Pam Nicol

A student-centred feedback model for educators.

Background:  Effective feedback is instrumental to effective learning. Current feedback models tend to be educator driven rather than learner‐centred, with the focus on how the supervisor should give feedback rather than on the role of the learner in requesting and responding to feedback.

Retention into internship of resuscitation skills learned in a medical student resuscitation program incorporating an Immediate Life Support course

AIMS This study describes the acquisition and retention of resuscitation skills by medical students during and following a vertically integrated training program incorporating an Immediate Life Support course (ILS): and the skills demonstrated by interns on entry to clinical practice. METHODS Yearly resuscitation workshops were held in the final 3 years of a 6-year undergraduate medical curriculum. These consisted of a basic life support course in year 4; a resuscitation workshop including shock-advisory defibrillation in year 5; and an ILS course in year 6. A medical student cohort was tested during the course and at the beginning of internship. RESULTS Before year 5 training, an average of 36.6% of students passed each criterion and this increased to 72.3% 10 weeks after training. Prior to the ILS course (approximately 6-18 months following year 5 training), this proportion had decreased to 35.2%; and on retesting as interns the proportion was 64.1%, with delay between ILS training and testing of between 3 and 9 months. The proportion of interns correctly performing airway opening, initial rescue breathing and ventilation technique was lower than other measured skills. Those with ILS training performed better in initial rescue breaths (p=0.03), ventilation technique (p=0.04), and recommencement of CPR without delay following defibrillation (p=0.02). CONCLUSIONS A vertically integrated undergraduate resuscitation course appears to reinforce the maintenance of resuscitation skills until internship. Skills are maintained for at least 6-9 months following an ILS course. This may be due to the ILS course embedding the skills more thoroughly.

Informing a culturally appropriate approach to oral health and dental care for pre-school refugee children: a community participatory study

BackgroundPre-school children in families of recently settled refugees often have very high rates of early childhood caries (ECC). ECC is associated with a high level of morbidity and is largely preventable, however effective culturally appropriate models of care are lacking. This study aimed to provide a deeper understanding of the refugee experience related to early oral health by exploring pre-school refugee families (i) understanding of ECC and child oral health, (ii) experiences of accessing dental services and (iii) barriers and enablers for achieving improved oral health. The knowledge gained will be critical to the development of effective early oral health programs in refugee children.MethodsCommunity based participatory qualitative methodology using focus groups of resettled refugee families and community refugee nurse interviews. A community reference group was established and a bi-lingual community research associate was employed. Transcripts were analysed for thematic content using NVivo software.ResultsThere were 44 participants: eight focus groups (nine countries of origin) and five interviews. Emergent themes were (i) the major influence of parents’ previous experience, including their beliefs about deciduous (baby) teeth, traditional feeding practices and poverty; and a consequent lack of understanding of the importance of early oral health and early dental caries, (ii) the burden of resettlement including prioritising, parenting, learning about new foods and how to assimilate into the community, and (iii) refugees’ difficulties in accessing both information and dental services, and the role of schools in addressing these issues. An Opportunities for Change Model was proposed.ConclusionsThe main implication of the study is the demonstration of how enhanced understanding of the refugee experience can inform improvement in early oral prevention and treatment. The community participatory methodology of the study provided a basis for cross-cultural understanding and has already assisted in translating the findings and raising awareness in the provision of targeted refugee oral health services.

Caries burden and efficacy of a referral pathway in a cohort of preschool refugee children

BACKGROUND This study aimed to assess the early caries experience and the efficacy of a community based dental referral pathway in preschool refugees in Western Australia. METHODS Preschool refugee children referred to the Western Australian paediatric hospital Refugee Health Clinic were prospectively screened for caries by a paediatric dentist before being referred to community dental clinics. Dental forms and medical records were audited to assess decayed, missing and filled teeth (dmft), medical data and dental services engagement. Poisson regression analysis determined the contribution of count variables to the final model. RESULTS Among the 105 screened children (54% male, median age 3.2 years, 41% Burmese), community dental clinic engagement was low (46%, n=48). Of the 62% with caries (n=65/105, mean dmft 5.2, SD 4.1), 45% were recommended for specialist dental services and 48% were treated. After adjustment for age, gender and total number of teeth, caries incidence was significantly associated with BMI-for-age Z score (p=0.02). CONCLUSIONS Preschool refugee caries burden was high. The community dental referral pathway was ineffective compared to co-located intersectorial dental screening. Specialist dental service needs are high in this cohort and require a targeted approach.

“Helping someone with a skill sharpens it in your own mind”: a mixed method study exploring health professions students experiences of Peer Assisted Learning (PAL)

BackgroundPeer assisted learning (PAL) has been described as “the development of knowledge and skill through active help and support among status equals or matched companions”. To enhance the learning experience of health professions students and improve collaborative and collegial learning, six pilot Peer Assisted Learning (PAL) projects were conducted across a health science faculty.MethodsA responsive mixed method evaluation design was applied to explore the adequacy of the preparation for PAL, the impact PAL had on student attainment of examination, consultation, communication and feedback skills and to explore students’ learning experiences through PAL.ResultsThe 149 participants agreed the training programme was well organised, offered a safe learning environment and prepared the participant for the PAL activity. The impact of PAL included improvements in students’ confidence and ability to give feedback and developed students’ teaching, clinical and communication skills. Qualitative analysis revealed participants experienced deeper learning through teaching and learning from their peers, became more open to giving and receiving feedback and valued the comfortable/safe learning environment offered through PAL.ConclusionProviding appropriate training in peer teaching and feedback and the schools engagement and openness to peer learning in the classroom and clinical setting enhances students’ peer assisted learning experience.

Interprofessional health education in Australia: Three research projects informing curriculum renewal and development

PURPOSE This paper reports on three interrelated Australian studies that provide a nationally coherent and evidence-informed approach to interprofessional education (IPE). Based on findings from previous studies that IPE tends to be marginalized in mainstream health curriculum, the three studies aspired to produce a range of resources that would guide the sustainable implementation of IPE across the Australian higher education sector. METHOD Nine national universities, two peak industry bodies and a non-government organization constituted the study team. Data were gathered via a mixture of stakeholder consultations, surveys and interviews and analyzed using quantitative and qualitative methods. RESULTS & CONCLUSION An important outcome was a curriculum renewal framework which has been used to explore the implications of the studys findings on Australian nursing. While the findings are pertinent to all health professions, nursing is well placed to take a leading role in establishing IPE as a central element of health professional education.

International trial of online auditory training programme for distinguishing innocent and pathological murmurs

Recognition of normal and abnormal heart sounds and murmurs is an important but declining clinical skill among practitioners. Current teaching methods are often ineffective. This may result from inadequate repetition and normal–abnormal comparisons needed for auditory recognition. This paper describes a rapid new method of teaching murmur recognition using principles of auditory training.

Utilizing curriculum renewal as a way of leading cultural change in Australian health professional education

Health systems globally are engaged with major reforms focused on the need to deliver more responsive, effective and sustainable health services. Interprofessional practice (IPP), and the development of interprofessional educational (IPE) targeted at enabling IPP, sit at the heart of many of these reforms. IPP enabled by IPE could be argued as the practice foundation for achieving new and more effective forms of health service provision and health professional practice (World Health Organization, 2010; Gittell et al., 2013).