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Workplace-based learning

Clare Morris, Tim Swanwick
INTRODUCTION: Postgraduate medical education takes place almost entirely in the clinical workplace, supported by healthcare professionals who strive to combine service and educational roles. Over the past decade, we have witnessed the emergence and growth of new forms of educational activity within postgraduate medical education. Under the umbrella term of "faculty development", these activities move beyond a narrow emphasis on "teaching the teachers to teach" to a wide range of interventions focused on enhancing educational climate, educational infrastructure and educational practices within and across healthcare organizations...
March 11, 2018: Medical Teacher
Pim W Teunissen, Jennifer R Kogan, Olle Ten Cate, Larry D Gruppen, Lorelei A Lingard
The logical consequence of implementing competency-based education is moving to time-variable training. Competency-based, time-variable training (CBTVT) requires an understanding of how learners interact with their learning context and how that leads to competence. In this article, the authors discuss this relationship. They first explain that the time required to achieve competence in clinical practice depends on the availability of clinical experiences that are conducive to ongoing competence development...
March 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Olle Ten Cate, Larry D Gruppen, Jennifer R Kogan, Lorelei A Lingard, Pim W Teunissen
The introduction of competency-based medical education has shifted thinking from a fixed-time model to one stressing attained competencies, independent of the time needed to arrive at those competencies. In this article, the authors explore theoretical and conceptual issues related to time variability in medical training, starting with the Carroll model from the 1960s that put time in the equation of learning. They discuss mastery learning, deliberate practice, and learning curves.While such behaviorist theories apply well to structured courses and highly structured training settings, learning in the clinical workplace is not well captured in such theories or in the model that Carroll proposed...
March 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Danielle Blouin
OBJECTIVES: Informal learning includes all occurrences during one's life when learning is not deliberate. Prior research on informal learning in healthcare contexts examined learning happening outside of the formal curriculum, yet still in the workplace. This study explores residents' perceptions about extracurricular factors outside of the workplace that contribute to their learning and development of professional identity, whether interpersonal relations are recognised as such factors, and positive and negative impacts of interpersonal relations...
February 26, 2018: Emergency Medicine Australasia: EMA
Sandra E Moll, Jessica VandenBussche, Katelyn Brooks, Bonnie Kirsh, Heather Stuart, Scott Patten, Joy C MacDermid
OBJECTIVES: Despite growing awareness of the importance of workplace mental health training and an increasing number of educational resources, there is a gap in knowledge regarding what shapes training effectiveness. The purpose of this study was to compare and describe the active ingredients of 2 workplace mental health education programs for health care workers. METHODS: Within the context of a randomized clinical trial, a multimethod process evaluation was conducted to explore key process elements shaping implementation outcomes: the innovation, service recipients, service providers, and the organizational context...
January 1, 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Aine Marie Kelly, Patricia B Mullan
Teaching and assessing trainees' professionalism now represents an explicit expectation for Accreditation Council Graduate Medical Education-accredited radiology programs. Challenges to meeting this expectation include variability in defining the construct of professionalism; limits of traditional teaching and assessment methods, used for competencies historically more prominent in medical education, for professionalism; and emerging expectations for credible and feasible professionalism teaching and assessment practices in the current context of health-care training and practice...
February 22, 2018: Academic Radiology
Karline Wilson-Mitchell, Jamie Robinson, Mary Sharpe
OBJECTIVE: to develop and deliver a two-day Respectful Maternity Care workshop for midwives using Intellectual Partnership Model principles SETTING: rural Tanzania BACKGROUND: respectful Maternity Care is an objective, measurable indicator of quality maternal newborn care INTERVENTIONS: using the Intellectual Partnership Model, educators facilitated cocreation of solutions alongside learners for complex ethical and logistic problems in the workplace FINDINGS: the mean scores on a 10-item multiple choice test increased by 20% on average following completion of the interventions; however 2-year certificate learners were less prepared for critical thinking work and social innovations than those midwives who had 3 or 4 year formal training KEY CONCLUSIONS: the implementation of the Intellectual Partnership Model revealed that midwife learners were creative, innovative, context specific in their social innovation creations related to Respectful Maternity Care when supported by respectful facilitators...
February 7, 2018: Midwifery
Lisa Jane Gould, Peter Griffiths, Hannah Ruth Barker, Paula Libberton, Ines Mesa-Eguiagaray, Ruth M Pickering, Lisa Jane Shipway, Jackie Bridges
OBJECTIVE: Compassionate care continues to be a focus for national and international attention, but the existing evidence base lacks the experimental methodology necessary to guide the selection of effective interventions for practice. This study aimed to evaluate the Creating Learning Environments for Compassionate Care (CLECC) intervention in improving compassionate care. SETTING: Ward nursing teams (clusters) in two English National Health Service hospitals randomised to intervention (n=4) or control (n=2)...
February 22, 2018: BMJ Open
Gwen Sherwood, Usha Koshy Cherian, Sara Horton-Deutsch, Rebecca Kitzmiller, Cheryl Smith-Miller
Nurses' decisions about their intent to remain in the workforce are based on various factors. A healthy work environment in which work done well is recognised and appreciated contributes to nurses' satisfaction and better patient outcomes. This article examines the American Association of Critical-Care Nurses framework for a healthy work environment, focusing on standards for meaningful recognition. Reflective practice, which provides a self-analytical approach to appreciate and value one's work, is viewed as self-recognition...
February 22, 2018: Nursing Management (Harrow)
Hugh A Stoddard, Erica D Brownfield
PROBLEM: Undergraduate medical education (UME) has trended toward outcomes-based education, unveiling new issues for UME program organization and leadership. Using a common language for categorizing and linking all program components is essential. The Emory Curriculum Alignment Taxonomy (ECAT) was designed as a common vocabulary for curriculum mapping in the outcomes-based environment of the Emory University School of Medicine. APPROACH: The ECAT, developed in 2016, uses a set of 291 controlled identifiers, or "tags," to describe every educational activity's content, instruction, assessment, and outcomes, and thereby to align teaching inputs with student outcomes...
February 20, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Ankie C M Hazen, Esther de Groot, Antoinette A de Bont, Simone de Vocht, Johan J de Gier, Marcel L Bouvy, Niek J de Wit, Dorien L M Zwart
PURPOSE: To unravel boundary crossing as it relates to professional identity formation in pharmacists transitioning from a community pharmacy to working as nondispensing clinical pharmacists in general practice, with the aim of optimizing their education. METHOD: A multiple case study, including two-stage interviews, peer feedback, and individual reflection, that collected data in 2014 and 2015 from eight clinical pharmacists working in general practice in The Netherlands...
February 20, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Nancy D Harada, Laural Traylor, Kathryn Wirtz Rugen, Judith L Bowen, C Scott Smith, Bradford Felker, Deborah Ludke, Ivy Tonnu-Mihara, Joshua L Ruberg, Jayson Adler, Kimberly Uhl, Annette L Gardner, Stuart C Gilman
This paper describes the Centers of Excellence in Primary Care Education (CoEPCE), a seven-site collaborative project funded by the Office of Academic Affiliations (OAA) within the Veterans Health Administration of the United States Department of Veterans Affairs (VA). The CoEPCE was established to fulfill OAA's vision of large-scale transformation of the clinical learning environment within VA primary care settings. This was accomplished by funding new Centers within VA facilities to develop models of interprofessional education (IPE) to teach health professions trainees to deliver high quality interprofessional team-based primary care to Veterans...
February 20, 2018: Journal of Interprofessional Care
Denise A Traicoff, Dave Basarab, Derek T Ehrhardt, Sandi Brown, Martin Celaya, Dennis Jarvis, Elizabeth H Howze
Background: Predictive Evaluation (PE) uses a four-step process to predict results then designs and evaluates a training intervention accordingly. In 2012, the Sustainable Management Development Program (SMDP) at the Centers for Disease Control and Prevention used PE to train Stop Transmission of Polio (STOP) program volunteers. Methods: Stakeholders defined specific beliefs and practices that volunteers should demonstrate. These predictions and adult learning practices were used to design a curriculum to train four cohorts...
March 2018: Pedagogy in Health Promotion
Anne-Marie Boström, Disa K Sommerfeld, Annika W Stenhols, Anna Kiessling
Implementation of evidence-based practice (EBP) is a complex task. This study, conducted in an acute geriatric setting, aims to compare self-reported capability beliefs on EBP between health professionals and students, and to compare the use of EBP between health professional groups. Occupational therapists, physicians, physiotherapists and registered nurses with three or more months' employment, and all students from the occupational therapy, medical, physiotherapy and nursing programs, who had conducted workplace learning at the department, were invited...
2018: PloS One
C A Fleming, G Humm, J R Wild, H M Mohan, S T Hornby, R L Harries, J E F Fitzgerald, A J Beamish
BACKGROUND: As front-line healthcare staff, doctors in surgical training occupy a unique organisational space rotating through hospitals and services in which they witness first hand both good and bad practice. This puts trainees in a clear position to identify and raise patient safety issues, and to contribute to discussions regarding quality and safety improvement. However, there are a number of real and perceived barriers to trainees doing so. These include concerns about the impact on training assessments and career progression, and uncertainty about the appropriate route...
February 8, 2018: International Journal of Surgery
Anne Marie Lunde Husebø, Marianne Storm, Bodil Bø Våga, Adriana Rosenberg, Kristin Akerjordet
OBJECTIVE: To give an overview of empirical studies investigating nursing homes as a learning environment during nursing students' clinical practice. BACKGROUND: A supportive clinical learning environment is crucial to students' learning and for their development into reflective and capable practitioners. Nursing students' experience with clinical practice can be decisive in future workplace choices. A competent workforce is needed for the future care of older people...
February 5, 2018: Journal of Clinical Nursing
Jeffrey Sordahl, India C King, Kyle Davis, Rick Tivis, Scott C Smith, Amber Fisher, Janet Willis, Timothy Gordon, William G Weppner
Transition to interprofessional team-based care is a quickly progressing healthcare model and requires changes in medical training approaches. The Department of Veteran Affairs (VA) has taken a lead role in creating such training experiences, one of which is the establishment of multiple Centers of Excellence in Primary Care Education (CoEPCE). These sites are tasked with developing teaching innovations to better facilitate interprofessional team-based care. The patient-aligned care team interprofessional care update (PACT-ICU) is an interprofessional workplace learning activity with the goals of simultaneously addressing educational and patient care needs...
January 27, 2018: Translational Behavioral Medicine
Sarah Yardley, Michiel Westerman, Maggie Bartlett, J Mark Walton, Julie Smith, Ed Peile
INTRODUCTION: Transitions are traditionally viewed as challenging for clinicians. Throughout medical career pathways, clinicians need to successfully navigate successive transitions as they become progressively more independent practitioners. In these guidelines, we aim to synthesize the evidence from the literature to provide guidance for supporting clinicians in their development of independence, and highlight areas for further research. METHODS: Drawing upon D3 method guidance, four key themes universal to medical career transitions and progressive independence were identified by all authors through discussion and consensus from our own experience and expertise: workplace learning, independence and responsibility, mentoring and coaching, and patient perspectives...
February 2018: Perspectives on Medical Education
Chris Merritt, Michelle Daniel, Brendan W Munzer, Mariann Nocera, Joshua C Ross, Sally A Santen
In just a few years of preparation, emergency medicine (EM) trainees must achieve expertise across the broad spectrum of skills critical to the practice of the specialty. Though education occurs in many contexts, much learning occurs on the job, caring for patients under the guidance of clinical educators. The cognitive apprenticeship framework, originally described in primary and secondary education, has been applied to workplace-based medical training. The framework includes a variety of teaching methods: scaffolding, modeling, articulation, reflection, and exploration, applied in a safe learning environment...
January 2018: Western Journal of Emergency Medicine
Anna T Höglund, Marianne Carlsson, Inger K Holmström, Linda Lännerström, Elenor Kaminsky
BACKGROUND: Although Swedish legislation prescribes equity in healthcare, studies have reported inequalities, both in face-to-face encounters and in telephone nursing. Research has suggested that telephone nursing has the capability to increase equity in healthcare, as it is open to all and not limited by long distances. However, this requires an increased awareness of equity in healthcare among telephone nurses. The aim of this study was to explore and describe perceptions of equity in healthcare among Swedish telephone nurses who had participated in an educational intervention on equity in health, including which of the power constructs gender, ethnicity and age they commented upon most frequently...
January 22, 2018: International Journal for Equity in Health
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