Search results

Suicide is a major cause of preventable mortality and primary healthcare professionals, including pharmacists, require appropriate training to communicate with and support people at risk of suicide. Mental Health First Aid (MHFA) training teaches participants how to communicate with and support people experiencing suicidal thoughts. The purpose of this paper is to use a novel MHFA assessment approach involving simulated role-plays enacted by people with a lived experience of mental illness and explore MHFA participants’ and simulated patients’ views of participating in simulated role-plays of mental health crises.

MHFA is embedded into the Sydney School of Pharmacy curriculum. Post-MHFA training, pharmacy students were randomly allocated to participate in or observe a simulated role-play of one of three suicide crisis scenarios, with a person with a lived experience of mental illness. Two purpose-designed, semi-structured interview guides were used to conduct student focus groups and interviews with simulated patients to explore their views. Focus groups and interviews were digitally recorded, transcribed verbatim and thematically content analysed using a constant comparison approach.

In total, 22 pharmacy students participated in two focus groups and three simulated patients participated in interviews. Five themes emerged including: the benefits of participating; the value of having a lived experience; challenges with suicide assessment; communication; and the value of immediate feedback and debrief.

Students and simulated patients both benefited from participating in the role-plays. Students valued practicing their MHFA skills post-training with simulated patients with lived experiences. This unique approach to post-training assessment provides an opportunity to practice skills realistically and authentically, in a safe, learning environment.

The aim of the study was to explore aspects of learning in terms of gain in knowledge, confidence and empathy with immersive virtual reality (VR) from the patient perspective in undergraduate nursing students.

A pilot study integrating immersive VR experiences during clinical courses was facilitated based on the INACSL (2016) standards for simulation practices with a convenience sample of 165 nursing students in three levels of cohorts, using two different VR scenario simulations. Quantitative and qualitative data were collected through pre- and post-surveys.

Student participants embodied patients with chronic disease using immersive VR. Findings showed substantial gains in most measures of knowledge, confidence and empathy, with slightly less difference seen in lower level nursing students particularly with empathy and understanding.

Embodiment through immersive VR scenarios was shown to increase learner development. The positive findings from the pilot study justified continuance of integration of immersive VR in nursing education, recommending further use and research.

Simulated learning for nursing has known benefits on knowledge and understanding. Immersive VR is gaining recognition within nursing education as a method to enhance cognitive and affective knowledge. This paper hopes to add insights on the impact of immersive VR for student learning and encourage discussion about the future for innovative immersive teaching and learning approaches for experiential learning.

This study aims to compare Finnish medical students' perceptions of the suitability of three experiential methods in learning interpersonal communication competence (ICC). The three methods it seeks to explore are: theatre in education; simulated patient interview with amateur actors; and role‐play with peers. The methods were introduced in a pilot course of speech communication.

Students (n=132) were randomly assigned to three groups. The data were collected via questionnaire and focus group interviews, and analysed using qualitative content analysis and cross‐case analysis.

Most of the medical students thought these methods were suitable or very suitable for learning ICC. The methods had five similar elements: the doctor's role, the patient's role, reflective participation, emotional reactions and teachers' actions. Being in a doctor's role, realistic scripts and patient‐roles, observing the interaction and reflection in small groups were the most helpful elements in these methods.

The results of this study show that simulated patient interview with amateur actors, role‐play with peers, and TIE are very suitable methods for practising professionally relevant ICC in the context of doctor‐patient encounters from the medical students' perspective.

The changing clinical landscape in psychiatry, both before and after the pandemic, has impacted students’ direct contact with psychiatric patients. It is imperative, therefore, that medical education keeps pace with evolving clinical pathways to ensure that clinicians are always appropriately trained not just for common presentations but also for low-prevalence, high-risk situations. Simulated-based training is well established. However, it is not without its limitations, many of which could be overcome with the use of virtual simulation. This study aims to analyse the use of virtual simulation within medical education to train clinicians in psychiatric assessments.

A scoping review was undertaken with a comprehensive literature search of the six most relevant online peer-reviewed databases, including PubMed, PsycINFO, CINAHL, Medline, EMBASE and Cochrane. All published papers in English that discussed simulation in teaching psychiatric assessments were included.

Virtual patients can be used for educational, diagnostic and therapy purposes attributable to advances in speech-recognition technology. Virtual simulations are well received and positively affect clinicians’ knowledge and skill development. Educational faculties should consider using virtual simulation technologies to improve learning outcomes. Further studies should enhance the fidelity and quality of virtual assessment simulation situations, mainly focusing on the virtual patient’s empathy, gesturing and body language to enable this evidence-based tool to be used effectively and efficiently for the benefit of future patient care.

The changing clinical landscape in psychiatry, both before and after the pandemic, has impacted students’ direct contact with psychiatric patients. This scoping review has reviewed the use of virtual simulation-based education to train clinicians for psychiatric assessments. To the best of the authors’ knowledge, this work has not been conducted before.

Two different systems for streaming patients were considered to improve efficiency measures such as waiting times (WTs) and length of stay (LOS) for a current emergency department (ED). A typical fast track area (FTA) and a fast track with a wait time threshold (FTW) were designed and compared effectiveness measures from the perspective of total opportunity cost of all patients’ WTs in the ED. The paper aims to discuss these issues.

This retrospective case study used computerized ED patient arrival to discharge time logs (between July 1, 2009 and June 30, 2010) to build computer simulation models for the FTA and fast track with wait time threshold systems. Various wait time thresholds were applied to stream different acuity-level patients. National average wait time for each acuity level was considered as a threshold to stream patients.

The fast track with a wait time threshold (FTW) showed a statistically significant shorter total wait time than the current system or a typical FTA system. The patient streaming management would improve the service quality of the ED as well as patients’ opportunity costs by reducing the total LOS in the ED.

The results of this study were based on computer simulation models with some assumptions such as no transfer times between processes, an arrival distribution of patients, and no deviation of flow pattern.

When the streaming of patient flow can be managed based on the wait time before being seen by a physician, it is possible for patients to see a physician within a tolerable wait time, which would result in less crowded in the ED.

A new streaming scheme of patients’ flow may improve the performance of fast track system.

The purpose of this paper is to use Lean Six Sigma (LSS) to reduce patient waiting time in a Kuwaiti private hospital obstetrics and gynaecology clinic.

The define, measure, analyse, improve and control methodology was used. The “define” stage involved identifying patients’ needs, system capabilities and project objectives. The “measure” stage assessed the system’s current state through data collection on waiting times. Dunnett’s test, control charts and process capability analysis were used to ensure data accuracy. In the “analyse” stage, an Ishikawa diagram and Pareto chart were constructed, showing that overbooking appointments, doctors’ unscheduled breaks and doctors not arriving on time were the root causes of the problem. The “improve” stage used an Arena simulation model to represent current and improved system status. The proposed solutions were implemented and monitored in the “control” stage.

A sigma-level improvement of 300 per cent (0.5–2.0) was realized for appointment patients on Saturdays, with a 67 per cent reduction in waiting time. For walk-ins, the sigma level improved by 288 per cent (0.8–3.1), with a 55 per cent reduction in waiting time. For weekday appointments, the sigma level improved by 111 per cent (0.9–1.9), with a 63 per cent reduction in waiting time. For walk-ins, the sigma level improved by 69 per cent (1.6–2.7), with a 46 per cent reduction in waiting time. A cost–benefit analysis estimated the present project value at $656,459, leading to a total of $5,820,319 in savings by 2025.

This paper fulfils the need for process improvement, increasing patients’ satisfaction and hospitals’ profitability using LSS.

The purpose of this study is to gain insight into the interaction-sensitive skills medical practitioners enact as they manage multiple organizational factors in the context of discharging patients.

For that purpose, we carried out a cognitive ethnographic study in a Danish hospital, where we video-recorded three pre-ward round meetings, five discharge conversations and conducted seven semi-structured interviews. Fieldnotes and interview transcripts were analyzed using the method Cognitive Task Analysis, and video-recordings were analyzed via the interactivity-based approach Cognitive Event Analysis.

Our findings show that practitioners coordinate multi-scalar resources (e.g. verbal patterns and cognitive artifacts) in order to discharge patients in a safe and integrated way, which we propose amounts to the social and intercorporeal ability to align simultaneously emerging factors, like organizational procedures in the hospital, artifacts in use, sociocultural resources and the individual medical expertise of the practitioner in the emerging social interaction with the patient. In pursing this claim, we investigate the linguistic and cognitive processes emerging in a single case study of a nurse who discharges a patient. We propose that the interaction-sensitive skill which enables the nurse to solve the task of discharging the patient can be characterized via hybrid cognition.

Thus, the value of the article is dual: On the one hand, it empirically contributes with knowledge of the complex organizational structures that constrains micro-level medical interactions in discharges, and on the other, the article contributes theoretically with a hybrid cognitive framework that allows organizational researchers to understand and assess complex cognitive and linguistic processes that goes into the social micro-coordination in complex organizational-medical task.

Interprofessional education (IPE) is a method to create an environment that fosters interprofessional communication, understanding the roles and responsibilities of each profession, learning the skills to organize and communicate information for patients, families and members of the health care team. Providing IPE to health professional students can prepare them in the workforce to have the necessary skills to function in a collaborative practice ready environment. The purpose of this paper is to demonstrate the methods used in developing IPE curriculum, faculty training as debriefers/facilitators, identify learning objectives and outcomes.

The faculty and student surveys utilized a Likert scale. Learning objectives for the student survey assessed learning objective including communication of roles and responsibilities, communication and organization of information, engagement of other health professions (HP) in shared patient-centered problem solving, interprofessional assessment of patient status, and preparation of patients from transition of care to home. The faculty survey assessed faculty experience levels in IPE, role as facilitator/debriefer, and future needs for sustainability of the program.

Student evaluation of IPE simulation experience revealed students believed they improved their interprofessional communication skills and had a better understanding of health professional roles and responsibilities. Faculty feedback indicated that HP students achieved learning objectives and their continued commitment to IPE however additional training and development were identified as areas of need.

This paper can assist other educational institutions in developing IPE and structuring IPE assessment particularly in the HPs.

The public health care will be impacted positively by having health care providers specifically trained to work in teams and understand collaborative care. Student graduates in the HPs will be better prepared to function as a team in real clinical care following their participation in interprofessional simulation.

This interprofessional simulation curriculum involves student learners from eight different HPs and participation of over 30 faculty from differing professions. This curriculum is unique in its bread and depth of collaboration and true teamwork across disciplines.

This article describes the experiences of a librarian in a tutor/facilitator role immersed within a mainstream problem‐based learning (PBL) curriculum at the University of New Mexico School of Medicine. The role of tutor might be a suitable non‐traditional role for librarians. Tutoring turns out to be an entirely different role from traditional teaching. This tutor role requires practicing reciprocity, patience and commitment. This role has provided a profound understanding of the curriculum as it relates to library and informatics services, earned respect from non‐librarians, and prompted one to re‐think the integrated model of library instruction. Librarians willing to meet the challenges of tutoring can succeed in this non‐traditional role with the many associated benefits.

Drawing on positioning theory, the purpose of this paper is to characterize the activities and positions of students and supervisors at workplaces and on-campus skills training sites across the higher health professional educations of medicine, sports science, and nursing. Furthermore, the study explored the impact of work-based learning (WBL) and skills training on students’ personal professional identity development.

A qualitative case study was conducted across six workplace sites and three on-campus skills training sites with 20 days of observation and 21 in-depth interviews. The data were inductively analyzed resulting in the identification of 12 characteristic narratives. This was followed by abductive analysis using Harré’s concept of positioning as the theoretical framework.

Across the three higher health professional educations, work-based and on-campus skills training sites were characterized by two learning spaces with distinct positions, rights, and duties. The WBL sites gave the students rich opportunities to position themselves, act independently, and behave as professionals seriously striving for mastery. On the on-campus sites, the students behaved less seriously, and were conscious of their rights to try out things, get support, and have fun.

The authors recommend that future studies explore aspects of professional identity formation due to its consequences for curriculum design, including the distribution of simulated spaces and professional spaces in students’ learning environments.

This study adds to the empirical evidence and conceptual frameworks of personal and shared professional identity development in the field of skills and WBL, and it underlines the ongoing value of Harré’s positioning theory in educational research.