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Issue: Health professions education (HPE) is intimately linked with teaching and learning in the clinical environment. While the value of authentic clinical experiences is acknowledged, whether learning actually occurs is to a large extent dependent on students' behaviors and attitudes. The kinds of student behaviors and attitudes that are necessary to optimize learning in the clinical environment thus becomes relevant. Evidence: Tips and recommendations to maximize clinical learning in a variety of settings have been well documented. There is, however, a dearth of literature which takes a narrative-based praxis approach focused on resource-constrained environments. We developed this praxis-orientated article as a means to translate the available literature and theory into a simple, practical guide, focused on optimizing clinical learning from a student perspective, remaining cognizant of the particular challenges present in a resource-constrained setting. Implications: Based on the resource-constrained environments our students are exposed to, we outline the following six key aspects: student-driven learning, integration into the community of practice, student engagement, empathy, interprofessional learning opportunities, and feedback for learning. These aspects provide useful pointers for students in general. Furthermore, exploration into what strategies students may utilize in resource-constrained clinical contexts is addressed. [ABSTRACT FROM AUTHOR]

AbstractIntroductionMethodsResultsConclusionsSelf-regulated learning (SRL) in medical education is important for successful learning and safe patient care. However, supervisors may be unaware of behaviours that explicitly facilitate or inhibit their students’ or residents’ SRL, therefore this BEME review explores the role of the supervisor in SRL in clinical environments.A qualitative systematic review using meta-aggregation was performed, seeking to draw on the knowledge of included studies and the participants those studies represent to create context-rich recommendations that are relevant and applicable to practice. Categories were developed from individual findings and then synthesised in the form of guidance.Twenty-two studies were included. Six categories were developed. A supervisor who facilitates SRL is: adaptive, engaged and supportive, builds trusting relationships, is knowledgeable, learner-centred, and crafts the architecture of the clinical learning environment.Within the categories, reciprocal trust and dialogue creates a positive cycle of supervisor-learner engagement which facilitates SRL, but due to the power imbalance inherent in the supervisor-learner relationship, the supervisor needs to make the first move. The curriculum has an important role to play in fostering supervisor-learner relationships. Supervisor beliefs about their role, and the architecture of the clinical learning environment can facilitate or inhibit SRL. [ABSTRACT FROM AUTHOR]

The collection and analysis of settled dust samples from indoor environments has become one of several environmental sampling methods used to assess bioburden indoors. The aim of the study was to characterize the bioburden in vacuumed settled dust from 10 Primary Health Care Centers by culture based and molecular methods. Results for bacterial load ranged from 1 to 12 CFU.g−1 of dust and Gram-negative bacteria ranged between 1 to 344 CFU.g−1 of dust. Fungal load ranged from 0 CFU.g−1 of dust to uncountable. Aspergillus section Fumigati was detected in 4 sampling sites where culture base-methods could not identify this section. Mucorales (Rhizopus sp.) was observed on 1 mg/L voriconazole. Three out of 10 settled dust samples were contaminated by mycotoxins. Settled dust sampling coupled with air sampling in a routine way might provide useful information about bioburden exposure. [ABSTRACT FROM AUTHOR]

Medical team members require information in order to improve the quality of patient treatment. The large volume of information and limited time of medical teams necessitates the involvement of clinical librarians in order to provide up to date and evidence-based information. The goal of this study is to identify the necessary skills required of a clinical librarian in order to work with medical teams; to define their roles and duties, and to detail advantages and possible barriers of clinical librarian involvement on medical teams based on literature review. A search for related articles was carried out in 2017 using keywords including: clinical librarian, hospital librarian, medical librarian and health sciences librarian in Noormags, SID, MagIran, Scopus, Web of Science and PubMed databases. After reviewing articles in English and Persian, a total of 46 were selected for further analysis. The findings showed that the skills required of clinical librarians on medical teams can be divided into three main categories: general skills, medicine-related skills, and professional librarianship skills. The duties of clinical librarians were also divided into two groups; medical information services and evidence-based medicine services. The involvement of clinical librarians on medical teams can create advantages for patients, medical teams, clinical librarians as well as for education and research. However, this involvement suffers from barriers due to inadequate librarian's skills, insufficient human resources, lack of organizational support, the attitude of medical teams, lack of understanding from the healthcare sector and lack of proper infrastructure. [ABSTRACT FROM AUTHOR]

Noise overload within the clinical environment has been found to interfere with the healing process for patients, as well as nurses' ability to assess patients effectively. Awareness and responsibility for noise production begins during initial nursing training and consequently a program to enhance aural awareness skills was designed for graduate entry nursing students in an Australian university. The program utilized an innovative combination of music education activities to develop the students' ability to distinguishing individual sounds (hearing), appreciate patients' experience of sounds (listening) and improve their auscultation skills and reduce the negative effects of noise on patients (action). Using a mixed methods approach, students reported heightened auscultation skills and greater recognition of both patients' and clinicians' aural overload. Results of this pilot suggest that music education activities can assist nursing students to develop their aural awareness and to action changes within the clinical environment to improve the patient's experience of noise. [ABSTRACT FROM AUTHOR]

Health administrators and educators working in clinical settings are often charged with cultivating a culturally competent clinical environment for lesbian, gay, bisexual, and transgender (LGBT) patients. To better understand what constitutes such an environment, we conducted seven focus groups with health care providers and LGBT patients living in a Midwestern metropolitan area of the United States. Findings identified a culturally competent clinical environment consisting of structural components such as decor and patient flow, systemic components, such as mission statements, policies, and forms, and interpersonal components, such as a trusting provider-patient relationship. Strategies to create a more culturally competent clinical environment were identified. [ABSTRACT FROM AUTHOR]

Ten hand-touch sites were screened weekly on two surgical wards over two consecutive six-month periods. The results were analysed using hygiene standards, which specify (i) an aerobic colony count (ACC) > 2.5 cfu/cm2, and (ii) presence of coagulase-positive staphylococci, as hygiene failures. Sites most often failing the standards were beds and hoist (64%: 33 of 52 weeks), bedside lockers (62%: 32 of 52) and overbed tables (44%: 23 of 52). Methicillin-susceptible/resistant Staphylococcus aureus (MSSA/MRSA) were more often recovered from lockers, overbed tables and beds. Recovery of MSSA/MRSA at any site was significantly associated with an ACC > 2.5 cfu/cm2 from that site (p = 0.001; OR: 3.35 [95% CI 1.79, 6.28]). In addition, total ACC's > 2.5 cfu/cm2 each week were significantly associated with weekly bed occupancies > 95% (p = 0.0004; OR: 2.94 [95% CI 1.44, 6.02]). Higher microbial growth levels from hand-touch sites reflect weekly bed occupancies and indicate a risk for both resistant and susceptible S. aureus. These organisms are more likely to be recovered from near-patient sites on the ward. [ABSTRACT FROM AUTHOR]