Focus on Health Professional Education: A Multi-Professional Journal

Developing your philosophical stance as a PhD student: A case study

Damian Castanelli — 2024-06-28

Developing your philosophical stance can be daunting for new PhD candidates in health professional education. Contemplating the diversity of worldviews in the social sciences may be confronting for those of us from a biomedical background who are unfamiliar with the concepts and unused to metaphysical reflection. However, we need to explore the literature and reflect on our own underlying beliefs to maintain the cohesion of our research. Philosophical stance is generally taken to mean ontology and epistemology, or “what is real” and “how we know what we know”, so developing your philosophical stance involves clarifying your beliefs about the nature of reality and knowledge. Our philosophical stance will influence our research design, practice and reporting. If we are unaware or uncertain of our philosophical stance, we risk misalignment, which will detract from our research claims and undermine their impact. Our philosophical stance is, thus, crucial for ourselves and our audience. This article presents a case study of how my philosophical stance developed over my candidature. I share it to provide insights for others contemplating the same journey. In particular, this paper acknowledges and normalises how understanding and articulating that stance evolved over time.

Considering the review process as a constructive conversation

Megan Anakin — 2024-06-28

Paramedic student and preceptor experiences of a clinical facilitator model during ambulance clinical placements: A qualitative study

Liam Langford — 2024-06-28

Introduction: Ambulance service clinical placements are fundamental to paramedicine student education, but the quality and safety of these placements can be highly variable. Inspired by positive results from a nursing facilitator model, this study reports on a collaboration between an Australian university and ambulance service that introduced a paramedic clinical facilitator for undergraduate paramedic students during their ambulance clinical placements. This article describes the experiences of a clinical facilitator model for paramedicine students and their preceptors during the study period.

Methods: This study follows an exploratory qualitative research methodology. After implementation of the paramedic clinical facilitator model, two focus groups with paramedicine student participants and two semi-structured interviews with their paramedic preceptors were conducted. Intimate observations were recorded in a reflexive logbook by the facilitator, which was kept for data analysis. Purposive sampling was used to recruit participants, and thematic analysis was used to code data and conceptualise themes.

Results: Three broad overarching themes were conceptualised from the data: 1) increased educational opportunities, 2) improved clinical placement management and 3) greater student support and welfare. Both paramedicine students and paramedic preceptors felt that the paramedic clinical facilitator model improved the quality of ambulance clinical placements for undergraduate paramedicine students.

Conclusion: This study suggests that a paramedic clinical facilitator model improved the safety and quality of ambulance clinical placement experience for paramedicine students and preceptors. Universities and ambulance services could consider implementing a paramedic facilitator model for ambulance clinical placements in their local contexts.

Physiotherapy students’ perceptions of engagement with people from culturally and linguistically diverse communities during clinical placement

Romany Martin — 2024-06-28

Introduction: Student physiotherapists’ perceptions and experiences when working with people from culturally and linguistically diverse communities in Australia have not been explored. Understanding the perceptions of student physiotherapists in this context may inform educational experiences in the pursuit of culturally responsive care. Therefore, this paper explores the perceptions and experiences of student physiotherapists engaging with people from culturally and linguistically diverse communities during clinical placement.

Methods: Semi-structured telephone interviews (n = 13) were conducted between March and September 2022 with final-year physiotherapy students from a single cohort at a single tertiary institution. Data were subject to reflexive thematic analysis.

Results: Four themes were generated from the data: 1) culture is a challenge for all stakeholders in health, 2) adapting care and communication, 3) modelling from clinical educators and 4) university preparation. Students understood that culture significantly impacts health and that healthcare must be responsive to culture to be appropriate for a person from a culturally and linguistically diverse community. Understanding and being responsive to the unique attitudes, values and beliefs of each individual underpinned student physiotherapists’ perception of how healthcare can be culturally responsive, and this was viewed as a pivotal principle of person-centred care.

Conclusion: Recommendations are made for stakeholders in physiotherapy clinical education to support opportunities for the development of cultural responsivity during physiotherapy training. University educators are encouraged to consider evaluating the volume and method in which cultural responsivity training is included in physiotherapy programs. Similarly, clinical educators are encouraged to integrate available frameworks for culturally safe practice that are appropriate to their setting of work.

Developing palliative care skills in undergraduate allied health students using an interprofessional simulation-based learning experience

Nathan E Reeves — 2024-06-28

Introduction: There is a growing need to prepare the health workforce to work collaboratively to meet the needs of people affected by life-limiting illness. Despite the call from industry for the inclusion of palliative care in undergraduate curriculum, there are few established methods to deliver this education for interprofessional student cohorts. Where clinical experience options are limited, the simulation-based learning experience (SBLE) offers a valuable experiential learning opportunity in the preparation of students to care for dying patients and their families. This research aims to examine the impact of SBLE on the level of allied health students' confidence in delivering palliative care.

Methods: A quasi-experimental, pre-test/post-test design was used with 11-point rating scales to measure the change in levels of self-reported confidence in knowledge, providing care, preparedness, management and assessment of need, and professional and ethical practice among allied health students who participated in either a face-to-face or an online palliative care SBLE.

Results: A total of 130 students participated in the SBLE in 2019 and 2020. A paired-sample t-test showed improvement post simulation, with mean differences ranging from 2.87 [95% CI 2.45–3.29] for knowledge to 3.2 [95% CI 2.79–3.60] for confidence. All categories were statistically significant (p < .05). Analysis of opened-ended questions indicated that after the simulation, students recognised the importance of a holistic focus and patient-centred care model.

Conclusions: The SBLE improved levels of student perceived confidence for the delivery of palliative care. Educators are encouraged to use SBLE to support the development of graduate capabilities in palliative care in allied health students.

Intrinsic motivation and perceived competence among junior doctors in managing ophthalmic disease

Deepaysh Dutt Charanjeet Singh Dutt — 2024-06-28

Introduction: Perceived competence among junior medical officers (JMOs) in managing ophthalmic disease remains low, and attempts to address this in ophthalmology education often neglect student motivation. This study aims to investigate whether JMOs’ perceived competence in managing ophthalmic patients could be predicted by their levels of motivation while studying ophthalmology as medical students.

Methods: Seventy-one JMOs completed a 7-point Likert scale 34-item questionnaire. Intrinsic motivation as a medical student was measured using the Intrinsic Motivation Inventory (IMI), which included autonomy, competence, relatedness, interest and pressure subscales. Perceived competence in managing ophthalmic disease was measured using the Perceived Competence Scale (PCS). Linear regression analysis was used to determine if intrinsic motivation during medical school predicted perceived competence as JMOs.

Results: Mean IMI scores and PCS scores were low, at 59 (out of 133) and 14 (out of 28), respectively. PCS scores were positively correlated with IMI scores (r = 0.61, p < 0.001), competence (r = 0.59, p < 0.001), relatedness (r = 0.49, p < 0001) and interest (r = 0.61, p < 0.001) and negatively correlated with pressure (r = -0.31, p = 0.009) and female gender (r = -0.30, p = 0.011). Linear regression analysis showed that IMI scores (β = 0.79, p < 0.001) significantly predicted PCS scores. Subscale analysis showed that there was significant predictive value in competence (β = 0.32, p = 0.009) and interest (β = 0.39, p = 0.035) for PCS scores.

Conclusion: This study shows that intrinsic motivation of medical students studying ophthalmology is significantly predictive of their perceived competence as JMOs managing ophthalmic disease. These results point to the importance of fostering medical student intrinsic motivation in an effort to improve perceived competence in JMOs.

Zombies, space stations and a mysterious virus! An online game for teaching outbreak management to medical students

Nikolas Scovell — 2024-06-28

We created an online educational game to teach outbreak management principles to first-year medical students. A post-game survey was administered to evaluate the learning experience and identify areas for improvement. Our results show the game was well received, indicating its acceptability and effectiveness as an educational tool. This supports a growing body of literature demonstrating the positive results of gamification in not only medical teaching but also health education more broadly.

The four-dimensional curriculum framework: 10 years on

Carole Steketee — 2024-06-28

The Four-Dimensional Curriculum Framework (4DF) was first published in Focus on Health Professional Education in 2013. It was created in response to a gap in the literature for a curriculum development tool for interprofessional health that could navigate the challenges associated with conceptualising shared educational opportunities across siloed health professional programs. Its four interconnecting dimensions emphasise the dynamic interplay between curricular elements, highlighting the fact that curriculum design is rarely linear. As a theoretical curriculum framing tool, it facilitates the articulation of big picture considerations when designing learning and teaching activities. Since 2013, it has been cited 60 times by researchers and educators across the globe, indicating that it has been used largely as it was originally intended—to interrogate the purpose and effectiveness of a curriculum in broad terms. This paper revisits the features of the 4DF and, in the light of its application in the literature, explores opportunities to expand its functionality from a theoretical framing tool to one that also provides a practical application of the framework.

Editorial, Vol 25.2: Moving away from comfort in clinical educator professional development through a concerns-based pedagogy

Elizabeth Molloy — 2024-06-28

Learning, teaching and assessment in health professional education and scholarship in the next 50 years

Chinthaka Balasooriya — 2024-06-28

This paper explores how health professional education and scholarship is likely to evolve over the next 50 years. Recognising the ambitious nature of this goal, we have adopted an approach of “looking back to predict the future”, drawing on past trends and lessons learnt to offer some predictions and recommendations. In doing so, we are mindful that recent advances in technology, especially related to generative artificial intelligence (AI), have added a further layer of complexity. The rapid rate of maturation of these technologies and the accompanying array of AI-based software solutions suggest that the educational landscape is likely to change dramatically—and continuously—over the foreseeable future. Within this context, it may seem premature to predict the future or make recommendations. However, in this paper we argue that urgent action is needed by educators to engage with the evolving landscape and to proactively develop models to harness the full potential of emerging technologies. Six themes are addressed, including: 1) the evolving role of educators and education providers, 2) innovative educational models and ethical frameworks, 3) future-focused competencies, 4) authentic assessment, 5) interprofessional education and 6) educational scholarship. This paper proposes a set of recommendations with the intention of stimulating critical discourse that can potentially lead to ongoing exploration of relevant issues.

“It would have been more constructive if she had given me points to improve on”: Student perceptions of patient feedback in dietetics

Simone Gibson — 2024-06-28

Introduction: The voice of the patient has historically been peripheral in many health professional programs.

Methods: We investigated the merit of health professional students seeking patient feedback on the effectiveness of their clinical consultations as part of usual clinical placements. Dietetic students (n = 34) formally sought patient feedback after usual consultations (n = 48) then completed a reflective feedback tool. The experience of seeking and receiving patient feedback was then explored through student written narratives, facilitated with a focus group (n = 4). The student reflective forms, and recorded and transcribed focus group, were inductively analysed for themes.

Results: Despite the positive perception of the educational task, students did not value the overwhelmingly positive feedback they received from patients, preferring more critical clinical educator feedback.

Conclusion: The lack of value attributed to patient perspectives in the learning process raises questions about the success of the current teaching of patient-centred care despite the aspiration to legitimise the patient voice as central to health professional education.

Influencing attitudes of medical students towards substance misusers

Lucy Gilkes — 2024-06-28

Introduction: Substance use disorder is a stigmatised medical condition that is commonly associated with negative attitudes from clinicians, which results in a barrier to best practice treatment. Medical schools need to help develop professional behaviours in students, including compassion, empathy and respect.

Methods: We designed and implemented a brief experiential teaching activity that allowed students to hear multiple patient narratives of their addiction. The effects of this activity on the students’ attitudes were investigated using an attitudinal questionnaire before and after the session. Differences in agreement with the attitudinal statements before and after the seminar are described.

Results: 118 second-year MD students participated in this study, with 102 completing both the pre- and post-seminar questionnaire. In most domains covered by the questionnaire, the proportion of student agreement with statements demonstrated a significant positive change in their attitude towards working with substance misusers.

Conclusion: Student knowledge, sense of responsibility and role legitimacy were high before the seminar, suggesting students accepted that they would have a duty to understand and treat addiction. By contrast, their initial responses to the “I don’t like” and “I feel uncomfortable” questions suggested that they did not feel comfortable or confident with that role or anticipate that it would be rewarding or that the people would be likeable. Student responses to these questions all showed a significant positive change after the seminar. This suggests that listening to narratives of people in recovery from substance use disorders can positively influence attitudes of medical students.