Simulation-based training improves polypectomy skills among practicing endoscopists

Background and study aims Practicing endoscopists have variable polypectomy skills during colonoscopy and limited training opportunities for improvement. Simulation-based training enhances procedural skill, but its impact on polypectomy is unclear. We developed a simulation-based polypectomy intervention to improve polypectomy competency. Methods All faculty endoscopists at our tertiary care center who perform colonoscopy with polypectomy were recruited for a simulation-based intervention assessing sessile and stalked polypectomy. Endoscopists removed five polyps in a simulation environment at pretest followed by a training intervention including a video, practice, and one-on-one feedback. Within 1–4 weeks, endoscopists removed five new simulated polyps at post-test. We used the Direct Observation of Polypectomy Skills (DOPyS) checklist for assessment, evaluating individual polypectomy skills, and global competency (scale: 1–4). Competency was defined as an average global competency score of ≥ 3. Results 83 % (29/35) of eligible endoscopists participated and 95 % (276/290) of planned polypectomies were completed. Only 17 % (5/29) of endoscopists had average global competency scores that were competent at pretest compared with 52 % (15/29) at post-test (P = 0.01). Of all completed polypectomies, the competent polypectomy rate significantly improved from pretest to post-test (55 % vs. 71 %; P < 0.01). This improvement was significant for sessile polypectomy (37 % vs. 65 %; P < 0.01) but not for stalked polypectomy (82 % vs. 80 %; P = 0.70). Conclusions Simulation-based training improved polypectomy skills among practicing endoscopists. Further studies are needed to assess the translation of simulation-based education to clinical practice.

Getting Undergraduates Ready for China’s Belt and Road Initiative (BRI) Through an Overseas Experiential Learning Project

In this paper, we explain how an experiential learning course and study tour to Gansu Province (People’s Republic of China) enabled undergraduates at the Singapore Management University (SMU) to acquire 21st-century competencies and higher-order thinking skills by analyzing and evaluating specific aspects of China’s Belt and Road Initiative (BRI) and China–Singapore (Chongqing) Connectivity Initiative — New International Land–Sea Trade Corridor (CCI-ILSTC) with emphasis on developing viable Go-To-Market (GTM) strategies aimed at selling Gansu produce in four Southeast Asian markets. We share how the course was designed to support the attainment of key learning goals and discuss how we turned pedagogical aspirations into concrete learning outcomes. We introduce key aspects of the so-called “SMU-XO” project that the students conducted in partnership with an industry partner, Pacific International Lines (PIL), and discuss how the project work helped learners to gain global competency by (i) examining critical issues related to BRI such as multi-modal infrastructure connectivity, (ii) appreciating the local perspectives of project stakeholders in Lanzhou and Shanghai and (iii) successfully interacting with people from different cultures, namely China, Indonesia, Vietnam, Malaysia and Thailand.

Assessing Physician’s Motivational Communication Skills: The development of the Motivational Communication Competency Assessment Test (MC-CAT) (Preprint)

BACKGROUND Training physicians to provide effective behaviour change counselling (BCC) using approaches like motivational communication (MC) is an important aspect of non-communicable chronic disease (NCD) prevention and management. However, existing evaluation tools for MC skills are complex, invasive, time consuming, and impractical for use within the medical context. OBJECTIVE The objective of this study was to develop and validate a short, web-based tool evaluating healthcare providers (HCPs) skills in MC, the Motivational Communication Competency Assessment Test (MC-CAT). METHODS Between 2016 and 2021, starting with a set of core 11 MC competencies previously identified and using a 5-step mixed-methods integrated knowledge translation (iKT) approach, the MC-CAT was created by: 1) developing a series of four base cases and a scoring scheme; 2) validating the base cases and scoring scheme with international experts; 3) creating three alternative versions of the four base cases (to create a bank of 16 cases, four of each type of ‘base’ case) and translating the cases into French; 4) integrating the cases into the online MC-CAT platform; and 5) conducting initial internal validity assessments with university health students. RESULTS The MC-CAT assesses MC competency in 20 minutes by presenting HCPs with 4 out of a possible 16 cases (randomly selected and ordered) addressing various behavioural targets (e.g., smoking, physical activity, diet, medication adherence). Individual and global competency scores are calculated automatically for the 11 competency items across the 4 cases providing automatic scores out of 100. From the factorial analysis of variance for the difference in competency and ranking scores, no significant differences were identified between the different case versions across individual and global competency and ranking scores (p’s > 0.05). Initial tests of internal consistency for rank order among 24 student participants were in the ‘acceptable’ range (alpha = 0.78). CONCLUSIONS Results suggest the MC-CAT is an internally valid tool to facilitate the evaluation of MC competencies among HCPs, and is ready to undergo comprehensive psychometric property analyses with a national sample of healthcare providers. Once psychometric property assessments have been completed, this tool is expected to facilitate the assessment of MC skills among HCPs, skills that will better support patients to adopt healthier lifestyles, which will significantly reduce the personal, social, and economic burden of NCDs.

Global Competency Through Collaborative Online International Learning (COIL)

There is a need for college students to develop global perspectives and gain cultural awareness to become responsible global citizens. Innovative ways to create such experiences are known as Collaborative Online International Learning (COIL experiences). COIL is a voluntary partnership between professors in different countries collaborating on jointly-constructed learning experiences to enhance international and intercultural understanding. The purpose of this article is to highlight a successful COIL partnership between students from SUNY Oswego in New York and The Hague University of Applied Sciences in the Netherlands during the COVID-19 pandemic. 35 students participated in the experience that served as a platform to educate students through a health educator’s unique cultural lens. Benefits from the experiences regarding global outcomes showed that both US students (n=70.6%) and Holland students (n=61.1%) felt that they gained the appropriate skills and knowledge to use in their future careers. 70.6% of US and 61.2% of Holland students reported that the COIL experience introduced them to a new outlook and new ways of thinking about how they relate to the world. The current COVID-19 pandemic has created an opportunity to rethink education pathways and integrate global learning in our classrooms.Keywords: Global learning; COIL; Partnerships, Collaboration

127 Standardising Access to Fracture Fixation Simulation for Core Surgical Trainees

Introduction Simulation is increasingly being used to augment clinical experience. However, access to simulation varies geographically and national courses can be costly. The Severn School of Surgery aimed to provide a locally run, cost-neutral “Basic Principles in Fracture Fixation” course to standardise access to simulation for core surgical trainees (CSTs). Method The course ran from a district general hospital, accommodating lectures, case discussions, and practical stations (screw fixation, plate fixation, dynamic hip screw, and external fixation). Faculty donated their time and a devices company provided kit and dry bones. CSTs organised the course. Pre- and post-course self-rated Intercollegiate Surgical Curriculum Programme (ISCP) global competency ratings in the practical stations were recorded and usefulness of aspects of the course was recorded. Results 32 candidates attended. Mean self-rated competency increased by at least one global rating in all practical stations (p &lt; 0.05). All aspects of the course were deemed useful (pre-course reading by 27/28, lectures by 31/32, and case discussions by 31/32). No net cost was incurred. Conclusions Increases in self-rated competency in surgical skills can be obtained through a cost-neutral, trainee-organised, regional skills course. Pre-course reading, lectures, case discussions, and practical sessions are all useful. This model can be used by others to standardise the simulation curriculum.

The development of nurses’ core competencies and the analysis of validity and importance-performance

Purpose: The purpose of this study was to develop nurses’ core competencies and sub-competencies and to verify the validity and importance-performance of core competencies.Methods: The core competencies of nurses were derived through an analysis of strengths, weaknesses, opportunities, and threats, as well as a literature analysis of domestic and foreign accreditation institutions. Validity and importance-performance analyses were conducted on the core competencies derived from nursing colleges nationwide.Results: Six core competencies of nurses were revealed: integration of knowledge and nursing skills, critical thinking, communication, leadership, safety management, and global competency. Further, eighteen sub-competencies were derived. The content validity ratio values for the core competencies were higher than 0.74. Communication skills among multidisciplinary teams and communication skills among nursing teams were shown to be the most important competencies to be improved.Conclusion: The results of this study are meaningful in terms of how the core competencies of nurses were derived and evaluated for the fourth cycle of nursing education accreditation according to the changes of time and culture.