scholarly journals Creating Significant Learning Experiences for Clinical Reasoning by Physical Therapist Students

2019 ◽  
Author(s):  
Lois Stickley
Keyword(s):  
Decision Making ◽  
Clinical Reasoning ◽  
Curriculum Design ◽  
Clinical Decision Making ◽  
Physical Therapist ◽  
Learning Experiences ◽  
First Year ◽  
Clinical Decisions ◽  
First Year Students ◽  
Significant Difference

Background: Clinical reasoning skills are embedded in all aspects of practice. There is a lack of consensus and standards for curriculum design and teaching methods of clinical reasoning in entry-level education of health professionals. Purpose: The purpose was to describe a process of designing one comprehensive, planned sequence of four courses to create significant learning experiences for clinical reasoning for Doctor of Physical Therapy students. Method: Fink’s design process was used to develop four clinical decision-making courses to ensure a close alignment of learning goals, feedback and assessment, and learning activities to engage students in practicing components of clinical reasoning. Student outcomes were measured by self-efficacy ratings for clinical reasoning in a practical exam for first-year students and by ratings of performance by clinical instructors for third-year students. Results: 41 first-year students ranked their confidence in making clinical decisions both before and after a midterm practical. A paired t-test found a significant difference (.05t40 = -6.66, ρ=0.00) in the mean ratings of students from the pre-practical assessment to the post-practical assessment about confidence in making clinical decisions. Third-year students received ratings that met or exceeded expectations on five audited skills from the Physical Therapist manual for the Assessment of Clinical Skills (PT MACS), both at midterm and at the final assessment. No significant differences between midterm and final ratings on any of the selected skills were found using a Chi-Square Test of Independence (α=.05). Conclusion: The four-course sequence was designed using four themes: patient-centered care, models of practice, and evidence-based practice, and ethics/legal issues. This paper offers specific details about how one method of teaching clinical reasoning meets the current trends in education and health care for accountability and meaningful outcomes. Students gained practical knowledge and skills in the components of clinical reasoning and decision-making by participating in active and engaging significant learning experiences.

scholarly journals Impact of quaternary prevention as a brief intervention in medical students’ clinical decisions: experience from Vietnam

2015 ◽  
Vol 10 (35) ◽  
pp. 1-8 ◽  
Author(s):  
Thi Hoa Vi Tran ◽  
Thanh Liem Vo
Keyword(s):  
Decision Making ◽  
Medical Students ◽  
Brief Intervention ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Second Phase ◽  
Clinical Decisions ◽  
Clinical Scenarios ◽  
Significant Difference ◽  
Quaternary Prevention

Objective: to evaluate undergraduate medical students’ clinical decision-making process after a brief intervention lecture on quaternary prevention (P4). Methods: quantitative self-controlled intervention study carried out with fifth-year medical students of Pham Ngoc Thach University, Hochiminhcity, Vietnam. The medical students were asked to list their eventual interventions based on three different simulated clinical scenarios. The survey was conducted before and after the intervention. Student’s propositions were classified into one of the four groups of prevention, according to Jamoulle’s model. Results: 115 students participated, resulting in 211 answered sheets. The interventions proposed by the students were mostly centered on prevention groups 1, 2 and 3; the three clinical scenarios partially explained student’s intentions of counseling, screening and palliative care. Comparing the data of second phase survey, the intervention was associated with changes in students’ aptitude on clinical decision-making, which was especially more important for prevention group 1 (OR = 7.5) and prevention group 4 (OR = 30.05). There was no statistically significant difference in changing students’ decision for prevention group 2 (OR = 0.95 p = 0.466) and prevention group 3 (OR = 2.29 p = 0.932). Conclusion: introducing quaternary prevention to the undergraduate medical course can help to steer clinical decisions toward primary prevention and to avoid inappropriate medical interventions.

scholarly journals Predicting mortality in adults with suspected infection in a Rwandan hospital: an evaluation of the adapted MEWS, qSOFA and UVA scores

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040361
Author(s):  
Amanda Klinger ◽  
Ariel Mueller ◽  
Tori Sutherland ◽  
Christophe Mpirimbanyi ◽  
Elie Nziyomaze ◽  
...  
Keyword(s):  
Decision Making ◽  
Quality Improvement ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Tertiary Hospital ◽  
Early Warning Score ◽  
Receiver Operating Curve ◽  
Predictive Capacity ◽  
Suspected Infection ◽  
Significant Difference

RationaleMortality prediction scores are increasingly being evaluated in low and middle income countries (LMICs) for research comparisons, quality improvement and clinical decision-making. The modified early warning score (MEWS), quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA), and Universal Vital Assessment (UVA) score use variables that are feasible to obtain, and have demonstrated potential to predict mortality in LMIC cohorts.ObjectiveTo determine the predictive capacity of adapted MEWS, qSOFA and UVA in a Rwandan hospital.Design, setting, participants and outcome measuresWe prospectively collected data on all adult patients admitted to a tertiary hospital in Rwanda with suspected infection over 7 months. We calculated an adapted MEWS, qSOFA and UVA score for each participant. The predictive capacity of each score was assessed including sensitivity, specificity, positive and negative predictive value, OR, area under the receiver operating curve (AUROC) and performance by underlying risk quartile.ResultsWe screened 19 178 patient days, and enrolled 647 unique patients. Median age was 35 years, and in-hospital mortality was 18.1%. The proportion of data missing for each variable ranged from 0% to 11.7%. The sensitivities and specificities of the scores were: adapted MEWS >4, 50.4% and 74.9%, respectively; qSOFA >2, 24.8% and 90.4%, respectively; and UVA >4, 28.2% and 91.1%, respectively. The scores as continuous variables demonstrated the following AUROCs: adapted MEWS 0.69 (95% CI 0.64 to 0.74), qSOFA 0.65 (95% CI 0.60 to 0.70), and UVA 0.71 (95% CI 0.66 to 0.76); there was no statistically significant difference between the discriminative capacities of the scores.ConclusionThree scores demonstrated a modest ability to predict mortality in a prospective study of inpatients with suspected infection at a Rwandan tertiary hospital. Careful consideration must be given to their adequacy before using them in research comparisons, quality improvement or clinical decision-making.

The influence of narrated group discussions on the interpretational ability of medical students: a prospective observational study

2021 ◽  
Vol 6 (8) ◽  
Keyword(s):  
Decision Making ◽  
Medical Students ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
First Year ◽  
Group Discussions ◽  
Prior Literature ◽  
Long Course ◽  
Long Term Impact ◽  
First Year Medical Students

Background: Clinical decision making is predominantly knowledge-based perception, interpretation under terms of uncertainty. It is unclear whether interpretational ability can be improved. We evaluated the effect of a narrated group-discussions course (NGDC) on the interpretational ability of first-year medical students. Objective: To evaluate the effect of our course on first year medical students in respect to: a) their interpretational abilities b) their attitude towards studying literature and the core subjects. Method: Using a pre-post questionnaire, of a semester-long course, among two consecutive classes, the authors evaluated the participant’s interpretational ability and depth of understanding when analyzing four complex passages. Results: Out of 235 students, 146 (62%) responded to both questionnaires. There was a significant increase in the participant’s interpretational ability (P=0.003). ninety one participants (38%) improved their level of understanding in at least one out of the four passages, and 37 participants (25%) improved in two passages. A multivariate analysis revealed that the improvement in the interpretational ability was associated with younger age (P=0.034, CI 95%=0.64-0.98, OR=0.79), positive pre-course attitude and motivation (P<0.001, CI 95%=1.43-3.05, OR=2.09), and lack of a prior literature background (P=0.064, CI 95%=0.17-1.05, OR=0.43). Conclusion: Our data suggests that NGDC may improve and refine interpretational ability. Further studies are required to establish the short- and long-term impact of this change and whether it can be translated into better clinical decision making.

Standardized Synoptic Cancer Pathology Reports — So What and Who Cares?: A Population-Based Satisfaction Survey of 970 Pathologists, Surgeons, and Oncologists

2013 ◽  
Vol 137 (11) ◽  
pp. 1599-1602 ◽  
Author(s):  
Sara Lankshear ◽  
John Srigley ◽  
Thomas McGowan ◽  
Marta Yurcan ◽  
Carol Sawka
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Physician Satisfaction ◽  
Cross Sectional ◽  
Cancer Pathology ◽  
Report Turnaround Time ◽  
Significant Difference ◽  
Pathology Reporting ◽  
The Impact

Context.—Cancer Care Ontario implemented synoptic pathology reporting across Ontario, impacting the practice of pathologists, surgeons, and medical and radiation oncologists. The benefits of standardized synoptic pathology reporting include enhanced completeness and improved consistency in comparison with narrative reports, with reported challenges including increased workload and report turnaround time. Objective.—To determine the impact of synoptic pathology reporting on physician satisfaction specific to practice and process. Design.—A descriptive, cross-sectional design was utilized involving 970 clinicians across 27 hospitals. An 11-item survey was developed to obtain information regarding timeliness, completeness, clarity, and usability. Open-ended questions were also employed to obtain qualitative comments. Results.—A 51% response rate was obtained, with descriptive statistics reporting that physicians perceive synoptic reports as significantly better than narrative reports. Correlation analysis revealed a moderately strong, positive relationship between respondents' perceptions of overall satisfaction with the level of information provided and perceptions of completeness for clinical decision making (r = 0.750, P &lt; .001) and ease of finding information for clinical decision making (r = 0.663, P &lt; .001). Dependent t tests showed a statistically significant difference in the satisfaction scores of pathologists and oncologists (t169 = 3.044, P = .003). Qualitative comments revealed technology-related issues as the most frequently cited factor impacting timeliness of report completion. Conclusion.—This study provides evidence of strong physician satisfaction with synoptic cancer pathology reporting as a clinical decision support tool in the diagnosis, prognosis, and treatment of cancer patients.

scholarly journals Algorithm for Assessment of Students’ Individual Choice of Sports Sections

2016 ◽  
pp. 21-26
Author(s):  
Ж. О. Цимбалюк ◽  
Л. В. Коник ◽  
В. А. Тихонова
Keyword(s):  
Decision Making ◽  
Factor Analysis ◽  
Hierarchical Model ◽  
University Research ◽  
First Year ◽  
Sports Facilities ◽  
Individual Choice ◽  
First Year Students ◽  
Language And Literature ◽  
Hierarchy Analysis

Research objective. To develop a model of students’ decision-making when individually choosing a sports section. Research methods: The study relies on the analysis of scientific and methodological literature, questionnaires, and factor analysis. The participants in the study were 55 first-year students (2015 enrollment year) of the School of Ukrainian Language and Literature of H.S. Skovoroda Kharkiv National Pedagogical University. Research results. The analysis of the questionnaires showed diverse motivational choices. The factor analysis revealed the prevailing motifs. The study comes up with a hierarchical model of students’ choice of a training section by a particular sport, and determines the system of subjective values of each student in points. Conclusions. The model developed by the hierarchy analysis allows to take into account all the variants of priorities in the students’ motivational choice. The method of hierarchy analysis allows to objectively process the subjective advantages seen by the students (who do not have any sports experience) when choosing a training section in the opted-for sport. This, in its turn, cultivates a steady motivation for physical education, allows to determine the required number of sports sections, and to distribute the educational and sports facilities at the higher educational university.

scholarly journals Study On The Use Of Oral Drills And Role-Play Method In Improving Students’ Interactive Speaking Achievement

2017 ◽  
Vol 2 (1) ◽  
pp. 24-45
Author(s):  
Kelvri L. Sinambela ◽  
Debora Chaterin Simanjuntak
Keyword(s):  
Experimental Method ◽  
Quantitative Research ◽  
Role Play ◽  
P Value ◽  
First Year ◽  
First Year Students ◽  
Significant Difference ◽  
Post Test ◽  
Experimental Group

This study examines whether the use of Oral Drills and Role-Play method could improve students’ interactive speaking achievement. This study used quantitative research using pre-experimental method with one group pre and posttest design. The study was conducted in SMP Advent II, Setia Budi, Bandung. The participants of this study were 30 students from the first year students at SMP Advent II Setia budi, Bandung as the sample and they were grade VII at SMP Advent II Setia Budi, Bandung. This study used one experimental group as the sample. A pre-test and post-test were done. The experimental group was given treatment (Oral Drill and Role-Play Method). The data gathered was then statistically calculated and analysed. According to the interpretation, if p Value (Sig.) ≤ 􀟙 (0.05) then HA is accepted and H0 is rejected and If p Value (Sig.) ≥ 􀟙 (0.05) then H0 is accepted and HA is rejected. After calculating the data it was known that the p-value = 0.000 lesser than alpha 0.05. Result of the study showed that there is a significant difference in improving students’ interactive speaking achievement after using oral drills and role-play method.   Keywords: Interactive Speaking, Oral Drills, Role-Play Method

scholarly journals Autonomous English Language Learning Beyond the Classroom: Indonesian Tertiary Students’ Practices and Constraints

2020 ◽  
Vol 19 (10) ◽  
pp. 194-213
Author(s):  
Daflizar Daflizar
Keyword(s):  
Language Learning ◽  
English Language ◽  
Autonomous Learning ◽  
Learning Activities ◽  
First Year ◽  
English Language Learning ◽  
First Year Students ◽  
Significant Difference ◽  
English Major ◽  
Attention To Students

. In response to the interest in learner autonomy in recent years, educational research has been increasingly paying attention to students’ out-of-class autonomous learning activities. This study aims to (1) describe the extent to which Indonesian tertiary students engaged in autonomous English language learning outside the class, (2) explore their perceived constraints in practicing autonomous learning, and (3) examine whether there are any significant differences in the autonomous learning activities between female and male students and between the English major students and non-English major students. Employing the explanatory mixed-method design, a total of 402 first-year students completed a questionnaire, and 30 of whom were interviewed. The questionnaire data were analyzed using descriptive statistics and non-parametric tests, and the interview data were analyzed using thematic analysis. The results showed that the students did engage in several out-of-class English learning activities, however many of the activities were more receptive than productive. The interviews echoed the questionnaire results, and the students claimed that they were not autonomous in their learning due to several constraints. The results also revealed that there is no significant difference in the level of practice of autonomous out-of-class activities based on gender but a significant difference was found concerning majors of study. Practical implications for the Indonesian context are put forward.

scholarly journals THE EFFECT OF BLINDFOLD GAME ON STUDENTS’ VOCABULARY ACHIEVEMENT AT SMP NEGERI 13 KENDARI

2020 ◽  
Vol 5 (3) ◽  
pp. 200
Author(s):  
Andi An-Nisaa Arfin ◽  
Kamaluddin Kamaluddin ◽  
Wa Ode Fatmawati
Keyword(s):  
Junior High School ◽  
Alternative Hypothesis ◽  
First Grade ◽  
First Year ◽  
First Year Students ◽  
Comparison Research ◽  
Significant Difference ◽  
Post Test ◽  
The Difference ◽  
Vocabulary Achievement

The purpose of conducting this research is to examine the difference NGain scores between students who learn vocabulary with Blindfold Game and students who learn vocabulary without Blindfold Game at the first year students of SMP Negeri 13 Kendari. The samples of this research are the first grade four (VII-4) and the first grade three (VII-3) which consists of 27 students for each class. This research is conducted in comparison research design that consists of experimental class (VII-4) and controll class (VII-3). The data of this research are collected by giving pre-test and post-test in two classes (VII-4 & VII-3). The result shows that there is an improvement of the students’ vocabulary achievement. Independent samples t-test shows that, there is a significant difference in the Ngain scores for experimental class ( M = 60.08,  SD = 9.36 ) and controll class ( M = 20.41, SD = 14.56 ), t (52) = 11.904, p (0.000) < 0.05. Therefore, it can be concluded that the value of Sig (2 tailed) is lower than the significance α value (0.000 < 0.05). In other words, alternative hypothesis (H1) is accepted and the null hypothesis (H0) is rejected. It means that the Blindfold game can enrich students’ vocabulary achievement for Junior High School Student.

scholarly journals The Influence of Teaching Vocabulary by Using Picture

2016 ◽  
Vol 1 (2) ◽  
pp. 159
Author(s):  
Hanik Nuzulimah
Keyword(s):  
Control Group ◽  
First Year ◽  
First Year Students ◽  
Significant Difference ◽  
Post Test ◽  
The Subject ◽  
And Control ◽  
Data Analysis Result ◽  
Experimental Group ◽  
Better Than

This paper attempts to explore whether there is significant difference of achievement in vocabulary between students taught by using pictures and those are not. The subject of this study is the first year students of SLTP Muhammadiyah Simo Susukan, Semarang where the sample contains 50 students that is divided into experimental group (with treatment) and control group (without treatment). The data is gathered from participants’ score obtained from pre test and post test. Using t test as technique of data analysis, result shows that students taught by using pictures perform better than those are not. It means that there is significant difference between the two groups. Keywords: Vocabulary Teaching; Picture

scholarly journals Assessment of knowledge, attitude and skills towards e-learning in first year medical students

2019 ◽  
Vol 7 (11) ◽  
pp. 4119 ◽  
Author(s):  
Monali Hiwarkar ◽  
Onjal Taywade
Keyword(s):  
Medical Students ◽  
Medical Training ◽  
Positive Impact ◽  
First Year ◽  
First Year Students ◽  
Learning Modalities ◽  
Conventional Teaching ◽  
Significant Difference ◽  
Education In India ◽  
E Learning

Background: With digitization the e-learning modalities are being increasingly used by medical students. These often help the first MBBS students to overcome limitations of conventional teaching methods like didactic lectures. However, e-learning is not official part of medical education in India and the awareness about its use among medical students need to be evaluated. Aim and objective of the study was to assess the extent to which MBBS first year students use e-resources for learning as well as to assess knowledge, attitude, skills and habits of first MBBS students towards e-learning.Methods: A questionnaire of twenty five questions on various aspects of e-learning was administered to the first MBBS students at two medical colleges. The data generated from responses was compiled and analyzed on SPSS to get insight on various aspects of e-learning.Results: Out of 236 students surveyed 77.97% were aware about the academic websites related to first MBBS subjects. 90.68 % accepted that e-learning helped in understanding topics, 84.32% recommended conventional teaching to be supplemented with e-learning. However there was no statistically significant difference between responses from two groups i.e. female and male students (p>0.05).Conclusions: The majority of first MBBS students use e-resources for learning various topics in anatomy, physiology and biochemistry. The e-resources have made a positive impact on overall learning especially anatomy. e-learning can supplement conventional teaching in the first year of medical training.

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