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Abstract Background Medical students benefit from direct observation of clinical performance and timely feedback from multiple sources. While self and peer feedback have been the focus of numerous research studies, how they influence feedback engagement and receptivity in medical students of varying achievement levels in the clinical skills laboratory setting remains relatively unexplored. Methods We conducted an exploratory qualitative study to investigate students’ engagement and receptivity to self and peer feedback across academic performance levels at a medical teaching institution. Data from five focus groups with third-year medical students(n = 25) were thematically analysed. Results The ways in which low and high performing students engaged with self-assessment and peer feedback were divided into three categories: affective (or interpersonal), orientational, and transformational. Lower achievers believed they lacked the necessary skills to effectively engage in self and peer feedback interventions, but they agreed with higher achievers who recognized that peer feedback combined with prior knowledge of learning objectives allowed them to take ownership of monitoring their own development over time. Learners' emotional maturity in response to feedback ratings and feedback from activities testing clinical cognition had an impact on self-regulated learning. Conclusions Creating a trusting environment is critical for improving the acceptability of peer feedback. It is also critical to provide multiple opportunities for self-assessment in order to improve one's judgment. Giving learners the ability to actively seek and engage with feedback encourages participation in the feedback cycle, focusing on self-regulation rather than reliance on feedback providers. Feedback and action plan development can be improved by teaching students how to understand criticism, manage emotions constructively, and practice developing evaluative judgment and self-regulation skills. Based on the study findings an integrated three stage training model is recommended for effective self- and peer feedback practice for undergraduate medical education.

Background: Medical students benefit from direct observation of clinical performance and timely feedback from multiple sources. While self and peer feedback have been the focus of numerous research studies, how they influence feedback engagement and receptivity in medical students of varying achievement levels in the clinical skills laboratory setting remains relatively unexplored. Methods: We conducted an exploratory qualitative study to investigate students' engagement and receptivity to self and peer feedback across academic performance levels at a medical teaching institution. Data from five focus groups with third-year medical students(n = 25) were thematically analysed. Results: The ways in which low and high performing students engaged with self-assessment and peer feedback were divided into three categories: affective (or interpersonal), orientational, and transformational. Lower achievers believed they lacked the necessary skills to effectively engage in self and peer feedback interventions, but they agreed with higher achievers who recognized that peer feedback combined with prior knowledge of learning objectives allowed them to take ownership of monitoring their own development over time. Learners' emotional maturity in response to feedback ratings and feedback from activities testing clinical cognition had an impact on self-regulated learning. Conclusions: Creating a trusting environment is critical for improving the acceptability of peer feedback. It is also critical to provide multiple opportunities for self-assessment in order to improve one's judgment. Giving learners the ability to actively seek and engage with feedback encourages participation in the feedback cycle, focusing on self-regulation rather than reliance on feedback providers. Feedback and action plan development can be improved by teaching students how to understand criticism, manage emotions constructively, and practice developing evaluative judgment and self-regulation skills. Based on the study findings an integrated three stage training model is recommended for effective self- and peer feedback practice for undergraduate medical education. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND: To highlight the importance of clinical simulations and simulated laboratories for student training, especially in physical examination teaching. OBJECTIVE: To evaluate the gains obtained by medical students in their cognitive and practical performance of physical examinations (abdominal, cardiological, and pulmonary), as well as satisfaction and self-confidence in what they have learned, after concentrated practice developed in a skills and simulation laboratory. DESIGN AND SETTING: A quantitative and quasi-experimental study in which 48 students were evaluated at the Faculdade de Odontologia de Bauru, São Paulo, Brazil. METHODS: A quantitative and descriptive study was conducted with regularly enrolled 2nd year medical students over 18 years of age who had content prior to data collection regarding anamnesis and physical examination remotely taught in a Moodle virtual learning environment. For data collection, the participants were subjected to a concentrated period of skill training (abdominal, cardiological, and pulmonary). Every day after the skill training session, they were subjected to a practical evaluation and completed a theoretical test before and after the practical activities. At the end of all activities, they answered the instrument to assess the simulated practices (self-confidence and satisfaction). RESULTS: Among the 49 students evaluated, positive and significant theoretical and practical gains were identified in all three components (abdominal, cardiological, and pulmonary) (P = 0.000), as well as in the general evaluation (Theoretical 1 and Theoretical 2) (P = 0.000), satisfaction, and self-confidence (P = 0.000). CONCLUSION: Concentrated laboratory practice resulted in positive improvements in students’ physical examination skills.

Clinical skills training, which was first used in the early eighteenth century, has gained an important place in modern medical education today. Clinical skills labs (CSL) help students achieve clinical proficiency be fore encountering patients. It is known that traditional medicine education is insufficient for students to acquire basic clinical skills. A similar problem is faced by students in Veterinary Medicine education. Therefore, clinical skill straining should be created in such a way that students can benefit effectively in Veterinary Medicine education. In this study, using the example of Erciyes University Faculty of Veterinary Medicine, the opinions and satisfaction levels of Veterinary Medicine students about CSL were determined. The rate of students who think that the use of CSL is beneficial for veterinary education was determined as 44.1%. 83.8% of the students described CSL as one of the important links of Veterinary Medicine education, and 84.5% of them stated that CSL should be widespread in Veterinary Faculties. [ABSTRACT FROM AUTHOR]

Ultrasound phantoms are training tools that can help students learn basic ultrasound principles. The purpose of this prospective cohort design study was to determine whether preclinical veterinary students in a curriculum with more phantom training sessions acquire better‐quality ultrasound images of kidneys in live canines compared with students in a curriculum without sequential phantom training sessions. In clinical skills labs, 132 second‐year (2VM) and 130 third‐year (3VM) veterinary students obtained sagittal and transverse images of the left kidney of healthy, student‐owned dogs. Images were graded on proper identification/orientation, technique, and image anatomy using a modified Brightness Mode Quality Ultrasound Imaging Examination Technique, a modified standardized ultrasound interpretation scale. A two‐sample t‐test was used to compare 2VM and 3VM performance. 2VM students were inaugural members of a redesigned curriculum and had previously participated in eight clinical skills labs involving hands‐on ultrasound practice using phantoms and live animals prior to this study. The 3VM students were the final members of the prior curriculum and had previously participated in a single ultrasound lab using phantoms and a single ultrasound lab using live animals. For Identification/Orientation categories, 2VM students acquired slightly but statistically significantly better transverse images (P = 0.04). There were no significant differences between identification/orientation tasks for sagittal images or for technique and image anatomy categories. The findings indicate that future studies assessing more sensitive evaluation tools and serial evaluation of students may be beneficial in monitoring student competency and assist in evaluating the role of phantoms in ultrasound training in the veterinary curriculum. [ABSTRACT FROM AUTHOR]

Background: Clinical Skills Laboratory (CSL) was established at Foundation University Medical College (FUMC) in year 2009 with the introduction of integrated modular teaching program. A structured integrated curriculum was introduced from the Class of year 2013 for learning of clinical skills at CSL. This study was conducted to evaluate the effect of introducing the new curriculum on student's performance in CSL. Methods: A comparative analytical study was conducted. The OSCE scores of group A (Class of year 2011) were compared with group B (Class of 2013). Data collection tool was institutional checklist. The OSCE stations were of General Physical Examination (GPE), history taking, systemic examination of Gastrointestinal tract and communication skills. Reliability of the scores was estimated through Cronbach α. Mean scores of the two groups were compared using the independent sample t test and Mann Whitney U-test. Chi-square test was used to compare variables (years, gender and educational background). Comparison of student scores at different components of OSCE using Analysis of Variance (ANOVA) was done. Results: Reliability of scores was 0.65 for group B and 0.52 for group A. comparison of overall scores of the two groups reflected improved performance in the group B (p 0.001). Comparison of scores at different components of OSCE using ANOVA also reflected better performance of group B (p<0.01). OSCE scores of both the groups were also correlated for gender and educational background. No difference was found in the two groups on the basis of gender and educational background. Conclusion: To enhance the value of clinical skills training and to make it more effective, skill lab curriculum must be structured and integrated within the undergraduate curriculum. [ABSTRACT FROM AUTHOR]

Veterinary students need to develop competence in clinical skills in preparation for working in practice. Models and simulators are increasingly used to help supplement existing training and are often housed in a clinical skills laboratory. The laboratory provides a safe environment where students can practise repeatedly on models in order to develop proficiency. It is also an ideal venue to run practical classes and assessments, such as an objective structured clinical examination (OSCE). The veterinary clinical skills laboratory initiative is relatively new and recent growth and has been facilitated by several factors. There is much that can be learned from medical education and other health professions as their clinical skills laboratories have been running for many years. Additionally, there are several veterinary conferences that now include dedicated clinical skills sessions and have workshops where, for example, delegates can share tips about making models and discuss developing and managing laboratories. To complement face-to-face meetings, there is a thriving international community, the Veterinary Clinical Skills & Simulation group, in the online forum NOVICE (Network Of Veterinarians In Continuing Education). Members ask questions, usually receiving rapid responses, share tips and collate useful information. Recently a free guidebook to clinical skills laboratories has been written by an international collaboration and provides key information for those setting up laboratories or extending existing facilities. There can be little doubt that the veterinary clinical skills initiative will continue to grow and share expertise with associated benefits for student learning and animal welfare.

A system has been developed to simulate transport in a medical emergency vehicle with the intent of assisting paramedics improve their skills in en-route cannulation. En-route cannulation makes pre-hospital venous access possible, which in turns helps to minimize the risk of lengthening transfer times. The system is designed to attain full monitoring of transport conditions, not just in the spatial but also in the temporal sense, and to physically recreate these parameters on a fabricated six degree of freedom simulator system. Tests conducted revealed the viability of applying an inertial measurement unit board sensor to collect data from a vehicle during transport and to subsequently reproduce the exact motions encountered on the simulator. It was found that a smartphone could be used to collect transport data that are dominated by perturbations in the O (10 1 ) Hertz scale. With a training arm for venipuncture placed on the simulator, a preliminary study conducted with six participants showed more pronounced performance deterioration amongst those who were untrained in cannulation when the simulator was switched on. The demonstrated system has features that make it amenable for incorporation into a clinical skills laboratory setting. [ABSTRACT FROM AUTHOR]

Despite an increasing focus on simulation as a learning strategy in nursing education, there is limited evidence on the transfer of simulated skills into clinical practice. Therefore it's important to increase knowledge of how clinical skills laboratories (CSL) can optimize students' learning for development of professional knowledge and skills, necessary for quality nursing practice and for patient safety. Thus, the aim was to describe nursing students' experiences of learning in the CSL as a preparation for their clinical practice. Interviews with 16 students were analysed with content analysis. An overall theme was identified -- walking the bridge -- in which the CSL formed a bridge between the university and clinical settings, allowing students to integrate theory and practice and develop a reflective stance. The theme was based on categories: conditions for learning, strategies for learning, tension between learning in the skills laboratory and clinical settings, and development of professional and personal competence. The CSL prepared the students for clinical practice, but a negative tension between learning in CSL and clinical settings was experienced. However, this tension may create reflection. This provides a new perspective that can be used as a pedagogical approach to create opportunities for students to develop their critical thinking. [ABSTRACT FROM AUTHOR]

Flipped classroom is an educational technique in which content is delivered online for students to study at their own pace in preparation for in-class learning. Benefits include increased flexibility, enhanced student engagement and satisfaction, and more effective use of time spent during face-to-face teaching. However, the development and implementation of flipped classroom teaching are also associated with challenges, including time required to develop learning materials and getting students to engage with the preparatory work. This teaching tip describes a structured approach to designing and implementing the flipped classroom approach for clinical skills to allow a greater focus on practicing the hands-on skills and the provision of feedback during the laboratory session. First, the rationale for flipping the classroom and the expected benefits should be considered. On a practical level, decisions need to be made about what to include in the flipped component, how it will complement the face-to-face class, and how the resources will be created. In the design phase, adopting a structured template and aligning with established pedagogical principles is helpful. A well-designed flipped classroom motivates learners by including different elements such as quality educational media (e.g., videos), the opportunity to self-assess, and well-defined connections to relevant knowledge and skills. Student engagement with the flipped material can be promoted through different strategies such as clear communication to manage student expectations and adapting the delivery of the face-to-face component. Finally, gathering feedback and evaluating the initiative are important to inform future improvements.

Background: The advantages of using simulators in skills training are generally recognized, but simulators are often too expensive for medical schools in developing countries. Cheaper locally-made models (or part-task trainers) could be the answer, especially when teachers are involved in design and production (teacher-made models, TM). Methods: We evaluated the effectiveness of a TM in training and assessing intravenous injection skills in comparison to an available commercial model (CM) in a randomized, blind, pretest-posttest study with 144 undergraduate nursing students. All students were assessed on both the TM and the CM in the pre-test and post-test. After the post-test the students were also assessed while performing the skill on real patients. Results: Differences in the mean scores pre- and post-test were marked in all groups. Training with TM or CM improved student scores substantially but there was no significant difference in mean scores whether students had practiced on TM or CM. Students who practiced on TM performed better on communication with the patient than did students who practiced on CM. Decreasing the ratio of students per TM model helped to increase practice opportunities but did not improve student's mean scores. The result of the assessment on both the TM and the CM had a low correlation with the results of the assessment on real persons. Conclusions: The TM appears to be an effective alternative to CM for training students on basic IV skills, as students showed similar increases in performance scores after training on models that cost considerably less than commercially available models. These models could be produced using locally available materials in most countries, including those with limited resources to invest in medical education and skills laboratories. [ABSTRACT FROM AUTHOR]

Objective: Drug application skills are often used in clinical education years and medical practice and generally appear in the lists of occupational risks and medical errors. The aim of this study was to emphasize the importance of drug application skills in medical education and to assess our clinical skills laboratory via analyzing students' feedbacks. Methods: A three and a half years period of drug application skills education was investigated, retrospectively. The results of 2671 feedbacks in nine categories were analyzed in respect to academic years and skills. Results: Planned steps fort the drug application skills education (p=0.018), level of making the skill alone (p=0.000), approach of the educator (p=0.026) and general satisfaction of having the skills education (p=0.016) were statistically improved during years. Although there was not a difference between academic years in total scores of feedbacks (p=0.088), the difference was significant between subcutaneous injection and intravenous injection and intravenous serum application (p=0.004). Conclusion: This study shows that drug application skills education in clinical skills laboratory is valued positively by the students. [ABSTRACT FROM AUTHOR]

Abstract Background The advantages of using simulators in skills training are generally recognized, but simulators are often too expensive for medical schools in developing countries. Cheaper locally-made models (or part-task trainers) could be the answer, especially when teachers are involved in design and production (teacher-made models, TM). Methods We evaluated the effectiveness of a TM in training and assessing intravenous injection skills in comparison to an available commercial model (CM) in a randomized, blind, pretest-posttest study with 144 undergraduate nursing students. All students were assessed on both the TM and the CM in the pre-test and post-test. After the post-test the students were also assessed while performing the skill on real patients. Results Differences in the mean scores pre- and post-test were marked in all groups. Training with TM or CM improved student scores substantially but there was no significant difference in mean scores whether students had practiced on TM or CM. Students who practiced on TM performed better on communication with the patient than did students who practiced on CM. Decreasing the ratio of students per TM model helped to increase practice opportunities but did not improve student’s mean scores. The result of the assessment on both the TM and the CM had a low correlation with the results of the assessment on real persons. Conclusions The TM appears to be an effective alternative to CM for training students on basic IV skills, as students showed similar increases in performance scores after training on models that cost considerably less than commercially available models. These models could be produced using locally available materials in most countries, including those with limited resources to invest in medical education and skills laboratories.

The flipped classroom is a technique that involves a reordering of classroom and at-home activities. Content provided prior to classroom interactions is used to prepare students for face-to-face classes. The flipped classroom has been shown to benefit students, including improving examination results, and there is increasing interest in using it in veterinary education. The current study aimed to investigate the potential of the flipped classroom approach to preparing students for practicals in a clinical skills laboratory. An online survey was distributed to the international veterinary clinical skills community to determine the extent to which a flipped classroom is used prior to teaching in a clinical skills laboratory and how educators viewed the benefits, challenges, and possibilities. There were 101 survey participants representing 22 countries, and all were involved in clinical skills teaching; 42 were using flipped classroom techniques prior to teaching in a clinical skills laboratory, and 55 others would consider using the technique in this context in the future. Videos were the most common resource used. The main benefits, experienced or anticipated, were positive changes in student behavior, including preparation and better use of time during practicals by both the students and instructors. The main challenges were the time needed for instructors to develop the materials, lack of student engagement with the flipped classroom, space in the curriculum, and institutional issues. In conclusion, many potential benefits could be realized with a flipped classroom approach embedded prior to clinical skills laboratory practicals.

The University of Illinois College of Veterinary Medicine opened a clinical skills laboratory in August 2009, making it one of the earliest North American veterinary schools to do so. The Clinical Skills Learning Center has been an integral component of the Illinois veterinary professional curriculum since its inception. However, its role in the curriculum has changed over time, which has had an impact on its size, scope, and staffing. In this article, we describe the development and growth of the Clinical Skills Learning Center, with an emphasis on its evolving curricular role and the lessons we have learned over nine years.

Summary: Background: The Clinical Skills Laboratory has become an essential structure in nurse education and several benefits of its use have been identified. However, the literature identifies the need to examine the transferability of skills learned there into the reality of practice. Objective: This research explored the role of the Clinical Skills Laboratory in preparing nursing students for the real world of practice. This paper focuses specifically on the perceptions of the teaching and assessment strategies employed there. Design: Qualitative multiple case study design. Setting: Five case study sites. Participants: Interviewees (n=58) included academic staff, clinical staff and nursing students. Methods: Semi-structured interviews. Results: The Clinical Skills Laboratory can provide a pathway to practice and its authenticity is significant. Teaching strategies need to incorporate communication as well as psychomotor skills. Including audio-visual recording into assessment strategies is beneficial. Effective relationships between education institutions and clinical settings are needed to enhance the transferability of the skills learned. Conclusions: The Clinical Skills Laboratory should provide an authentic learning environment, with the appropriate use of teaching strategies. It is crucial that effective links between educators and clinical staff are established and maintained. [Copyright &y& Elsevier]