Clinical Settings and Internships

The ultimate outcome of clinical or internship preparation of students is safe quality patient care.  Clinical rotations may also include simulation hours.  We hope you find some of the resources helpful as you design your Canvas course.   

Resources 

? Online Learning During COVID-19  

• What do medical students need to do to maximize their online education 

? Instructor Characteristics 

• The analysis of the literature suggests the ability to develop interpersonal relationships is the most valued skill for clinical instructors. Overall, approachability emerged as the most important personality trait needed to be an effective clinical instructor. 

? Fresscola, M. & Patterson, E. (2017). Transition from Clinician to Educator: A practical approach.  

• As the population continues to age and retire, the shortage of qualified nurse educators continues to grow. Simultaneously, student demand is also increasing. In order to address this current and future need, organizations are looking toward practicing clinicians to fill the gap. Transition from Clinician to Educator: A Practical Approach is a hands-on guide to prepare future educators who are entering the world of education. Written in an accessible style, it focuses on real issues that new educators will face as they move into the classroom. With topics drawn from the authors own experiences, it is an essential resource to understanding the intricacies involved in being a successful educator. Each new print copy includes Navigate 2 Preferred Access that unlocks a comprehensive and interactive eBook and Navigate 2 TestPrep.” 

? Gubrud, P. (2016). Teaching in the Clinical Setting. In D. Billings & J. Halstead (Eds). Teaching in Nursing: A guide for faculty (5th ed).  

• Textbook – A Guide for Faculty 

? Creating a Culture of Caring – Clinical Practice  

• Strong academic and practice partnerships are needed in the ever‐changing health care environment. Sometimes an invisible barrier exists between clinical practice and academia; academic‐practice partnerships are a way to bridge this barrier. Since 2008a team‐based model of clinical education known as the Culture of Caring (COC) has brought together three academic institutions with a large hospital system to develop a unified clinical experience and curriculum that improves the student, provider, and patient experience. In the COC model the team consists of academic‐practice leaders, clinical instructors, staff nurses, and students. Together they engage in a structured curriculum that is integrated into both the clinical environment and the academic setting. Each week of clinical the students focus on a topic that is paired with journal articles and learning activities that allow the team to engage in learning that is applicable to the clinical practice environment. The learning activities allow students to engage in learning about evidence‐based practice and quality improvement initiatives that are taking place on the unit. The implementation of this collaborative approach to a clinical nursing education model has had a positive impact on the working relationships between the academic partners and clinical practice leaders. 

? Strategies for Successful Clinical Teaching 

• This article is one in a series on the roles of adjunct clinical faculty and preceptors, who teach nursing students and new graduates to apply knowledge in clinical settings. This article describes teaching strategies as well as the importance of the learning environment. 

? COVID-19 Strategies Medical Students  

• What do medical students need to do to maximize their learning? A medical school dean and online learning expert offered their thoughts. 

? Virtual Learning Resources during COVID-19  

• The current COVID-19 pandemic is affecting health care institutions in ways that may disrupt the training of future health care professionals. It is more important than ever to ensure that the community has access to high-quality educational materials to ensure trainee preparedness for these clinical and global health challenges. This collection features peer-reviewed teaching resources that can be used for distance learning, including self-directed modules and learning activities that could be converted to virtual interactions. As always, the resources are free to download and free for adaptation to local settings. The collection will be reviewed and updated regularly. 

? Suspected COVID-19 Case for the Simulation Lab  

• In an effort to assist clinicians with gaining knowledge, confidence and competency in handling suspect and diagnosed cases of COVID-19 in patients, CAE Healthcare is offering a free, downloadable Suspected COVID-19 Simulated Clinical Experience (SCE) for the entire healthcare community. 

? Reopening After COVID-19 (Simulation Programs)

• The COVID-19 global pandemic has shut down thousands of clinical education programs around the world, including countless healthcare simulation facilities. Lou Clark, PhD, MFA Executive Director of the M Simulation Program at the University of Minnesota recently shared with us their team’s “Flexible Operations Plan in the COVID-19 Response” which is an extremely useful document for medical simulation managers looking to consider ways of ‘re-opening’ this summer. From covering core definitions of potential learning activities with online, hybrid, and on-site simulated learning activities to highlighting risks, safety protocols, and utilization guidelines — this downloadable document linked below is an absolute must read for those operating healthcare simulation programs during the COVID-19 crisis! 

? Clinical Rubrics -Campbell

• Osteopathic medical schools are now challenged to document student achievement of the 13 Core Entrust able Professional Activities for Entry into Residency as well as 7 or more Core Competencies.  The EPAs provide more concrete skills that can be assessed by clinical preceptors, and many preceptors find an entrust ability scale more intuitive than Likert scale numbers.  Behavioral anchors are helpful in performance assessment, but the practicality of asking preceptors to evaluate large numbers of items with verbal descriptors is uncertain.  This poster describes a new assessment instrument designed to assess student performance and entrust ability on all the EPAs, categorizing them under the AACCOM Core Competencies.  Results of pilot testing will be presented, with discussion of advantages, dis–advantages, and issue surrounding the potential for full implementation in 2018-2019.   

? Portfolio Rubric

• The University of North Carolina at Chapel Hill School of Nursing Master’s Comprehensive Exam/Portfolio 

? SOAP Note Rubrics

• Family Nurse Practitioner (FNP) students need to be proficient in assessment of patients and identification and management of the most common primary care acute and chronic disease processes. Competency based education requires demonstration of student ability to practice independently, managing previously diagnosed and undiagnosed patients within the full spectrum of health care services. Structured SOAP note assignments that require FNP students to address the most common primary care diagnoses were created for each of their practicum courses. FNP student’s initial practicum and SOAP notes focus on health promotion/disease prevention. The second practicum and SOAP notes focuses on clinical management of the young family (including women’s health), while the third practicum and SOAP notes focus on clinical management of the aging family. The final clinical synthesis and SOAP notes focus on the culmination of all other clinical experiences, including complex, co-morbid conditions and collaborative needs of the patient. Instructors, all seasoned nurse practitioners, provide feedback to ensure continued improvement in clinical application of evidence-based practice. 

Faculty-to-Faculty Ideas

Academic Literature

• Medical School Videoconferencing
  • Abstract: Videoconferencing with the clinical microbiology laboratory can be used to effectively teach microbiology and infectious diseases content to advanced medical students. Whether this exposure to the microbiology laboratory can enhance patient care outcomes requires further study 
• Reflective Journaling Dental School
  • Abstract: Reflection involves taking the time to deeply consider a past situation and examine areas of weakness or confusion. It allows identification of learning needs and the development of an action plan to improve future experiences. 
• Preceptor expectations and issues with nurse practitioner clinical rotations
  • Abstract: Conducting an assessment of preceptor’s issues and expectations of faculty site visits can improve relationships with preceptors and secure and maintain clinical placements for NP students. Recommendations include improving communication, establishing guidelines for site visits, and periodic assessment of progress in preceptor-student relationships. 
• PA Clinical Rotation Assessment
  • Abstract: This is the first validated instrument to evaluate PA rotation experiences. Application of the PACRE questionnaire could inform rotation directors about ways to improve clinical experiences. The findings of this study suggest that PA students must be adequately prepared to have a successful experience on their rotations. PA programs should consider offering transition courses like those offered in many medical schools to prepare their students for clinical experiences. Future research should explore whether additional rotation characteristics and educational outcomes are associated with PACRE scores. 
• CRNA Skills and Sim Rotation
  • Abstract: Current Accreditation Council for Graduate Medical Education (ACGME) requirements allow PGY-1 otolaryngology-head and neck surgery (ORL-HNS) residents to spend 6 months on service, prompting reconsideration of educational best practices for the first-year resident experience. The aim of this study was to determine feasibility and value of a 1-month PGY-1 otolaryngology clinical skills rotation integrated with anesthesiology to complement clinical ORL-HNS rotations. Changing rotation structure in ORL-HNS training programs provides an opportunity to develop novel rotations with high educational impact. Early outcome data suggest that the described clinical skills rotation is practically feasible and was perceived to have measurable value as part of the PGY-1 curriculum  
• High Fidelity Simulation Registered Dieticians
  • Abstract: Dietetics students complete science and counseling courses in preparation for supervised clinical practice rotations. However, dietetic students generally receive little exposure to real-life scenarios other than written case studies… 
• High Fidelity Simulation Physical Therapy and Nursing
  • Abstract: Format Physical therapy and nursing students engaged in an interprofessional high fidelity simulation (HFS) scenario focusing on critical care in groups of 6–8 individuals with additional students observing. Students were expected to focus on in… 
• Cultural Competence Evaluation
  • Abstract: The 75-item SAPLCC is a reliable instrument covering a full range of domains that can be used to measure pharmacy students’ perceived level of cultural competence at baseline and upon completion of the pharmacy program. 
• Social Determinants of Health
  • Abstract: Medical students often lack training in understanding and addressing the social determinants that shape the health of high-risk populations. We describe a novel clinical elective rotation in which fourth-year medical students served as apprentices to community health workers in order to develop community engagement skills and cultural humility.  
• Integration of Simulation NP
  • Abstract: Although resource intensive, simulation provides an unparalleled opportunity for NP students to independently perform, without direct supervision, as an NP. Presenting an example of simulation integration can aid other educators seeking to develop a similar program.  
• One on One Teaching
  • Abstract: ABC of learning and teaching in medicine One to one teaching and feedback 
• Microlectures
  • Abstract: Microlectures are a flexible way to supplement classroom learning. They consist of focused, 5 to 10 minute video or audio lectures which each cover a single concept. 
• Peer Assisted Study Sessions
  • Abstract: Developing and implementing a formalized P.A.S.S. facilitator training manual and workshop with an OSTE helped improve students’ confidence in facilitating an organized, effective, and interactive peer teaching session. Students’ positive feedback on the OSTE suggests that OSTEs can be useful tools to help peer teachers learn skills to cope with challenging situations with students. 
• Teaching Portfolio Resources
  • Teaching portfolios 
• Problem Based Learning Medical School
  • Abstract: Systematic reviews on the effects of problem-based learning have been limited to knowledge competency either during medical school or postgraduate training. We conducted a systematic review of evidence of the effects that problem-based learning during medical school had on physician competencies after graduation. 
• Medical School Lectures Effectiveness
  • Abstract: Lectures have been criticized for being outmoded, ineffective and inefficient. If lectures are compact and well‐structured, a lot of knowledge can be transmitted to a lot of students. When students are fully engaged their attention span seems infinite. In a small group discussion, a tutor can be authoritarian and oppressive. Lectures can not only transmit knowledge, but also stimulate higher‐order thinking. Learning should be closely related to understanding and solving real‐life problems.
• Effective PowerPoint Tutorials for Medical Educators
  • Abstract: When should you use PowerPoint slides? What standard slide designs make it more difficult for students to learn from the slides? How can you design your slides to make them easier to understand? This tutorial will answer these questions by showing how to design slides according to these four learning principles: 
    • Ease Cognitive Load 
    • Direct Attention 
    • Ease Reception 
    • Build on Experience  
• Addressing Microaggressions and Discrimination in Medical and Dental Students
  • Abstract: Given the high self-reported prevalence of microaggressions in the clinical setting, students need the skills to respond. This innovative session improves readiness to address microaggressions by helping participants build and practice these skills in a supportive environment. 
• Sweeney-Clark Simulation Rubric 
  • Abstract: This validated, user-friendly, one-page simulation performance evaluation rubric was designed for academic venues but has also found use in service arenas. 
• Simulation and Rubrics – Nurse Anesthesia
  • Abstract: The use of simulation technology has introduced a challenge for simulation nurse educators: evaluation of student performance. The subjectivity of student performance evaluation has been in need of improvement. It is imperative to provide clear and consistent information to the learner of expectations for their performance. Educators use objectives to define for the learner what the primary focus will be in the learning activities. Creation of rubrics to replace checklists to evaluate learner performance is a team task. Improved rubrics assist instructors in providing valuable, immediate, and postactivity feedback and consistency among instructors, and improved inter-rater reliability. 
• Physical Therapy Rubric
  • Abstract: The purpose of this perspective article is to describe the development and potential use of a grading rubric to assess pediatric psychomotor and clinical reasoning skills in professional pediatric physical therapist students. Feedback from focus groups made up of pediatric physical therapy educators informed development of the rubric. In addition, preliminary reliability and feasibility of the rubric were evaluated using videotaped student performance on a related pediatric case. Pilot data suggest a range of reliability between slight and moderate across the components of the rubric. Both the case and the rubric are included as appendices, and recommendations are provided for implementation and for future research 
• Formative and Summative Evaluation Audiology
  • Abstract: This article provides an overview of a comprehensive assessment system that documents that students have obtained the skills and knowledge necessary to obtain a Doctor of Audiology (AuD) degree. The individual components of the assessment system; rationale for development of each assessment; and grading criteria, outcomes measures, faculty commentary, missteps, and successes of the system are discussed. Carefully planned and dynamic assessments can be integrated successfully into the AuD students’ program of study with generally reasonable expectations for faculty workload. It is crucial for program directors to continually assess the system used to document student learning and to make modifications based on formal and informal feedback from students, faculty, alumni, evidence-based clinical practice, and clinical preceptors. 
• Rubric Development Dental Education 
  • Abstract: Identifying and implementing effective methods for assessing dental student performance are ongoing challenges for dental educators. Questions related to grading and assessment are common among faculty and students alike. Faculty members who are well‐trained clinicians or scientists often have little formal training in education. In addition, assessment of performance brings with it an element of subjectivity. Questions about assessment and grading are most likely to arise when expectations are unclear or the rationale for the grade awarded is not articulated. The authors propose that one solution to assessment dilemmas can be found in the use of rubrics: scaled tools with levels of achievement and clearly defined criteria placed in a grid. Rubrics establish clear rules for evaluation and define the criteria for performance. Rubrics speak to both teaching and learning expectations and outcomes and can provide faculty members with a tool that can be useful in evaluating dental student performance. Rubrics can also provide students with clear expectations of performance, an opportunity to self‐assess, and timely, detailed feedback. The purpose of this article is to define a rubric, apply the steps of rubric development as described in the educational literature to dental student assessment, present two examples of rubric implementation for assessing student progress toward competence, and recommend electronic resources for rubric development. 
• Preceptor Checklist
  • Abstract: The National Organization of Nurse Practitioner Faculties and the American Association of Nurse Practitioners collaborated to develop a document outlining expectations when establishing clinical experiences for nurse practitioner (NP) students. A literature review explored the beliefs of clinical preceptors and NP faculty in relation to the process of the establishment and completion of successful clinical experiences. From the literature, the development of two guidance checklists addressed the expectations and responsibilities of the NP faculty and clinical preceptor during the clinical placement process. In light of challenges to secure clinical sites for NP students, it is imperative that the clinical placement process is standardized and the communicative pathway between the NP faculty and clinical preceptor improved. 
• Effective Case Presentations
  • Abstract: Effective case presentations are an important component of the nurse practitioner’s skills, yet very little literature exists to guide the development of this skill, and frequently little priority is given to teaching this skill during the education of the nurse practitioner. This report discusses the importance of effective case presentations, describes the organization of the presentation, and outlines the appropriate information to be included. The main components of a case presentation-introduction, history of the present illness, physical examination, diagnostic studies, differential diagnosis, management, and summary of the case-are discussed in detail. Examples of a formal and an informal case presentation are presented and used to illustrate key points in the text.