Melih Elçin

Training of ‘first-aid’ trainers: a medical school example in Turkey

Objective A student-oriented basic life support and first-aid training is practical to enlarge the number of qualified people in the field. In this study, we aimed to describe and discuss the training process of a group of medical students at Hacettepe University, School of Medicine and their assessment as basic life support and first-aid trainers. Methods A ‘6-hour’ ‘Training the Trainers’ course was conducted and participants’ demonstration and coaching skills were evaluated by using a 3-point scale (1 – needs improvement; 2 – competently performed; 3 – proficiently performed). In total, 31 students out of 45 volunteers were certified as trainers. Results All of the students proficiently performed ‘explain the aim of the demonstration’, ‘motivate participants to use checklists’, and ‘motivate the participants to ask questions’ for demonstraton skills. Similarly, they all got the maximum grade for ‘answer the questions of the participant’, ‘discuss the coach role of the participant’, ‘apply the skills’, and ‘follow up with the participant by using the checklist’ as steps of coaching skills. None of the skills within the checklists needed improvement for any of the candidates. Conclusion Although there are limitations, we hope that our experience of the Training the Trainers course will be useful for readers to highlight the importance of skill-based peer education on a very important public health concern, especially for the developing countries.

Using Standardized Patients in Nursing Education: Effects on Students' Psychomotor Skill Development.

The present study used a quasi-experimental design to examine the effects of using standardized patients for the psychomotor skills development of nursing students. The performance of the experimental group in blood pressure measurement was significantly higher than that of the control group; however, there was no significant difference between the groups with regard to their administration of subcutaneous injections. The results indicated that standardized patients can be integrated into nursing education for developing psychomotor skills of students.

The impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students

BACKGROUND The use of standardized patients is not very common in psychiatric nursing education and there has been no study conducted in Turkey. AIM This study evaluated the impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students. DESIGN This manuscript addressed the quantitative aspect of a doctoral thesis study in which both quantitative and qualitative methods were used. A pre-test and post-test were employed in the quantitative analysis in a randomized and controlled study design. RESULTS The motivation scores, and interim and post-test scores for perceived learning were higher in the experimental group compared to pre-test scores and the scores of the control group. The students in the experimental group reported that they felt more competent about practical training in clinical psychiatry, as well as in performing interviews with patients having mental problems, and reported less anxiety about performing an interview when compared to students in the control group. CONCLUSION It is considered that the inclusion of standardized patient methodology in the nursing education curriculum in order to improve the knowledge level and skills of students would be beneficial in the training of mental health nurses.

Development and evaluation of the evidence-based medicine program in surgery: a spiral approach.

Background Evidence-based medicine (EBM) aims to provide skills that help physicians answer clinically important questions, determine new evidence, and incorporate the acquired knowledge in practice. EBM skills are necessary for the practice of modern medicine, since physicians should use up-to-date knowledge and information to justify their medical decisions. Purpose We aimed to evaluate the EBM program implemented at Hacettepe University School of Medicine. Methods In 2004, a spiral program for the teaching and practice of EBM was developed for the first 3 years of medical school. Following this program, a practice of EBM was included in the fourth year during the surgery clerkship, after an introductory lecture. The students worked within collaborative teams of 3–5 and practiced EBM with actual cases seen in the surgical service in which they were involved. Each student was asked to complete a questionnaire that evaluated the more theoretical program from the first 3 years and the practical application in the fourth year. Results Nearly half of the students stated that the preclinical years of the EBM program were ‘adequate’, but only 30% of the students indicated that the program was practical. They stated that ‘more practical approaches were used in the fourth year, whereas more theory-based approaches were used during the preclinical years’. More than 75% of the students declared that the practice of EBM in the fourth year was useful and appropriate for team-based learning. Conclusions The EBM program was evaluated as ‘adequate’. EBM courses should be included in the entire curriculum in an integrated manner. The students understand the main philosophy of EBM in the clinical year when involved in its practical application with actual patients.

Report of the MEDINE2 Bachelor of Medicine (Bologna First Cycle) Tuning Project

Abstract Background: European Higher Education institutions are expected to adopt a three-cycle system of Bachelor, Master and Doctor degrees as part of the Bologna Process. Tuning methodology was previously used by the MEDINE Thematic Network to gain consensus on core learning outcomes (LO) for primary medical degrees (Master of Medicine) across Europe. Aims: The current study, undertaken by the MEDINE2 Thematic Network, sought to explore stakeholder opinions on core LO for Bachelor of Medicine degrees. Method: Key stakeholders were invited to indicate, on a Likert scale, to what extent they thought students should have achieved each of the Master of Medicine LO upon successful completion of the first three years of university education in medicine (Bachelor of Medicine). Results: There were 560 responses to the online survey, representing medical students, academics, graduates, employers, patients, and virtually all EU countries. There was broad consensus between respondents that all LO previously defined for primary medical degrees should be achieved to some extent by the end of the first three years. Conclusions: The findings promote integration of undergraduate medical curricula, and also offer a common framework and terminology for discussing what a European Bachelor of Medicine graduate can and cannot do, promoting mobility, graduate employability and patient safety.

The first medical humanities programme in Turkey

The medical humanities  The arts and humanities have been considered a recreational activity related to the interests and talents of the doctor, rather than to their practice of medicine.

The effectiveness of traditional Basic Life Support training and alternative technology-enhanced methods in high schools

Background: Implementation of resuscitation training in school programs is a promising approach to improve rates of cardiopulmonary resuscitation use by trained bystanders. Unfortunately, theoretical cardiopulmonary resuscitation instruction alone is not sufficiently effective in developing practical skills. Objectives: This study aimed to investigate the effectiveness of traditional Basic Life Support training and alternative instructional methods to achieve learning objectives of Basic Life Support education. Methods: This quasi-experimental study was conducted in a secondary school in Ankara, Turkey. Eighty-three voluntary students were randomly allocated to theoretical (Group A), video-based (Group B), and mobile-assisted video-based instructions (Group C). All groups were led by the course teacher. Assessments were conducted in training and again 1 week later. Assessments were based on Basic Life Support knowledge and confidence performance scores. Results: Statistically significant difference was found for the groups’ Confidence Scale scores (F(2, 73) = 3.513, p = 0.035, ηp2 = 0.088); Group C (6.76 ± 1.70) scored higher than Group A. The groups’ Basic Life Support checklist scores were statistically significant (F(2, 73) = 28.050, p = 0.000, ηp2 = 0.435); Group C (32.32 ± 3.84) scored higher than the other groups. Statistically significant difference was found for the groups’ measurable Basic Life Support scores (F(2, 73) = 13.527, p = 0.000, ηp2 = 0.270); and Group C (23.76 ± 3.98) scored higher than the other groups. Conclusion: Our findings showed that all instruction methods led to increased Basic Life Support knowledge scores. The mobile-assisted program significantly increased knowledge scores. Same-group high-quality cardiopulmonary resuscitation parameters were more positive than the other instruction groups except for hand position. Group C students expressed higher confidence in their ability to act in an emergency when witnessing a victim collapse.

Developing a Simulation-Based Training Program for the Prehospital Professionals and Students on the Management of Middle East Respiratory Syndrome.

Introduction Middle East Respiratory Syndrome (MERS) is a major global health threat. Prehospital professionals face the risk of infection as they work to save lives. They should be made aware of the disease and be prepared to handle such cases. The aims of our study are to develop a training program about the prehospital management of a MERS case using standardized patient (SP) scenarios, to evaluate the awareness and preparedness of the participants about MERS, and to evaluate the effectiveness of this training. Methods We developed 5 scenarios using SPs and an observation form. We included paramedic students and emergency medical service (EMS) providers in our study. They were involved in the simulations. Results A total of 24 paramedic students and 33 EMS providers participated in our study. Sixteen (84%) of 19 teams recognized the possibility of MERS as a measure of their awareness in the baseline evaluation. The participants lacked donning and doffing personal protective equipments, which revealed their baseline level of preparedness for MERS. Certain improvements in donning and doffing personal protective equipment were observed in the posttraining evaluation. The participants provided positive feedback on the training program. Conclusions The training program was appropriate for both paramedic students and EMS providers. A positive educational climate was created. Because the main concerns of this study were awareness and preparedness, which required human interaction, the SP methodology was the optimal simulation modality.

Nursing students' opinions about the standardized patients and part task trainers used in the clinical skills training

Yöntem: Bu araştırma, yarı deneysel desenli bir çalışmadır. Araştırmanın evrenini 87 hemşirelik lisans birinci sınıf öğrencisi oluşturmuştur. Öğrenciler olasılıksal olarak kontrol grubu (n=43) ve deney grubu (n=44) olmak üzere iki gruba ayrılmıştır. Kontrol grubunda yer alan öğrenciler laboratuar uygulamalarını maketler üzerinde, deney grubu öğrencileri ise standart hasta üzerinde/hibrit simülasyon ile gerçekleştirilmiştir. Laboratuvar çalışmalarının ardından öğrencilerden Laboratuar Çalışması Değerlendirme Formu’nu doldurmaları istenmiştir. Verilerin değerlendirilmesinde sayı, yüzdelik, ortalama ile standart sapma kullanılmıştır.

Development and Evaluation of a Training Program for Organ Procurement Coordinators Using Standardized Patient Methodology.

OBJECTIVES The low rate of consent by next of kin of donor-eligible patients is a major limiting factor in organ transplant. Educating health care professionals about their role may lead to measurable improvements in the process. Our aim was to describe the developmental steps of a communication skills training program for health care professionals using standardized patients and to evaluate the results. MATERIALS AND METHODS We developed a rubric and 5 cases for standardized family interviews. The 20 participants interviewed standardized families at the beginning and at the end of the training course, with interviews followed by debriefing sessions. Participants also provided feedback before and after the course. The performance of each participant was assessed by his or her peers using the rubric. We calculated the generalizability coefficient to measure the reliability of the rubric and used the Wilcoxon signed rank test to compare achievement among participants. Statistical analyses were performed with SPSS software (SPSS: An IBM Company, version 17.0, IBM Corporation, Armonk, NY, USA). RESULTS All participants received higher scores in their second interview, including novice participants who expressed great discomfort during their first interview. The participants rated the scenarios and the standardized patients as very representative of real-life situations, with feedback forms showing that the interviews, the video recording sessions, and the debriefing sessions contributed to their learning. CONCLUSIONS Our program was designed to meet the current expectations and implications in the field of donor consent from next of kin. Results showed that our training program developed using standardized patient methodology was effective in obtaining the communication skills needed for family interviews during the consent process. The rubric developed during the study was a valid and reliable assessment tool that could be used in further educational activities. The participants showed significant improvements in communication skills.