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1 – 10 of 251Gertrude Mwalabu, Annie Msosa, Ingrid Tjoflåt, Kristin Hjorthaug Urstad, Bodil Bø, Christina Furskog Risa, Masauko Msiska and Patrick Mapulanga
The purpose of this study was to explore the clinical readiness of simulation-based education (SBE) in preparing nursing and midwifery students for clinical practice in…
Abstract
Purpose
The purpose of this study was to explore the clinical readiness of simulation-based education (SBE) in preparing nursing and midwifery students for clinical practice in sub-Saharan Africa. This study has synthesised the findings from existing research studies and provides an overview of the current state of SBE in nursing and midwifery programs in the region.
Design/methodology/approach
A qualitative meta-synthesis of previous studies was conducted using the following steps: developing a review question, developing and a search strategy, extracting and meta-synthesis of the themes from the literature and meta-synthesis of themes. Five databases were searched for from existing English literature (PubMed, Cumulative Index for Nursing and Allied Health Professional Literature [CINAHL], PsycINFO, EMBASE and ScienceDirect Medline, CINAHL and Science Direct), including grey literature on the subject. Eight qualitative studies conducted in sub-Saharan Africa between 2014 and 2022 were included. Hawker et al.'s framework was used to assess quality.
Findings
The following themes emerged from the literature. Theme 1: Improved skills and competencies through realism and repetition. Theme 2: Improved skills and competencies through realism and repetition. Theme 3: Improved learning through debriefing and reflection. Theme 4: Constraints of simulation as a pedagogical teaching strategy.
Research limitations/implications
The qualitative meta-synthesis intended to cover articles from 2012 to 2022. Between 2012 and 2013, the authors could not identify purely qualitative studies from sub-Saharan Africa. The studies identified were either mixed methods or purely quantitative. This constitutes a study limitation.
Practical implications
Findings emphasise educator training in SBE. Comprehensive multidisciplinary training, complemented by expertise and planned debriefing sessions, serves as a catalyst for fostering reflective learning. Well-equipped simulation infrastructure is essential in preparing students for their professional competencies for optimal patient outcomes. Additional research is imperative to improve the implementation of SBE in sub-Saharan Africa.
Originality/value
The originality and value of SBE in nursing and midwifery programs in sub-Saharan Africa lie in its contextual relevance, adaptation to resource constraints, innovative teaching methodologies, provision of a safe learning environment, promotion of interprofessional collaboration and potential for research and evidence generation. These factors contribute to advancing nursing and midwifery education and improving healthcare outcomes in the region. This study fills this gap in the literature.
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Oscar Y. Moreno Rocha, Paula Pinto, Maria C. Consuegra, Sebastian Cifuentes and Jorge H. Ulloa
This study aims to facilitate access to vascular disease screening for low-income individuals living in remote and conflict areas based on the results of a pilot trial in…
Abstract
Purpose
This study aims to facilitate access to vascular disease screening for low-income individuals living in remote and conflict areas based on the results of a pilot trial in Colombia. Also, to increase the amount of diagnosis training of vascular surgery (VS) in civilians.
Design/methodology/approach
The operation method includes five stages: strategy development and adjustment; translation of the strategy into a real-world setting; operation logistics planning; strategy analysis and adoption. The operation plan worked efficiently in this study’s sample. It demonstrated high sensibility, efficiency and safety in a real-world setting.
Findings
The authors developed and implemented a flow model operating plan for screening vascular pathologies in low-income patients pro bono without proper access to vascular health care. A total of 140 patients from rural areas in Colombia were recruited to a controlled screening session where they underwent serial noninvasive ultrasound assessments conducted by health professionals of different training stages in VS.
Research limitations/implications
The plan was designed to be implemented in remote, conflict areas with limited access to VS care. Vascular injuries are critically important and common among civilians and military forces in regions with active armed conflicts. As this strategy can be modified and adapted to different medical specialties and geographic areas, the authors recommend checking the related legislation and legal aspects of the intended areas where we will implement this tool.
Practical implications
Different sub-specialties can implement the described method to be translated into significant areas of medicine, as the authors can adjust the deployment and execution for the assessment in peripheral areas, conflict zones and other public health crises that require a faster response. This is necessary, as the amount of training to which VS trainees are exposed is low. A simulated exercise offers a novel opportunity to enhance their current diagnostic skills using ultrasound in a controlled environment.
Social implications
Evaluating and assessing patients with limited access to vascular medicine and other specialties can decrease the burden of vascular disease and related complications and increase the number of treatments available for remote communities.
Originality/value
It is essential to assess the most significant number of patients and treat them according to their triage designation. This management is similar to assessment in remote areas without access to a proper VS consult. The authors were able to determine, classify and redirect to therapeutic interventions the patients with positive findings in remote areas with a fast deployment methodology in VS.
Plain language summary
Access to health care is limited due to multiple barriers and the assessment and response, especially in peripheral areas that require a highly skilled team of medical professionals and related equipment. The authors tested a novel mobile assessment tool for remote and conflict areas in a rural zone of Colombia.
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Amruta Rout, Golak Bihari Mahanta, Bibhuti Bhusan Biswal, Renin Francy T., Sri Vardhan Raj and Deepak B.B.V.L.
The purpose of this study is to plan and develop a cost-effective health-care robot for assisting and observing the patients in an accurate and effective way during pandemic…
Abstract
Purpose
The purpose of this study is to plan and develop a cost-effective health-care robot for assisting and observing the patients in an accurate and effective way during pandemic situation like COVID-19. The purposed research work can help in better management of pandemic situations in rural areas as well as developing countries where medical facility is not easily available.
Design/methodology/approach
It becomes very difficult for the medical staff to have a continuous check on patient’s condition in terms of symptoms and critical parameters during pandemic situations. For dealing with these situations, a service mobile robot with multiple sensors for measuring patients bodily indicators has been proposed and the prototype for the same has been developed that can monitor and aid the patient using the robotic arm. The fuzzy controller has also been incorporated with the mobile robot through which decisions on patient monitoring can be taken automatically. Mamdani implication method has been utilized for formulating mathematical expression of M number of “if and then condition based rules” with defined input Xj (j = 1, 2, ………. s), and output yi. The inputs and output variables are formed by the membership functions µAij(xj) and µCi(yi) to execute the Fuzzy Inference System controller. Here, Aij and Ci are the developed fuzzy sets.
Findings
The fuzzy-based prediction model has been tested with the output of medicines for the initial 27 runs and was validated by the correlation of predicted and actual values. The correlation coefficient has been found to be 0.989 with a mean square error value of 0.000174, signifying a strong relationship between the predicted values and the actual values. The proposed research work can handle multiple tasks like online consulting, continuous patient condition monitoring in general wards and ICUs, telemedicine services, hospital waste disposal and providing service to patients at regular time intervals.
Originality/value
The novelty of the proposed research work lies in the integration of artificial intelligence techniques like fuzzy logic with the multi-sensor-based service robot for easy decision-making and continuous patient monitoring in hospitals in rural areas and to reduce the work stress on medical staff during pandemic situation.
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Yew Kong Lee, Ping Yein Lee, Yee Ling Lau, Chirk Jenn Ng, Wei Leik Ng, Thiam Kian Chiew, Adina Abdullah, Jamuna Vadivelu, Amirah Amir, Christina Phoay Lay Tan and Caroline Kwong Leng Chin
This study aimed to evaluate the effectiveness of using a virtual patient (VP) software program in increasing clinical reasoning skills confidence among medical students.
Abstract
Purpose
This study aimed to evaluate the effectiveness of using a virtual patient (VP) software program in increasing clinical reasoning skills confidence among medical students.
Design/methodology/approach
A quasi-experimental design was used to compare the outcomes of students’ confidence levels on clinical reasoning between problem-based learning (PBL) and VP program with 122 pre-clinical Year 2 medical students. History taking, physical examination, clinical investigations and diagnosis was investigated using four PBL cases in the oncology block. Pre- and post-differences in mean confidence scores between the arms were compared, as well as mean difference by type of case and skill category.
Findings
A total of 122/156 (78.2%) students participated; n = 55 were from 7 VP groups and n = 67 were from 13 control arm groups. For the primary outcome, the VP arm showed a statistically significant increase in confidence measures among 11/16 (4 cases × 4 skills) categories, compared to 4/16 for the control arm. The proportion of the students who indicated an improved confidence was statistically significant for the cervical cancer case for physical examination (60.0% improved in VP vs 12.5% in control), investigation (60.0% VP vs 18.8% control) and diagnosis (60.0% in VP vs 25.0% in control). Finally, analysis by case showed an increment in overall mean scores from the start to end of the case within the VP arm while the pattern was erratic in the control arm cases.
Originality/value
The study results showed that incorporating the VP into PBL was more effective in increasing students’ clinical reasoning confidence levels compared to the usual PBL. As the study utilized existing PBL cases, it demonstrates how medical schools can incorporate digital VP tools into pre-clinical years before students' transition to learning from actual patients in the clinical years.
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Tillmann Boehme, Brogan Rylands, Joshua Poh Fan, Sharon Williams and Eric Deakins
This study investigates how a hospital can increase the flow of patients through its emergency department by using benchmarking and process improvement techniques borrowed from…
Abstract
Purpose
This study investigates how a hospital can increase the flow of patients through its emergency department by using benchmarking and process improvement techniques borrowed from the manufacturing sector.
Design/methodology/approach
An in-depth case study of an Australasian public hospital utilises rigorous, multi-method data collection procedures with systems thinking to benchmark an emergency department (ED) value stream and identify the performance inhibitors.
Findings
High levels of value stream uncertainty result from inefficient processes and weak controls. Reduced patient flow arises from senior management’s commitment to simplistic government targets, clinical staff that lack basic operations management skills, and fragmented information systems. High junior/senior staff ratios aggravate the lack of inter-functional integration and poor use of time and material resources, increasing the risk of a critical patient incident.
Research limitations/implications
This research is limited to a single case; hence, further research should assess value stream maturity and associated performance enablers and inhibitors in other emergency departments experiencing patient flow delays.
Practical implications
This study illustrates how hospital managers can use systems thinking and a context-free performance benchmarking measure to identify needed interventions and transferable best practices for achieving seamless patient flow.
Originality/value
This study is the first to operationalise the theoretical concept of the seamless healthcare system to acute care as defined by Parnaby and Towill (2008). It is also the first to use the uncertainty circle model in an Australasian public healthcare setting to objectively benchmark an emergency department's value stream maturity.
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Haifa Mohammad Algahtani, Haitham Jahrami and Mariwan Husni
The COVID-19 pandemic has had a significant impact on medical education and training, with many medical schools and training programs having to adapt to remote or online learning…
Abstract
Purpose
The COVID-19 pandemic has had a significant impact on medical education and training, with many medical schools and training programs having to adapt to remote or online learning, social distancing measures and other challenges. This paper aimed to examine the disruption for clinical training, as it has reduced the opportunities for students and trainees to gain hands-on experience and interact with patients in person.
Design/methodology/approach
The ethnographic qualitative research design was chosen as the research methodology. Using Gibbs' reflective cycle, the researcher explored the psychiatry clerks' (final-year medical students) reflections on the disruption of their clinical training during the COVID-19 pandemic.
Findings
The findings demonstrated that the students had a significant psychological impact on their coping capacities as the crisis progressed from shock and depression to resilience. The students being the key stakeholders provided a concrete foundation for the development of a framework for improving practices during uncertain times.
Originality/value
Students' reflections provided valuable insight into the pandemic’s impact on their psychosocial lives with uncertainty and incapacity to cope up with changing stressful dynamics. The results will assist in planning how to best support medical students' well-being during interruptions of their educational process brought about by similar future crises.
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Craig Brown, Mintu Nath, Wendy Watson and Mary Joan Macleod
The OSCE is regarded as the gold standard of competence assessment in many healthcare programs, however, there are numerous internal and external sources of variation contributing…
Abstract
Purpose
The OSCE is regarded as the gold standard of competence assessment in many healthcare programs, however, there are numerous internal and external sources of variation contributing to checklist marks. There is concern amongst organisers that candidates may be unfairly disadvantaged if they follow an “excellent” preceding candidate. This study assessed if average checklist scores differed depending on who a candidate follows accounted for different sources of variation.
Design/methodology/approach
This study examined assessment data from final year MBChB OSCEs at the University of Aberdeen and categorised candidates into three levels dependent on examiner awarded global scores of preceding candidates for each station. Data were modelled using a linear mixed model incorporating fixed and random effects.
Findings
A total of 349 candidates sat the OSCEs. The predicted mean (95% CI) score for students following an “excellent” candidate was 21.6 (20.6, 22.6), followed “others” was 21.5 (20.5, 22.4) and followed an “unsatisfactory” student was 22.2 (21.1, 23.3). When accounted for individual, examiner and station levels variabilities, students following an “excellent” candidate did not have different mean scores compared to those who followed “other” (p = 0.829) or “unsatisfactory” candidates (p = 0.162), however, students who followed an “unsatisfactory” student scored slightly higher on average compared to those who followed “other” (p = 0.038).
Originality/value
There was weak evidence that candidate's checklist variations could be attributed to who they followed, particularly those following unsatisfactory students; the difference in predicted mean scores may be of little practical relevance. Further studies with multiple centres may be warranted assuring perceived fairness of the OSCE to candidates and educators.
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Aderonke Oyetunji, Kailee Bunte and Val Bellman
This paper aims to illuminate the issue of workplace violence (WPV) against psychiatry residents. Workplace violence is known to negatively impact physical and emotional…
Abstract
Purpose
This paper aims to illuminate the issue of workplace violence (WPV) against psychiatry residents. Workplace violence is known to negatively impact physical and emotional well-being, professional development and the quality of the care that mental health professionals provide to patients. The authors discuss the prevalence of, risk factors for and consequences of WPV against psychiatry residents, as well as the need for support and resources to help residents cope with the emotional challenges of their job.
Design/methodology/approach
This paper is a review of the literature on WPV against psychiatry residents, and includes studies on its prevalence, associated risk factors and consequences.
Findings
Psychiatry residents face a heightened risk of WPV, including physical and verbal attacks, which can harm their mental and physical health and disrupt their continuity of care. Factors that contribute to WPV against psychiatry residents include exposure to aggressive or violent behaviors, inadequate training in WPV, understaffing, the stigmatization of mental illnesses, and discriminatory treatment. Furthermore, psychiatry residents who encounter WPV may develop negative emotions and attitudes toward their patients, which can compromise the care they provide.
Research limitations/implications
The inherent heterogeneity of study designs highlighted in this review could hinder the establishment of definitive conclusions about the impact of workplace violence on psychiatry residents. A focus on studies published in English may inadvertently exclude relevant literature in other languages, potentially limiting the comprehensiveness of study findings.
Originality/value
This paper highlights resident physicians’ personal experiences with and perceptions of WPV encountered during residency training. In response, potential solutions are proposed to address WPV, including increased support for resident physicians, mandatory reporting of WPV incidents, and a cultural shift toward zero tolerance for WPV. In addition, the paper raises awareness of the limited research on this topic and the importance of further investigation.
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Omaima Hajjami and Sunyoung Park
The purpose of this study is to explore the potential contribution of the metaverse to improve training and development as a function of human resource development (HRD…
Abstract
Purpose
The purpose of this study is to explore the potential contribution of the metaverse to improve training and development as a function of human resource development (HRD) perspective. The authors explore the benefits and challenges of the metaverse and introduce cases of companies using the metaverse in training.
Design/methodology/approach
A narrative literature review was conducted to collect information on the metaverse in training. The authors reviewed peer- and non-peer-reviewed articles, book chapters, white papers, corporate websites and blogs and business magazines.
Findings
A total of 75 articles were reviewed, including 14 cases, which were summarized to demonstrate how companies are applying metaverse technology in training contexts. For a more in-depth review, three cases were selected and summarized in terms of context, process and outcomes.
Originality/value
The metaverse is an emergent topic in HRD. It has the potential to revolutionize the functions of training and development through the combination of advanced technologies, including virtual reality, augmented reality and mixed reality. This article is the foundational attempt to provide a comprehensive summary of existing literature and case studies that highlight the potential of the metaverse in training within the context of HRD.
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