competency

Competency
  • 文章类型: Journal Article
    美国胃肠镜检查培训的一般原则是在十多年前制定和总结的,到目前为止,这些原则一直是一致的。总结一下,受训者应准备(i)根据咨询评估的结果适当推荐内窥镜检查程序,对公认的具体适应症有明确的理解,禁忌症,和诊断/治疗替代方案,(ii)安全地执行程序,完全,迅速地,包括对清醒镇静/镇痛技术的原理有透彻的了解,适当时使用麻醉辅助镇静,以及术前临床评估和患者监测,(iii)正确解释内窥镜检查结果并将其整合到医学或内窥镜治疗中,(Iv)确定每个程序的风险因素,了解如何最小化每一个,并在并发症发生时识别并适当管理,(v)承认内窥镜手术和个人技能的局限性,并知道何时请求帮助,(六)了解质量测量和改进的原则。本文概述了内窥镜培训系统和结构,评估方案,以及美国的能力和认证过程。
    The general principles of gastrointestinal endoscopy training in the United States were formulated and summarized more than a decade ago and the principles have been consistent until now. To summarize, trainees should be prepared to (i) appropriately recommend endoscopic procedures as indicated by the findings of the consultative evaluation, with an explicit understanding of accepted specific indications, contraindications, and diagnostic/therapeutic alternatives, (ii) perform procedures safely, completely, and expeditiously, including possessing a thorough understanding of the principles of conscious sedation/analgesia techniques, the use of anesthesia-assisted sedation where appropriate, and pre-procedure clinical assessment and patient monitoring, (iii) correctly interpret endoscopic findings and integrate them into medical or endoscopic therapy, (iv) identify risk factors for each procedure, understand how to minimize each, and recognize and appropriately manage complications when they occur, (v) acknowledge the limitations of endoscopic procedures and personal skills and know when to request help, and (vi) understand the principles of quality measurement and improvement. This article provides an overview of the endoscopy training system and structure, evaluation scheme, and competence and credentialing process in the United States.
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  • 文章类型: Journal Article
    背景:急诊复苏护士是急诊科重症监护实践最前沿的具有挑战性的专业角色。尽管他们广泛的专业知识和技能要求,在澳大利亚,对于如何最好地提供符合一组固定目标和复苏护士所需技能的培训,没有全州或全国商定的方法.由于护理人口老化和劳动力流失增加,获得专科复苏护理知识的有效加速途径,是必要的。
    目的:这篇综述的目的是确定,巩固和总结有关紧急复苏护士资格标准的必要临床和非技术技能的培训需求的可用证据:关于目前在急诊科工作的护士的论文;包括护士单元经理(NUM),临床护士教育者(CNEs),临床护士顾问(CNCs),临床护士专家(CNSs),包括注册护士(RN)和注册护士(EN)。审查包括初级和非初级研究,包括关于如何培训急诊护士的论文。没有设置日期限制以确保可以审查所有结果。没有用英文发表的论文,包括没有在急诊室工作的护士,或者包括医生,联合健康,和其他无法区分人口群体的工作人员,被排除在外。仅抽象,社论,会议海报或口头报告,也被排除在外。
    方法:在MEDLINE中进行搜索,CINAHL和EMCRE。作者对所包括的研究参考列表以及灰色文献进行了广泛的手工搜索,以确保捕获所有相关文献。
    方法:进行了范围界定文献综述。
    结果:对最后33篇文章(23篇同行评审研究和10篇能力和实践标准文件)进行了数据提取。不存在特定的培训要求,以实现复苏护理中必要的临床和非技术技能的能力。据报道,在没有定期加强的情况下,能力下降。多模式方法,结合不同的教学方法,显示出增强知识保留和技能获取的潜力。
    结论:复苏护理在澳大利亚缺乏标准化的培训方法,导致护士在确保一致的技能获取和知识方面存在差距。需要研究以确定哪些复苏护理技能和培训是必要的,以确保实践有效地满足患者的需求。
    BACKGROUND: The emergency resuscitation nurse is a challenging and specialised role at the forefront of critical care practice in the emergency department. Despite their extensive specialist knowledge and skill requirements, in Australia there is no state-wide or nationally agreed approach to how to best provide training that meets a set of fixed objectives and requisite skills for resuscitation nurses. Due to an ageing nursing population and increasing workforce attrition, an efficacious accelerated pathway to acquire specialist resuscitation nursing knowledge, is necessary.
    OBJECTIVE: The aim of this review is to identify, consolidate and summarise the available evidence on the training needs for the requisite clinical and non-technical skills of emergency resuscitation nurses ELIGIBILITY CRITERIA: Papers about nurses currently working in the emergency department; including Nurse Unit Managers (NUMs), Clinical Nurse Educators (CNEs), Clinical Nurse Consultants (CNCs), Clinical Nurse Specialists (CNSs), Registered Nurses (RNs) and Enrolled Nurses (ENs) were included. The review included primary and non-primary research, including papers addressing how emergency nurses are trained. There was no date limitation set to ensure all results could be reviewed. Papers that were not published in English, included nurses who were not working in the ED, or included doctors, allied health, and other staff where population cohorts could not be distinguished, were excluded. Abstract only, editorials, conference posters or oral presentations, were also excluded.
    METHODS: Searches were conducted in MEDLINE, CINAHL and EMCARE. The authors conducted extensive hand-searching of the included study reference lists as well as the grey literature to ensure that all relevant literature was captured.
    METHODS: A scoping literature review was conducted.
    RESULTS: Data extraction was conducted on the final 33 articles (23 peer reviewed studies and 10 competency and practice standards documents). Specific training requirements to achieve competence in the requisite clinical and non-technical skills in resuscitation nursing do not exist. A decline in competency without regular reinforcement was reported. Multi-modal approaches, incorporating diverse teaching methods, show potential in enhancing knowledge retention and skill acquisition.
    CONCLUSIONS: Resuscitation nursing lacks a standardised training approach in Australia, leading to a gap in ensuring consistent skill acquisition and knowledge among nurses. Research is required to identify what resuscitation nursing skills and training are necessary to ensure practice effectively meets the needs of patients.
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  • 文章类型: Journal Article
    早产曾经是婴儿死亡的主要原因之一。早产儿需要高度称职的护理团队提高医疗和护理技能。
    本调查旨在评估指导指南和小组讨论对新生儿重症监护病房(NICU)护理早产儿的新护士能力的影响。
    单匿名,2022年进行了试验前和试验后两组研究设计.该研究伴随着50名新毕业的护士,他们在两家医院的新生儿重症监护病房(NICU)中对早产儿的护理管理能力进行了研究:Al-Namas总医院,KSA,和阿西特大学儿科医院,埃及。通过指导指南或小组讨论,从接受早产儿护理能力培训的护士中随机选择两组。使用问卷和检查表在培训前后测量护理态度和实践。
    在干预前护理早产儿的态度(11.72和14.65,P=0.455)和实践(14.36和14.80,P=0.494)的平均总分上,指导指南组和小组讨论组之间没有显着差异。虽然干预后两组护士的平均态度和实践得分显着增加,在讨论小组中,护士的实践得分显着增加(p=0.001)。尽管如此,指导指南组无显著变化(P=0.202).
    两种方法对新毕业护士的态度都有效;然而,指导指南并未影响他们关于早产儿护理的实践.然而,分组讨论培训技术能有效提高护士对早产儿护理的态度和实践。
    小组讨论培训方法应成为医院培训新护士以增加临床实践的认可和行之有效的方法,特别是在早产儿护理期间,因为这种方法已经证明了它在提高护士技能方面的价值。它使一个小组能够谈论特定主题并交换个人故事。这种方法涉及组组长促进参与者之间的沟通和互动。
    UNASSIGNED: Premature birth was once one of the leading causes of infant mortality. Premature infants require improved medical and nursing skills from a highly competent nursing team.
    UNASSIGNED: This investigation aimed to assess the effects of instructional guidelines and group discussion on new nurses\' competency in preterm infants caring at the Neonatal Intensive Care Unit (NICU).
    UNASSIGNED: A single-anonymized, two-group pre-test and post-test study design was accompanied in 2022. The study was accompanied for 50 newly graduated nurses concerned with competence in nursing management of preterm infants at the Neonatal Intensive Care Unit (NICU) in two hospitals: Al-Namas General Hospital, KSA, and the Pediatric Hospital of Assiut University, Egypt. Two groups were randomly selected from among the nurses to be trained on preterm infant nursing care competence either through an instructional guideline or group discussion. Nursing attitudes and practices were measured before and after training using questionnaires and checklists.
    UNASSIGNED: There was no significant difference between the instructional guideline group and the group discussion in the mean total score of attitudes (11.72 and 14.65, P = 0.455) and practices (14.36 and 14.80, P = 0.494) towards caring for preterm infants before intervention. While mean nurses\' attitude and practice scores increased significantly in both groups after the intervention, in the discussion group, nurses\' practice scores increased significantly (p = 0.001). Still, there were no significant changes in the instructional guideline group (P = 0.202).
    UNASSIGNED: Both methods were effective on the newly graduated nurses\' attitude; however, the instructional guidelines did not affect their practice regard nursing care of preterm infants. However, group discussion training techniques can effectively improve the nurses\' attitude and practice toward nursing care of preterm infants.
    UNASSIGNED: The group discussion training method should be the approved and proven method for hospitals to train new nurses to increase clinical practices, especially during nursing care for premature infants, because this method has proven its worth in increasing the skill of nurses. It enables a group to talk about a specific subject and exchange personal stories. This approach involves a group leader facilitating communication and interaction between participants.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    由于国际上医疗保健服务性质的迅速变化以及需要规范先进的实践理疗,因此对先进的实践理疗的全球核心能力和能力框架的需求非常重要。
    确定拟议的国际核心能力和能力框架对高级实践物理治疗的重要性。
    我们对七个国家的高级实践物理治疗师进行了一项横断面在线调查。每个能力和能力的重要性都以五点协议李克特量表进行了评分。与会者来自联合王国,爱尔兰,澳大利亚,新西兰,加拿大,瑞士和阿根廷。
    共有99名参与者完成了调查,包括63%(57/90)的女性和33%(30/90)的男性。百分之六十,60%(54/90),有超过20年的经验。调查参与者代表了不同的地理分布,25%(23/90)来自澳大利亚,25%(23/90)来自加拿大,18%(6/90)来自新西兰,18%(6/90)来自英国。4%4%(4/90)来自爱尔兰,4%(4/90)来自其他国家(瑞士和阿根廷)。调查显示,参与者之间达成了强烈共识,所有能力和能力都排名很高,被认为对高级实践很重要。
    这项研究表明,七个国家的高级实践物理治疗师对拟议的能力和能力框架的重要性达成了共识。这些发现强调了在先进的物理治疗中需要一个全球标准,特别是考虑到快速变化的医疗环境。
    UNASSIGNED: The need for a global core competency and capability framework for advanced practice physiotherapy is important due to the rapidly changing nature of health care delivery internationally and the need to standardize advanced practice physiotherapy.
    UNASSIGNED: To determine the importance of a proposed international core competency and capability framework for advanced practice physiotherapy.
    UNASSIGNED: We conducted a cross-sectional online survey of advanced practice physiotherapists across seven countries. The importance of each competency and capability was rated on a five-point agreement Likert scale. Participants were from the United Kingdom, Ireland, Australia, New Zealand, Canada, Switzerland and Argentina.
    UNASSIGNED: A total of 99 participants completed the survey, comprising 63% (57/90) females and 33% (30/90) males. Sixty percent, 60% (54/90), had over 20 years of experience. The survey participants represented a diverse geographic distribution, with 25% (23/90) from Australia, 25% (23/90) from Canada, 18% (6/90) from New Zealand, and 18% (6/90) from the United Kingdom. Four percent 4% (4/90) from Ireland, and 4% (4/90) from other countries (Switzerland and Argentina). The survey revealed a strong consensus among participants, with all competencies and capabilities ranked as high and considered important to advanced practice.
    UNASSIGNED: This study demonstrates a consensus among advanced practice physiotherapists across seven countries on the importance of a proposed competency and capability framework. The findings highlight the need for a global standard in advanced practice physiotherapy, particularly in light of the rapidly changing healthcare landscape.
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  • 文章类型: Journal Article
    矫形器和假肢(O&P)行业具有以被动而非主动的方式响应市场需求的历史。这造成了重大影响,包括实践范围的缩小以及由于设备付费第三方付款人系统导致的专业服务报酬的限制。技术和医疗保健的快速变化以及过时的以设备为中心的报销系统正在带来前所未有的挑战,威胁着O&P行业的可持续性。因此,重新评估O&P护理的价值,和O&P工作流程是必要的,以通知更新的价值主张和实践模式的可持续性。本文回顾了导致O&P现状的关键因素,以及涉及从业者能力更新的潜在解决方案,和护理交付模式(从以设备为中心到以客户为中心和基于价值)。可以通过利用数字工作流程来实现更新,从而提高效率并增强临床结果的价值。最终,这些更新可以使O&P行业提升与其最重要的利益相关者相一致的价值主张:客户患者和第三方报销机构在快速变化的技术和医疗保健环境中。
    The orthotics and prosthetics (O&P) profession has a history of responding to market demands in a reactive rather than proactive manner. This has created significant impacts including shrinkage in scope of practice and constraint in remuneration for professional services due to a fee-for-device third party payer system. Rapid changes in technology and healthcare combined with an outdated device-centric reimbursement system are creating unprecedented challenges that threaten sustainability of the O&P profession. Hence, a reassessment of the value of O&P care, and the O&P workflow process is necessary to inform an update to the value proposition and practice model for sustainability. This article reviews key factors contributing to the current state of O&P, and potential solutions involving an update in practitioner competencies, and the care delivery model (from device-centric to client-centric and values-based). Updates could be achieved by leveraging the use of digital workflows that increase efficiencies and enhance the value of clinical outcomes. Eventually, these updates could enable the O&P profession to elevate the value proposition that aligns with its most important stakeholders: client-patients and third-party reimbursement agencies in a rapidly changing technology and healthcare landscape.
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  • 文章类型: Journal Article
    这项研究的目的是创建一个量表来评估进行团体认知行为治疗(G-CBT)的治疗师的能力。该量表旨在作为帮助培训治疗师的工具。
    进行了三步研究。过程1:通过文献综述和专家共识过程,根据认知疗法量表的标准对G-CBT的基本技能进行了阐述和分类,用于评估临床医生个体认知行为治疗技能的公认评定量表。这些技能的列表被组织成一个评级量表。过程2:将行为锚点添加到每个技能中,并按难度级别进行分类(初学者,中间,和先进水平),根据G-CBT专家的评级。过程3:在41个实际临床课程和教育角色扮演的录像带G-CBT课程样本中,检查了评定量表的评分者间信度和效度。
    制定了12项小组认知治疗量表(G-CTS)。它由11个项目组成,这些项目改编自原始的认知疗法量表,和一个新的第12项称为“使用与其他参与者的关系进行干预,“它描述了治疗师解决群体动态的技能。G-CTS显示出优异的内部一致性(Cronbach'sα:0.95),令人满意的评分者间可靠性(类间相关系数:0.65-0.88),和高预测效度。
    开发并成功验证了一种评估G-CBT治疗师能力的新评定量表。在这项研究中创建的G-CTS行为清单提供了具体的指导方针,可以被治疗师用来磨练他们在G-CBT中的技能。
    UNASSIGNED: The aim of this research was to create a scale to assess the competency of therapists who conduct group cognitive behavioral therapy (G-CBT). The scale is intended to serve as a tool to aid the training of therapists.
    UNASSIGNED: Three stepped studies were conducted. Process 1: Through literature review and experts\' consensus process, essential skills for G-CBT were articulated and categorized according to the criteria of the Cognitive Therapy Scale, a well-established rating scale for evaluating clinicians\' skills in individual cognitive behavioral therapy. The list of those skills was organized into a rating scale. Process 2: Behavioral anchors were added to each skill and were classified by the levels of difficulty (beginner, intermediate, and advanced levels), based on the rating by G-CBT experts. Process 3: Inter-rater reliability and validity of the rating scale were examined in a sample of 41 videotaped G-CBT sessions of actual clinical sessions and educational role-plays.
    UNASSIGNED: The 12-item Group Cognitive Therapy Scale (G-CTS) was developed. It consists of 11 items that are adapted from the original Cognitive Therapy Scale, and a new 12th item called \"Intervention using relationships with other participants,\" which describes therapists\' skills to address group dynamics. The G-CTS showed excellent internal consistency (Cronbach\'s α: 0.95), satisfactory inter-rater reliability (interclass correlation coefficients: 0.65-0.88), and high predictive validity.
    UNASSIGNED: A novel rating scale to evaluate therapists\' competency in G-CBT was developed and successfully validated. The G-CTS behavioral checklist created in this study provides concrete guidelines that can be used by therapists to hone their skills in G-CBT.
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  • 文章类型: Journal Article
    背景:脓毒症是一种危及生命的疾病,可能是由任何器官系统的感染引起的,需要早期识别和管理。在任何专业工作的医疗保健专业人员可能需要管理败血症患者。对医学生进行有关这种情况的教育可能是确保所有未来医生都有足够能力诊断和治疗败血症患者的有效方法。然而,目前对于医学生在败血症识别和治疗方面应取得哪些能力尚无共识.这项研究旨在概述在高或中高收入国家/地区以及中低收入国家/地区的医学生培训结束时,医学生应达到与败血症相关的能力。
    方法:来自中高收入国家/地区和中低收入国家/地区的两个独立小组参加了Delphi方法,对医学生的败血症能力进行建议和排名。每个小组由13-18个医学教育的主要利益相关者和败血症是常见问题的专业医生(专家和受训人员)组成。小组成员来自各大洲,除了南极洲。
    结果:小组就中低收入国家/地区的38项基本败血症能力和中高收入国家/地区的33项基本败血症能力达成共识。这些包括诸如脓毒症和脓毒性休克的定义和抗生素治疗的紧迫性的能力。在低收入或中低收入国家/地区组中,对排名非常重要的能力也达成了共识,并在被评为中等重要的4/5能力中获得。在高收入或中高收入国家/地区组中,在被评为非常重要的41/57能力中达成了共识,但只有6/11能力被评为中等重要。
    结论:医学院应考虑开发课程以解决基本能力,至少,但也要考虑解决被评为非常重要或中等重要的能力。
    BACKGROUND: Sepsis is a life-threatening condition which may arise from infection in any organ system and requires early recognition and management. Healthcare professionals working in any specialty may need to manage patients with sepsis. Educating medical students about this condition may be an effective way to ensure all future doctors have sufficient ability to diagnose and treat septic patients. However, there is currently no consensus on what competencies medical students should achieve regarding sepsis recognition and treatment. This study aims to outline what sepsis-related competencies medical students should achieve by the end of their medical student training in both high or upper-middle incomes countries/regions and in low or lower-middle income countries/regions.
    METHODS: Two separate panels from high or upper-middle income and low or lower-middle income countries/regions participated in a Delphi method to suggest and rank sepsis competencies for medical students. Each panel consisted of 13-18 key stakeholders of medical education and doctors in specialties where sepsis is a common problem (both specialists and trainees). Panelists came from all continents, except Antarctica.
    RESULTS: The panels reached consensus on 38 essential sepsis competencies in low or lower-middle income countries/regions and 33 in high or upper-middle incomes countries/regions. These include competencies such as definition of sepsis and septic shock and urgency of antibiotic treatment. In the low or lower-middle income countries/regions group, consensus was also achieved for competencies ranked as very important, and was achieved in 4/5 competencies rated as moderately important. In the high or upper-middle incomes countries/regions group, consensus was achieved in 41/57 competencies rated as very important but only 6/11 competencies rated as moderately important.
    CONCLUSIONS: Medical schools should consider developing curricula to address essential competencies, as a minimum, but also consider addressing competencies rated as very or moderately important.
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  • 文章类型: Journal Article
    本研究旨在开发和验证OSABSS(基本手术技能的客观结构化评估),改良的客观结构化临床检查(OSCE),评估居民的基本手术技能。
    分两个阶段进行的发育研究。通过文献综述和差距分析确定基本技能。OSABSS随后被设计为经过修改的OSCE。
    这项研究在伊朗Alborz医科大学进行。
    OSABSS是使用Harden的OSCE(客观结构化临床检查)方法创建的。情景,清单,和车站配置是通过专家小组开发的。该考试由居民作为参与者和教师作为评估者进行试点和实施。
    32名妇科外科住院医师,普外科,骨科,和神经外科参与。22名教职员工是评估员。
    主要结果是OSABSS考试成绩。次要结果是笔试成绩,和国家居住权入口等级。
    所有站点的平均OSABSS评分为16.59±0.19。通过OSABSS分数之间的相关性证明了标准有效性,书面分数和入学排名。可靠性高,克朗巴赫的阿尔法为0.87。没有发现评分者之间的显着差异。
    严格的OSABSS开发过程产生了一个考试,证明了评估基本手术技能的强大有效性和可靠性。综合站品种评估不同的技术和非技术能力。进一步的研究应该扩大跨外科学科的参与者样本。
    UNASSIGNED: This study aimed to develop and validate the OSABSS (Objective Structured Assessment of Basic Surgical Skills), a modified Objective Structured Clinical Examination (OSCE), to assess basic surgical skills in residents.
    UNASSIGNED: A developmental study conducted in two phases. Basic skills were identified through literature review and gap analysis. The OSABSS was then designed as a modified OSCE.
    UNASSIGNED: This study took place at Alborz University of Medical Sciences in Iran.
    UNASSIGNED: The OSABSS was created using Harden\'s OSCE (Objective Structured Clinical Examination) methodology. Scenarios, checklists, and station configurations were developed through expert panels. The exam was piloted and implemented with residents as participants and faculty as evaluators.
    UNASSIGNED: 32 surgical residents in gynecology, general surgery, orthopedics, and neurosurgery participated. 22 faculty members were evaluators.
    UNASSIGNED: The primary outcome was OSABSS exam scores. Secondary outcomes were written exam scores, and national residency entrance ranks.
    UNASSIGNED: The mean OSABSS score was 16.59 ± 0.19 across all stations. Criterion validity was demonstrated through correlations between OSABSS scores, written scores and entrance ranks. Reliability was high, with a Cronbach\'s alpha of 0.87. No significant inter-rater score differences were found.
    UNASSIGNED: The rigorous OSABSS development process produced an exam demonstrating strong validity and reliability for assessing basic surgical skills. The comprehensive station variety evaluates diverse technical and non-technical competencies. Further research should expand participant samples across surgical disciplines.
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  • 文章类型: Journal Article
    由于学科作为科学和实践的复杂性,在学术环境中教授流行病学概念提出了挑战。虽然传统的课堂教学方法普遍采用,有证据表明,它们可能不是培养现实生活中科学工作所需的核心能力和技能的最有效方法。在这篇文章中,我们描述了我们从传统的流行病学课堂教学向基于实践的指导过渡的过程,以将流行病学概念传达给生物医学领域的学士和硕士学生。我们选择了随机对照试验(RCT)的框架,因为它们提供了在实践课程中教授流行病学概念的绝佳机会。这个以实践为基础的课程涵盖了研究的整个生命周期,允许学生设计和进行短期实验,分析其数据并准备科学论文。我们提供课程结构的全面概述,内容,学习目标和课程评估,同时还讨论了这种创新格式的优缺点。我们的方法提供了一个有前途的替代课堂教学,结合实际,实践经验为学生提供高水平的独立性和自决权,以及教师的便利和指导。它有可能在不同的学术环境中应用,为学生提供有价值的流行病学技能和能力。
    Teaching epidemiological concepts in academic settings poses a challenge due to the intricate nature of the discipline as both a science and a practice. Whereas traditional classroom-based teaching methods are commonly employed, evidence suggests they may not be the most effective approach for fostering core competencies and skills required in real-life scientific work. In this article, we describe our process of transitioning from traditional classroom teaching of epidemiology towards practice-based coaching to convey epidemiological concepts to bachelor\'s and master\'s students in Biomedicine. We chose the framework of randomized controlled trials (RCT) since they offer a great opportunity to teach epidemiological concepts in a hands-on course. This practice-based course encompasses the entire life cycle of a study, allowing students to design and conduct a short-term experiment, analyse its data and prepare a scientific paper. We provide a comprehensive overview of the course structure, content, learning objectives and course evaluation, while also discussing the advantages and disadvantages of this innovative format. Our approach offers a promising alternative to classroom teaching by incorporating practical, hands-on experiences offering students a high level of independence and self-determination, as well as facilitation and coaching by faculty. It has the potential to be applied across diverse academic settings, providing students with valuable skills and competencies in epidemiology.
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