A Novel Interprofessional Mock Clinic Workshop for Medical Students With Orthotics and Prosthetics Students.
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ABSTRACT:
SUBMITTER: Misra SM
PROVIDER: S-EPMC6869978 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionBecause many older adults lack dental insurance and have limited or no access to dental care, it is essential to train future physicians to conduct brief oral health assessments on them. Likewise, interprofessional educational experiences are crucial in teaching medical students the skills necessary to provide comprehensive, team-based care to complex and vulnerable populations. Thus, this workshop was designed to increase fourth-year medical students' knowledge and confidence in performing oral health examinations on older adult patients using an interprofessional and hands-on approach.MethodsThe curriculum includes an online presession self-study module followed by a 75-minute workshop. The workshop is comprised of a brief introduction (5 minutes), a lecture about the impact of oral health on older adults (30 minutes), a hands-on skill session practicing a focused oral exam led by dental students (30 minutes), and a large-group debrief and wrap-up (10 minutes).ResultsA pre-/postsurvey assessed learners' knowledge, attitudes, and confidence in oral health skills. The results were compared to a lecture-only format that was in place prior to the implementation of the workshop. In comparison to medical students who received the lecture-only format, those who participated in the workshop showed a greater increase in confidence and skills over time. The medical students also expressed interest in more frequent opportunities for collaborative learning experiences with dental students.DiscussionThis workshop was successful in introducing an interprofessional experience to medical students in order to ensure more comprehensive and coordinated care for older adult patients in the future.
| S-EPMC6338206 | biostudies-literature
Project description:BACKGROUND:Health economic evaluations are essential to support health care policy and investment decisions. To date, health economic evaluations in orthotics and prosthetics have focused on discrete components of an orthosis/prosthesis (e.g. a microprocessor controlled prosthetic knee joint) rather than the broader service provided by orthotist/prosthetists. As such, the contribution to orthotic/prosthetic policy and investment decisions is unclear. Whilst there are opportunities to conduct more informative health economic evaluations that describe the costs and benefits of the orthotic/prosthetic service, it is important that prospective research is informed by a critical review of the method design challenges and an understanding of how this research can be improved. The aim of this systematic review is to critically appraise the existing orthotic/prosthetic health economic evaluation literature and therefore determine evidence gaps, critical method design issues and the extent to which the literature informs orthotic/prosthetic policy and investment decisions. METHODS:A comprehensive range of databases-AMED, EMBASE, MEDLINE and PsychINFO, Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest Nursing and Allied Health, Web of Science, Cochrane Database of Systematic Reviews (CDSR) and specialty health economic databases-will be searched using National Library of Medicine Medical Subject Headings (MeSH) terms as well as the title, abstract, and keyword terms. Search terms related to the intervention (e.g. orthosis), including variants used by varying professional disciplines (e.g. brace), will be used in preference to defining the populations that use orthotic and prosthetic services (e.g. people living with rheumatoid arthritis). Search terms related to health economic evaluations will be guided by previously developed and tested search strings and align with recommendations by the Canadian Agency for Drugs and Technologies in Health. Articles meeting the inclusion criteria will be hand-searched for relevant citations, and a forward citation search using Google Scholar will also be conducted to identify early online articles not yet indexed in traditional databases. Original research published in the English language and after 1 January 2000 will be included. The Checklist for Health Economic Evaluation Reporting Standards (CHEERS) and the Consensus on Health Economic Criteria (CHEC)-Extended list will be used to appraise the methodological quality and identify sources of bias. Data extraction and appraisal will be conducted by one reviewer independently using appraisal instrument guidelines and a content specific decision aid with exemplars. A subsequent review by a second researcher will be undertaken to confirm the accuracy of the extraction and appraisal, and a final review by a third where consensus cannot be reached. The data will be extracted to a purpose-built data extraction template with decision-making guidelines to support consistency. Where possible, the findings of the review will be reported as a meta-analysis, although the heterogeneity of the literature will likely mean a narrative review that illuminates method design issues that contribute to imprecision and variation will be more appropriate. DISCUSSION:This protocol has been purposefully designed to summarise the existing evidence and appraise the methodological approaches used and the quality of the health economic evaluations in orthotics and prosthetics. What we learn from this review will be used to guide further work in this area and design more rigorous health economic evaluations into the future. SYSTEMATIC REVIEW REGISTRATION:PROSPERO CRD42018116910.
| S-EPMC6595622 | biostudies-literature
Project description:Introduction:Advance care planning (ACP) is an essential discussion between a health care provider and a patient about their future care during serious illness. In clinical practice, high-quality ACP may be addressed with an interprofessional approach. Role-playing is an ideal method to practice both ACP and shared decision-making before having these conversations with patients. Methods:This asynchronous role-playing workshop is prefaced with two prerecorded 25-minute videos for faculty and student preparation with one introducing ACP concepts, and one depicting a patient-physician ACP discussion. During the 2-hour workshop, students complete four role-play ACP scenarios with the following roles: patient, family member, nurse, nurse practitioner, and physician. Students rotate through different roles guided by scripts, and have a fact sheet for each scenario detailing prognostic information for disease processes. The role-play works optimally with three nursing students, three medical students, and one faculty facilitator per group. Facilitators are provided with a timeline, a guide for debriefing, and an evaluation rubric. Results:The survey data from 85 students spread over four course offerings were summarized. When asked both if learning objectives were met, and to reflect on the clinical relevance, teaching effectiveness, and the overall workshop experience, most participants reported a good to excellent rating. Discussion:This role-play activity allows students to practice ACP and shared decision-making, both with patient and family presence, and in premeeting rounds with the health care team. ACP exposure during student training helps trainees recognize the impact of high-quality interprofessional conversations on the care patients want and ultimately receive.
| S-EPMC6338169 | biostudies-other
Project description:Orthotic and prosthetic materials should have good mechanical and antibacterial properties. Therefore, in our study, we consider four common foamed closed-cells and two solid polymeric materials regarding their mechanical behaviour and tendency for bacterial adhesion. For all materials, the surface roughness, hydrophobicity, zeta potential, tensile properties, hardness and CIE color parameters were measured. We found that foamed polymeric materials have higher roughness, higher hydrophobicity, lower Young's modulus, lower maximum tensile strength and lower hardness than solid materials. Bacterial adhesion test measurements based on observation by scanning electron microscopy show much a lower adhesion extent of S. aureus on solid materials than on foamed materials. The measured biophysical properties could be the key data for users to select the optimal materials.
| S-EPMC8619838 | biostudies-literature
Project description:Introduction:The adoption of electronic health records (EHRs) presents new challenges for information gathering, documentation, and patient care. Medical students spend a significant amount of time using the EHR during their clerkship experiences and will continue to do so as they progress to residency. However, formal training varies between institutions and leaves gaps in data-gathering skills, documentation skills, and order entry-these three skills formed the basis for our learning objectives. We designed a workshop using a simulated EHR to teach these skills. Methods:We offered the workshop during a class-wide transition-to-internship course for senior medical students. After a brief didactic, students worked in small groups using a simulated EHR to complete cases addressing each of the three learning objectives. Faculty facilitators assisted groups and then guided a large-group discussion of the challenges encountered during the cases. Results:Twenty-five senior medical students attended the first optional workshop. Of these students, 66.7% recommended that the workshop continue to be included in the curriculum. Comments from those who recommended otherwise suggested that many of them would recommend the workshop if it used our local EHR (Epic). Correct answers to the factual questions increased for most questions between the pretest and the posttest. Confidence to perform all skills targeted in the learning objectives increased between the pretest and the posttest. Discussion:This EHR workshop was well received by senior medical students and increased confidence in EHR skills, including data gathering, documentation, and handling unsolicited information with a plan including order entry.
| S-EPMC6946580 | biostudies-literature
Project description:Introduction:Medical school reproductive health curricula often lack adequate education regarding intrauterine devices (IUDs). When placed in clinical scenarios, students may have insufficient knowledge and training to counsel patients about IUDs. Methods:We developed a workshop for preclinical medical students and assessed whether it improved knowledge of and comfort with counseling patients on IUDs. The workshop consisted of a 45-minute lecture and a 45-minute IUD simulation training. Each session was taught to groups of 40 to 50 students. The workshop was evaluated between January 2016 and November 2017. Participants completed pre- and postsurveys. The primary outcome was comfort level with IUD counseling. Results:One hundred forty-two students completed the workshop, and 137 completed both pre- and postsurveys (96% response rate). At baseline, more than half (56%, n = 77) had not seen an IUD inserted. Students scoring 75% or higher on the IUD knowledge questions increased from 51% (n = 70) on presurveys to 87% (n = 119) on postsurveys (p < .0001). Students agreeing or strongly agreeing that they felt comfortable counseling patients on IUDs increased from 27% (n = 37) to 92% (n = 122, p < .0001) on postsurveys. All students felt the workshop was worthwhile. Discussion:Preclinical students showed increased knowledge of and comfort with IUDs after a simple IUD simulation. Medical schools could utilize this workshop to ensure students have hands-on training and experience related to IUDs prior to clinical rotations and for their future careers.
| S-EPMC6944262 | biostudies-literature
Project description:BACKGROUND:Effective Interprofessional Communication (IPC) between healthcare professionals enhances teamwork and improves patient care. Yet IPC training remains poorly structured in medical schools. To address this gap, a scoping review is proposed to study current IPC training approaches in medical schools. METHODS:Krishna's Systematic Evidence Based Approach (SEBA) was used to guide a scoping review of IPC training for medical students published between 1 January 2000 to 31 December 2018 in PubMed, ScienceDirect, JSTOR, Google Scholar, ERIC, Embase, Scopus and PsycINFO. The data accrued was independently analysed using thematic and content analysis to enhance the reproducibility and transparency of this SEBA guided review. RESULTS:17,809 titles and abstracts were found, 250 full-text articles were reviewed and 73 full text articles were included. Directed Content analysis revealed 4 categories corresponding to the levels of the Miller's Pyramid whilst thematic analysis revealed 5 themes including the indications, stages of trainings and evaluations, content, challenges and outcomes of IPC training. Many longitudinal programs were designed around the levels of Miller's Pyramid. CONCLUSION:IPC training is a stage-wise, competency-based learning process that pivots on a learner-centric spiralled curriculum. Progress from one stage to the next requires attainment of the particular competencies within each stage of the training process. Whilst further studies into the dynamics of IPC interactions, assessment methods and structuring of these programs are required, we forward an evidenced based framework to guide design of future IPC programs.
| S-EPMC7574565 | biostudies-literature
Project description:This study explores the extent to which a one-week nursing rotation for medical students changed the interprofessional attitudes of the participating nurses and students. Third-year medical students worked with nurses before starting clinical rotations. Pre- and post-experience surveys assessing perceptions of mutual respect, nurse-doctor roles, and interprofessional communication and teamwork were given to 55 nurses and 57 students. The surveys consisted of qualitative questions and a Likert scale questionnaire that was analyzed using qualitative and quantitative content analyses. The response rate was 51/57 (89%) students and 44/55 (80%) nurse preceptors. Nurses reported that students met nurses' expectations by displaying responsibility, respect, effective communication, and an understanding of nursing roles. Medical students' narratives demonstrated two significant changes. First, their views of nurses changed from that of physician helpers to that of collaborative patient-centred professionals. Second, they began defining nursing not by its tasks, but as a caring- and communication-centred profession. Responses to Likert-scaled questions showed significant differences corresponding to changes described in the narrative. A one-week immersive clinical nursing rotation for medical students was a transformative way of learning interprofessional competencies. Learning in an authentic workplace during a clinical rotation engendered mutual respect between nurses and future doctors. Students' view of the role of nurses changed from nurses working for doctors with patients, to working with doctors for patients.
| S-EPMC5967832 | biostudies-literature
Project description:IntroductionSafe transitions of care are an essential component of safety and quality for the patient community. It is imperative that providers choose appropriate discharge settings to reduce avoidable hospital readmissions. Additionally, providers must also ensure that the multifaceted needs of each patient are met with every discharge recommendation. There is often a lack of formal instruction in medical school on the various discharge dispositions, indications for rehab, and clinical indications for each setting. This is problematic for new interns who are tasked with entering discharge orders and relaying critical information between lead physicians and the interprofessional team.MethodsA 60-minute workshop with both didactic and experiential components provided medical students with opportunities to gain an overview of discharge dispositions while also exercising critical thinking using case examples. The workshop was part of a 2-week Transition to Residency course at a single institution.ResultsTwenty-two fourth-year medical students participated in the workshop. Following the workshop, 100% of the participants stated that they had learned something new and that they intended to use the content in practice as interns. Subjective responses indicated that workshop content ought to be incorporated earlier in medical training.DiscussionThese results suggest that a 60-minute workshop including didactic instruction as well as experiential and inquiry-based learning can impact medical student knowledge and intent for practice change in regard to providing safe transitions of care for the patient community.
| S-EPMC6354794 | biostudies-literature
Project description:Introduction:Internship preparation should include curricula to hone key skills such as acute medical management and communication with consulting and interprofessional providers. Methods:To enhance these skills, we developed an interprofessional mock paging and consult curriculum incorporating direct observation and peer, faculty, and nursing feedback for fourth-year medical students entering medical internships. Our brief mock paging and consult curriculum was designed as part of a larger 2-week internship preparation course. Our curriculum was delivered in two 2-hour sessions by physician and nurse educators. Sessions were conducted in small groups, offering the opportunity for direct observation and feedback from faculty, nurse educators, and peers. Our curriculum was expanded from a pilot for 10-15 students to 60 students after 2 years of a successful pilot. Results:Mock paging and consult sessions were highly rated by medical students and resulted in significantly enhanced self-assessment of preparedness in key intern skills such as returning pages, interprofessional communication, calling a consult, and managing acute issues for cross-cover patients. Discussion:We have demonstrated the effectiveness of a brief, interprofessional mock paging and consult curriculum incorporating faculty, nurse educator, and peer feedback. The tenets of our curriculum can be widely adopted for other learner groups.
| S-EPMC6342441 | biostudies-other