BACKGROUND: Although there is a growing number of children dependent on medical technology, graduating paediatric residents are underprepared to adequately care for these patients. OBJECTIVE: We aimed to help fill this e...BACKGROUND: Although there is a growing number of children dependent on medical technology, graduating paediatric residents are underprepared to adequately care for these patients. OBJECTIVE: We aimed to help fill this educational gap by piloting a novel hands-on medical device curriculum and assessing learner-driven outcomes. METHODS: We used Kern's six-step approach to develop, implement, and evaluate our curriculum. Five educational workshops (central lines, chest tubes, enteral feeds, tracheostomies, shunts) were designed using Kolb's experiential learning theory. Workshops were led by multidisciplinary content experts and integrated into a noon conference series. We studied the curricular impact by measuring feasibility and learner relevance as well as competency-based outcomes via self-evaluations, board-style knowledge assessments and Accreditation Council for Graduate Medical Education (ACGME) Milestones. RESULTS: Thirteen postgraduate year 1 (PGY1) paediatric residents participated in the curriculum. Thematic analysis highlighted the value of practical application of skills with improved comfort managing medical devices. Exposed residents demonstrated statistical improvement in self-assessed skills associated with 3/5 devices and in 9/10 Milestones. These residents also scored higher on the knowledge assessment compared to nonexposed peers, though this was not statistically significant. DISCUSSION: Our study demonstrates the value of a hands-on medical device curriculum in formal paediatric resident education. While this curriculum was successfully integrated into a traditional didactic series, was universally enjoyed, and had a meaningful impact on acquired skills and knowledge, further research on patient-level outcomes may be valuable for programmes interested in adapting a similar learning experience into their current educational model.
BACKGROUND: Effective communication during patient handovers is critical to ensuring patient safety. While previous teaching methods locally have been successful, they have typically relied on substantial faculty input a...BACKGROUND: Effective communication during patient handovers is critical to ensuring patient safety. While previous teaching methods locally have been successful, they have typically relied on substantial faculty input and resources. Drawing inspiration from contemporary approaches to small group learning, this study explores the impact of a gamified clinical simulation-delivered through an interactive, 'Dragon's Den'-style format-on medical students' self-reported confidence and preparedness in handover and referral skills. APPROACH: A 90-min workshop was developed incorporating a 'Dragon's Den'-inspired activity. Students assumed the role of 'investors', in teams, using a structured checklist to evaluate pre-recorded video handovers. This was followed by paired practice of referrals with fictional clinical scenarios, during which students gave and received peer feedback, using the same checklist. Paired pre- and postsession responses were collected via Wooclap to assess changes in self-reported confidence and preparedness. An anonymous free-text feedback form was also distributed following the session. EVALUATION: Quantitative analysis revealed a statistically significant improvement in both confidence and preparedness. Thematic analysis of qualitative feedback highlighted that students found the session engaging, relevant, and valuable; however, some expressed a desire for additional resources and suggested the session may be beneficial if scheduled earlier in the curriculum. IMPLICATIONS: This study supports the use of gamified clinical simulation as an effective method for teaching handover skills. The peer-led, experiential format offers a scalable, low-resource approach that aligns well with the constraints of modern medical curricula. Moreover, this model carries potential for broader application in wider educational settings.
OBJECTIVE: The objective of this study is to evaluate the effectiveness of a novel training model that integrates problem-based learning (PBL) and simulation-based learning (SBL) in improving the emergency response of ra...OBJECTIVE: The objective of this study is to evaluate the effectiveness of a novel training model that integrates problem-based learning (PBL) and simulation-based learning (SBL) in improving the emergency response of radiology staff to iodinated contrast media (ICM) allergic reactions. METHODS: A sequential exploratory mixed-methods design was employed. First, qualitative data from semi-structured interviews with nine radiology staff members (June-August 2024) were analysed using Colaizzi's method to inform the development of a contextually relevant PBL-SBL training model. Subsequently, a randomised controlled trial (September-December 2024) was conducted with 60 radiology staff (physicians, technologists and nurses), who were assigned to either an observation group (PBL-SBL training) or a control group (traditional lectures and skill demonstration). The primary outcome was emergency skills performance, assessed via a structured practical simulation. Secondary outcomes included critical thinking disposition, measured by the Critical Thinking Disposition Inventory (CTDI-CV), and training satisfaction. RESULTS: Compared to the control group, the observation group performed significantly better in emergency procedures, medication use and teamwork (Z = -6.544 to -6.667, p < 0.05) and scored higher across all critical thinking dimensions (Z = -5.660 to -6.654, p < 0.01). They also reported higher satisfaction with teaching methods, stronger teamwork and self-directed learning, improved learning quality and greater learning interest (Z = -2.149 to -5.161, p < 0.05). CONCLUSION: The integrated PBL-SBL model is more effective than traditional methods in enhancing emergency skills, critical thinking and learner satisfaction, supporting its adoption for training healthcare providers in managing ICM allergies.
BACKGROUND: The complexities of the operating theatre present barriers to learning, particularly for medical students. Enhanced preparation, focusing on the expectations, behaviours and environment of the operating theat...BACKGROUND: The complexities of the operating theatre present barriers to learning, particularly for medical students. Enhanced preparation, focusing on the expectations, behaviours and environment of the operating theatre, is essential to ensure students feel confident when attending. Traditional teaching modalities are often limited by resources required, highlighting the need for an engaging, standardised, and resource-efficient approach. APPROACH: Multiple video-based modalities were leveraged: (1) a brief educational video showcasing appropriate and examples of inappropriate theatre attire, (2) a 360° tour of a typical operating theatre at our institution and (3) Shadowbox simulation videos depicting frequent challenges students face in this environment. A 60-min session was embedded within the existing induction programme for early clinical year students. Students interacted with each video, with interactive polling and quizzes used to reinforce key learning points. EVALUATION: Students rated the session as enjoyable and relevant to their learning. Across a number of domains, self-perceived preparedness significantly improved after the session. Qualitative analysis revealed that following the session, students' intended future behaviours in the operating theatre included engaging with preoperative practices, being primed for active participation and seeking learning opportunities beyond the operating theatre. IMPLICATIONS: The model is low-cost, easily updated, and transferable across institutions, supporting scalability and sustainability in diverse educational settings. The next phase will focus on evaluating the longitudinal impact of this intervention on student experiences during clinical placements and developing video-based resources to guide students through the process of surgical hand preparation and gowning.
PURPOSE: Medical training is full of challenging moments due to the increasing volume and complexity of medical knowledge and skills. Thus, an understanding of how learners experience moments of knowledge deficits is imp...PURPOSE: Medical training is full of challenging moments due to the increasing volume and complexity of medical knowledge and skills. Thus, an understanding of how learners experience moments of knowledge deficits is important. This study sought to gain insight into medical students' metacognitive reflections when they encounter knowledge gaps. METHODS: In July 2023, 12 medical students from five cohorts at a private US medical school were recruited via email after providing informed consent. This constructivist study analyzed participants' thoughts and emotions when confronted with a complex clinical scenario using think-alouds and debriefing interviews. Interviews were recorded, transcribed and analyzed using Braun and Clark's thematic coding approach. RESULTS: Our analysis suggests that while participants had disorienting metacognitive experiences in the face of challenging clinical scenarios, they also displayed awareness of their limitations. This awareness was accompanied by a sense of responsibility and efficacy to address those limitations. Additionally, participants' knowledge deficits were characterized by disorganized reasoning and feelings of uncertainty, which for some could then grow into frustration, embarrassment and various kinds of emotional discomfort. Participants reported feeling ill-equipped to move past these moments. CONCLUSIONS: Given that medical students must engage in complex tasks that highlight their knowledge gaps, metacognitive reflection training can provide the tools learners need to regulate emotions. Specifically, training in monitoring, regulation and control could equip students to manage discomfort and stay engaged in effortful learning. This insight will be helpful in determining how to design and teach layered metacognitive reflection skills within medical curricula.
BACKGROUND: Clinical workplace learning was severely disrupted during the COVID-19 pandemic because of social distancing measures. In response, we developed a Virtual Clinic using head-mounted cameras to preserve authent...BACKGROUND: Clinical workplace learning was severely disrupted during the COVID-19 pandemic because of social distancing measures. In response, we developed a Virtual Clinic using head-mounted cameras to preserve authentic patient contact and clinical team interaction for medical students. Our aim was to create virtual teaching activities that allowed participation in real-time patient care and facilitated peer learning and feedback. APPROACH: The Virtual Clinic was established in a separate space with live video connections to the hospital ward. Students rotated between wearing head-mounted cameras during rounds, teaching visits and consultations, whereas peers observed remotely in small groups. Educational design was informed by principles of authentic and active learning strategies. Remote students contributed through discussion, documentation tasks and peer feedback. EVALUATION: Twenty-seven medical students participated in the Virtual Clinic during their internal medicine clerkship. Data were collected through 37 Likert-scale items and 13 open-ended questions. Students reported that Virtual Patient Rounds and Virtual Teaching Visits were both engaging and intellectually stimulating. Despite remote engagement, students reported a strong sense of integration within the medical team. Limitations included occasional connectivity issues. IMPLICATIONS: This innovation supported continued clinical education during pandemic restrictions while fostering student autonomy and team integration. The approach is transferable to other disciplines and contexts, such as interprofessional or global health education. Key lessons include the potential for virtual bedside learning beyond COVID-19.
INTRODUCTION: Clinical placement provides a valuable opportunity for healthcare students to apply their theoretical knowledge in a real-world setting. In paramedicine, factors such as the number and variety of clinical c...INTRODUCTION: Clinical placement provides a valuable opportunity for healthcare students to apply their theoretical knowledge in a real-world setting. In paramedicine, factors such as the number and variety of clinical cases can affect the learning experience. The ability of paramedics to effectively undertake the preceptor role can also impact student learning. Therefore, improving the effectiveness of paramedic preceptors may enhance clinical placements for students. This study explored student perspectives on the skills, knowledge and attributes required to be an effective paramedic preceptor. METHODS: Using convenience and snowball sampling, in September 2024, a cross-sectional online survey was conducted with second-, third- and fourth-year undergraduate and postgraduate students enrolled in an Australian entry-to-practice university paramedicine programs. Students were required to have completed a formally assessed clinical placement to be eligible to participate. RESULTS: Survey responses were received from seventy-five (N = 75) student paramedics. Descriptive data analysis revealed that the key personal attributes paramedic preceptors require are being respectful, approachable and enthusiastic. Knowing how to provide constructive feedback and develop critical thinking skills in students was also viewed as highly important. Additionally, paramedic preceptors are expected to be skilled communicators in high-stress situations. CONCLUSION: These findings may help improve student clinical placement experiences by outlining the skills, knowledge and attributes required of paramedic preceptors. Further research is needed to understand paramedics' views on this topic and the best way to prepare them for the preceptor role.
BACKGROUND: Simulation-based medical education is a widely recognised tool to improve patient safety culture and outcomes. Many preventable clinic errors are specific to the unit where they occur. We planned and conducte...BACKGROUND: Simulation-based medical education is a widely recognised tool to improve patient safety culture and outcomes. Many preventable clinic errors are specific to the unit where they occur. We planned and conducted an interprofessional in situ simulation program aligned with unit-specific errors and report its design, implementation and evaluation. APPROACH: This prospective, survey-based study was conducted at a paediatric tertiary care centre on a medical-surgical inpatient ward. Incident and accident reports were reviewed; the most frequent and/or severe events were identified. Eight in situ simulations were implemented over 8 months. Participants, including residents, medical students, nurses, pharmacists and physicians completed a survey exploring perceptions of the program's ability to improve patient safety. EVALUATION: Incident reports over 12 months were reviewed (n = 329). Four most frequent and serious errors were identified: intravenous solutions selection, enteral feeding rate or type selection, medication transcription and IV infiltration. Simulation participation rate was 86%; survey response rate was 65%. We evaluated the program using Kirkpatrick's model of educational training, assessing reaction through self-reported surveys and results through changes in incident report frequency. Overall, 86% of participants responded positively regarding the program's potential impact to enhance patient safety. This is supported by an increase in incident reporting the year following program implementation and a decrease in each simulation-targeted medical error, albeit not statistically significant. IMPLICATIONS: Our experience in creating an in situ simulation program that aligns with unit-specific needs and addresses implementation challenges may provide valuable insights for other centres seeking enhance patient safety.
Growth mindset, the belief that one's abilities are changeable, is a valued attribute in medical education. Developing a growth mindset is also in direct tension with systems that evaluate performance, such as in medical...Growth mindset, the belief that one's abilities are changeable, is a valued attribute in medical education. Developing a growth mindset is also in direct tension with systems that evaluate performance, such as in medical training. The senior resident role is a microcosm of this tension because it is a pivotal transition time from training to attending. A recently updated framework for clinical competency places trusted as the highest goal for trainees, defined as self-awareness that is bolstered by humility, integrity, and reliability. We provide strategies for both the senior and attending to foster a senior's goal of trusted status. This requires intentional work by both the senior and attending, but we posit that the attending role is paramount in first creating a learning environment that celebrates a growth mindset. The strategies work to promote self-reflection, active problem solving, and exploration of the gray areas of medical decision making to maximize the learning experience.
Incorporating the patient voice into health professional education enhances empathy, promotes person-centred care and enriches learning. This cocreation article describes the development of a practical, feedback-informed...Incorporating the patient voice into health professional education enhances empathy, promotes person-centred care and enriches learning. This cocreation article describes the development of a practical, feedback-informed toolkit to support early medical education through expert by experience (EBE) engagement. EBEs from The Silverlining Brain Injury Charity contributed to the design via a qualitative study using open-ended questionnaires. Thematic analysis identified six key themes: the importance of respectful engagement, logistical challenges, clarity of session expectations, recognition of EBE expertise, personal benefits of participation and ethical concerns. EBEs emphasised the need for dignity, structured facilitation, emotional safeguards and flexible delivery methods. The resulting toolkit is mapped directly to these themes. It includes guidance on planning, facilitation, ethical considerations, orientation and evaluation. Designed for Level 3 of the patient engagement spectrum, where EBEs share lived experiences in faculty-facilitated teaching, the toolkit promotes meaningful, sustainable involvement. It responds to growing calls for coproduction in health education and serves as a replicable model for integrating patient insights into curriculum design and delivery. While based on a small, specialised sample, the depth and clarity of EBE feedback offer strong foundations for this resource. Future work should explore its adaptability across different healthcare disciplines and settings. To increase accessibility, the toolkit is available in two formats: as a shareable webpage and a navigable PDF document. This approach enables wider reach and sustained use by educators, ensuring that patient voices remain central to shaping future health professionals.
BACKGROUND: Evidence is limited internationally regarding medical students' perceptions and training needs in patient safety, following the WHO Global Patient Safety Action Plan 2021-2030, the COVID-19 pandemic, and the...BACKGROUND: Evidence is limited internationally regarding medical students' perceptions and training needs in patient safety, following the WHO Global Patient Safety Action Plan 2021-2030, the COVID-19 pandemic, and the subsequent acceleration in digitalization. To address this gap, this study explores undergraduate medical students' knowledge of patient safety, attitudes regarding safety culture, experiences with errors, and their perspectives on improving patient safety through training and digitalization. METHODS: A mixed-method design was employed, consisting of an online survey with open-ended questions administered at a medical school in Greece. All registered undergraduate students were invited to complete a pretested 46-item study tool, including demographics, the Greek version of the scale 'What is patient safety?' and their personal experiences, views on digitalization and educational needs. RESULTS: A total of 638 students from all 6 years of study participated (58% female; 54.2% preclinical students). Findings revealed poor knowledge regarding error management (mean 2.4/5) and the reporting process (mean 1.8/5). Fear of blame culture was reported by 51.2%. Digitalization was expected to advance patient safety in multiple ways. Students advocated strengthening patient safety training (92.8%), emphasizing case-based learning, integrating patient safety principles into the teaching of all clinical courses and watching their professors acting as role models. CONCLUSIONS: Medical students feel underprepared to manage patient safety issues and request more relevant knowledge and skills. These findings highlight the urgency for appropriate training reforms, tailored to the students' needs, aiming to optimally prepare them to become key players in improving patient safety in a digitally evolving healthcare system.
INTRODUCTION: Role transition can be a challenging time for specialist medical trainees. Insight into the move from junior to senior registrar in Intensive Care is needed to help trainees prepare for this transition, and...INTRODUCTION: Role transition can be a challenging time for specialist medical trainees. Insight into the move from junior to senior registrar in Intensive Care is needed to help trainees prepare for this transition, and educators to support them. This study investigated the role transition experiences of Intensive Care senior registrars to identify the knowledge, skills and capabilities required of trainees to ensure a successful transition. METHODS: Australasian College of Intensive Care Medicine trainees who had completed at least a year as a senior registrar were invited via email from the College to participate in a one-on-one interview. Seven trainees responded and all agreed to an interview. Interviews were transcribed, deidentified and analysed thematically. RESULTS: Three themes represented the seven male participants' experiences: Apprehension, Weight of responsibility and Decision-making. These themes illustrate that the experience of moving from junior to senior ICU registrar is complex, requires a shift in decision-making focus and is characterised by uncertainty. CONCLUSION: Communication skill development appeared to be key to the perspectives shared by our participants. Leadership development warrants more attention in Intensive Care Medicine. This study provides junior doctors at the cusp of transitioning to the role of Intensive Care senior registrars with helpful insights for their own transition. The findings are also helpful to Intensive Care Medicine more broadly and re-imagining what may be required for contemporary and sustainable trainee development.
BACKGROUND: Games are well recognized for enhancing student engagement, yet most reported game-based interventions in higher education remain limited to single, one-time activities. Comprehensive integration of gaming co...BACKGROUND: Games are well recognized for enhancing student engagement, yet most reported game-based interventions in higher education remain limited to single, one-time activities. Comprehensive integration of gaming concepts across an entire course is still uncommon, particularly in health professional education. APPROACH: In this context, a game-based strategy was embedded into an entire dental hygiene (DH) course using a gated pathway and rewards. In a real game, a gated pathway requires players to complete specific tasks before unlocking the next level. In the learning management system (LMS), the same game-based concept was applied by restricting students' access to weekly content until they completed reviewing lecture materials and passed a quiz. Successful completion of the quiz unlocked the next week's materials. Quiz games designed in Gimkit were integrated as rewards for students. EVALUATION: Student engagement data were collected from the LMS, and exam performance was compared with the previous cohort, where no gated pathway was used. Voluntary, anonymous surveys captured students' perceptions. Eighty-eight percent of the survey respondents agreed that the gated pathway helped them complete their tasks on time, and 87% found this intervention helpful for their studies. IMPLICATIONS: This study demonstrates the successful integration of game-based concepts across a full DH course, with positive effects on engagement and performance. Clinical educators can adapt this approach to offer students a better learning experience in a game-like course.
BACKGROUND: In the United Kingdom (UK), newly qualified doctors are routinely responsible for out-of-hours (OOH) care, often managing acutely unwell patients with limited supervision. Despite national recommendations enc...BACKGROUND: In the United Kingdom (UK), newly qualified doctors are routinely responsible for out-of-hours (OOH) care, often managing acutely unwell patients with limited supervision. Despite national recommendations encouraging OOH experience during medical school training, there is no formal curriculum for OOH practice. OBJECTIVES: This scoping review aimed to identify the range of educational interventions designed to prepare UK medical students for OOH clinical responsibilities and assess their reported effects on perceived and actual preparedness. METHODS: Following Joanna Briggs Institute methodology, a systematic search of seven databases and grey literature sources was conducted. Eligible studies involved UK-based medical students and reported empirical outcomes on educational interventions focused on OOH preparedness. Data were extracted and synthesised using the Template for Intervention Description and Replication checklist and Kirkpatrick's evaluation hierarchy. RESULTS: Eighteen studies were included, primarily using quasi-experimental designs of simulation-based teaching. Interventions targeted a wide range of competencies, including prioritisation, communication, clinical decision-making, and leadership. Thirteen studies demonstrated improvements in learner confidence or attitudes (Kirkpatrick Level 2a), while only three showed measurable performance improvement (Level 2b), and one demonstrated behavioural change (Level 3). Most lacked long-term follow-up. Grey literature analysis revealed inconsistent institutional expectations for OOH experience. CONCLUSIONS: Educational interventions on OOH are well-received and enhance perceived preparedness. Current interventions often lack objective assessment and long-term evaluation. This review was limited to published sources and may not reflect all current practice. Nationally standardised, longitudinal curricula supported by robust evaluation strategies are needed to improve graduate preparedness for OOH practice.