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Background: Oral health care programs offer a platform for experiential learning that include prospects for skills development; opportunities for knowledge application and for the creation of an awareness of community responsibilities. Gaining experience in the care for special needs patients is ideally achieved through exposure in special needs settings such as the school community., Aim: This study investigated the perceptions and reflections of experiential learning by final year oral hygiene students in a special need's oral health care program at the University of Western Cape., Methods: This study incorporated a concurrent triangulation study design that included final year Oral Hygiene students who participated in a special need's oral health care program. Students completed an on-line self-administered questionnaire, a reflective journal and participated in a focus group discussion., Results: All respondents understood the concept of experiential learning. The predominant dispositions that emerged included student adaptation, awareness, empathy, and experience which were regarded as particularly important for personal growth. With regards to academic growth, facets of confidence, theory translation, clinical skill development and improved communication were identified as critical elements in development. Challenges included lack of cooperation from the learners and lack of kills in non-verbal communication. An increased awareness and a strong willingness to participate in community projects was also reported amongst the student respondents., Conclusion: The experiential learning opportunity in the school-based special needs oral health care program was invaluable to the children as well as the students. This community -based program supported personal and academic growth and it provided authentic learning opportunities; facilitated professional development, improved clinical skills and competence, enhanced problem solving and communication skills and raised awareness on social responsibility. Challenges experienced pertained to cooperation and communication with the children. Suggestions included maintaining access to care for the children through oral care program initiatives, as well as ongoing rotation of Oral Hygiene students who are ideally positioned to provide promotive and preventive oral care to special needs individuals. Schools for special needs children provide an ideal platform to facilitate access to care and to provide experiential learning opportunities in authentic settings., Competing Interests: Declarations. Ethics approval and consent to participate: Ethics and consent to participate was obtained from Biomedical Research and Ethics Committee at the University of Western Cape: Reference is (BM/23/4/7). Consent to participate was also obtained from the final year oral hygiene students. Clinical Trial Number in the manuscript. This study was approved by the Biomedical Research and Ethics Committee of The University of Western Cape, (BM23/4/7). All methods and processes in this study were performed in accordance with the relevant guidelines and regulations of the Biomedical Research and Ethics Committee of The University of Western Cape. Written informed consent was obtained from the participating undergraduate students at the University of Western Cape. Approval to conduct this study was also obtained from the Western Cape Department of Education (1645DCF18000045-20230609) Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Practice placement is a crucial part of pre-registration physiotherapy education worldwide. However, educators face challenges in finding practice sites for students to undertake placement. The use of simulation-based (SBL) learning has the potential to replace some traditional placement, thereby increasing placement capacity, but the benefits have not been fully explored. This study aimed to assess the impact of SBL placement on students' knowledge, attitude, and performance during practice placements with external providers., Methods: This study utilised an exploratory qualitative research design using a semi-structured interview to collect data from Year 2 students of a 2-year MSc pre-registration physiotherapy programme in the UK. To be eligible to be included in the study, students must have participated in the 4-week simulation placement and have completed all their practice placements with external providers. All the interviews were conducted virtually in a 1:1 setting and recorded. The interviews lasted an average of 45 min. An inductive thematic analysis based on Braun and Clarke's approach was utilised in this study., Results: Twelve students consented to participate in this study. The 56 codes generated from the data were categorised into 5 themes; [1] Working together, [2] Working with Service Users, [3] Professionalism, [4] Profession-specific practical skills and [5] Generic practical skills. Participants unanimously expressed a positive view on working in groups, and they believe that engaging with service users who acted as patients enhanced the authenticity of the simulation placement. Subjective and objective assessments were considered important profession-specific skills gained during the simulation. Despite the benefits derived from the simulation placement, some participants felt that the learning experience would have been enriched by periodically changing the groups they were working in and having the opportunity for more 1:1 feedback throughout the four weeks., Conclusions: SBL has the potential to be a valuable educational experience for physiotherapy students. It may assist in better preparing students for successful integration into the dynamic healthcare environment. To enhance and improve the authenticity of this type of placementour recommendations include recruiting more service users, incorporating and encouraging more intervention-based elements, and increasing the practice educators' and students' contact time., (© 2024. Crown.)

Background: Clinical competence encompasses attitudes, skills, and knowledge regarding diverse client groups. Appropriate clinical competence requires an understanding of the cultural context in which healthcare is delivered. In conservative countries such as Israel, there is a noticeable scarcity of information regarding the clinical competency of physiotherapy students (PTSs) in effectively treating lesbian, gay, bisexual and transgender (LGBT) individuals. The objective of this study was to assess the level of LGBT clinical competence among PTSs in Israel., Methods: Conducted through an anonymous online self-report survey, this study gathered personal and academic background information and self-reported data on previous LGBT education during undergraduate studies of PTSs. It utilized the Hebrew version of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS) questionnaire. Descriptive statistics were computed for all outcome measures. The internal reliability of the LGBT-DOCSS was assessed. Total scores of the LGBT-DOCSS, along with scores in each of the three subscales (clinical preparedness, knowledge, and attitudes), were compared across different levels of religiosity and gender., Results: The sample comprised of 251 PTSs, with an average age of 25.57 ± 3.07 years (34.7% men, 65.3% women). All students reported a lack of LGBT community-related courses during their undergraduate studies. The translated Hebrew version demonstrated good internal consistency, with Cronbach's alpha ranging from 0.65 to 0.83. The LGBT-DOCSS total score was 4.55 ± 0.61 out of 7, indicating a low level of clinical competency. The highest mean score was in the attitudes subscale (6.55 ± 0.87), which was significantly higher than the scores for the knowledge subscale (3.14 ± 1.46) and clinical preparedness subscale (3.36 ± 0.86). Religiousness was significantly associated with clinical preparedness and attitudes. Men exhibited higher self-reported levels of knowledge and clinical preparedness, albeit with more negative attitudes compare to women. Sexual orientation was significantly associated with clinical competency, with PTSs who identified as heterosexual demonstrating a lower level of clinical competency compared to participants who identified as non-heterosexual., Conclusions: In Israel, PTSs demonstrated a low level of clinical competency in terms of self-reported knowledge and self-reported clinical preparedness but contrasting positive attitudes toward the LGBT community. Religiousness, gender and sexual orientation had a significant influence on competency levels.These preliminary findings highlight the urgent necessity to enhance the knowledge of PTSs regarding the LGBT community to improve their clinical competence., Trial Registration Nr: Not applicable., (© 2024. The Author(s).)

Purpose: Speech-language pathology programs use simulated learning experiences (SLEs) to teach graduate student clinicians about fidelity to therapeutic interventions, including static skills (clinical actions that are delivered in a prespecified way regardless of the client's behavior) and dynamic skills (contingent responses formulated in response to a client's behavior). The purpose of this study was to explore student learning of static and dynamic skills throughout SLEs and live clinical practice., Method: Thirty-three speech-language pathology graduate students participated in this study. Students were first trained to deliver an intervention before having their treatment fidelity measured at three time points: an initial SLE, actual clinical practice, and a final SLE. Treatment fidelity was first summarized using an overall accuracy score and then separated by static and dynamic skills. We hypothesized that (a) overall accuracy would increase from the initial simulation to treatment but remain steady from treatment to the final simulation and that (b) students would acquire dynamic skills more slowly than static skills., Results: In line with our hypotheses, students' overall accuracy improved over time. Although accuracy for static skills was mostly established after the first simulation, dynamic skills remained less accurate, with a slower acquisition timeline., Conclusions: These results demonstrate that SLEs are efficacious in teaching students the clinical skills needed for actual clinical practice. Furthermore, we show that dynamic skills are more difficult for students to learn and implement than static skills, which suggests the need for greater attention to dynamic skill acquisition during clinical education.

Background: Simulation is a safe, supported, and accessible learning method for students to gain skills and experience, especially in difficult to access range of practice areas such as voice., Objective: The study aimed to explore change in students' perceptions of knowledge, confidence, anxiety, and clinical readiness for assessment and management of an adult with a voice disorder after participation in simulation-based learning activities., Methods: Participants (N = 113) were students enrolled in a mandatory course dedicated to the voice and voice disorders. Students completed 32 hours of academic coursework which included lectures and tutorials and two 30-minute simulation-based learning activities with a standardized patient playing the role of an adult with a voice disorder. The impact of the simulation-based learning activities on student perceptions of their knowledge, confidence, anxiety, and clinical readiness for work within the area of voice were surveyed at three time points: (1) pre lectures, (2) post lectures but pre simulation, and (3) post simulation. Change across time was analyzed using repeated measures analysis of variance with post hoc Bonferroni adjustment., Results: All students perceived significant (P ≤ 0.001) positive changes in knowledge and confidence across time points for all activities, except for writing an assessment report. Anxiety related to the management of a client with a voice disorder fluctuated significantly (P ≤ 0.001) throughout the program. Overall, the majority (>90%) of students agreed or strongly agreed that the simulation-based learning activities were useful and helped them to develop clinical skills, apply content taught in lectures, and gain confidence and interest in voice., Conclusion: This study supports incorporation of simulation-based learning as part of students' clinical preparation for the assessment and management of voice disorders., (Crown Copyright © 2021. Published by Elsevier Inc. All rights reserved.)

Objectives: Mental Health First Aid (MHFA) is designed to help the general public acquire the knowledge and skills needed to respond to a person in a mental health emergency and offer support to someone in emotional distress. Through the PA Foundation's Mental Health Outreach Fellowship, 16 physician assistants (PAs) were selected to become MHFA instructors and teach the course to members of their local communities over 1 year., Methods: MHFA course evaluations, completed by course participants, were reviewed to determine the effectiveness of the PA fellows as instructors., Results: The fellows' mean evaluation instructor presentation score was 4.82 and the mean course content score was 4.75. The national mean for instructor presentation was 4.72 for presentation and 4.66 for course content. The maximum possible score in each category was a 5., Conclusions: The PAs selected for the Mental Health Outreach Fellowship were effective MHFA instructors. Benefits to having a PA serve as the instructor include positively affecting communities by increasing the public's mental health literacy, reducing the stigma associated with mental illness, increasing visibility and promotion of the PA profession, and enhancement of a PA's individual career through education and service.

Background/aim: One way to facilitate occupational therapy undergraduate students transferring their academic skills of data gathering and analysis to professional settings is to ensure they can competently use diagnostic reasoning. Nevertheless, there are several obvious gaps in empirical evidence related to the learning and development of this style of reasoning in occupational therapy undergraduates. The most important are related to promoting higher-order thinking and the use of information to solve problems in the context of professional practice. This study analyses undergraduates' diagnostic reasoning and its changes during their education., Materials and Methods: This multicentre study was conducted with a descriptive observational design. The study took place at the University of Coruña (Spain), University of Castilla-La Mancha (Spain), and University of el Valle (Colombia). The sample was n = 247. For data collection, a clinical case was specifically designed. IBM SPSS Statistics (v19) and EPIDAT 3.1 were used for the data analysis., Results: Participants identified and categorized occupational performance problems. However, they had difficulties when identifying and categorizing the occupational performance components (specifically, the symptoms and signs of the disease presented in the study case). They presented limitations to analyse and synthesize the information collected to develop an explanation of the occupational problems and their causes., Conclusions: Undergraduate students' ability to analyse and synthesize information during data collection is poorly organized, so it makes the problem formulation difficult. This study contributes to the knowledge of undergraduates' diagnostic reasoning features, specifically the undergraduate students' capacities and limits to process information during the occupational assessment., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2020 Pedro Moruno-Miralles et al.)

Purpose: To examine how the implementation of a year-long interprofessional clinical case course for pharmacy and physician assistant (PA) students affects student self-reported interprofessional collaboration-related competencies in 6 skill areas (communication, collaboration, roles and responsibilities, collaborative patient/family-centered approach, conflict management/resolution, and team functioning) and whether outcomes differed between the 2 professions., Methods: Pharmacy and PA students completed the Interprofessional Collaborative Competency Attainment Survey (ICCAS) at the beginning and end of a year-long interprofessional, team-based clinical case course. Survey results were compared using a mixed-design analysis of variance model to determine the effect the course had on students' self-reported competencies of interprofessional care and whether the outcomes differed between student groups., Results: One-hundred fifteen students completed both the presurvey and postsurvey. Significant improvement in student self-reported team-based behaviors were noted in 11 of the 20 ICCAS items, and results were similar among student groups., Conclusion: This study demonstrates that an interactive, interprofessional clinical case course can positively change student self-reported team-based behaviors.

Background/aim: Demand for occupational therapy graduates able to work in complex and diverse workplaces is increasing. The threshold concepts framework has emerged as one pathway to assist in the development of work-ready graduates. A previous Australian study identified 10 threshold concepts for occupational therapy; the aim of this study was to explore the acquisition of these., Method: A mixed-methods study using observational, cross sectional design and a triangulation design convergence model was undertaken. A survey using Likert scales and open response questions was developed by the authors. Seventy-three surveys were completed by 13 first and 20 final year Victorian occupational therapy students. Twenty recent graduates and 20 experienced clinicians from across Australia also participated. Seven first and 10 final year occupational therapy students, 10 recent graduates and 10 experienced clinicians also took part in in-depth interviews. Likert scales were used by participants to rate confidence that they had acquired the threshold concepts, they also answered open-response questions (via survey or interview) asking them to provide examples of how they would use threshold concepts in practice., Results: Fourth year students were statistically significantly less confident than experienced clinicians for the threshold concepts Understanding the models and theories of occupational therapy and Applying clinical reasoning (P < 0.05). When whole group data were analysed, participants were most confident for Occupation and Client centred practice (P < 0.05). These results resonated with the qualitative findings which demonstrated a shift from surface to deep knowledge with increased experience. Fourth year students reported responses that suggested some threshold concepts were still in development, while experienced clinicians used a web of threshold concepts., Conclusion: This exploratory study provides provisional data to suggest that students appear to still be acquiring some threshold concepts at graduation and experienced clinicians make use of a web of threshold concepts in their clinical practice., (© 2019 Occupational Therapy Australia.)

Purpose: To assess students' level of perceived preparedness for clinical competencies and simultaneously identify the effective curricular methods to develop these competencies., Methods: Prior to graduation students reported their level of preparedness for clinical practice using a modified Preparation for Hospital Practice Questionnaire and rated the most effective teaching methods to improve the development of clinical and professional competencies., Results: Students gave a high rating to group dynamics and teamwork, along with continuous professional development. They felt least prepared in pharmacotherapeutics and the handling of medical emergencies. Rated most effective were didactic lecturing instruction for the acquisition of medical knowledge, standardized patient encounters and simulations for the promotion of interpersonal skills, case groups for the integration of knowledge and critical thinking, and interprofessional events for the maintenance of professional accountability., Conclusion: This survey approach may lead to an efficient and focused method for improving clinical and professional competencies and serve as an additional self-assessment tool to support curriculum development and reform.

Introduction: Identifying priority research topics that meet the needs of multiple stakeholders should maximize research investment. Aim: To identify priorities for health education research. Methods: A three-stage sequential mixed methods study was conducted. Priorities for health education research were identified through a qualitative survey with 104 students, patients, academics, and clinicians across five health sciences and 12 professions (stage 1). These findings were analyzed using framework analysis and transposed into a quantitative survey whereby 780 stakeholders rated and ranked the identified priorities. Descriptive statistics identified priorities, exploratory factor analysis grouped priorities and differences between stakeholders were determined using Mann-Whitney U tests (stage 2). Six individual or group interviews with 16 participants (stage 3) further explicated the results from previous stages. Results: Of 30 priorities identified, the top were: how best to ensure students develop the required skills for work; how to promote resiliency and well-being in students; and ensuring the curriculum prepares students for work. For the majority of priorities, no significant differences were found between different stakeholder groups. Conclusions: These findings will be used to inform health educational research strategy both locally and nationally. Further research should explore if setting priorities can be translated effectively into education research policy and practice.

Background: Practice placements in occupational therapy are fundamental components in developing a student's professional identity. Various models of placements are available to expose and expand students' participation in various community-based services. The purpose of this study was to compare occupational therapy students' perceptions and expectations prior to placements with their perceptions and satisfaction levels upon completion of placements, and to compare clinical placement models (role-established and role-emerging)., Methods: The study included 155 undergraduate occupational therapy students, who completed questionnaires prior to and upon completion of their placements. The questionnaire included items that were divided into categories of placement setting and supervision, personal skills, professional skills, and community. Paired t-tests and two-way repeated measures analyses of variance (ANOVA) were used in order to examine the change in scores over time, and a-parametric tests were used in order to compare the two models., Results: For all students a significant decrease in scores was found from pre- to post-placement regarding setting and supervision (t[df] = 3.96[154], p < .001), and a significant increase in scores was found from pre- to post-placement regarding personal and professional skills (t[df] = 7.82[154], p < .001; t[df] = 14.24[154], p < .001, respectively). Comparison between placement models indicated nonsignificant differences regarding personal and professional skills. However, role-established post-scores were significantly higher than role-emerging scores regarding setting and supervision, but significantly lower regarding the contribution of services to the community., Conclusions: Practice placements promote a student's personal and professional skills. Students were less satisfied with the setting and supervision in comparison to their pre-placement expectations. Both models may contribute to students' professional development. Role-established model had an advantage in students' satisfaction with settings and supervision, while role-emerging models had an advantage in students' perceptions regarding contribution to the community. Role-emerging model may contribute to developing and expanding areas of practice in the community.

Objective: To examine the effectiveness of a three-day training programme on knowledge, confidence and fidelity to Motivational Interviewing (MI) delivery in an undergraduate occupational therapy and physiotherapy cohort (n = 25)., Methods: Training outcomes were assessed pre-training, post-training and following a subsequent clinical placement. The Motivational Interviewing Knowledge and Attitudes Test (MIKAT) and an 8-item survey assessed knowledge, attitudes and confidence respectively. MI fidelity was evaluated by a simulated patient interview rated with the Motivational Interviewing Treatment Integrity scale (MITI). Analysis was by one-way repeated measures ANOVA., Results: Self-report measurements indicated increased confidence but no effect on knowledge or attitude. MITI analysis showed superior performance in all four global criteria and an increased frequency of MI adherent behaviours post-training. Positive changes were maintained following clinical placement. MITI summary scores indicated an improvement in question to reflection ratio in line with beginner competency., Conclusion(s): Participation in a three-day MI training programme significantly improved student confidence and MI skilfulness., Practice Implications: Where feasible, MI training should be embedded within the curriculum. Further research is needed elucidate the best practices to incorporate teaching this skill set within the curriculum in order to best prepare students to counsel clients in behaviour change in their applied settings., (Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.)

Background:: the need for health care to be safe is increasingly guiding the development of policies to improve clinical practice and education; risk management and patient safety are essential competencies for health professionals., Objective:: to examine how students working towards different degrees in Italy perceived their competence in clinical risk management and patient safety when learning in the classroom and the clinical setting., Methods:: the Italian version of the H-PEPSS questionnaire was given to 154 students; 78 were studying for a nursing degree and 76 were on the cardio-circulatory pathophysiology and cardiovascular perfusion techniques (CPCPT) degree course., Results:: nearly half of the students (46.10%) did not feel confident about their competence in patient safety and risk management during clinical training., Conclusion:: significant differences in confidence between the two types of students were found in many areas, including in critical aspects of clinical risk management. However, both types of students had similar levels of confidence in some essential areas.

Background: To consistently prepare physical therapist students for their first full-time clinical experience, the entry-level curriculum must provide and assess competency in the essential knowledge, skills, attitudes, and professional behaviors., Objective: The purpose of this Delphi study was to develop consensus on a core set of elements that should be demonstrated by physical therapist students prior to entry into their first full-time clinical experience. A second aim was to obtain the recommended competency levels and assessment methods., Design: The study was conducted using the Delphi method., Methods: Purposive selection and snowball sampling techniques were used to recruit clinical instructors, recent graduates, directors or academic coordinators of clinical education, and academic faculty. Four web-based survey rounds were used to achieve consensus, defined as agreement among ≥80% of respondents. The first round gathered demographic information on respondents and identified elements that were deemed essential; the second collected information about clarity and redundancy in the elements provided; the third asked participants to rank their agreement with elements and themes; and the fourth gathered the level of competency that physical therapist students should demonstrate prior to beginning a first full-time clinical experience., Results: Consensus revealed 95 elements, categorized under 14 themes, which were deemed essential for readiness for the first clinical experience. Levels of competency for each element were identified., Limitations: Participants might not have represented all academic programs, practice settings, and geographic locations., Conclusion: This study identified the specific knowledge, skills, attitudes, and professional behaviors in which all physical therapist students in the United States need to demonstrate competency before their first clinical experience, regardless of school or setting, which would allow learning experiences to be tailored appropriately.

Assessing competence in interprofessional collaborative practice (ICP) among health professions students is a high priority. This cross-sectional study built on the authors' prior work that led to the development of the 38-item Interprofessional Education Collaborative Competency Self Efficacy Tool (IPECC-SET), an instrument to evaluate health professions students' self-efficacy in interprofessional collaborative competency, and addressed two primary questions. First, could a unidimensional scale based on the IPEC competencies and assessing perceived self-efficacy for competence in ICP and be constructed? Second, could a shorter version of that instrument still meet criteria for unidimensionality and retain the ability to separate students in distinct levels of perceived self-efficacy for competence in ICP? Study participants were two cohorts of students from 11 health professions programs participating in an institutional interprofessional immersion event in 2015 and 2016. Statistical stepwise analyses were conducted using a Rasch rating scale model. The original 38 IPECC-SET items did not meet the criteria to generate a valid unidimensional measure of self-efficacy for competence in ICP, but could be condensed into a 27-item scale that met all set criteria for unidimensionality, with an explained variance of 61.2% and a separation index of 3.02. A shorter, 9-item scale demonstrated a separation index of 2.21. The nine items included also demonstrated a relatively equivalent range (54.93-45.65) as compared to the 27-item scale (57.26-46.16). Findings confirm empirically the conceptual suggestion from our earlier work that the four dimensions in the original IPEC competencies contribute to a shared underlying construct: perceived competence in interprofessional collaboration. Given the emphasis on ICP, psychometrically sound instruments are needed to evaluate the effectiveness of educational efforts to promote competency for ICP. Based on the findings from this study, both the IPECC-SET 27 and IPECC-SET 9 can be used to measure perceived self-efficacy for competence in ICP.

Purpose: Interprofessional education (IPE) is a concept that allows students from different health professions to learn with and from each other as they gain knowledge about their chosen professions and the professions of their colleagues. The purpose of this systematic review was to determine the effectiveness of IPE in the academic preparation of students of the health professions., Methods: A search was conducted of the PubMed and CINAHL databases using the following eligibility criteria: IPE including students from 3 or more healthcare professions, IPE exposure within academic coursework, measurement of attitudes and/or perceptions as outcomes, and quantitative reporting of results. Articles were screened by title, abstract, and full text, and data were extracted., Results: The search yielded 870 total articles. After screening, 7 articles remained for review. All studies reported a positive impact of IPE on the education of students of the health professions., Conclusion: Evidence showed that IPE activities were an effective tool for improving attitudes toward interdisciplinary teamwork, communication, shared problem-solving, and knowledge and skills in preparation for collaboration within interdisciplinary teams.

Purpose: It aimed at describing the perception of the clinical educational environment by physiotherapy students based on the Educational Environment Measurement Questionnaire of the Postgraduate Hospital in Chile., Methods: The clinical education environment was evaluated according to the PHEEM by 192 students originally enrolled in the fifth year of the physiotherapy career at three different headquarters of the academic institution: Santiago, Viña del Mar and Concepcion Campus (Metropolitan, Valparaiso and Bio Bio region, respectively), from March to October 2018. The Cronbach's alpha was applied to measure the reliability of the instrument and the Student t and ANOVA tests were used to compare the differences of PHEEM scores by headquarters, environmental areas, and experience of internship., Results: A total overall average score of 125.88 was obtained, which meant an excellent educational environment. The overall score was 127.6±22.7 for Headquarters1, 125.6±21.6 for Headquarters2 and 122.5±26.9 for Headquarters3. According to the type of establishment, the scores were of 127.1±22.1 for private and 123.5±26.3 for public institutes. According to the type of area, the score was cataloged as an excellent educational environment in all cases, except in the respiratory care area (lowest score: 117.5±29.1). Finally, the score was 126.9±20.5 for the first internship, 121.7±29.3 for the second and 129.4±19.6 for the third., Conclusion: There is relative homogeneity of the clinical educational environment for different headquarters, types of establishment or type of area; but there are significant differences in the number of the internship. The promotion of a good clinical educational environment can have an important impact on the development and performance of the future professional, being the detection of negative aspects an opportunity to improve the hidden curriculum.

Objective: Although audio and visual information constitute relevant channels to communicate pain, it remains unclear to what extent observers combine and weight these sources of information when estimating others' pain. The present study aimed to examine this issue through the theoretical framework of the Information Integration Theory. The combination and weighting processes were addressed in view of familiarity with others' pain., Method: Twenty-six participants familiar with pain (novice podiatry clinicians) and thirty non-specialists were asked to estimate the level of pain associated with different displayed locomotor behaviors. Audio and visual information (i.e., sound and gait kinematics) were combined across different intensities and implemented in animated human stick figures performing a walking task (from normal to pathological gaits)., Results: The novice clinicians and non-specialists relied significantly on gaits and sounds to estimate others' pain intensity. The combination of the two types of information obeyed an averaging rule for the majority of the novice clinicians and an additive rule for the non-specialists. The novice clinicians leaned more on gaits in the absence of limping, whereas they depended more on sounds in the presence of limping. The non-specialists relied more on gaits than on sounds. Overall, the novice clinicians attributed greater pain levels than the non-specialists did., Conclusion: Depending on a person's clinical experience, the combination of audio and visual pain-related behavior can qualitatively change the processes related to the assessment of others' pain. Non-verbal pain-related behaviors as well as the clinical implications are discussed in view of the assessment of others' pain., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: The fourth year of podiatric medical school is an important period in the education of the podiatric medical student, a period that consists largely of month-long clerkships. Nonetheless, there has been limited formal study of the quality of learning experiences during this period. Furthermore, there is limited knowledge of how podiatric medical students evaluate residency programs during clerkships., Methods: An online survey was developed and distributed electronically to fourth-year podiatric medical school students. The focus of the survey was the quality of learning experiences during externships, and decision making in ranking residency programs., Results: The most valuable learning experiences during clerkships were interactions with attending physicians, interactions with residents, and general feedback in surgery. Students self-identified that they most improved in the following areas during clerkships: forefoot surgery, clinical podiatry skills, and rearfoot surgery. The areas in which students improved the least were research, pediatrics, and practice management. The three most important factors students considered as they created their rank list were hands-on resident participation in surgical training, the attitude and personality of the residents, and the attitude and personality of the attending physicians. A range of surgical interest was identified among students, and students lacking in surgical interest self-reported less improvement in various surgical topics., Conclusions: The perspectives of fourth-year podiatric medical students are currently an underused resource. Improved understanding can help residency programs improve the quality of associated learning experiences and can make their programs more appealing to potential residency candidates.

Purpose: To assess student perceptions of the use of the "Muddiest Point" as a type of formative classroom assessment technique (CAT) in a clinical skills laboratory course., Methods: Physician assistant (PA) students enrolled in a private university were invited to complete a perception survey regarding the use of the Muddiest Point at the conclusion of the course., Results: Survey results showed positive overall student perceptions of the Muddiest Point and desire for broader use of this CAT in other courses., Conclusions: The Muddiest Point is a CAT that is simple for the instructor to implement and showed overall perceived benefit to the PA student. The Muddiest Point is an effective method to gauge student learning and allows students to be active participants in their education.

Health science courses aim to prepare students for the demands of their chosen profession by learning ways appropriate to that profession and the contexts they will work and live in. Expectations of what students should learn become re-contextualised and translated into entry-level curriculum, with students operating as a connection between what is intended and enacted in curriculum, and required in the real world. Drawing on phenomenology, this paper explores how students understand practice-the collective, purposeful knowing, doing and being of a community-in entry-level physiotherapy programs. Ways of thinking and practising (WTP)-a framework attentive to the distinctive nature of a discipline, its values, philosophies and world-view (McCune and Hounsell in High Educ 49(3):255-289, 2005)-provides the conceptual lens. Six themes describing how students see the WTP of physiotherapy practice emerged from the analysis: discovery of new knowledge; problem solving client related contexts; adopting a systems based approach to the body; contributing to a positive therapeutic alliance; developing a sense of self and the profession; and the organisation of the workforce. The study produces knowledge about practice by focusing on physiotherapy students' experiences of disciplinary learning. Including students in educational research in this way is an approach that can help students realise their potential as part of a community of practice.

Background/aim: Interpersonal skills such as active listening, verbal communication and body language are essential competencies for occupational therapists, and students are expected to demonstrate these skills when completing practice placements. To investigate whether interpersonal skills are predictive of occupational therapy students' practice performance., Methods: A cross-sectional study was conducted involving third and fourth year occupational therapy undergraduate students (n = 70). Students' interpersonal skills were measured using the Interpersonal Communication Competence Scale (ICCS), Listening Styles Profile (LSP-R) and Active-Empathic Listening Scale (AELS). Students' practice performances at the mid-way and final points of their placements were measured using the Student Practice Evaluation Form-Revised (SPEF-R). The relationships between students' interpersonal skills and practice performance were examined using univariate and multi-variate regressions., Results: Higher ICCS Interaction Management subscale scores predicted better SPEF-R Self-Management Skills at the mid-way point through practice placements (β = 1.93, SE = 0.76), and better Professional Behaviours (β = 1.28, SE = 0.64) and better Service Evaluation Skills (β = 2.84, SE = 0.95) at the final SPEF-R completion point. Higher ICCS Empathy subscale scores predicted lower SPEF-R Documentation scores at the mid-way point (β = -0.81, SE = 0.38), while higher ICCS Supportiveness subscale scores predicted lower mid-way SPEF-R Service Provision scores (β = -2.84, SE = 1.77). No ICCS subscale scores were predictive of the SPEF-R communication, co-worker communication and information gathering subscale scores. As well, LSP-R and AELS subscale scores were not predictive of the SPEF-R subscale scores., Conclusion: While predictive relationships were not found between occupational therapy students' communication, co-worker communication and information gathering skills, this preliminary evidence indicates that students' interpersonal skills (including interaction management and empathetic supportiveness) were predictive of some notable SPEF-R competencies (including Professional Behaviours, Self-Management, Documentation, Service Provision and Service Evaluation). Therefore, students' exposure to professional interpersonal skills should be incorporated into the curriculum of academic education programs with the aim of better preparing them for practice education., (© 2018 Occupational Therapy Australia.)

Background: The purpose of clinical placements and supervision is to promote the development of healthcare students´ professional skills. High-quality clinical learning environments and supervision were shown to have significant influence on healthcare students´ professional development., Objectives: This study aimed to describe healthcare students` evaluation of the clinical learning environment and supervision, and to identify the factors that affect these., Design: The study was performed as a cross-sectional study., Methods: The data (n = 1973) were gathered through an online survey using the Clinical Learning Environment, Supervision and Nurse Teacher scale during the academic year 2015-2016 from all healthcare students (N = 2500) who completed their clinical placement at a certain university hospital in Finland. The data were analysed using descriptive statistics and binary logistic regression analysis., Results: More than half of the healthcare students had a named supervisor and supervision was completed as planned. The students evaluated the clinical learning environment and supervision as 'good'. The students´ readiness to recommend the unit to other students and the frequency of separate private unscheduled sessions with the supervisor were the main factors that affect healthcare students` evaluation of the clinical learning environment and supervision. Individualized and goal-oriented supervision in which the student had a named supervisor and where supervision was completed as planned in a positive environment that supported learning had a significant impact on student's learning., Conclusions: The clinical learning environment and supervision support the development of future healthcare professionals' clinical competence. The supervisory relationship was shown to have a significant effect on the outcomes of students' experiences. We recommend the planning of educational programmes for supervisors of healthcare students for the enhancement of supervisors' pedagogical competencies in supervising students in the clinical practice., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Purpose: Competency-based education is employed to ensure students are prepared to perform tasks required by entry-level practitioners. The American Dental Education Association's curriculum for dental hygiene programs states that students should learn skills consistently performed by dental hygienists to the level of competence. The purpose of this study was to assess the implementation of a competency- based dental hygiene clinical program at University of Arkansas for Medical Sciences. The program included components such as the development of competencies, assessment techniques, portfolios (self-assessment/reflection), mock boards, faculty feedback, remediation, and competency notebooks., Methods: To evaluate the competency-based clinical program, surveys were conducted on 30 students and 5 faculty members who experienced the transition from a traditional grade-based clinical program to a non-graded competency-based program. Survey questions included Likert-type questions, ranking aspects of the competency- based program in order of importance, and open-ended questions. Frequency/descriptive statistics were stated in aggregate form to evaluate the students' and faculty's perceptions of the competency-based program., Results: Survey results showed that the majority of students and faculty members felt confident in the students' skills to practice as entry-level hygienists. Students and faculty thought the most valuable aspect of the competency- based program was quad scale experiences. The least beneficial aspect was reflection/ self-assessment., Conclusion: There were many challenges involved in implementing a newly established non-graded competency- based clinical program. Although there was resistance from students and faculty, their overall perceptions of the program were positive.

Generation Y’s (born between 1981 and 1999) educational approach in healthcare studies raises questions about their expectations and which teaching methods to use with this generation. The study involved third year students of occupational therapy. One hundred and twelve students were consulted in September 2012 and September 2013 about their expectations regarding the courses and the teaching methods which were offered. Results allowed to highlight firstly the importance of the usefulness of the course and secondly expectations regarding the teachers’ soft skills. If the link between soft skills and success was pointed out in many studies, only a few studies focus on the teachers’ own soft skills development in order to respond to students’ expectations in higher education. This is the topic of this article, which main interest could be the means to develop teaching methods adapted to this students’ generation.

Purpose: Videofluoroscopic swallowing study (VFSS) has been widely used in clinical settings and in research for evaluating swallowing functions. The interpretation of such studies requires subjective judgment by the raters, which may be affected by clinical experience and definitions of the rating parameters. Two methods have been proposed to improve the reliability: training and use of a coordinate mapping (CM) protocol. This study aimed at investigating the effect of training on improving the intra-and inter-rater reliabilities of VFSS analysis; and comparing the intra- and inter-rater reliabilities of a clinical evaluation (CE) protocol and a CM protocol for analysing VFSS., Method: Forty inexperienced judges were randomly assigned to one of two groups: a CE group or a CM group. Each group received training to perform VFSS judgments using the relevant analysis protocol. All participants were tested individually before and after training., Result: Results showed that training significantly improved the intra- and inter-rater reliabilities of both protocols. In addition, the CE group achieved significantly higher intra- and inter-rater reliabilities than the CM group after training., Conclusion: It is recommended that standard training protocols be implemented during clinical training to improve the reliability in VFSS analysis.

This article provides a conceptual framework for asymmetrical relationships between family therapy educators and trainees. Our framework is based on contextual family therapy, and we apply the concepts of trust, entitlement, self-validation, and loyalty to training relationships. We highlight the value of educators modeling responsible uses of power in addition to teaching trainees clinical concepts and skills. We propose that training can be a process where trainers earn constructive entitlement through their interactions with trainees, who then give to future clients, supervisees, and trainees to continue the cycle of intergenerational trustworthiness. We also provide examples that illustrate the application of contextual therapy skills such as multidirected partiality, I-Thou relating, acknowledgment, validation, and accountability to family therapy training., (© 2017 American Association for Marriage and Family Therapy.)

Academics often develop software for teaching and learning purposes with the best of intentions, only to be disappointed by the low acceptance rate of the software by their students once it is implemented. In this study, the focus is on software that was designed to enable veterinary students to record their clinical skills. A pilot of the software clearly showed that the program had not been received as well as had been anticipated, and therefore the researchers used a group interview and a questionnaire with closed-ended and open-ended questions to obtain the students' feedback. The open-ended questions were analysed with conceptual content analysis, and themes were identified. Students made valuable suggestions about what they regarded as important considerations when a new software program is introduced. The most important lesson learnt was that students cannot always predict their needs accurately if they are asked for input prior to the development of software. For that reason student input should be obtained on a continuous and regular basis throughout the design and development phases.

This study evaluated hospital readiness and interprofessional clinical reasoning in speech-language pathology and dietetics students following a simulation-based teaching package. Thirty-one students participated in two half-day simulation workshops. The training included orientation to the hospital setting, part-task skill learning and immersive simulated cases. Students completed workshop evaluation forms. They filled in a 10-question survey regarding confidence, knowledge and preparedness for working in a hospital environment before and immediately after the workshops. Students completed written 15-min clinical vignettes at 1 month prior to training, immediately prior to training and immediately after training. A marking rubric was devised to evaluate the responses to the clinical vignettes within a framework of interprofessional education. The simulation workshops were well received by all students. There was a significant increase in students' self-ratings of confidence, preparedness and knowledge following the study day (p < .001). There was a significant increase in student overall scores in clinical vignettes after training with the greatest increase in clinical reasoning (p < .001). Interprofessional simulation-based training has benefits in developing hospital readiness and clinical reasoning in allied health students.

Background: Globalisation has brought new possibilities for international growth in education and professional mobility among healthcare professionals. There has been a noticeable increase of international degree programmes in non-English speaking countries in Europe, creating clinical learning challenges for healthcare students., Objective: The aim of this systematic review was to describe mentors' experiences of international healthcare students' learning in a clinical environment. The objective of the review was to identify what influences the success or failure of mentoring international healthcare students when learning in the clinical environment, with the ultimate aim being to promote optimal mentoring practice., Design: A systematic review was conducted according to the guidelines of the Centre for Reviews and Dissemination., Data Sources: Seven electronic databases were used to search for the published results of previous research: CINAHL, Medline Ovid, Scopus, the Web of Science, Academic Search Premiere, Eric, and the Cochrane Library., Review Methods: Search inclusion criteria were planned in the PICOS review format by including peer-reviewed articles published in any language between 2000 and 2014. Five peer-reviewed articles remained after the screening process. The results of the original studies were analysed using a thematic synthesis., Results: The results indicate that a positive intercultural mentor enhanced reciprocal learning by improving the experience of international healthcare students and reducing stress in the clinical environment. Integrating international healthcare students into work with domestic students was seen to be important for reciprocal learning and the avoidance of discrimination., Conclusion: Many healthcare students were found to share similar experiences of mentoring and learning irrespective of their cultural background. However, the role of a positive intercultural mentor was found to make a significant difference for international students: such mentors advocated and mediated cultural differences and created a welcoming environment for international students by helping to minimise feelings of social isolation., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Introduction: Supervision of students is a key role of senior physiotherapy clinicians in teaching hospitals. The objective of this study was to test the effect of simulated learning environments (SLE) on educators' self-efficacy in student supervision skills., Methods: A pilot prospective randomized controlled trial with concealed allocation was conducted. Clinical educators were randomized to intervention (SLE) or control groups. SLE participants completed two 3-hour workshops, which included simulated clinical teaching scenarios, and facilitated debrief. Standard Education (StEd) participants completed two online learning modules. Change in educator clinical supervision self-efficacy (SE) and student perceptions of supervisor skill were calculated. Between-group comparisons of SE change scores were analyzed with independent t-tests to account for potential baseline differences in education experience., Results: Eighteen educators (n = 18) were recruited (SLE [n = 10], StEd [n = 8]). Significant improvements in SE change scores were seen in SLE participants compared to control participants in three domains of self-efficacy: (1) talking to students about supervision and learning styles (p = 0.01); (2) adapting teaching styles for students' individual needs (p = 0.02); and (3) identifying strategies for future practice while supervising students (p = 0.02)., Conclusions: This is the first study investigating SLE for teaching skills of clinical education. SLE improved educators' self-efficacy in three domains of clinical education. Sample size limited the interpretation of student ratings of educator supervision skills. Future studies using SLE would benefit from future large multicenter trials evaluating its effect on educators' teaching skills, student learning outcomes, and subsequent effects on patient care and health outcomes.

Unlabelled: The purpose of this study was to determine whether licensed physical therapists (n=8) serving as standardized patients (SPs) for practical examinations evaluate physical therapy students (n=51) equivalently to the physical therapy course instructor (n=1)., Methods: The SPs completed the same assessment based on the evaluation criteria as did the instructor. The scores for the practical examination, answers to three questions, and the documentation note were summarized separately for the SP and the instructor by means and standard deviations. A paired t-test and an intraclass correlation coefficient (ICC) for each aspect of the score were calculated. ICC(1,1) values were reported along with corresponding 95% confidence intervals., Results: The instructor had significantly higher scores for the practical exam and the overall score compared to the ratings from the SPs. No differences were observed between the instructor and SP scores on the three answers to the questions and documentation note scores., Conclusions: Based on the ICC values identified in this study, a physical therapist serving as an SP may not be an adequate replacement for an instructor when it comes to grading physical therapy students on all aspects of their competency tests.

Veterinary studies in Germany are regulated by the Veterinary Certification Act (TAppV). The practical part of the education consists of 1,170 hours, whereby up to 850 hours can be spent on the curative work placement. A curative work placement can result in physical and psychological stress in the sense of a professional overload. It is the aim of this study to find out in what areas and to what extent competence is acquired and psychological stress exists in students during their work placement. Veterinary students (n=142) from all German education institutes participated in a voluntary online-study based on Burnout Screening Scales (BOSS) as well as a questionnaire regarding the acquisition of competence and excessive stress during the work placement (FKÜP). The distribution of values for work placement related stress show that such work placement related stress is generally slightly increased (T=60) and lies above that of occupational stresses within the normal population. Work placement related physical complaints also show a significant slight increase (T=61). A value (T=42) within the normal range was determined for the resource values. Few of the students questioned considered themselves to be excessively stressed in favour of a high subjective acquisition of competences. The largest increase regarding the acquisition of competence was noted for the areas of animal handling/restraint and application and injection techniques. In the sense of a perceived excessive demand regarding practical capabilities the areas of emergency management, surgery and medication dispensation were mentioned. With regard to the load structure and the acquisition of competence by veterinary students during their work placement, more support of the individual and a balancing of teaching/learning goals would be desirable and represents a promising approach.

Background: Peer assisted learning (PAL) has been described as "the development of knowledge and skill through active help and support among status equals or matched companions". To enhance the learning experience of health professions students and improve collaborative and collegial learning, six pilot Peer Assisted Learning (PAL) projects were conducted across a health science faculty., Methods: A responsive mixed method evaluation design was applied to explore the adequacy of the preparation for PAL, the impact PAL had on student attainment of examination, consultation, communication and feedback skills and to explore students' learning experiences through PAL., Results: The 149 participants agreed the training programme was well organised, offered a safe learning environment and prepared the participant for the PAL activity. The impact of PAL included improvements in students' confidence and ability to give feedback and developed students' teaching, clinical and communication skills. Qualitative analysis revealed participants experienced deeper learning through teaching and learning from their peers, became more open to giving and receiving feedback and valued the comfortable/safe learning environment offered through PAL., Conclusion: Providing appropriate training in peer teaching and feedback and the schools engagement and openness to peer learning in the classroom and clinical setting enhances students' peer assisted learning experience.

Background: Many undergraduate and graduate-entry health science curricula have incorporated training in motivational interviewing (MI). However, to effectively teach skills that will remain with students after they graduate is challenging. The aims of this study were to find out self-assessed MI skills of health students and whether reflecting on the results can promote transformative learning., Methods: Thirty-six Australian occupational therapy and physiotherapy students were taught the principles of MI, asked to conduct a motivational interview, transcribe it, self-rate it using the Motivational Interviewing Treatment Integrity (MITI) tool and reflect on the experience. Student MI skills were measured using the reported MITI subscores. Student assignments and a focus group discussion were analysed to explore the student experience using the MITI tool and self-reflection to improve their understanding of MI principles., Results: Students found MI challenging, although identified the MITI tool as useful for promoting self-reflection and to isolate MI skills. Students self-assessed their MI skills as competent and higher than scores expected from beginners., Conclusions: The results inform educational programs on how MI skills can be developed for health professional students and can result in transformative learning. Students may over-state their MI skills and strategies to reduce this, including peer review, are discussed. Structured self-reflection, using tools such as the MITI can promote awareness of MI skills and compliment didactic teaching methods.

Background/aim: Feedback on clinical reasoning skills during fieldwork education is regarded as vital in occupational therapy students' professional development. The nature of supervisors' feedback however, could be confirmative and/or corrective and corrective feedback could be with or without suggestions on how to improve. The aim of the study was to evaluate the impact of supervisors' feedback on final-year occupational therapy students' clinical reasoning skills through comparing the nature of feedback with the students' subsequent clinical reasoning ability., Method: A mixed-method approach with a convergent parallel design was used combining the collection and analysis of qualitative and quantitative data. From focus groups and interviews with students, data were collected and analysed qualitatively to determine how the students experienced the feedback they received from their supervisors. By quantitatively comparing the final practical exam grades with the nature of the feedback, their fieldwork End-of-Term grades and average academic performance it became possible to merge the results for comparison and interpretation., Results: Students' clinical reasoning skills seem to be improved through corrective feedback if accompanied by suggestions on how to improve, irrespective of their average academic performance. Supervisors were inclined to underrate high performing students and overrate lower performing students., Conclusions: Students who obtained higher grades in the final practical examinations received more corrective feedback with suggestions on how to improve from their supervisors. Confirmative feedback alone may not be sufficient for improving the clinical reasoning skills of students., (© 2015 The Authors. Australian Occupational Therapy Journal published by Wiley Publishing Asia Pty Ltd on behalf of Occupational Therapy Australia.)

Aim: This article provides insight into the impact that exposure to an occupational therapist, in personal capacity or via a professional interaction, has on the decision to enter an occupational therapy undergraduate programme., Methods: A quantitative survey was completed by 139 occupational therapy students. The survey tool focussed on the students' exposure to a range of allied health professions (e.g. occupational therapy, physiotherapy, psychology) and investigated how exposure to occupational therapy had influenced their decision to enter the programme., Results: The results indicated that over 70% of respondents had personal professional exposure to occupational therapy prior to making a career decision. Exposure most frequently involved occupational therapy intervention of a friend or family member. The majority of students who had professional exposure to occupational therapy (e.g. family, self, friend received occupational therapy) identified that it was the most influential factor in their career choice. Forty per cent of the occupational therapy students did not enter the programme straight from school and the influence of 'working with an occupational therapist' was noteworthy for mature aged students., Conclusion: Occupational therapists need to consider that every interaction they have with the community provides valuable information regarding the profession and gives insight into occupational therapy as a potential career path for other people. Additionally, the current research identifies there were differences in the impact, type and number of exposures for different student groups, and this potentially offers some insight into ways in which occupational therapy could target specific groups within the community to increase future diversity in the profession., (© 2015 Occupational Therapy Australia.)

Experience is one of the most commonly studied variables in clinical judgment research. In a meta-analysis of research from 1970 to 1996 of judgments made by 4,607 participants from 74 studies, Spengler, White, Ægisdóttir, Maugherman, Anderson, et al. (2009) found an experience-accuracy fixed effect of d = .121 (95% CI [.06, .18]), indicating that with more experience, counseling and other psychologists obtain only modest gains in decision-making accuracy. We sought to conduct a more rigorous assessment of the experience-accuracy effect by synthesizing 40 years of research from 1970 to 2010, assessing the same and additional moderators, including subgroup analyses of extremes of experience, and conducting a sensitivity analysis. The judgments formed by 11,584 clinicians from 113 studies resulted in a random effects d of .146 (95% CI [.08, .21]), reflecting the robustness of only a small impact of experience on decision-making accuracy. The sensitivity analysis revealed that the effect is consistent across analysis and methodological considerations. Mixed effects metaregression revealed no statistically significant relation between 40 years of time and the experience-accuracy effect. A cumulative meta-analysis indicated that the experience-accuracy effect stabilized in the literature in the year 1999, after the accumulation of 82 studies, with no appreciable change since. We assessed a broader range of experience comparing no experience to some experience and comparing nonexperts with experts, and for differences as a function of decision making based on psychological tests; however, these and most other moderators were not significant. Implications are discussed for clinical decision-making research, training, and practice., ((c) 2015 APA, all rights reserved).)

Skills have recently received widespread attention in education policy documents and discussions. This article reports the results of research on Bachelor's degree physiotherapy students' conceptions of skill at the beginning of their studies. The aim of the present study was to examine how beginning students understand skill, and the focus was on conceptions of skill in general rather than on any particular skills. The participants of the study were 35 physiotherapy students. The data were gathered within the first two weeks of their university studies. Specifically, requested essays written by the students were analyzed using the phenomenographic approach. The data-driven analysis yielded four descriptive categories which reflect the students' conceptions of skill: (1) Talents; (2) Skills requiring individual practice; (3) Skills requiring social practice; and (4) Competence requiring collaboration. The categories form a hierarchy. The differences between the categories are described along seven themes of variation. The themes were named: (1) Acquisition; (2) Emotions; (3) Motivation; (4) Reflection; (5) Evaluation; (6) Agency; and (7) Social Environment. This hierarchical system of categories sheds new light on students' understanding of the skill. The findings can be used as a basis for planning physiotherapy curricula, especially for designing skills education and training, and for supporting students along their educational path, especially in offering opportunities for students to reflect on their skill conceptions. Ultimately, physiotherapy students' awareness of different skill conceptions and developing their skills to advise and treat will benefit patients.

This mixed methods study aimed to explore perceptions/attitudes, to evaluate knowledge/ skills, to investigate clinical behaviours of undergraduate physiotherapy students exposed to a composite education curriculum on evidence-based practice (EBP). Students' knowledge and skills were assessed before and after integrated learning activities, using the Adapted Fresno test, whereas their behaviour in EBP was evaluated by examining their internship documentation. Students' perceptions and attitudes were explored through four focus groups. Sixty-two students agreed to participate in the study. The within group mean differences (A-Fresno test) were 34.2 (95% CI 24.4 to 43.9) in the first year and 35.1 (95% CI 23.2 to 47.1) in the second year; no statistically significant change was observed in the third year. Seventy-six percent of the second year and 88% of the third year students reached the pass score. Internship documentation gave evidence of PICOs and database searches (95-100%), critical appraisal of internal validity (25-75%) but not of external validity (5-15%). The correct application of these items ranged from 30 to 100%. Qualitative analysis of the focus groups indicated students valued EBP, but perceived many barriers, with clinicians being both an obstacle and a model. Key elements for changing students' behaviours seem to be internship environment and possibility of continuous practice and feedback.

The purpose of this study was to develop, deliver, and assess relevant interprofessional (IP) simulation experiences for prelicensure students from multiple disciplines in certificate, diploma, and degree programs. Seventy-eight students from four post-secondary institutions participated in either a high-fidelity mannequin postoperative simulation experience (dynamic simulation) or a standardized patient homecare simulation experience (routine simulation). The University of West England Questionnaire was used pre- and post-simulation experience to determine the change in communication and teamwork. Overall, students' perceptions of their communication and teamwork skills increased after completing either simulation. Students from certificate, diploma, and degree programs participating in the same simulations demonstrated improvements on self-report measures of communication and teamwork. The key was creating a simulation learning experience that reflected the realities of practice, rather than the participants' credentials. Placing students in teams that are relevant for practice, rather than grouping them by academic credentials, is necessary and can provide positive learning experiences for all participants, as demonstrated by these results.

Background: The development of reflective learning skills is a continuous process that needs scaffolding. It can be described as a continuum, with the focus of reflection differing in granularity from recent, concrete activities to global competency development., Aim: To explore learners' perceptions regarding the effects of two reflective writing activities designed to stimulate reflection at different degrees of granularity during clinical training., Methods: Totally 142 respondents (students and recent graduates) completed a questionnaire. Quantitative and qualitative data were triangulated., Results: Immediate reflection-on-action was perceived to be more valuable than delayed reflection-on-competency-development because it facilitated day-to-day improvement. Delayed reflection was perceived to facilitate overall self-assessment, self-confidence and continuous improvement, but this perception was mainly found among graduates. Detailed reflection immediately after a challenging learning experience and broad reflection on progress appeared to serve different learning goals and consequently require different arrangements regarding feedback and timing., Conclusions: Granularity of focus has consequences for scaffolding reflective learning, with immediate reflection on concrete events and reflection on long-term progress requiring different approaches. Learners appeared to prefer immediate reflection-on-action.

Purpose: The purpose of this mixed-method study was to explore students' attitudes, knowledge, experience, and receptiveness to interprofessional education (IPE) in the health sciences., Methods: An embedded mixed-method design was used whereby 29 students from 5 health sciences schools (Law, Medicine, Nursing, Pharmacy, Social Work) were administered The Readiness for Interprofessional Learning Scale (RIPLS) and participated in semi-structured interviews., Results: Quantitative results indicated that there was no significant difference regarding readiness for interprofessional learning among the different academic disciplines. Qualitative interviews identified that students were exposed to two types of interprofessional learning experiences: curricular IPE and clinical interprofessional training (IPT). The majority of interprofessional experiences occurred through internships, student activities, and community service opportunities, not in the classroom. The study findings also uncovered lost opportunities for IPE, characteristics of successful interprofessional learning, and students' personal and organizational barriers to IPE., Conclusion: Results have implications for creating and implementing IPE and IPT experiences for students in the health sciences. Specifically, it is important to bring these students together as a collaborative team, both within the classroom and within a clinical setting. This will require a unique type of curriculum and team of instructors.

In the education of veterinary medicine undergraduate students are taught theoretical knowledge and practical clinical skills in order to become practically trained professionals. A possibility to teach practical skills is a center for clinical skills ("Clinical Skills Lab"). Students can train skills and gain experience through frequent repetitions of exercises. To respect animal welfare and introduce alternative methods to animal testing simulators and models are used in such a skills lab. In the current study the demands for a center for clinical skills and its equipment should be identified. The hypothesis should be proven, that students and teachers of veterinary medicine are highly motivated to enhance the education in practical skills. Focus group interviews were conducted with students, veterinarians (private practitioners), lecturers of veterinary medicine and experts for simulation of clinical skills. Needs and requirements of students participating in skills lab classes were identified.The interviews were conducted in individual or in group interviews. Many opinions, topics and needs were expressed, from which great benefit for the development of the skills lab can be drawn. The hypothesis that a skills lab is supported by all participants had to be rejected. Especially students were afraid of this new lab, because no former experience existed. In the interviews many needs and requirements were raised. However, they could easily be summarized to formulate an accurate list of requirements for the Clinical Skills Lab. A Skills Lab planned taking into consideration the results of this qualitative study will have a positive impact on veterinary medical education and teaching. According to empirical values of experts from other Skills Labs a widespread acceptance by the users can be expected on a long-term basis.

Background: To prepare students for pediatric practice, the professional (entry-level) curriculum must reflect the essential knowledge, skills, and abilities (KSA) required for pediatric physical therapist practice., Objectives: The aim of this study was to develop consensus concerning the pediatric-specific KSA that should be expected of doctor of physical therapy (DPT) students at various points in the curriculum: prior to a pediatric clinical education experience, after a pediatric clinical education experience, and at the end of a DPT program., Design and Methods: The study was conducted using the Delphi method. Purposive and snowball sampling were used to recruit pediatric academic faculty and pediatric clinical instructors. Three Web-based survey rounds were used to achieve consensus, defined as agreement among ≥70% of informants. The first round identified pediatric-specific KSA that were essential for DPT students to demonstrate at the identified points in the curriculum. In the second round, informants indicated their level of agreement with each item identified in the first round. Items that achieved consensus were included in the third round, in which informants rated the level of proficiency that DPT students should demonstrate related to pediatric-specific KSA., Results: Consensus revealed the informants' perspectives concerning pediatric-specific KSA that a DPT student should be able to demonstrate at the identified curricular points. Consensus was reached on items in the curricular categories of basic science and foundations for practice; common pediatric diagnoses/pathologies, examination, interventions/plan of care/documentation; and general skills and abilities., Limitations: Limitations included the small sample size and the potential for informants to feel uncomfortable prioritizing KSA., Conclusions: This study is an initial step toward identifying pediatric-specific KSA that should be demonstrated by DPT students.

Objective: The objective of this study was to identify student, clinical instructor (CI), and environmental characteristics and behaviors that make for positive clinical experiences as perceived by physical therapy students., Participants: Nine third-year physical therapist students from entry-level physial therapist education programs around the United States participated in this study., Methods: In this phenomenologic study, participants were interviewed using open-ended questions designed to facilitate rich description. Interviews were recorded, transcribed, validated, and analyzed., Results: Themes were identified through collaborative analysis using constant comparative coding. Students described student, CI, and environmental factors and behaviors that contribute to a quality clinical experience, including: the students' demonstration of initiative to prepare for the clinical experience and preparation after clinic hours; the importance of the CI's insight, allowing CIs to ascertain how much guidance to give in order to foster independence in the student; and the clinical environment's ability to welcome a student and provide the student with novel learning experiences., Conclusion: The student descriptions, including positive and negative examples shared by the interviewees, demonstrate essential characteristics that contribute to a positive clinical experience. Many of the factors identified by students can be influenced by student and CI training and preparation prior to the clinical experience.

Introduction: What health professional students know of AIDS and their attitudes towards PLWA enrich our knowledge in assuring quality of care administered to AIDS patients., Objectives: This study was designed to assess 1) What Nigerian students in various health disciplines know about AIDS and how they behave towards PLWA. and 2) Determine the sociodemographic variables that could influence knowledge of AIDS and behaviour towards PLWA among students of the various health disciplines in a university in North- Eastern Nigeria., Methods: This cross-sectional study involving student volunteers (n=644) in the last two years of their professional training drawn from six disciplines were surveyed using a two-part questionnaire. Section I of which elicited students' sociodemographic and previous AIDS encounter information, and section II assessed knowledge and behaviour towards PLWA., Results: Students in surveyed health professions had an unsatisfactory level of knowledge on AIDS pathophysiology and their behaviour towards PLWA was negative. Gender, clinical year, religious affiliation, discipline, level of satisfaction with AIDS instructions, knowing a family member or another person with a diagnosis of AIDS and willingness to provide care for an AIDS patient influenced the students' knowledge and behaviour., Conclusion and Recommendation: The study revealed a real possibility for health professional students to hesitate to care for PLWA, or render uncoordinated or fragmented care at the time of their graduation. It suggests the need for intervention to include methodical and all inclusive clinical clerkship on HIV/AIDS and small group discussions with real life case scenerios involving PLWA while in training.