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Clinical placement before or after simulated learning environments? A naturalistic study of clinical skills acquisition among early-stage paramedicine students

Mills, Brennen W., Carter, Owen B.J., Rudd, Cobie J., Ross, Nathan P. and Claxton, Louise A. 2015, Clinical placement before or after simulated learning environments? A naturalistic study of clinical skills acquisition among early-stage paramedicine students, Simulation in healthcare, vol. 10, no. 5, pp. 263-269, doi: 10.1097/SIH.0000000000000107.

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Title Clinical placement before or after simulated learning environments? A naturalistic study of clinical skills acquisition among early-stage paramedicine students
Author(s) Mills, Brennen W.
Carter, Owen B.J.
Rudd, Cobie J.
Ross, Nathan P.
Claxton, Louise A.
Journal name Simulation in healthcare
Volume number 10
Issue number 5
Start page 263
End page 269
Total pages 7
Publisher Lippincott William & Wilkins
Place of publication Philadelphia, Pa.
Publication date 2015-10
ISSN 1559-713X
Keyword(s) allied health
early-stage students
early-stage clinical placements
simulated learning environments
clinical skills acquisition
Summary BACKGROUND: There is conflicting evidence surrounding the merit of clinical placements (CPs) for early-stage health-profession students. Some contend that early-stage CPs facilitate contextualization of a subsequently learned theory. Others argue that training in simulated-learning experiences (SLEs) should occur before CP to ensure that students possess at least basic competency. We sought to investigate both claims. METHODS: First-year paramedicine students (n = 85) undertook 3 days of CP and SLEs as part of course requirements. Students undertook CP either before or after participation in SLEs creating 2 groups (Clin → Sim/Sim → Clin). Clinical skills acquisition was measured via direct scenario-based clinical assessments with expert observers conducted at 4 intervals during the semester. Perceptions of difficulty of CP and SLE were measured via the National Aeronautics and Space Administration Task Load Index. RESULTS: Students' clinical assessment scores in both groups improved significantly from beginning to end of semester (P < 0.001). However, at semester's end, clinical assessment scores for the Sim → Clin group were statistically significantly greater than those of the Clin → Sim group (P = 0.021). Both groups found SLEs more demanding than CP (P < 0.001). However, compared with the Sim → Clin group, the Clin → Sim group rated SLE as substantially more time-demanding than CP (P = 0.003). CONCLUSIONS: Differences in temporal demand suggest that the Clin → Sim students had fewer opportunities to practice clinical skills during CP than the Sim → Clin students due to a more limited scope of practice. The Sim → Clin students contextualized SLE within subsequent CP resulting in greater improvement in clinical competency by semester's end in comparison with the Clin → Sim students who were forced to contextualize skills retrospectively.
Language eng
DOI 10.1097/SIH.0000000000000107
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 920299 Health and Support Services not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Lippincott Williams & Wilkins
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080762

Document type: Journal Article
Collection: School of Medicine
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