Simulation-based clinical education versus early clinical exposure for developing clinical skills in respiratory care students

Objectives: A good conceptual understanding of physiology is very important to build a strong foundation for medical students. It is a daunting job for teachers to emphasise the clinical relevance of basic science subjects as exposure to patients invariably starts after these subjects have been taught. With the introduction of early clinical exposure in the newly revised Indian undergraduate medical curriculum, this problem can be addressed to a certain extent. We developed an integrated simulation module for teaching cardiovascular physiology to pre-clinical students as a part of early clinical exposure. Materials and Methods: We included 145 medical students of a Private Medical College of a Deemed to be University in Mangalore, Karnataka, India. The teaching module covered the topics of cardiovascular physiology such as functional anatomy, cardiac cycle, normal electrocardiogram (ECG), arrhythmia, arterial pulse examination, heart sounds and hands-on cardiovascular examination using a variety of simulators. The assessment was done by pre-test and post-test. A retro-pre questionnaire was used to assess their self-perceived knowledge gain and level of clinical skills. Feedback on overall experience was collected from the participants. Results: The student feedback showed that learning experience was life-like (98.6%), effective, innovative and enjoyable (99.3%) and making the overall experience of learning easier (95.2%). It also improved participation, communication (93.8%), clinical skills and a better understanding of patient care (99.3%). The results of the retro- pre questionnaire to assess their self-perceived knowledge gain (95%) and level of clinical skills (96%) were highly satisfactory. The assessment of knowledge domain showed 100% of the students achieved pass percentage (>50%) with significant difference among pre- and post-test scores. Faculty (100%) opined that simulation-based teaching resulted in effected learning. Conclusions: The use of simulation-based teaching in cardiovascular physiology as part of early clinical exposure leads to enhanced learning and clinical application. This will stimulate interest in subject and promote better learning.

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Development and validation of simulated virtual patients to impart early clinical exposure in endocrine physiology

AJP Advances in Physiology Education ◽

10.1152/advan.00110.2017 ◽

2018 ◽

Vol 42 (1) ◽

pp. 15-20 ◽

Cited By ~ 4

Author(s):

Akriti Gupta ◽

Satendra Singh ◽

Farah Khaliq ◽

Upreet Dhaliwal ◽

S. V. Madhu

Keyword(s):

Clinical Reasoning ◽

Clinical Skills ◽

Knowledge Gain ◽

Virtual Patients ◽

Learning Tools ◽

Clinical Exposure ◽

Improved Learning ◽

Teaching Learning ◽

Real Patients ◽

Early Clinical Exposure

In the country presently, preclinical medical students are not routinely exposed to real patients. Thus, when they start clinical postings, they are found to have poor clinical reasoning skills. Simulated virtual patients (SVPs) can improve clinical skills without endangering real patients. This pilot study describes the development of two SVPs in endocrine physiology and their validation in terms of acquisition of clinical knowledge and student engagement. Two SVPs, Nandini Sharma (unintentional weight gain) and Sunil Yadav (polyuria), were created and published on the i-Human Patients platform through an iterative, interdisciplinary, and transdisciplinary collaborative process using the conceptual framework of Kim et al. (Kim S, Phillips WR, Pinsky L, Brock D, Phillips K, Keary J. Med Educ 40: 867–876, 2006). After internal and external peer validation, the SVPs were piloted on 40 students (20 students per virtual patient) over 2 wk. A cognitive pretest was conducted before exposure, and a posttest soon after. Faculty and student feedback were collected. Faculty found SVPs authentic, helpful as teaching-learning tools, and useful for giving feedback and for assessment. Students found SVPs more engaging than paper cases and helpful in developing clinical reasoning and in imparting clinical exposure. Pretest and posttest scores indicated knowledge gain ( P < 0.01). Although challenging to create, SVPs created on the i-Human Patients platform improved learning in endocrine physiology and were well accepted by students and faculty as a means to provide early clinical exposure. More SVPs can be developed through collaboration between stakeholder departments and integrated into the curriculum for greater benefit.

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Early Clinical Exposure in Preclinical Years of Medical School

Journal of Nepal Medical Association ◽

10.31729/jnma.5341 ◽

2021 ◽

Vol 59 (242) ◽

pp. 936-938

Author(s):

Anisha Basukala ◽

Kabita Chaudhary

Keyword(s):

Communication Skills ◽

Clinical Skills ◽

Medical Science ◽

Learning Method ◽

Traditional Curriculum ◽

Clinical Exposure ◽

The Past ◽

Wide Gap ◽

Teaching Learning ◽

Early Clinical Exposure

Medical science is one of the sectors which has faced rapid advancement in the past few years. But sadly, medical schools are still following the traditional curriculum where a wide gap between the pre-clinical and clinical phases prevails. Early clinical exposure is known to act as a bridge to this gap. It contributes to the overall development of naive medical students enhancing their communication skills, clinical skills, teamwork, empathy development, and motivation towards selfdirected learning and hence making them more competent for clinical years. So, as it reinforces the conventional didactic teaching-learning method it becomes a much-needed part for the students in preclinical years.

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Outcomes: Promoting Reflective Practice Using Performance Indicator Questionnaires

Perspectives on Administration and Supervision ◽

10.1044/aas20.2.64 ◽

2010 ◽

Vol 20 (2) ◽

pp. 64-70 ◽

Cited By ~ 2

Author(s):

Mary Pat McCarthy

Keyword(s):

Clinical Education ◽

Performance Indicator ◽

Clinical Skills ◽

Self Assessment ◽

Clinical Practicum ◽

Self Reflection ◽

Healthcare Settings ◽

Language Pathology ◽

Traditional Performance ◽

The University

This article details the process of self-reflection applied to the use of traditional performance indicator questionnaires. The study followed eight speech-language pathology graduate students enrolled in clinical practicum in the university, school, and healthcare settings over a period of two semesters. Results indicated when reflection was focused on students' own clinical skills, modifications to practice were implemented. Results further concluded self-assessment using performance indicators paired with written reflections can be a viable form of instruction in clinical education.

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Application and Evaluation of Case-Based Learning as a Part of Early Clinical Exposure for Undergraduate Medical Education Program

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol05-i08/914 ◽

2020 ◽

Vol 5 (08) ◽

pp. 284-288

Author(s):

Vandana Daulatabad ◽

Prafull K. ◽

Dr. Surekha S. Kadadi-Patil ◽

Ramesh S. Patil

Keyword(s):

Medical Education ◽

Research Centre ◽

Muscle Physiology ◽

Case Scenario ◽

Clinical Exposure ◽

Clinical Scenarios ◽

Case Based Learning ◽

Nerve Muscle ◽

Case Based ◽

Early Clinical Exposure

Introduction: Medical Education is witnessing a significant transition and global shift towards competency based medical education (CBME) which includes early clinical exposure (ECE) program to help students apply and correlate principles of preclinical subjects with clinical scenarios, in various forms and in a variety of settings. One of the easy and feasible methods of ECE being Case Based Learning (CBL), our study aimed to design a case scenario and to evaluate impact of case base learning as a part of ECE module in first year undergraduate medical teaching program in nerve muscle physiology. Methods: The present study was conducted in 96 students at Ashwini Rural Medical College Hospital and Research Centre, Solapur after obtaining institutional ethics committee approval. 3 hrs session of CBL was conducted for a case scenario on myasthenia gravis in the nerve muscle physiology module. The students’ responses on pre-test, post-test and their insights regarding the CBL were taken through a pre validated questionnaire using 5-point Likert scale. Results: High impact of CBL was seen as significant improvement in student’s performance. Maximum students felt CBL to be easy method of learning and was highly appreciated through their feedback. Conclusion: CBL was found to have positive impact on understanding and perception of topic. CBL helped students to understand, evaluate, analyze, diagnose and interpret the case, paving them towards newer approach of self-directed and vertical integrated learning. CBL is easier, feasible an effective method among other early clinical exposure methods as it involves students in deeper and self-directed active learning, encouraging and promoting them to reach higher levels of cognitive domain of Bloom’s taxonomy. This method will be very useful in its practical implementation during online classes for ECE module in the threat of COVID 19 situation as well.

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Early clinical exposure in medical curricula across Europe: An overview

European Journal of General Practice ◽

10.1080/13814780902745930 ◽

2009 ◽

Vol 15 (1) ◽

pp. 4-10 ◽

Cited By ~ 16

Author(s):

Okay Başak ◽

John Yaphe ◽

Wolfgang Spiegel ◽

Stefan Wilm ◽

Francesco Carelli ◽

...

Keyword(s):

Clinical Exposure ◽

Medical Curricula ◽

Early Clinical Exposure

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Medical students’ perceptions of the effectiveness of integrated clinical skills sessions using different simulation adjuncts

AJP Advances in Physiology Education ◽

10.1152/advan.00097.2016 ◽

2016 ◽

Vol 40 (4) ◽

pp. 514-521 ◽

Cited By ~ 1

Author(s):

Muhammad Zafar

Keyword(s):

Factor Analysis ◽

Medical Students ◽

Response Rate ◽

Clinical Skills ◽

Medical Curricula ◽

Effective Implementation ◽

Simulation Based

Simulation-based integrated clinical skills sessions have great potential for use in medical curricula. Integration is central to simulation efficacy. The aim of this study was to obtain medical students' perceptions toward effectiveness of integrated clinical skills sessions by using different simulation adjuncts and to know the challenges/obstacles encountered toward the implementation of such sessions. A study was conducted to obtain anonymous feedback from male ( n = 156) and female ( n = 179) medical students in years 2 and 3 during the 2014–2015 academic sessions at Alfaisal University about their perceptions of the effectiveness of integrated clinical skills sessions, uses of simulation adjuncts, and obstacles encountered toward the effective implementation of such sessions. The response rate was 93.4. Factor analysis showed data being valid and reliable. Cronbach’s α-values for effectiveness of sessions, use of simulation adjunct, and obstacles encountered were 0.97, 0.95, and 0.95, respectively. We conclude that students perceived positively the effectiveness of integrated clinical skills sessions as well as the use of simulation adjuncts, especially SPs. They suggested overcoming the obstacles and limitations of simulation. They highly valued the role of the facilitators in achieving effective sessions.

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Early Clinical Exposure to Geriatric Psychiatry and Medical Students' Interest in Caring for Older Adults: A Randomized Controlled Trial—Preliminary Findings

American Journal of Geriatric Psychiatry ◽

10.1016/j.jagp.2017.01.133 ◽

2017 ◽

Vol 25 (3) ◽

pp. S112-S113 ◽

Cited By ~ 1

Author(s):

Klara Pokrzywko ◽

Petal S. Abdool ◽

Gabriela Torres-Platas ◽

Trent Semeniuk ◽

Yara G. Moussa ◽

...

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Medical Students ◽

Controlled Trial ◽

Geriatric Psychiatry ◽

Clinical Exposure ◽

Randomized Controlled ◽

Early Clinical Exposure

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Student perceptions of the care of children: impacts of pre-clerkship pediatric and primary care clinical teaching

Canadian Medical Education Journal ◽

10.36834/cmej.36624 ◽

2014 ◽

Vol 5 (1) ◽

pp. e38-e49 ◽

Cited By ~ 1

Author(s):

Beverley Karras ◽

Saumya Selvaraj ◽

Athena McConnell ◽

Deirdre Andres ◽

Krista Trinder ◽

...

Keyword(s):

Medical Care ◽

Student Perceptions ◽

Clinical Teaching ◽

Clinical Skills ◽

Multidisciplinary Care ◽

Medical Specialty ◽

Pediatric Care ◽

Clinical Exposure ◽

Positive Attitudes ◽

Before And After

Background: Pediatric clinical skills teaching sessions provide an early opportunity for students to be exposed to the medical care of children. This report describes second and third year medical students’ perceptions of and attitudes towards working with children before and after the pediatric clinical skills teaching sessions, and the experiences of those students precepted by pediatricians only compared to those students working with a combination of pediatricians and family physicians.Method: A 13 question survey was voluntarily completed before and after teaching sessions. Written reflective assignments were qualitatively analyzed for key themes. Response rate averaged 68% with class sizes of 84 and 85 students.Results: Students’ perceptions of the care of children were generally very positive. Some differences were found based on gender, phase of study and prior clinical exposure to pediatric care. Pre and post responses were similar, regardless of preceptor specialty. Students with family physician preceptors identified the themes of prevention, health promotion and multidisciplinary care in their reflections. Conclusions: Students had already formed positive attitudes toward the medical care of children and intended to care for children in their future practice. Further research is needed into the effects of pre-clerkship experiences in the care of children on choice of medical specialty.

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