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PubMed1997

[A study on clinical teaching method in nursing education--focusing on teaching method of touching].

The purpose of this study is the development of effective clinical teaching methods of nursing education using touching in hospital nursing care. The clinical teaching-learning process was designed based on the Steinaker, N.W. & R. Bell's experiential learning model (1979), in which teaching-learning process was divided into five steps-exposure, participation, identification, internalization, and dissemination. Three hypotheses were postulated as follows: 1-1. Guidance given to nursing students to use touching in nursing care will make them conscious of the efficiency of touching. 1-2. Nursing students will grasp the efficiency of their nursing action by "cause and effect" relations. 2-0. Guidance given to nursing students to use touching in their nursing care will allay and soften their anxiety and tension toward such nursing practices. 3-0. Nursing intervention by touching will heighten the clinical judgement ability of nursing students. The teaching-learning plan was carried out in a nursing school in Kitakyushu-shi. Fifteen nursing students studied by this plan. The results was as follows: a. Hypotheses 1-1, 1-2, 2-0, were confirmed. b. Hypothesis 3-0, was not confirmed.

Clinical Competence↗

PubMed1994

Diffusion of innovation I: Formulary acceptance rates of new drugs in teaching and non-teaching British Columbia hospitals--a hospital pharmacy perspective.

Lag times in the diffusion of new drugs in the hospital setting have both patient care and pharmaceutical industry implications. This two-part series uses diffusion theory to examine differences in the adoption rates of new drugs in British Columbia teaching and non-teaching hospitals. Formulary addition of a new drug by a hospital's Pharmacy and Therapeutics Committee was considered the adoption indicator. Time for adoption was defined as the difference between a drug's Canadian market approval date and the date of formulary addition. Surveys were mailed in September 1990 to 41 hospital pharmacies (response rate = 88%), asking respondents to provide formulary inclusion dates of 29 drugs marketed between July 1987 and March 1990. A significant difference (Mann-Whitney U Test, p < 0.0358) in median adoption time was observed between the six teaching and 25 non-teaching study hospitals, with the former adopting a new drug in 7.5 months versus the latter adopting a new drug in 12.1 months.

British Columbia↗

PubMed2002

Investigation of a brief teaching encounter using standardized patients: teaching residents alcohol screening and intervention.

OBJECTIVE: To investigate a brief teaching intervention using standardized patients (SPs) trained to improve residents' detection and advising of problem drinkers. DESIGN: Pretest-posttest design assessing resident behavior and skills. SUBJECTS: Nineteen internal medicine residents in a University Hospital General Internal Medicine Clinic. INTERVENTION: Announced SPs were interviewed by residents and presented to faculty who provided brief instruction on the National Institute on Alcohol Abuse and Alcoholism guidelines for screening and brief counseling of problem drinkers. MEASURE: Unannounced SPs assessed resident behavior and skills. RESULTS: Following the teaching intervention, 2 times more residents screened for alcohol use and nearly 3 times more residents did brief counseling. Residents reported that the intervention was informative and valuable. CONCLUSION: A single, 1-hour teaching intervention lead to a 2- to 3-fold increase in resident detection and advising of problem drinkers. SPs provide effective teaching encounters and a useful measure of resident behavior.

Alcoholism↗

PubMed2002

Teaching digital rectal examinations to medical students: an evaluation study of teaching methods.

PURPOSE: The digital rectal examination (DRE) is a necessary part of a complete physical examination and evaluation of a patient, yet teaching of this examination to medical students is often inadequate. This study was a comparative evaluation of the effectiveness of the rectal teaching associate (RTA), lecture, role-playing, and simulated models as methods for teaching the DRE procedure to undergraduate medical students at Memorial University of Newfoundland Faculty of Medicine. METHOD: A total of 65 third-year medical students were randomly assigned to either an experimental or control group. Both groups received a lecture and practiced the DRE on a simulated model. The experimental group received further training from an RTA. Students completed a pre- and post-intervention knowledge assessment, an objective structured clinical exam (OSCE) measuring performance of the DRE, and a satisfaction survey. RESULTS: Mean knowledge scores increased significantly for both groups (18.73 to 22.32, p <.0001). The control group scored significantly higher on the post-intervention assessment than did the experimental group (23.11 versus 21.47, p =.025) The experimental group scored higher on the OSCE (27.52 versus 23.80, p =.001) and rated the RTA as a more effective method for learning the DRE. CONCLUSIONS: This first study using RTAs to teach the DRE as a global skill for evaluating the rectum suggests that the RTA method is effective for increasing skills and students' confidence in the procedure.

Curriculum↗

PubMed1985

Physicians and the teaching of breast self-examination: implications from a survey at a university teaching hospital.

We surveyed 80 physicians from four specialties (Family Medicine, General Medicine, General Surgery, Ob-Gyn) to investigate how they taught breast self-examination (BSE). Only half reported personally teaching BSE. Few MDs reported routinely using techniques to assess BSE competency. Most (72 per cent) claimed no formal training in teaching BSE; 10 per cent claimed no training at all. Techniques used to teach BSE may vary, and physicians may lack the training to teach BSE.

Adult↗

PubMedDate not supplied

Use of an interactive teaching program to teach medical workers, about MUMPS programming.

The MUMPS computer language is widely and increasingly used for medical applications. It is useful for medical students and others in the medical environment to have an understanding of such languages that can help them perform their jobs well. The author is therefore making available an interactive teaching program to instruct such people in the MUMPS computer language. Use of the teaching program is reported for 19 novice MUMPS programmers and compared with results for two experienced programmers. Free-text comments by the novices emphasize areas in which they had difficulty. There is a considerable variation in the mean time taken by the novices to answer the questions, and in the number of questions repeated because of erroneous answers. Most novices found the teaching program very helpful. A copy of the Standard MUMPS teaching program and the QUEST driver on which it is based has been sent to 24 institutions, including six in Europe and one in Japan, for further use.

Allied Health Personnel↗

PubMed2026

Teaching Engagement and Caregiving Help in the Intensive Care Unit (TEACH-ICU) Scale: Content Validity.

BACKGROUND: Having family members provide care to their loved ones in the intensive care unit (ICU) is a beneficial yet seldom implemented approach. For family members to perform caregiving, nurses must be willing to teach, and such willingness is a developing area of research. OBJECTIVES: To adapt an instrument validated in family members, the Family Willingness for Caregiving Scale, to address nurses' willingness to teach family members caregiving skills. METHODS: Purposive and snowball sampling were used to recruit 10 expert ICU nurses through the American Association of Critical-Care Nurses' research website and social media platforms. The researchers conducted cognitive interviews with the nurses to address the instrument's content validity. RESULTS: The scale was refined based on the participants' feedback. Items were deleted, added, and revised. Furthermore, scale instructions were adjusted to emphasize the willingness to teach families of patients receiving mechanical ventilation. Qualitative themes emerged related to barriers to family engagement, including time constraints, patient acuity, and nurse and family characteristics. CONCLUSIONS: Content validity of the scale was assessed, with future research aimed at pilot testing and evaluating construct validity before using the scale as a research instrument. Practical implications include using the scale as an evaluation tool to determine nurses' willingness to teach family members about caregiving. After evaluation, various strategies could be incorporated to enhance family engagement in adult ICUs.

Humans↗

PubMed2002

A real-time case approach to teaching information systems in health services administration: hardwiring research to teaching.

The pace of change in the health policy and health administration environments supports the need for linking teaching and research. This article describes a successful effort to tap real-time synergies between faculty research on health care information systems development and teaching in health services administration. It describes the real-time case approach (RTCA), a highly interactive case method employed in teaching a graduate health management information systems course. The approach offers another alternative to the "teach-the-text-and-lecture" model and adds important dimensions to the standard "case discussion" model. The article discusses the mechanics of implementing the RTCA, the instructor's role, and five cases used in the course. Among the benefits of the RTCA is that students place great reliance upon cases in interpreting other reading material, lectures, and discussion points in the course. Students are more likely to make theory connections to elements in one or more of the cases. Potential weaknesses include students' inhibitions to criticize and question key decision makers who they have met, as opposed to those who might appear in a fictional case. Also, some possible concession of comprehensiveness and time-ordered treatment of information systems issues, as might be found in a written case study, is made in favor of the dynamics of information gathering, distillation, and integration by students in the real-time case environment.

Education, Graduate↗

PubMed2006

A multi-level assessment of a program to teach medical students to teach.

Few longitudinal programs exist to teach senior students (MS4s) to be teachers, nor have there been any reports of comprehensive program evaluation in this area. The primary objectives of this study were to describe our ongoing faculty development effort and to develop a multi-level program evaluation, using Dixon's model. The TALKS (Teaching and Learning Communication Skills) program is a senior elective and open to all MS4s. We evaluated our program through assessment of its participants at three levels: level 1, opinion; level 2, competence; and level 3, performance; but not level 4, patient outcomes. The authors used a retrospective, pre-post questionnaire to assess MS4 attitudes about their educational experiences, a traditional instrument to assess their teaching, an interaction analysis technique using Bloom's taxonomy to assess MS4s' feedback skills, and a SP exam to assess MS4 communication skills. The authors hypothesized that MS4s participating in TALKS would view medical education more positively and informatively, would demonstrate important principles in giving feedback, would be assessed as excellent teachers, and would perform better than controls in an SP exam emphasizing communication skills. Results revealed that MS4s' ratings as teachers were very good to excellent, with the highest scores on the items "knowledgeable, supportive of me, and answering questions clearly." (Level 1, Opinion) MS4s' perceptions of their knowledge, attitudes and skills increased significantly from the pre to the post-questionnaire. (Level 2, Competence) MS4 feedback skills to MS2s revealed they did more talking than ideal, often at the lowest levels of Bloom's taxonomy. (Level 3, Performance) MS4s demonstrated better communication skills than controls on an evaluation by professional SPs. (Level 3, Performance).

Curriculum↗

PubMed2006

Undergraduate musculoskeletal examination teaching by trained patient educators--a comparison with doctor-led teaching.

BACKGROUND: To compare the core hand and knee examination skills gained by undergraduates taught either by trained patient educators (PEs) or by doctors. METHODS: A total of 50 final year medical students were randomized to receive training from PEs or doctors. Group A were taught hand examination by a PE with rheumatoid arthritis, and knee examination by a PE with osteoarthritis. Group B was taught hand and knee examination by a consultant rheumatologist plus an untrained patient with appropriate signs. All students were taught an established core skills set in small group workshops. Students then undertook two validated objective structured clinical examination (OSCE) stations with two blinded assessors. Pre- and post-teaching questionnaires established the students' self-reported levels of skills (SRS) and a student evaluation of teaching (SET). The study was analysed as an equivalence trial. A mean difference in OSCE scores of 10% was assumed to be of educational significance. RESULTS: Although the SET scores of both groups were high, the doctor-led group received higher scores. Aside from this, the two student groups did not differ significantly. There were no significant differences in mean hand OSCE (mean difference = 0.88, P = 0.28, 95% CI = -0.73 to 2.49) or knee OSCE (mean difference = 0.28, P = 0.7, 95% CI = -1.19 to 1.75) scores. Both the upper and lower confidence intervals for each mean difference fell within the 10% range (-2.8 to 2.8 for the hand, and -2.5 to 2.5 for the knee) and equivalence was assumed. CONCLUSIONS: Adequately trained PEs can deliver clearly structured undergraduate skills, teaching with equivalent learning outcomes to those of rheumatology consultants. PEs are a valuable development to augment musculoskeletal education in the face of expanding student numbers.

Adult↗

PubMed2006

Facilitating the development of moral insight in practice: teaching ethics and teaching virtue.

Abstract The teaching of ethics is discussed within the context of insights gleaned from ancient Greek ethics, particularly Aristotle and Plato and their conceptions of virtue (arete, meaning excellence). The virtues of excellence of character (moral virtue) and excellence of intelligence (intellectual virtue), particularly practical wisdom and theoretical wisdom, are considered. In Aristotelian ethics, a distinction is drawn between these intellectual virtues: experience and maturity is needed for practical wisdom, but not for theoretical wisdom. In addition to this, excellence of character is acquired through habitual practice, not instruction. This suggests that there is a need to teach more than theoretical ethics and that the ethics teacher must also facilitate the acquisition of practical wisdom and excellence of character. This distinction highlights a need for various educational approaches in cultivating these excellences which are required for a moral life. It also raises the question: is it possible to teach practical wisdom and excellence of character? It is suggested that virtue, conceived of as a type of knowledge, or skill, can be taught, and people can, with appropriate experience, habitual practice, and good role models, develop excellence of character and become moral experts. These students are the next generation of exemplars and they will educate others by example and sustain the practice of nursing. They need an education which includes theoretical ethics and the nurturing of practical wisdom and excellence of character. For this purpose, a humanities approach is suggested.

Attitude of Health Personnel↗

PubMed1992

Is undergraduate otoscopy teaching adequate?--An audit of clinical teaching.

Otoscopy is an important skill for the general practitioner, yet skill in the technique is rarely assessed formally at undergraduate level. This study aimed to assess the effect of teaching on the acquisition of otoscopic skill. Thirty-five medical students were assessed prospectively during their ENT attachments. Seventeen students were randomized to the standard course and 18 attended an additional seminar on otoscopy. Students' confidence was assessed for various aspects of otoscopy using a visual analogue scale, and clinical skill was assessed in examining four patients. Assessments took place at the beginning and end of the course. Students gained in their confidence and skill for all parameters, although the clinical ability to distinguish normal from abnormal tympanic membranes changed little from baseline levels. Extra teaching produced better gains in confidence (P less than 0.05) and skill (P less than 0.01) in identifying specific features of the tympanic membrane and eliminated errors of the 'false negative' variety. A minimal investment in teaching effort produces appreciable gains in students' otoscopic skills. This has implication for the planning of undergraduate ENT courses and vocational training for general practice.

Clinical Competence↗

PubMed2005

Scholarly teaching and scholarship of teaching: noting the difference.

Scholarly teaching and the scholarship of teaching are being discussed more frequently in the nursing education literature, yet a clear distinction between the two is often not made. In this paper we will identify the differences between the two and the role each plays in faculty evaluation. We argue that all faculty members should be scholarly teachers but not all will or should engage in the scholarship of teaching.

Education, Nursing↗

PubMed2006

Surgical and anesthesiological procedures and patients outcome in a major teaching hospital, in a major non-teaching hospital and in a minor hospital.

AIM: This study was carried out to evaluate the outcome of patients in different hospitals with the aim to plan future structural and management changes. METHODS: All the anaesthesiological and surgical procedures were observed for a 2 weeks period in a major teaching hospital (A), in a major nonteaching hospital (B) and in a minor nonteaching hospital (C) in all the patients requiring anaesthesia. The main and the co-existing diseases and the surgical and anaesthesiological treatments they received were evaluated to determine the outcome. The ASA class, the duration of the procedure, the length of staying in hospital, the transfusions of blood or derivatives, the adverse events for each patient were also observed. RESULTS: The results showed that the patients admitted to the teaching hospital were classified in higher ASA risk classes and had surgery of longer duration, with a higher ratio of major surgery. The outcome was satisfactory in all the 3 hospitals, with a 2 days length of stay respectively in 30% (A and B) and 50% (C) of the patients. The rate of mortality was low: only 3 patients in hospital A and no patient in B and C died in a period of 2 days following surgery. Hospitals B and C showed a large use of modern techniques such as autologous blood transfusion and central and peripheral anaesthetic blocks, with a better cost-benefit ratio than the major teaching hospital. CONCLUSIONS: This study showed good results, but it should be repeated in a few years in order to evaluate any change and possible improvement in the management and outcome of the patients.

Adult↗

PubMedDate not supplied

Audit of medical students' experiences of paediatric teaching: a tool to monitor and improve clinical teaching.

We provide clear aims and objectives for our students during their attachment in child health. To assess how well these are being met we reviewed their experience over the 3-year period 1991-1994. The audit was based on a questionnaire and was anonymous and voluntary; 45.4% of the students completed the questionnaire. These students' experiences were generally satisfactory and covered a wide variety of common childhood disorders. Of concern was that 32% of them received less than 1 hour per week of teaching in protected time and that they seemed reluctant to avail themselves of the opportunity of attending casualty; 54% did not visit the casualty department at all during their attachment. We have identified several areas where improvements in our teaching can be made and we are confident that our system of regular audit constitutes a valuable tool to monitor and improve clinical teaching.

Education, Medical↗

PubMed1997

[Medical teaching and humanistic-communicative aspects: two step-children of quality evaluation. An example of a compact teaching experiment with integrated final examination shows better results].

Evaluation of teaching regarding the humanitarian communicative aspect can not take place without controls. However, isolated controls without other evaluative measures are irrational instruments. This specially holds true for final exams. It seems important to use methods of evaluation which at the same time improve the quality and do not in the negative sense (like a final exam) knock out and disqualify (Tab. 2). We can give some examples out of daily routine which--alas--are very wide reaching. The humanitarian communicative factor, which is an integrative part of medicine very badly is strongly disregarded in favour of educating towards a mechanistic apparatschikway, namely in medical education, carrier, supervision of hospitals. We need strong good will for reformation! We do not only raise postulates here but can show an example of a teaching experiment, where students were put in small groups for intensive teaching with an integrated final exam. This was possible without more costs, but with more human engagement on the side of the teachers.

Altruism↗

PubMed2003

Consultation by the United Kingdom to South Africa to develop human diversity teaching.

This paper describes consultation provided by the University of Leicester to the Medical University of Southern Africa (Medunsa) funded through British Council and the Department for International Development to develop a course addressing issues of diversity at Medunsa. The aims of the link were essentially for Leicester to provide support and guidance on the development of aspecific module. This inevitably included the provision of training in key areas such as teaching skills and evaluation of teaching. This paper focuses on the potential difficulties of such a link, which included cultural differences, issues of hierarchy and student influence. The project outcomes have been the development of a coherent module on human diversity which is assessed in such a way as to support the development of student writing skills, increased staff teaching skills and a joint conference to disseminate the learning that has taken place from the project.

Consultants↗

PubMed1990

Content areas for cardiac teaching: patients' perceptions of the importance of teaching content after myocardial infarction.

This descriptive study was undertaken to investigate patients' perceptions of the seven content areas commonly included in cardiac teaching in terms of how important and how realistic they were for being learned following the experience of an acute myocardial infarction (MI). Lazarus's stress-coping theory was used as a framework for the study. A sample of 30 MI subjects were interviewed before discharge and during early convalescence. Before discharge, subjects rated six out of the seven content areas as "important" for learning. Although the information was considered important, it was not rated as equally realistic to learn. During early convalescence, mean scores under 'important to learn' were slightly lower, but all seven content areas were rated as significantly more realistic to be learned (P less than 0.05). Little variation in patients' perceptions of the importance of teaching content was noted over time. However, there was major variation between their perceptions of how important and how realistic it was to learn the material before discharge. Both dimensions, how important and how realistic, are therefore crucial to consider in cardiac teaching.

Adult↗