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Teaching session for Open Fractures Assignment
The open fracture is one in which the bone has fractured and the skin is torn or compromised in some manner, possibly far from the location of the fracture. Based on this, any fracture that there is a wound associated with it should be treated as such an open injury. It is critical to evaluate and this condition should not be ruled out when giving a diagnosis (Eccles et al. 2023). It has therefore been established in this chapter the role of the interprofessional team in managing and treating open fractures.
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The learners for this teaching session were identified by applying the Dreyfus model for choosing them. The Dreyfus model is considered as a skill acquisition model that is an influential framework that has the potential of outlining the level of progression of the skills and their developments throughout various distinct phases or stages. This model has five different stages that helps to provide a comprehensive aspect of the process of learning and offering valuable perspectives and understanding regarding the process of acquisition, refining every individual and learning new skills. Although, this model of skill acquisition mainly highlights the expected challenges as well as cognitive contagious problems that a learner might undergo through, which majorly become helpful in the development of the expertise in s particularly specified domain (Yeung et al. 2023). This Dreyfus model also emphasizes the process of transition of the learner from the stage of reliance more often on the strict rules of learning in order to make it easier to understand the required skills.
![Dreyfus Model]()
Figure 1: Dreyfus Model
The teaching session was done formally in the hospital’s boarding room where participants sat around in a circular manner (Verheul et al. 2021). Hence, what was offered to the learners enhanced both the classroom learning and the clinical experience since the learners were able to discuss the theoretical aspects of the concept as well as practice the open fracture management techniques on simulated patients and models in a clinical setting.
Education Strategy
Smart Learning Outcomes
Table 1: Educational Strategy for the teaching session
Smart Learning Outcomes |
Domain of Learning (Cognitive, Affective, or Psychomotor) |
Level within the Domain of Learning |
Content to be Covered by the Learning Outcome |
Instructional Method(s) Utilized |
Assessment Method(s) Utilized |
The strategies and procedures for the initial management of open fractures |
Cognitive |
Understand |
Steps and required protocols for the primary treatment and management of open fractures (Cebrián et al. 2020) |
1. Lecture 2. Interactive Q&A 3. Simulation-based learning |
Case study in form of a multiple choice question and short-answer written test. |
Illustrate basic care on wound cleaning and dressing for the particular case of open fractures |
Psychomotor |
Apply |
Wound dressing and the materials and techniques used to dress open fractures. |
1. Hands-on workshop 2. Demonstration by instructor 3. Peer practice |
An essential part of skills assessment as well as testing is the use of practical experience assessment by the direct observation of the students (El-Sofany and El-Haggar 2020). |
Describe the involvement of the interprofessional team in open fracture care |
Affective |
Value |
Roles of team work and good communication in the management of open fractures |
1. Group discussion 2. Role-playing 3. Reflection exercises |
Peer assessment and the reflective essay |
Evidence-Based Justification of Constructive Alignment
Explanation of Constructive Alignment
As demonstrated in the table, the educational strategy here is consistent with the constructive alignment of John Biggs as it arranges the learning activities, the methods of instruction, and the forms of assessment to support the intended learning outcomes. Constructive alignment refers to integrating all the activities that take place in the learning process as well as the assessment tasks in such a way that interconnects.
Constructive alignment remains the guide to the implementation of the educational strategy based on the correspondence of the learning outcomes, assessment, and teaching activities to the goal of successful open fracture management. The strategy of targeting the medical students and residents at the competent to proficient level of the Dreyfus model make sure that the basic knowledge acquired in orthopedics is applicable on the live patients. The curriculum delivery strategies are intended to incorporate interprofessional strategies, as is the practice of the team approach. To this end, assessments are linked to competencies of real life management and teamwork that students acquire as they focus on competencies basic for the treatment of open fractures.
Application in the Provided Educational Strategy
Learning Outcomes and Instructional Methods
- Initial management of open fractures explanation: The particular domain involved here is the cognitive one which is at the “understand” stage (Kang and Kim 2021). The learners comprehend the protocol and the steps by participating in the lectures besides the follow-up, question and answer sessions as well as the simulation.
- Demonstration of proper wound dressing: This outcome lies in the psychomotor domain at the apply level. Practical sessions such as workshops, demonstrations, and practice with partner learners are used to facilitate the acquisition of the competencies by the learners.
- Discussing role of interprofessional team in open fracture: The affective domain at the “value” level is targeted in this section (Deng et al. 2022). Debates, dramatizations, and other conversational activities are incorporated and employed to provide focus on the correct working of a team. These methods aid the learners in developing concepts of the value of IP as well as the effects on healthcare dispensation.
Assessment Methods
- Short-answer written test: This assessment correlates with the cognitive learning outcome as it measures the learner’s comprehension of the management of open fractures through realistic scenarios.
- Practical skills assessment: In relation to the psychomotor learning outcome, prisoner demonstration of wound dressing allows the instructor to observe the correct technique and assess whether the prisoner is capable of proficiently completing such tasks.
- Reflective essay and peer assessment: Because the affective learning outcome entails the understanding of the interprofessional team’s role and the ability to self-reflect and report on personal experiences and attitudes, such methods as reflective essays with peers’ assessment are suitable for this learning outcome
Evidence-Based Justification
Thus, constructive alignment helps to combine learning activities, teaching methods, and assessment measures into one whole which contributes to maximal learning outcomes. Particularly this strategy based on John Biggs’ theory helps to specify expectations and accurately measure outcomes (Karasmanis and Murphy 2022). Methods that are applied in the lesson include lectures, practical sessions, debates, which enhances the cognitive, psychomotor, and the affective domain. Outcomes that can be assessed by written tests, practical examinations, and essays include the following since such assessments promote deep learning and practical skills.
Providing feedback to learner(s)
Feedback Model Used
This process of providing feedback to the learners include the Pendleton’s Feedback Model that has been used to give feedback to the learners as discussed in this study (Weallans et al. 2022). This model fosters a systematic, positive and learner-focused strategy that incurs constructive discussion and reflection.
![Pendletons Rule]()
Figure 2: Pendleton’s Rule
The Pendleton’s Feedback Model is an well-structured approach that has the potential of aligning the learning approach in a very well manner with the constructive alignment principles, for this reason this feedback model has become the best choice for using it as the main media of giving the students their deserved feedback as per their learning abilities. This feedback model also helps in balancing the constructive approach that has been used (Weallans et al. 2022). This is very crucial and significantly influential to ensure the feedback in order to support the feedback regarding learning outcomes, strategies used for assessment procedures along with the teaching method used.
Apart from this, there is a key reason for choosing this feedback model is that this Pendleton’s Model primarily focuses on the self estimation through encouraging the learners, in the way they are being comfortable for every individual along with individual reflection. Although, this method of giving feedback allows the learners to express the constructive thoughts of the learners, which help them to integrate and bring improvements within their thinking process, which ultimately helps in fostering an effective impact on their aspects on responsibility for their learning procedure.
Application of Pendleton’s Feedback Model
- Establish a Comfortable Environment: Learners were ensured they are comfortable to receive feedback and the feedback sessions were conducted in an environment which was non-threatening to learners.
- Self-assessment: The approach was started by making the learners develop questions related to their performance. For example, after a simulation exercise on wound dressing, the learners were required to discuss what they thought was effective and or what difficulties they encountered.
- Positive Feedback: A few specific positive things were pointed out about the performance, thus, strengthening what was done right. For instance, it was recommended on their ability to maintain hygiene measures while treating other patients during the wound dressing exercise.
Evidence-Based Justification
Pendleton’s Feedback Model is supported by research and is well-known in medical training due to its organization, positive tone, and focus on self-assessment and discussion. According to the findings, this model increases learners’ participation and motivations because of their direct involvement in the feedback process (Orsini et al. 2022). This can be categorized under the aspect known as constructive alignment where feedback is tied to learning outcomes and modes of instructions to improve on the progress and enhance understanding.
Although, the Pendleton’s Model for giving feedback is considered to be a positive aspect for healthy and effective learning environment that has the ability of ensuring that the given feedback to each learners are constructive in nature rather than being more critical, which could have a bit negative impact on the self confidence of the learners. Also, this feedback model has a crucial yet significant role to play when it gets used in skills that deals with certain equipment like wound dressing, and certain critical conditions as these type of conditions require more mental power, strengths and self-confidence (Orsini et al. 2022). As this feedback works by providing step by step guidance to the learners about both their positive and negative sides it helps to identify the learners certain specified special areas that require special care for bringing improvement in the time of reinforcing the skills in which they got trained before. This helped to enhance the previously acquired skills a bit more.
Gathering feedback from learner(s)
The instructor also ensured that he collected qualitative as well as quantitative feedback from the learners relating to the teaching session.
![Gathering feedback from learner]()
Figure 3: Gathering feedback from learner
- Anonymous Written Surveys: At the end of the session, the learners were given a set of written questionnaires with both closed and open questions that they filled in the manner of anonymous answering. These surveys measured concernable aspects of the session such as clarity of instructions, concerns and relevance of materials used and effectiveness of different teaching approaches and cumulative satisfaction.
- Focus Group Discussions: The instructor for unknown reasons interactively performed small-made focus group discussions with a portion of the learners (Grant-Freemantle et al. 2020). These discussions were very helpful to the learners as they allowed them to elaborate on what they know, what they have witnessed, or any suggestions as compared to the previous two types that only included open-ended questions.
- One-on-One Interviews: Thus, to get more detailed information, the instructor decided to interview several learners individually this way, the instructor could give individual feedback to each learner and discuss the issues in detail that potentially could not be disclosed during group discussions.
Evidence-Based Justification for Chosen Methods
The use of anonymous written surveys, focus group discussions and qualitative interviews is furthermore aligned with educational research as the multiple methods that provide thorough and truthful feedback.
- Anonymous Surveys: There are certain literatures that reveal that anonymous feedback is beneficial in that learners will not hold back on giving their genuine opinions on a course.
- Focus Group Discussions: Hearings and focus groups offer detailed, qualitative data and information gathered through interaction, and hence are valuable for understanding the learners’ experience in more depth (Grant-Freemantle et al. 2020).
- One-on-One Interviews: In particular, when the interview is carried out personally, it is possible to identify specific aspects of learners’ experience and find out detailed feedback and possible recommendations.
Strategies for Improvement
Strategy-1: Contact ED Consultant to Share the Word and Invite ED Registrars/SHOs
The instructor should call the ED consultant to give information on the teaching session to be conducted around management of open fractures. The consultant can then pass this information to the ED team, the registrars and Senior House Officers (SHOs) so that they encourage attendance of the session. This way ensures that the concerned health personnel who are directly involved in the initial management of open fractures are informed and given a chance to participate.
Evidence Based Justification
- Targeted Communication: Subsequently, through consulting the ED, one is assured of delivering the invitation to the right target group, which requires the intervention. Literature reviews have revealed that all those direct messages through leadership channels enhance attendance and participation in professional development meetings.
- Enhanced Learning Outcomes: Engaging the ED staff who interact with open fractures in their daily practice can result in more realistic and applicative discourses concerning the material covered during the training (Karasmanis and Murphy 2022). This can enrich both the theoretical concepts and practical practices since peer education improves learning processes.
- Professional Development: Such opportunities help in enhancing the CPD of ED registrars and SHOs which is a determinant in providing quality and safe patient care as well as promoting up-to-date practices.
Strategy-2: Create Posters with Open Fracture Management Guidelines and Display Them in ED/UTC Walls
In this case, the instructor should develop attractive and helpful posters that contain the rules of managing open fractures. These posters can be placed on the walls of the ED and UTC and due to their design, information on them will be read by all the providers in these settings.
Evidence Based Justification
- Visual Learning and Recall: Posters make sure that compliance concerning recommended policies and measures is evident at all times (Kang and Kim 2021). This research shows that the use of visual aids in learning is effective particularly in areas where there is pressure or more so in situations as this emergency department whereby simple things that one would take long to refer, in this case they are made to refer within short time hence use of anything that can help one to remember more is very effective.
- Accessible Information: Posters can also be used to enhance the ED staff knowledge because regardless of whether one attended the teaching session, the poster doubles up as a notice board. Besides, this passive learning tool facilitates continuing education to the entire faculty and the sustaining of best practices.
- Reinforcement of Learning: For the individuals who may attend the session, then posters are useful in reinforcing what has been taught and may act as constant reminders of right procedures and precautions to be observed (Kang and Kim 2021). This ACP evidence-guideline paper demonstrates that exposure to information of the same content but different styles enhances learning and its practical application to clinical practice.
Reference List
Journals
- Allsop, S., Morphet, J., Lee, S. and Cook, O., 2021. Exploring the roles of advanced practice nurses in the care of patients following fragility hip fracture: A systematic review. Journal of Advanced Nursing, 77(5), pp.2166-2184.
- Cebrián, G., Palau, R. and Mogas, J., 2020. The smart classroom as a means to the development of ESD methodologies. Sustainability, 12(7), p.3010.
- Deng, J.M., Carle, M.S. and Flynn, A.B., 2022. Students’ reasoning in chemistry arguments and designing resources using constructive alignment.
- Eccles, S., Handley, B., Khan, U., McFadyen, I., Nanchahal, J. and Nayagam, S. eds., 2020. Standards for the management of open fractures. Oxford University Press.
- El-Sofany, H. and El-Haggar, N., 2020. The effectiveness of using mobile learning techniques to improve learning outcomes in higher education.
- Grant-Freemantle, M.C., Ryan, E.J., Flynn, S.O., Moloney, D.P., Kelly, M.A., Coveney, E.I., O'Daly, B.J. and Quinlan, J.F., 2020. The effectiveness of negative pressure wound therapy versus conventional dressing in the treatment of open fractures: a systematic review and meta-analysis. Journal of Orthopaedic Trauma, 34(5), pp.223-230.
- Kang, H.Y. and Kim, H.R., 2021. Impact of blended learning on learning outcomes in the public healthcare education course: a review of flipped classroom with team-based learning. BMC Medical Education, 21, pp.1-8.
- Karasmanis, S. and Murphy, F., 2022. Sustaining Curriculum Design Conversations Transform the Teaching of Evidence-Based Practice in Health Sciences. In Connecting the Library to the Curriculum: Transformative Approaches that Enhance Skills for Learning (pp. 125-136). Singapore: Springer Singapore.
- Orsini, C., Rodrigues, V., Tricio, J. and Rosel, M., 2022. Common models and approaches for the clinical educator to plan effective feedback encounters. Journal of Educational Evaluation for Health Professions, 19.
- Toal, G.G., Gisondi, M.A., Miller, N.M., Sebok-Syer, S.S., Avedian, R.S. and Dixon, W.W., 2021. Simulation-based mastery learning to teach distal radius fracture reduction. Simulation in Healthcare, 16(6), pp.e176-e180.
- Verheul, E., Berner, J.E., Oflazoglu, K., Troisi, L., Arnež, Z., Ortega-Briones, A., Nanchahal, J. and Rakhorst, H., 2021. Development of guidelines for the management of patients with open fractures: the potential cost-savings of international collaboration. Journal of Plastic, Reconstructive and Aesthetic Surgery, 75(1).
- Weallans, J., Roberts, C., Hamilton, S. and Parker, S., 2022. Guidance for providing effective feedback in clinical supervision in postgraduate medical education: a systematic review. Postgraduate Medical Journal, 98(1156), pp.138-149.
- Yeung, J.K., Ladak, A.R., Bruchet, N. and Pachev, G., 2023. Assessing student performance using a novel rubric based on the Dreyfus model of skill acquisition. American Journal of Pharmaceutical Education, 87(6), p.100060.
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