Developing chiropractic students clinical practice skills - elements of best practice : a qualitative exploratory descriptive study
- Authors: Haworth, Navine
- Date: 2021
- Type: Text , Thesis , PhD
- Full Text:
- Description: Background Although chiropractic has 125 years as an established profession, scrutiny of the literature proves that few studies have examined the clinical education of chiropractic students with a call for research from academics. This thesis is significant as it develops knowledge that can inform chiropractic bodies and help them improve an essential component of chiropractic education: clinical skill development. Research Purpose and Aims The purpose of this study was to identify elements of best practices in clinical education by critically examining, exploring and describing the aspects of an exemplar chiropractic clinical program that develops students’ clinical practice skills for transition into practice. This study explored the innovative clinical program of a reputable American chiropractic institution providing a scaffolded clinical program across varied clinical settings, patient populations and amongst other health disciplines. Research Design A six-phase exploratory descriptive qualitative design (EDQD) study was conducted to explore and describe the phenomenon being examined (Flick, 2014). This design enabled the collection of information about perceptions and lived experiences of three stakeholder cohorts: clinical faculty members, students and new graduates. Methods Purposive sampling (of students and clinical faculty members) and snowball sampling techniques (of new graduates) were used to derive the sample. Data were collected in three cycles across a two-year period using in-depth, semi-structured interviews. Interviews were conducted with 15 clinical faculty members and eight new graduates, and semi-structured focus groups were conducted with 20 students. All data were audio recorded, transcribed and thematically analysed using an inductive approach. Findings Chiropractic clinical education programs ought to be developed within a framework that incorporates adult learner principles; situated, social and experiential learning theories. Valued was a student-centred learning experience that includes authentic and diverse clinical placements, supervision and mentoring from multiple clinical educators which enhances students’ access to varied perspectives of clinical practices that contributes to developing clinical skills and professional identity. Business knowledge and entrepreneurial skills was an area of deficiency, which is problematic when the objective is to build graduates’ independence in clinical practice and professional prospects are predominantly private practice (NBCE, 2020). Embedding evidence-based practice within curricula and clinical training for educators and students are necessary to ensure this becomes a part of clinical practice. Conclusion This thesis posits best practice in chiropractic clinical education consists of the following: (a) using a scaffolded longitudinal clinical program, (b) varying clinical placements and case mix, (c) supervision and mentoring from multiple clinical educators, (d) educating the clinical educator, (e) curricula designed around industry standards and desired graduate attributes and capabilities, (f) an evidence-based practice approach in the curricula and clinical context, (g) aligning business skills, knowledge and practices with the professional context and (h) interprofessional learning and practice opportunities. Although this study has made a contribution to scholarly discourse, there remain many gaps in our knowledge where further studies are needed.
- Description: Doctor of Philosophy
- Authors: Haworth, Navine
- Date: 2021
- Type: Text , Thesis , PhD
- Full Text:
- Description: Background Although chiropractic has 125 years as an established profession, scrutiny of the literature proves that few studies have examined the clinical education of chiropractic students with a call for research from academics. This thesis is significant as it develops knowledge that can inform chiropractic bodies and help them improve an essential component of chiropractic education: clinical skill development. Research Purpose and Aims The purpose of this study was to identify elements of best practices in clinical education by critically examining, exploring and describing the aspects of an exemplar chiropractic clinical program that develops students’ clinical practice skills for transition into practice. This study explored the innovative clinical program of a reputable American chiropractic institution providing a scaffolded clinical program across varied clinical settings, patient populations and amongst other health disciplines. Research Design A six-phase exploratory descriptive qualitative design (EDQD) study was conducted to explore and describe the phenomenon being examined (Flick, 2014). This design enabled the collection of information about perceptions and lived experiences of three stakeholder cohorts: clinical faculty members, students and new graduates. Methods Purposive sampling (of students and clinical faculty members) and snowball sampling techniques (of new graduates) were used to derive the sample. Data were collected in three cycles across a two-year period using in-depth, semi-structured interviews. Interviews were conducted with 15 clinical faculty members and eight new graduates, and semi-structured focus groups were conducted with 20 students. All data were audio recorded, transcribed and thematically analysed using an inductive approach. Findings Chiropractic clinical education programs ought to be developed within a framework that incorporates adult learner principles; situated, social and experiential learning theories. Valued was a student-centred learning experience that includes authentic and diverse clinical placements, supervision and mentoring from multiple clinical educators which enhances students’ access to varied perspectives of clinical practices that contributes to developing clinical skills and professional identity. Business knowledge and entrepreneurial skills was an area of deficiency, which is problematic when the objective is to build graduates’ independence in clinical practice and professional prospects are predominantly private practice (NBCE, 2020). Embedding evidence-based practice within curricula and clinical training for educators and students are necessary to ensure this becomes a part of clinical practice. Conclusion This thesis posits best practice in chiropractic clinical education consists of the following: (a) using a scaffolded longitudinal clinical program, (b) varying clinical placements and case mix, (c) supervision and mentoring from multiple clinical educators, (d) educating the clinical educator, (e) curricula designed around industry standards and desired graduate attributes and capabilities, (f) an evidence-based practice approach in the curricula and clinical context, (g) aligning business skills, knowledge and practices with the professional context and (h) interprofessional learning and practice opportunities. Although this study has made a contribution to scholarly discourse, there remain many gaps in our knowledge where further studies are needed.
- Description: Doctor of Philosophy
Exploring interprofessional clinical placements to understand perceptions and outcomes for pre-registration healthcare students
- Authors: Hood, Kerry
- Date: 2021
- Type: Text , Thesis , PhD
- Full Text:
- Description: Background There is an ongoing need for preregistration healthcare students to acquire skills that equip them to collaborate with others for patient-centred care and outcomes. Traditional models of university learning and clinical placement seldom offer students the opportunities to experience interprofessional learning or to ‘test the waters’ of collaborative practice. Aims A range of interprofessional learning opportunities were offered to preregistration healthcare students while on clinical placement in a large metropolitan health service. This research evaluated interprofessional learning opportunities for preregistration healthcare students as preparation for collaborative practice. It also explored the perceived value for student learning of these activities and examined the challenges and opportunities accompanying the design and implementation of the student-led beds model. Methods A mixed methods approach was undertaken. In particular, there was a focus on the experiences of students in an immersive two-week interprofessional placement in which interprofessional student teams worked together to lead the care of inpatients in a variety of clinical settings. This experience enabled students to experience authentic collaborative practice in a real clinical setting. The Theory of Planned Behaviour was used to retrospectively evaluate the findings presented in the published papers. Outcomes This research reflects a journey of student experience of clinical interprofessional learning (IPL), from understanding attitudes to IPL to perceptions of clinical workshops and culminating in the experience of an immersive clinical placement. Outcomes included positive learning experiences and a sense of clarity of professional and interprofessional identity. The model of placement was informed by the international literature, most notably the ‘student-led bed’ model pioneered at Karolinska Institute in Sweden. Despite solid evidence of the usefulness and efficacy of this model, it is yet to be embedded in clinical environments across the world. This research demonstrated that the model can be successfully implemented in a metropolitan health service and may contribute to real behavioural change of our future health professionals
- Description: Doctor of Philosophy
- Authors: Hood, Kerry
- Date: 2021
- Type: Text , Thesis , PhD
- Full Text:
- Description: Background There is an ongoing need for preregistration healthcare students to acquire skills that equip them to collaborate with others for patient-centred care and outcomes. Traditional models of university learning and clinical placement seldom offer students the opportunities to experience interprofessional learning or to ‘test the waters’ of collaborative practice. Aims A range of interprofessional learning opportunities were offered to preregistration healthcare students while on clinical placement in a large metropolitan health service. This research evaluated interprofessional learning opportunities for preregistration healthcare students as preparation for collaborative practice. It also explored the perceived value for student learning of these activities and examined the challenges and opportunities accompanying the design and implementation of the student-led beds model. Methods A mixed methods approach was undertaken. In particular, there was a focus on the experiences of students in an immersive two-week interprofessional placement in which interprofessional student teams worked together to lead the care of inpatients in a variety of clinical settings. This experience enabled students to experience authentic collaborative practice in a real clinical setting. The Theory of Planned Behaviour was used to retrospectively evaluate the findings presented in the published papers. Outcomes This research reflects a journey of student experience of clinical interprofessional learning (IPL), from understanding attitudes to IPL to perceptions of clinical workshops and culminating in the experience of an immersive clinical placement. Outcomes included positive learning experiences and a sense of clarity of professional and interprofessional identity. The model of placement was informed by the international literature, most notably the ‘student-led bed’ model pioneered at Karolinska Institute in Sweden. Despite solid evidence of the usefulness and efficacy of this model, it is yet to be embedded in clinical environments across the world. This research demonstrated that the model can be successfully implemented in a metropolitan health service and may contribute to real behavioural change of our future health professionals
- Description: Doctor of Philosophy
Multidisciplinary simulation training for perioperative teams : an integrative review
- Hibberson, Michelle, Lawton, Jessica, Whitehead, Dean
- Authors: Hibberson, Michelle , Lawton, Jessica , Whitehead, Dean
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Perioperative Nursing Vol. 34, no. 2 (2021), p. 3-13
- Full Text:
- Reviewed:
- Description: Background The perioperative environment is a high-risk and complex area and the provision of safe, high-quality surgical care requires a multifaceted approach provided by multidisciplinary health care teams. However, it is reported that the multidisciplinary nature of perioperative teams can present barriers to patient safety through ineffective teamwork, ineffective collaboration and/ or ineffective communication. Multidisciplinary simulation training creates realistic situations in safe environments to allow perioperative teams to improve teamwork and communication alongside the technical skills needed to manage emergency situations. This integrative review critically examines and reports the effects of multidisciplinary simulation training on perioperative teams and highlights the actual and potential advantages and disadvantages of such training. Method A structured integrative literature review process was undertaken yielding 14 key articles that were critically appraised and examined for emergent ‘themes’. Results Multidisciplinary simulation training improved communication, teamwork, teamwork behaviours and teamwork attitudes between multidisciplinary perioperative team members. Overall, improvements in communication and teamwork correlated with improvements in perioperative patient safety. Despite the numerous benefits of multidisciplinary simulation training there are notable barriers to the implementation of such training programs. Multidisciplinary simulation training can be costly to set up and time consuming to facilitate. However, overall increases in patient safety offset the cost of simulation training and time-based barriers can be reduced by running simulation training in conjunction with existing education programs. Conclusion Multidisciplinary simulation training improved communication and teamwork among perioperative teams and this method of training is recommended overall within perioperative units. However, there were notable gaps within the literature, and further research involving multidisciplinary perioperative teams within Australian perioperative units should be conducted to gain a greater insight into the presence of multidisciplinary simulation training and the effects of such training. © 2021, Australian College of Perioperative Nurses. All rights reserved.
- Authors: Hibberson, Michelle , Lawton, Jessica , Whitehead, Dean
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Perioperative Nursing Vol. 34, no. 2 (2021), p. 3-13
- Full Text:
- Reviewed:
- Description: Background The perioperative environment is a high-risk and complex area and the provision of safe, high-quality surgical care requires a multifaceted approach provided by multidisciplinary health care teams. However, it is reported that the multidisciplinary nature of perioperative teams can present barriers to patient safety through ineffective teamwork, ineffective collaboration and/ or ineffective communication. Multidisciplinary simulation training creates realistic situations in safe environments to allow perioperative teams to improve teamwork and communication alongside the technical skills needed to manage emergency situations. This integrative review critically examines and reports the effects of multidisciplinary simulation training on perioperative teams and highlights the actual and potential advantages and disadvantages of such training. Method A structured integrative literature review process was undertaken yielding 14 key articles that were critically appraised and examined for emergent ‘themes’. Results Multidisciplinary simulation training improved communication, teamwork, teamwork behaviours and teamwork attitudes between multidisciplinary perioperative team members. Overall, improvements in communication and teamwork correlated with improvements in perioperative patient safety. Despite the numerous benefits of multidisciplinary simulation training there are notable barriers to the implementation of such training programs. Multidisciplinary simulation training can be costly to set up and time consuming to facilitate. However, overall increases in patient safety offset the cost of simulation training and time-based barriers can be reduced by running simulation training in conjunction with existing education programs. Conclusion Multidisciplinary simulation training improved communication and teamwork among perioperative teams and this method of training is recommended overall within perioperative units. However, there were notable gaps within the literature, and further research involving multidisciplinary perioperative teams within Australian perioperative units should be conducted to gain a greater insight into the presence of multidisciplinary simulation training and the effects of such training. © 2021, Australian College of Perioperative Nurses. All rights reserved.
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