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Integrating patient management, reflective practice, and ethical decision-making in an emergency medicine intern boot camp

BACKGROUND: Integration of clinical skills, ethical decision-making, and reflection skills have emerged as cornerstones of clinical teaching in medical schools. This study aimed to detect whether a multimodal learning environment approach consisting of lectures, a drill, post-drill video debriefing,...

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Autores principales: Yaylaci, Serpil, Ulman, Yesim Isil, Vatansever, Kevser, Senyurek, Gamze, Turkmen, Suha, Aldinc, Hasan, Gun, Cem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8532285/
https://www.ncbi.nlm.nih.gov/pubmed/34686161
http://dx.doi.org/10.1186/s12909-021-02970-8
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author Yaylaci, Serpil
Ulman, Yesim Isil
Vatansever, Kevser
Senyurek, Gamze
Turkmen, Suha
Aldinc, Hasan
Gun, Cem
author_facet Yaylaci, Serpil
Ulman, Yesim Isil
Vatansever, Kevser
Senyurek, Gamze
Turkmen, Suha
Aldinc, Hasan
Gun, Cem
author_sort Yaylaci, Serpil
collection PubMed
description BACKGROUND: Integration of clinical skills, ethical decision-making, and reflection skills have emerged as cornerstones of clinical teaching in medical schools. This study aimed to detect whether a multimodal learning environment approach consisting of lectures, a drill, post-drill video debriefing, and written reflection in an emergency medicine rotation boot camp improves interns’ patient management skills, ethical decision-making, and reflection skills. METHODS: A multimodal learning environment was created by the collaboration of emergency medicine, ethics, and medical education specialists. Multiple educational techniques involving lectures, case discussions, and role-playing a crisis scenario were applied. Pre-test and post-test, debriefing on performances on video records, video-recorded performance assessment, and reflective essays about their own and group’s performances were used to assess various aspects of the student performances. Additionally, a meeting was organized with the presence of the authors to create qualitative data obtained through the program evaluation meeting conducted on three themes: influences of teaching methods, students’ performances, and common achievements and mistakes of students. RESULTS: 133 students participated. Post-test multiple-choice question (MCQ) test scores were slightly higher than pre-test. A low and medium correlation was detected among pre-test and post-test patient management problem (PMP) and reflection scores, which was more prominent for female students. Multiple linear regression showed that pre-test and post-test PMP scores significantly contributed to reflection scores. These results might support that better patient management predicts more robust reflective practice. Teachers observed that students appreciated being inspired by well-performing peers, particularly noting the empathic needs of patients, companions, and other health professionals. However, students overlooked summoning forensic or social services and were inhibited by the pressure of the contextual traits of the drill. CONCLUSION: The multimodal learning environment created by multidisciplinary collaboration contributed to the improvement of components of situational awareness of the interns: patient management skills, ethical decision-making, and reflective practice. During this research, we created a toolbox better to capture the richness and diversity of student interactions. Considering the scarcity of context-specific assessment methods and widespread use of MCQs or generic scales for higher-order thinking skills in medicine, this study might be regarded as a step forward in that context. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-021-02970-8.
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spelling pubmed-85322852021-10-25 Integrating patient management, reflective practice, and ethical decision-making in an emergency medicine intern boot camp Yaylaci, Serpil Ulman, Yesim Isil Vatansever, Kevser Senyurek, Gamze Turkmen, Suha Aldinc, Hasan Gun, Cem BMC Med Educ Research BACKGROUND: Integration of clinical skills, ethical decision-making, and reflection skills have emerged as cornerstones of clinical teaching in medical schools. This study aimed to detect whether a multimodal learning environment approach consisting of lectures, a drill, post-drill video debriefing, and written reflection in an emergency medicine rotation boot camp improves interns’ patient management skills, ethical decision-making, and reflection skills. METHODS: A multimodal learning environment was created by the collaboration of emergency medicine, ethics, and medical education specialists. Multiple educational techniques involving lectures, case discussions, and role-playing a crisis scenario were applied. Pre-test and post-test, debriefing on performances on video records, video-recorded performance assessment, and reflective essays about their own and group’s performances were used to assess various aspects of the student performances. Additionally, a meeting was organized with the presence of the authors to create qualitative data obtained through the program evaluation meeting conducted on three themes: influences of teaching methods, students’ performances, and common achievements and mistakes of students. RESULTS: 133 students participated. Post-test multiple-choice question (MCQ) test scores were slightly higher than pre-test. A low and medium correlation was detected among pre-test and post-test patient management problem (PMP) and reflection scores, which was more prominent for female students. Multiple linear regression showed that pre-test and post-test PMP scores significantly contributed to reflection scores. These results might support that better patient management predicts more robust reflective practice. Teachers observed that students appreciated being inspired by well-performing peers, particularly noting the empathic needs of patients, companions, and other health professionals. However, students overlooked summoning forensic or social services and were inhibited by the pressure of the contextual traits of the drill. CONCLUSION: The multimodal learning environment created by multidisciplinary collaboration contributed to the improvement of components of situational awareness of the interns: patient management skills, ethical decision-making, and reflective practice. During this research, we created a toolbox better to capture the richness and diversity of student interactions. Considering the scarcity of context-specific assessment methods and widespread use of MCQs or generic scales for higher-order thinking skills in medicine, this study might be regarded as a step forward in that context. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-021-02970-8. BioMed Central 2021-10-22 /pmc/articles/PMC8532285/ /pubmed/34686161 http://dx.doi.org/10.1186/s12909-021-02970-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Yaylaci, Serpil
Ulman, Yesim Isil
Vatansever, Kevser
Senyurek, Gamze
Turkmen, Suha
Aldinc, Hasan
Gun, Cem
Integrating patient management, reflective practice, and ethical decision-making in an emergency medicine intern boot camp
title Integrating patient management, reflective practice, and ethical decision-making in an emergency medicine intern boot camp
title_full Integrating patient management, reflective practice, and ethical decision-making in an emergency medicine intern boot camp
title_fullStr Integrating patient management, reflective practice, and ethical decision-making in an emergency medicine intern boot camp
title_full_unstemmed Integrating patient management, reflective practice, and ethical decision-making in an emergency medicine intern boot camp
title_short Integrating patient management, reflective practice, and ethical decision-making in an emergency medicine intern boot camp
title_sort integrating patient management, reflective practice, and ethical decision-making in an emergency medicine intern boot camp
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8532285/
https://www.ncbi.nlm.nih.gov/pubmed/34686161
http://dx.doi.org/10.1186/s12909-021-02970-8
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