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Whiting, Michael Francis. "Learning in clinical contexts : clinical education in podiatry". Thesis, University of Sussex, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.262305.
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Locascio, Nicholas (Nicholas J. ). "Deep learning for clinical mammography screening". Thesis, Massachusetts Institute of Technology, 2017. http://hdl.handle.net/1721.1/113130.
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Thesis: M. Eng., Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, 2017.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.
"June 2017." Cataloged from student-submitted PDF version of thesis.
Includes bibliographical references (page 37).
Breast cancer is the most common cancer among women worldwide. Today, the vast majority of breast cancers are diagnosed from screening mammography. Multiple randomized clinical studies have demonstrated that screening mammography can help reduce the number of deaths from breast cancer among women ages 40 to 74, especially for those over age 50 [4], and can provide women diagnosed with breast cancer more options for less aggressive treatment [7]. Screening mammography is the first entry into the funnel of clinical mammography. A screening mammogram can result in a suspicious finding, leading the patient to receive additional imaging, and even surgical biopsy if the additional imaging. Screening mammography, as the first part of this funnel, is a place for machine learning to have impact on the largest amount of patients. In this work, we apply machine learning models to tasks in clinical mammography such as density estimation, and Bi-Rads prediction.
by Nicholas Locascio.
M. Eng.
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Walker, Rachel M. "Leading for Effective Clinical Education". Thesis, Griffith University, 2012. http://hdl.handle.net/10072/367404.
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Supportive clinical learning environments are dependent on effective interactions between staff and students (Henderson, Creedy, Boorman, Cooke & Walker., 2010a). Implicit in this description is the role of effective leaders who role-model change and promote positive work cultures. International reviews and research examining contemporary and historical influences on the nursing profession acknowledge the underdevelopment of leadership infrastructure within clinical learning settings. There are increasing calls for an agenda of change within the profession, yet little practical advice about ‘how’ to do this (Cummings et al., 2010; Davidson, Elliott & Daly, 2006; Heath, 2002; Senate Community Affairs Committee, 2002). The purpose of this study was to develop, apply and evaluate a leadership capacity building intervention on the clinical culture.
This program of research commenced with a review of the literature via narrative synthesis around nursing and leadership, clinical learning and learning culture, and identified two broad themes: influence of leadership on organisational learning and development and; influence of leadership in undergraduate clinical education. Within these themes emerged factors/elements integral to effective leadership in contemporary clinical contexts including transformational principals, the role of the nurse unit/ward manager, collaboration and relationship building and role-modelling.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Griffith Health
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Zhao, Yufan Kosorok Michael R. "Reinforcement learning design for cancer clinical trials". Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2009. http://dc.lib.unc.edu/u?/etd,2857.
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Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2009.Title from electronic title page (viewed Jun. 4, 2010). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Biostatistics, School of Public Health." Discipline: Biostatistics; Department/School: Public Health.
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Marrow, Carol Elizabeth. "Professional learning through clinical supervision in nursing". Thesis, University of Birmingham, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.396514.
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Bray, Farahnaz. "Student views on early clinical learning experiences". Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86497.
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Thesis (MPhil)--Stellenbosch University, 2014.ENGLISH ABSTRACT: Aim - The aim of this study was to explore second year medical students’ perceptions of their early clinical experiences with a view to improving curriculum development so as to enhance early clinical training programmes at Stellenbosch University (SU). Methodology - A qualitative, interpretive study, based on semi-structured focus group discussions with second year medical students was conducted in order to capture the relevant data that would provide information about their attitudes, feelings, beliefs and views on their early clinical learning experiences during their first year of studying medicine at SU. Thirty seven students participated in four focus group discussions after a process of selection of candidates using purposive sampling methods and stratification criteria to obtain the research sample. The interviews were moderated by an external facilitator, and were audiotaped and transcribed verbatim. The data transcripts were analysed and manually coded, and four broad categories with subthemes which illustrated the findings of the study, were identified and decided upon by the researcher and verified by the supervisor. Results - Early clinical exposure was generally positively perceived by students. It fostered a sense of vocation and feeling like real doctors, leaving students motivated and enhancing their learning interest. Early clinical skills training led to students’ professional development, acquiring the technical skills of a doctor, familiarisation with basic clinical terminology, and normal clinical findings which prepared them for later clinical studies. The new setting of practical learning in a simulated environment required students to adapt to small group learning and student clinical demonstrations which developed new learning styles and study skills. Some of the challenges that students encountered in the transition to clinical learning were, understanding the new subject of clinical medicine, having limited background knowledge to acquire basic clinical skills, and student clinical demonstrations. Although the strategy of peer physical examination was perceived to be effective, some ethical dilemmas emerged for students in terms of autonomy, and no opportunities available to practice on female models. Acting as a simulated patient proved to have both positive and negative outcomes on students’ skills acquisition. Factors that had a negative outcome on clinical skills learning were limited practice opportunities due to high student to teacher ratios per clinical session, and the variability of teaching content and practical techniques taught by various clinical tutors with different teaching strategies. The most stressful experience for students was the OSCE since it was a new method of assessment. Stress was attributed to uncertainty about the correct clinical content and techniques resulting from the teaching variability, while performance anxiety during the exam was related to inappropriate examiner behaviour. The OSCE was a positive learning experience because its format simulated the hospital setting which fostered students’ critical thinking abilities and time management. Conclusion - Early clinical exposure and practice have a great impact on junior medical students’ academic growth, and have positive learning outcomes. However, further development by the faculty in the areas of didactic skills, addressing the ethical issues related to student clinical demonstrations, and supporting students to enable a smooth transition to clinical learning will enhance and optimise their early clinical training.
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Needham, Judith. "Best Practice in Clinical Facilitation of Undergraduate Nursing Students: The Perspectives of Clinical Facilitators". Thesis, Griffith University, 2015. http://hdl.handle.net/10072/365929.
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This study sought to investigate what constituted best practice in clinical facilitation of undergraduate nursing students from the perspectives of those who undertake this role in health care agencies. Understanding clinical facilitation is important for maintaining quality of care, staff and student retention with an emphasis on employment and educational practices. The clinical facilitators reflected on their role highlighting aspects of the role and influences that either help or hinder them in achieving best practice. The study is important and unique educationally because what constitutes best practice in clinical facilitation can potentially inform both educational and management strategies for clinical facilitation. Importantly, this knowledge could strengthen opportunities for recruitment and retention of these members of the nursing workforce.
A case study using an interpretive, naturalistic approach was conducted to identify best practice in clinical facilitation of undergraduate nursing students from the clinical facilitators’ perspective. Data included focus group discussions, individual interviews and concept maps produced by focus group participants. Participants were recruited from the Griffith University School of Nursing and Midwifery Clinical Facilitator Database with data collected at a time and place of mutual convenience. Thematic analysis, with constant comparison of focus group discussions, interview data and concept maps was used to identify three common themes and ten subthemes.Thesis (Professional Doctorate)
Doctor of Education (EdD)
School of Education and Professional Studies
Arts, Education and Law
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Cefo, Linda M. Dr. "Qualitative Study Exploring the Development of Clinical Reasoning in Nursing's Clinical Education Settings". Cleveland State University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=csu1556456523899578.
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Msiska, Gladys. "Exploring the clinical learning experience : voices of Malawian undergraduate student nurses". Thesis, University of Edinburgh, 2012. http://hdl.handle.net/1842/7772.
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Very little has been done to define the process of clinical learning in Malawi and yet anecdotal observations reveal that it is more challenging than classroom teaching and learning. This set the impetus for this hermeneutic phenomenological study, the aim being to gain an understanding of the nature of the clinical learning experience for undergraduate students in Malawi and to examine their clinical experiences against some experiential learning models (Kolb 1984; Jarvis et al 1998). The study setting was Kamuzu College of Nursing (KCN) and the sample was selected purposively and consisted of 30 undergraduate students who were recruited through volunteering. Conversational interviews were conducted to obtain students’ accounts of their clinical learning experience and an eclectic framework guided the phenomenological analysis. The study raises issues which relate to nursing education and nursing practice in Malawi. From an experiential learning perspective, the study reveals that clinical learning for KCN students is largely non-reflective. The study primarily reveals that the clinical learning experience is enormously challenging and stressful due to structural problems prevalent in the clinical learning environment (CLE). In some clinical settings the CLE appears hostile and oppressive due to negative attitudes which some of the clinical staff display towards KCN students. Consequently, students’ accounts depict emotionally charged situations which confront them and this illustrates that clinical learning for KCN students is an experience suffused with emotions. In literature issues on emotions are commonly discussed under emotional labour (Hochschild 1983) and I used the concept as a basis for my pre-understandings and interpreted the students’ accounts of their clinical learning experience against such a conceptual framework. What resonated from their narratives was the depth of the emotion work they engage in. This enabled me to arrive at a new and unique conceptualisation of clinical learning redefined in terms of emotional labour within the perspective of nurse learning in Africa. The findings are a unique contribution to the literature on emotions and provide essential feedback which forms the basis for improving clinical learning in Malawi.
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Nori, Nozomi. "Machine Learning Approaches for Personalized Clinical Risk Modeling". 京都大学 (Kyoto University), 2017. http://hdl.handle.net/2433/225729.
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Ajjawi, Rola. "Learning to communicate clinical reasoning in physiotherapy practice". University of Sydney, 2006. http://hdl.handle.net/2123/1556.
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Doctor of Philosophy (PhD)Effective clinical reasoning and its communication are essential to health professional practice, especially in the current health care climate. Increasing litigation leading to legal requirements for comprehensive, relevant and appropriate information exchange between health professionals and patients (including their caregivers) and the drive for active consumer involvement are two key factors that underline the importance of clear communication and collaborative decision making. Health professionals are accountable for their decisions and service provision to various stakeholders, including patients, health sector managers, policy-makers and colleagues. An important aspect of this accountability is the ability to clearly articulate and justify management decisions. Considerable research across the health disciplines has investigated the nature of clinical reasoning and its relationship with knowledge and expertise. However, physiotherapy research literature to date has not specifically addressed the interaction between communication and clinical reasoning in practice, neither has it explored modes and patterns of learning that facilitate the acquisition of this complex skill. The purpose of this research was to contribute to the profession’s knowledge base a greater understanding of how experienced physiotherapists having learned to reason, then learn to communicate their clinical reasoning with patients and with novice physiotherapists. Informed by the interpretive paradigm, a hermeneutic phenomenological research study was conducted using multiple methods of data collection including observation, written reflective exercises and repeated semi-structured interviews. Data were analysed using phenomenological and hermeneutic strategies involving in-depth, iterative reading and interpretation to identify themes in the data. Twelve physiotherapists with clinical and supervisory experience were recruited from the areas of cardiopulmonary, musculoskeletal and neurological physiotherapy to participate in this study. Participants’ learning journeys were diverse, although certain factors and episodes of learning were common or similar. Participation with colleagues, peers and students, where the participants felt supported and guided in their learning, was a powerful way to learn to reason and to communicate reasoning. Experiential learning strategies, such as guidance, observation, discussion and feedback were found to be effective in enhancing learning of clinical reasoning and its communication. The cultural and environmental context created and supported by the practice community (which includes health professionals, patients and caregivers) was found to influence the participants’ learning of clinical reasoning and its communication. Participants reported various incidents that raised their awareness of their reasoning and communication abilities, such as teaching students on clinical placements, and informal discussions with peers about patients; these were linked with periods of steep learning of both abilities. Findings from this research present learning to reason and to communicate reasoning as journeys of professional socialisation that evolve through higher education and in the workplace. A key finding that supports this view is that clinical reasoning and its communication are embedded in the context of professional practice and therefore are best learned in this context of becoming, and developing as, a member of the profession. Communication of clinical reasoning was found to be both an inherent part of reasoning and an essential and complementary skill necessary for sound reasoning, that was embedded in the contextual demands of the task and situation. In this way clinical reasoning and its communication are intertwined and should be learned concurrently. The learning and teaching of clinical reasoning and its communication should be synergistic and integrated; contextual, meaningful and reflexive.
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Schweitzer, Janine M. "An investigation of professional learning by clinical dietitians". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq22393.pdf.
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Cella, Matteo. "Emotion-based learning : an experimental and clinical investigation". Thesis, Swansea University, 2009. https://cronfa.swan.ac.uk/Record/cronfa42967.
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Emotion-based learning has emerged as a concept referring to a specific class of learning in uncertain situations that is facilitated by a substantial input from the emotion system. The precise nature of this input, however, remains a controversial and wellstudied topic. The present thesis builds on existing emotion-based learning research and investigates several understudied and novel research questions in both experimental and clinical domains. In Chapter 1, a literature review outlines the evolution of research on emotion-based learning, its neuropsychological correlates and focuses on one of the most popular tasks used to measure the concept: the Iowa Gambling Task (IGT). The IGT is an experimental task developed in order to simulate real world complex decision-making. In it, participants make choices from decks of cards that vary in both frequency and magnitude of reward (gain) and punishment (loss). Advantageous decision-making involves foregoing immediate gains with higher long-term losses for lower immediate gains and lower long-term losses. Research has indicated considerable variability in the extent to which healthy controls produce evidence of advantageous learning on the IGT. Chapter 2 showed that placing time constraints on the critical decision-making period in the IGT systematically disrupted the performance of healthy participants. Chapters 3 and 4 introduced a novel variant contingency shifting IGT in which the reward and punishment contingencies were systematically altered following initial exposure to the task. Research was undertaken with a large sample, using a repeated exposure design and by measuring the autonomic skin conductance correlates of contingency shifting IGT performance. Chapter 5 extended the investigation to the dimensional spectrum of depression and schizophrenia by applying the task to participants scoring high and low on measures of psychosis proneness and depression. Results showed that individuals with high psychotic and depressive features displayed poor flexible emotion-based learning performance. Chapter 6 showed that patients with schizophrenia exhibit impaired performance compared to controls, while Chapter 7 showed that depressed patients also underperformed compared to controls, in both the initial and contingency shifting phase of the variant IGT. Overall, the findings of the present thesis offer insights into the nature of flexible emotion-based learning, as measured with the contingency shifting IGT, and its impairment, across healthy volunteers, individuals at higher risk of developing psychosis or depression and patients with schizophrenia and depression.
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Petty, Nicola Jane. "Towards clinical expertise : learning transitions of neuromusculoskeletal physiotherapists". Thesis, University of Brighton, 2009. https://research.brighton.ac.uk/en/studentTheses/240304d3-3f6b-463f-a193-0c4d28a112aa.
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Postgraduate neuromusculoskeletal physiotherapy courses in the UK, accredited by the Manipulation Association of Chartered Physiotherapists (MACP), aim to promote clinical expertise. Gaining the specialist qualification has been demonstrated to enhance career progression to extended scope practitioner, clinical specialist and consultant roles within the NHS. While research has identified the attributes of expertise, there is limited understanding of how individuals learn and develop that expertise. The aim of the study was to develop an explanatory theory of the learning transitions of neuromusculoskeletal physiotherapists on completion of an MACP approved Masters programme. The methodology was a naturalistic inquiry using a single theory-seeking case study design and insider research. Twenty six semi-structured face to face or telephone, audio-taped interviews with eleven alumni who had successfully completed a MSc neuromusculoskeletal physiotherapy course participated and were selected using purposeful sampling. Alumni were interviewed between six months and five years after completion of the MSc. A further two study participants with high levels of clinical expertise, were theoretically sampled and interviewed once. Dimensional analysis of the research data was used to develop a substantive theory of the learning transition. The learning transition was from hidden, received practice knowledge with routine, therapist centred clinical practice to critical understanding of practice knowledge that enabled patient centred practice and the capability to learn in, and from, practice. This development towards clinical expertise was primarily facilitated by critical evaluation of practice knowledge through critical companionship in the practice setting. The learning transition varied between study participants and depended on their conception of clinical practice, epistemology of practice knowledge, conception of teaching and learning, achievement motivation, locus of control, perceived self efficacy in practice knowledge, professional self esteem, emotional control, learning relationships and learning style. Findings suggest that direct observation of clinical practice together with the questioning and challenging approach of critical companionship within clinical practice enhanced the clinical expertise of neuromusculoskeletal physiotherapists. Clinical expertise was characterised by critical understanding of practice knowledge, patient centred practice and a capability to learn in, and from, clinical practice. The explanatory theory of the learning transition has implications for physiotherapy clinical practice, education and research.
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Loftus, Stephen Francis. "Language in clinical reasoning learning and using the language of collective clinical decision making /". Faculty of Health Sciences, School of Physiotherapy, University of Sydney, 2006. http://hdl.handle.net/2123/1165.
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Doctor of PhilosophyThe aim of the research presented in this thesis was to come to a deeper understanding of clinical decision making from within the interpretive paradigm. The project draws on ideas from a number of schools of thought which have the common emphasis that the interpretive use of language is at the core of all human activity. This research project studied settings where health professionals and medical students engage in clinical decision making in groups. Settings included medical students participating in problem-based learning tutorials and a team of health professionals working in a multidisciplinary clinic. An underlying assumption of this project was that in such group settings, where health professionals are required to articulate their clinical reasoning for each other, the individuals involved are likely to have insights that could reveal the nature of clinical decision making. Another important assumption of this research is that human activities, such as clinical reasoning, take place in cultural contexts, are mediated by language and other symbol systems, and can be best understood when investigated in their historical development. Data were gathered by interviews of medical students and health professionals working in the two settings, and by non-participant observation. Data analysis and interpretation revealed that clinical decision making is primarily a social and linguistic skill, acquired by participating in communities of practice called health professions. These communities of practice have their own subculture including the language game called clinical decision making which includes an interpretive repertoire of specific language tools and skills. New participants to the profession must come to embody these skills under the guidance of more capable members of the profession, and do so by working through many cases. The interpretive repertoire that health professionals need to master includes skills with words, categories, metaphors, heuristics, narratives, rituals, rhetoric, and hermeneutics. All these skills need to be coordinated, both in constructing a diagnosis and management plan and in communicating clinical decisions to other people, in a manner that can be judged as intelligible, legitimate, persuasive, and carrying the moral authority for subsequent action.
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Buthelezi, Sibusiso. "Clinical learning experiences of university male student nurses during their placement in a clinical setting". University of the Western Cape, 2014. http://hdl.handle.net/11394/4174.
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Magister Curationis - MCurAn increasing number of males is entering the nursing profession. The researcher in his position as a clinical supervisor at the School of Nursing at the University of the Western Cape (UWC), through informal ward rounds with student nurses in the wards, has received concerns raised by male student nurses regarding their dissatisfaction with their clinical learning. Given the paucity of literature about the experiences of males working in a profession dominated by females, the researcher embarked on this study to understand how male student nurses experienced the clinical learning environment. The aim of the study was to explore and describe the lived clinical learning experience of male student nurses during their experiential learning in the clinical setting. A descriptive phenomenological design was used. Purposive sampling was used to select participants from the second, third and fourth year of their study. Three focus group discussions, consisting of six participants per group were used to collect data. One open-ended question guided the interviews. Focus group discussions were audio-recorded and transcribed verbatim. Data analysis was conducted by means of Colaizzi`s (1978) seven steps method of qualitative analysis. Three major themes identified focused on the experiences regarding the constraints in the learning environment, the impact on the self and social support of students working in a female dominated profession. The participants in this study were male students only, but after looking at the findings and literature, the problem of not being given opportunities to practise clinical skills in a clinical learning environment, particularly according to their level of study, is a problem that faces both male and female students. The findings indicate that male nurses do have different experiences compared to female nurses because of their masculinity, hence they are limited in the care that they can provide to female patients.
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Poon, Wai Sha. "Staged participation : student nurses' and clinical facilitators' perceptions of the clinical learning environment in Macau". Thesis, University of Edinburgh, 2016. http://hdl.handle.net/1842/20988.
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With the movement of nurse education into the higher education sector, the role of student nurses has moved from that of apprentices to learners with full student status on placement. Although supernumerary status is key to current nursing training, not much attention has been paid to its influence on student participation in the community of practice of the workplace. This thesis has set out to address this research gap. A qualitative dominant mixed methods study closely examined student participation on placement by comparing and contrasting students’, mentors’ and clinical instructors’ clinical learning and mentoring experiences and their perceptions of supernumerary status was carried out. Data were collected in a nursing college in Macau. In the qualitative part, a sample of seven third year and six fourth year student nurses were recruited to participate in a focus group interview corresponding to their year of study. In addition, five mentors and five clinical instructors were interviewed individually. Views from participants were compared and contrasted. For the quantitative part, all second to fourth year students were invited to respond to a questionnaire after placement. One hundred and fifty-one questionnaires were returned. Descriptive and inferential statistics were used to analyse the quantitative data. This study revealed that there is a lack of clarity about supernumerary status among student nurses. However, students’, mentors’, clinical instructors’ and nurses’ perceptions of clinical learning and supernumerary status exert an impact on student participation on placement. Although students were temporary peripheral participants of the workplace, they had to be engaged in the clinical environment and authentic practice in order to create connections with the workplace and develop nurse identities. It was found that students who were facilitated by mentors, who were drawn from ward staff, had more opportunities to participate in qualified nurses’ work and work with the nursing team on placement than those supported by university-based clinical facilitators.
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Bradley, Jennifer. "Facilitating choice for people with learning disabilities". Thesis, University of Hull, 2010. http://hydra.hull.ac.uk/resources/hull:5792.
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Background: Choice constitutes a core element of the human experience. To deny this right can be seen as a denial of basic human rights and yet for people with learning disabilities this has often been a reality. Some argue that choice is different for people with learning disabilities for a variety of intellectually based reasons. The effect of choice on people with learning disabilities therefore is an important area of concern for researchers to establish the underlying meaning and drivers for increasing choice for this group of people. Method: A systematic literature review was conducted to bring together studies examining the effects of choice for people with learning disabilities. The review utilised three databases and selected reference lists to find relevant articles and these were brought together in a summary of findings. Results: Studies focused heavily on task behaviours and challenging behaviours and whether and how this would be altered by introducing elements of choice or preference. A large majority of studies demonstrated that the main basis for the improvement of tasks and behaviours was the introduction of preferred stimuli rather than the being able to actively choose between stimuli. Other studies demonstrated that choice has a positive effect on mood, quality of life and motivation during a self care exercise.
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Joshua, Beverly. "Nursing students' approaches to learning and clinical decision-making". Thesis, London South Bank University, 2017. http://researchopen.lsbu.ac.uk/1840/.
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The present and categorical correspondence between how students approach their learning and the way such approaches impact on the acquisition and augmentation of clinical decision-making skills is neither well understood, nor yet clearly established, in nurse education research. To address this gap, this study investigated the approaches to learning and the clinical decision-making of adult nursing students in their final year of training on two separate campuses of a central London university. Approaches to Learning Theory, promulgated by Martin and Sӓljö in 1976, and subsequently expanded and updated by Entwistle and colleagues, provided a theoretical lens and explanatory framework for this study. Acknowledging that the Approaches to Learning Theory adopts a hierarchy of three domains of approach, surface, strategic, and deep, it is argued that students’ clinical decisionmaking should be improved by changing their predominant approach to learning from the surface or strategic to the deep approach. To test this hypothesis, a research intervention was implemented for a purposive sample of participants who adopted either the surface or strategic approach to learning. Consistent with the underpinning principles of the deep approach to learning, the intervention focused on enhancing engagement with learning, problem-solving, and critical thinking skills. A second survey of approaches to learning and clinical decision-making was administered after the intervention, and semi-structured interviews were conducted to further corroborate the statistical findings. Instruments for data collection comprised the Approaches to Study Skills Inventory for Students, known as the ASSIST (Tait et al, 1998), Jenkins’ (1985) Clinical Decision-making Nursing Scale (CDMNS), and a short demographic questionnaire designed by the researcher. This research found that by altering the learning approach, consequent on the researchintervention, the adoption of the deep approach to learning enhanced clinical decision-making. Post-intervention findings revealed a strong positive correlation between the deep approach and clinical decision-making. Participants’ disposition for the surface approach also decreased significantly. Male participants indicated an affinity for the deep approach in comparison to female students who predominantly adopted the strategic approach. The study concluded that by cultivating students’ deeper engagement, underpinned by the intention to seek meaning and understand their learning, clinical decision-making was improved.
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Grimes, Richard. "Learning through experience : developing clinical models for legal education". Thesis, Northumbria University, 2017. http://nrl.northumbria.ac.uk/32492/.
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Since the time when legal education became the preserve of universities and other higher education providers there has been an uneasy relationship between the ‘aims’ of a liberal course of study and the demands of a practising profession. In addition, educators have dominated formal legal learning with a rules-driven curriculum delivered principally in the format of lectures – where students are seen and treated primarily as passive recipients of knowledge. On joining academia from legal practice in the early 1990s my work has been principally focused on addressing the tensions implicit in the above – looking at what we as educators, practitioners, students and the wider public need and want from legal education and the most effective ways of achieving that. Taking the importance of knowledge, skills and values as a framework I have published widely on both the content and means of delivery of legal education. Whilst the former (content) must be seen in context – undergraduates for example may have very different outcomes set for them as compared with those an overtly vocational course – the latter (delivery) has a common denominator. This is to do with how students learn and how they can be encouraged to take responsibility for, and make the most of, that. Learning through experience supported by the means to conduct critical reflection is at the centre of my work. I have looked, in particular, at developing models of 'clinic' where students, under requisite supervision, engage in real or realistic casework in order to comprehend relevant content, be that legal doctrine, lawyering skills or professional and ethical considerations. This work has been recognised as ‘pioneering’ in the development of clinical legal education both in the UK and further afield, as evidenced by the volume of publications, numerous citations in other works and requests made by others for assistance, particularly in developing clinics. Most recently I have been looking at whether these pedagogic and professional practice models have transferable value in civil and common law jurisdictions and to what extent they aide access to justice. The publications – a mix of books, book chapters, articles in refereed journals and other material in the public domain – that I rely on are listed in Appendix 1 to this commentary and show, I submit, how I have made a significant contribution to knowledge through the development of clinic as pedagogy and the utility of this, for student, client, profession and the wider public in a domestic and international context. This submission looks initially at the context of my published work and recounts a journey encompassing different models of clinical legal education. This is followed by a section setting out a framework for understanding the nature, scope and extent of ‘clinic’. In order the encapsulate what clinic is and what potential is offered a taxonomy is suggested based on the variants that determine the educational, public service and professional reach of experiential learning in general and clinical legal education in particular. I then focus on three aspects of my work represented by the publications on which I rely for this award – simulation, model modification and international transferability and provide examples of these manifestations of clinic alongside analysis from other scholars. The final substantive section of the submission attempts to locate what I have published within the wider context of current changes and proposed reforms in legal education. The conclusions reached include the recognition of the importance of clinic (actual and potential) in serving the various agendas held by relevant stakeholders.
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Jamieson, Earle Spencer. "Haptic enhancement of sensorimotor learning for clinical training applications". Thesis, University of Leeds, 2015. http://etheses.whiterose.ac.uk/12571/.
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Modern surgical training requires radical change with the advent of increasingly complex procedures, restricted working hours, and reduced ‘hands-on’ training in the operating theatre. Moreover, an increased focus on patient safety means there is a greater need to objectively measure proficiency in trainee surgeons. Indeed, the existing evidence suggests that surgical sensorimotor skill training is not adequate for modern surgery. This calls for new training methodologies which can increase the acquisition rate of sensorimotor skill. Haptic interventions offer one exciting possible avenue for enhancing surgical skills in a safe environment. Nevertheless, the best approach for implementing novel training methodologies involving haptic intervention within existing clinical training curricula has yet to be determined. This thesis set out to address this issue. In Chapter 2, the development of two novel tools which enable the implementation of bespoke visuohaptic environments within robust experimental protocols is described. Chapters 3 and 4 report the effects of intensive, long-term training on the acquisition of a compliance discrimination skill. The results indicate that active behaviour is intrinsically linked to compliance perception, and that long-term training can help to improve the ability of detecting compliance differences. Chapter 5 explores the effects of error augmentation and parameter space exploration on the learning of a complex novel task. The results indicate that error augmentation can help improve learning rate, and that physical workspace exploration may be a driver for motor learning. This research is a first step towards the design of objective haptic intervention strategies to help support the rapid acquisition of sensorimotor skill. The work has applications in clinical settings such as surgical training, dentistry and physical rehabilitation, as well as other areas such as sport.
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Lindblad, Simon. "Labeling Clinical Reports with Active Learning and Topic Modeling". Thesis, Linköpings universitet, Interaktiva och kognitiva system, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-148463.
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Supervised machine learning models require a labeled data set of high quality in order to perform well. Available text data often exists in abundance, but it is usually not labeled. Labeling text data is a time consuming process, especially in the case where multiple labels can be assigned to a single text document. The purpose of this thesis was to make the labeling process of clinical reports as effective and effortless as possible by evaluating different multi-label active learning strategies. The goal of the strategies was to reduce the number of labeled documents a model needs, and increase the quality of those documents. With the strategies, an accuracy of 89% was achieved with 2500 reports, compared to 85% with random sampling. In addition to this, 85% accuracy could be reached after labeling 975 reports, compared to 1700 reports with random sampling.
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Mohr, Peggy, i Kara Boynewicz. "Team-Based Learning: Clinical Decision-Making Across the Lifespan". Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/8351.
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Join your colleagues for dynamic group discussions about best practice in pediatric physical therapy. Attendees will participate in Team-Based Learning activities, sharing their knowledge, experiences, and skills, to problem-solve and come to a team consensus on clinical decisions. Participants will review a case study that is designed to address pediatric therapy across the lifespan, incorporate multiple practice areas, and stimulate critical thinking. Team-Based Learning is an instructional strategy that uses a set of structured activities to create active, energetic, collaborative learning environments. Information designed to support individuals’ ability to participate in the activities and clinical decision-making will be provided prior to APPTAC to those registered for the session. This session will take place in multiple rooms.
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Compton, Christa M. "Learning from experience : a study of clinical pastoral education /". May be available electronically:, 2007. http://proquest.umi.com/login?COPT=REJTPTU1MTUmSU5UPTAmVkVSPTI=&clientId=12498.
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Denhup, Steven Allen. "Behavioral analysis in the athletic training clinical learning environment". Morgantown, W. Va. : [West Virginia University Libraries], 2003. http://etd.wvu.edu/templates/showETD.cfm?recnum=2843.
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Thesis (M.S.)--West Virginia University, 2003.Title from document title page. Document formatted into pages; contains vi, 82 p. : ill. (some col.). Includes abstract. Includes bibliographical references.
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Lewis, Kathleen M. (Kathleen Marie). "Fast learning-based registration of sparse 3D clinical images". Thesis, Massachusetts Institute of Technology, 2019. https://hdl.handle.net/1721.1/122546.
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Thesis: S.M., Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, 2019Cataloged from PDF version of thesis.
Includes bibliographical references (pages 37-40).
We introduce SparseVM, a method to register clinical 3D MR scans faster and more accurately than previously possible. Deformable alignment, or registration, of clinical scans is a fundamental task for many medical image applications such as longitudinal population studies. Most registration algorithms are designed for high-resolution research-quality scans, and under-perform when applied to clinical data. Clinical scans present unique challenges because, in contrast to research-quality scans, clinical scans are often sparse, missing up to 85% of the slices available in research scans. We build on a state-of-the-art learning-based registration method to improve the accuracy of sparse clinical image registration. We evaluate our method on both a clinically-acquired MRI dataset of stroke patients, and on a simulated sparse clinical scan dataset. SparseVM registers MR scans in under a second on a GPU, which is over 1000 x faster than the most accurate clinical registration methods, without compromising accuracy. SparseVM has statistically significant improvements in runtimes over all baselines, and a statistically significant improvement in accuracy over the fastest baseline. Because of these contributions, SparseVM enables clinical analyses that were not previously possible. Our code is publicly available at voxelmorph. mit . edu.
by Kathleen M. Lewis.
S.M.
S.M. Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science
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Chavez-Gehrig, Arturo. "Modeling correlations in clinical trial outcomes using machine learning". Thesis, Massachusetts Institute of Technology, 2019. https://hdl.handle.net/1721.1/123075.
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Thesis: M. Eng., Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, 2019Cataloged from PDF version of thesis.
Includes bibliographical references (pages 69-71).
This thesis explores the problem of characterizing the covariance of clinical trial outcomes using drug and trial features. The binary nature of FDA approvals makes drug development risky, but approaches in finance theory could better manage that risk, allowing more high potential drugs to be developed. To apply these methods confidently, it is necessary to understand the covariance between projects. The paper outlines several approaches for this task and their theoretical foundations, such as finding the nearest valid covariance matrix, online sequence prediction, and a new approach using function approximation via random forest. This function approximation approach to estimating covariance is implemented and tested on historical clinical trial data.
by Arturo Chavez-Gehrig.
M. Eng.
M.Eng. Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science
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Kholghi, Mahnoosh. "Active learning for concept extraction from clinical free text". Thesis, Queensland University of Technology, 2017. https://eprints.qut.edu.au/112420/1/Mahnoosh_Kholghi_Thesis.pdf.
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This thesis is a step towards automating information extraction from clinical free-text. It establishes a Cost-efficient Enhanced Active Learning framework to significantly reduce annotation cost, while ensuring high-quality extracted information. The practical significance of this research is three-fold: (1) benefitting the overall patient healthcare by facilitating downstream eHealth workflows such as supporting clinical information processing and efficient decision making, (2) benefitting the research in medical informatics by facilitating the development of rich annotated corpora from clinical free text resources, and (3) benefitting the research in machine learning by developing domain-independent and effective active learning approaches.
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Chiu, Yuen-han. "Clinical learning environment and approach to learning : perspectives of mature nursing students in Hong Kong /". View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B31683484.
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Macdonald, Morag M. "Craft knowledge in medicine : an interpretation of teaching and learning in apprenticeship". N.p, 1997. http://ethos.bl.uk/.
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Heradien, Zenobia. "Clinical supervisors’ perceptions regarding the factors that promote or inhibit nursing students’ skills transfer from the skills laboratory to the clinical practice environment". University of the Western Cape, 2019. http://hdl.handle.net/11394/7016.
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Magister Curationis - MCurBackground: Nursing as a profession is based on firm knowledge, values, clinical skills and attitudes. In the current dynamic healthcare system nursing students are challenged to be insightful and have clinical reasoning and psychomotor skills in order to apply theory to practice. Clinical teaching is therefore considered an essential part of the undergraduate nursing curriculum, as it provides the opportunity for students to apply theory to practice in the skills laboratory and then to transfer it into real life situations. Nursing students spend time in the clinical practice environment learning the skills and values of the nursing profession, with the goal of achieving the clinical learning outcomes, as prescribed by their nursing education institution and the South African Nursing Council. During this time nursing students depend on the support of clinical supervisors and nursing staff in the clinical practice environment to meet their learning outcomes. Clinical supervisors for the undergraduate nursing programme, at the university included in the study, are tasked with clinical teaching in the skills laboratory, supervision of nursing students in clinical practice and assessment of learning. Nonetheless, there are challenges ascertained by the clinical supervisors, which inhibits students from achieving their learning outcomes. Purpose of the study: The purpose of the study was to explore and describe the clinical supervisor’s perception of students’ skills transfer from skills laboratory to the clinical environment.
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Crowley, Maureen A. "A longitudinal study exploring student nurses' perceptions of the impact of a simulated clinical environment on their clinical learning experience and transfer of learning". Thesis, Edinburgh Napier University, 2013. http://researchrepository.napier.ac.uk/Output/6354.
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Nurse education has evolved from an apprenticeship model to one with a graduate focus. However, numerous factors have resulted in less opportunity for students to practice clinical skills in practicum (Scholes et al., 2004). Simulation was introduced to address this (NMC 2007) and research has shown that simulation is effective in the acquisition of skills over the short term (Alinier et al., 2006; Ironside et al., 2009). However, no research had looked at the student experience of simulation over an extended period of time. The aim of this longitudinal qualitative study was to explore the progressive nature of the student nurses' experiences of learning within a simulated clinical environment (SCE) and the impact it had on their learning and transfer of skills to practicum. A purposive sample of twelve students was recruited from two different intakes. Cohort one comprised four students. Cohort two comprised eight. Students consented to being interviewed five times, from entry into the branch programme to registration. Each cohort participated in an initial focus group, one observation in practicum and four semi-structured one–to–one interviews over the course of the two–year branch programme. Data were thematically analysed (Colaizzi 1978), with existing literature used to support or counter emerging themes. A recurring focus was how well students were able to participate in the SCE. What was apparent was that those able to fully engage with the simulation events appeared to get the most out of it. Findings revealed many factors, which facilitated or inhibited student engagement. The categories that emerged were: learning in the simulated clinical environment; authenticity of the simulated clinical environment; concrete experiences in the simulated clinical environment; visual mental model; and practicum experiences. An important recurring factor that was unforeseen was the impact students' preferred learning style could have on their skill development and subsequent transfer to practicum. Findings were returned to participants for verification of accuracy.
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Rowe, Michael. "Blended learning in physiotherapy education: designing and evaluating a technology-integrated approach". Thesis, University of the Western Cape, 2012. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_1973_1365674895.
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Background: Practice knowledge exists as a complex relationship between questions and answers in a context of meaning that is often intuitive and hidden from the novice practitioner. Physiotherapy education, which aims to develop patterns of thinking, reflection and reasoning as part of practice knowledge, is often based on didactic teaching methods that emphasise the learning of facts without highlighting the relationships between them. In order to improve health outcomes for patients, clinical educators must
consider redesigning the curriculum to take into account the changing and complex nature of physiotherapy education. There is some evidence that a blended approach to
teaching and learning may facilitate the development of graduates who are more capable of reflection, reasoning and critical thinking, and who can adapt and respond to the
complex clinical environment. The purpose of this study was to develop principles that could be used to guide the design of blended learning environments that aim to develop
capability in undergraduate physiotherapy students. Method: The study took place in a university physiotherapy department in the Western Cape in South Africa, among
undergraduate students. Design research was used as a framework to guide the study, and included a range of research methods as part of that process. The problem was
identified using a systematic review of the literature and a survey of students. The design of the blended intervention that aimed to address the problem was informed by a
narrative review of theoretical frameworks, two pilot studies that evaluated different aspects of blended learning, and a Delphi study. This process led to the development of a set
of design principles which were used to inform the blended intervention, which was implemented and evaluated during 2012. Results: The final results showed that students had undergone a transformation in how they thought about the process and practice of learning as part of physiotherapy education, demonstrating critical approaches towards
knowledge, the profession and authority. These changes were brought about by changing teaching and learning practices that were informed by the design principles in the
preliminary phases of the project. These principles emphasised the use of technology to interact, articulate understanding, build relationships, embrace complexity, encourage
creativity, stimulate reflection, acknowledge emotion, enhance flexibility and immerse students in the learning space. Discussion: While clinical education is a complex undertaking with many challenges, evidence presented in this study demonstrates that the development of clinical reasoning, critical thinking and reflection can be enhanced through the intentional use of technology as part of a blended approach to teaching and learning. The design principles offer clinical educators a framework upon which to construct learning environments where the affordances of technology can be mapped to the principles, which are based on a sound pedagogical foundation. In this way, the use of technology in the learning environment is constructed around principles that are informed by theory. However, clinical educators who are considering the integration of
innovative strategies in the curriculum should be aware that students may initially be reluctant to engage in self-directed learning activities, and that resistance from colleagues
may obstruct the process. Conclusion: The development of clinical reasoning, critical thinking and reflection in undergraduate physiotherapy students may be enhanced through
the intentional use of appropriate technology that aims to fundamentally change teaching and learning practices. Design research offers a practical approach to conducting
research in clinical education, leading to the development of principles of learning that are based on theory.
iii
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Gaddis, Stephen R. "Narrative means to research ends: Learning about therapy from clients' descriptions". Related electronic resource: Current Research at SU : database of SU dissertations, recent titles available full text, 2002. http://wwwlib.umi.com/cr/syr/main.
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O'Halloran, Catherine. "Student learning in clinical education : a case study in podiatry". Thesis, University of Newcastle Upon Tyne, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299666.
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Sinozic, Tanja. "Learning in clinical practice : findings from CT, MRI and PACS". Thesis, University of Sussex, 2014. http://sro.sussex.ac.uk/id/eprint/49367/.
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This thesis explores learning in clinical practice in the cases of CT, MRI and PACS in UK hospitals. It asks the questions of how and why certain evolutionary features of technology condition learning and change in medical contexts. Using an evolutionary perspective of cognitive and social aspects of technological change, this thesis explores the relationships between technology and organisational learning processes of intuition, interpretation, integration and institutionalisation. Technological regimes are manifested in routines, skills and artefacts, and dynamically evolve with knowledge accumulation processes at the individual, group and organisational levels. Technological change increases the uncertainty and complexity of organisational learning, making organisational outcomes partially unpredictable. Systemic and emergent properties of medical devices such as CT and MRI make learning context-specific and experimental. Negotiation processes between different social groups shape the role and function of an artefact in an organisational context. Technological systems connect artefacts to other parts of society, mediating values, velocity and directionality of change. Practice communities affect how organisations deal with this complexity and learn. These views are used to explore the accumulation of knowledge in clinical practices in CT, MRI and PACS. This thesis develops contextualised theory using a case-study approach to gather novel empirical data from over 40 interviews with clinical, technical, managerial and administrative staff in five NHS hospitals. It uses clinical practice (such as processes, procedures, tasks, rules, interpretations and routines) as a unit of analysis and CT, MRI and PACS technology areas as cases. Results are generalised to evolutionary aspects of technological learning and change provided by the framework, using processes for qualitative analysis such as ordering and coding. When analysed using an evolutionary perspective of technology, the findings in this thesis suggest that learning in clinical practice is diverse, cumulative and incremental, and shaped by complex processes of mediation, by issues such as disease complexity, values, external rules and choice restrictions from different regimes, and by interdisciplinary problem-solving in operational routines.
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Ashfaq, Awais. "Predicting clinical outcomes via machine learning on electronic health records". Licentiate thesis, Högskolan i Halmstad, CAISR Centrum för tillämpade intelligenta system (IS-lab), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-39309.
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The rising complexity in healthcare, exacerbated by an ageing population, results in ineffective decision-making leading to detrimental effects on care quality and escalates care costs. Consequently, there is a need for smart decision support systems that can empower clinician's to make better informed care decisions. Decisions, which are not only based on general clinical knowledge and personal experience, but also rest on personalised and precise insights about future patient outcomes. A promising approach is to leverage the ongoing digitization of healthcare that generates unprecedented amounts of clinical data stored in Electronic Health Records (EHRs) and couple it with modern Machine Learning (ML) toolset for clinical decision support, and simultaneously, expand the evidence base of medicine. As promising as it sounds, assimilating complete clinical data that provides a rich perspective of the patient's health state comes with a multitude of data-science challenges that impede efficient learning of ML models. This thesis primarily focuses on learning comprehensive patient representations from EHRs. The key challenges of heterogeneity and temporality in EHR data are addressed using human-derived features appended to contextual embeddings of clinical concepts and Long-Short-Term-Memory networks, respectively. The developed models are empirically evaluated in the context of predicting adverse clinical outcomes such as mortality or hospital readmissions. We also present evidence that, surprisingly, different ML models primarily designed for non-EHR analysis (like language processing and time-series prediction) can be combined and adapted into a single framework to efficiently represent EHR data and predict patient outcomes.
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Engelhard, Chalee R. "Advancing Clinical Instructor Best Practices: A Venture into Online Learning". University of Cincinnati / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1352484966.
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Farhidzadeh, Hamidreza. "Learning to Predict Clinical Outcomes from Soft Tissue Sarcoma MRI". Scholar Commons, 2017. https://scholarcommons.usf.edu/etd/7398.
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Soft Tissue Sarcomas (STS) are among the most dangerous diseases, with a 50% mortality rate in the USA in 2016. Heterogeneous responses to the treatments of the same sub-type of STS as well as intra-tumor heterogeneity make the study of biopsies imprecise. Radiologists make efforts to find non-invasive approaches to gather useful and important information regarding characteristics and behaviors of STS tumors, such as aggressiveness and recurrence. Quantitative image analysis is an approach to integrate information extracted using data science, such as data mining and machine learning with biological an clinical data to assist radiologists in making the best recommendation on clinical trials and the course of treatment.
The new methods in “Radiomics" extract meaningful features from medical imaging data for diagnostic and prognostic goals. Furthermore, features extracted from Convolutional Neural Networks (CNNs) are demonstrating very powerful and robust performance in computer aided decision systems (CADs). Also, a well-known computer vision approach, Bag of Visual Words, has recently been applied on imaging data for machine learning purposes such as classification of different types of tumors based on their specific behavior and phenotype. These approaches are not fully and widely investigated in STS.
This dissertation provides novel versions of image analysis based on Radiomics and Bag of Visual Words integrated with deep features to quantify the heterogeneity of entire STS as well as sub-regions, which have predictive and prognostic imaging features, from single and multi-sequence Magnetic Resonance Imaging (MRI). STS are types of cancer which are rarely touched in term of quantitative cancer analysis versus other type of cancers such as lung, brain and breast cancers. This dissertation does a comprehensive analysis on available data in 2D and multi-slice to predict the behavior of the STS with regard to clinical outcomes such as recurrence or metastasis and amount of tumor necrosis.
The experimental results using Radiomics as well as a new ensemble of Bags of Visual Words framework are promising with 91.66% classification accuracy and 0.91 AUC for metastasis, using ensemble of Bags of Visual Words framework integrated with deep features, and 82.44% classification accuracy with 0.63 AUC for necrosis progression, using Radiomics framework, in tests on the available datasets.
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McGuinness, Meghan Ann. "Adult Learning-Focused Professional Development for Dental Hygiene Clinical Instructors". ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/1907.
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At a dental hygiene program within a community college in New York State, clinical instructors are hired based on their expertise as practitioners. Most clinical instructors lack a background in adult learning theory and practice, which is an issue because their students are adult learners whose average age is 26. The instructors' lack of knowledge in this area challenges their effectiveness. The purpose of this qualitative case study was to explore dental hygiene instructors' views about what kind of professional development offerings related to adult learning might help improve their teaching effectiveness. The conceptual framework for this project study was Lave and Wenger's situated learning theory. Semi-structured interviews were conducted with 8 part-time clinical instructors from the same academic department. Data were analyzed using thematic analysis. Five themes emerged from data analysis: participants' commitment to teaching, experience with students' attitudes, desire for communication, satisfaction with students' successes, and need for professional development. These findings led to the design of a professional development program that includes content on behaviorism, humanism, social cognitive theory, cognitivism, constructivism, and experiential learning theory. The goals of the program include providing clinical instructors with a background in adult learning theory and identifying ways to implement adult learning theory into clinical instruction. In potentially improving the teaching effectiveness of clinical instructors, this study may result in the better preparation of dental hygiene students and, ultimately, lead to improved patient care.
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Montecuollo, Brittany. "Program Evaluation of the RN Clinical Learning and Development Specialist". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6928.
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The purpose of this project was to evaluate the impact of a quality improvement strategy to implement an RN clinical learning and development specialist (CLDS) with the intent to reduce high turnover in novice nurses and low nurse engagement. The CLDS served as expert, role-model, coach, and mentor. Benner's model of novice-to-expert was used as the conceptual framework to monitor progression of nurses mentored by the CLDS. The Institute for Healthcare Improvement model for improvement was reviewed to assess the effectiveness of the CLDS on turnover rates and nurse engagement. At the time of program evaluation, the CLDS role had been operational at the project site for 8 months in inpatient and perioperative service lines. An analysis of turnover rate by headcount of 1510 RNs within the practice environment was completed. The change from the preintervention period to the postintervention period was statistically significantly lower. A nonparametric test to compare the monthly rates was used (z = -2.613; p = .005). To evaluate nurse engagement, the practice environment scale was deployed to all RN nurse residents from 9/2018 through 3/2019. A total of 166 surveys were deployed. There were 86 responses; 62 respondents were RNs with an assigned CLDS. There were no statistically significant differences in the scores between these 2 groups. The social impact of this project is important to share with nursing and operational leadership as an intervention to reduce RN turnover across healthcare settings, specifically in acute care practice areas. The issues of RN turnover and satisfaction with the practice environment are relevant across organization types and settings.
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Chiu, Yuen-han, i 焦婉嫻. "Clinical learning environment and approach to learning: perspectives of mature nursing students in Hong Kong". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45011631.
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Booth, Ian M. "Developing community dentistry through action learning : the actions, reflections and learning of a clinical director". Thesis, University of Manchester, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.520729.
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Action learning is increasingly being adopted by NHS organisations as a way of providing leadership and organisational development for staff, including senior clinicians. The benefit of action learning is that it allows work-based learning to take place with the intention of improving patient care and developing a strategic direction for individual services. Through this approach, senior clinicians will increase their selfawareness and be sensitive to the cultures within their organisation and ensure that their actions are responsive to these and not consider their actions in isolation. The research had an organisational project to consider how a salaried primary dental care service had to change in order to meet the needs of the local population in a changing NHS environment and a personal project of a journey of learning, development and change. The thesis analysed the development of the Community Dental Service from the School Dental Service to the recent developments of salaried personal dental services, including dental access centres. Moreover, it looked at how market forces and shortages in the dental workforce have influenced national policies and how these in turn have affected salaried dental services. Using my work within the Community Dental Service, I described the personal, service and organisational problems facing a clinical director. With the involvement of an action learning set, I explained how possible solutions to these problems were identified, action implemented to address them, their effects monitored and evaluated and to reflect upon the learning from these actions. The key achievements have been on a personal, professional and organisational level. I have developed as a clinical leader of a NHS service. Through the knowledge and understanding I have gained, I have matured as a manager and have been able to identify a strategy within my organisation and have implemented this for the benefit of the staff, patients and PCT. This in turn gave me personal confidence both in my work life as Clinical Director and in my life outside my work. The clinical service I lead still needs to improve, but this will always be the case. This thesis has been an opportunity for me to undertake a postgraduate qualification within a full time position in the NHS. The benefit has been the pragmatic learning which has occurred within my workplace, the learning set and through my academic studies. In summary, this process of enquiry has brought together theory, professional practice and organisational development. It is recommended that action learning is an appropriate methodology for enabling change to take place in the NHS. Action learning has been demonstrated to be a valuable approach for continuing professional development. It should be explored further within dentistry and in the wider area of health care, incorporating it into clinical leadership training programmes. 10
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Hoffman, Margaret Ursula Marinda. "Perceptions of clinical supervisors about their preparedness for clinical teaching at a university in the Western Cape". University of the Western Cape, 2019. http://hdl.handle.net/11394/7018.
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Magister Curationis - MCurBackground: Clinical supervision or clinical accompaniment is considered an integral part of nursing education and is crucial for the development of nursing students’ clinical competence. In order to achieve this, clinical supervision requires skilled human resources which vary from one educational institution to another and may include lecturers, clinical supervisors/facilitators and professional nurses. Clinical supervisors are required to be good educators as well as excellent clinicians. In addition, they often draw on their individual, personal and professional experiences to guide their teaching to meet the demands of both the clinical and academic contexts in which they work. However, the clinical teaching model or framework used by educational institutions is often not aligned to clinical practice activities and vice versa. This poses challenges for students due to the different expectations of educators and professional nurses in practice. Inadequately prepared clinical supervisors can have a detrimental effect on the delivery of the nursing programme that may include poor clinical teaching and inadequate integration of theory and clinical competencies, which ultimately leads to poorly trained nursing students. Aim of the study: The aim of this study was to explore the perceptions of clinical supervisors regarding their preparedness for clinical teaching. Methods: The study adopted a qualitative research approach, utilising an exploratory descriptive design. A non-probability purposive sampling method was used to select 12 clinical supervisors in the undergraduate programme. The researcher collected the data by means of semi-structured interviews with open-ended questions and analysed this data using content data analysis. Analysis of the data using ATLAS, ti 8 research software programme generated four themes and 18 categories. Findings: The findings indicated that clinical supervisors required time to adapt to their role and improve their knowledge and skills despite them having a positive experience during their orientation. Although appreciative of the support and guidance, clinical supervisors stated that not all colleagues were supportive, which in some instances had a negative impact on interpersonal relationships. The findings furthermore indicated that clinical supervisors apply all the steps of the five phases in the skills lab methodology employed by the School of Nursing at the university where the study was conducted. Clinical supervisors are required to be well informed and committed to continuing education in order to incorporate theory into practice with the latest developments and equipment in facilities. Furthermore, the findings indicated that inconsistency and failure to attend to students’ clinical learning needs can have a negative impact on student learning. Ethics: The researcher adhered to all principles of research ethics throughout the study.
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Nash, Robyn Elizabeth. "Collaboration in clinical education : development, implementation and evaluation of an innovative model of clinical education for undergraduate nursing students". Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16493/1/Robyn_Nash_Thesis.pdf.
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Introduction
The purpose of this study was to enhance the prac experience of undergraduate nursing students and registered nursing staff. An innovative model of clinical education, the Clinical Education Unit (CEU) model was developed, implemented and evaluated.
Background to the study
Clinical education is a vital component of the undergraduate nursing curriculum. 'Real world' practice provides students with the opportunity to develop the knowledge, attitudes and skills needed to function effectively as a registered nurse. Despite the commitment of universities to produce competent graduates, there has continued debate regarding the preparedness of new graduates for practice as registered nurses. This has focussed continued attention on the adequacy of students' clinical education and, in particular, on the models used for clinical facilitation/supervision. There is little published evidence that clearly demonstrates the effectiveness of any of the current models of clinical education or that any particular model is better than any other in achieving quality outcomes (Wellard, Williams and Bethune 2000; Clare, White, Edwards and Van Loon 2002). Hence, as recommended in the recent National Review of Nurse Education (2002), ongoing evaluation of nursing curricula and teaching practice, including clinical education, is clearly warranted.
Methods
The study utilised action research methodology to examine the effects of the Clinical Education Unit (CEU) on the quality of clinical prac as experienced by undergraduate nursing students and registered nurses working with the students in wards where they were placed for their practicums. It was undertaken in two iterations or phases: Phase 1 - Development, implementation and initial evaluation of an innovative model of clinical education (the CEU model) and Phase 2 - Refinement and re-evaluation of the CEU model of clinical education. Using focus group discussions and survey questionnaires, qualitative and quantitative data were collected from undergraduate nursing students and clinical nursing staff in conjunction with each iteration of the study.
Results
Phase 1 results indicated that the CEU model was evaluated more positively by students and registered nurses than were the non-CEU models that were used for comparison. This result was demonstrated in the comments of students and registered nurses with regard to the respective models of clinical education and supported by their ratings of the quality of clinical experience through the QPE-Phase questionnaires. A similar trend was found in the results from Phase 2. The CEU-2 model was again evaluated more positively by students and registered nurses than were the non-CEU models that were used for comparison.
Conclusion
In summary, the results of this study indicate that the CEU model had a positive impact on the prac experience of students and registered nurses. In both phases of the study, students and registered nurses in wards where the CEU model was being used evaluated the prac experience more positively than did students and registered nurses in wards where non-CEU models were being used. Two key factors were found to be important in achieving this outcome: the collaborative nature of the CEU model and nursing staff ownership of students' clinical education. These factors provided an operating framework which enabled the development of positive learning environments in the wards where students were placed for prac. Equally important were arrangements for the supervision of students' practice which involved local clinical facilitation and the explicit inclusion of other nursing staff in the ward. Further, continued support from the university to allow the clinical facilitators to take a supernumary role when facilitating students, to provide staff development for clinical education and to support staff on a day-to-day basis during the prac was also important, if not essential. It is proposed that these factors, acting synergistically, promoted enhanced access to learning opportunities for students and improved learning outcomes for students and staff. The study makes an important contribution to nursing education by providing evidence that can inform future developments in the area of undergraduate clinical education. It has potential benefits for nursing education not only in the local context, but within the international arena as well.
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Nash, Robyn Elizabeth. "Collaboration in clinical education : development, implementation and evaluation of an innovative model of clinical education for undergraduate nursing students". Queensland University of Technology, 2007. http://eprints.qut.edu.au/16493/.
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Introduction The purpose of this study was to enhance the prac experience of undergraduate nursing students and registered nursing staff. An innovative model of clinical education, the Clinical Education Unit (CEU) model was developed, implemented and evaluated. Background to the study Clinical education is a vital component of the undergraduate nursing curriculum. 'Real world' practice provides students with the opportunity to develop the knowledge, attitudes and skills needed to function effectively as a registered nurse. Despite the commitment of universities to produce competent graduates, there has continued debate regarding the preparedness of new graduates for practice as registered nurses. This has focussed continued attention on the adequacy of students' clinical education and, in particular, on the models used for clinical facilitation/supervision. There is little published evidence that clearly demonstrates the effectiveness of any of the current models of clinical education or that any particular model is better than any other in achieving quality outcomes (Wellard, Williams and Bethune 2000; Clare, White, Edwards and Van Loon 2002). Hence, as recommended in the recent National Review of Nurse Education (2002), ongoing evaluation of nursing curricula and teaching practice, including clinical education, is clearly warranted. Methods The study utilised action research methodology to examine the effects of the Clinical Education Unit (CEU) on the quality of clinical prac as experienced by undergraduate nursing students and registered nurses working with the students in wards where they were placed for their practicums. It was undertaken in two iterations or phases: Phase 1 - Development, implementation and initial evaluation of an innovative model of clinical education (the CEU model) and Phase 2 - Refinement and re-evaluation of the CEU model of clinical education. Using focus group discussions and survey questionnaires, qualitative and quantitative data were collected from undergraduate nursing students and clinical nursing staff in conjunction with each iteration of the study. Results Phase 1 results indicated that the CEU model was evaluated more positively by students and registered nurses than were the non-CEU models that were used for comparison. This result was demonstrated in the comments of students and registered nurses with regard to the respective models of clinical education and supported by their ratings of the quality of clinical experience through the QPE-Phase questionnaires. A similar trend was found in the results from Phase 2. The CEU-2 model was again evaluated more positively by students and registered nurses than were the non-CEU models that were used for comparison. Conclusion In summary, the results of this study indicate that the CEU model had a positive impact on the prac experience of students and registered nurses. In both phases of the study, students and registered nurses in wards where the CEU model was being used evaluated the prac experience more positively than did students and registered nurses in wards where non-CEU models were being used. Two key factors were found to be important in achieving this outcome: the collaborative nature of the CEU model and nursing staff ownership of students' clinical education. These factors provided an operating framework which enabled the development of positive learning environments in the wards where students were placed for prac. Equally important were arrangements for the supervision of students' practice which involved local clinical facilitation and the explicit inclusion of other nursing staff in the ward. Further, continued support from the university to allow the clinical facilitators to take a supernumary role when facilitating students, to provide staff development for clinical education and to support staff on a day-to-day basis during the prac was also important, if not essential. It is proposed that these factors, acting synergistically, promoted enhanced access to learning opportunities for students and improved learning outcomes for students and staff. The study makes an important contribution to nursing education by providing evidence that can inform future developments in the area of undergraduate clinical education. It has potential benefits for nursing education not only in the local context, but within the international arena as well.
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Thompson, Janny M. "Human performance differences following the learning of behavior sequences by chaining procedures". Thesis, University of Ottawa (Canada), 1993. http://hdl.handle.net/10393/6910.
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Chaining procedures (forward chaining, backward chaining, and whole task craining) are used to teach sequences of behaviors to diverse populations. Recent research comparing the three procedures has revealed differences between the procedures in terms of acquisition variables e.g., number of errors made during learning, time required to the learn a sequence). Much less research has examined whether the procedures produce differences in performance following acquisition. A series of six experiments investigating performance differences following exposure to four chaining procedures are presented. The four chaining procedures included the three traditional chaining procedures--forward, backward, and whole task--as well as a random chaining technique. Overall, results indicated that forward chaining led to the most accurate and fastest performance of responses in the absence of the external antecedent stimuli used during training. Forward chaining also led to more accurate ordering of these stimuli following training. Random chaining led to the most accurate and the fastest performance of responses following presentation of the antecedent external stimuli out of sequence order. The theoretical and practical implications of these findings are discussed.
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Eliatamby, Anna. "The use of frames by clinical psychologists in learning difficulties services to aid clinical decision making in crises". Thesis, University of Surrey, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.264381.
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Mugerwa, Pumla Princess. "The relationship between clinical learning environmental factors and clinical competence of newly qualified registered nurses in public hospitals". Thesis, Nelson Mandela Metropolitan University, 2017. http://hdl.handle.net/10948/19266.
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There is increasing concern that newly qualified registered nurses (RNs) find it difficult to make a smooth transition from completing their four-year nursing training to taking up their posts as first time RNs. In a constantly changing healthcare system, these newly qualified RNs are expected to work independently and be competent in applying the decision making and problem-solving skills gained during their training. While certain aspects of clinical incompetence may be ascribed to individual factors, the importance of the clinical learning environment and its influence on the development of clinical competence cannot be ignored. Nurses need support and guidance to effect a successful transition from being novice to competent nurse and the environment is regarded as important in developing technical competencies. The research study followed a positivistic, quantitative paradigm, where the hypothesized relationship between clinical learning environmental factors and clinical competence of newly qualified RNs were explored. Data was collected from the experienced RNs in the hospitals by means of a structured pre-existing questionnaire, namely the Competency Inventory for Registered Nurses (CIRN). Descriptive statistics and inferential statistics were used to analyse data. The analysed data was used to describe the findings. Recommendations were made based on the findings. Results suggested that the development of clinical competence is dependent on both the individual and context. Positive relations were reported between clinical learning environmental factors and clinical competencies.
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Alharbi, Mohammad Khadran. "THE ROLE OF EMOTIONAL AND SOCIAL COMPETENCIES:ASSESSMENT OF WORK ENGAGEMENT AND CLINICAL PERFORMANCE IN THE CLINICAL LEARNING ENVIRONMENT". Case Western Reserve University School of Graduate Studies / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=case1560354173421555.
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