effective assessment tool for clinical skills and can be used to show item reliability. The preceptors should be trained on how to use the rubrics as many inherent factors could influence inter-rater reliability. Objective:: To evaluate inter-rater reliability among preceptors on evaluating clinical competence of pharmacy students, before and after a group discussion intervention. Methods:: In this quasi experimental study in a United Arab Emirates teaching hospital, Seven clinical pharmacy preceptors rated clinical pharmacy competencies of ten recent PharmD graduates referring to their portfolios and preceptorship. Clinical pharmacy competencies were adopted from ACCP and mildly modified to be relevant for the local settings. Results:: Inter-rater reliability (Cronbach's Alpha) among preceptors was reasonable being practitioners at a single site for 2-4 years. At domain level, inter-rater reliability ranged from 0.79 - 0.93 before intervention and 0.94 - 0.99 after intervention. No inter-rater reliability was observed in relation to certain competency elements ranging from 0.31 – 0.61 before intervention, but improved to 0.79 – 0.97 after intervention. Intra-class correlation coefficient improved among all individual preceptors being reliable with each other after group discussion though some had no reliability with each other before group discussion. Conclusion:: Group discussion among preceptors at the training site was found to be effective in improving inter-rater reliability on all elements of the clinical pharmacy competency evaluation. Removing a preceptor from analysis did not affect inter-rater reliability after group discussion.

Reliability and Validity of a Simulation-based Acute Care Skills Assessment for Medical Students and Residents

2003 ◽  
Vol 99 (6) ◽  
pp. 1270-1280 ◽  
Author(s):  
John R. Boulet ◽  
David Murray ◽  
Joe Kras ◽  
Julie Woodhouse ◽  
John McAllister ◽  
...  
Keyword(s):  
Medical Students ◽  
Acute Care ◽  
Reliability And Validity ◽  
Faculty Members ◽  
First Year ◽  
Clinical Experiences ◽  
Critical Events ◽  
Simulation Based ◽  
Broad Domain ◽  
Simulation Exercises

Background Medical students and residents are expected to be able to manage a variety of critical events after training, but many of these individuals have limited clinical experiences in the diagnosis and treatment of these conditions. Life-sized mannequins that model critical events can be used to evaluate the skills required to manage and treat acute medical conditions. The purpose of this study was to develop and test simulation exercises and associated scoring methods that could be used to evaluate the acute care skills of final-year medical students and first-year residents. Methods The authors developed and tested 10 simulated acute care situations that clinical faculty at a major medical school expects graduating physicians to be able to recognize and treat at the conclusion of training. Forty medical students and residents participated in the evaluation of the exercises. Four faculty members scored the students/residents. Results The reliability of the simulation scores was moderate and was most strongly influenced by the choice and number of simulated encounters. The validity of the simulation scores was supported through comparisons of students'/residents' performances in relation to their clinical backgrounds and experience. Conclusion Acute care skills can be validly and reliably measured using a simulation technology. However, multiple simulated encounters, covering a broad domain, are needed to effectively and accurately estimate student/resident abilities in acute care settings.

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