The Pattern-Focused Case Conceptualization Approach

In this era of accountability, therapists and other mental health professionals are expected to employ evidence-based interventions to achieve therapeutic change. Case conceptualization is an intervention that many consider one of the most essential clinical competencies. A useful case conceptualization approach, at a minimum, should explain the presenting problem and guide the planning and implementation of treatment. Approaches that are more clinically valuable will include a third function: anticipate and predict challenges in the treatment process. Analogous to the paradigm shift toward personalized treatments in precision medicine based on biomarkers is a similar shift occurring in psychotherapy practice. It will be based on behavioral markers like the ones in the pattern-focused case conceptualization approach and can explain, guide, and predict treatment challenges, as well as optimize treatment outcomes. A case example illustrates key points.

OSCE: An Effective Tool of Assessment for Medical Students

Background: To assess the competency of a student different tools are used. Since its introduction in 1975 by Dr. Harden and his team, OSCE has gained tremendous strides to assess the clinical competencies. Since 1975 onward OSCE has been very successfully used to assess the clinical competencies of medical student globally. OSCE is an assessment tool in which student is observed for performance of different tasks at specified stations. In the current study perception of medical students about OSCE examination was done which shall give room for positive criticism and further improvement of the system where ever required. Objective: To expedite view of final year MBBS students of Azra Naheed College about OSCE Material and Method Study design: Quantitative, cross sectional study. Settings: Azra Naheed College, Lahore. Duration: Six months i.e. 1st July2020 to 31st December 2020 Data Collection procedure: After an informed consent and appropriate briefing, the questionnaire was distributed among the final year medical students of Azra Naheed Medical College. Questionnaire developed by Russell et al was used. Results: Out of 148 students who participated in the study, 66(45%) students were females and 82(55%) were male. Majority of the students were satisfied with the quality of the exam. Consensus about the quality of exam was that, 29.7% were aware about the nature of the exam, 52.7% were satisfied that the syllabus taught was asked in the exam, 58.1% were satisfied about the time allocation for each station. Majority i.e. 60% considered OSCE an exam of practical nature which is not biased by gender or ethnicity. More than 50% of the students were satisfied with the standard of the exam. At the same time more than 50% students considered essay exam the easiest format of assessment. However, OSCE was considered to be fairest form of assessment 73%. 68.9% perceived that learning is enhanced by MCQs rather than other formats of assessment. Conclusion: To conclude this study, it is very much clear that the perception of students about OSCE as an assessment tool was very encouraging, as it not only provided them the opportunity to highlight their weaknesses but also helped them to perform well in the exam, manage time during exam and to overcome them stress which influenced their results. Key words: OSCE, Objective, Examinations, Clinical skills, qualitative analysis

Customising clinical studies for the new nursing generation

Nursing education in the Nordic countries follows the European Union directive requirements, and clinical studies for nursing students in the Nordic countries have many similarities. Now a new generation of students with different needs and characteristics is entering the nursing profession. The faculty, teachers and nurses will face challenges in meeting this new generation’s needs. The primary aim of this discussion paper is to explore and compare the current clinical studies in the five Nordic countries. The secondary aim is to find means to address the future challenges with a focus on the new generation. The idea of Objective Structured Clinical Reflection creates the possibility to discuss a new form of evaluation that may enhance the clinical competencies of the new generation entering clinical studies during their nursing education.

Comparative Study of Evaluating the Clinical Competence of Emergency Nurses Using Self-assessments and Assessment by Head Nurses

Background: Clinical competency is the ability of nurses to play a professional role in a clinical environment, in terms of the quality of the services provided. Objectives: The present study aimed to compare the clinical competence of emergency department nurses using self-assessments and evaluations by head nurses. Methods: A descriptive-analytical study was conducted from July to September 2019. The census method was used to select 70 nurses working in the emergency departments of three hospitals. Data was collected by using self-assessment questionnaires and evaluations by head nurses. The instrument was a clinical competency questionnaire with questions related to seven functional fields and 73 skills. Results: The viewpoints of nurses and head nurses on the clinical competencies of nurses were assessed at a moderate level in the majority of domains. Nurses defined their clinical competencies at a significantly higher level than the head nurses (P < 0.05). Conclusions: Based on the results, it is assumed that using more than one method and simultaneously applying multiple methods in an assessment will provide more accurate results about nurses’ clinical competence.

e-Learning for enhancement of medical student performance at the Objective Structured Clinical Examination (OSCE)

This study aimed to investigate the impact of student e-learning on the development of clinical competencies. The study participants were 3rd year students (n = 43) at a private mid-sized medical school located in a South Korean suburb on a four-year medical program. Educational intervention was implemented to enhance student clinical performance. Students engaged in learning activities that intended to promote their self-directed learning abilities and clinical performances using e-learning resources. Intervention was conducted for the duration of six months during the 3rd year and its effectiveness was investigated by comparing student performances in OSCEs in a pre- and post- comparison format and also by comparing them with national scores. In addition, student perceptions of the impact of e-learning on their OSCE performances were assessed using a questionnaire, which included 36 items that elicited student perceptions of their experiences of e-learning and readiness for e-learning. Student OSCE scores improved significantly after educational intervention in all domains of clinical competencies assessed and for total scores (p < 0.001). Furthermore, students achieved higher OSCE scores than national average scores in the post-test, whereas they had performed lower than national average scores in the pre-test. Students showed neutral or slightly positive responses to the effectiveness of e-learning, and their perceptions of e-learning were not associated with their e-learning readiness scores. The study shows student OSCE performance improved significantly after educational intervention, which indicate the effectiveness of e-learning to support student learning of clinical performance. Despite significant improvements in student OSCE scores after e-learning, their perceptions of its effectiveness were neutral. Furthermore, student perceptions of e-learning were not associated with their readiness for it. Suggestions are made to help students use e-learning more effectively to enhance their clinical competencies.

Clinical competencies of emergency medical services paramedics in responding to emergency conditions using Objective Structured Clinical Examination (OSCE) in Guilan

Objective: Evaluating the abilities of emergency medical services (EMS) staff who are in the frontline of the diseases could be an excellent reflection of the accuracy of curriculum both before and after graduation. This study was done to determine the clinical competencies of Guilan EMS staff in responding to emergency conditions using Objective Structured Clinical Examination (OSCE). Methods: In this descriptive study, 70 EMS staff from selected Emergency Centres in Guilan were recruited. Data were collected using a questionnaire and a checklist which included 9 different skills. Validity of the checklist was assessed by obtaining the opinions of 10 experts. The content validity index (CVI) and content validity ratio (CVR) of the checklist were 0.7 and 0.8, respectively. The reliability of the checklist was obtained using the test-retest method (r=0.89). In order to collect data, observations were done using the designated checklist. Data were analysed using SPSS software version 22 and descriptive statistical tests. Results: Findings showed that 56.3% of the paramedics got good scores for trauma competency but the mean scores for two competencies of spinal cord immobilization and vehicle extrication were low, indicating major skills problem. There was a statistically significant relationship between education (P=0.02) and work experience (P=0.03) as well as clinical skills in confronting trauma. Conclusion: Although the EMS staff had an acceptable range of performance in most of the skills, it seems that there is a need for training of performance-based competencies in which paramedics had a poor performance.