Simulated versus traditional therapeutic radiography placements: A randomised controlled trial

IntroductionClinical placements provide rich learning environments for health professional pre-registration education but add significant workload pressure to clinical departments. Advances in simulation approaches mean that many aspects of students’ clinical learning can be undertaken in the academic environment. There is, however, little data identifying specific pedagogical gains afforded by simulation compared to clinical placement. This study measured the impact of a comprehensive integrated simulation placement on student clinical skill acquisition.MethodsA virtual department was developed using a range of simulation equipment and software, with actors and service users providing a range of patients for students to engage with. A cohort of 29 first-year undergraduate therapeutic radiography students were randomly assigned to either simulated or conventional clinical placement. Clinical skills assessment scores provided by a blinded assessor were then compared.ResultsMean overall assessment scores for each cohort were within 3% of each other. The simulation cohort had over 10% higher “communication” scores than the traditional group (p = 0.028). The ability to gain both technical and interpersonal skills simultaneously improved learning compared to clinical placement. Students valued the structured approach of the simulated placement and the opportunity to practice techniques in a safe unpressured environment.ConclusionAn integrated simulated placement can help students to achieve clinical learning outcomes and lead to improved interpersonal skills.Implications for practiceUse of blended simulation resources can enable students to acquire technical, procedural and interpersonal skills which in turn may enable reduction of overall clinical placement time and departmental training burden.     

预约诊疗服务技术及实现方法综述

本文对目前医院开展的现场预约挂号、远程预约挂号具体的实现方式和采取的技术方法进行研究，分析阐述各种方式的优缺点、技术特点和实际开展应用的情况。     

英国药学教育制度对我国药学教育发展的启示

目的:探讨英国药学教育制度对我国药学教育发展的启示。方法:分析英国药学教育制度的成功之处及其缺点,提出对我国药学教育未来发展的建议。结果与结论:英国药学教育以培训药学硕士为主,其教学内容需遵从英国药物政务局的全国统一指示性药学教学大纲,教学及考试方式以案例教学法和临床能力测验为主,有效地规范了全国的药学教育,使课程的质量和学生能力达到较高水平。这些制度对我国药学教育有正面的参考价值,也有实施的可能性。     

Pre-registration house officers: What do they know about pain management?

Sixty-three new pre-registration house officers (PRHO) in two university teaching hospitals in the West of Scotland answered a two-part questionnaire developed by the investigators. This attempted to study how well they would manage specific acute pain situations and pain management related complications. A non-clinical section assessed their experiences with undergraduate teaching of acute pain management, their prescribing habits and interest in continuing education in pain related topics.Many of the doctors surveyed felt that their undergraduate training in acute pain was inadequate and turned to seniors, nurses and drug formularies for help. Most expressed an interest in learning a wider range of pain-related topics. The acute pain service (APS) and anaesthetists were underutilised. Less than 50% were aware of the availability of protocols for opioid administration, epidurals and patient controlled analgesia (PCA).There was a tendency to underestimate pain and hence to prescribe inadequate analgesia. In unambiguous scenarios, most doctors fared well, whilst responses to more complex scenarios were only satisfactory. In a scenario relating to opioid overdose, 36% were unsure how much naloxone to use. Too few considered getting senior help or attending to Airway, Breathing and Circulation (ABC). Many could not manage PCA.Undergraduate teaching in acute pain is receiving more emphasis. On the job seminars and continuing education in acute pain topics are beneficial. The results of our survey will be considered when planning training for future PRHOs in this region.     

Factors affecting the programme completion of pre-registration nursing students through a three year course: A retrospective cohort study

Students who leave pre-registration nurse education having failed to complete remain a concern for higher education institutions. This study identifed factors influencing completion using a retrospective cohort analysis to map student characteristics at entry against Year 3 completion data. The study was set in a nursing faculty in a higher education institution in northern England. Data were collected between 2009 and 2014 with five cohorts of students participating (n = 807).Multinomial logistic regression was used to model the dependent variable Progression Outcome with categories of; completion and non-completion (academic and non-academic reasons). Predictors included cohort, programme, branch, gender, age on entry, ethnic group, disability status, domicile, change of home postcode, change of term-time postcode, entry qualifications, previous experience of caring, and dependents.Age on Entry and Domicile or alternatively Dependents and Domicile emerged as statistically significant (p < 0.05) in the multivariable analysis. Older students were less likely to be lost from the programme, as were students who lived locally at all times and those with dependents.There is currently little reliable, consistent information on nursing student attrition, progression and completion. This study contributes to the evidence base by identifying some of the factors that may contribute to successful programme completion.     

Students' perceptions of practice assessment in the skills laboratory: An evaluation study of OSCAs with immediate feedback

Assessment of clinical skills is fundamental to undergraduate nursing programmes. However, enabling assessment to be a good learning experience as well is a challenge to nurse educators. The study presented here presents the change from using an objective structured clinical examination (OSCE) for summative assessment (with feedback given to students after results had gone to the examination board – 6 weeks after the OSCE) to one with immediate feedback. Because the previous OSCEs were universally disliked by students, for reasons that included absence of immediate feedback, in making this change the university re-branded the OSCE as an objective structured clinical assessment (OSCA) with immediate feedback provided to students. A survey was undertaken to measure student engagement with the OSCA, its value and impact, and its sustainability from the students’ perspectives. There is little in the literature about student engagement with OSCEs and sustainability. Findings show that the OSCA with immediate feedback was perceived positively by students, was valued with regard to a number of factors, had a positively impact on student learning and confidence and was felt to be a form of assessment that this university should continue to use.     

Pre‐registration education: making a difference to critical care?

This paper aims to discuss the development of a pre-registration high-dependency nursing programme and evaluate its effects on student's perceived learning and confidence in managing critically ill patients. The programme consists of two modules that compliment one another, 'Care of the Acutely III Adult' focuses on a variety of disease processes and subsequent nursing care. Whilst the second module titled 'Caring for the Highly Dependant/Critically III Adult' focuses on assessment skills related to critically ill patients. The paper explores the content and delivery of the modules including the advantages and disadvantages of implementing them. Student evaluation from 59 nursing students found that student's knowledge, assessment skills and management of the critically ill patient had improved since completing the modules. Nurse Consultants, intensive therapy unit matrons and Critical Care Outreach nurses have acknowledged an increase in the number of nursing students identifying and referring critically ill patients to outreach teams. They also stated improvements in nurse recruitment in critical care since commencement of the modules.