Search

Featured Application: Featured Application: We have validated two clinical virtual reality environments, both with varying levels of threat, for use in future health research. There is an increasing need for virtual reality (VR) health applications. In the field of pain, VR has been used mainly as a distraction, with minimal use of VR to answer basic clinical questions. Pain is multifactorial and inherently threatening. Our lab recently designed two VR clinical environments with varying threat values; the present study sought to validate these environments. Subjects were randomly allocated into either the threatening or non-threatening VR consultation room and both subjective (threat questionnaire) and physiological (salivary cortisol) measurements were taken. As hypothesised, subjects in the threat condition recorded a higher threat score (p < 0.001; effect size = 0.76). There was a cortisol change across time in the threat condition (χ2(2) = 13.83, p < 0.001), but there were unexpected decreases at both 20 (p = 0.001) and 26 min (p = 0.03) following VR. While the physiological findings need further clarification, this study provides some validation of the threat value of our VR clinical tools. As such, these VR environments can potentially be used in pain experiments to help better our understanding of basic pain mechanisms. It is only with such understanding that we might offer new avenues for pain management. [ABSTRACT FROM AUTHOR]

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]

AbstractBackground Midwifery practice is a requirement in the integrated undergraduate nursing programme which includes general, midwifery, community, and psychiatric nursing disciplines. Students are placed in these clinical areas for learning experiences. Students’ experiences in midwifery practice are mostly overwhelming due to the nature of the services rendered. This makes them have mixed feelings of anxiety and excitement. These experiences might hinder or enhance learning.Objective The study sought to explore student nurses’ experiences during placement in midwifery practice.Methods A phenomenological, qualitative approach was used to obtain the experiences of students in midwifery practice. Nonprobability purposive sampling was used to sample midwifery practice areas and nursing students. Measures to ensure trustworthiness were ensured. Ethical considerations were ensured. Data was collected through focus groups of 6–7 members each and analysed using Tesch’s open coding method. Data was collected over a period of nine months. Data was collected until saturation was reached.Results Two main themes that emerged from the findings are: positive and negative experiences which both impacted their clinical learning.Conclusion Findings revealed that students view midwifery training as fascinating as they were the first people to hold babies at birth. However, there are challenges like fear of not meeting learning outcomes and fear of making errors which require the support of professional nurses.

Abstract Introduction There is an increasing emphasis on exploring ways to improve students' transition from the classroom into the clinical environment. Diagnostic radiography (DR) students undergo rigorous theoretical and practical training before they are exposed to the clinical environment. It has been found that when DR students commence clinical learning in the workplace for the very first time, they experience difficulties in this transition. At the site of investigation, a newly integrated and dedicated clinical preparedness (CP) programme was offered; however, little is known about the DR students' perceptions of this programme. Methods A qualitative approach coupled with a self‐developed, cross‐sectional research tool was employed. First‐year DR students were purposefully sampled against the inclusion and exclusion criteria. The principle of voluntary participation was upheld throughout the data collection process. The data were analysed using Braun and Clarke's six steps of thematic analysis. Results Forty‐two responses were collected. Following a thematic analysis, two overarching themes were developed, namely: (1) reflections on the CP programme and (2) suggestions for future CP programmes. Conclusion This study demonstrated the need for effective CP programmes as an approach to ease the transition of first‐year DR students from the classroom into the clinical environment. Several suggestions, for example, an extended CP programme and a clinical information pack were made for the offering of similar programmes in the future.

Background: The prevalence of bullying behaviors in clinical education environments is an important obstacle for students' learning, because it has severe psychological consequences. This study was conducted with the aim of determining the incidence of bullying behaviors among medical students in clinical education environments.Method: This cross-sectional study was conducted in 2019-2020 among medical, undergraduate nursing, midwifery, operating room technology, and anesthesiology students. The research environment consisted of selected teaching hospitals in Zanjan city, Iran, while the sampling method was stratified random sampling. Data were collected using the 18-item Bullying Behaviors in Nursing Education (BBNE) questionnaire and analyzed using SPSS software version 24.Results: Of the 391 participants, the majority (% 61.9) were women, single, with an average age of 22.88±1.71 years. The total bullying score was 16.46±13.44, which was considered low on the range of 0-90. The dimension of aggression towards the student's personality had the highest score of 7.29±6.54. A significant relationship existed between the total bullying score and age, field of study, marital status, place of residence, and semester (P

There is an increasing need for virtual reality (VR) health applications. In the field of pain, VR has been used mainly as a distraction, with minimal use of VR to answer basic clinical questions. Pain is multifactorial and inherently threatening. Our lab recently designed two VR clinical environments with varying threat values; the present study sought to validate these environments. Subjects were randomly allocated into either the threatening or non-threatening VR consultation room and both subjective (threat questionnaire) and physiological (salivary cortisol) measurements were taken. As hypothesised, subjects in the threat condition recorded a higher threat score (p < 0.001; effect size = 0.76). There was a cortisol change across time in the threat condition (χ2(2) = 13.83, p < 0.001), but there were unexpected decreases at both 20 (p = 0.001) and 26 min (p = 0.03) following VR. While the physiological findings need further clarification, this study provides some validation of the threat value of our VR clinical tools. As such, these VR environments can potentially be used in pain experiments to help better our understanding of basic pain mechanisms. It is only with such understanding that we might offer new avenues for pain management.

Background: The prevalence of bullying behaviors in clinical education environments is an important obstacle for students' learning, because it has severe psychological consequences. This study was conducted with the aim of determining the incidence of bullying behaviors among medical students in clinical education environments. Method: This cross-sectional study was conducted in 2019-2020 among medical, undergraduate nursing, midwifery, operating room technology, and anesthesiology students. The research environment consisted of selected teaching hospitals in Zanjan city, Iran, while the sampling method was stratified random sampling. Data were collected using the 18-item Bullying Behaviors in Nursing Education (BBNE) questionnaire and analyzed using SPSS software version 24. Results: Of the 391 participants, the majority (% 61.9) were women, single, with an average age of 22.88±1.71 years. The total bullying score was 16.46±13.44, which was considered low on the range of 0-90. The dimension of aggression towards the student's personality had the highest score of 7.29±6.54. A significant relationship existed between the total bullying score and age, field of study, marital status, place of residence, and semester (P<0.05). Conclusion: The findings indicated a low occurrence of bullying among medical students. Additionally, those who were married, older, and highly educated were more vulnerable to being bullied. Universities ought to improve students' capacity to recognize bullying in clinical education surroundings and instruct them on how to react. [ABSTRACT FROM AUTHOR]

Introduction: There is an increasing emphasis on exploring ways to improve students' transition from the classroom into the clinical environment. Diagnostic radiography (DR) students undergo rigorous theoretical and practical training before they are exposed to the clinical environment. It has been found that when DR students commence clinical learning in the workplace for the very first time, they experience difficulties in this transition. At the site of investigation, a newly integrated and dedicated clinical preparedness (CP) programme was offered; however, little is known about the DR students' perceptions of this programme. Methods: A qualitative approach coupled with a self‐developed, cross‐sectional research tool was employed. First‐year DR students were purposefully sampled against the inclusion and exclusion criteria. The principle of voluntary participation was upheld throughout the data collection process. The data were analysed using Braun and Clarke's six steps of thematic analysis. Results: Forty‐two responses were collected. Following a thematic analysis, two overarching themes were developed, namely: (1) reflections on the CP programme and (2) suggestions for future CP programmes. Conclusion: This study demonstrated the need for effective CP programmes as an approach to ease the transition of first‐year DR students from the classroom into the clinical environment. Several suggestions, for example, an extended CP programme and a clinical information pack were made for the offering of similar programmes in the future. [ABSTRACT FROM AUTHOR]

BACKGROUND: University nursing tutoring from clinical nurses is an essential and necessary component in supporting students to be successful in curricular activities in support of classroom learning. The aim of this study was to describe the experience of the nurse involved in clinical tutoring of students in the Bachelor of Science in Nursing course at an Italian university. METHODS: A survey questionnaire created on the basis of a literature review was sent to all nurses involved in clinical tutoring within the ASL Bt. RESULTS: 67.44% reported that they had never received any kind of specific training despite the fact that 92.51% considered it essential for the correct performance of the role. 82.13% believe that this activity is not adequately valued CONCLUSIONS: The results obtained represent beginning of an educational pathway aimed at standardising the training processes of the clinical tutor, oriented towards improving the learning pathway of the future nursing class.

Background: Transitioning to a professional role is difficult for newly qualified professional nurses. Given the challenges that these nurses experience during the transition to practice, support is essential for them to become efficient, safe, confident, and competent in their professional roles. Objectives: The purpose of this study was to explore the transition experiences of newly qualified professional nurses to develop a preceptorship model. Method: This study employed a qualitative approach to purposively collect data. Concept analyses were conducted applying the steps suggested by Walker and Avant, and the related concepts were classified utilising the survey list of Dickoff, James and Wiedenbach’s practice theory. Results: A preceptorship model for the facilitation of guidance and support in the clinical area for newly qualified professional nurses was developed. The model consists of six components, namely, the clinical environment, the operational manager and preceptor, the newly qualified professional nurse, the preceptorship, the assessment of learning, and the outcome. Conclusion: The study revealed that newly qualified professional nurses face many transition challenges when entering clinical practice. They are thrown far in, experience a reality shock, and are not ready to start performing their professional role. The participants agreed that guidance and support are needed for their independent practice role. Contribution: The preceptorship model for newly qualified professional nurses would be necessary for the transition period within hospitals. This preceptorship model may be implemented by nursing education institutions as part of their curriculum to prepare pre-qualifying students for the professional role.

Background: The clinical environment plays a crucial role in patient safety, as it encompasses the physical, organizational, and cultural aspects of healthcare delivery. Adverse events, such as active errors, can often be attributed to systemic issues within the clinical environment. Addressing and improving environmental factors is essential for minimizing adverse events and enhancing overall patient care quality. Methods: A descriptive, cross-sectional design was applied. The study utilized two questionnaires: the Reporting of Clinical Adverse Events Scale (RoCAES) and the Revised Professional Practice Environment (RPPE) scale. A total of 1388 questionnaires were fully filled out, with a response rate of 71 percent. Results: Nurses who expressed higher levels of satisfaction with various aspects of the clinical environment were more inclined to indicate their intention to report adverse events in the future. These positive relationships suggest that a contented clinical environment fosters a greater willingness among nurses to report adverse event occurrences. Conclusion: The findings of our study support the evidence that demonstrated that the clinical environment plays a significant role in influencing the reporting of adverse events in healthcare settings. It significantly influences nurses' attitudes, quality of care, and adverse event reporting rate. [ABSTRACT FROM AUTHOR]

This study was undertaken within the Degree in Clinical Technology program at Durban University of Technology, South Africa. Clinical technology curricula in South Africa have undergone several changes in response to the demand for a more integrated curriculum. This served as a catalyst for this study, which explored students' and academics' perceptions of the factors that influence learning experiences during work-integrated learning (WIL). A qualitative exploratory research design within an interpretivist paradigm was utilized. The sample comprised 13 students registered for Clinical Technology in the Faculty of Health Sciences, and four academics. Four themes reflecting various factors influencing learning experiences during WIL emerged: learning culture, social nature of learning, student attributes and learning in the time of COVID-19. This study has shed light on factors that influence the learning experiences of Clinical Technology students during WIL and may inform possible improvements to learning experiences, as well as the WIL of students in other contexts. [ABSTRACT FROM AUTHOR]

AIM The aim of this study was to bring awareness to how racism and discrimination, accompanied by bullying and incivility, negatively impact the health of nurses of color. BACKGROUND Racism and discrimination encountered in the daily lives of nurses of color present risk for psychological and physiological damage to their health. Repeated exposure to racism and discrimination leads to cumulative stress that may pose a negative impact on the health status of affected nurses. METHODS Phenomenology served as the methodology for this research study. The principal investigator transcribed and coded data from 10 nurse participants. RESULTS Data illustrate a pattern of nurses of color experiencing discrimination and racism, with racism being a potential public health issue. Their stories may empower others tomake positive, productive decisions and persevere. CONCLUSION Long-term exposure to racism and its related potential effects on nurses' health presents a grave concern for nurses of color. [ABSTRACT FROM AUTHOR]

Background: This study sought to investigate whether different physical function tests (objective measures of physical performance) may identify a low physical resilience in breast cancer survivors (BCS). Methods: This analytical cross-sectional study evaluated 146 BCS and 69 age-matched women without breast cancer history. The different times after the end of treatment were used as criteria for group division. Participants were divided into four groups: control (CT: n = 69–women without breast cancer history); 4 YAT: n = 41). Physical function was evaluated by 4 m walk test (4-MWT), five-times-sit-to-stand test (FTSST), timed up and go test (TUG), and short physical performance battery (SPPB). Age, menopausal status, smoking, number of medications, level of physical activity, body mass index, and muscle strength were used as confounding variables in ANCOVA. Results: All groups that underwent cancer treatment (p < 0.001) identified by 4 MWT, TUG, and FTSST when compared to the CT group. For the SPPB, the p = 0.005) when compared to the CT. Conclusions: The different physical function tests can be used to identify a low physical resilience in BCS.

Althea Gamble Blakey,1 Lynley Anderson,2 Kelby Smith-Han,3 Emma Collins,4 Elizabeth Berryman,5 Tim J Wilkinson1 1Otago Medical School, University of Otago, Dunedin, New Zealand; 2Bioethics Centre, University of Otago, Dunedin, New Zealand; 3Medical Education Unit, University of Western Australia, Perth, Australia; 4Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand; 5Chnnl Limited, Auckland, New ZealandCorrespondence: Althea Gamble Blakey, Otago Medical School, University of Otago, Sayers Building, Dunedin, New Zealand, Email althea.blakey@otago.ac.nzBackground: Medical student and health-care staff bullying remain international concerns. Our understanding about what might solve such problems is still developing. A common approach suggested for bystanders to bullying is that they challenge or “stand up” to the bully. At the same time, the considerable risks should they act (eg, verbal rebuke) are rarely acknowledged, and neither is the potential for considerable cognitive dissonance should they choose not to.Methods: Drawing on a substantial literature review, we developed an interventional program, initially with medical student bullying in mind, that generally employed a discourse for values cultivation. We implemented and evaluated this program through 6 cycles of action research methodology in 6 different departments of one tertiary teaching hospital. Data include individual interviews, discussions with key participants plus freehand comments from wider staff’s workshop evaluations.Results: Alongside others, an early serendipitous finding was the “IMO” [Indirect, focus on Me, focus on Outcome] framework, intended for bystanders to student bullying. From using this framework, participants reported developing confidence in tackling negative behaviours, that interactions had better outcomes and that the workplace atmosphere felt more relaxed. It’s use also significantly reduced cognitive dissonance. Encouragingly, participants went on to use IMO for staff–staff bullying incidents, and other common negative behaviours. We attribute IMO’s utility to its memorability, simplicity and for catering to the many possible causes of bullying, including values issues, without perpetuating or creating conflict.Conclusion: The IMO framework is offered as a widely usable framework for all staff in a clinical environment – a useful addition to popular frameworks used in the clinical workplace, ideas from which might also help these be further refined. Further evaluation would establish whether IMO invites long-term change and its utility in other contexts.Keywords: bullying, bystander, clinical environment, framework, IMO, intervention, medical student, onlooker, verbal

Introduction Conducting research on human-computer interaction and information retrieval requires unobtrusive observations within existing network architectures. State of the art Most of the available tools are not suitable to be applied within restricted clinical systems. The specific requirements hinder analysis of the human factors in health sciences. Concept We identified extensions for popular web browsers as a suitable way to conduct studies in highly regulated environments. Implementation Considering the specialized requirements and an adequate level of transparency for the recorded clinician, we developed an opensource Web Extension compatible with major web browsers. Lessons learned We identified the challenges associated with the specific tool and are preparing its use to understand clinical reasoning in personalized oncology. [ABSTRACT FROM AUTHOR]

Objectives: This study had two purposes: to explore the main socio-demographic and medical characteristics of the psychiatric patients with a history of suicidal behavior, and to identify the main risk factors underlying the suicidal ideation and acts among psychiatric patients, in the light of two recent theories of suicidal behavior. Methods: The study is based on a mixed methodological design. During 2019 to 2021, 65 hospitalized psychiatric patients, who committed at least one non-lethal suicide attempt, were investigated using a questionnaire a scales for data collection. Medical records were used to gather data about certain socio-demographic characteristics and the health status of the respondents. Patients also participated in a narrative interview aimed at disclosing their subjective experiences about their past suicidal behavior. Results: The typical psychiatric patient with a history of suicidal behavior, as highlighted by the quantitative analysis, portraits a young old male from an urban environment, childless, educated, having experienced employment problems, being involved in religious activities. The clinical picture of the patient with suicidal antecedents included a moderate or severe level of depression, the presence of socio-emotional loneliness, the manifestation of frequent and long episodes of suicidal ideation, and the intention of committing suicide in order to stop the pain, whose acts resulted in minor injuries. Findings from the qualitative data revealed four major risk factors for the non-lethal suicidal attempts: family disruptions and social problems; economic burdens; a mixture of psychiatric pathologies; and, to a lesser extent, somatic pathologies. Conclusion: This study is the first to explore the triggers of suicide acts conducted in a clinical environment in the Balkan region. Implications of the pandemic are also discussed. The findings are useful for designing prevention strategies based on individual psychotherapy and therapeutic or support groups, addressing the main risk factors behind the suicidal ideation and gestures. [ABSTRACT FROM AUTHOR]

Munawar Farooq, Shabbir Ahmad, Faisal K Hanjra, Obaidullah Zafar, Khalid Bashir Emergency Department, Hamad General Hospital, Doha, QatarCorrespondence: Khalid Bashir, Tel +974 33766596, Email Khalidbashir1@btinternet.comObjective: There is paucity of evidence for interprofessional education (IPE) conducted within the working environment of emergency departments (EDs). This study demonstrates favorable perception of on-floor IPE sessions conducted in a busy emergency department.Materials and Methods: Between January and December 2020, IPE was conducted in EDs using low fidelity manikins and involved nurses, doctors, respiratory therapists, and medical students already present on floor. The three key areas were, taught cardiac arrest, escalating oxygen therapy for COVID-19 patients, and procedural sedation. Each session lasted 30 min, and feedback was obtained immediately after the session in both transcribed and written forms through scannable survey monkey links.Results: Forty-seven sessions were conducted covering the three topics for 141 participants. The majority of the participants benefited from on-floor IPE and preferred this approach in the future. Both participant and faculty recommended to have some protected time to maximize the learnings.Conclusion: IPE in the clinical environment is feasible, with careful planning it can enhance collaborative learning in the ED.Keywords: interprofessional education, cardiac arrest, procedural sedation, COVID-19, clinical environment, emergency department

Background: The clinical learning environment is crucial for student nurses' skill acquisition and satisfaction in clinical settings. This study aimed to evaluate the relationship between Sudanese student nurses' satisfaction with clinical placements and the clinical learning environment. The study focused on the impact of students' perceptions of their learning environment on their satisfaction levels. Methods: The study was an analytical cross-sectional study that recruited 204 Sudanese student nurses. Participants completed a questionnaire consisting of socio-demographic information, satisfaction with clinical assignments, and the Clinical Learning Environment Scale (CLES). Statistical analyses included descriptive and bivariate analyses, the Mann-Whitney U test, the Kruskal-Wallis test, Spearman correlation, and ordinal logistic regression analysis. Results: The mean satisfaction score was 5.3, with no significant difference between male and female participants. The hospital manager's leadership style had the highest score among the CLES dimensions, while the supervisory relationship had the lowest score. The study found a significant positive correlation between satisfaction level, overall CLES score, and all CLES dimensions. The regression analysis showed that the supervisory relationship and the pedagogical atmosphere in the hospital were the most significant predictors of satisfaction level, while the overall score had the weakest relationship with the outcome variable. Conclusion: Assessing the clinical learning environment is essential to improving student learning outcomes and ensuring a positive educational experience for student nurses. The study recommends paying attention to dimensions with lower scores, such as the supervisory relationship, while maintaining and enhancing dimensions with higher scores, such as the hospital manager's leadership style. [ABSTRACT FROM AUTHOR]

Background: This study sought to investigate whether different physical function tests (objective measures of physical performance) may identify a low physical resilience in breast cancer survivors (BCS). Methods: This analytical cross-sectional study evaluated 146 BCS and 69 age-matched women without breast cancer history. The different times after the end of treatment were used as criteria for group division. Participants were divided into four groups: control (CT: n = 69–women without breast cancer history); <1.0 years after the end of treatment (<1 YAT: n = 60); 1–3.9 years after the end of treatment (1–3.9 YAT: n = 45); and ≥4 years after the end of treatment (>4 YAT: n = 41). Physical function was evaluated by 4 m walk test (4-MWT), five-times-sit-to-stand test (FTSST), timed up and go test (TUG), and short physical performance battery (SPPB). Age, menopausal status, smoking, number of medications, level of physical activity, body mass index, and muscle strength were used as confounding variables in ANCOVA. Results: All groups that underwent cancer treatment (<1 YAT, 1–3.9 YAT and ≥4 YAT) had lower physical performance (p < 0.001) identified by 4 MWT, TUG, and FTSST when compared to the CT group. For the SPPB, the <1 YAT and ≥4 YAT groups had lower performance (p = 0.005) when compared to the CT. Conclusions: The different physical function tests can be used to identify a low physical resilience in BCS. [ABSTRACT FROM AUTHOR]

Introduction: The aims of this study were to explore the undergraduate dental clinical students' experiences and perspectives of paired working in the clinical learning environment. Materials and methods: An interpretivist methodological approach with a socio‐cultural lens was used. A stratified purposeful sampling strategy was chosen. Students digitally recorded three audio‐diaries using Gibbs' cycle to guide reflection on collaborating clinically with a peer. 1:1 semi‐structured interviews were held using a topic guide. Inductive thematic data analysis was undertaken. Results: Eight participants were recruited. Main themes related to individual characteristics (motivation, professionalism, knowledge and experience) and relational features (feeling safe, attaching value, positive working relationships) that contributed to effective collaborative partnerships. The social setting is important for learning in the dental clinical environment. Benchmarking is used by students to motivate and reassure. Students learnt from their peers, particularly when they felt safe and supported and had developed good relationships. A lesser quality learning experience was highlighted in the assistant role. Conclusion: Paired working for clinical training was viewed mostly positively. Working with a variety of peers was beneficial and enabled development of interpersonal skills and professionalism. More effective collaborative learning partnerships were described when students felt they belonged and had affective support. Disadvantages of paired working were noted as reduced hands‐on experience, particularly for senior students and when working in the assistant role. Ground rules and setting learning goals to change the mind‐set about the assistant role were recommended. Emotional and practical support of students is needed in the clinical setting. [ABSTRACT FROM AUTHOR]

Objective Nursing intern students are important observers in the clinical environment. Comprehensive data about palliative care in medical environment can come from a survey that asked nursing intern students about the behaviors of faculty. Methods This survey included a total of 126 third-year nursing intern students from Peking Union Medical College. A self-designed questionnaire was used to investigate the extent to which the students were satisfied about faculty's behaviors related to palliative care, including communication, symptom control and difficult conversations. The students aged 20 to 21. Results There were 63.5%(80/126) students satisfied with the pain management, 34.1%(43/126) and 35.7%(45/126) students were satisfied with the daily communication and conversations to overcome barriers between faculty and patients. Only 33.3%(42/126) were satisfied with the care to the family members after patient'deaths. Nursing intern students who recently experienced the death of patients had significantly lower satisfaction with clinical environment dealing with decedent's family members than those without this experience(25.21 vs 28.41, P＜0.01). Students who received training of palliative care had shown significantly lower satisfaction with clinical environment than those without the training (26.18 vs 31.90, P＜0.001). Conclusions Nursing intern students are unsatisfied with the clinical environment for the training of palliative care indicating some weakness in the performance of palliative care in hospital and the need to improve clinical teaching of palliative care.

Copyright of Zdravotnicke listy is the property of Alexander Dubcek University in Trencin, Faculty of Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Caring behaviours are taught through instruction and clinical instructors’ role modelling while training student nurses. Learning to care for patients and providing safe nursing care is central to any nursing programme. The effects of caring actions are lifelong, positively impact patient outcomes, and result in nurses’ improved physical and emotional well-being.During student nurses’ clinical placement, they complete clinical assessments where they demonstrate practical and theoretical knowledge and interact with the clinical instructor while observing the presence of caring. This study aimed to examine the presence of caring during clinical assessments at five campuses of a private nursing education institution in South Africa. Recommendations were formulated to facilitate caring during student nurses’ clinical assessments. A descriptive, comparative, correlational research method was used. These perceptions were defined and compared as the clinical assessments naturally occurred, and the findings were correlated according to various variables such as age, gender, and location.The results indicated the site of students’ placement had the most significant influence on their perception of the presence of caring. The research findings indicate a correlation between clinical instructors’ characteristics and student nurses’ perceptions of caring. Based on the study’s findings, recommendations were to hold workshops for clinical instructors on methods to demonstrate caring during clinical assessments, facilitate strategies for student nurses to provide feedback on clinical assessments, develop professional, supportive behaviours among clinical instructors, and increase their emotional intelligence.

Objective:Analyzing students’ experiences about clinical practice will help instructors prepare learning settings where students can have more positive experiences. The purpose of this article is to identify nursing students’ views regarding their clinical placement.Method:This descriptive study was conducted with fresher’s in a nursing department of university during spring term of the 2014-2015 academic year in Ankara/Turkey. The data was collected with the question forms prepared by the researchers after the final exam of the “Fundamentals of Nursing Course”. 253 students were provided questionnaires to answer, which were collected after completion.Results:Students mean age was 20.2; 85.4% of them were female and 40.3% of them choose this department for employment opportunities. Students evaluated professional competence and presence of nurses, as “Good” and “Very Good” (with 80% to 90%) and, communication between nurse and patient as “Moderate” and “Bad” (with 60%). Prejudices regarding clinical practice (with 38.7%), fear of making mistake (with 55.3%), prejudices toward clinical setting (with 58.5%), and grade anxiety (with 29.2%) were stated as factors that affect clinical learning negatively.Conclusion:Students’ learning was affected by healthcare professions especially nurses, they worked with, instructors as well as some factors stem from themselves (fear of making a mistake, grade anxiety).

Belonging to the clinical environment and the professional values of the performers play a role in forming a professional identity. Therefore, it is necessary to understand the degree of connection among these concepts.This study aimed to examine the mediating effects of professional values on the relationship between nurses’ clinical environment belongingness and professional identity.In the present study, a descriptive cross-sectional multicenter design was used.A convenient sample of 635 nurses recruited from three hospitals in Fars Province, Southern Iran, from September 2023 to January 2024. Nurses Professional Values Scale–Revised, Clinical Environment Belongingness Scale, and Professional Identity Scale were used to collect the data. The mediation model was analyzed using SPSS v27 and the Process Macro 4.0.The protocol of this study was approved by the Research Ethics Committee of Fasa University of Medical Sciences, and informed consent was obtained from all nurses. The study conforms to the principles outlined in the Declaration of Helsinki.Based on the results of regression analysis, clinical environment belongingness had a positive and significant impact on professional identity (β = 0.366, p < 0.001) and professional value (β = 0.676, p < 0.001). Professional value significantly predicted professional identity (β = 0.170, p < 0.001). The indirect effect of clinical environment belongingness on professional identity via professional values was statistically significant (β = 0.115, SE = 0.024, 95% CI = [0.068, 0.162]), and this effect was directly (β = 0.336, SE = 0.034, 95% CI = [0.297, 0.434]) significant.The new theoretical framework for nurses developed in this study can contribute to professional development. It is further recommended that the promotion of professional value and clinical environment belongingness may be effective in enhancing the professional identity of the nursing staff, as indicated by the results. [ABSTRACT FROM AUTHOR]

The prevalence of mental health conditions in college students is increasing. Due to this rising number, more students with mental health conditions (NSWMHCs) are enrolling in nursing programs. There is a need for nurse educators to discover new ways to foster retention and success for this student population. The purpose of this study was to examine the experiences of undergraduate NSWMHCs in the inpatient clinical setting, particularly related to perceived barriers and changes they would make to their clinical rotations. Qualitative descriptive design. The study was conducted at a 4-year public university in the Northeast region of the United States. A purposeful sample of seven junior and senior undergraduate nursing students diagnosed with mental health conditions. Data were collected between November 2021 and February 2022 through in-depth, semi-structured interviews that lasted between 30 and 60 min each. Data were analyzed using thematic analysis. The data analysis identified seven major themes: dealing with internal and external barriers, relating to patients' experiences particularly those with mental health conditions, sharing perceptions with peers to understand interactions and experiences, using particular coping skills, improving over time, inconsistent faculty interactions, and recommended changes. Findings suggest that while NSWMHCs face multiple challenges in the clinical setting, they also have valuable experiences and possess unique insight that can foster their success. • Nursing students with mental health conditions have valuable experiences to share related to developing coping skills. • This population of students faces multiple internal and external stressors. • Nurse educators can improve the clinical experiences of nursing students with mental health conditions. [ABSTRACT FROM AUTHOR]

Aims: To examine the associations between nurse work environment with nurses' silence about patient safety and the mediating effects of professional discrimination experienced by nurses. Design: Multicentre cross‐sectional study. Methods: Between January and April 2019, 607 nurses and nursing assistants from seven hospitals in Greece assessed their clinical environment using the 'Practice Environment Scale of the Nursing Work Index Revised‐PES‐NWIR', and the silence about patient safety. The 'Experiences of Discrimination Index' was adapted to specifically address experienced discrimination based on the nursing profession. The PROCESS macros for SPSS were used to examine the above associations. Findings: Better nurse practice environment, with the exception of 'staffing and resource adequacy' dimension, was directly associated with less experienced professional discrimination, and directly and indirectly associated with less silence about patient safety, through the mediating role of professional discrimination experienced by nurses. Conclusions: Silence about patient safety is dependent on the clinical work environment and may be a response of nurses to discrimination in the work context. Both an improvement in the nurse work environment and a decrease in professional discrimination would minimize silence about patient safety. Impact: On many occasions, nurses are directly or indirectly discouraged from voicing their concerns about patient safety or are ignored when they do, leading to employee silence and decreasing the standard of care (Alingh et al., BMJ Quality & Safety, 2019, 28, 39; Pope, Journal of Change Management, 2019, 19, 45). Nurses' work‐related determinants for silence are not clearly understood in the patient safety context. A favourably evaluated nurse practice environment is associated with less experienced professional discrimination and less silence about patient safety. To minimize silence about patient safety, both the nurse work environment and the experienced professional discrimination should be taken into consideration by nurse and healthcare managers. [ABSTRACT FROM AUTHOR]

Our study aims to determine the dentist's image and clinical environment features that can overcome the dental anxiety of the child and parent. The study was carried out on 400 children with their parents (n=400) who applied to Erciyes University pediatric dentistry department. The survey method involved questioning the experience of the dentist, the desired dentist, and the clinical environment. According to the results of the survey, it was determined that the children and the parents had positive feelings about this experience (65.5%-68.8%) since the majority of children and their parents had already gone to the dentist (77.5%-93.5%). It was observed that both parents and children want the dentist to wear a mask, but the use of identity cards and glasses is not preferred (p [Med-Science 2020; 9(3.000): 668-73]

Background and Aim: One of the most important components of medical student education, it is clinical education that should always be observed because of its importance. Accordingly, the present study aimed to investigate barriers to quality of clinical education from the viewpoints of medical students of Birjand University of Medical Sciences in the academic year 2018-2019. Materials and Methods: This descriptive cross-sectional study was performed on medical students. A total of 133 students who had completed their basic sciences courses were selected by the available sampling method. The data collecting tool was researcher made questionnaire that its validity and reliability were confirmed. Data were analyzed by SPSS software (Version 16). Results: The mean score of professor’s domain was 15.06±5.69, educational environment and staff 6.1±2.38, personal characteristics of students 6.64 ± 2.43 and curriculum 7.66 ±3.05. The lack of emphasis on important points of the educational materials while presenting the lesson, master's disregard for communication between theoretical knowledge and clinical skills, inadequate knowledge and theoretical information of students, and the student’s lack of confidence in the patient's bedside they were identified as the most important barriers to clinical education. There was also no agreement between the existing and the desired conditions in the areas of interest from the viewpoint of the students and the clinical environment and staff had the highest inconsistency. Conclusion: According to the present study, Students of among master's fields, Student individual characteristics, curriculum, staff and clinical environment, the most important barriers to education knew staff and clinical environments, which could be remedied by providing equipment and facilities and creating the necessary coordination between students and staff.

Objective: The objective of the study is to understand the attitude and perceptions of children toward dentists, dental treatment, and clinical environment. Materials and Methods: A cross-sectional study was conducted where pictorial questionnaires were distributed among 498 children, within the age range of 3–14 years, who visited dental clinics in Aseer region of Saudi Arabia. Fisher's exact and Chi-square tests were applied to the collected data. Results: A majority (59.6%) of the children did like their visit to the dentists. About 63.1% of children preferred to be treated by a female dentist, and 53% of them liked their dentists wearing a colored coat. Female children were found to have significantly more positive responses toward protective gear of dentist and dental experience as compared to the males. Further, 9–11 years of children had more positive responses than the other children of different age groups. Conclusions: It was observed that most of the children liked visiting the clinics, and their siblings also shared their positive experience during dental treatment. However, children are found to fear the dental treatment procedure, especially the use of syringes. Fear toward dentists and clinical environment can be curbed using engaging dental practices. Children are found to be strongly affected by the gender and appearance of the dentists.

Abstract Background Student bullying in the clinical environment continues to have a substantial impact, despite numerous attempts to rectify the situation. However, there are significant gaps in the literature about interventions to help students, particularly a lack of specific guidance around which to formulate an intervention program likely to be effective. With this narrative review about student bullying interventions in the clinical learning environment, we examine and draw together the available, but patchy, information about ‘what works’ to inform better practice and further research. Methods We initially followed a PICO approach to obtain and analyse data from 38 articles from seven databases. We then used a general inductive approach to form themes about effective student bullying intervention practice, and potential unintended consequences of some of these, which we further developed into six final themes. Results The diverse literature presents difficulties in comparison of intervention efficacy and substantive guidance is sparse and inconsistently reported. The final analytical approach we employed was challenging but useful because it enabled us to reveal the more effective elements of bullying interventions, as well as information about what to avoid: an interventionist and institution need to, together, 1. understand bullying catalysts, 2. address staff needs, 3. have, but not rely on policy or reporting process about behaviour, 4. avoid targeting specific staff groups, but aim for saturation, 5. frame the intervention to encourage good behaviour, not target poor behaviour, and 6. possess specific knowledge and specialised teaching and facilitation skills. We present the themed evidence pragmatically to help practitioners and institutions design an effective program and avoid instigating practices which have now been found to be ineffective or deleterious. Conclusions Despite challenges with the complexity of the literature and in determining a useful approach for analysis and reporting, results are important and ideas about practice useful. These inform a way forward for further, more effective student bullying intervention and research: an active learning approach addressing staff needs, which is non-targeted and positively and skilfully administered. (331w).

Abstract Background Student bullying in clinical practice persists, and poor outcomes continue: for learning, academic achievement and career goals, for their mental and physical health and potentially affecting all staff and patients in a clinical workplace. We describe an emergent framework for the strategic design of a bullying intervention, presented as a staff development opportunity. Methods CAPLE (Creating A Positive Learning Environment) was a bullying intervention designed around current best evidence about ameliorating student bullying in the clinical environment. CAPLE was also an action research project delivered in two eight- week cycles, one in 2016 & another in 2017. CAPLE’s primary practical foci were to offer clinical staff in two separate hospital wards an opportunity to develop their clinical teaching skills and to guide them in reflection and cultivation of values around students and learning. Research foci were: 1. to gain insight into staff experiences of CAPLE as a development process and 2. to evaluate how CAPLE might best help staff reflect on, discuss and develop values around student learning, to include bullying. Staff undertook five active learning workshops combined with supportive contact with one researcher over the research period. Data include individual interviews, staff and researchers’ reflective journals and a paper survey about staff experiences of the 2017 intervention. Results We confirm the effectiveness of best evidence from the literature and also that a strategic four-part framework of approach, process, content and person can further enhance a bullying intervention by increasing the likelihood of participant engagement, learning and values change. Conclusions This research aggregates and adds weight to the current literature about student bullying and adds important pragmatic detail about best practice for bullying intervention design and delivery. Ultimately, this emergent framework offers insight to help move past some persistent barriers encountered by those wishing to improve workplace behaviour.

The evaluation of medical students in the clinical setting (outside the classroom) is a great challenge due to the fact that the learning process becomes more complex. There is little scientific literature in which the research ends in an action to design efficient forms of evaluation. We aimed to design and validate an instrument to reach an evaluation by competencies in the Course: Introduction to Clinical Medicine at the National University of San Marcos (UNMSM) in Lima-Peru. This publication follows a research-action methodology, where the initial results led to the design of an evaluation methodology in clinical environments that is then re-evaluated again to determine if it really manages to evaluate the comprehensive skills required in a medical student. Results: 14 professors were interviewed. In the clinical environment, theoretical lectures and planned didactic sessions are used based on clinical cases. In clinical practice, the priority is given to clinical thinking, and problem-based learning (PBL). The reseach team in conjunction with the professors started the evaluation by competences process developing an evaluation instrument for the specific clinical practice. The participants observed resistance to the change because of certain administrative barriers y poor institutional support. The critical point in this investigation was the training in evaluation and learning methodologies. A training plan was required before starting their teaching activities. The professors agreed with the new form of evaluation and recognized the value of the teaching service with responsible and ethical dedication.

Background: This study explored the experiences of undergraduate nursing students during clinical practice at healthcare facilities in the Boland Overberg area in Western Cape, South Africa. Few studies have been done on experiences of nursing students during clinical practice. However, there are still inadequacies, which lead to the deterioration of clinical practice quality. Objectives: To explore and describe the experiences of undergraduate student nurses during clinical practice in healthcare facilities in Boland Overberg, in Western Cape, South Africa. Method: A qualitative, exploratory descriptive design was applied. Data collection was done using focus-group interviews to ascertain the undergraduate student nurses’ experiences during clinical practice in healthcare facilities in the Boland Overberg area in Western Cape Region. Thirty-eight undergraduate nursing students from Boland Campus were selected, using purposive sampling. The sample size was based on data saturation. Colaizzi’s method of coding and thematic content analysis was used to interpret the data. Ethical principles were adhered to. Results: After data analysis, the following themes emerged: clinical learning environment, challenges and inability to reach objectives. Conclusion: During clinical practice in healthcare facilities, students were confronted with dilemmas which must be addressed with proper planning to decrease the challenges in clinical education of future nurses. The findings can be used in planning of nursing education, could provide help to develop effective clinical teaching strategies in nursing education and to support these undergraduate nursing students.

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]

Aim: This study aimed to explore the impact of preceptor clinical teaching behaviours on transition shock in graduate nurses using bi‐directional feedback between graduate nurses and clinical preceptors and to assess preceptor clinical teaching behaviours. Design: This was a descriptive cross‐sectional study. Methods: This study was conducted from January‐February 2019. Participants included graduate nurses (N = 117) and clinical preceptors (N = 908) from a major public tertiary hospital in Western China. Results: Overall level of transition shock of graduate nurses was moderate (mean = 89 SD 17.54). Transition shock level of graduate nurses rose with the increasing of time in clinical work. Intensive care unit graduate nurses suffered the strongest transition shock, whereas surgery graduate nurses suffered the least. Graduate nurses thought that clinical preceptors were best at evaluation and feedback, whereas clinical preceptors thought they were best at showing concern and support. The primary factors associated with transition shock in graduate nurses were the time admitted to the hospital, feedback, and evaluation, use of appropriate teaching strategies, and showing concern and support, explaining 63.5% of the total variation in transition shock in graduate nurses. Conclusion: In Western China, where the development of economic and medical conditions lag, transition shock is a major obstacle to the professional development of graduate nurses and clinical teaching behaviours is the key to overcoming transition obstacles. However, the serious shortage of nurses makes it difficult to not only complete heavy clinical nursing work but also to undertake the teaching of students and graduate nurses. The clinical teaching system is influenced by many factors. Focusing on clinical teaching behaviours and transition shock in graduate nurses will provide valuable data for future intervention studies. Implication: The findings of this study will be of interest to managers at all levels and will enable them to support graduate nurses by engaging in excellent clinical teaching behaviours. In the clinical teaching process, giving more feedback and evaluation, improving the ability of using appropriate teaching strategies and focusing on the physical and mental health of graduate nurses may effectively decrease transition shock of graduate nurses and reduce the turnover rate. [ABSTRACT FROM AUTHOR]

Background: Nursing is a practice based profession that is built on theoretical knowledge, both of which gained through nursing education program. Clinical learning environment component has a great role in providing students with professional abilities by combining cognitive, psychomotor and affective skills. Evidences have identified clinical learning environment as one of the key factor to achieve the desired out comes. Students often face challenges during the courses of clinical learning, which may affect their competence. The aim was to explore challenges faced by nursing students in clinical learning environment. Method: An exploratory approach qualitative method was used in Addis Ababa University, Department of Nursing in January 2018. Semi-structured data collection tool was designed to gather information from students. Final year nursing students were purposively selected and interviewed about their experiences and challenges they faced in the clinical learning environment during their stay in the school. Data was audio record, verbatim transcribed, condensed, coded and analyzed based on content analysis. The data was peer reviewed to ensure its trustworthiness. Result: The participants consisted of nine nursing students, five males and four females aged between 22 and 24 years were involved. Three major themes including Theme 1: learner’s non-readiness, Theme 2: insufficient clinical supervision and Theme 3: unsupportive clinical environment were emerged. Conclusion: proper preparation of students, good selection of ideal clinical environment that fulfill the objective and adequate coaching, guidance and supervision may be necessary to enhance quality education and to produce competent nurse professionals.

In a situation of respiratory failure (RF), patients show signs of increased work of breathing leading to the involvement of accessory respiratory muscles and a desynchronization between rib cage and abdomen known as thoraco-abdominal asynchrony (TAA). Proper assessment of these signs requires sufficiently skilled and trained medical staff. However, human assessment is subjective and is practically impossible to audit. A new non-contact method is proposed for TAA visualization and quantification, in children with RF. The surface variations are analyzed by calculating the 3-dimensional motion of the thorax and abdomen regions during the breathing process. A high-fidelity mannequin was used to simulate thoraco-abdominal asynchrony. The proposed system uses depth information recorded by an RGB-D (Red Green Blue-Depth) camera. Furthermore, surface displacement was calculated in four simulated modes from the normal to the severe TAA mode. Respiratory rates were also calculated based on the analysis of the surface movements. The proposed method was compared to a highly precise laser-ranging system with 1 mm resolution. The resulting root mean square deviation (RMSD) showed an error of 1.78 ml in normal mode, 2.83 mm in mild mode, 2.23 mm in severe mode and 2.34 mm in irregular mode. The results showed a high correlation between the two methods in estimating the retraction distance and respiratory rate (ρ >0.985).

Purpose: The purpose of this study is to explore the perspectives of international nursing students in Turkey on their learning experience. Design and Methods: Qualitative semi‐structured individual interviews and focus group interviews were used to explore nursing students' perspectives on their learning experiences in Turkey. The research population comprised 10 international students. Results: The students expressed fear of being rejected by patients in a clinical setting, as well as feelings of isolation and discrimination. They feel foreign and experience the typical prejudice against their color and language. Practice Implications: Educators should take language and cultural differences into consideration and should listen to international students regarding education methods. Teachers of international students, both academic and clinical, need to be cognizant of the "otherness" of international students. [ABSTRACT FROM AUTHOR]

Early diagnosis of lung cancer via computed tomography can significantly reduce the morbidity and mortality rates associated with the pathology. However, searching lung nodules is a high complexity task, which affects the success of screening programs. Whilst computer-aided detection systems can be used as second observers, they may bias radiologists and introduce significant time overheads. With this in mind, this study assesses the potential of using gaze information for integrating automatic detection systems in the clinical practice. For that purpose, 4 radiologists were asked to annotate 20 scans from a public dataset while being monitored by an eye tracker device, and an automatic lung nodule detection system was developed. Our results show that radiologists follow a similar search routine and tend to have lower fixation periods in regions where finding errors occur. The overall detection sensitivity of the specialists was 0.67 ± 0.07, whereas the system achieved 0.69. Combining the annotations of one radiologist with the automatic system significantly improves the detection performance to similar levels of two annotators. Filtering automatic detection candidates only for low fixation regions still significantly improves the detection sensitivity without increasing the number of false-positives. [ABSTRACT FROM AUTHOR]

Copyright of Croatian Nursing Journal is the property of University of Applied Health Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)