Teaching Clinical Skills During Pandemic Times

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.

Continuous Workplace-based Assessment as an Indication of Clinical Competence in Paediatric Dentistry

An authentic workplace setting provides the ideal opportunity for assessmentof students’ clinical competence at the ‘does’ level of performance.Final-year dental students in the Department of Paediatric Dentistry at theUniversity of the Western Cape are evaluated in the clinical environmenton a daily basis through multiple clinical evaluations which assess clinicaland diagnostic skills over a year. An additional end-of-module clinicalassessment in the form of a single-blinded patient case (BPC) determines ifstudents have reached the expected level of clinical competence in terms ofpatient evaluation and diagnosis. However, the reliability and feasibility ofthis single end-of-module clinical case have been questioned in this setting.This study aimed to determine if the current continuous workplace-basedassessment (WPBA) results could be used as an indication of final-yearstudents’ clinical competence at the end of the module. A retrospective,quantitative, cross-sectional study was conducted of all complete assessmentrecords. The correlation between the continuous WPBA components wasanalysed together with an evaluation of the reliability and validity of theassessment results. The continuous formative WPBA practices were foundto be both valid and reliable when using Kane’s (2013) and Royal’s (2017)frameworks for analysis. However, the BPC should be reconsidered due tofeasibility and reliability concerns. Key words: Dental education, Paediatric Dentistry, clinical skills, workplace,summative, formative, continuous assessment

A Short Note on Objective Structured Clinical Examination (OSCE)

Objective Structured Clinical Examination (OSCE) is a structured competency based examination popularly used in examining the Medical and Nursing students. The clinical competence is evaluated by a team of examiners through uniformly timed, multiple stations. OSCE as an evaluation tool is gaining importance and it is becoming very popularly used by examiners all over the world as it is standardised and multiple observations and skills can be assessed equally for all the students in a single preparation. OSCE with its advantages like objectivity, tailored stations, safety of the patients and provision of audit and recording of the entire process has made it the most needed assessment of the skill component in most of the professional programmes concerning medical and nursing students.

Meta-Analysis of Flipped Learning Effects in Nursing Education

Background: This study is a meta-analysis confirming the effect size of clinical competence, critical thinking ability, self-directedness, and learning satisfaction, the outcome variables of flipped learning applied to nursing education. Methods: We selected 18 related studies that analyzed data using CMA (Comprehensive Meta-Analysis 2.2). Results: The effect size of the entire study was Hedges’ g = 0.68 (95% CI = 0.43~0.92). The heterogeneity of the overall effect size was I2 = 90.7% (Q = 246.67, p < 0.001); critical thinking ability had an effect size of Hedges’ g = 0.87, learning satisfaction of Hedges’ g = 0.79, clinical competence of Hedges’ g = 0.53, and self-directedness of Hedges’ g = 0.37. The differences were statistically significant. Conclusion: Flipped learning can effectively improve nursing students’ clinical competence, critical thinking ability, self-direction, and learning satisfaction.

Nurses' efforts to maintain competence: a qualitative study

Background: The clinical competence of nurses should be maintained to ensure patient safety. Competence is the integration of knowledge, skills, and attitudes. Nurse competency also improves the quality of nursing care and reduces the incidence of missed nursing care. This study aimed to explore the experiences of nurses maintaining a nurse competence system in hospitals through continuing education.Design and Methods: The research method used was qualitative phenomenological research, and the data was collected through an in-depth interview which was consist of six participants.Results: The results of the research were 1). continuing professional development to maintain the competence, 2) credentialing system in the career ladder system, 3). missed care still occurred in the implementation of nursing services 4). Nurses had hopes that managers supported the efforts to maintain competence through continuing professional development.Conclusion: Nurse managers are expected to improve the supervision program to maintain clinical competence and decrease missed care.

Retention of knowledge and clinical competence among Ugandan mid-level health providers 1 year after intensive clinical mentorship in TB and HIV management

Introduction Clinical mentorship is effective in improving knowledge and competence of health providers and may be a useful task sharing approach for improving antiretroviral therapy. However, the endurance of the effect of clinical mentorship is uncertain. Methods The midlevel health providers who participated in a cluster-randomized trial of one-on-one, on-site, clinical mentorship in tuberculosis and HIV for 8 h a week, every 6 weeks over 9 months were followed to determine if the gains in knowledge and competence that occurred after the intervention were sustained 6- and 12-months post-intervention. In December 2014 and June 2015, their knowledge and clinical competence were respectively assessed using vignettes and a clinical observation tool of patient care. Multilevel mixed effects regression analysis was used to compare the differences in mean scores for knowledge and clinical competence between times 0, 1, 2, and 3 by arm. Results At the end of the intervention phase of the trial, the mean gain in knowledge scores and clinical competence scores in the intervention arm was 13.4% (95% confidence interval ([CI]: 7.2, 19.6), and 27.8% (95% CI: 21.1, 34.5) respectively, with no changes seen in the control arm. Following the end of the intervention; knowledge mean scores in the intervention arm did not significantly decrease at 6 months (0.6% [95% CI − 1.4, 2.6]) or 12 months (− 2.8% [95% CI: − 5.9, 0.3]) while scores in the control arm significantly increased at 6 months (6.6% [95% CI: 4.4, 8.9]) and 12 months (7.9% [95% CI: 5.4, 10.5]). Also, no significant decrease in clinical competence mean scores for intervention arm was seen at 6 month (2.8% [95% CI: − 1.8, 7.5] and 12 months (3.7% [95% CI: − 2.4, 9.8]) while in the control arm, a significant increase was seen at 6 months (5.8% [95% CI: 1.2, 10.3] and 12 months (11.5% [95% CI: 7.6, 15.5]). Conclusions Mentees sustained the competence and knowledge gained after the intervention for a period of one year. Although, there was an increase in knowledge in the control group over the follow-up period, MLP in the intervention arm experienced earlier and sustained gains. One-on-one clinical mentorship should be scaled-up as a task-sharing approach to improve clinical care. Trial Registration The study received ethics approvals from 3 institutions—the US Centers for Disease Control and Prevention Institutional Review Board (USA), the Institutional Review Board “JCRC’s HIV/AIDS Research Committee” IRB#1-IRB00001515 with Federal Wide Assurance number (FWA00009772) based in Kampala and the Uganda National Council of Science and Technology (Uganda) which approves all scientific protocols to be implemented in Uganda.