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Al-Beltagi M, Saeed NK, Bediwy AS, Alhawamdeh R, Elbeltagi R. Management of critical care emergencies in children with autism spectrum disorder. World J Crit Care Med 2025; 14:99975. [DOI: 10.5492/wjccm.v14.i2.99975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2024] [Revised: 12/13/2024] [Accepted: 12/30/2024] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND Managing critical care emergencies in children with autism spectrum disorder (ASD) presents unique challenges due to their distinct sensory sensitivities, communication difficulties, and behavioral issues. Effective strategies and protocols are essential for optimal care in these high-stress situations.
AIM To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD. The review focuses on key areas, including sensory-friendly environments, communication strategies, behavioral management, and the role of multidisciplinary approaches.
METHODS A comprehensive search was conducted across major medical databases, including PubMed, Embase, and Cochrane Library, for studies published between 2000 and 2023. Studies were selected based on their relevance to critical care management in children with ASD, encompassing randomized controlled trials, observational studies, qualitative research, and case studies. Data were extracted and analyzed to identify common themes, successful strategies, and areas for improvement.
RESULTS The review identified 50 studies that met the inclusion criteria. Findings highlighted the importance of creating sensory-friendly environments, utilizing effective communication strategies, and implementing individualized behavioral management plans. These findings, derived from a comprehensive review of current evidence, provide valuable insights into the best practices for managing critical care emergencies in children with ASD. Sensory modifications, such as reduced lighting and noise, visual aids, and augmentative and alternative communication tools, enhanced patient comfort and cooperation. The involvement of multidisciplinary teams was crucial in delivering holistic care. Case studies provided practical insights and underscored the need for continuous refinement of protocols.
CONCLUSION The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD. Sensory-friendly adjustments, effective communication, and behavioral strategies supported by a multidisciplinary team are integral to improving outcomes. Despite progress, ongoing refinement of care practices and protocols is necessary. This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.
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Affiliation(s)
- Mohammed Al-Beltagi
- Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31511, Alghrabia, Egypt
- Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
| | - Nermin Kamal Saeed
- Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, Ministry of Health, Kingdom of Bahrain, Manama 26671, Manama, Bahrain
- Medical Microbiology Section, Department of Pathology, Irish Royal College of Surgeon, Bahrain, Busaiteen 15503, Muharraq, Bahrain
| | - Adel Salah Bediwy
- Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt
- Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
| | - Rawan Alhawamdeh
- Department of Pediatrics Research and Development, Sensoryme Dwc-llc, Dubai 712495, Dubai, United Arab Emirates
- Department of Pediatrics Research and Development, Genomics Sensory Play and Creativity Center, Manama 22673, Manama, Bahrain
| | - Reem Elbeltagi
- Department of Medicine, The Royal College of Surgeons in Ireland-Bahrain, Busiateen 15503, Muharraq, Bahrain
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Huang YW, Dowlatshahi S, Ayilavarapu S, Chang J, Maney P, Eswaran S. An analysis of dental board disciplinary action among general dentists in Texas. J Am Dent Assoc 2025:S0002-8177(25)00037-6. [PMID: 39903157 DOI: 10.1016/j.adaj.2024.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 11/15/2024] [Accepted: 12/10/2024] [Indexed: 02/06/2025]
Abstract
BACKGROUND Dental care professionals can gain valuable insights by examining infractions reported to the state board of dentistry, which can serve as a resource to enhance their professional practice. By reviewing various infractions (violations resulting in disciplinary action) reported by the state boards, dental care professionals can foster ethical awareness, uphold professional conduct, manage risks effectively, prioritize patient-centered care, engage in continuous professional development, and promote peer accountability. This study analyzes state dental board disciplinary action data in Texas to identify common infractions among practicing general dentists and to leverage this information as an educational tool for dental care professionals. METHODS An electronic search of disciplinary actions was conducted, using the Texas State Board of Dental Examiners database. For this study, 1,056 disciplinary action reports were reviewed, and disciplinary infractions were classified into 5 main categories based on the nature of the infractions related to diagnosis, treatment, renewals, recordkeeping, and ethics and professionalism. RESULTS After reviewing 1,056 disciplinary actions, the results showed that most infractions were due to inadequate recordkeeping (39%). The rest of the infractions included inadequate treatment (23%), lack of ethics and professionalism (23%), improper diagnosis (9%), and renewal issues (6%). CONCLUSIONS Dental disciplinary records offer valuable insights into common instances of misconduct within dental practices. It is essential to approach this information with a critical and reflective mindset, aiming to enhance clinical practice by learning from the common mistakes made by other clinicians. PRACTICAL IMPLICATIONS Understanding the frequency and nature of infractions may promote a deeper awareness and sense of direction regarding where additional focus on ethics and practice management is needed.
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Staudacher HM, Teasdale S, Cowan C, Opie R, Jacka FN, Rocks T. Diet interventions for depression: Review and recommendations for practice. Aust N Z J Psychiatry 2025; 59:115-127. [PMID: 39628343 PMCID: PMC11783990 DOI: 10.1177/00048674241289010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2025]
Abstract
OBJECTIVE this paper aims to present the evidence for the role of diet in the prevention and treatment of depression, review the potential underlying mechanisms and provide practice recommendations for mental health clinicians. METHODS A literature review was conducted through searches of PubMed with the search terms 'depression', 'diet', 'prevention', 'treatment' and 'mechanisms' and combinations thereof. Additional articles were identified through hand searching. RESULTS Greater adherence to several healthy dietary patterns, traditional diets such as the Mediterranean diet and other diets such as the DASH diet are associated with or can treat symptoms of depression. Several limitations of the research were noted, many of which relate to inherent challenges of studying diet. Mechanisms by which dietary intervention can influence mood include the gut microbiome, modulation of inflammatory processes, reduction in oxidative stress and modulation of hypothalamic-pituitary-adrenal axis function. Recommendations for mental health clinicians to enable translation of the evidence into practice are provided. CONCLUSION Diet can play an important role in preventing and treating depression. Mental health clinicians are well placed to provide dietary counselling and to use clinical judgement in choosing the specific approach that reflects the needs of the patient but are encouraged to refer to a specialist dietitian where necessary.
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Affiliation(s)
- Heidi M Staudacher
- Food & Mood Centre, Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Scott Teasdale
- Discipline of Psychiatry and Mental Health, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Caitlin Cowan
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Rachelle Opie
- Food for Thought Nutrition and Dietetics, Glen Iris, VIC, Australia
| | - Felice N Jacka
- Food & Mood Centre, Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Tetyana Rocks
- Food & Mood Centre, Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia
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Leigh L, Mok ZH. The effect of different patient-based learning models on student perceptions of empathy, engagement, knowledge, and learning experience. MEDICAL TEACHER 2025; 47:292-299. [PMID: 38608671 DOI: 10.1080/0142159x.2024.2337254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/26/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Problem-based learning is used widely in pharmacy and medical programmes, incorporating realistic patient scenarios into regular teaching as a way of linking theory to practice. Routine case-based learning lessons ranges from real patient involvement, scripted patient scenarios, digital simulations (avatars) as well as through media such as Zoom. The existing literature has explored the extensive benefits of using patients in clinical education, but fewer studies have directly compared the efficacy of each model as learning tools. AIM To compare student perceptions of patient-based learning models to elicit student empathy, increase engagement, improve knowledge, and enrich learning experience. METHODS A questionnaire was distributed to second-year pharmacy students in Swansea University to gather their perceptions on the nine different patient-based learning models in their routine teaching (SUMS RESC 2023-0011). Students were asked to rank their experience of the models explicitly against each other, based on the four pillars of (1) eliciting student empathy, (2) increasing engagement, (3) improving knowledge and (4) enriching the learning experience. Students were also asked to rate the significance of realism (i.e. knowing the patient demographics/having a visual representation of the patient) to their experience. RESULTS Altogether, 31 student rankings of the nine learning models were weighted (9 = highest rank; 1 = lowest ranked). The data showed clear preferences for real-patient involvement over fictional cases, especially for eliciting empathy. Interestingly, scripted scenarios were rated highly for both engagement and learning experience only when avatars were involved, which suggests a role of animated visual representation of the patient in facilitating these outcomes. CONCLUSION Whilst it is useful to have multiple patient-based learning models, this study serves as a guide for educators in preparing case-based learning sessions for achieving the desired outcomes of any of the four pillars above.
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Affiliation(s)
- Luke Leigh
- Swansea University Medical School, Swansea, UK
| | - Zi Hong Mok
- Swansea University Medical School, Swansea, UK
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5
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Hardan-Khalil K, Jadalla A, Deckers CM, Costa CB. Undergraduate Nursing Student Perceptions of Clinical Training Approaches: A Quasi-Experimental Study. NURSING REPORTS 2025; 15:47. [PMID: 39997783 PMCID: PMC11858538 DOI: 10.3390/nursrep15020047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2024] [Revised: 01/25/2025] [Accepted: 01/28/2025] [Indexed: 02/26/2025] Open
Abstract
BACKGROUND/OBJECTIVES Undergraduate nursing students report encountering significant challenges when they perform preplanning for clinical days. The literature lacks evidence regarding this educational model for clinical training, yet faculty continue to use it despite the lack of evidence that supports it. This study explored undergraduate nursing students' perceptions of their preclinical training activities. METHODS A quasi-experimental, after-only, nonequivalent control group design was employed at a public nursing school in an urban setting. A total of 110 undergraduate nursing students enrolled in an advanced medical-surgical course. Participants were divided into two groups based on their preparation approach for clinical practice. Data were collected using a paper-and-pencil survey at the end of the course's clinical rotation. The survey comprised three sections: (1) sociodemographic information, (2) the nursing clinical education tool (NCET) developed for this study, and (3) two open-ended questions focusing on the pros and cons of preplanning and reflective care approaches. The responses were analyzed and compared using a nonparametric two-independent-samples Mann-Whitney U test. RESULTS The findings indicated that students in eight out of ten nursing clinical education survey categories favored the reflective care approach. No differences were found between groups concerning class grade point average (GPA), the National Council Licensure Examination (NCLEX) passing rate, or standardized tests. CONCLUSIONS The reflective care approach was perceived more favorably than preplanning. Engaging in clinical reasoning strategies requires educators to reconsider how students interact with clinical education. Further research is needed to develop evidence-based methods to enhance the clinical learning experience and promote patient safety.
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Affiliation(s)
- Kholoud Hardan-Khalil
- School of Nursing, California State University, Long Beach, CA 90840, USA; (A.J.); (C.M.D.); (C.B.C.)
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Aydin Er R, Mergen M, Akpinar A. A methodological proposal for midwifery education: Asking, Learning, Telling, and Embracing Diversity (ALTE). Midwifery 2025; 140:104230. [PMID: 39522442 DOI: 10.1016/j.midw.2024.104230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 09/20/2024] [Accepted: 11/01/2024] [Indexed: 11/16/2024]
Abstract
OBJECTIVE This study addressed the imperative for educational methodologies that effectively cultivate an understanding of diverse cultures within midwifery education curricula, particularly focusing on culture-based practices in the professional milieu. The primary objective was to develop a comprehensive methodology for the integration of cultural competence acquisition into midwifery undergraduate education. This study endeavoured to introduce and critically assesses an educational approach tailored to facilitate the acquisition of cultural competence and sensitivity among midwifery students. DESIGN The Asking, Learning, Telling, and Embracing Diversity (ALTE) method, which was developed for use in the "History and Philosophy of Midwifery" course curriculum, was evaluated within the framework of instructor experiences and feedback from students. SETTING Kocaeli University Faculty of Health Sciences, Department of Midwifery in Türkiye. PARTICIPANTS A cohort of midwifery students enrolled in the History and Philosophy of Midwifery course between 2011 and 2016 (N = 95). FINDINGS The ALTE method, which is characterized by a student-cantered approach and active participation facilitation, presents an opportunity to enhance student engagement and foster active learning. Student feedback underscored that ALTE, emphasizing active participation, is perceived as an instructive and enriching educational approach, diverging from conventional didactic teaching methods. The ALTE method has emerged as an effective instrument for instilling cultural competence within midwifery education. KEY CONCLUSIONS The implementation of the ALTE method empowered midwifery students from diverse geographical backgrounds to discern varied cultural codes and traditional practices. This methodology facilitated the identification of commonalities across regions, exploration of preserved cultural values, and scrutiny of potential advantages, disadvantages, and risks associated with such practices concerning maternal and neonatal well-being. Notably, ALTE exhibited commendable efficacy in fostering cultural sensitivity, active learning, acquisition of communication and presentation skills, peer learning, development of cultural competence, and critical thinking skills.
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Affiliation(s)
- Rahime Aydin Er
- Department of History of Medicine and Ethics, Kocaeli University School of Medicine, Umuttepe Campus 41001, İzmit/Kocaeli, Türkiye; Department of Nursing- Kocaeli University Faculty of Health Sciences, Umuttepe Campus 41001, İzmit/Kocaeli, Türkiye.
| | - Merve Mergen
- Department of History of Medicine and Ethics, Kocaeli University School of Medicine, Umuttepe Campus 41001, İzmit/Kocaeli, Türkiye
| | - Aslıhan Akpinar
- Department of History of Medicine and Ethics, Kocaeli University School of Medicine, Umuttepe Campus 41001, İzmit/Kocaeli, Türkiye
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Butler S. Feedback in nursing practice: exploring barriers to and strategies for effective delivery. Nurs Manag (Harrow) 2024:e2145. [PMID: 39686579 DOI: 10.7748/nm.2024.e2145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2024] [Indexed: 12/18/2024]
Abstract
Feedback is essential for promoting nurses' professional development and enhancing the quality of patient care. Effective feedback, in terms of delivery, content and receipt, can support nurses to identify their strengths and areas for improvement, enhance patient care and strengthen teamwork and communication. Despite its importance, however, delivering feedback can be challenging, notably due to concerns about how it will be received. Creating a supportive environment, using a structured framework and fostering self-reflection among staff can support nurse managers to deliver feedback effectively. This article explores the importance of feedback in nursing practice, examines some of the barriers to providing feedback and suggests strategies for delivering effective feedback.
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Affiliation(s)
- Sarah Butler
- programme director postgraduate certificate in clinical practice, School of Paramedical Perioperative and Advanced Practice, Faculty of Health Sciences, University of Hull, Hull, England
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8
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Butler S. Using journalling to support nurses' mental well-being and self-care in challenging times. Nurs Manag (Harrow) 2024; 31:22-27. [PMID: 38915253 DOI: 10.7748/nm.2024.e2136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 06/26/2024]
Abstract
Nurses frequently experience multiple challenges and face numerous demands in their professional role, which may lead to adverse effects such as stress, depression, anxiety and burnout. Therefore, it is important to identify effective and accessible strategies that can support them. This article explores how nurses can use journalling as a tool for navigating the challenges they experience in their practice. It offers a step-by-step guide that provides nurses with an accessible and effective approach to journalling, which they can use to support their mental well-being and self-care.
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Affiliation(s)
- Sarah Butler
- programme director - PGCert Clinical Practice, University of Hull, Hull, England
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Moniz T, Melro CM, Warren A, Watling C. Twelve tips for maximizing the potential of reflective writing in medical education. MEDICAL TEACHER 2024; 46:1410-1415. [PMID: 38508199 DOI: 10.1080/0142159x.2024.2326093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/28/2024] [Indexed: 03/22/2024]
Abstract
Reflective writing (RW) is a popular tool in medical education, but it is being used in ways that fail to maximize its potential. Literature in the field focuses on why RW is used - that is to develop, assess, and remediate learner competencies - but less so on how to use it effectively. The emerging literature on how to integrate RW in medical education is haphazard, scattered and, at times, reductionist. We need a synthesis to translate this literature into cohesive strategies for medical educators using RW in a variety of contexts. These 12 tips offer guidelines for the principles and practices of using RW in medical education. This synthesis aims to support more strategic and meaningful integration of RW in medical education.
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Affiliation(s)
- Tracy Moniz
- Department of Communication Studies, Mount Saint Vincent University, Halifax, Canada
| | - Carolyn M Melro
- Department of Communication Studies, Mount Saint Vincent University, Halifax, Canada
| | - Andrew Warren
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - Chris Watling
- Department of Oncology, Clinical Neurological Sciences, and Family Medicine, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Canada
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O'Dowd AT, McEvoy NL, Read C, O'Keeffe D, Curley GF. Twelve tips for developing and implementing an effective critical care simulation programme. MEDICAL TEACHER 2024; 46:1422-1427. [PMID: 38588719 DOI: 10.1080/0142159x.2024.2331055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 03/12/2024] [Indexed: 04/10/2024]
Abstract
Simulation training in healthcare settings has become a valuable training tool. It provides an ideal formative assessment for interdisciplinary teaching. It provides a high fidelity and highly immersive environment where healthcare staff and students can practice developing their skills in a safe and controlled manner. Simulation training allows staff to practice skills that better prepare them for clinical emergencies, therefore possibly optimising clinical care. While the benefits of simulation education are well understood, establishing a programme for use by critical care staff is complex. Complexities include the highly specialised scenarios that are not typically encountered in non-critical care areas, as well as the need for advanced monitoring equipment, ventilation equipment etc. These 12 tips are intended to assist healthcare educators in navigating the complexities in the establishment of a critical care simulation programme, providing advice on selecting target audiences, learning outcomes, creating a critical care simulation environment and recommendations on evaluation and development of the programme.
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Affiliation(s)
- Aidan T O'Dowd
- Department of Anaesthesia and Critical Care, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Natalie L McEvoy
- Department of Anaesthesia and Critical Care, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Dara O'Keeffe
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Gerard F Curley
- Department of Anaesthesia and Critical Care, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Beaumont Hospital, Dublin, Ireland
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Ziada H, Webberson M, Sharma R, Abubakr NH. Qualitative Analysis of Student Reflections on Preclinical Dental Implant Education. Dent J (Basel) 2024; 12:293. [PMID: 39329859 PMCID: PMC11431706 DOI: 10.3390/dj12090293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 09/06/2024] [Accepted: 09/11/2024] [Indexed: 09/28/2024] Open
Abstract
Dental implant education is required to prepare students for independent general practice. This investigation aimed to assess students' perceptions of their educational experience and training in a preclinical dental implant introduction course, using reflective logs anonymously extracted from course portfolios. METHODS This study employed qualitative research methodology to analyze second-year dental students' reflections on their educational and development of psychomotor skills in a preclinical course focusing on dental implants at the University of Nevada, Las Vegas. These reflections served as the primary data source for qualitative analysis. The analysis was facilitated using NVivo software version 12 plus, which assisted in data coding and the organization of these codes into meaningful units, patterns, and themes. RESULTS Four themes emerged, which interrelated to each other and to the research question. Students reported positive course outcomes in dental implant learning, improvements in applying theoretical implant knowledge while developing practical skills, digitally scanning implant cases for the final restoration, and enhancement of their insight in evidence-based restoratively driven implant planning. They generally found the hands-on experience to have improved their understanding of the dental implant as an option for restoration. Although there were challenges, students viewed these as learning opportunities. For us, as educators, it provided invaluable feedback to understand students' perceptions of difficulties in knowledge acquisition and psychomotor skill development in placing and restoring dental implants. CONCLUSIONS Within the limitation of this study, students expressed a positive perception of their learning experience in the introductory course on dental implants.
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Affiliation(s)
- Hassan Ziada
- Clinical Science Department, School of Dental Medicine, University of Nevada, 1001 Shadow Lane, Las Vegas, NV 89106, USA
| | - Michael Webberson
- Clinical Science Department, School of Dental Medicine, University of Nevada, 1001 Shadow Lane, Las Vegas, NV 89106, USA
| | - Rassilee Sharma
- Clinical Science Department, School of Dental Medicine, University of Nevada, 1001 Shadow Lane, Las Vegas, NV 89106, USA
| | - Neamat Hassan Abubakr
- Biomedical Sciences Department, School of Dental Medicine, University of Nevada, Las Vegas, NV 89106, USA
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Alodhialah AM, Almutairi AA, Almutairi M. Exploring Nurses' Emotional Resilience and Coping Strategies in Palliative and End-of-Life Care Settings in Saudi Arabia: A Qualitative Study. Healthcare (Basel) 2024; 12:1647. [PMID: 39201205 PMCID: PMC11353972 DOI: 10.3390/healthcare12161647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 08/09/2024] [Accepted: 08/13/2024] [Indexed: 09/02/2024] Open
Abstract
BACKGROUND Nurses working in palliative and end-of-life care settings face significant emotional challenges due to the demanding nature of their profession. This study aimed to explore the emotional resilience of these nurses, understanding the factors that contribute to their resilience, the impact on their professional well-being and performance, and strategies to enhance resilience. METHODS A qualitative study was conducted involving 15 registered nurses from various healthcare facilities in Riyadh, Saudi Arabia. Data were collected through semi-structured interviews, document analysis, and observational data. Thematic analysis was employed to identify recurring themes. RESULTS The study identified three key themes: Emotional Challenges and Resilience-Building, Support Systems and Resources for Resilience, and Professional Growth and Fulfillment as Resilience Factors. The findings revealed the emotional toll of patient suffering, highlighting resilience-building strategies, such as peer support, mindfulness, and reflective practices. Support systems, including workplace support, organizational resources, and mentorship, were identified as crucial for fostering resilience. Professional growth, a sense of purpose, and recognition emerged as factors contributing to resilience. CONCLUSIONS This study underscores the importance of emotional resilience for nurses in palliative and end-of-life care settings. Healthcare organizations can enhance resilience by implementing resilience training, providing counseling services, fostering a supportive culture, and offering professional development opportunities. Addressing the emotional needs of nurses is vital for their well-being and the delivery of compassionate care.
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Affiliation(s)
- Abdulaziz M. Alodhialah
- Department of Medical Surgical Nursing, College of Nursing, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Ashwaq A. Almutairi
- School of Nursing & Midwifery, Monash University, Melbourne, VIC 3800, Australia;
| | - Mohammed Almutairi
- Department of Medical Surgical Nursing, College of Nursing, King Saud University, Riyadh 11451, Saudi Arabia;
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Lodge J, Neptune C, Tun NN. Factors Affecting Engagement With Portfolio-Based Reflection Among Internal Medicine Trainees: A Survey-Based Study. Cureus 2024; 16:e63022. [PMID: 38915838 PMCID: PMC11194999 DOI: 10.7759/cureus.63022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2024] [Indexed: 06/26/2024] Open
Abstract
Background Contemporary medical education emphasizes that postgraduate clinicians should look at their daily experiences as an opportunity to learn and advance their knowledge and practice of medicine. This is the concept of reflective practice. Internal medicine trainees (IMT) in the UK are encouraged to record written reflections in their electronic portfolios but it is not a mandatory requirement. There is literature suggesting that the level of engagement with these written reflections is varied and that when these are produced, they can be superficial. Thus, the aim of this research was to ascertain what percentage of trainees engaged in written reflections and the factors that affected the likelihood they would reflect. There are no studies that have attempted to quantify de novo engagement with reflective practice and to quantify the significance of different theorized barriers to reflection. Methods This study was in the form of a quasi-experimental cross-sectional study. A 15-item survey was sent out to the IMT in the northwest deanery of England (n=592). The survey remained open for approximately three months with periodic reminders sent out to the trainees. The survey was closed to further responses when the number of responses reached the predetermined sample size of 240 (5% margin of error at a confidence interval of 95%). The data were analyzed by chi-square testing and represented using descriptive statistics. Results There were 243 responses to this survey. A total of 81.5% (n=198) wrote reflections in their portfolio and 19.5% (n=45) did not write any reflections. The main content of written reflections were clinical outcomes (positive and negative), teaching, and new learning. Several background factors had a statistically significant influence on the likelihood that trainees would write reflections in their portfolios. These included their stage of training, years practicing medicine, location of primary medical training, first exposure to reflective practice, and whether they have ever been tutored on reflection. Concerns about legal or General Medical Council (GMC) use of reflective notes against trainees also significantly impacted on reflection. The main perceived barriers to written reflections were the fact that trainees felt they had no time to properly reflect and the lack of perceived benefits from reflections. Conclusion Most trainees wrote reflections in their portfolios, but the majority did not perceive any benefits in doing this. The varied backgrounds of trainees seem to have an impact on their likelihood to reflect and strategies to increase engagement would need to address this.
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Affiliation(s)
- Jeorghino Lodge
- Internal Medicine, Blackpool Victoria Hospital, Blackpool, GBR
| | - Cornelius Neptune
- Acute Medicine, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, GBR
| | - Nwe Ni Tun
- Internal Medicine, Blackpool Teaching Hospitals, Blackpool, GBR
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Janssen L, Schick K, Neurohr T, Pittroff SID, Reiser S, Bauer J, Berberat PO, Gartmeier M. Reflect to interact - fostering medical students' communication through reflection-focused e-learning. BMC MEDICAL EDUCATION 2024; 24:541. [PMID: 38750528 PMCID: PMC11097513 DOI: 10.1186/s12909-024-05368-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 03/28/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Previous research indicates that reflection can foster medical communication competence. However, best practices for embedding reflection in online medical education are missing. This study examined how reflection processes can be promoted and embedded in an e-learning course on physician-patient communication to foster learning. METHODS We investigated three differently designed e-learning conditions featuring different proportions of reflection triggers and compared their effects on students' reflections. We had 114 medical students in their first clinical year complete one of the variants: video modelling (VM, n = 39), video reflection (VR, n = 39), or a variant merging both approaches (VMR, n = 36). Each student wrote a total of nine reflections based on the same guiding questions at three time points embedded in the course. The students' levels of reflection were measured using an adapted version of the REFLECT rubric (scale 0-18). RESULTS Students of all course variants achieved good levels of reflection beyond the descriptive level at all three time points, with no significant differences between the variants. The mean reflection scores at the end of the course were M = 14.22 for VM (SD = 2.23), M = 13.56 for VR (SD = 2.48), and M = 13.24 for VMR (SD = 2.21). Students who completed VM showed significantly improved levels of reflection over the course, whereas we found no statistically significant development for those in VR or VMR. The reflection scores correlated significantly positively with each other, as did the text lengths of the written reflections. Reflection scores also correlated significantly positively with text length. CONCLUSIONS Our study offers a teaching strategy that can foster good levels of reflection, as demonstrated in the three e-learning variants. The developed reflection prompts can be easily embedded in various e-learning environments and enable reflections of good quality, even in settings with limited available teaching time.
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Affiliation(s)
- Laura Janssen
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany.
| | - Kristina Schick
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Tiziana Neurohr
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Sylvia Irene Donata Pittroff
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Sabine Reiser
- Educational Research and Methodology, University of Erfurt, Erfurt, Germany
| | - Johannes Bauer
- Educational Research and Methodology, University of Erfurt, Erfurt, Germany
| | - Pascal O Berberat
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Martin Gartmeier
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany
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15
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Phua GLG, Owyong JLJ, Leong ITY, Goh S, Somasundaram N, Poon EYL, Chowdhury AR, Ong SYK, Lim C, Murugam V, Ong EK, Mason S, Hill R, Krishna LKR. A systematic scoping review of group reflection in medical education. BMC MEDICAL EDUCATION 2024; 24:398. [PMID: 38600515 PMCID: PMC11007913 DOI: 10.1186/s12909-024-05203-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/20/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Reviewing experiences and recognizing the impact of personal and professional views and emotions upon conduct shapes a physician's professional and personal development, molding their professional identity formation (PIF). Poor appreciation on the role of reflection, shortages in trained tutors and inadequate 'protected time' for reflections in packed medical curricula has hindered its integration into medical education. Group reflection could be a viable alternative to individual reflections; however, this nascent practice requires further study. METHODS A Systematic Evidence Based Approach guided Systematic Scoping Review (SSR in SEBA) was adopted to guide and structure a review of group reflections in medical education. Independent searches of articles published between 1st January 2000 and 30th June 2022 in bibliographic and grey literature databases were carried out. Included articles were analysed separately using thematic and content analysis, and combined into categories and themes. The themes/categories created were compared with the tabulated summaries of included articles to create domains that framed the synthesis of the discussion. RESULTS 1141 abstracts were reviewed, 193 full-text articles were appraised and 66 articles were included and the domains identified were theories; indications; types; structure; and benefits and challenges of group reflections. CONCLUSIONS Scaffolded by current approaches to individual reflections and theories and inculcated with nuanced adaptations from other medical practices, this SSR in SEBA suggests that structured group reflections may fill current gaps in training. However, design and assessment of the evidence-based structuring of group reflections proposed here must be the focus of future study.
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Affiliation(s)
- Gillian Li Gek Phua
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Jasmine Lerk Juan Owyong
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, 463 Clementi Road, Singapore, Singapore
| | - Ian Tze Yong Leong
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Suzanne Goh
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- KK Women's and Children Hospital, 100 Bukit Timah Rd, Singapore, 169854, Singapore
| | - Nagavalli Somasundaram
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Eileen Yi Ling Poon
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | | | - Simon Yew Kuang Ong
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Crystal Lim
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Medical Social Services, Singapore General Hospital, 16 College Road, Block 3 Level 1, Singapore, 169854, Singapore
| | - Vengadasalam Murugam
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Eng Koon Ong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Assisi Hospice, 832 Thomson Rd, Singapore, Singapore
- Office of Medical Humanities, SingHealth Medicine Academic Clinical Programme, 31 Third Hospital Ave, Singapore, 168753, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Rd, Liverpool, L3 9TA, UK
| | - Ruaridh Hill
- Health Data Science, University of Liverpool, Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, UK
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Singapore, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore.
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Rd, Liverpool, L3 9TA, UK.
- PalC, The Palliative Care Centre for Excellence in Research and Education, PalC c/o Dover Park Hospice, Singapore, Singapore.
- Centre for Biomedical Ethics, National University of Singapore, Singapore, Singapore.
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16
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Leung KCY, Lele K. A hospital-wide group approach to promote open dialogues of workplace issues and staff wellbeing with Schwartz Rounds. Australas Psychiatry 2024; 32:151-156. [PMID: 38288725 PMCID: PMC10913322 DOI: 10.1177/10398562241229887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
OBJECTIVES This study aims to explore the feasibility and impact of Schwartz Rounds® led by psychiatrists/mental health professionals in an urban Australian public hospital setting and to develop strategies for optimising participants' experiences. METHODS Being a mixed-methods study collecting qualitative and quantitative data through post-Rounds evaluation surveys, this study thematically analysed responses from 105 participants attending four consecutive monthly Rounds between February and May 2023 to assess the perceived benefits and challenges of Schwartz Rounds. RESULTS Respondents highly valued the Rounds and felt cared for by the healthcare organisation. Themes related to perceived benefits included (i) Connectedness and shared experience; (ii) Understanding other professionals; (iii) Normalisation of emotional distress, validation and a safe space for vulnerability; and (iv) Fostering authenticity and humanitarian aspects of healthcare. Challenges included (i) Fear of exposure and judgment; (ii) Emotional discomfort; (iii) Unfamiliarity with reflection; and (iv) Safety concerns. CONCLUSIONS This study suggests acceptability and feasibility of implementing Schwartz Rounds within an Australian public health setting, particularly when facilitated by skilled mental health professionals. The outcomes provide preliminary support for the use of group interventions to enhance staff collegiality and culture in healthcare settings, thereby addressing critical needs for health professional wellbeing.
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Affiliation(s)
| | - Kiran Lele
- University of Sydney, Camperdown, NSW, Australia
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17
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Kawakami C, Chung A, Arndt R, Masaki K, Loos JR, Teruya K, Wong L, Tokumaru S. Improving Interprofessional Collaboration Between Social Work and Pharmacy Through Hybrid and Virtual Learning Experiences. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2024; 83:36-44. [PMID: 38344696 PMCID: PMC10850864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
The professions of pharmacy and social work are not generally assumed to directly collaborate in patient care; however, these professions are complementary. Health and wellbeing outcomes are significantly improved when care is managed by an interprofessional team that communicates and collaborates to ensure all aspects of care are effectively managed. The creation of educational opportunities for students to practice working together provides enhanced educational experiences and leads to their success as professionals. Pharmacy and social work faculty developed an interprofessional education activity specifically aimed at integrative student learning. Faculty and students based on various islands throughout the state of Hawai'i and the US territory of Guam participated in the experience. The case study encouraged interprofessional teamwork and collaboration. The case study also challenged students to share profession-specific knowledge with each other. Mean evaluation scores were compared between hybrid and fully online platforms. Evaluation scores were high and at least as good or higher in the fully online exercise compared to the hybrid exercises. Using the 20-item pre-post format, Interprofessional Collaborative Competencies Attainment Survey, results indicated statistically significant improvements in scores for all questions and domains (all P<.001). When hybrid training and fully online training were compared, there were no significant differences in pre scores, but post domain scores were significantly higher in students who experienced fully online training. This interprofessional case-based activity successfully promoted interprofessional learning and collaboration. Introducing learners to this type of collaborative practice while in school is critical for future collaboration in the workforce.
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Affiliation(s)
- Chad Kawakami
- The Daniel K. Inouye College of Pharmacy, University of Hawai‘i at Hilo, Hilo, HI (CK, ST)
| | - Aimee Chung
- Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI (AC, RA)
| | - Robin Arndt
- Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI (AC, RA)
| | - Kamal Masaki
- Department of Geriatrics, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (KM)
| | - Joanne R. Loos
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Mānoa, Honolulu, HI (JL, KT, LW)
| | - Kimm Teruya
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Mānoa, Honolulu, HI (JL, KT, LW)
| | - Lorrie Wong
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Mānoa, Honolulu, HI (JL, KT, LW)
| | - Sheri Tokumaru
- The Daniel K. Inouye College of Pharmacy, University of Hawai‘i at Hilo, Hilo, HI (CK, ST)
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18
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Deluche E, Coudert PE, Darbas T, Pinet S, Labriffe M, Laloze J, Taibi A, Roux A, Usseglio-Grosso J, Messager V, Salle L, Monteil J, Fourcade L, Fredon F, Vergne-Salle P. [ACACIAS 3: Learning about announcement consultations in the second cycle of medical studies]. Bull Cancer 2024; 111:153-163. [PMID: 38042749 DOI: 10.1016/j.bulcan.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 12/04/2023]
Abstract
INTRODUCTION The second cycle of medical studies is a key time for developing interpersonal skills and the doctor-patient relationship. High-fidelity simulation is an initial learning option that enables learners to confront situations involving empathy. METHODS This is a feedback report from May 2023 on the implementation of simulation as a training tool for 2nd cycle medical students in the announcement consultation. The training consists of two parts: theoretical teaching via a digital platform with an assessment of theoretical knowledge and a practical part with a simulation session with an actress playing a standardized patient. The acquisition of skills and the reflexivity of learners are assessed by means of a pre- and post-test. RESULTS Twenty-nine externs took part in this project. Student satisfaction was 96 %. The feedback was very positive, both in terms of the quality of the sessions and the briefings/debriefings. Almost all the students wanted to repeat the experience. The simulation exercise was beneficial for the students in terms of the development (before vs. after) of their skills (verbal, emotional and relational) (1.05±0.25 vs. 1.22±0.19, P=0.047) and appeared to be relevant to the development of reflexivity (3.29±0.72 vs. 3.48±0.9, P=0.134). CONCLUSION This first published French study demonstrates the feasibility and value of training in announcing a diagnosis, combining teaching via a digital platform and high-fidelity simulation for second cycle medical students.
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Affiliation(s)
- Elise Deluche
- Service d'oncologie médicale, CHU Dupuytren, 87042 Limoges Cedex, France; Département universitaire d'enseignement numérique en santé, faculté de médecine de Limoges, 87025 Limoges, Cedex, France.
| | - Pierre-Etienne Coudert
- Département universitaire d'enseignement numérique en santé, faculté de médecine de Limoges, 87025 Limoges, Cedex, France
| | - Tiffany Darbas
- Service d'oncologie médicale, CHU Dupuytren, 87042 Limoges Cedex, France
| | - Sandra Pinet
- Service d'oncologie médicale, CHU Dupuytren, 87042 Limoges Cedex, France
| | - Marc Labriffe
- Service de pharmacologie toxicologie et pharmacovigilance, CHU Dupuytren, 87042 Limoges Cedex, France
| | - Jérôme Laloze
- Service de chirurgie maxillo-faciale, plastique et reconstructive, CHU Dupuytren, 87042 Limoges Cedex, France
| | - Abdelkader Taibi
- Service de chirurgie viscérale, CHU Dupuytren, 87042 Limoges Cedex, France
| | - Alexia Roux
- Service de chirurgie viscérale, CHU Dupuytren, 87042 Limoges Cedex, France
| | - Julie Usseglio-Grosso
- Service de chirurgie maxillo-faciale, plastique et reconstructive, CHU Dupuytren, 87042 Limoges Cedex, France
| | | | - Laurence Salle
- Service d'endocrinologie, CHU Dupuytren, 87042 Limoges Cedex, France
| | - Jacques Monteil
- Service de médecine nucléaire, CHU Dupuytren, 87042 Limoges Cedex, France
| | - Laurent Fourcade
- Service de chirurgie pédiatrique, CHU Dupuytren, 87042 Limoges Cedex, France; Département universitaire d'enseignement numérique en santé, faculté de médecine de Limoges, 87025 Limoges, Cedex, France
| | - Fabien Fredon
- Service de chirurgie viscérale, CHU Dupuytren, 87042 Limoges Cedex, France
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Beamish N, Footer C, Lowe R, Cunningham S. Rehabilitation professions' core competencies for entry-level professionals: a thematic analysis. J Interprof Care 2024; 38:32-41. [PMID: 37551889 DOI: 10.1080/13561820.2023.2241519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 06/26/2023] [Indexed: 08/09/2023]
Abstract
Rehabilitation services are essential interventions designed to optimize functioning and reduce disability in individuals with health conditions. Eight core professions offer rehabilitation services: audiology, occupational therapy, physical and rehabilitation medicine, physiotherapy, psychology, prosthetics and orthotics, rehabilitation nursing, and speech-language pathology. These professions often work together to provide patient-centered care. Each rehabilitation profession has developed its own international or national document to describe entry-level competencies. However, it is not evident in the literature whether rehabilitation professions share the same core competencies. Therefore, we explored the international standards for rehabilitation professions to identify commonalities and differences in entry-level professionals' required core competencies. A thematic analysis of current, published, international, or national entry-level competencies documents was conducted to determine commonalities and differences in the core competence requirements for the eight rehabilitation professions. The following four themes were evident across all professions: (a) evidence-based clinical practice knowledge and skills; (b) culturally competent communication and collaboration; (c) professional reasoning and behaviors; and (d) interprofessional collaboration. This thematic analysis highlighted the commonalities among rehabilitation professionals and may be used to provide a greater understanding of how rehabilitation professionals can support and work together on interprofessional teams.
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Affiliation(s)
- Nicole Beamish
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | | | | | - Shala Cunningham
- Physiopedia, London, UK
- Department of Physical Therapy, Radford University, Radford, Virginia, USA
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20
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Joshi MK. Novel teaching-learning and assessment tools to complement competency-based medical education in postgraduate training. Indian J Anaesth 2024; 68:11-16. [PMID: 38406330 PMCID: PMC10893807 DOI: 10.4103/ija.ija_1175_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/01/2024] [Accepted: 01/07/2024] [Indexed: 02/27/2024] Open
Abstract
Medical and educational techniques and approaches have evolved globally over the past few decades. The modern approach is more learner-centred, with a focus on the acquisition of skills. The recently implemented competency-based medical education (CBME) for the National Medical Commission (NMC) undergraduate course curriculum is also competency-based rather than an outcome-based traditional curriculum. It is vital to embrace innovative teaching-learning and educational strategies to achieve the aspiration of CBME. This article provides a list of some of the newer tools and their perceived advantages and challenges and serves as a guide for using these methods effectively to meet the objectives of CBME as proposed by the NMC. Virtual teaching, learning from digital resources, objective-structured practical and clinical examination, flipped classroom, case-based learning, serious gaming, simulation-based learning and learning from role-plays and portfolios emerged as novel instructional strategies.
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Affiliation(s)
- Mohit K. Joshi
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
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21
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Richardson E, Jackson Koku G, Kaul H. Reflection in clinical practice: guidance for postgraduate doctors in training. Postgrad Med J 2023; 99:1295-1297. [PMID: 37535867 DOI: 10.1093/postmj/qgad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/01/2023] [Indexed: 08/05/2023]
Affiliation(s)
- Emma Richardson
- Specialist Registrar, Occupational Health Department, St George's University Hospitals National Health Service Foundation Trust, London SW17 0QT, United Kingdom
| | - Gordon Jackson Koku
- Consultant Physician, St George's University Hospitals National Health Service Foundation Trust, London LE1 5WW, United Kingdom
| | - Harjinder Kaul
- Consultant Physician, Occupational Health Department, University Hospitals of Leicester National Health Service Trust, Leicester SW17 0QT, United Kingdom
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22
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Bartley T, O'Connor R, Beard K. Should All Nurses Be Required to Complete Implicit Bias Training? Am J Nurs 2023; 123:20-21. [PMID: 37882396 DOI: 10.1097/01.naj.0000995336.31551.4e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Bias mitigation requires a systematic approach.
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Affiliation(s)
- Tanya Bartley
- Tanya Bartley is director of clinical simulation at the Mercy University School of Nursing, Dobbs Ferry, NY. Rebecca O'Connor is an associate professor at the University of Washington School of Nursing in Seattle. Kenya Beard is dean and chief nursing officer at the Mercy University School of Nursing, and a member of AJN's editorial board. Contact author: Tanya Bartley, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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23
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Jensen JF, Ramos J, Ørom ML, Naver KB, Shiv L, Bunkenborg G, Kodal AM, Skram U. Improving patient's intensive care admission through multidisciplinary simulation-based crisis resource management: A qualitative study. J Clin Nurs 2023; 32:7530-7542. [PMID: 37458172 DOI: 10.1111/jocn.16821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/24/2023] [Accepted: 06/27/2023] [Indexed: 07/21/2023]
Abstract
AIM To explore nurses' and physicians' experiences of simulation-based training in a crisis resource management quality improvement intervention on intensive care admission. BACKGROUND Quantitative studies have documented that staffs' non-technical skills are improved after simulation-based training in crisis resource management interventions. Experienced-based consensus led to development of a quality improvement intervention based on principles of crisis resource management and tested in simulation-based training to enhance staffs' non-technical skills. However, the impact on staff is unexplored, leaving little understanding of the relationship between simulation-based training in crisis resource management interventions and changes in non-technical skills. DESIGN A qualitative study with a hermeneutical approach. METHODS Data consisted of semi-structured interviews with physicians (n = 5) and nurses (n = 15) with maximum variation in work experience. Data were collected 3 months after implementation and analysed using thematic analysis. The COREQ guideline was applied. RESULTS The analysis revealed three themes: prioritising core clinical activities and patient centredness; transition into practice; and reflection on patient safety. These themes reflected staff's experiences of the intervention and implementation process, which evolved through prioritising core clinical activities that facilitated the transition into clinical practice and staff's reflection on patient safety. CONCLUSIONS Prioritising core clinical activities were facilitated by clear communication, predefined roles and better teamwork. Transition into practice stimulated professional growth through feedback. Reflection on patient safety created a new understanding on how a new structure of intensive care admission could be implemented. Collectively, this indicated a joint understanding of admissions. IMPLICATIONS FOR PRACTICE Findings enables health care professionals to understand how the intervention can contribute to improve quality of care in management of intensive care admission. Improving non-technical skills are vital in high-quality admissions, which supported a structured process and a collaborative professional standard of admissions. PATIENT AND PUBLIC CONTRIBUTION None.
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Affiliation(s)
- Janet F Jensen
- Department of Neurology, Zealand University Hospital, Roskilde, Denmark
- Department of Anesthesiology, North Zealand Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Joanna Ramos
- Department of Anesthesiology, North Zealand Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Thoracic Anaesthesiology, Rigshospital, Copenhagen, Denmark
| | - Marie-Louise Ørom
- Department of Anesthesiology, North Zealand Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Kirsten B Naver
- Department of Anesthesiology, North Zealand Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Louise Shiv
- Department of Anesthesiology, North Zealand Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Gitte Bunkenborg
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark
- Department of Anesthesiology, Holbaek Hospital, Holbaek, Denmark
| | - Anne Marie Kodal
- Department of Anesthesiology, North Zealand Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik Skram
- Department of Anesthesiology, North Zealand Hospital, University of Copenhagen, Copenhagen, Denmark
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24
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Kasdovasilis P, Cook N, Montasem A. Sustaining Resilience of Healthcare Workers and Leaders during a Pandemic: A Protocol to Support Coping during the COVID-19 Pandemic. Psychiatry 2023; 86:329-343. [PMID: 37707877 DOI: 10.1080/00332747.2023.2246847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Objective: One way healthcare organisations can support their staff is through supervision. Supervision is typically defined as a process in which professionals receive support and guidance from more experienced colleagues. In this brief review we propose a tailored protocol for supporting support workers during a pandemic. Method: We collected narrative data from difference sources including a systematic meta ethnography and used expert advise in order to tailor the protocol. Results: This protocol can be used by management teams (e.g., senior support workers, team leaders, registered managers, and operation managers) without any prior experience of supervision. The protocol suggested includes a template with easy-to-follow instructions. Conclusions: It provides an easy step-by-step guide that simplifies the process whilst maintaining the depth needed to ensure effective supervision.
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25
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Lim AJS, Hong DZ, Pisupati A, Ong YT, Yeo JYH, Chong EJX, Koh YZ, Wang M, Tan R, Koh KK, Ting JJQ, Lam BKY, Chiam M, Lee ASI, Chin AMC, Fong W, Wijaya L, Tan LHS, Krishna LKR. Portfolio use in postgraduate medical education: a systematic scoping review. Postgrad Med J 2023; 99:913-927. [PMID: 36961214 DOI: 10.1093/postmj/qgac007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 10/15/2022] [Accepted: 11/05/2022] [Indexed: 03/25/2023]
Abstract
BACKGROUND Portfolios are increasingly commonplace in postgraduate medical education. However, poor understanding of and variations in their content, quality, and structure have hindered their use across different settings, thus dampening their efficacy. METHODS This systematic scoping review on portfolios in postgraduate medical education utilized Krishna's Systematic Evidence Based Approach (SEBA). Braun and Clarke's thematic analysis and Hsieh and Shannon's directed content analysis were independently used to evaluate the data. RESULTS In total, 12 313 abstracts were obtained, and 76 full-text articles included. Six key themes/categories were identified: (i) portfolio definitions and functions, (ii) platforms, (iii) design, (iv) implementation, (v) use in assessments, and (vi) evaluations of their usage. CONCLUSIONS Portfolios allow for better appreciation and assessments of knowledge, skills, and attitudes in time-, learner-, and context-specific competencies through the establishment of smaller micro-competencies and micro-credentialling. Organized into three broad stages-development, implementation, and improvement-a six-step framework for optimizing and instituting portfolios in postgraduate medical education is offered.
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Affiliation(s)
- Annabelle Jia Sing Lim
- Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 169610, Singapore
| | - Daniel Zhihao Hong
- Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 169610, Singapore
| | - Anushka Pisupati
- Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 169610, Singapore
| | - Yun Ting Ong
- Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 169610, Singapore
| | - Jocelyn Yi Huang Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 169610, Singapore
| | - Eleanor Jia Xin Chong
- Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 169610, Singapore
| | - Yi Zhe Koh
- Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 169610, Singapore
| | - Mingjia Wang
- Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 169610, Singapore
| | - Rei Tan
- Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 169610, Singapore
| | - Kai Kee Koh
- Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 169610, Singapore
| | - Jacquelin Jia Qi Ting
- Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 169610, Singapore
| | - Betrand Kai Yang Lam
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 169610, Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, 169610, Singapore
| | - Alexia Sze Inn Lee
- Division of Cancer Education, National Cancer Centre Singapore, 169610, Singapore
| | | | - Warren Fong
- Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore
- Duke-NUS Medical School, National University of Singapore, 169857, Singapore
- Department of Rheumatology and Immunology, Singapore General Hospital, 169854, Singapore
| | - Limin Wijaya
- Duke-NUS Medical School, National University of Singapore, 169857, Singapore
- Department of Infectious Diseases, Singapore General Hospital, 169854, Singapore
| | - Laura Hui Shuen Tan
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 169610, Singapore
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 169610, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 169610, Singapore
- Duke-NUS Medical School, National University of Singapore, 169857, Singapore
- Marie Curie Palliative Care Institute Liverpool, Cancer Research Centre, University of Liverpool, 200 London Rd, Liverpool L3 9TA, United Kingdom
- Centre of Biomedical Ethics, National University of Singapore, 119077, Singapore
- PalC, The Palliative Care Centre for Excellence in Research and Education, 308436, Singapore
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Thompson J. NASA resilience and leadership: examining the phenomenon of awe. Front Psychol 2023; 14:1158437. [PMID: 37359869 PMCID: PMC10288108 DOI: 10.3389/fpsyg.2023.1158437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023] Open
Abstract
This study examines how a phenomenon, awe, along with related resilience practices, is perceived by a NASA medical and mental health professional, who also serves in a leadership role, and how awe has impacted their work and personal life. Considering both their leadership role and how their work involves supporting the wellbeing of astronauts pre-mission, during missions, and post-mission, the potential impact of awe on the NASA expert has individual implications along with many others, especially in stressful environments. The results indicate that reflecting on awe experiences can support a person finding meaning and purpose in their life, evoke gratitude, increase social connectedness, promote optimism and other resilience skills in the moment, and generally have a sustainable positive effect.
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Affiliation(s)
- Jeff Thompson
- Columbia University Irving Medical Center, Columbia University, New York, NY, United States
- Lipscomb University, Nashville, TN, United States
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Nurse Residents' Legacy Letters: A Qualitative Analysis. J Nurses Prof Dev 2023; 39:80-86. [PMID: 34739440 DOI: 10.1097/nnd.0000000000000819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
It is important for graduate nurses to reflect on their time in residency programs. Legacy letters, written by oncology nurse residents to future residents, reflect on "what I wish I knew" and "what I learned." A retrospective, qualitative thematic analysis of 30 letters at a National Cancer Institute-designated comprehensive cancer center in the southeastern United States was conducted. Four themes arose. Understanding these experiences can provide insight to nurse residents and guide improvements for the residency program.
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Belfi LM, Chetlen A, Frigini A, Jay A, Methratta ST, Robbins J, Woods R, Deitte L. Recovering Joy in the Workplace Requires P.R.A.C.T.I.C.E. Acad Radiol 2023; 30:536-540. [PMID: 35654656 PMCID: PMC9151245 DOI: 10.1016/j.acra.2022.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Lily M. Belfi
- Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Room F-054, New York, NY,Address correspondence to: L.M.B
| | - Alison Chetlen
- Department of Radiology, Penn State University, Hershey, Pennsylvania
| | | | - Ann Jay
- Department of Radiology, MedStar Georgetown University Hospital, Washington DC
| | | | - Jessica Robbins
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Ryan Woods
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Lori Deitte
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
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Edwards KH, Franklin RC, Edwards MT, Stewart RA. Requesting air ambulance transport of patients with suspected appendicitis: The decision‐making process through the eyes of the rural clinician. Aust J Rural Health 2022. [DOI: 10.1111/ajr.12956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 03/23/2022] [Accepted: 11/27/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Kristin H. Edwards
- College of Public Health, Medical and Veterinary Sciences James Cook University Townsville Queensland Australia
| | - Richard C. Franklin
- College of Public Health, Medical and Veterinary Sciences James Cook University Townsville Queensland Australia
| | - Mark T. Edwards
- LifeFlight Retrieval Medicine Australia Brisbane Queensland Australia
| | - Ruth A. Stewart
- College of Medicine and Dentistry James Cook University Townsville Queensland Australia
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Nuzzo C, Girard E, Xu WS, Wijaya L, Karoonuthaisiri N, Gray F, Jimenez YA. Opportunities to develop leadership skills in the undergraduate diagnostic radiography program: Insights from students at an Australian university. J Med Imaging Radiat Sci 2022; 53:S131-S136. [PMID: 36038423 DOI: 10.1016/j.jmir.2022.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/06/2022] [Accepted: 08/11/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION/BACKGROUND Leadership is defined as the ability to influence others to work towards common visions and goals. A key principle of the Australian Health Leadership Framework is that it applies to all leaders and potential leaders, who are at any place in the system. Hence, leadership is everyone's responsibility, including health profession students. In this short communication, we discuss the concept of leadership development in the undergraduate diagnostic radiography (DR) program through experiential learning. Examples from students' and academics' perspectives are presented, with the intention of providing a broad context to the range of opportunities that support development of leadership skills in DR students. DISCUSSION Experience and experiential learning are fundamental and natural means of learning. Experiential learning has a positive effect on leadership because of its impact on personal, attitudinal, moral, social, and cognitive outcomes. Undergraduate DR students value opportunities to develop leadership skills during their university education. Four opportunities to develop and reflect on leadership skills are discussed. Two of the opportunities, clinical placements and honours programs, form part of the curricula, whilst others, such as mentoring and profession-specific social groups, are not. Through experience-based learning, students may benefit from transformational effects in their individual skills, which may ultimately benefit the organisation or community in which the individual participates. CONCLUSION Commitment from clinical and academic educators to enable leadership development in DR students is essential. Through implementation of obligatory and optional experiential learning opportunities, it is anticipated that leadership skills will be cultivated in DR students, enabling students to exercise effective leadership in their current student roles and establish essential skills for their future professional roles.
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Affiliation(s)
- Christopher Nuzzo
- Faculty of Medicine and Health, The University of Sydney Science, Susan Wakil Health Building (D18), Western Avenue, Camperdown, NSW 2006, Australia
| | - Emily Girard
- Faculty of Medicine and Health, The University of Sydney Science, Susan Wakil Health Building (D18), Western Avenue, Camperdown, NSW 2006, Australia
| | - Whitney Summer Xu
- Faculty of Medicine and Health, The University of Sydney Science, Susan Wakil Health Building (D18), Western Avenue, Camperdown, NSW 2006, Australia
| | - Lauren Wijaya
- Faculty of Medicine and Health, The University of Sydney Science, Susan Wakil Health Building (D18), Western Avenue, Camperdown, NSW 2006, Australia
| | - Nareuchaya Karoonuthaisiri
- Faculty of Medicine and Health, The University of Sydney Science, Susan Wakil Health Building (D18), Western Avenue, Camperdown, NSW 2006, Australia
| | - Frances Gray
- Faculty of Medicine and Health, The University of Sydney Science, Susan Wakil Health Building (D18), Western Avenue, Camperdown, NSW 2006, Australia
| | - Yobelli A Jimenez
- Faculty of Medicine and Health, The University of Sydney Science, Susan Wakil Health Building (D18), Western Avenue, Camperdown, NSW 2006, Australia.
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Brown T, Yu ML, Hewitt A, Cousland R, Etherington J. Professionalism, Resilience and Reflective Thinking: How Do These Influence Occupational Therapy Student Fieldwork Outcomes? Occup Ther Health Care 2022; 36:327-352. [PMID: 34565264 DOI: 10.1080/07380577.2021.1978606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
The relationship between entry-level, undergraduate occupational therapy students' fieldwork performance and measures of professionalism, reflective thinking and resilience was examined. A group of 135 undergraduates (86% female) completed a self-report questionnaire containing the standardized instruments measuring professionalism, resilience and reflective thinking. The Australian Student Practice Evaluation Form-Revised (SPEF-R) measured fieldwork performance. Linear regression analyses identified Staying Healthy and Relationships with Others as significant predictors of students' fieldwork performance in Professional Behaviors, Self-Management and Information Gathering. The findings highlight the importance of interpersonal skills and engagement in healthy lifestyles in key fieldwork performance areas.
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Affiliation(s)
- Ted Brown
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University - Peninsula Campus, Frankston, Victoria, Australia
| | - Mong-Lin Yu
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University - Peninsula Campus, Frankston, Victoria, Australia
| | - Alana Hewitt
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University - Peninsula Campus, Frankston, Victoria, Australia
| | - Robert Cousland
- Student Academic Support Unit, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia
| | - Jamie Etherington
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University - Peninsula Campus, Frankston, Victoria, Australia
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Prashar J, Ranasinghe C, Rao CB. Twelve tips for medical students to enhance clinical skills learning during disrupted placements. MEDICAL TEACHER 2022; 44:596-600. [PMID: 33856946 DOI: 10.1080/0142159x.2021.1910644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Disruption to healthcare settings can present a significant challenge to traditional, face-to-face models of learning in medical education. Reductions in undergraduate medical students' clinical exposure, whether due to periods of increased healthcare demand, localised service changes or infectious disease outbreaks, are likely to result in fewer opportunities to develop key clinical and practical skills. Proficiency in these skills is often essential to progression and future practice, creating a broad incentive for students to develop techniques to maintain and refine their clinical skills during disrupted placements. These tips, based on our experiences as senior medical students, are intended to help students on disrupted placements to engage in reflective practice, discover ways to facilitate further opportunities for clinical skills learning, and to make the most of clinical skills learning opportunities that they do receive.
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Affiliation(s)
- Jai Prashar
- UCL Medical School, University College London, London, UK
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Hejazi MM, Al-Rubaki SS, Bawajeeh OM, Nakshabandi Z, Alsaywid B, Almutairi EM, Lytras MD, Almehdar MH, Abuzenada M, Badawood H. Attitudes and Perceptions of Health Leaders for the Quality Enhancement of Workforce in Saudi Arabia. Healthcare (Basel) 2022; 10:891. [PMID: 35628028 PMCID: PMC9141873 DOI: 10.3390/healthcare10050891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/29/2022] [Accepted: 05/01/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND AND AIM Besides the unique exposure and experience of health leaders in facing challenges and overcoming them, and the relatively fewer articles relating to the perception of health leaders in workforce quality enhancement, health leadership plays a crucial role in redirecting the workforce, increasing job satisfaction, professional development, and burnout prevention. Thus, this study aimed to understand the current healthcare workforce quality and future expectations from the attitudes and perceptions of health leaders. METHODS A qualitative research was carried out using semi-structured interviews consisting of 24 different questions. Participants of the study were healthcare leaders from different backgrounds and governmental institutions. All interviews were recorded, transcribed, and then analyzed using thematic analysis via the N-Vivo program. RESULTS Eleven participants were involved in the study, with one female and ten males. A thematic analysis and N-Vivo program yielded 5 main themes: (1) workforce competency, (2) health transformation, (3) leadership, (4) workforce planning, and (5) healthcare quality, with 22 emerging sub-themes. Moreover, participants responded with different attitudes and perceptions. CONCLUSION Health leaders are satisfied with the current direction of workforce competency and planning, yet fragmentation of the system and poor accessibility may need further enhancement. Furthermore, misutilization of services and the uncertainty of the future and talent pool are potential barriers for capability building. Moreover, with the existing gap in the workforce, health leaders believe that privatization and corporatization may have a positive effect. Aside from that, Saudization with the current plan of having a minimum standard of accepting non-Saudis in certain areas might benefit in maintaining competition and enriching experience. However, catching up with further research in healthcare quality in Saudi Arabia is needed because of the ongoing health transformation.
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Affiliation(s)
- Majid M. Hejazi
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 14611, Saudi Arabia
| | - Shayma S. Al-Rubaki
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Medicine Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia
| | - Othman M. Bawajeeh
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Faculty of Dentistry, King Abdulaziz University, Jeddah 80209, Saudi Arabia
| | - Ziad Nakshabandi
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- National Center for Health Workforce Planning, Riyadh 11614, Saudi Arabia
| | - Basim Alsaywid
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Saudi National Institute of Health Education and Research Skills, Riyadh 12382, Saudi Arabia
| | - Eman M. Almutairi
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Health Academy, Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia
| | - Miltiadis D. Lytras
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Effat College of Engineering, Effat University, Jeddah 21551, Saudi Arabia
| | - Manal H. Almehdar
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Research and Development Center, Saudi Commission for Health Specialties, Jeddah 23343, Saudi Arabia
| | - Maha Abuzenada
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Research and Development Center, Saudi Commission for Health Specialties, Jeddah 23343, Saudi Arabia
| | - Halla Badawood
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Occupational Therapy Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah 14611, Saudi Arabia
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El-Hassan M. Impact of Intercalated Degree on Post-graduate Career Progression and Academic Development in the UK: A Rapid Review of the Literature. Cureus 2022; 14:e24569. [PMID: 35664375 PMCID: PMC9148273 DOI: 10.7759/cureus.24569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 11/16/2022] Open
Abstract
An intercalated degree offers medical students an avenue to explore their interests and become competent in scientific literacy. Although intercalating can pose a financial burden and time commitment, they do provide competitive academic and speciality training applications. The aim of this review was to explore academic development and subsequent outcomes of career progression. Medline and EMBASE were systematically searched using keywords. After the removal of duplicates, the studies were screened against the inclusion criteria. For the five studies included in this review, a narrative synthesis was performed. The two main themes were academic development and career progression. All studies showed a plethora of academic achievements during and after intercalation. Two studies showed that students are more likely to enter a career in academic medicine. A further two studies have shown that the transferable skills of academia have allowed alumni to make more competitive applications for foundation year and speciality training. The results have shown a correlation between academic achievements and an increase in competitiveness in foundation programmes and speciality applications. There are clear discrepancies in the success of academic careers depending on the institution and type of intercalated degree. Current literature suggests a master's degree results in more academic success compared to a bachelor's degree. Due to the sheer diversity of intercalated degrees offered to medical students in the UK, there is limited literature on post-graduate career progression. More research should be undertaken to look at the implications of intercalation on post-graduate career progression.
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Glass G, Tan H, Chan EY. Effect of an evidence-based poster on the knowledge of delirium and its prevention in student nurses: A quasi-experimental study. Contemp Nurse 2022; 57:462-471. [PMID: 35184674 DOI: 10.1080/10376178.2022.2044872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND A major barrier to nurses adopting evidence-based practice (EBP) has been the limited awareness of evidence underpinning clinical practice, often due to poor access and understanding of the literature base. To address this, we piloted the development of educational posters summarizing the evidence base around clinical practices to see if they help nurses better understand the rationale behind their care. Our first poster focused on the evidence supporting the management of delirium in older persons, specifically delirium identification and its prevention. OBJECTIVE To examine the effect of an evidence-based poster education on the delirium knowledge of student nurses. DESIGN A prospective two-armed quasi-experimental study. METHODS 188 student nurses were recruited in December 2017. Participants were alternated to receive either an evidence-based poster education session or a reflective education session as a control. Both groups were assessed on their general knowledge on delirium, knowledge on delirium detection and knowledge on delirium prevention. This was conducted both before exposure to either the intervention or control, and one week after exposure. Unpaired t-tests with 95% confidence intervals (CI) were applied to compare the mean change in pre-test and post-test delirium knowledge. We used the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) checklist to report our methods and findings. RESULTS Students in the poster education group reported greater improvements in mean scores of delirium identification (Mean increase =1.0, p = 0.007, 95% CI: 0.3-1.6), delirium prevention (Mean increase =1.6, p < 0.001, 9% CI: 1.0-2.2) and overall delirium knowledge (Mean increase = 2.7, p < 0.001, 95% CI: 1.5-3.8) than students in the control. CONCLUSION Summarised research evidence within a poster format can increase student nurses' access to the evidence base. This has shown to increase their knowledge to guide their clinical practice. IMPACT STATEMENT Exposure to poster summaries of research evidence underpinning delirium care increases student nurses' clinical knowledge of delirium identification and prevention.
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Affiliation(s)
- George Glass
- Nursing Research Unit, Nursing Service, Tan Tock Seng Hospital, Singapore
| | - Hongyun Tan
- Nursing Service, Tan Tock Seng Hospital, Singapore
| | - Ee-Yuee Chan
- Nursing Research Unit, Nursing Service, Tan Tock Seng Hospital, Singapore.,Alice Lee Centre of Nursing Studies, National University of Singapore, Singapore
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Ziada HM, Ditmyer MM, Abubakr NH. Reflections of psychomotor skill development in preclinical simulation: A qualitative analysis. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2022; 26:157-165. [PMID: 33730391 DOI: 10.1111/eje.12684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 03/12/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Reflection on competency helps students become more proficient in performing skills, with the ultimate goal of better retention of knowledge and skill. Competency progression involves a complex interplay of factors, and not having the insight of such multiple perspectives of the same experience, we will not be able to understand students as learners fully and consequently may rely on assumption and may not be able to provide the necessary interventions for growth and progress towards competency. This study aims to investigate students' insight of their own progression during psychomotor skill development. MATERIALS AND METHODS Data were obtained from scanned reflective dialogue log document portfolios from the preclinical fixed dental prosthodontics section, which is part of a comprehensive dental care course during the second year. Data were coded using NVivo software version 12 plus (QSR International Pty Ltd, Vic, Australia), and subsequent thematic analyses identified emerging themes. RESULTS Three themes emerged and these were (a) challenges to overcome, (b) feed-back and self-appraisal, and (c) progress and growth. The qualitative data generated did not reveal considerable variation in the students' reflections, and the three themes seem to interrelate. CONCLUSIONS The main challenge was the concept of the single path of insertion and the perception that it was a source of frustration during this course. Self-appraisal identified time management issues and the transformation from preconceived or learned concepts. As the semester progressed, students reflected progress and growth.
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Affiliation(s)
- Hassan M Ziada
- Department of Clinical Sciences, University of Nevada, Las Vegas, Nevada, USA
| | - Marcia M Ditmyer
- School of Dental Medicine, University of Nevada, Las Vegas, Nevada, USA
| | - Neamat H Abubakr
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada, Las Vegas, Nevada, USA
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McGough S, Wynaden D, Gower S, Duggan R, Wilson R. There is no health without cultural safety: Why cultural safety matters. Contemp Nurse 2022; 58:33-42. [PMID: 35014602 DOI: 10.1080/10376178.2022.2027254] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The authors would like to pay respect to Aboriginal and Torres Strait Islander Peoples by acknowledging the traditional owners of the lands on which this paper was written, the Wadjuk people of the Nyungar Nation and the Darkinjung people. One author (XX) would like to acknowledge her Wiradjuri ancestry and express respect to her Elders past and present and to Culture and Country.
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Affiliation(s)
- S McGough
- School of Nursing. Curtin University, Perth, Australia
| | - D Wynaden
- School of Nursing. Curtin University, Perth, Australia
| | - S Gower
- School of Nursing. Curtin University, Perth, Australia
| | - R Duggan
- School of Nursing. Curtin University, Perth, Australia
| | - R Wilson
- School of Nursing. Curtin University, Perth, Australia.,School of Nursing and Midwifery. The University of Newcastle, Australia.,School of Nursing. Massey University, New Zealand
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Lewis S, Jones GM, Barach P, Tomos H, Davies M, Eckley B, Dowell HR, Subbe CP. How To Hospital: barriers to developing a patient 'Hospital Survival Guide' to support information transfer during ward-rounds on the patient journey from admission to hospital to discharge. BMJ Open Qual 2022; 11:e001556. [PMID: 34983802 PMCID: PMC8728439 DOI: 10.1136/bmjoq-2021-001556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/23/2021] [Indexed: 11/15/2022] Open
Abstract
Clinicians can enable patients to actively participate in their care but communication with patients is often poor and highly variable. The aim of this study was to explore patients' understanding of their current illness while in hospital and using a codesign process to create prototype tools to facilitate better communication during ward rounds.A mixed-methods, multistep design with step 1: Application of a questionnaire addressing domains of care in the acute medical unit; step 2: Development of communication aids that were codesigned with active help of patients, students and a specialist in user centric design to address patient needs and step 3: Evaluation of tools with patients in four Plan-Do-Study-Act cycles.In the initial survey of 30 patients 12 (40%) patients did not know what their diagnosis was and 5 (17%) did not know the results of recent key tests. 20 (67%) patients felt that staff communication and coordination could be improved.An intervention was prototyped with four variations: (1) An A6 ward-round summary sheet completed by doctors during ward rounds. The system worked well but was highly person dependent. (2) An A4 patient-owned diary ('How to Hospital') that contained information about key processes in hospital and space to document conversations from rounds and prompts for questions. 10 patients read the diary and commented favourably but did not complete any pages. (3) 'Diary-cards': a basic set of information cards was given to patients on admission to hospital. (4) Patient specific 'diary-cards' were completed by clinicians-10 forms were piloted during rounds and improved subsequent day information retention of diagnosis to 80%.Our study identified interventions that were feasible but remained person-dependent. The patients' ownership of information in relation to their care might facilitate retention and satisfaction but the optimal format for these interventions for enhancing communication remains unclear.
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Affiliation(s)
| | | | - Paul Barach
- Pediatrics, Wayne State University, Detroit, Michigan, USA
- Thomas Jefferson University; College of Population Health, Philadelphia, Pennsylvania, USA
| | - Hawys Tomos
- Royal College of Art: School of Design, London, UK
| | - Mari Davies
- Cardiff University; School of Medicine, Cardiff, UK
| | | | | | - Christian Peter Subbe
- Medicine, Ysbyty Gwynedd, Bangor, UK
- Medicine, Bangor University School of Medical Sciences, Bangor, UK
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Abstract
This professional development paper aims to give you some pointers that will help you get the most from your mentorship experience as a mentor or a mentee. We look at how mentoring can support your professional development. A simple definition is that a mentor may share with a mentee (or protege) information about his or her own career path, as well as provide guidance, motivation, emotional support, and role modelling. A mentor may help with exploring careers, setting goals, developing contacts, and identifying resources.
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Affiliation(s)
- David Bryson
- School of Human Sciences, College of Life and Natural Sciences, University of Derby, Derby, UK
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Bijani M, Mohammadi F, Haghani F, Yamani N, Karimi S. Development and psychometric evaluation of a reflection on clinical practice questionnaire for nursing students. BMC Nurs 2021; 20:185. [PMID: 34592987 PMCID: PMC8482662 DOI: 10.1186/s12912-021-00705-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 09/22/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Reflection on clinical practice is the core of education for nursing students. Evaluating reflection on clinical experiences requires a tool which accurately measures reflection skills. The present study aims to develop and test the psychometric properties of a tool for measuring nursing students' reflection on clinical practice. METHODS Based on a mix-method exploratory approach, the study was carried out in two stages: in the first stage (the qualitative phase), the concept of reflection on clinical practice was established. In the second stage (the quantitative phase), the psychometric properties of the developed scale were evaluated. RESULTS Based on the results of the exploratory factor analysis and the verification process, the final version of the scale came to consist of 36 items and 6 dimensions. The dimensions were: professional competence, internal sources of motivation, challenging situational clinical setting, dynamic organizational atmosphere, reflection-based self-management, and dynamic professional growth. Overall, 6 factors accounted for 62.79% of the variances. The factor loadings of the items ranged between 0.62 and 0.94, all of which were significant. The total intraclass correlation (ICC) of the scale was found to be 0.94. Also, evaluation of the reliability of the scale as measured through internal homogeneity yielded a total Cronbach's alpha of 0.90. CONCLUSION The findings show that the developed scale for evaluation of nursing students' reflection on clinical practice possesses satisfactory validity and reliability, and nursing professors can use this instrument to assess students' reflection skills.
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Affiliation(s)
- Mostafa Bijani
- Department of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Fateme Mohammadi
- Chronic Diseases (Home Care) Research Center and Autism Spectrum Disorders Research Center, Department of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fariba Haghani
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nikoo Yamani
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahnaz Karimi
- Department of Medical Education, Medical Education Research Center, Fasa University of Medical Sciences, Fasa, Iran
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Devakumar A, Jay Modh, Saket B, Baumer EPS, De Choudhury M. A Review on Strategies for Data Collection, Reflection, and Communication in Eating Disorder Apps. PROCEEDINGS OF THE SIGCHI CONFERENCE ON HUMAN FACTORS IN COMPUTING SYSTEMS. CHI CONFERENCE 2021; 2021:547. [PMID: 35615054 PMCID: PMC9128313 DOI: 10.1145/3411764.3445670] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Eating disorders (EDs) constitute a mental illness with the highest mortality. Today, mobile health apps provide promising means to ED patients for managing their condition. Apps enable users to monitor their eating habits, thoughts, and feelings, and offer analytic insights for behavior change. However, not only have scholars critiqued the clinical validity of these apps, their underlying design principles are not well understood. Through a review of 34 ED apps, we uncovered 11 different data types ED apps collect, and 9 strategies they employ to support collection and reflection. Drawing upon personal health informatics and visualization frameworks, we found that most apps did not adhere to best practices on what and how data should be collected from and reflected to users, or how data-driven insights should be communicated. Our review offers suggestions for improving the design of ED apps such that they can be useful and meaningful in ED recovery.
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Affiliation(s)
| | - Jay Modh
- Georgia Institute of Technology, Atlanta, GA, USA
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Adebayo O, Omosule B, Muhammed AA, Somiari A, Agiri Jr. U, Worgu G, Ezeme C, Obazenu L, Uyilawa O, Williams A, Ishaya D. Reflective practice and resident doctors. NIGERIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4103/njm.njm_124_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abedi M, Khurram A, Abedi D. RE: learning medical professionalism - the application of appreciative inquiry and social media. MEDICAL EDUCATION ONLINE 2020; 25:1780723. [PMID: 32552569 PMCID: PMC7482767 DOI: 10.1080/10872981.2020.1780723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/03/2020] [Indexed: 06/11/2023]
Abstract
A letter to the editor in response to the article by Hsieh et al. published in this journal, discussing the application of appreciative inquiry and social media on medical professionalism education.
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Affiliation(s)
- Mohsin Abedi
- Faculty of Medical Sciences, Newcastle University, Newcastle-Upon-Tyne, UK
| | - Aqsa Khurram
- Barts and the London School of Medicine and Dentistry, London, UK
| | - Dina Abedi
- Barts and the London School of Medicine and Dentistry, London, UK
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Brice S, Almond H. Health Professional Digital Capabilities Frameworks: A Scoping Review. J Multidiscip Healthc 2020; 13:1375-1390. [PMID: 33173300 PMCID: PMC7646414 DOI: 10.2147/jmdh.s269412] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/09/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The term "digital healthcare professional" alludes to a health professional with the additional digital capabilities such as information and technology. The assumption that attaining technical knowledge and skills to meet the available professional standards in digital healthcare, will engage and empower healthcare users, thus deliver person-centered digital healthcare (PCDHc), is flawed. Identifying where digital healthcare and technologies can genuinely support person-centered care may lead to future discourse and practical suggestions to build person-centered integrated digital healthcare environments. This review examines current digital health and informatics capability frameworks and identifies the opportunity to include additional or alternative principles. METHODS A scoping review was conducted. Literature valuing person-centered digital healthcare requirements, digital health capabilities, and competencies were identified between 2000 and 2019 inclusive, then collated and considered. Using a PRISMA approach for eligibility screening, thirteen articles met the study inclusion criteria. Analysis used a thematic framework approach, which assisted in the data management, abstraction and description, and finally the explanations. RESULTS Analysis indexed fifty-nine (59) capabilities, charted thirteen (n13) categories, mapped four (n4) themes, which were then interpreted as findings. FINDINGS The four themes identified were Change Management; User Application; Data, Information, and Knowledge; and Innovation. The themes recognize the opportunity to align the application of technical skills towards the capabilities required to deliver authentic PCDHc. DISCUSSION Holistic mindsets are imperative in maintaining the objective of PCDHc. The authors propose that debates regarding professional digital capability persist in being "siloed" and "paternalistic" in nature. They also recommend that the transition to authentic PCDHc requires refocusing (rather than rewriting) current capabilities. The realignment of capabilities towards individual healthcare outcomes, rather than professional obligation, can steer the perspective towards a genuine PCDHc system. CONCLUSION This scoping review confirms the assumption that digital skills will empower all healthcare stakeholders is incorrect. This review also draws attention to the need for more research to enable digital healthcare systems and services to be designed to realize complex human behaviors and multiple person-centered care requirements. Now more than ever, it is imperative to align healthcare capabilities with technologies to ensure that the practice of PCDHc is the empowering journey for the healthcare user that theory implies.
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Affiliation(s)
- Sophie Brice
- Department of Nursing and Allied Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Helen Almond
- Department of Nursing and Allied Health, Swinburne University of Technology, Melbourne, VIC, Australia
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Emmamally W, Erlingsson C, Brysiewicz P. Describing healthcare providers' perceptions of relational practice with families in the emergency department: A qualitative study. Curationis 2020; 43:e1-e7. [PMID: 33179946 PMCID: PMC7670033 DOI: 10.4102/curationis.v43i1.2155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/06/2020] [Accepted: 08/19/2020] [Indexed: 11/17/2022] Open
Abstract
Background Emergency departments are regarded as stressful working environments, associated with staff shortages, increased patient numbers and long waiting times. Increased organisational demands for performance can compromise genuine interactions between families and healthcare providers working in emergency departments. A relational practice approach in caring for families can enhance the capability of healthcare providers to simultaneously overcome these difficulties and provide emergency healthcare of high quality. Objectives The purpose of the study was to describe healthcare providers’ perceptions of relational practice with families in three emergency departments in KwaZulu-Natal, South Africa. Method Using a qualitative descriptive approach data were collected through semi-structured interviews with healthcare providers working in emergency departments. The data were analysed and categorised using qualitative content analysis. Results Four categories emerged from data analysis: (1) families and healthcare providers connecting; (2) recognising the uniqueness of families; (3) caring interactions; and (4) taking charge when necessary. Conclusion The study elicited that healthcare providers working in emergency departments perceived that despite high patient volumes and resource constraints, collaborative relationships with families were important. However, these collaborative relationships cannot be willed into practice, instead training workshops are needed to develop relational skills of healthcare providers which can facilitate family and healthcare professional collaboration.
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Affiliation(s)
- Waheedha Emmamally
- Discipline of Nursing, College of health Sciences, University of KwaZulu-Natal, Durban.
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Hobbs G, Tully MP. Realist evaluation of public engagement and involvement in data-intensive health research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:37. [PMID: 32612850 PMCID: PMC7325137 DOI: 10.1186/s40900-020-00215-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND High quality public engagement and involvement (PEI) in data-intensive health research is seen as one way of ensuring that social legitimacy, i.e. a social license, is conferred through public acceptance of the need for research use of their data. This is a complex research area, and portfolios of involvement have been suggested, but not yet evaluated, to support the role of public contributors. The study aim was to evaluate if and how membership of a data-intensive research public forum can act as a mechanism for enhancing members' personal development. Our objective was to understand the circumstances and mechanisms that help to explain how, why and for whom involvement with a public forum enhanced those members' personal development. METHOD Qualitative data were collected from 15 current and previous members, via semi-structured interviews, notes from meetings, and consultations with and feedback from members. Data were critically compared, contrasted and reviewed until no new themes could be discerned and then condensed into context-mechanism-outcome (CMO) configurations. Realist evaluation was used to generate a theoretical and empirical appreciation of the contextual circumstances and mechanisms which help to explain the extent to which involvement with a public forum would enhance members' personal development and, if so, how, why, and for whom. RESULTS Three CMO configurations were identified. All of them showed that using the portfolio facilitated growth in forum members' personal development, but only where the members valued using the portfolio. This was particularly so for female members. Members valued the portfolio in one or more of three ways: as a tool to record and evidence activities, to facilitate reflective practice or as a guiding framework. CONCLUSIONS Data analysis and consideration of the three CMO configurations suggests a refined middle range theory that 'The use of a portfolio as a framework for learning in a public forum will facilitate members' personal development if they value its use as a framework for learning'. Further work is needed to confirm these findings both elsewhere in data-intensive health research and in other complex research areas using public forums for PEI. PLAIN ENGLISH SUMMARY Public engagement and involvement in health research is now well established and makes a valuable contribution to the research process. However, little is known about its impact on participants. This article investigates how involvement in a data-intensive health research public forum impacts on public forum members, rather than the research process. Personal involvement portfolios were used to support their involvement work and help evaluate if and how involvement in research activities enhanced members' personal development. Taking a realist evaluation approach, 'Context-Mechanism-Outcome' configurations were used to explore how membership of a public forum might enhance public forum members' personal development. The Context-Mechanism-Outcome configuration refers to an exploration of what influences the extent to which an intervention is successful or unsuccessful in producing positive outcomes and tries to identify the reasons why it is successful for some and unsuccessful for others. However, evidence from this realist evaluation recommends that engagement and involvement should always be underpinned by procedures which ensure that public contributors receive ongoing and tailored guidance and support throughout the process.
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Affiliation(s)
- Georgina Hobbs
- Evidence and Research Manager, Manchester Health and Care Commissioning, Parkway 3, Princess Rd, Manchester, M14-7LU UK
| | - Mary P. Tully
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Kidd S, Christiansen K, Coumar A, Williams J, Ito K, Petersen A, Niculescu R, Eisenberg S, Schwab D, Wojnar DM, Jablonski A, Shannon Dorcy K. A Dedicated Education Unit and a Novel Resident Nurse Transition-to-Practice Program in an Ambulatory Oncology Setting. Semin Oncol Nurs 2020; 36:151027. [PMID: 32418765 DOI: 10.1016/j.soncn.2020.151027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To summarize an innovative initiative in oncology nurse workforce development that addresses critical current and future gaps and encompasses use of dedicated education units for student nurse rotation and a transition-to-practice residency program. DATA SOURCES Review of institutional data including original pilot analysis and ongoing programmatic metrics (N=8 years), consensus, professional guidelines, and published literature. CONCLUSION The dedicated education unit serves as a conduit for recruitment into institutional oncology nurse residency positions, and retention rates in the residency program continue to exceed national averages. Subsequent mentoring of these nurses in transition to practice has manifested high rates of promotion into nurse leadership roles year over year. IMPLICATIONS FOR NURSING PRACTICE Oncology nurse practice incorporates state-of-the-science approved therapies, early phase clinical trial implementation, and evidence-based complex oncology patient care management. A new model of student clinical nurse rotations in ambulatory settings, nurse resident transition to practice, and ongoing leadership mentoring is essential in creating a sustainable, highly skilled, and robust oncology nurse work force.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Kathleen Shannon Dorcy
- Seattle Cancer Care Alliance, Seattle, WA; Fred Hutchinson Cancer Research Center, Seattle WA.
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Choperena A, Pardavila-Belio MI, Errasti-Ibarrondo B, Oroviogoicoechea C, Zaragoza-Salcedo A, Goñi-Viguria R, Martín-Pérez S, Llàcer T, La Rosa-Salas V. Implementation and evaluation of a training programme to promote the development of professional competences in nursing: A pilot study. NURSE EDUCATION TODAY 2020; 87:104360. [PMID: 32135456 DOI: 10.1016/j.nedt.2020.104360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 12/09/2019] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Clinical narratives may be used as a means to improve the acquisition of clinical competences. Even though there are studies that recognize the potential value of clinical narratives to promote nursing professional development, there is no evidence that shows their value as a tool to improve nurses' competences to provide person-centred nursing care. PURPOSE To evaluate the preliminary efficacy of narratives for the development of three nursing professional competences -respect, intentional presence and knowing the person- for providing person-centred care. METHOD Using a pre-post quasi-experimental design, a pilot study with a total of 34 nurses enrolled in a training course of nursing specialization was conducted between September 2016 and June 2017. All the nurses received a multi-component intervention based on the Critical Reflective Inquiry model. The strategies of this programme consisted of writing three narratives, attending two masterclasses, participating in a discussion group, and participating in a face-to-face interview. The NarratUN Evaluation tool was used to assess the outcomes. Changes among nurses were analysed using the Wilcoxon signed Rank test. RESULTS The difference in the means between the pre- and post-intervention scores were statistically significant for respect [0.59 (95% CI 0.23-0.95; p = 0.001)], intentional presence [0.75 (95% CI 0.32-1.17; p < 0.0001)] and knowing the person [0.62 (95% CI 0.25-0.99; p = 0.001)]. The difference in the mean score for use of the narrative and reflection also increased significantly [0.65 (95% CI 0.32-0.98, p < 0.001)]. CONCLUSIONS The use of narratives combined with other reflective strategies (masterclass sessions and discussion groups) proved to be effective for the development of professional competences of nurses.
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Affiliation(s)
- Ana Choperena
- Faculty of Nursing, University of Navarra, Calle Irunlarrea, 1, 31008 Pamplona, Spain; IdisNA, Navarra Institute for Health Research, Spain.
| | - Miren Idoia Pardavila-Belio
- Faculty of Nursing, University of Navarra, Calle Irunlarrea, 1, 31008 Pamplona, Spain; IdisNA, Navarra Institute for Health Research, Spain.
| | - Begoña Errasti-Ibarrondo
- Faculty of Nursing, University of Navarra, Calle Irunlarrea, 1, 31008 Pamplona, Spain; IdisNA, Navarra Institute for Health Research, Spain.
| | | | - Amparo Zaragoza-Salcedo
- Faculty of Nursing, University of Navarra, Calle Irunlarrea, 1, 31008 Pamplona, Spain; IdisNA, Navarra Institute for Health Research, Spain.
| | | | | | - Teresa Llàcer
- Clínica Universidad de Navarra, Avda. Pío XII, 36, 31008 Pamplona, Spain.
| | - Virginia La Rosa-Salas
- Faculty of Nursing, University of Navarra, Calle Irunlarrea, 1, 31008 Pamplona, Spain; IdisNA, Navarra Institute for Health Research, Spain.
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Continuing Professional Development. J Med Radiat Sci 2020; 67:94-96. [PMID: 32153139 PMCID: PMC7063256 DOI: 10.1002/jmrs.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lehmkuhl L, Egerod I, Overgaard D, Bestle MH, Jensen JF. Stimulated by insight: Exploration of critical care nurses' experience of research participation in a recovery programme for intensive care survivors. J Clin Nurs 2020; 29:1312-1322. [PMID: 31971298 DOI: 10.1111/jocn.15193] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/23/2019] [Accepted: 01/10/2020] [Indexed: 01/17/2023]
Abstract
AIMS AND OBJECTIVES To explore critical care nurses' experiences of research participation during a one-year recovery programme for intensive care survivors. BACKGROUND Nurse-led postintensive care follow-up consultations have emerged to help patients to recover and overcome problems related to critical illness and admission at the intensive care unit (ICU). Previous research exploring post-ICU follow-up programmes have shown inconclusive evidence of their effectiveness on patient-reported outcome measurements, and provider evaluation is scarce. The context of this study is the Recovery and Aftercare in Postintensive care Therapy (RAPIT) trial. DESIGN A qualitative descriptive telephone interview study. METHODS Data were collected after completion of the RAPIT trial. Participants (n = 14) were trained intensive care nurses, who delivered the post-ICU recovery programme, representing nine out of ten sites from the RAPIT trial. Two focus group discussions were used to construct a semistructured interview guide. A thematic data analysis was performed using Braun and Clark's six-step method. This study conforms to the COREQ Research Reporting Guidelines for qualitative studies. RESULTS Our study indicated that nurses considered participation in research as a positive experience. The main finding "Stimulated by insight" described how nurses' engagement and professional growth was gained by reflection, patient feedback and research competencies acquired in the clinical setting. The research programmes stimulated to new knowledge, broaden their perspectives and enhanced critical reflection of ICU nursing practice. CONCLUSIONS The study indicates that nurses developed research competencies and enhanced their job satisfaction by using critical reflection and patient feedback. However, there is still a substantial need for support to strengthen nurses' competencies in collaboration with colleagues, managers and researchers. RELEVANCE TO CLINICAL PRACTICE This study can contribute to the development of recommendations supporting nurses doing research and to optimise implementation of clinical research.
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Affiliation(s)
- Lene Lehmkuhl
- Department of Anesthesiology and Intensive Care Medicine, OUH Svendborg Hospital, Svendborg, Denmark
| | - Ingrid Egerod
- Intensive Care Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Dorthe Overgaard
- Department of Nursing, University College Copenhagen, Copenhagen, Denmark
| | - Morten H Bestle
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Anesthesiology, Nordsjaellands Hospital, University of Copenhagen, Hillerød, Denmark
| | - Janet F Jensen
- Department of Anesthesiology, Nordsjaellands Hospital, University of Copenhagen, Hillerød, Denmark.,Department of Anesthesiology, Holbaek Hospital, Holbaek, Denmark
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