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Clinical learning environment

Catherine de Blacam, Sean Tierney, Odhran Shelley
BACKGROUND: Surgical training requires exposure to clinical decision-making and operative experience in a supervised environment. It is recognised that learning ability is compromised when fatigued. The European Working Time Directive requires a decrease in working hours, but compliance reduces trainees' clinical exposure, which has profound implications for plastic surgery training. The aim of this study was to evaluate plastic surgery registrars' experience of an EWTD-compliant rota, and to examine its impact on patient care, education, and logbook activity...
October 20, 2016: Journal of Plastic Surgery and Hand Surgery
Hans Lehrach
Every human is unique. We differ in our genomes, environment, behavior, disease history, and past and current medical treatment-a complex catalog of differences that often leads to variations in the way each of us responds to a particular therapy. We argue here that true personalization of drug therapies will rely on "virtual patient" models based on a detailed characterization of the individual patient by molecular, imaging, and sensor techniques. The models will be based, wherever possible, on the molecular mechanisms of disease processes and drug action but can also expand to hybrid models including statistics/machine learning/artificial intelligence-based elements trained on available data to address therapeutic areas or therapies for which insufficient information on mechanisms is available...
September 2016: Dialogues in Clinical Neuroscience
Deborah Edwards, Sally Anstey, Daniel Kelly, Jessica Ballie, Jane Hopkinson
AIMS AND OBJECTIVES: To explore the views of student nurses' and stakeholders of what is important for student nurses to know about cancer treatment and care. BACKGROUND: Worldwide, the number of people living with cancer is increasing because the population is aging and effective cancer treatments are prolonging survival. All nurses need knowledge, skills, confidence and competence to support people living with cancer. Education is an important tool in preparing a nursing workforce that can support people affected by cancer...
October 18, 2016: Journal of Clinical Nursing
Peter Nilsson
A number of chronic disease conditions tend to cluster in families with an increased risk in first-degree relatives, but also an increased risk in second-degree relatives. This fact is most often referred to as the heritability (heredity) of these diseases and explained by the influence of genetic factors, or shared environment, even if the more specific details or mechanism leading to disease are not known. New methods have to be explored in screening studies and register linkage studies to define and measure consequences of a positive family history of disease...
September 2016: Journal of Hypertension
David Mathar, Leonora Wilkinson, Anna K Holl, Jane Neumann, Lorenz Deserno, Arno Villringer, Marjan Jahanshahi, Annette Horstmann
Incidental learning of appropriate stimulus-response associations is crucial for optimal functioning within our complex environment. Positive and negative prediction errors (PEs) serve as neural teaching signals within distinct ('direct'/'indirect') dopaminergic pathways to update associations and optimize subsequent behavior. Using a computational reinforcement learning model, we assessed learning from positive and negative PEs on a probabilistic task (Weather Prediction TaskĀ - WPT) in three populations that allow different inferences on the role of dopamine (DA) signals: (1) Healthy volunteers that repeatedly underwent [(11)C]raclopride Positron Emission Tomography (PET), allowing for assessment of striatal DA release during learning, (2) Parkinson's disease (PD) patients tested both on and off L-DOPA medication, (3) early Huntington's disease (HD) patients, a disease that is associated with hyper-activation of the 'direct' pathway...
September 19, 2016: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
Mary Thuss, Yolanda Babenko-Mould, Mary-Anne Andrusyszyn, Heather K S Laschinger
The purpose of this study was to explore Rwandan nursing clinical instructors' (CIs) experiences of structural and psychological empowerment. CIs play a vital role in students' development by facilitating learning in health care practice environments. Quality nursing education hinges on the CI's ability to enact a professional role. A descriptive qualitative method was used to obtain an understanding of CIs empowerment experiences in practice settings. Kanter's Theory of Structural Power in Organizations and Spreitzer's Psychological Empowerment Theory were used as theoretical frameworks to interpret experiences...
October 15, 2016: International Journal of Nursing Education Scholarship
Karen Luetsch, Judith Burrows
BACKGROUND: Graduate and post-graduate education for health professionals is increasingly delivered in an e-learning environment, where automated, continuous formative testing with integrated feedback can guide students' self-assessment and learning. Asking students to rate the certainty they assign to the correctness of their answers to test questions can potentially provide deeper insights into the success of teaching, with test results informing course designers whether learning outcomes have been achieved...
October 14, 2016: BMC Medical Education
Mary Ann Cantrell, Bette Mariani, Colleen Meakim
The aim of this learning experience was to enhance students' knowledge of safety practices. A threefold approach was used, which involved viewing a prerecorded scenario in which safety practices were violated and another scenario that consistently depicted safe practice behaviors. Students then performed an environmental safety check of the physical simulated scene and then participated in a debriefing session. The conceptual basis for this project was the teaching-learning strategy "What's Wrong With This Patient," which requires the learner to evaluate a simulated learning environment to identify safety practices that were not followed and suggest strategies to correct these errors...
July 2016: Nursing Education Perspectives
Mohammad Mahdi Parvizi, Mitra Amini, Mohammad Reza Dehghani, Peyman Jafari, Zahra Parvizi
PURPOSE: Evaluation is the main component in design and implementation of educational activities and rapid growth of educational institution programs. Outpatient medical education and clinical training environment is one of the most important parts of training of medical residents. This study aimed to determine the validity and reliability of the Persian version of Ambulatory Care Learning Educational Environment Measure (ACLEEM) questionnaire, as an instrument for assessment of educational environments in residency medical clinics...
2016: Advances in Medical Education and Practice
Marlene Z Bloom
It was four months in Alaska, in the middle of winter, that changed Joseph Marek's view of what it means to be a pharmacist. Marek was on his last rotation in pharmacy school when he experienced the kind of practice that he wanted for himself. He found that kind of practice as a consultant pharmacist, and next month, Marek, 49, will become the 2016-2017 president of the American Society of Consulting Pharmacists. Working at the Public Health Service (PHS) in the Arctic Circle in 1990, he dispensed and carried out clinical duties with the chief pharmacist and provided care to the native Inuit population through the Indian Health Service...
2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Saroj Jayasinghe
Clinicians often encounter patients having complex clinical scenarios (CCS) where diverse and dynamic diagnostic and therapeutic issues interact. A limited range of bedside methods are available to describe such patients and most often it is a diagnostic summary, a problem list, or a list of differential diagnoses. These methods fail to portray the interconnected nature of CCCs. They prevent visualization of a system of networks or a web of causation operative in CCSs.A more holistic conceptualization is required and the author argues for an approach based on systems science...
October 10, 2016: BMC Medical Education
Megan Delisle, Ruby Grymonpre, Rebecca Whitley, Debrah Wirtzfeld
Clinical errors due to human mistakes are estimated to result in 400,000 preventable deaths per year. Strategies to improve patient safety often rely on healthcare workers' ability to speak up with concerns. This becomes difficult during critical decision-making as a result of conflicting opinions and power differentials, themes underrepresented in many interprofessional initiatives. These elements are prominent in our interprofessional initiative, namely Crucial Conversations. We sought to evaluate this initiative as an interprofessional learning (IPL) opportunity for pre-licensure senior healthcare students, as a way to foster interprofessional collaboration, and as a method of empowering students to vocalise their concerns...
August 11, 2016: Journal of Interprofessional Care
Fatemeh Ghaffari, Nahid Dehghan-Nayeri, Nasrin Navabi, Khatereh Seylani
BACKGROUND: Improving the quality of health care and rehabilitation for the elderly is one of the most important priorities of the health care system. Given the importance of evaluating the strengths and weaknesses of any program after its implementation, this study was conducted to identify the advantages and weaknesses of a geriatric nursing program at Tehran University of Medical Sciences. METHODS: This was a qualitative study, and the study population comprised students, graduates, and professors of geriatric nursing at the Master of Science level...
2016: Clinical Interventions in Aging
Sebastiaan Koole, Veronique Christiaens, Jan Cosyn, Hugo De Bruyn
Despite the consensus on the importance of reflection for dental professionals, a lack of understanding remains about how students and clinicians should develop their ability to reflect. The aim of this study was to investigate dental students' and mentors' perceptions of mentor groups as an instructional method to facilitate students' reflection in terms of the strategy's learning potential, role of the mentor, group dynamics, and feasibility. At Ghent University in Belgium, third- and fourth-year dental students were encouraged to reflect on their clinical experiences and personal development in three reflective mentor sessions...
October 2016: Journal of Dental Education
Taylor Sawyer, Megan M Gray
This review examines the current environment of neonatal procedural learning, describes an updated model of skills training, defines the role of simulation in assessing competency, and discusses potential future directions for simulation-based competency assessment. In order to maximize impact, simulation-based procedural training programs should follow a standardized and evidence-based approach to designing and evaluating educational activities. Simulation can be used to facilitate the evaluation of competency, but must incorporate validated assessment tools to ensure quality and consistency...
September 27, 2016: Seminars in Perinatology
Aussama Nassar, Angela Coates, Faiz Tuma, Forough Farrokhyar, Susan Reid
OBJECTIVES: To develop a novel assessment tool for trainees-led trauma resuscitation. Assess psychometric properties of the proposed tool. Evaluate feasibility and utility of the tool. INTRODUCTION: Trauma resuscitation is a structured and complex process involving unique sets of skills. There is currently no published structured formative evaluation tool for trauma trainees. Therefore, many trauma trainees rely upon limited, unstructured feedback on their performance...
September 26, 2016: Journal of Surgical Education
Liqing Yue, Virginia Plummer, Wendy Cross
AIM: To identify the effectiveness of education interventions provided for nurses for clinical alarm response and management. BACKGROUND: Some education has been undertaken to improve clinical alarm response, but the evidence for evaluating effectiveness for nurse education interventions is limited. DESIGN: Systematic review METHOD: A systematic review of experimental studies published in English from 2005 to 2015 was conducted in four computerised databases (MEDLINE, EMBASE, CINAHL, Scopus)...
September 29, 2016: Journal of Clinical Nursing
Carina Anderson, Lorna Moxham, Marc Broadbent
AIM: This discussion paper poses the question 'What enables or deters Registered Nurses to take up their professional responsibility to support undergraduate nursing students through the provision of clinical education?'. BACKGROUND: Embedded within many nursing standards are expectations that Registered Nurses provide support and professional development to undergraduate nursing students undertaking clinical placements. Expectations within nursing standards that Registered Nurses provide support and professional development to nursing students are important because nursing students depend on Registered Nurses to help them to become competent practitioners...
August 10, 2016: Contemporary Nurse
Mehran Haidari, Marwan Yared, Juan P Olano, C Bruce Alexander, Suzanne Z Powell
Context .- Previous studies suggest that training in pathology residency programs does not adequately prepare pathology residents to become competent in clinical chemistry. Objectives .- To define the beliefs of pathology residents in the United States regarding their preparation for practicing clinical chemistry in their career, their attitude toward the discipline, and the attractiveness of clinical chemistry as a career. Design .- The residents of all pathology residency programs in the United States were given the opportunity to participate in an online survey...
September 28, 2016: Archives of Pathology & Laboratory Medicine
He Cai, Shuying Yang, Xibo Pei, Hai Qing, Jian Wang
STATEMENT OF PROBLEM: Gingival displacement is recognized as a substantive and difficult procedure in fixed prosthodontics. However, a realistic simulation of gingival displacement is unavailable for preclinical dental students. PURPOSE: The purpose of this study was to evaluate whether practice-based preclinical instruction of gingival displacement with animal models could improve students' skill in patient care. MATERIAL AND METHODS: Isolated bovine mandibles (calves were younger than 6 months of age) and isolated porcine hemimandibles were prepared for this study...
September 24, 2016: Journal of Prosthetic Dentistry
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