Embed Size (px)
Citation preview
Education Horizon-Scanning
Bulletin – November 2015
Compiled by John Gale
JET Library – Mid-Cheshire
NHS Foundation Trust
Contents Dental Education ..................................................................................................................................... 4
Video vs live demonstration – which works best?.............................................................................. 4
General Healthcare Education ................................................................................................................ 4
Health Education England looks into work experience ...................................................................... 4
Maths anxiety – why a little worry might not be such a bad thing .................................................... 4
Students give thumbs up to virtual classrooms .................................................................................. 5
Problem-based learning – how much do we really know about it? ................................................... 5
How students learn to be paramedics ................................................................................................ 5
Is film the best way to report qualitative research? ........................................................................... 6
Medical Education .................................................................................................................................. 6
Junior doctors and their supervisors – is there a leadership crisis? ................................................... 6
Dealing with uncertainty – how do junior doctors cope?................................................................... 7
What do medical students think makes people fat? .......................................................................... 7
Measuring mentorship in Munich ...................................................................................................... 8
Getting to grips with professionalism in Canada ................................................................................ 8
CBT app cuts suicidal thoughts in junior doctors ................................................................................ 9
Feeling safe or feeling competent. Which is the better yardstick for junior doctors? ....................... 9
GMC sets up medical-education database ....................................................................................... 10
Mini-CEX and OSCEs does the one reflect the other? ...................................................................... 10
Gynaecological teaching associates – are they really an improvement? ......................................... 10
Is hospital the best place to teach doctors? ..................................................................................... 11
Nursing Education ................................................................................................................................. 11
Teaching nurses to look after dying children .................................................................................... 11
Teaching nurses diagnosis – does software help? ............................................................................ 12
Fitness to practise – how well does it really work? .......................................................................... 12
New nurses’ job satisfaction ............................................................................................................. 13
Health Education England launches new nursing frameworks......................................................... 13
Self-confidence and simulation......................................................................................................... 13
Self-directed learning, learning environments and academic performance .................................... 14
Helping mental-health nurses tackle physical illness ....................................................................... 14
Are nursing students ready for the world of work? It depends who you ask. ................................. 14
Student nurses’ first clinical experiences – how do they feel about them? ..................................... 15
Dental Education
Video vs live demonstration – which works best? Source: BMC Medical Education
Date of Publication: November 2015
In a nutshell: Among the many pernicious ideas which have become accepted in the 21st century is
the one that everyone should have perfect teeth. This is a great boon for orthodontists who make a
fortune by inserting various wire contraptions into people’s mouths to gratify their patients’ vanity
and boost their own bank balance. One such contraption is an Adam’s Clasp and this study – led by
Nasser D. Alqahtani from King Saud University in Saudi Arabia – compared two ways of teaching
trainee dentists how to insert one. 49 dental students were divided into two groups. One group
watched a live demonstration of an Adam’s Clasp being inserted while another group watched a
video. There was no difference in the practical skills of the two groups when they were tested
afterwards although the group who watched the video thought that the instructions were more
clearly presented and understandable.
You can read the whole of this article here.
General Healthcare Education
Health Education England looks into work experience Source: NHS Employers’ web site
Date of Publication: November 2015
In a nutshell: Health Education England are trying to find out how much and what kind of work
experience healthcare employers are able to offer. They did a similar survey last year and are
building on that work to provide a ‘baseline,’ level of activity for work-related learning activities;
work-experience opportunities and employability programmes as part of the national Talent for Care
and Widening Participation programmes. The survey takes around 10 to 15 minutes to do and you
can find it here.
Maths anxiety – why a little worry might not be such a bad thing Source: PsychCentral web site
Date of Publication: November 2015
In a nutshell: Maths – particularly the strange branches of it that include letters and can’t be tackled
with a calculator – often gives people the heebie-jeebies. Zhe Wang, from Virginia Polytechnic
Institute and State University and Stephen Petrill from Ohio State University investigated how maths
anxiety affected 237 students’ performance in maths tests. They found that for students who had
little motivation to get to grips with maths the more anxious they felt the worse they performed in
tests. However, for students who were keener at tackling maths there was a U-shaped relationship
between maths anxiety and maths performance. The more anxious they felt the better their
performance up to a certain level of anxiety, but once this level had been exceeded their
performance started to go downhill again.
You can find out more about this study here.
Students give thumbs up to virtual classrooms Source: European Journal of Dental Education
Date of Publication: November 2015
In a nutshell: In this study C. Shi from Dalian University in China led a team of researchers looking
into students’ attitudes to technology and the effectiveness of social-media virtual classrooms. They
surveyed 708 medical students, 385 dental students and 366 foreign (i.e. not Chinese) students
about their use of technology and then created a virtual classroom for some of the students where
they could use instant messaging to freely ask and discuss questions with their tutors. Perhaps not
surprisingly the students were highly proficient in internet usage and navigation. 88.37% of them
owned a computer and frequently logged on to the internet. Most of them thought that the internet
was helpful for their studies and were positive about computerised teaching. The two groups of
students who were enrolled into the virtual classrooms did significantly better in their exams than
the other students.
You can see the abstract of this article here.
Problem-based learning – how much do we really know about it? Source: European Journal of Dental Education
Date of Publication: November 2015
In a nutshell: In education, as in many other spheres of activity, new ideas are enthusiastically taken
up without a huge amount of evidence to back them up. So what do we really know about the
effectiveness of problem-based learning? S.A. Azer from Saud University in Saudi Arabia and D. Azer,
from RMIT University in Melbourne reviewed the evidence on this topic. They found 42 high-quality
studies 43% of which used video recording to measure group interaction. Other studies used indirect
approaches such as focus groups, interviews and questionnaires. Factors affecting group interactions
included students’ and tutors’ perceptions, tutors’ subject-matter expertise, and tutors’ group
dynamics. There was no conclusive evidence about the impact of interaction in problem-based
learning on students’ learning. Nearly two-thirds (64%) of the studies were taken from the world of
medicine and most were carried out in Europe, North America and Asia.
You can read the abstract of this article here.
How students learn to be paramedics Source: Nurse Education Today
Date of Publication: Nurse Education Today
In a nutshell: This study, led by Christer Axelsson, from the University of Borás in Sweden, looked at
how students made the difficult transition to becoming pre-hospital emergency nurses. It found that
the wide range of assignments the students were expected to go on led them to feel great
uncertainty about themselves and excessive respect for qualified staff. The students’ vulnerability
decreased when their supervisors behaved calmly, knowledgeably, confidently and reflectively
although being involved with traumatic incidents early in their career did make them feel more
anxious. Not going out on enough call-outs made the students less active in their student role and
prevented them from ‘availing themselves of potential learning situations.’ Tiredness and hunger
due to long periods working without a break also inhibited the students’ learning.
You can see the abstract of this study here.
Is film the best way to report qualitative research? Source: BMC Medical Education
Date of Publication: November 2015
In a nutshell: In this study Fran Toye, from Oxford University Hospitals NHS Foundation Trust, looked
into the effectiveness of a film based on qualitative research into people’s experience of chronic
pain. 19 healthcare students watched Struggling to be me and were then interviewed about their
reactions to it. Analysis of their responses fell into four distinct themes:
A glimpse beneath the surface – seeing the person behind the pain
Pitfalls of the medical model – recognising that sometimes ‘sitting in,’ with a person rather
than trying to ‘fix them,’ was the better thing to do
Feeling bombarded by despair – acknowledging the intense emotions felt by clinicians in
clinical encounters
Reconstructing the clinical encounter as a shared journey – seeing an appointment as the
first step on a shared journey rather than a one-stop fix
You can see the whole of this article here.
Medical Education
Junior doctors and their supervisors – is there a leadership crisis? Source: BMC Medical Education
Date of Publication: November 2015
In a nutshell: The novelist Anthony Powell thought that people could be divided into two categories,
agents and patients. Agents were the people who did things to others while patients were those
who were done to and, in Powell’s view, the latter far outnumbered the former. Doctors on the
other hand – however much they might be thinking wistfully of pensions, day-time television and
Mediterranean cruises – are expected to manifest leadership to those around them. In practice this
is mostly self-taught, something learnt either by doing it oneself or experiencing it from others. But
how well does this work in practice? Martha A. van der Wal, from Groningen University in Holland,
led a team of researchers who interviewed 117 junior doctors and 201 supervisors. They were both
asked the same four questions
Does the supervisor say exactly how, where and when to perform tasks?
Does the supervisor give general directions on how to perform a task?
Is there a two-way communication with the supervisor?
Does the supervisor make mutual decisions with the resident?
with the junior doctors being asked whether their supervisors exhibited this behaviour and the
supervisors being asked whether they themselves exhibited it. The study found that a third of the
junior doctors did not observe these behaviours and this was the case however advanced, or
otherwise, they were in their training. And not all the supervisors said they displayed this leadership
behaviour either. Both the junior doctors and their supervisors said that they needed more formal
leadership training.
You can read the whole of this article here.
Dealing with uncertainty – how do junior doctors cope? Source: BMC Medical Education
Date of Publication: November 2015
In a nutshell: Among the holy trinity of wisdom imparted to me by my mother (the other two parts
being ‘there’s nowt so queer as folk,’ and ‘there’s no accounting for taste.’) is ‘you never know
what’s going to happen when you wake up.’ This uncertainty is no doubt worse for junior doctors as
the potentialities they are faced with are more unpredictable, mysterious and serious than which
pair of socks they’ll fish out of the wardrobe or whether there’ll be a fresh packet of biscuits at work
today. In this study – led by Alicia Hamai-Sutton from the Universidad Nacional Autónoma de México
– 128 junior doctors were asked about critical incidents during their clinical practice and how they
dealt with the uncertainty surrounding them. Five types of uncertainty were distinguished by the
researchers: technical, conceptual, communicational, systemic and ethical. The critical incidents
about which the junior doctors were uncertain were most frequently resolved by communicating
with senior physicians.
You can read the whole of this article here.
What do medical students think makes people fat? Source: Patient Education and Counseling
Date of Publication: November 2015
In a nutshell: In this study Sean M. Phelan, from the Mayo Clinic, in Rochester, Minnesota asked
1,244 fourth-year medical students why they thought people became obese. Their answers – put,
naturally enough, in a pie chart - were as follows:
The researchers concluded that “targeted interventions may help to improve depth of knowledge
about the causes of obesity and lead to more effective care for obese patients.”
Measuring mentorship in Munich Source: BMC Medical Education
Date of Publication: November 2015
In a nutshell: The most famous piece of paper to emanate from Munich didn’t end happily for any of
the parties involved but when it comes to measuring the quality of junior doctors’ mentoring
arrangements there might be something more effective on the horizon coming out of Bavaria.
Despite the widespread recognition of the importance of mentoring in medical education there has,
up until now, been few ways of measuring the quality of this relationship. Matthias Schäfer from the
Institut für Didaktik und Ausbildungforschung in der Medizin, Klinikum der Ludwig-Maximilians-
Universität (try saying that after a few pints of Lȍwenbrau) in Munich led a team of researchers
trying to develop a survey to do just that. The authors got 134 junior doctors to define their areas of
interest in the mentoring relationship, assign how much importance they attached to each of them
and rate their level of satisfaction with their mentors’ support in each area of interest. The survey
was seen as neither distressing nor too time-consuming and the junior doctors’ scores correlated
closely with their overall satisfaction with the mentoring relationship.
You can read the whole of this article here.
Getting to grips with professionalism in Canada Source: BMC Medical Education
Date of Publication: November 2015
In a nutshell: Developing professionalism in medical students is – like a comprehensive peace plan
for the Middle East – one of those concepts that is easy to express but rather more difficult to bring
about. This study – led by Anna Byszewski, from Ottawa University – looked into how this was
tackled in Canada. The researchers found that most formal teaching about professionalism took
place in the form of lectures and small-group sessions in students’ pre-clinical years with formal
teaching declining significantly once doctors started going out on the wards. Evaluation of trainee
doctors’ professionalism was usually done by their clinical supervisors but OSCEs, portfolios and
‘concern notes’ were being increasingly used. Role modelling was heavily relied on during doctors’
clinical years. Formal remediation strategies were in place at most schools involving essay writing,
reflection exercises or completion of learning modules about professionalism. However there was a
lack of clarity about what defined a lapse from professional standards and fears about reprisal
meant that these weren’t reported as often as they should have been.
You can read the whole of this article here.
CBT app cuts suicidal thoughts in junior doctors Source: PsychCentral web site
Date of Publication: November 2015
In a nutshell: First-year doctors experience a lot of stress, too much responsibility and not enough
sleep all of which has been shown to make them four times more likely than other people to think
about killing themselves. In this study psychiatrists from Michigan University and South Carolina
Medical University looked into the effectiveness of a CBT app they themselves had developed called
MoodGYM. 199 junior doctors took part in the study. Half of them used the app and half were given
general information about depression and suicide. By the end of their first year as junior doctors one
in eight of the doctors who used the app had thought about killing themselves at some point during
the year, compared to one in five of the control group.
You can find out more about this study here.
Feeling safe or feeling competent. Which is the better yardstick for junior doctors? Source: BMJ Open
Date of Publication: November 2015
In a nutshell: Everybody wants junior doctors to be confident and competent but they themselves
aren’t quite sure what these terms are supposed to mean and often use them in different ways from
one another. In this study Damian Roland, from Leicester University, led a team of researchers
looking into how junior doctors perceived their own performance in the context of managing
feverish children in an emergency department. 14 first-year junior doctors and eight second years
took part in the study which found that the doctors weren’t able to distinguish between competence
and confidence in practical terms. However they all agreed about the concept of feeling ‘safe,’ a
term which the researchers believed could help them in their self-evaluation and could be used
more by supervisors and educators in assessing junior doctors.
You can read the whole of this article here.
GMC sets up medical-education database Source: GMC web site
Date of Publication: November 2015
In a nutshell: The General Medical Council (GMC), the Medical Schools Council and several other
bodies are joining forces to set up a UK Medical Education Database (UKMED) which, it hopes, will
pull together facts about the education of undergraduate medical students and postgraduate
doctors. The GMC hope that researchers will be able to use the database to investigate issues such
as how well medical-school selection tests predict future performance or how people’s background
affects applicants’ chances of getting a place at medical school and their success (or lack thereof) in
their future career.
You can find out more about the database – including how to apply to use the information contained
in it – here.
Mini-CEX and OSCEs does the one reflect the other? Source: BMC Medical Education
Date of Publication: November 2015
In a nutshell: It’s reasonably easy to measure how much doctors know – you just make them sit an
exam. It’s a bit more complicated assessing how well they deal with patients. At the moment there
are two main ways of doing this: an Objective Structured Clinical Examination (OSCE) in which
doctors ‘treat’ people pretending to be patients and a Mini-Clinical Evaluation Exercise (mini-CEX)
where they are assessed in their workplace. In this study Anja Rogausch, from the University of
Berne, looked into how well junior doctors’ assessments in OSCE exams matched up with their
assessments in mini-CEX exams. The biggest influence on the junior doctors’ mini-CEX scores were
their trainers’ positions (presumably in the medical hierarchy not vertical, horizontal etc). Highly
complex tasks and assessments taking place in large clinics significantly enhanced overall mini-CEX
scores but high marks in OSCEs did not significantly increase overall mini-CEX scores.
You can read the whole of this article here.
Gynaecological teaching associates – are they really an improvement? Source: Medical Education
Date of Publication: November 2015
In a nutshell: Gynaecological training associates (GTAs) are trained expert patients who take part in
simulations so that junior doctors can practise pelvic examinations. An increasing number of
graduating students are unable to confidently and competently carry out a pelvic examination and
it’s thought that being able to practise on real people without the stresses of a clinical situation is
both more realistic than using a manikin and less harrowing for all concerned than practising on a
genuinely ill woman. Paul P. Smith, from Birmingham University, led a team of researchers reviewing
studies into the effectiveness of GTAs. The researchers found eleven high-quality studies into this
topic which showed that GTAs improved training compared to other teaching methods and
enhanced students’ competence. The students’ communication skill were also improved although
there was no effect on their confidence.
You can read the abstract of this article here.
Is hospital the best place to teach doctors? Source: Medical Education
Date of Publication: November 2015
In a nutshell: Doctors have traditionally been trained in hospitals but community settings are being
used more and more in undergraduate medical courses and this study – led by Rashmi Shahi, from
Flinders University in Adelaide – looked into the different experiences of medical students training in
a hospital, in a community and in a ‘rural longitudinal integrated clerkship (LIC) programme’ – i.e.
working for a long time in the back of beyond. 35 students took part in the study; 20 had trained in a
hospital, seven had done a rural LIC and eight had done a mixture of community and hospital
placements. The students kept log books recording what they had done as part of their placements.
The LIC doctors had seen the most patients, followed by those who had done some placements in
the community with the doctors who had trained in a hospital seeing fewest. Similarly those who
had done a LIC placement in rural areas had taken more patient histories and carried out more
clinical examinations than the other students
You can see an abstract of this article here.
Nursing Education
Teaching nurses to look after dying children Source: BMC Medical Education
Date of Publication: November 2015
In a nutshell: In 2013 the Dutch authorities introduced new national guidelines for looking after
dying children. Charissa Thari Jagt-van Kampen, from the Emma Children’s Hospital in Amsterdam,
led a team of researchers looking into the effectiveness of an educational programme at teaching
nurses to comply with the new guidelines. The programme included an element of e-learning and an
‘interactive educational meeting.’ There were four e-learning modules covering 19 hypothetical
cases covering symptoms, diagnosis and treatment and the nurses’ compliance to the guidelines was
measured before and after the courses. The study found that the educational programme did not
lead to “improvement in documentation of compliance to the guideline.”
You can read the whole of this article here.
Teaching nurses diagnosis – does software help? Source: Nurse Education Today
Date of Publication: November 2015
In a nutshell: In this study – led by Vanessa E.C. Sousa, from Brazil – a team of researchers
developed a piece of software designed to help nursing students get to grips with nursing diagnoses.
The software, called Wise Nurse, was designed to increase the capacity of student nurses to identify
nursing diagnoses and to establish relationships between nursing diagnoses, defining characteristics
and related factors. 37 students were divided into two groups. One group tested the software while
another group solved printed clinical cases. By the end of the study there was no difference between
the two groups which both showed an improvement although the ‘usability score,’ for the software
was good.
You can see an abstract of this article here.
Fitness to practise – how well does it really work? Source: Nurse Education Today
Date of Publication: November 2015
In a nutshell: Universites are responsible for making sure nursing students and newly-qualified
nursing students are fit to be let loose on the general public. However, some research suggests that
universities’ policies a propos fitness to practise can be inconsistent, unclear and open to legal
challenge. Jessica MacLaren, from Edinburgh University, led a team of researchers looking into this
issue by interviewing 11 nursing academics responsible for fitness-to-practise processes in nine
Scottish universities. They found ‘diverse’ processes were in place which, although they were based
on a shared set of principles, were couched in different terminology and varied from one university
to another. However, the researchers also concluded that the universities were tackling broadly-
similar issues and were “building a body of expertise in this area.” Areas of good practice included:
The use of staged processes and graduated outcomes
The incorporation of teaching about fitness-to-practise in nursing programmes
Positive attitudes about health and disability
Collaborative decision making
Areas of ‘challenge,’ included:
Systems for student support
Consistent, equitable and auditable fitness-to-practise processes
You can see an abstract of this article here.
New nurses’ job satisfaction Source: Nurse Education Today
Date of Publication: November 2015
In a nutshell: Anyone who takes an interest in the NHS wouldn’t be at all surprised to find Egyptian
hieroglyphs complaining about a shortage of nurses around the time the pyramids were put up. To
make the problem worse a fair proportion of newly-qualified nurses leave within a few years of
starting work. Patricia Kenny, from the University of Technology in Sydney, led a team of researchers
looking into some of the issues surrounding newly-qualified nurses’ job satisfaction. They found that
two factors influenced how happy the newly-qualified nurses were: their work environment and
their hours and pay. How prepared the new nurses felt for the world of work was significantly, and
positively, associated with both factors. However, it was only satisfaction with their work
environment that was significantly associated with new nurses’ likelihood of leaving the profession.
How satisfied the nurses were with their training at university played only a small part in their
intentions to stay in, or leave, nursing. One of the most important factors contributing to keeping
new nurses in the profession was taking part in a graduate-transition programme which reduced the
probability of expecting to leave by 26%.
You can see an abstract of this article here.
Health Education England launches new nursing frameworks Source: NHS Employers’ web site
Date of Publication: November 2015
In a nutshell: Health Education England have launched two new frameworks for staff development
and education. The District and General Practice Nursing Framework sets out the core competencies
needed for moving from acute to primary and community care and outlines the requirements for
working and getting on in both spheres of activity. And the Dementia Core Skills Education and
Training Framework highlights the skills and knowledge needed for good dementia care and aims to
help organisations to standardise dementia education and training, ensure key learning outcomes
are delivered and improve the quality and consistency of education and training provision.
You can download both these documents here.
Self-confidence and simulation Source: Nurse Education Today
Date of Publication: November 2015
In a nutshell: In this study Cynthia L. Cummings and Linda K. Connelly from the University of North
Florida looked into the links between undergraduate nursing students’ satisfaction, confidence and
educational-practice level and their participation in simulation activities over the course of their
studies. The researchers found that there was a link between the students’ self-confidence and
active learning and the amount of simulation activity they had undertaken.
You can see an abstract of this article here.
Self-directed learning, learning environments and academic performance Source: Nurse Education Today
Date of Publication: November 2015
In a nutshell: Self-directed learning relies on students actively seeking out information to fill gaps in
their knowledge rather than passively waiting to be spoon-fed by lecturers. Self-directed learning
has been shown to be superior to traditional methods in terms of students’ academic performance
and the development of positive attitudes towards learning. This study – by Khaled N. Alotaibi from
King Saud University – looked into the links between learning environment, self-directed learning
and students’ achievement. 342 students from nursing and emergency-medical-services degree
courses took part in the study which showed that the students’ perceptions about their learning
environment played a significant role in determining their levels of self-directed learning and, in
turn, their academic performance. The researchers recommended that lecturers provide a
supportive learning environment in terms of good teaching, clear goals and standards, appropriate
assessment, appropriate workload and emphasis on independence to encourage students to do
more self-directed learning.
You can see an abstract of this article here.
Helping mental-health nurses tackle physical illness Source: Nurse Education in Practice
Date of Publication: November 2015
In a nutshell: People suffering from mental distress often have worse health than other people. On
average they drink and smoke more, are fatter and take less exercise – something not always helped
by the side effects of their medication. Carolyn T. Martin, from California State University, looked
into the effectiveness of a physical-assessment assignment taken by 145 mental-health-nursing
students and found that it helped them understand that physical and mental well-being are
intrinsically linked. The students felt more comfortable carrying out physical health checks after the
assignment and were less biased against the patients afterwards.
You can see an abstract of this article here.
Are nursing students ready for the world of work? It depends who you ask. Source: Lippincott Williams and Wilkins
Date of Publication: November 2015
In a nutshell: Most parents think their children are marvellous as they drop them off at school every
morning. Some of their teachers might beg to differ. Apparently the same thing holds true for
nursing lecturers and ward managers with the former more likely to say their charges are well-
prepared for the world of work than the latter. Electronic publisher Lippincott Williams and Wilkins
surveyed 190 ward managers and 267 nursing academics to ask them how well they thought nursing
students were equipped for the world of work. Half the lecturers thought the students were well
prepared, compared to only 15% of the ward managers. And while only a quarter of lecturers
thought newly-qualified nurses lacked the knowledge and experience to perform basic procedures
nearly half the ward managers held this gloomy view of new nurses. Only a third of lecturers thought
nurses were less well prepared than they were five years ago whereas nearly two-thirds of ward
managers thought new nurses had got worse in the last five years. In terms of specific skills ward
managers were much more likely to be dissatisfied with new nurses’ clinical training (56% vs 21%),
clinical experience (93% vs 58%) and critical-thinking skills (85% vs 49%). Both groups agreed that
new graduates’ main strengths were using technology and general knowledge of nursing and both
agreed that their main weaknesses were time management and prioritization; ability to take charge
and doctor and peer communication.
Student nurses’ first clinical experiences – how do they feel about them? Source: Nurse Education in Practice
Date of Publication: November 2015
In a nutshell: The first contact with a patient is a big milestone in a nurses’ career. Camille Payne,
from Kennesaw State University in Georgia, looked a little further into how new nurses felt about
this encounter in a study of three year groups of students in two universities. The study found that
the students’ anticipation of their first encounter with a patient included emotions of fear,
nervousness and anxiety. Clinical experiences allowed processing/working through something which
was affected by the actions of teachers, nurses and patients. Finally the participants in the study
developed ‘awareness,’ as a result of their experiences.
You can see an abstract of this article here.
