Journal of Advances in Medical Education & Professionalism
Volume:11 Issue: 4, Oct 2023

Focussed professionalism training improves surgical trainees’ communication, information gathering, and counselling skills. This study reviews the impact of a professionalism workshop for surgical trainees within a large trust in the United Kingdom developed during the pandemic to support the trainees and help them develop resilienceand appropriate behaviours during the time of increased pressure.

A workshop involving case-based discussions and reflections on professionalism was developed from the themes and methods of training noted to be effective on a literature search of Medline, EMBASE, and PsycINFO databases carried out in May 2020. The impact of Covid on surgical trainees and educator’s professionalism training and the techniques of training preferred by trainees was evaluated by a survey of trainees and trainers after the intervention to evolve future training initiatives. During the workshop, a behavioural marker checklist was used to improve feedback on the observed behaviours.

83 trainers and trainees were surveyed following a professional behaviour workshop training 63 surgeons at various stages of training. Surgical list availability had reduced by at least 5-10 a month for all the trainees within the trust during the pandemic. Most trainees surveyed (49 (60%)) felt that this had reduced the opportunities to train technical skills and develop professional non-technical skills like teamwork and communication skills, adversely impacting the trainee’s clinical performance. The increased support offered by the workshop helped 50 trainees (80%) to improve non-technical skill performance objectively by referencing to behavioural markers and this was felt to have become embedded in practice when surveyed 4 weeks later in 38 trainees (60%). The majority of those surveyed (47 (75%)) felt trainers and trainees had acted professionally during the pandemic and subsequently. The workshop discussions also helped (56 (67%)) trainers and trainees to consider how best to engage professionally with new ways of working as work, and training switched to virtual or telemedicine platforms during the pandemic.

Professionalism-based education facilitates surgical trainee development, making them stronger team members and helping to restore team working skills and embrace new working practices.

The affirmative policies in Brazil guarantee the provision of undergraduate medical education to People with Disability (PWD). The objective was to estimate the prevalence of PWD undergraduate medical students in Brazil in 2019. This is an exploratory, descriptive study that used census data from the total population of the undergraduatemedical students (N=183,646) who were enrolled at the Brazilian medical schools, in 2019. The data are secondary, unidentified and accessed online, and were originally collected by the Higher Education Census conducted by Anísio Teixeira National Institute of Educational Studies and Research (INEP), which used a questionnaire designed to capture information from students and medical courses. The descriptive analysis was based on absolute and relative frequencies. The prevalence of medical students that were PWD was 0.80% (1,460/183,646), and this includes both Brazilian and foreign students. The latter includes people from 76 different countries. Foreign students who are PWD came from eight different countries: Bolivia, Burundi, Cabo Verde, Republic of Congo, Paraguay, Philippines, Singapore and Spain. Most of the PWD were male (51.37%), aged 20 to 24 years (46.78%) and of non-white ethnicity (52.26%). Most students were enrolled in public medical schools (73.97%). A fraction of PWD students (6.51%) was enrolled in medical schools with no specific resource or assistance for PWD. The highest prevalence was the physical disability (39.11%), followed by low vision accuracy (24.45%), intellectual (15.41%), low hearing (14.11%), blindness (3.97%), multiple disabilities (2.47%) and deafness (1.51%). The prevalence of PWD medical students in Brazil is low, and is dominated by students with physical and sensory disabilities but lacks the deaf-blind. Despite the existence of legal regulations favoring PWD to study medicine, some medical schools have not done adequate adjustments to accommodate them. This suggests that affirmative policies for the inclusion of PWD in higher education, particularly in medicine, still need improvement.

Health service in the current global era requires health workers to provide qualified service, this also applies to teaching hospitals. Collaboration between several professions involved (doctors, nurses, and pharmacists) in an interprofessional collaboration system is needed in providing such service. Factors influencing interprofessional collaboration is unique to each health care center. The purpose of this study was to determine the factors that influence the implementation of interprofessional collaborative practice among health workers in Dr. Wahidin Sudirohusodo General Hospital. This is a mixed-method explanatory sequential design study, utilizing quantitative and qualitative data. Quantitative data were obtained from the Indonesian-validated Collaborative Practice Assessment Tool (CPAT) questionnaire. CPAT in Indonesian language has been validated in previous research by Findyartini, et al. in 2019 in Indonesian population. The questionnaire was internally validated with the study population with Cronbach alpha of 0.812. All health care professionals meeting the selection criteria were enrolled for the quantitative study. Thequestionnaire was given to 152 health professionals enrolled as research subjects, including nutritionists, nurses, doctors, pharmacists, and medical rehabilitation specialists serving in Dr. Wahidin Sudirohusodo Hospital for >3 years. Five participants with highest and lowest CPAT score from each profession were invited for FGD entitled “Exploring factors involved in interprofessional collaboration in Wahidin Sudirohusodo General Hospital” and divided into 2 groups according to the CPAT score. The score from each subscale in the questionnaire is obtained for each research subjects and the median is compared among each profession group using Kruskall-Wallis test significant to a p-value of <0.05. Qualitative data as recording transcript is acquired from FGD; the transcript was then coded into several general themes by 2 of the authors and was discussed using thematic analysis using MaxQDA.
Research subjects were predominantly women (121 respondents (79.6%)), 32.9% were nurses, and most of the healthcare professional (81 subjects (55.1%)) have been working for >10 years. Among profession groups (Doctors, Pharmacists, Medical Rehabilitation Specialists, Nutritionists, and Nurses), difference in score distribution (P<0.05) wasfound in relationships among team members (40 vs 39 vs 39.5 vs 36 vs 42, P<0.001), barriers to team collaboration (10 vs 18.5 vs 14 vs 18 vs 10, P<0.001), and leadership (20 vs 20 vs 23 vs 20 vs 20, p 0.045). From the FGD, factors influencing interpersonal collaborative practice are leadership factors, system/rule factors, and personal factors.
This research showed that personal, system/organizational and leadership factors influence the implementation of interprofessional collaboration. In this study, there is a different perception regarding relationships among team members, barriers to team collaboration, and leadership among profession group.

1000 First Days of Life (1000FDL) training program is carried out for 2 years from the 3rd to 6th semester;in this program, students are asked to accompany pregnant women until their children are 2 years old. This study aimed to analyse undergraduate medical students’ communication skills and empathy levels and determine the association between communication skills and empathy after the training program.

This is a cross-sectional study in which 176 undergraduate medical students in Hasanuddin Universityparticipated; they were enrolled in 1000FDL training program and selected using purposive sampling. Data were collected using Modified Arabic Version of the ABIM’s Patient Assessment (MAV-ABIM) and Jefferson Scale of Empathy – Student Version (JSE-S) questionnaires to assess their level of communication skills and empathy. In this study, demographic data were obtained using a semi-open-ended questionnaire. Data were analysed using descriptive statistics, Chi-Square, and Spearman tests.

Communication skill was very good (83.5%), good (15.9%), and inadequate (0.6%), while the empathy level washigh (9.1%), medium (25%), and low (65.9%). There was no significant difference between the level of communication skills (P=0.168) and empathy (P=0.145) based on gender, but there was a significant difference between <12 or >12 times interaction with the empathy level (P<0.001). The association between the level of communication showed that the level of empathy was significant (P<0.001, r=0.399).

Undergraduate medical students had very good communication skills but low empathy levels. There was a positive association between communication skills and empathy level after the training program. The students’ empathy level can be improved by increasing the frequency of interaction with patients in experiential learning through training programs.

Gamification is the use of game design elements in non-game contexts. It is considered a student-centeredinstructional design to motivate student learning and academic behavior. In this study, the effects of gamification on learning statistics (hypothesis testing issue) and attitude toward statistics in comparison with the common e-learning approach were investigated. The students’ experience and critical elements of gamification on learning statistics were assessed, too. In a before and after trial, in a census manner, 64 health faculty students of Guilan University of Medical Sciences, Rasht, Iran, non-randomly were assigned to the intervention (n=42) and control (n=22) groups. Learning activities were gamified in the intervention group, while the control group received traditional problem-solving in the learning management system. Narrative, avatar, level, point, progress bar, scoreboard, challenge and feedback elements were used in the game experience. The implementation of gamification was applied based on Landers’ theory of gamified content. Valid and reliable Persian version of the Survey Attitude toward Statistics questionnaire measuredthe students’ attitude before and after the intervention. The EGameFlow questionnaire and a valid and reliable researchermade exam measured the users’ experience of gamified content and learning hypothesis testing after the intervention. The independent samples T-test, analysis of covariance and the partial eta-squared effect size were calculated by SPSS software, version 26. Compared to the control group, the intervention group had a more positive attitude toward learning difficulty (moderate partial eta-squared 0.099), value and cognitive competency (weak partial eta-squared=0.01 and 0.05). Learning between the two groups was not different (P=0.522). There was a significant correlation between learning and the students’ perceived experience with feedback (r=0.583, P<0.001), concentration (r=0.509, P=0.005), and challenge (r=0.421, P=0.023) of the gamified content. It suggests using gamification on learning statistics while optimizing the design with more focus on the feedback, challenge and concentration elements.

As to the significance of clinical competency, the competency concept should be up-to-date periodically until clinical competency is evaluated based on it. This study aimed to develop and evaluate psychometric properties of a new tool to measure the postgraduate psychiatric nursing students’ competencies. The current study was conducted with a sequential exploratory mixed-method, in Iran, in 2019 -2022. The qualitative part was conventional content analysis, and the quantitative part was a methodology study. The questionnaire was developed by the item generation via individual semi-structured interviews with 21 participants sampled purposefully, and a literature systematic review. In the quantitative phase, psychometric analysis was performed based onconsensus-based standards for the selection of health status measurement instruments (COSMIN) criteria, and using face, content, and construct (i.e., convergent, known group, and exploratory factor analysis done on 199 postgraduate psychiatric nursing students by available sampling) validity. t-test analysis was used to compare the clinical competenceratings of two groups of experienced and inexperienced postgraduate psychiatric nursing students. Additionally, dependability was examined for internal consistency, stability over a one-month period, and measurement error. The sampling technique used for content validity was deliberate. Then, the responsiveness (through minimally detectablechanges), and interpretability (through minimal important changes) were calculated. The questionnaire consisted of 43 items. Construct validity assessment via exploratory factor analysis (EFA) showed that 67.53% of the cumulative variance was explained by two factors: “Education and nursing care” (23 items) and “Evidence based psychiatric nursing interventions” (20 items). The convergent validity with one golden standard instrument was 0.49. The difference of the clinical competency scores of the two groups of experienced and novice was significant (P<0.001). The internal consistency of the entire instrument, and the first and second factors analyzed using alpha Cronbach (α) were respectively 0.947, 0.897, and 0.891. Stability was confirmed by the ICC agreement 0.956 for interrater (CI 0.907-0.980). Standard error of measurement was 3.14. The competency score of students based on their demographic information was not significant (P>0.05). The 43-item postgraduate psychiatric nursing students’ clinical competency questionnaire is a valid and reliable newly developed instrument. Further studies are recommended to be conducted to assess competency with the largest sample size to promote instrument.

Creating a supportive clinical learning environment (CLE) is one of the characteristics of an effective clinical instructor in nursing. Perhaps empowering novice clinical educators using mentorship method can reduce or resolve this problem. The aim of this study was to determine the impact of the mentorship program for novice clinical educators on the nursing students’ actual and preferred understanding of CLE. This quasi-experimental study on three groups was conducted as post-intervention with the participation of 139 undergraduate nursing students of Mashhad University of Medical Sciences. Sampling was done via stratified and multistage method. Students were placed in three groups: expert clinical educator (n=47), novice clinical educator (n=51), and mentorship (n=41). In the novice and expert clinical educator groups, training was conducted through the conventional method. In the mentorship group, a novice clinical educator (mentee) and an expert clinical educator (mentor) had a mentoring relationship for two weeks. The Chan (2001) CLE inventory was completed at the end of the first and second weeks of externship. Data were analyzed through SPSS v. 16 software using one-way ANOVAand paired t-tests. The students of the three groups were homogeneous in terms of gender (P=0.101) and level of interest in the field (P=0.278). According to the result of the paired t-test, the difference in the mean score of the actual and preferred CLE at the end of the first week was statistically significant in the novice clinical educators (P=0.008) and the mentorship group (P=0.04); however, after the implementation of mentorship program (at the end of the second week), the difference was significant only in the novice educators group (P=0.001). The implementation of the mentorship program for novice clinical educators (as with the expert educators group) could lead to a reduction in the mismatch between the actual and preferred views of students about the CLE. Thus, it is recommended that this method should be used under conditions of shortage of expert educators to create a supportive CLE.

Orthopedic residency training has long been an area of active research and discussion, and as the knowledge and concepts in subspecialties evolve, it is crucial to investigate the implications of these advancements in the musculoskeletal oncology field. It is important to note that the acquisition of surgical skills and scientific knowledge from orthopedic texts alone is not sufficient in this area. Orthopedic residents must also acquire multidisciplinary communication and leadership skills, as well as the mental capacity to make sound clinical decisions. Therefore, this commentary highlights the importance of assessing whether the current curriculum provides adequate preparation for residents’ future careers, despite the fact that the expansion of subspecialties in orthopedic education has undoubtedly enhanced the depth of knowledge and concepts in the field. In addition, orthopedic residents must adopt an open-minded and scientific approach toward orthopedic oncology, which has unique principles. Moreover, it is crucial that general orthopedic surgeons have the necessary skills to manage patients and know when to refer them. By exploring these issues, we hope to continually contribute to ongoing discussions about how to improve orthopedic residencyeducation.