Self-Efficacy and Readiness Towards Early Clinical Exposure Among Nursing Students

Background: Early Clinical Exposure is a learning approach that integrates classroom learning with the clinical practice at the students' academic stage. Based on an interview with 3rd-semester Nursing Students, the results showed that they had low self-efficacy and readiness towards early clinical exposure. Objective: This study aims to evaluate self-efficacy and readiness towards early clinical exposure among nursing students of Universitas Muhammadiyah Purwokerto (UMP). The study design was a cross-sectional study involving 218 undergraduate students at a private Islamic university in their third semester. Methods: Data were collected using an online questionnaire of Google Form developed by the researcher, and the questions were valid and reliable based on a reliability test. The sampling method in this study was the total sampling technique. There were 50 questions of the item in the questionnaire and 6 items for demographic data. Result: The majority of pupils showed strong self-efficacy (98.2%) according to the findings of this study and moderate self-efficacy (1.8%). The majority of students presented high readiness (97.7%) and moderate readiness (2.3%). According to the correlation test results, a correlation (r = 0.545, p0.05) was found between self-efficacy and readiness for early clinical exposure. Conclusion: The higher the student's self-efficacy is, the more the readiness will be to face the practice of early clinical exposure.

Early Clinical Exposure in Preclinical Years of Medical School

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.

A Task Based Learning (TskBL) strategy in preclinical medical education

Preclinical Task based learning (TskBL) is a simulated learning approach in which focus for students is a real task done by a medical professional. TskBL includes standardized patient encounters and is helpful to provide Early Clinical Exposure. Our study aimed at planning, implementing and assessing TskBL among first year Medical students and comparing it to conventional method of tutorials in Physiology MBBS curriculum.This is a non-equivalent group quasi experimental study approved by Institutional ethics committee. TskBL was conducted for five topics among first year medical students of Kasturba Medical College, Mangalore for three academic years. Participants  were divided into a TskBL group and a control group. Both groups attended the theory classes in Physiology, practical sessions and clinical examinations concerning the tasks. Following this, TskBL group underwent TskBL and control group underwent tutorials. Pre and post-test assessments were conducted using the MCQ test and Objective structured clinical examinations (OSCE).The mean TskBL scores for MCQ (exception:Hypertension) and OSCE (exception Anemia) were significantly higher than the tutorial group. Pre test and post test scores revealed significantly higher MCQ and OSCE scores for TskBL. Tutorial group did not show a significant improvement in test scores for all the tasks.TskBL strategy could be used for many other topics are likely to be encountered by the students during clinical attachments. Small group teaching can include TskBL over tutorials to provide early clinical exposure in medical schools.

Introducing reflective narrative for first-year medical students to promote empathy as an integral part of physiology curriculum

Guided reflective narratives facilitate deeper understanding and learning. The study was aimed at exploring the scope of guided reflective narratives on early clinical exposure, for first-year medical students, in promoting empathy. Strengths and limitations of the process of reflective narratives were also explored. First-year medical students ( n = 150) were exposed to guided reflective narrative writing following each of the three “early clinical exposure” sessions integrated into a physiology curriculum. A feedback on the entire program was obtained through a semistructured questionnaire. The contents of the reflective narratives and feedback on the program were analyzed. Students empathized with the situation and needs of patients and caregivers and could relate to responsibilities and challenges faced by members of health care team. They realized the importance of cooperation from patients and caregivers and work efficiency, communication, behavior, and teamwork from members of healthcare and thereby emerged with the idea of the coordinated effort in patient care. Students opined that reflective narratives made them reflect and empathize with people and situations. Too many narrative writing sessions and hesitation to share their thoughts were some of the suggested limitations. The process led to emergence of a working model for guided reflections to promote empathy. Guided reflective narratives made students reflect and relate to people and situations. While promoting empathy, the reflections also gave them an idea of holistic approach to patient-centered care. Inferences led to a conceptual model for guided reflections to promote empathy among medical students.

THE INFLUENCE OF EARLY CLINICAL EXPOSURE MODULE IN UNDERGRADUATE MEDICAL EDUCATION

Introduction: In traditional medical curriculum basic science subjects were taught in isolation from clinical subjects. Students would thereby find it difficult to retain concepts in basic sciences, recall and co-relate it when clinical setting was encountered. Early clinical exposure is early authentic patient contact in clinical or social setting which helps to enhance the understanding of health or illness/disease and the role of medical professional. The objective of this study was to study the influence of early clinical exposure for a module on jaundice on undergraduate students and faculty perception. Materials and Methods: ECE module on jaundice was introduced for study in first MBBS students. Pre-validated questionnaire was used for data collection and student and faculty perception about the module was evaluated. Results: Participating students got better score in post-test (6. 03 + 1.701) as compared with pre-test (5.82+1.701) although the results were not statistically significant. 92% students and faculty positively rated and appraised ECE as a teaching learning tool. Conclusion: ECE module on jaundice generated interest in students and could help students co-relate basic science concepts with cases. This could lead to improvement in academic performance and better patient care. Keywords: Early clinical exposure; student, faculty perception

A program evaluation reporting student perceptions of early clinical exposure to primary care at a new medical college in Qatar

Background Though common practice in Europe, few studies have described the efficacy of early clinical exposure (ECE) in the Middle East. The barriers to clinical learning experienced by these novice medical students have not been reported. This evaluation reports on introducing ECE in primary care, supported by Experiential Review (ER) debriefing sessions. The evaluation explores students’ experiences of their acquisition of clinical and non-technical skills, sociocultural issues commonly encountered but underreported and barriers to clinical learning experienced. Methods We conducted a cross-sectional study of three student cohorts in 2017–19: All second and third-year students at the new College of Medicine were invited to participate. The primary outcome was students’ perceptions of the aims of the Primary Health Centre Placement (PHCP) programme and how it facilitated learning. Secondary outcome measures were students’ perceptions of their learning in ER sessions and perceived barriers to learning during PHCPs. Student perceptions of the PHCPs were measured using a Likert scale-based questionnaire. Results One hundred and fifty-one students participated: 107 in year 2 and 44 in year 3; 72.3% were female. Overall, most students (> 70%) strongly agreed or agreed with the purposes of the PCHPs. Most students (71%) strongly agreed or agreed that the PCHPs allowed them to learn about patient care; 58% to observe doctors as role models and 55% to discuss managing common clinical problems with family physicians. Most students (year 2 = 62.5% and year 3 = 67%) strongly agreed/agreed that they were now confident taking histories and examining patients. Student barriers to clinical learning included: Unclear learning outcomes (48.3%); faculty too busy to teach (41.7%); lacking understanding of clinical medicine (29.1%); shyness (26.5%); and finding talking to patients difficult and embarrassing (25.8%). Over 70% reported that ER enabled them to discuss ethical and professional issues. Conclusions Overall, our Middle Eastern students regard ECE as beneficial to their clinical learning. PHCPs and ER sessions together provide useful educational experiences for novice learners. We recommend further exploration of the barriers to learning to explore whether these novice students’ perceptions are manifesting underlying cultural sensitivities or acculturation to their new environment.