Effectiveness of applying clinical simulation scenarios and integrating information technology in medical-surgical nursing and critical nursing courses

Background To determine the impact of combining clinical simulation scenario training and Information Technology Integrated Instruction (ITII) on the teaching of nursing skills. Methods 120 4th-year students in a nursing program who were enrolled in medical and surgical nursing courses. 61 received innovative instruction (experimental group) and 59 received conventional instruction (control group). The ADDIE model, systematic method of course development that includes analysis, design, development, implementation, and evaluation,was used to build simulation teaching and clinical scenarios and to create and modify objective structure clinical examination (OSCE) scenario checklists for acute myocardial infarction (AMI) care, basic life support and operation of automated external defibrillator (BLS), and subdural hemorrhage (SDH) care. The modified OSCE checklists were assessed for reliability, consistency, and validity. The innovative training included flipped classrooms, clinical simulation scenarios, ITII and blended learning formats. Results The reliability and validity of the OSCE checklists developed in this study were acceptable and comparable or higher than checklists in past studies and could be utilized as an OSCE performance tool. Students in innovative instruction obtained significantly better OSCE performance, lab scores and improvements from the previous year’s grades. Significant differences were found in situational awareness (SA). No strong correlations were found between OSCE scores and clinical internship scores, and no significant differences were found between the groups in overall clinical internship performance. Conclusions Innovative instruction showed better performance than conventional methods in summative evaluation of knowledge components, OSCE formative evaluation and clinical nursing internship scores, as well as improved situational awareness in nursing students.

Development of the methods for the class teacher effectiveness assessment

The problem of developing a methodology for assessing the effectiveness of the class teacher’s educational activity and the possibility of its implementation in the context of an educational establishment has been getting more vital. The developed methodology for assessing the class teacher performance efficiency was tested on the basis of four educational establishments in Nizhny Novgorod, which are the clinical internship bases to train future teachers and class teachers at Minin University (Nizhny Novgorod), who were experts carrying out the examination of the methodology for assessing the performance efficiency according to the proposed indicators. The developed methodology for assessing the class teacher performance efficiency can be used in the practice of educational organizations to develop a system for assessing the encouragement of the class teacher performance, supervising his professional growth, developing individual trajectories of professional improvement, analytical conclusions, and expertise.

Evaluation of a digitally enhanced cardiac auscultation learning method: a controlled study

Background Cardiac auscultation remains an efficient and accessible diagnostic tool, especially in resource-limited countries where modern diagnostic devices like cardiac ultrasound are expensive and difficult to access. However, cardiac auscultation skills of medical students and physicians are declining, mainly because of an ineffective teaching method for this technique. The objective of this study is to evaluate the effect of a digitally enhanced cardiac auscultation learning method on participants’ theoretical knowledge and auscultation skills. Methods This will be a controlled study with two parallel arms (1:1). Participants (fourth-year medical students) will be divided into two groups: an intervention group (receiving additional lectures, clinical internship and audio listening sessions) and a control group (receiving additional lectures and clinical internship). At the beginning of the study, all participants will undergo a pre-test that consist of two parts: a knowledge assessment based on multiple-choice questions and a skills assessment based on recognition of cardiac sounds from audio files. Thereafter, three specific additional lectures on cardiac auscultation will be delivered and all participants will take part in their official clinical internship. During these clinical internships (eight weeks), participants of the intervention group will be invited to two listening sessions based on five digital recordings of heart sounds. At the end of the clinical internship, all participants will be invited to a post-test to evaluate their knowledge, skills and satisfaction according to their learning method. The main outcome will be the participants’ knowledge progression. The other outcomes will be the participants’ skills progression, participants’ total progression and satisfaction. Data will be collected and analyzed in per protocol. Discussion This study could contribute to the development of a learning method that takes into account the advantages of the conventional method and the contribution of digital technology. Positive results could lead to improved cardiac auscultation skills among health professionals, especially in developing countries. Trial registration The trial is registered on the Pan-African Clinical Trials Registry (http://www.pactr.org) under unique identification number: PACTR202001504666847, registered the 29 November 2019.

Comparison of OSCE Performance Between 6- and 7-Year Medical School Curricula in Taiwan

BackgroundThe year 2013 marks a watershed in the history of medical education in Taiwan. Following Taiwan's Taskforce of Medical School Curriculum Reform recommendations, the medical school curriculum was reduced from 7 to 6 years. This study aimed to analyze the impact of medical school curriculum reform on medical students' performance in objective structured clinical examinations (OSCEs). MethodsWe retrospectively analyzed the OSCE records at Taipei Veterans General Hospital (Taipei VGH), one of Taiwan's largest tertiary medical centers, between November 2016 and July 2020. The eligibility criteria were medical students receiving a full one-year clinical internship training at Taipei VGH and in their last year of medical school. All medical students received a mock OSCE-1 at the beginning of their internship, a mock OSCE-2 after six months of training, and a national OSCE at the end of their internship. The parameters for performance in OSCEs included “percentage of scores above the qualification standard” and “percentage of qualified stations.” ResultsBetween November 2016 and July 2020, 361 undergraduates underwent clinical internship training at Taipei VGH. Among them, 218 were taught under the 7-year curriculum, and 143 were instructed under the 6-year curriculum. Based on baseline-adjusted ANCOVA results, medical students under the 7-year curriculum had a higher percentage of scores above the qualification standard than those under the 6-year curriculum at the mock OSCE-1 (7-year curriculum vs. 6-year curriculum: 33.8% [95% CI 32.0–35.7] vs. 28.2% [95% CI 25.9–30.4], p<0.001), and mock OSCE-2 (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 87.4–91.4] vs. 84.0% [95% CI 81.5–86.4], p=0.001). Moreover, medical students in the 7-year curriculum had a higher percentage of qualified stations in mock OSCE-1 (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 87.4–91.4] vs. 84.0% [95% CI 81.5–86.4], p=0.001) and mock OSCE-2 (7-year curriculum vs. 6-year curriculum: 91.9% [95% CI 90.1–93.8] vs. 86.1% [95% CI 83.8–88.3], p=0.001). After clinical internship training, there were no differences in the percentage of scores above the qualification standard (7-year curriculum vs. 6-year curriculum: 33.5% [95% CI 32.2–34.9] vs. 34.6 [95% CI 32.9–36.3], p=0.328) and percentage of qualified stations (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 88.1–90.7] vs. 90.2% [95% CI 88.6–91.8], p=0.492). ConclusionsAt the beginning of the internship, medical students under the 7-year curriculum had better OSCE performance than those under the 6-year curriculum. After the clinical internship training in Taipei VGH, there was no difference in the national OSCE score between the 6- and 7-year curricula. Our study suggests that clinical internship is crucial for the development of clinical skills and performance in the national OSCE.

Reflections from Ege University Medical School’s clinical internship mentoring program (2011–2018)

Objectives Ege University Medical School initiated system based integrated clinical internship in 2011. The need for a mentor who would closely monitor and guide the student in knowledge and skill gains for every clinical internship block and who would be an academic role model was well established. The aim of this study reports the results of the clinical internship mentoring program in the Ege University Medical School. Methods The Clinical Internship Counseling Committee reviewed similar programs in the literature, conducted focus group discussions, determined the wishes and needs of the students, and developed a mentoring program. Results The program was initiated by announcing the student-mentor matches and the procedure which was based on meetings of the student-mentor at the 1st, 8th and 13th weeks of the integrated internship. This meeting was designed to be a time for the mentor to guide the student to achieve the internship goals, to establish his/her internship progress file and to be an academic role model. At the final evaluation of the mentor, communication between student and the progress in the establishment of the internship progress file contributed to the 5% of the final internship success grade. Conclusions Evaluation of 7 years of experience led to the agreement that the goals of clinical internship program should be integrated into the newly established “Student Mentorship Program” that starts at the 1st year of the medical school.