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Biomedical subjects

Debra Nestel

Publications and source records attributed to Debra Nestel.

25 records · Page 2Linked to original sources
PubMed2003

Peer tutoring in patient-centred interviewing skills: experience of a project for first-year students.

Peer tutoring is a potentially valuable resource in higher education. There are few published accounts of the impact of peer tutoring in medical education. College-wide experience of peer tutoring together with difficulties recruiting medical teachers for a communication programme led to the development of a peer-tutoring project. This paper reports the impact on first-year medical students of peer tutoring in patient-centred interviewing. After attending a preparatory workshop, third-year medical students co-facilitated their first-year colleagues in a session:Interviewing a Simulated Patient. First-year students completed written evaluations immediately after the session and two months later randomly selected students were assessed in patient-centred interviews. The impact of the peer-tutoring experience was evaluated by comparing these outcomes for students in groups co-facilitated by peer tutors with those who worked in groups facilitated by medical teachers. The eight learning objectives were completely met by more than 56% of students. However, there were statistically significant differences for four objectives with more students in groups facilitated by medical teachers completely meeting these objectives. Although the seven educational techniques used in the session were rated favourably by all students, two were rated as more effective in achieving the learning objectives by students in groups facilitated by medical teachers. Free-text comments revealed no differences between groups. Two months after the session, there were no differences between students in terms of interviewing skills as rated by trained observers and simulated patients, whilst simulated patients were more satisfied with interviews from students facilitated by peer tutors (p <0.02). Peer tutors can support the acquisition of basic patient-centred interviewing skills in first-year medical students when contributing to one session of a structured programme. First-year students were receptive and willing to learn from their senior colleagues.

Communication↗
PubMed2002

An innovative model for teaching and learning clinical procedures.

CONTEXT: Performing a clinical procedure requires the integration of technical clinical skills with effective communication skills. However, these skills are often taught separately. OBJECTIVES: To explore the feasibility and benefits of a new conceptual model for integrated skills teaching. : Design A qualitative observation and interview-based study of undergraduate medical students. METHODOLOGY: Medical students performed technical and communication skills in realistic clinical scenarios (urinary catherization and wound closure), using latex models connected to simulated patients (SPs). Procedures were observed, videorecorded and assessed by tutors from an adjoining room. Students received immediate feedback from tutors and SPs, before engaging in a process of individual feedback through private review of their videotapes. Group interviews explored the response of students, SPs and tutors. Data were analysed using standard qualitative techniques. SUBJECTS: Fifty-one undergraduate students were recruited from the Faculty of Medicine, Imperial College, London. RESULTS: The scenarios provided a realistic simulation of two common clinical situations and proved feasible in terms of time, facilities and resources within this institution. Students found the opportunity to integrate communication and technical skills valuable, challenging and an appropriate learning experience. Immediate feedback was especially highly valued. Some students found difficulty integrating technical and communications skills, but benefited from conducting two procedures in the same session. CONCLUSION: The integrated model was feasible and was perceived to be valuable. Benefits include the opportunity to integrate, within a safe environment, skills which are often taught separately. Promoting reflective practice may enable the successful transfer of these integrated skills to other procedures.

Clinical Competence↗
PubMed2002

Modelling the lay expert for first-year medical students: the actor-patient as teacher.

Actors are widely used in medical education as simulated patients. In this session, the role of actors was extended to 'simulated students' and facilitators in an introductory communication session. After an initial activity with the entire cohort of first-year students, groups of 20 students worked with either an actor or medical teacher in three activities. The activities aimed to raise students' awareness of the range of communication challenges in medical education and practice. After the session, students completed evaluation forms based on their experiences in the session. The results revealed no difference between students who were facilitated by actors or medical teachers in relation to meeting the learning objectives and their ratings of the usefulness of the activities to support learning. The actors who participated in this session were experienced in working with medical students. Their enhanced role provides students with an opportunity to identify with and reflect on the expertise of a lay teacher and to consider extending their definition of a learning opportunity to more informal encounters.

Communication↗
PubMed2001

Evaluation of a communication skills course: cultural relevance of the patient-centred interview in a Hong Kong Chinese setting.

Evidence for the use of a patient-centred model for interviewing is well established in the West. There is much less evidence for the application of the model in other cultural settings. This paper describes the impact of a communication skills (CS) course for doctors (n = 32) working in government outpatient clinics in Hong Kong. Emphasis is placed on the cultural relevance of the patient-centred interview (PCI) and educational techniques. Knowledge scores increased immediately after the course and again 8 weeks later (p < 0.001). Participants held favourable attitudes at the outset of the course and these were largely maintained. Qualitative data suggests that the doctors' competence in CS increased. The PCI model was perceived as relevant to the practices of these doctors. Barriers preventing the implementation of this approach related to organizational rather than cultural factors. The educational strategies were well received, suggesting that adult Chinese learners are not dissimilar to their Western counterparts in approaches to learning.

Journal Article↗