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农村和偏远地区临床实习的实践准备、能力与技能发展及学习:对健康专业学生观点与经历的范围综述

Preparedness for practice, competency and skill development and learning in rural and remote clinical placements: A scoping review of the perspective and experience of health students.

作者信息

Hepburn Stevie-Jae, Fatema Syadani Riyad, Jones Rikki, Rice Kylie, Usher Kim, Williams Jen

机构信息

Faculty of Medicine and Health, University of New England, Armidale, NSW, 2350, Australia.

出版信息

Adv Health Sci Educ Theory Pract. 2025 Jun;30(3):935-972. doi: 10.1007/s10459-024-10378-4. Epub 2024 Sep 30.

Abstract

When considering health professionals' requirements and responsibilities, competence is a complex concept that extends beyond knowledge to encompass understanding, application, technical skills, problem-solving, and clinical judgment. Rural clinical placements provide a rich learning environment for students to improve their competencies, self-esteem, and preparedness for practice (PFP). This scoping review aimed to identify pre-registration health students' perspectives on rural placement regarding competency and skill development, and enablers and barriers to learning. The methodology outlined by the Joanna Briggs Institute was followed. Out of 1186 records (366 duplicates), 821 were screened by title and abstract, 59 underwent full-text screening and 18 studies were included. Over half the studies included medicine students (n = 11). Reported competencies predominantly focused on self-assessed confidence regarding clinical skills. The reported barriers and enablers to learning highlighted the complexity of the placement experience and the importance of interpersonal factors, learner engagement and the supervisor's role. The review identified a gap in the literature pertaining to student perspectives of competencies and skills not assessed or experienced as well as a lack of standardised measures for PFP. The identified enablers and barriers provide suggestions for rural placement design and emphasise the importance of the student learning experience. Future research could include multiple health disciplines and specific methodologies to identify health students' perspectives regarding the development of competency, relatedness and autonomy, that is how to support health students to think, feel and act like health professionals.

摘要

在考虑卫生专业人员的要求和职责时,能力是一个复杂的概念,它不仅包括知识,还涵盖理解、应用、技术技能、问题解决能力和临床判断力。农村临床实习为学生提供了丰富的学习环境,以提高他们的能力、自尊和实践准备(PFP)。本范围综述旨在确定预注册卫生专业学生对农村实习在能力和技能发展方面的看法,以及学习的促进因素和障碍。遵循了乔安娜·布里格斯研究所概述的方法。在1186条记录(366条重复记录)中,通过标题和摘要筛选出821条,59条进行全文筛选,纳入18项研究。超过一半的研究包括医学生(n = 11)。报告的能力主要集中在对临床技能的自我评估信心上。报告的学习障碍和促进因素突出了实习经历的复杂性以及人际因素、学习者参与度和督导员角色的重要性。该综述发现,在文献中存在与未评估或未经历的能力和技能的学生观点相关的空白,以及缺乏PFP的标准化衡量标准。确定的促进因素和障碍为农村实习设计提供了建议,并强调了学生学习体验的重要性。未来的研究可以包括多个卫生学科和特定方法,以确定卫生专业学生对能力、关联性和自主性发展的看法,即如何支持卫生专业学生像卫生专业人员一样思考、感受和行动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/047f/12119662/ed8013a46d55/10459_2024_10378_Fig1_HTML.jpg

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