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Clinical supervisors' and students' perspectives on preparedness for veterinary workplace clinical training: An international study

Article Open Access
Background: The alignment of student and workplace supervisors’ perspectives on student preparedness for veterinary workplace clinical training (WCT) is unknown, yet misalignment could negatively impact workplace learning. The aim of this study was to quantify the relative importance of WCT preparedness characteristics according to students and supervisors and to identify differences. Methods: A survey was completed by 657 veterinary students and 244 clinical supervisors from 25 veterinary schools, from which rankings of the preparedness characteristics were derived. Significant rank differences were assessed using confidence intervals and permutation tests. Results: ‘Honesty, integrity and dependability’ was the most important characteristic according to both groups. The three characteristics with the largest rank differences were: students’ awareness of their own and others’ mental wellbeing and the importance of self-care; being willing to try new practical skills with support (students ranked both of these higher); and having a clinical reasoning framework for common problems (supervisors ranked higher). Limitations: Using pooled data from many schools means that the results are not necessarily representative of the perspectives at any one institution. Conclusion: There are both similarities and differences in the perspectives of students and supervisors regarding which characteristics are more important for WCT. This provides insights that can be used by educators, curriculum developers and admissions tutors to improve student preparedness for workplace learning. © 2023 The Authors. Veterinary Record published by John Wiley & Sons Ltd on behalf of British Veterinary Association.
Background: The alignment of student and workplace supervisors’ perspectives on student preparedness for veterinary workplace clinical training (WCT) is unknown, yet misalignment could negatively impact workplace learning. The aim of this study was to quantify the relative importance of WCT prepared …

An integrated practical placement programme for students with disability: A pilot study

Article
Supported work internship programmes for young adults with disability are an evidence-based model, leading to greater employment outcomes. This mixed methods pilot study evaluated the experiences of students, supervisors and a project coordinator, who participated in an Integrated Practical Placement (IPP) programme for students with disability in Australia. Intervention students (n = 10) completed 3, 9-week rotations, and accessed personal placement support and employment coaches. Comparison students (n = 38) completed 3, 2-week placements without additional support. Intervention students perceived significantly greater initial changes in work skills (p < 0.01) and work readiness (p < 0.05). Intervention students reported development of communication and self-organisational skills and stressed the value of staff support. Post programme 70% of intervention students gained employment, compared with 15.4% of comparison students. The findings suggest an evidence-based supported employment programme emphasising personalised assessment and training, could provide individuals with disability the required skills to enable successful employment. © The Author(s) 2022.
Supported work internship programmes for young adults with disability are an evidence-based model, leading to greater employment outcomes. This mixed methods pilot study evaluated the experiences of students, supervisors and a project coordinator, who participated in an Integrated Practical Placemen …

Employability in health professional education: a scoping review

Article Open Access
Background: The concept of employability can help educators understand the variability in the career outcome of graduates. Within the health professional education (HPE) literature, various conceptions of employability are used and implied. This review considers how the concept ‘employability’ is depicted and characterised in HPE literature. Methods: A scoping review was conducted. The authors searched Medline, Web of Science and Scopus databases for English language literature relevant to employability in HPE. Arksey and O'Malley’s review protocol and the criteria defined in the preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews Checklist (PRISMA-ScR) were used with methodological guidance provided by Levac et al. and Peters et al. with the exception of formal stakeholder consultation. Results: The search resulted in 158 articles, of which 34 articles were included in this review. Charting the included articles revealed that within the set of articles, there is much diversity in study design, geographical setting and health profession. Three conceptions of employability were identified: acquiring a professional job, sustaining employment and thriving in the workforce. Conclusion: Conceptions of employability in HPE are largely focused on listing skills and capabilities for entry into employment and sustaining a career. To address gaps in research, structural contributions to employability and institutional strategies to promote conditions for thriving in disruption should be explored. © 2022, The Author(s).
Background: The concept of employability can help educators understand the variability in the career outcome of graduates. Within the health professional education (HPE) literature, various conceptions of employability are used and implied. This review considers how the concept ‘employability’ is de …

Clinical decision-making and adaptive expertise in residency: a think-aloud study

Article Open Access
Clinical decision-making (CDM) is the ability to make clinical choices based on the knowledge and information available to the physician. It often refers to individual cognitive processes that becomes more dependent with the acquisition of experience and knowledge. Previous research has used dual-process theory to explain the cognitive processes involved in how physicians acquire experiences that help them develop CDM. However, less is known about how CDM is shaped by the physicians’ situated cognition in the clinical environment. This is especially challenging for novice physicians, as they need to be adaptive to compensate for the lack of experience. The adaptive expert framework has been used to explain how novice physicians learn, but it has not yet been explored, how adaptive expertise is linked to clinical decision-making amongst novice physicians. This study aimed to analyse how residents utilize and develop adaptive expert cognition in a natural setting. By describing cognitive processes through verbalization of thought processes, we sought to explore their CDM strategies considering the adaptive expert framework. We used concurrent and retrospective think-aloud interviews in a natural setting of an emergency department (ED) at a university hospital, to query residents about their reasoning during a patient encounter. We analysed data using protocol analysis to map cognitive strategies from these verbalizations. Subsequently in a narrative analysis, we compared these strategies with the literature on adaptive expertise. Fourteen interviews were audio recorded over the course for 17 h of observation. We coded 78 informational concepts and 46 cognitive processes. The narrative analysis demonstrated how epistemic distance was prevalent in the initial CDM process and self-regulating processes occurred during hypothesis testing. However, residents who too quickly moved on to hypothesis testing tended to have to redirect their hypothesis more often, and thus be more laborious in their CDM. Uncertainty affected physicians’ CDM when they did not reconcile their professional role with being allowed to be uncertain. This allowance is an important feature of orientation to new knowledge as it facilitates the evaluation of what the physician does not know. For the resident to learn to act as an adaptive decision-maker, she relied on contextual support. The professional role was crucial in decisional competency. This supports current literature, which argues that role clarification helps decisional competency. This study adds that promoting professional development by tolerating uncertainty may improve adaptive decisional competency. © 2023, The Author(s).
Clinical decision-making (CDM) is the ability to make clinical choices based on the knowledge and information available to the physician. It often refers to individual cognitive processes that becomes more dependent with the acquisition of experience and knowledge. Previous research has used dual-pr …

How to become an excellent pediatric resident: a qualitative comparative study from China

Article Open Access
Background: Competency-oriented medical education has become a global trend. However, most current studies focus on the independent effects of various competencies and lack an examination of the combined effects. Therefore, the purpose of this study was to explore the competency configurations of excellent pediatric residents and general pediatric residents and to provide a scientific reference for the talent training and career development of pediatric residents. Methods: Behavioral event interviews were conducted with 23 pediatric residents at a children's hospital in Beijing in July and August 2019. Two researchers coded the interview data to summarize the competency of pediatric residents. The research group scored the performance of 23 pediatric residents in various aspects of competency and used the crisp-set qualitative comparative analysis method to explore the competency configurations of excellent pediatric residents and general pediatric residents. Results: This study concludes that pediatric residents should have six core competencies: professional spirit, clinical skills, communication ability, learning ability, mental capacity and research ability. There are 4 combinations of competencies for becoming an excellent pediatric resident: the clinical type, scientific research type, all-around development type and high emotional intelligence type. In addition, there are 3 combinations of competencies for becoming a general pediatric resident: the comprehensive ability deficiency type, lack of professionalism and mental capacity type, lack of communication ability type. Conclusions: There are differences in competence between excellent and general pediatric residents. Excellent pediatric residents do not need to possess all competencies but should specialize in clinical practice, scientific research or communication skills. This study suggests that training in mental capacity, professional spirit and communication ability should be strengthened during pediatric resident training. Pediatric residents should make career development plans according to their actual situation, and hospitals should arrange suitable positions according to the characteristics of pediatric residents. © 2023, The Author(s).
Background: Competency-oriented medical education has become a global trend. However, most current studies focus on the independent effects of various competencies and lack an examination of the combined effects. Therefore, the purpose of this study was to explore the competency configurations of ex …

Perceived social support and professional identity in nursing students during the COVID-19 pandemic era: the mediating effects of self-efficacy and the moderating role of anxiety

Article Open Access
Background: Health professionals, including nurses, experienced heavy workloads and significant physical and mental health challenges during the coronavirus disease (COVID) 19 pandemic, which may affect career choices for those considering nursing and for nursing students. The COVID-19 pandemic is not only a period of risk, but also an occasion to redeploy the professional identity (PI) of nursing students. However, the relationship between perceived social support (PSS), self-efficacy (SE), PI and anxiety remains unclear under the background of COVID-19. This study aims to explore whether PSS has an indirect effect on PI through mediation of SE and whether the anxiety can moderate the relationship between PSS and SE in nursing students during their internship period. Methods: An observational, national cross-sectional study was conducted following the STROBE guidelines. An online questionnaire was completed by 2,457 nursing students from 24 provinces in China during their internship during September to October 2021. Measures included Chinese translations of the Professional Identity Questionnaire for Nursing Students, the Perceived Social Support Scale, the General Self-Efficacy Scale, the 7-item Generalized Anxiety disorder scale. Results: Both PSS (r = 0.46, p < 0.001) and SE (r = 0.51, p < 0.001) were positively correlated with PI. The indirect effect of PSS on PI through SE was positive (β = 0.348, p < 0.001), with an effect of 72.7%. The results of the moderating effect analysis showed that anxiety attenuated the effect of PSS on SE. Moderation models indicated that anxiety has a weak negative moderating effect on the effect of PSS on SE (β =—0.0308, p < 0.05). Conclusions: A better PSS and higher scores in SE were associated with PI in nursing students, and a better PSS had an indirect effect on the PI of nursing students through SE. Anxiety played a negative moderating role in the relationship between PSS and SE. © 2023, The Author(s).
Background: Health professionals, including nurses, experienced heavy workloads and significant physical and mental health challenges during the coronavirus disease (COVID) 19 pandemic, which may affect career choices for those considering nursing and for nursing students. The COVID-19 pandemic is n …

Preventing a Scarring Start into the Labor Market: Integration Strategies for Young Persons with Disabilities

Article Open Access
Purpose: Sociodemographic and structural conditions have consequences for the labor market participation of young persons with disabilities (YPWD) in vocational rehabilitation (VR). As the type of program determines the labor market chances, we analyze the processes of selecting active labor market programs (ALMP) in VR. Which factors determine the allocation to (1) programs in general and (2) moreover, the allocation to specific programs? Materials and methods: We conduct logistic (1) and multinomial regression (2) using register data of the German Federal Employment Agency. Besides variables on the micro level, we control for a wide range of structural and organizational influences. The sample comprises VR and employment biographies of 255,009 YPWD accepted to VR between 2010 and 2015. Program participation is restricted to start 180 days after VR acceptance. Results: Sociodemographic factors, like age and the status before entering VR as well as the local apprenticeship market as a structural condition, highly influence the general allocation to ALMP. For the allocation to specific ALMP, sociodemographics (age, education, type of disability, status before entering VR) are highly relevant. Furthermore, structural conditions (regional structure of subsidized vocational training and of the apprenticeship market as well as local work possibilities on a special labor market for PWD) and – to a lesser extent - re-organization processes at the FEA (NEO, VR cohort) are important determinants. Conclusion: (Automatic) paths into VR programs for especially persons with mental disabilities in sheltered workshop are clearly shown. Furthermore, it is somewhat questionable that YPWD participate more often in sheltered workshops in regions where sheltered work possibilities are more common, as well as where NEO was implemented locally; and participate more often in company-external vocational training where VR service providers are commissioned to a greater extent. © 2023, The Author(s).
Purpose: Sociodemographic and structural conditions have consequences for the labor market participation of young persons with disabilities (YPWD) in vocational rehabilitation (VR). As the type of program determines the labor market chances, we analyze the processes of selecting active labor market …

Learning styles of medical students and related factors

Article Open Access
Background: The concept of learning style is quite important for teachers to teach, organize students’ learning experiences, and accomplish educational goals. Motivation is one of the most important psychological concepts in education. Motivation is multidimensional and ranges from amotivation to extrinsic motivation and intrinsic motivation. When students are motivated extrinsically, they enjoy striving toward rewards and goals which may differ from individual goals. Intrinsically motivated students enjoy exploring, learning, and curiosity-oriented academic efforts. Understanding learning styles can make it easier to create, modify, and develop more efficient curriculum and educational programs. It can also encourage students’ participation in these programs and motivate them to gain professional knowledge This study aims to determine the learning styles of medical school students and to evaluate whether there is a relationship between their learning styles and academic motivation and the sociodemographic variables. Methods: In this study a questionnaire containing socio-demographic factors, Grasha-Reichmann Learning Styles Scale, Academic Motivation Scale was filled out by 1st, 2nd, 3rd, 4th, and 5th -year medical students of the 2019–2020 academic year. Frequency, percentage, mean, ANOVA, Pearson correlation analysis, and independent group t-test (for analyzing data with normal distribution) were applied. Mann Whitney U test, Kruskal Wallis test, and Spearman correlation analysis were used for analyzing data without normal distribution. Results: We found that the mean of independent learning was the highest among the learning style dimensions, and the mean of the intrinsic motivation to know (IMKN) was the highest among the academic motivation dimensions. We found that there were significant relationships between independent learning and intrinsic motivation (IM), between avoidant learning and extrinsic motivation (EM) and between collaborative learning and IMKN, IM to accomplish things (IMAT) and IM to experience stimulation (IMES). Conclusion: We think that different teaching methods can be applied to strengthen collaborative learning, participant learning, and intrinsic motivation. We hope that this research will contribute to medical education on the subject of establishing appropriate teaching methods. Teachers have to plan and implement activities based on students’ learning styles and academic motivation to encourage students to effectively participate in the classroom. © 2023, The Author(s).
Background: The concept of learning style is quite important for teachers to teach, organize students’ learning experiences, and accomplish educational goals. Motivation is one of the most important psychological concepts in education. Motivation is multidimensional and ranges from amotivation to ex …

The reliability and validity of the training elements scale for clinicians in the new era——based on the perspective of Chinese doctors’ job demands

Article Open Access
Objective: The purpose of this study was to develop a scale of clinician training elements in the new period and test its reliability and validity. Methods: Our approach was based on interdisciplinary theory, systematology, collaborative innovation theory, and whole person education theory combined with the existing post competency model of Chinese doctors and the responsibilities and requirements endowed clinicians in the new historical period. The scale elements were extracted by referring to the relevant literature, and the training elements scale for clinicians in the new period were preliminarily formed. From July to August 2022, 1,086 clinicians from tertiary medical institutions in eastern, central, and western China were sampled and investigated. The questionnaire was revised via the critical ratio method and homogeneity test method, and the reliability and validity of the scale were also tested. Results: The training elements scale for clinicians in the new period included the following eight dimensions: basic clinical knowledge, interdisciplinary knowledge, clinical skill operation, public health knowledge, technological innovation capability, lifelong learning needs, medical humanistic literacy, and international exchange vision, as well as 51 other items. The Cronbach’s α coefficient of the scale was 0.981, the half-reliability was 0.903, and the average variance extraction of each dimension was greater than 0.5. An exploratory factor analysis extracted eight main factors, and the cumulative variance contribution rate was 78.524%. Confirmatory factor analysis showed that the model fit was ideal and the factor structure was stable. Conclusion: The clinician training factor scale in the new era can fully meet the current training needs of r clinicians, and has good reliability and validity. It can be widely used in medical colleges and universities as a reference to reform the content of medical training and education, and can also be used in the continuing education of clinicians after graduation to compensate for gaps in knowledge during clinical work. © 2023, The Author(s).
Objective: The purpose of this study was to develop a scale of clinician training elements in the new period and test its reliability and validity. Methods: Our approach was based on interdisciplinary theory, systematology, collaborative innovation theory, and whole person education theory combined …

Challenges to acquire similar learning outcomes across four parallel thematic learning communities in a medical undergraduate curriculum

Article Open Access
Background: To train physicians who are able to meet the evolving requirements from health care, the University of Groningen Medical Center adopted in 2014 a new curriculum named G2020. This curriculum combines thematic learning communities with competency-based medical education and Problem-based learning. In the learning community program, different learning tasks were used to train general competencies. The challenge of this program was whether students acquire similar levels of learning outcomes within the different variations of the program. Method: We used the assessment results of three cohorts for the first two bachelor years. We used progress tests and written tests to analyze knowledge development, and the assessment results of seven competencies to analyze competence development. Concerning knowledge, we used the cumulative deviation method to compare progress tests and used the Kruskal–Wallis H test to compare written test scores between programs. Descriptive statistics are used to present all assessments of the students’ competencies. Results: We observed similarly high passing rates both for competency and knowledge assessments in all programs. However, we did observe some differences. The two programs that focused more on competencies development underperformed the other two programs on knowledge assessment but outperformed on competencies assessment. Conclusion: This study indicates that it is possible to train students in different learning programs within one curriculum while having similar learning outcomes. There are however some differences in obtained levels between the different programs. The new curriculum still needs to improve by balancing variations in the programs and comparability of assessments across the programs. © 2023, The Author(s).
Background: To train physicians who are able to meet the evolving requirements from health care, the University of Groningen Medical Center adopted in 2014 a new curriculum named G2020. This curriculum combines thematic learning communities with competency-based medical education and Problem-based l …