Clinical Instructors' Experiences Working with and Assessing Students Who Perform below Expectations in Physical Therapy Clinical Internships.
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SUBMITTER: So OW
PROVIDER: S-EPMC6855354 | biostudies-literature | 2019
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe environment for medical education in Iraq has been difficult for many years. The 2003 invasion of Iraq accelerated a steady emigration of faculty and graduates. Kidnappings and deaths of doctors became commonplace. To understand current career plans, expectations and perceptions of medical students, three Baghdad medical schools were surveyed.MethodsWritten questionnaires were completed by 418 medical students variously in their 4th, 5th and 6th (final)years of training. We asked about perceptions of the quality of their medical education, the quality of health services in Iraq generally, and about deaths, injuries and migration of faculty, classmates and family.ResultsThe average age of students was 22 years, with 59% women. Most students (90%) were originally from Baghdad. Although there were some positive responses, many students (59%) rated the overall quality of their medical education as fair or poor. Three-fourths of students believed the quality of hospital care in Iraq to be only fair or poor. A majority of students (57%) stated they were thinking frequently or all the time about leaving Iraq after graduation. Reasons given for leaving included the desire for further education, seeking a better lifestyle and fleeing conflict. Leading reasons for staying included the pull of friends and family, familiarity with the health system, and a sense of responsibility to the country. Nearly one in five (18%) students reported the death of a family member attributable to intentional violence, and 15% reported the violent death of a medical school classmate or faculty member since the 2003 invasion. Half the students reported at least one school faculty members had left Iraq because of the war.ConclusionMedical students hold a mediocre view of the quality of their medical education and of Iraq's health system. Many of their faculty members have left the country. The majority of students may leave Iraq after graduation, afforded the opportunity. This poses a significant problem for staffing an already demoralized and stressed health system. Current circumstances suggest the situation will continue to deteriorate.
| S-EPMC5870482 | biostudies-literature
Project description:Feedback on submitted work is a crucial element of students' learning process, but UK undergraduate students are often dissatisfied with the nature and process of university feedback. This article explores the causes of this dissatisfaction by analysing students' past feedback experiences pre-university and how these relate to their expectations regarding feedback at the Higher Education level. This study is based on a large survey undertaken at a UK Business School at the beginning of course induction meetings for 1st year undergraduate students. The results reveal that there is a significant misalignment between students' university feedback expectations and actual university feedback. These findings highlight the importance of managing student expectations regarding the nature and timeliness of feedback. This paper offers suggestions for feedback design and managing students' feedback expectations for course leaders to facilitate students' transition from schools and colleges to UK universities.Supplementary informationThe online version contains supplementary material available at 10.1007/s43545-022-00313-y.
| S-EPMC8800546 | biostudies-literature
Project description:BACKGROUND:Clinical teaching plays a crucial role in the transition of medical students into the world of professional practice. Faculty development initiatives contribute to strengthening clinicians' approach to teaching. In order to inform the design of such initiatives, we thought that it would be useful to discover how senior medical students' experience of clinical teaching may impact on how learning during clinical training might be strengthened. METHODS:This qualitative study was conducted using convenience sampling of medical students in the final two months of study before qualifying. Three semi-structured focus group discussions were held with a total of 23 students. Transcripts were analysed from an interpretivist stance, looking for underlying meanings. The resultant themes revealed a tension between the students' expectations and experience of clinical teaching. We returned to our data looking for how students had responded to these tensions. RESULTS:Students saw clinical rotations as having the potential for them to apply their knowledge and test their procedural abilities in the environment where their professional practice and identity will develop. They expected engagement in the clinical workplace. However, their descriptions were of tensions between prior expectations and actual experiences in the environment. They appreciated that learning required them to move out of their "comfort zone", but seemed to persist in the idea of being recipients of teaching rather than becoming directors of their own learning. Students seem to need help in participating in the clinical setting, understanding how this participation will construct the knowledge and skills required as they join the workplace. Students did not have a strong sense of agency to negotiate participation in the clinical workplace. CONCLUSIONS:There is the potential for clinicians to assist students in adapting their way of learning from the largely structured classroom based learning of theoretical knowledge, to the more experiential informal workplace-based learning of practice. This suggests that faculty developers could broaden their menu of offerings to clinicians by intentionally incorporating ways not only of offering students affordances in the clinical learning environment, but also of attending to the development of students' agentic capability to engage with those affordances offered.
| S-EPMC6367744 | biostudies-literature
Project description:BackgroundWith the increasing popularity of e-learning programs, educational stakeholders are attempting to promote critical thinking in the virtual education system. This study aimed to explore the experiences of both the instructors and the students about critical thinking promotion within the virtual education system.MethodsThis qualitative study recruited the instructors and students from four academic disciplines provided by the Virtual School of Tehran University of Medical Sciences (Tehran, Iran). All programs were master's degree programs and utilized a blended (combination of e-learning and face to face) training. Semistructured interviews with the participants were used to collect data.ResultsThe participants had a variety of experiences about how to promote critical thinking. These experiences were conceptualized in four main themes, namely, instructional design, educational leadership and management, local evidence, and belief systems.ConclusionThe present study clarified the factors affecting critical thinking promotion in e-learning. Not only the instructors but also the educational designers and leaders can benefit from our findings to improve the quality of virtual education programs and promote critical thinking.
| S-EPMC4862758 | biostudies-literature
Project description:BackgroundMany UK junior doctors are now taking a year out of the traditional training pathway, usually before specialty training, and some choose to work as a clinical teaching fellow (CTF). CTFs primarily have responsibility for delivering hospital-based teaching to undergraduate medical students. Only a very small amount of literature is available regarding CTF posts, none of which has explored why doctors choose to undertake the role and their expectations of the job. This study aimed to explore the expectations and experiences of CTFs employed at NHS hospital Trusts in the West Midlands.MethodsCTFs working in Trusts in the West Midlands region registered as students on the Education for Healthcare Professionals Post Graduate Certificate course at the University of Birmingham in August 2019 took part in a survey and a focus group.ResultsTwenty-eight CTFs participated in the survey and ten participated in the focus group. In the survey, participants reported choosing a CTF role due to an interest in teaching, wanting time out of training, and being unsure of which specialty to choose. Expectations for the year in post were directly related to reasons for choosing the role with participants expecting to develop teaching skills, and have a break from usual clinical work and rotations. The focus group identified five main themes relating to experiences starting their job, time pressures and challenges faced in post, how CTF jobs differed between Trusts, and future career plans. Broadly, participants reported enjoying their year in a post at a mid-year point but identified particular challenges such as difficulties in starting the role and facing time pressures in their day-to-day work.ConclusionThis study has provided a valuable insight into the CTF role and why doctors choose a CTF post and some of the challenges experienced, adding to the sparse amount of literature. Understanding post holders' experiences may contribute to optimisation of the role. Those employing CTFs should consider ensuring a formal handover process is in place between outgoing and incoming CTFs, having a lead person at their Trust responsible for evaluating changes suggested by CTFs, and the balance of contractual duties and personal development time.
| S-EPMC10908057 | biostudies-literature
Project description:Systemic lupus erythematosus (SLE) is an autoimmune disease associated with widespread inflammation and tissue damage. It is more common and severe among Blacks, Hispanics, and Asians; with higher incidence in women. While the goals of medical treatment are to prevent flares and reduce organ damage, up to 50% of patients perceive their health to be suboptimal with unaddressed needs including fatigue and pain. Recent SLE treatment guidelines focus on improving quality of life. Yoga has shown improvements in quality-of-life and fatigue in various diagnoses. While there is growing evidence that yoga therapy may help osteoarthritis and rheumatoid arthritis symptoms, there is only one reference in the literature related to SLE. METHODS/SETTING:An adjunct study was undertaken to evaluate adapting the Yoga as Self Care for Arthritis in Minority Communities study for a bilingual population living with SLE in the Washington, DC area. Informants included 7 patients enrolled onto the study, and 3 yoga instructors living with SLE. Qualitative methods included journals and semi-structured interviews. RESULTS:Enrolling patients clarified revisions for intake questionnaires, and symptoms that may impact class participation. Participants demonstrated increased balance, body awareness, and tolerated a faster-paced yoga class when compared to those in the parent study. Yoga instructors' recommendations included modifying yoga based on energy levels and frequent changes in physical ability. CONCLUSION:This paper shares perspectives from various informants and affirms the feasibility of progressing to a larger study. It summarizes our findings and recommendations towards creating a randomized controlled trial, as there are currently none in the literature.
| S-EPMC6279250 | biostudies-literature
Project description:OBJECTIVE:This study sought to quantitatively characterize medical students' expectations and experiences of an electronic health record (EHR) system in a hospital setting, and to examine perceived and actual impacts on learning. METHODS:Medical students from July to December 2016 at a tertiary pediatric institution completed pre- and postrotation surveys evaluating their expectations and experience of using an EHR during a pediatric medicine rotation. Survey data included past technology experience, EHR accessibility, use of learning resources, and effect on learning outcomes and patient-clinician communication. RESULTS:Students generally reported high computer self-efficacy (4.16 ± 0.752, mean ± standard deviation), were comfortable with learning new software (4.08 ± 0.771), and expected the EHR to enhance their overall learning (4.074 ± 0.722). Students anticipated the EHR to be easy to learn, use, and operate, which was consistent with their experience (pre 3.86 vs. post 3.90, p = 0.56). Students did not expect nor experience that the EHR reduced their interaction, visual contact, or ability to build rapport with patients. The EHR did not meet expectations to facilitate learning around medication prescribing, placing orders, and utilizing online resources. Students found that the EHR marginally improved feedback surrounding clinical contributions to patient care from clinicians, although not to the expected levels (pre 3.50 vs. post 3.17, p < 0.01). CONCLUSION:Medical students readily engaged with the EHR, recognized several advantages in clinical practice, and did not consider their ability to interact with patients was impaired. There was widespread consensus that the EHR enhanced their learning and clinician's feedback, but not to the degree they had expected.
| S-EPMC6221827 | biostudies-other
Project description:BackgroundIn September 2011, the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, began offering a combined BScPhm/PharmD program to third-year students and postbaccalaureate graduates. Learning consisted of in-class teaching and Advanced Pharmacy Practice Experience (APPE) rotations.ObjectiveTo explore preceptors' expectations and perceptions of student performance in the APPE rotations of the new combined degree program.MethodsA survey was distributed via email to 132 pharmacists from the Toronto Academic Health Science Network who had acted as preceptors for the combined degree program in academic year 2011/2012. The 17 questions were designed to gather information on preceptors' demographic characteristics and their expectations and evaluations of the combined-program students. Responses were analyzed qualitatively for common themes and quantitatively using sums and means. Survey responses were compared to identify alignment and discrepancies between preceptors' expectations and evaluations of students.ResultsThe survey response rate was 48% (63/132). Most respondents (46 [73%]) were from a teaching hospital, and the same proportion (46 [73%]) reported being preceptors for a direct patient care rotation. Forty-four (70%) of the respondents expected students to be at the level of traditional PharmD students, hospital residents, or advanced-level Structured Practical Experience Program students, and 35 (80%) of these 44 respondents reported that their students met or exceeded expectations. According to survey responses, 31% of respondents (18/58) ranked students at the corresponding level of performance on the faculty's assessment form, while 62% (36/58) ranked students at a higher level (5 respondents did not complete the question). Only one-third of respondents felt that they personally had received adequate training before taking on preceptor duties for combined-program students.ConclusionsPreceptors' perceptions of the rotation and their expectations of students varied widely and were influenced by prior teaching and learning experiences. There was a disconnect between preceptor-specific expectations and preceptors' final evaluations of students. Training to standardize the expected level of performance and additional training for preceptors would further enhance the APPE rotations of the combined degree program.
| S-EPMC4690670 | biostudies-literature
Project description:BackgroundSuicide risk prediction models derived from electronic health records (EHR) and insurance claims are a novel innovation in suicide prevention but patient perspectives on their use have been understudied.MethodsIn this qualitative study, between March and November 2020, 62 patients were interviewed from three health systems: one anticipating implementation of an EHR-derived suicide risk prediction model and two others piloting different implementation approaches. Site-tailored interview guides focused on patients' perceptions of this technology, concerns, and preferences for and experiences with suicide risk prediction model implementation in clinical practice. A constant comparative analytic approach was used to derive themes.ResultsInterview participants were generally supportive of suicide risk prediction models derived from EHR data. Concerns included apprehension about inducing anxiety and suicidal thoughts, or triggering coercive treatment, particularly among those who reported prior negative experiences seeking mental health care. Participants who were engaged in mental health care or case management expected to be asked about their suicide risk and largely appreciated suicide risk conversations, particularly by clinicians comfortable discussing suicidality.ConclusionMost patients approved of suicide risk models that use EHR data to identify patients at-risk for suicide. As health systems proceed to implement such models, patient-centered care would involve dialogue initiated by clinicians experienced with assessing suicide risk during virtual or in person care encounters. Health systems should proactively monitor for negative consequences that result from risk model implementation to protect patient trust.
| S-EPMC9308306 | biostudies-literature
Project description:Standing desks may reduce sedentary behaviors in college students. Students at one mid-size urban university in the Midwestern United States were randomized into intervention (n = 21) and control groups (n = 27) to assess standing time when given access to standing desks. The intervention group received visual and oral instructor prompts to stand, while the control received no prompts during a 50 min lecture. All students were provided with adjustable tabletop standing desks. ActivPAL accelerometers measured sitting and standing time. A brief survey assessed student preferences, including facilitators and barriers to standing. Mean standing time was greater in the intervention vs. control group (26 vs. 17 min, p = 0.023). Students tended to stand in the corners and edges of the room. Main facilitators for standing included to break up sitting, reduce back pain, and increase attention and focus; main barriers were not wanting to distract others or be the only one standing. In total, 87.5% of intervention group participants found five prompts to stand were adequate. Students increased standing time in class when provided with standing desks and instructor prompts to stand. Findings can inform the layout of classrooms and when and how to promote standing desks during lectures.
| S-EPMC8122831 | biostudies-literature