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Al Jabri F, Kvist T, Turunen H. Core competencies of healthcare professionals in Oman: Research and evidence-based practice needs attention. Nurs Open 2023; 10:2053-2065. [PMID: 36323624 PMCID: PMC10006615 DOI: 10.1002/nop2.1453] [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: 06/30/2021] [Revised: 05/14/2022] [Accepted: 10/11/2022] [Indexed: 11/05/2022] Open
Abstract
AIM The aim of the study was to examine (1) the perceptions on core competencies of healthcare professionals working at clinical settings in Oman and (2) which demographic characteristics explain the overall core competency. DESIGN A cross-sectional design. METHODS Healthcare Professional Core Competency Instrument, consisting of 11 sub-scales with 81 items, was distributed to healthcare professionals (n = 1,543; 826 nurses and 717 physicians) who worked at primary, secondary and tertiary healthcare institutions. Descriptive statistics, t-test, ANOVA and linear regression were used for data analysis. RESULTS Altogether 1,078 healthcare professionals (628 nurses and 450 physicians) responded representing 70% overall response rate. Healthcare professionals perceived their overall core competence as excellent, safety being the highest, and research and evidence-based practice was the lowest. The multiple linear regression analysis revealed that ethnicity, gender and years of working experience were the characters that explained the overall core competence, where expatriate senior professionals reported higher competency levels compared with counterparts.
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Affiliation(s)
- Fatma Al Jabri
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Tarja Kvist
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Hannele Turunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Fernandez-Guzman D, Caira-Chuquineyra B, Baca-Rondan F, Yucra-Sosa MC, Ccami-Bernal F, Soriano-Moreno DR, Nieto-Gutierrez W, Benites-Zapata VA. Association between self-reported evidence-based medicine competencies and prescribing of drugs without scientific evidence against mild COVID-19 among recently graduated physicians in Peru. Heliyon 2023; 9:e15366. [PMID: 37064449 PMCID: PMC10082469 DOI: 10.1016/j.heliyon.2023.e15366] [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: 10/24/2022] [Revised: 03/20/2023] [Accepted: 04/04/2023] [Indexed: 04/18/2023] Open
Abstract
Objective To evaluate the association between self-rated evidence-based medicine (EBM) competencies and the prescription of drugs without scientific evidence against mild COVID-19 (present with any of the signs and symptoms of COVID-19 but who do not have shortness of breath, dyspnea, or abnormal chest imaging) among recently graduated physicians in Peru. Methods We conducted an analytical cross-sectional study where we evaluated a non-probability sample of recently graduated physicians during June and July 2021 (end of second wave of COVID-19 in Peru). Self-rated EBM competencies were assessed by four domains (formulation of a clinical question, search, analysis, and application) using a Likert scale with scores from zero to four ("Very inadequate" = 0, to "Very Adequate" = 4), it was considered as "Adequate" if the score was three or four. In addition, the variable "General competence on EBM" was rated as "Adequate" if in all domains evaluated it presented an adequate self-rating. For the outcome, drug prescription, we considered the use of ivermectin, azithromycin, other antibiotics, hydroxychloroquine, dexamethasone, and anticoagulants (drugs with no efficacy demonstrated for patients with mild COVID-19). To assess the association, we used Poisson regression models with robust variances and obtaining crude (cPR) and adjusted (aPR) prevalence ratios with their 95% confidence intervals (95%CI). Results Of a total of 239 physicians included 70.7% prescribed at least one drug without scientific evidence. A total of 51.1% reported adequate ratings in all evaluated domains of EBM. Self-rating the "Clinical Question Formulation" competency as adequate was associated with a lower frequency of prescribing medications for mild COVID-19 (aPR: 0.93; 95% CI: 0.91-0.95). While self-rating as adequate the competency of "Identify possible implications of investigations" was associated with an increase in the prescription of such drugs (aPR: 1.14; 95% CI: 1.09-1.20). Additionally, self-rating all domains as adequate were associated with less prescription (aPR: 0.93; 95% CI: 0.90-0.96). Conclusion Seven out of ten recently graduated physicians prescribed some type of medication without scientific evidence to treat patients with mild COVID-19. Having adequate self-perceived EBM competencies was associated with a lower frequency of prescribing medications without scientific evidence to manage patients with mild COVID-19.
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Affiliation(s)
| | | | - Fiorella Baca-Rondan
- Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Peru
| | - Maria Cristina Yucra-Sosa
- Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Peru
| | - Fabricio Ccami-Bernal
- Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Arequipa, Peru
| | - David R Soriano-Moreno
- Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima, Peru
| | | | - Vicente A Benites-Zapata
- Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
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Halm MA. An objective test to measure evidence-based practice knowledge and skill competency of acute care nurses: A psychometric validation study. Worldviews Evid Based Nurs 2023. [PMID: 36916411 DOI: 10.1111/wvn.12639] [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: 07/21/2022] [Revised: 11/17/2022] [Accepted: 02/12/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Few objective measures of evidence-based practice (EBP) knowledge/skill exist. The Fresno Test, one objective method, was validated first with medicine, followed by versions for physical therapists, occupational therapists, speech therapists, social workers, dietitians, pediatric nurses, and health care students. The Fresno Test was adapted and tested with cohorts of acute care nurses. Six of the 14 items required revision to achieve acceptable psychometrics. AIM The aim of this second validation study was to revise and validate a new version of the test, The Modified Fresno Test-Acute Care Nursing (MFT-ACN), to determine if it could distinguish EBP knowledge/skills among acute care nurses. METHODS A panel of eight EBP experts were engaged in multiple Delphi rounds to revise items. Individual-content validity indices (CVI) ranged from 0.83 to 1.0, with scale-CVI 0.92. Using a cohort design, a cross-sectional sample of 90 novice, master, and expert nurses were recruited via national listservs or snowball sampling to complete the revised test. Two doctorally prepared EBP experts independently scored tests using the standardized rubric. RESULTS The MFT-ACN yielded strong psychometric properties (intra-class correlation coefficients > 0.80; item discrimination indices > 0.20; item-total correlations > 0.30). One poorly performing item was dropped per a priori cut-off values. The final test included 13 items, with a Cronbach's alpha = 0.77. Item difficulty was moderate to high. Most items discriminated well between cohorts. Mean total scores were positively correlated with age, years since graduation, years of acute care experience, and formal EBP or research workshops or conferences or courses or immersions. Perceived level of EBP expertise was not associated with mean scores. Further research is recommended with a larger sample to assess the tests' responsiveness to change in EBP knowledge/skills over time and enhance its acceptability and feasibility. Additional research should further evaluate construct and concurrent validity against other objective assessments of EBP knowledge/skills. LINKING EVIDENCE TO ACTION The validated 13-item MFT-ACN can be used to evaluate EBP competencies of acute care nurses in academic and practice settings. It can also be used by nurse scientists to build a stronger evidence base on types of educational programs that excel in advancing the critical competency of EBP among our nursing workforce.
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Affiliation(s)
- Margo A Halm
- Nursing Research & Evidence-Based Practice, VA Portland Health Care System, Portland, Oregon, USA
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Bernabeu-Wittel M, Para O, Voicehovska J, Gómez-Huelgas R, Václavík J, Battegay E, Holecki M, van Munster BC. Competences of internal medicine specialists for the management of patients with multimorbidity. EFIM multimorbidity working group position paper. Eur J Intern Med 2023; 109:97-106. [PMID: 36653235 DOI: 10.1016/j.ejim.2023.01.011] [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] [Received: 12/04/2022] [Accepted: 01/10/2023] [Indexed: 01/19/2023]
Abstract
Patients with multimorbidity increasingly impact healthcare systems, both in primary care and in hospitals. This is particularly true in Internal Medicine. This population associates with higher mortality rates, polypharmacy, hospital readmissions, post-discharge syndrome, anxiety, depression, accelerated age-related functional decline, and development of geriatric syndromes, amongst others. Internists and Hospitalists, in one of their roles as Generalists, are increasingly asked to attend to these patients, both in their own Departments as well as in surgical areas. The management of polypathology and multimorbidity, however, is often complex, and requires specific clinical skills and corresponding experience. In addition, patients' needs, health-care environment, and routines have changed, so emerging and re-emerging specific competences and approaches are required to offer the best coordinated, continuous, and comprehensive integrated care to these populations, to achieve optimal health outcomes and satisfaction of patients, their relatives, and staff. This position paper proposes a set of emerging and re-emerging competences for internal medicine specialists, which are needed to optimally address multimorbidity now and in the future.
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Affiliation(s)
- M Bernabeu-Wittel
- Department of Medicine, Internal Medicine Department. Hospital Universitario Virgen del Rocío, University of Sevilla, Spain
| | - O Para
- Azienda Ospedaliero Universitaria Careggi, Firenze, Italy
| | - J Voicehovska
- Internal Diseases Department, Nephrology and Renal replacement therapy clinics, Riga Stradins University, Riga East University hospital, Riga, Latvia
| | - R Gómez-Huelgas
- Internal Medicine Department. Department of Medicine, Hospital Universitario Regional de Málaga, University of Málaga, Spain
| | - J Václavík
- Department of Internal Medicine and Cardiology, University Hospital Ostrava and Ostrava University Faculty of Medicine, Ostrava, Czech Republic
| | - E Battegay
- International Center for Multimorbidity and Complexity (ICMC), University of Zurich, Zurich, University Hospital Basel (Department of Psychosomatic Medicine) and Merian Iselin Klinik Basel. Switzerland
| | - M Holecki
- Department of Internal, Autoimmune and Metabolic Diseases. Medical University of Silesia, Katowice. Poland
| | - B C van Munster
- Department of Geriatric Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Molfenter T, Kim H, Kim JS, Kisicki A, Knudsen HK, Horst J, Brown R, Madden LM, Toy A, Haram E, Jacobson N. Enhancing Use of Medications for Opioid Use Disorder Through External Coaching. Psychiatr Serv 2023; 74:265-271. [PMID: 36196533 PMCID: PMC10836327 DOI: 10.1176/appi.ps.202100675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This randomized controlled trial tested whether external coaching influences addiction treatment providers' utilization of medications to treat opioid use disorder (MOUDs). METHODS This study recruited 75 unique clinical sites in Florida, Ohio, and Wisconsin, including 61 sites in specialty treatment agencies and 14 behavioral health sites within health systems. The trial used external coaching to increase use of MOUDs in the context of a learning collaborative and compared it with no coaching and no learning collaborative (control condition). Outcome measures of MOUD capacity and utilization were monthly tabulations of licensed buprenorphine slots (i.e., the number of patients who could be treated based on the buprenorphine waiver limits of the site's providers), buprenorphine use, and injectable naltrexone administration. RESULTS The coaching and control arms showed no significant difference at baseline. Although buprenorphine slots increased in both arms during the 30-month trial, growth increased twice as fast at the coaching sites, compared with the control sites (average monthly rate of 6.1% vs. 3.0%, respectively, p<0.001). Buprenorphine use showed a similar pattern; the monthly growth rate in the coaching arm was more than twice the rate in the control arm (5.3% vs. 2.4%, p<0.001). Coaching did not have an impact on injectable naltrexone, which grew less than 1% in both arms over the trial period. CONCLUSIONS External coaching can increase organizational capacity for and growth of buprenorphine use. Future research should explore the dimensions of coaching practice, dose, and delivery modality to better understand and enhance the coaching function.
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Affiliation(s)
- Todd Molfenter
- (Molfenter, Kisicki, Horst, Toy), Department of Educational Psychology (H. Kim, J.-S. Kim), Department of Family Medicine and Community Health (Brown), Institute for Clinical and Translational Research and School of Nursing (Jacobson), University of Wisconsin-Madison, Madison; Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, Lexington (Knudsen); APT Foundation and Department of Internal Medicine, Yale University, New Haven, Connecticut (Madden); Haram Consulting, Bowdoinham, Maine (Haram)
| | - Hanna Kim
- (Molfenter, Kisicki, Horst, Toy), Department of Educational Psychology (H. Kim, J.-S. Kim), Department of Family Medicine and Community Health (Brown), Institute for Clinical and Translational Research and School of Nursing (Jacobson), University of Wisconsin-Madison, Madison; Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, Lexington (Knudsen); APT Foundation and Department of Internal Medicine, Yale University, New Haven, Connecticut (Madden); Haram Consulting, Bowdoinham, Maine (Haram)
| | - Jee-Seon Kim
- (Molfenter, Kisicki, Horst, Toy), Department of Educational Psychology (H. Kim, J.-S. Kim), Department of Family Medicine and Community Health (Brown), Institute for Clinical and Translational Research and School of Nursing (Jacobson), University of Wisconsin-Madison, Madison; Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, Lexington (Knudsen); APT Foundation and Department of Internal Medicine, Yale University, New Haven, Connecticut (Madden); Haram Consulting, Bowdoinham, Maine (Haram)
| | - Abby Kisicki
- (Molfenter, Kisicki, Horst, Toy), Department of Educational Psychology (H. Kim, J.-S. Kim), Department of Family Medicine and Community Health (Brown), Institute for Clinical and Translational Research and School of Nursing (Jacobson), University of Wisconsin-Madison, Madison; Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, Lexington (Knudsen); APT Foundation and Department of Internal Medicine, Yale University, New Haven, Connecticut (Madden); Haram Consulting, Bowdoinham, Maine (Haram)
| | - Hannah K Knudsen
- (Molfenter, Kisicki, Horst, Toy), Department of Educational Psychology (H. Kim, J.-S. Kim), Department of Family Medicine and Community Health (Brown), Institute for Clinical and Translational Research and School of Nursing (Jacobson), University of Wisconsin-Madison, Madison; Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, Lexington (Knudsen); APT Foundation and Department of Internal Medicine, Yale University, New Haven, Connecticut (Madden); Haram Consulting, Bowdoinham, Maine (Haram)
| | - Julie Horst
- (Molfenter, Kisicki, Horst, Toy), Department of Educational Psychology (H. Kim, J.-S. Kim), Department of Family Medicine and Community Health (Brown), Institute for Clinical and Translational Research and School of Nursing (Jacobson), University of Wisconsin-Madison, Madison; Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, Lexington (Knudsen); APT Foundation and Department of Internal Medicine, Yale University, New Haven, Connecticut (Madden); Haram Consulting, Bowdoinham, Maine (Haram)
| | - Randy Brown
- (Molfenter, Kisicki, Horst, Toy), Department of Educational Psychology (H. Kim, J.-S. Kim), Department of Family Medicine and Community Health (Brown), Institute for Clinical and Translational Research and School of Nursing (Jacobson), University of Wisconsin-Madison, Madison; Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, Lexington (Knudsen); APT Foundation and Department of Internal Medicine, Yale University, New Haven, Connecticut (Madden); Haram Consulting, Bowdoinham, Maine (Haram)
| | - Lynn M Madden
- (Molfenter, Kisicki, Horst, Toy), Department of Educational Psychology (H. Kim, J.-S. Kim), Department of Family Medicine and Community Health (Brown), Institute for Clinical and Translational Research and School of Nursing (Jacobson), University of Wisconsin-Madison, Madison; Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, Lexington (Knudsen); APT Foundation and Department of Internal Medicine, Yale University, New Haven, Connecticut (Madden); Haram Consulting, Bowdoinham, Maine (Haram)
| | - Alex Toy
- (Molfenter, Kisicki, Horst, Toy), Department of Educational Psychology (H. Kim, J.-S. Kim), Department of Family Medicine and Community Health (Brown), Institute for Clinical and Translational Research and School of Nursing (Jacobson), University of Wisconsin-Madison, Madison; Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, Lexington (Knudsen); APT Foundation and Department of Internal Medicine, Yale University, New Haven, Connecticut (Madden); Haram Consulting, Bowdoinham, Maine (Haram)
| | - Eric Haram
- (Molfenter, Kisicki, Horst, Toy), Department of Educational Psychology (H. Kim, J.-S. Kim), Department of Family Medicine and Community Health (Brown), Institute for Clinical and Translational Research and School of Nursing (Jacobson), University of Wisconsin-Madison, Madison; Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, Lexington (Knudsen); APT Foundation and Department of Internal Medicine, Yale University, New Haven, Connecticut (Madden); Haram Consulting, Bowdoinham, Maine (Haram)
| | - Nora Jacobson
- (Molfenter, Kisicki, Horst, Toy), Department of Educational Psychology (H. Kim, J.-S. Kim), Department of Family Medicine and Community Health (Brown), Institute for Clinical and Translational Research and School of Nursing (Jacobson), University of Wisconsin-Madison, Madison; Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, Lexington (Knudsen); APT Foundation and Department of Internal Medicine, Yale University, New Haven, Connecticut (Madden); Haram Consulting, Bowdoinham, Maine (Haram)
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Thomes CR, Gonçalves Peres CV, Totolla MA, Barros LAPD, Rosetti EP, Costa LOP, Butini Oliveira L, Reis FJJD, Sanglard LF. Lack of evidence-based practice discipline in the curriculums of the Brazilian undergraduate dentistry programs. J Evid Based Med 2023; 16:10-12. [PMID: 36670335 DOI: 10.1111/jebm.12513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 01/04/2023] [Indexed: 01/22/2023]
Affiliation(s)
| | | | | | | | | | | | | | - Felipe José Jandre Dos Reis
- Instituto Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Pain in Motion Research Group, Faculty of Physical Education & Physiotherapy, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Luciana Faria Sanglard
- Department of Clinical Dentistry, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
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Briones Rojas C, León Godoy A, Osorio Viarengo N, Oyarzún Díaz P. Creencias y actitud hacia la Práctica Basada en la Evidencia de fonoaudiólogos latinoamericanos dedicados exclusivamente a la práctica clínica y educativa. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2023. [DOI: 10.5209/rlog.81165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
La Práctica Clínica Basada en la Evidencia (PBE) sugiere al fonoaudiólogo/a la incorporación de acciones orientadas a dar respuesta a las necesidades de los usuarios en contextos específicos. Dichas acciones incluyen planteamiento de interrogantes, revisión crítica de evidencia disponible y toma de decisiones integrando la experiencia clínica, la evidencia y las preferencias del usuario. Si bien este paradigma se ha posicionado en la disciplina en la última década, resulta compleja su implementación para los profesionales que se encuentran completamente dedicados a la práctica clínica y/o educativa. El objetivo de este estudio es analizar las creencias y actitud hacia la PBE de fonoaudiólogos/as dedicados a labores clínicas y/o educativas a tiempo completo en diferentes países de Latinoamérica. Se trata de un estudio cualitativo, fenomenológico. Se realizaron entrevistas semiestructuradas a fonoaudiólogos/as residentes en Argentina, Paraguay, Chile, Perú, Colombia, Uruguay y Costa Rica. Para los análisis de resultados se contó con entrevistas a 9 profesionales. La mayoría de los encuestados considera que la PBE se limita a las publicaciones científicas y que se dificulta la implementación en su contexto laboral, principalmente por la falta de tiempo asociada a la revisión de literatura científica actualizada. Como conclusión cabe indicarse que existe una creencia errada en términos conceptuales sobre el significado de la PBE, generando actitudes ambiguas hacia dicho paradigma. En Latinoamérica se hace necesaria la reflexión respecto a la formación de fonoaudiólogos/as para que desde el pregrado puedan manejar mayores recursos para la toma de decisiones en la evaluación e intervención; y así disminuir la brecha entre los investigadores y quienes se dedican eminentemente a la práctica clínica.
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Al-Ismail MS, Naseralallah LM, Hussain TA, Stewart D, Alkhiyami D, Abu Rasheed HM, Daud A, Pallivalapila A, Nazar Z. Learning needs assessments in continuing professional development: A scoping review. MEDICAL TEACHER 2023; 45:203-211. [PMID: 36179760 DOI: 10.1080/0142159x.2022.2126756] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND A rigorous learning needs assessment (LNA) is a crucial initial step in the Continuing Professional Development (CPD) process. This scoping review aimed to collate, summarize, and categorize the reported LNA approaches adopted to inform healthcare professional CPD and highlight the gaps for further research. METHOD In August 2020, nine bibliographic databases were searched for studies conducted with any health professional grouping, reporting the utilized LNA to inform CPD activities. Two reviewers independently screened the articles for eligibility and charted the data. A descriptive analytical approach was employed to collate, summarize, and categorize the literature. RESULTS 151 studies were included in the review; the majority adopted quantitative methods in the form of self-assessment surveys. Mixed-methods approaches were reported in only 35 studies. Descriptions of LNA development lacked detail of measures taken to enhance their rigor or robustness. DISCUSSION These findings do not reflect recommendations offered by the CPD literature. Further investigations are required to evaluate more recently advocated LNA approaches and add to their limited evidence-base. Similarly, the existing support afforded to CPD developers warrants further study in order to identify the necessary resource, infrastructure and expertise essential to design and deliver effective CPD programs.
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Affiliation(s)
- Muna Said Al-Ismail
- Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Lina Mohammad Naseralallah
- Department of Pharmacy, Hamad Medical Corporation, Doha, Qatar
- School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Tarteel Ali Hussain
- Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Derek Stewart
- Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Dania Alkhiyami
- Department of Pharmacy, Hamad Medical Corporation, Doha, Qatar
| | | | - Alaa Daud
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | | | - Zachariah Nazar
- Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
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Rodriguez D, Martinez-Alvarado JD, Garcia-Toto R, Genel-Rey TI. Teaching evidence-based medicine in Mexico: a systematic review of medical doctor curriculums at a national level. BMJ Evid Based Med 2023; 28:30-39. [PMID: 35688607 DOI: 10.1136/bmjebm-2021-111910] [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] [Accepted: 05/12/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To assess the teaching of evidence-based medicine (EBM) in medical curriculums. As a secondary objective, we assessed the representativeness of science courses related to EBM. DESIGN AND SETTING Systematic review. Accredited curriculums by the Mexican Council for the Accreditation of Medical Education. MAIN OUTCOME MEASURES We provided a descriptive analysis of the required or elective EBM courses and EBM-related courses, academic credits and teaching period. EBM-related courses included research methodology, epidemiology, biostatistics, clinical research, public health, clinical epidemiology, scientific dissemination and health informatics to explore scientific education and training offered by medical schools. Additionally, we examined the curriculum's structure, location, type of institution, total programme duration and academic credits. Data collection occurred from December 2020 to February 2021. RESULTS We identified 171 registered curriculums, of which we assessed 60 unique programmes (50% public) in our analysis. We identified 16 EBM single courses on the fifth and sixth semesters, of which 12 (20%) were mandatory and 4 were electives (6.7%). The allocated academic credits for EBM courses are minimal, without difference between public or private institutions, representing 0.08% of the total curriculum. Public health, epidemiology, research methodology and biostatistics courses are offered with greater frequency (55% or less) and curricular value (0.6% or less). In some cases, they are taught as combined courses. Clinical research, health informatics and clinical epidemiology are taught less than EBM, while scientific dissemination is nil. CONCLUSION In Mexico, EBM teaching is limited to only one of five curriculums with minimal curricular value. A comprehensive curricular review is necessary across programmes to incorporate EBM as a first step to improve medical education and, consequently, public health. We call to action through an online, collaborative platform with several applications to optimise teaching of EBM. REVIEW PROTOCOL REGISTRATION The systematic review protocol is excluded from the International Prospective Register of Systematic Reviews since this platform only accepts systematic reviews with health-related outcomes. Review protocol registration: https://osf.io/3xm2q/.
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Affiliation(s)
- David Rodriguez
- Teaching Evidence-Based Medicine Mexico (TEBMx), Cuernavaca, Mexico
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Van Remoortel H, De Buck E, Seifried E, Vandekerckhove P. Evidence-Based Medicine: Principles and Values as Illustrated by the Case of Patient Blood Management. Hamostaseologie 2023; 43:16-21. [PMID: 36807816 DOI: 10.1055/a-1985-7660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Evidence-based medicine is considered 1 of the 15 great inventions in medicine. It aims to remove bias in medical decision-making as much as possible through a rigorous process. In this article, the principles of evidence-based medicine are illustrated using the case of patient blood management (PBM). Acute or chronic bleeding, iron deficiency, and renal and oncological diseases may lead to preoperative anemia. To compensate for severe and life-threatening blood loss during surgery, doctors transfuse red blood cells (RBCs). PBM is an approach to take care of patients at risk for anemia, which includes detecting and treating anemia before surgery. Alternative interventions to treat preoperative anemia are the use of iron supplementation with or without erythro-stimulating agents (ESAs). The best available scientific evidence today indicates that preoperative intravenous (IV) or oral iron monotherapy may not be effective to reduce RBC utilization (low-certainty evidence). Preoperative IV iron supplementation in addition to ESAs is probably effective to reduce RBC utilization (moderate-certainty evidence), whereas oral iron supplementation in addition to ESAs may be effective to reduce RBC utilization (low-certainty evidence). The adverse events of preoperative oral/IV iron and/or ESAs and their impact on patient-important outcomes (morbidity, mortality, quality of life) remain unclear (very low-certainty evidence). Since PBM is a patient-centered approach, emphasis on monitoring and evaluation of patient-important outcomes in future research is urgently needed. Finally, the cost-effectiveness of preoperative oral/IV iron monotherapy is unproven, whereas preoperative oral/IV iron in addition to ESAs is extremely cost-ineffective.
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Affiliation(s)
- Hans Van Remoortel
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium.,Department of Public Health and Primary Care, Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium
| | - Emmy De Buck
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium.,Department of Public Health and Primary Care, Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium
| | - Erhard Seifried
- German Red Cross Blood Service BaWüHe, Frankfurt, Germany.,Institute for Transfusion Medicine and Immunohematology, Goethe University, Frankfurt, Germany
| | - Philippe Vandekerckhove
- Department of Public Health and Primary Care, Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium.,Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch Central, Stellenbosch, South Africa.,Belgian Red Cross, Mechelen, Belgium
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Research Critique Simulation: A Novel Approach to Build Staff Nurses' Confidence. J Perianesth Nurs 2023; 38:148-150. [PMID: 36610869 DOI: 10.1016/j.jopan.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/20/2022] [Indexed: 01/06/2023]
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Roberge-Dao J, Maggio LA, Zaccagnini M, Rochette A, Shikako K, Boruff J, Thomas A. Challenges and future directions in the measurement of evidence-based practice: Qualitative analysis of umbrella review findings. J Eval Clin Pract 2023; 29:218-227. [PMID: 36440876 DOI: 10.1111/jep.13790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/16/2022] [Accepted: 10/25/2022] [Indexed: 11/29/2022]
Abstract
UNLABELLED RATIONALE, AIMS AND OBJECTIVES: An important aspect of scholarly discussions about evidence-based practice (EBP) is how EBP is measured. Given the conceptual and empirical developments in the study of EBP over the last 3 decades, there is a need to better understand how to best measure EBP in educational and clinical contexts. The aim of this study was to identify and describe the main challenges, recommendations for practice, and areas of future research in the measurement of EBP across the health professions as reported by systematic reviews (SRs). METHODS We conducted a secondary analysis of qualitative data obtained in the context of a previously published umbrella review that aimed to compare SRs on EBP measures. Two reviewers independently extracted excerpts from the results and discussion/conclusion sections of the 10 included SRs that aligned with the three research aims. An iterative six-phase reflexive thematic analysis according to Braun and Clarke was conducted. RESULTS Our thematic analysis produced five themes describing the main challenges associated with measuring EBP, four themes outlining main recommendations for practice, and four themes representing areas of future research. Challenges include limited psychometric testing and validity evidence for existing EBP measures; limitations with the self-report format; lack of construct clarity of EBP measures; inability to capture the complexity of the EBP process and outcomes; and the context-specific nature of EBP measures. Reported recommendations for practice include acknowledging the multidimensionality of EBP; adapting EBP measures to the context and re-examining the validity argument; and considering the feasibility and acceptability of measures. Areas of future research included the development of comprehensive, multidimensional EBP measures and the need for expert consensus on the operationalization of EBP. CONCLUSIONS This study suggests that existing measures may be insufficient in capturing the multidimensional, contextual and dynamic nature of EBP. There is a need for a clear operationalization of EBP and an improved understanding and application of validity theory.
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Affiliation(s)
- Jacqueline Roberge-Dao
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada and Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Canada
| | - Lauren A Maggio
- Medicine and Health Professions Education, Uniformed Services University, Bethesda, Maryland, USA
| | - Marco Zaccagnini
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada and Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Canada
| | - Annie Rochette
- School of Rehabilitation, Université de Montréal, Montréa, Canada and Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Université de Montréal, Montréal, Canada
| | - Keiko Shikako
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada and Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Canada
| | - Jill Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montréal, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy and The Institute of Health Sciences Education, McGill University, Montréal, Canada and Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Canada
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Alarcon-Ruiz CA, Soriano-Moreno DR, Taype-Rondan A. Undergraduate courses of evidence-based medicine in Peruvian medical schools: Characteristics and addressed topics. Heliyon 2023; 9:e13320. [PMID: 36816297 PMCID: PMC9932740 DOI: 10.1016/j.heliyon.2023.e13320] [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: 08/25/2022] [Revised: 01/06/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
Background Medical schools are increasingly including evidence-based medicine (EBM) courses in their curricula. However, little is known about the characteristics of these courses in Peru. Therefore, the present study aimed to describe the characteristics and topics addressed by undergraduate courses on EBM in Peruvian medical schools, and to compare the content of these courses with predefined EBM competencies. Methods We conducted a cross-sectional study. We obtained the syllabi of undergraduate EBM courses from all medical schools for the latest year available. We extracted their characteristics and categorized the topics they included according to the five steps necessary to apply EBM, divided into 22 competencies. Results In 2021, Peru had 47 universities with active undergraduate medical schools, of which 9 (19.1%) had EBM courses. These courses were not mandatory in three of the universities, and were typically offered between the 2nd and 5th year of the degree program. When analysing the topics covered in the syllabi, we found that they addressed 7 to 13 of the 22 core competencies evaluated. The least addressed topics belonged to steps 4 (apply) and 5 (evaluate) of the EBM process. Conclusion We found that few Peruvian universities offer EBM courses, and that these courses have heterogeneous characteristics, with syllabi that do not include all essential topics for applying the five steps of EBM.
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Affiliation(s)
- Christoper A. Alarcon-Ruiz
- Neurociencia, Efectividad Clínica y Salud Pública, Universidad Científica del Sur, Lima, Peru
- EviSalud – Evidencias en Salud, Lima, Peru
| | | | - Alvaro Taype-Rondan
- EviSalud – Evidencias en Salud, Lima, Peru
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
- Corresponding author. Alvaro Taype-Rondan Universidad San Ignacio de Loyola Av. la Fontana 550, La Molina 15024, Lima, Peru.
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Sakuramoto H, Kuribara T, Ouchi A, Haruna J, Unoki T. Clinical practice competencies for standard critical care nursing: consensus statement based on a systematic review and Delphi survey. BMJ Open 2023; 13:e068734. [PMID: 36697042 PMCID: PMC9884938 DOI: 10.1136/bmjopen-2022-068734] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES A clear development process and scientifically validated clinical practice competencies in standard critical care nursing (SCCN) have not yet been developed in Japan. Thus, this study aimed to develop a consensus-based set of SCCN competencies to provide a framework for critical care nursing education, training and evaluation. DESIGN Multistep, modified Delphi study (a systematic review, focus group interviews, a three-round web-based Delphi survey and an external validation process). PARTICIPANTS A systematic review of 23 studies, focus group interviews by 12 experts, a Delphi survey by 239 critical care experts (physicians, nurses and physical therapists) and an external validation by 5 experts (physicians and nurses). RESULTS A systematic review identified 685 unique competencies. The focus group interviews resulted in the addition of 3 performance indicator items, a synthesis of 2 subdomains and 10 elements. Of the 239 participants, 218 (91.2%), 209 (98.9%) and 201 (96.2%) responded in rounds 1, 2 and 3 of the Delphi survey, respectively. After round 3, 57 items were below the consensus level and were removed in the final round. External validation process feedback was received from experts after two revisions to ensure that the final competencies were valid, applicable, useful and clear. The final set of competencies was classified into 6 domains, 26 subdomains, 99 elements and 525 performance indicators. CONCLUSIONS This study found a set of SCCN competencies after a multistep, modified Delphi study. The results of this study are robust, and the competency framework can be used in multiple areas to improve clinical practice, including the assessment, training and certification of standard critical care nurses.
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Affiliation(s)
- Hideaki Sakuramoto
- Department of Critical care and Disaster Nursing, Japanese Red Cross Kyushu International College of Nursing, Munakata, Fukuoka, Japan
| | - Tomoki Kuribara
- Department of Acute and Critical Care Nursing, School of Nursing, Sapporo City University, Sapporo, Hokkaido, Japan
| | - Akira Ouchi
- Department of Adult Health Nursing, College of Nursing, Ibaraki Christian University, Hitachi, Ibaraki, Japan
| | - Junpei Haruna
- Intensive Care Unit, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Takeshi Unoki
- Department of Acute and Critical Care Nursing, School of Nursing, Sapporo City University, Sapporo, Hokkaido, Japan
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Pramila-Savukoski S, Kärnä R, Kuivila HM, Juntunen J, Koskenranta M, Oikarainen A, Mikkonen K. The influence of digital learning on health sciences students' competence development- A qualitative study. NURSE EDUCATION TODAY 2023; 120:105635. [PMID: 36403496 DOI: 10.1016/j.nedt.2022.105635] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 10/19/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Health care experts need high levels of competence, yet there is little evidence on the influence of digital learning on health science students' competence development. OBJECTIVES This study aims to describe health sciences students' experiences of the development of their competence and the influences of digital learning upon their competence. DESIGN A qualitative descriptive research. PARTICIPANTS A total of 15 health sciences students were interviewed. METHODS The data was collected by using individual semi-structured interviews during the spring of 2021. The data was analyzed using content analysis. RESULTS The health sciences students felt that their expertise encompasses motivation for future career development, understanding the social and professional influences on their career development, versatile expertise in various aspects of health sciences, and developing competence in different learning environments. The students recognized that digital learning requires the active participation, digitalization is a part of a successful learning environment, and digital learning challenges social interactions. The students' digital learning facilitated competence development, which broadened their understanding of skills relevant to health sciences; however, these benefits could only be obtained when including adequate support. CONCLUSIONS The results hold social value for the development of health sciences education as policy-makers can use the presented information to develop high-quality, digital learning procedures.
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Affiliation(s)
- Sari Pramila-Savukoski
- Research Unit of Health Sciences and Technology, Faculty of Medicine, P.O. Box 5000, FI- 90014, University of Oulu, Finland.
| | - Raila Kärnä
- Research Unit of Health Sciences and Technology, Faculty of Medicine, P.O. Box 5000, FI- 90014, University of Oulu, Finland.
| | - Heli-Maria Kuivila
- Research Unit of Health Sciences and Technology, Faculty of Medicine, P.O. Box 5000, FI- 90014, University of Oulu, Finland.
| | - Jonna Juntunen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, P.O. Box 5000, FI- 90014, University of Oulu, Finland.
| | - Miro Koskenranta
- Research Unit of Health Sciences and Technology, Faculty of Medicine, P.O. Box 5000, FI- 90014, University of Oulu, Finland.
| | - Ashlee Oikarainen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, P.O. Box 5000, FI- 90014, University of Oulu, Finland.
| | - Kristina Mikkonen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, P.O. Box 5000, FI- 90014, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
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Kawar LN, Aquino-Maneja EM, Failla KR, Flores SL, Squier VR. Research, Evidence-Based Practice, and Quality Improvement Simplified. J Contin Educ Nurs 2023; 54:40-48. [PMID: 36595725 DOI: 10.3928/00220124-20221207-09] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Is the research process different than evidence-based practice and quality improvement, or is it the same? Scattered evidence and misperceptions regarding research, evidence-based practice, and quality improvement make the answer unclear among nurses. This article clarifies and simplifies the three processes for frontline clinical nurses and nurse leaders. The three processes are described and discussed to give the reader standards for differentiating one from the other. The similarities and differences are highlighted, and examples are provided for contextualization of the methods. [J Contin Educ Nurs. 2023;54(1):40-48.].
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Andersen P, Broman P, Tokolahi E, Yap JR, Brownie S. Determining a common understanding of interprofessional competencies for pre-registration health professionals in Aotearoa New Zealand: A Delphi study. Front Med (Lausanne) 2023; 10:1119556. [PMID: 37035298 PMCID: PMC10079912 DOI: 10.3389/fmed.2023.1119556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/13/2023] [Indexed: 04/11/2023] Open
Abstract
There is growing awareness that factors such as the growing incidence of co-morbidity and increasing complexity of patient health needs cannot be addressed by health professionals practicing in isolation. Given this, there is an increasing emphasis on preparing students in health-related programs for effective interprofessional practice. Less clear, however, are the specific skills and clinical or learning opportunities necessary for students to develop effectiveness in interprofessional practice. These factors drove a team associated with a tertiary health education provider in Hamilton, New Zealand to transform traditional clinical student experiences in the form of an interprofessional student-assisted clinic. The clinic was intended, in part, to provide students with opportunities to learn and experience interprofessionalism in practice but was hampered by limited information available regarding the specific skill requirements necessary for students in New Zealand to learn in this context. In this Delphi study, we synthesize national expert opinion on student competency indicators necessary for effective interprofessional practice. The resultant set of indicators is presented and opportunities for application and further research discussed. The paper offers guidance to others seeking to innovate health curricula, develop novel service-oriented learning experiences for students, and foster interprofessional practice competence in the future health workforce.
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Affiliation(s)
- Patrea Andersen
- Centre for Health and Social Practice, Waikato Institute of Technology–Te Pūkenga, Hamilton, New Zealand
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, QLD, Australia
- School of Nursing, Midwifery and Social Science, Central Queensland University, Norman Gardens, QLD, Australia
| | - Patrick Broman
- Centre for Health and Social Practice, Waikato Institute of Technology–Te Pūkenga, Hamilton, New Zealand
- *Correspondence: Patrick Broman,
| | - Ema Tokolahi
- Otago Polytechnic–Te Pūkenga, Dunedin, New Zealand
| | - Jia Rong Yap
- Centre for Health and Social Practice, Waikato Institute of Technology–Te Pūkenga, Hamilton, New Zealand
| | - Sharon Brownie
- Centre for Health and Social Practice, Waikato Institute of Technology–Te Pūkenga, Hamilton, New Zealand
- School of Health Science, Swinburne University of Technology, Melbourne, VIC, Australia
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia
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Tiller NB, Sullivan JP, Ekkekakis P. Baseless Claims and Pseudoscience in Health and Wellness: A Call to Action for the Sports, Exercise, and Nutrition-Science Community. Sports Med 2023; 53:1-5. [PMID: 35687251 DOI: 10.1007/s40279-022-01702-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2022] [Indexed: 01/12/2023]
Abstract
The global health and wellness industry has an estimated value of US$4 trillion. Profits derive from heath club memberships, exercise classes, diets, supplements, alternative 'therapies', and thousands of other products and services that are purported to improve health, recovery, and/or sports performance. The industry has expanded at an alarming rate, far outstripping the capacity of federal bodies to regulate the market and protect consumer interests. As a result, many products are sold on baseless or exaggerated claims, feigned scientific legitimacy, and questionable evidence of safety and efficacy. This article is a consciousness raiser. Herein, the implications of the mismatch between extraordinary health and performance claims and the unextraordinary scientific evidence are discussed. Specifically, we explore how pseudoscience and so-called 'quick fix' interventions undermine initiatives aimed at evoking long-term behavior change, impede the ongoing pursuit of sports performance, and lead to serious downstream consequences for clinical practice. Moreover, pseudoscience in health and wellness, if left unchecked and unchallenged, may have profound implications for the reputation of exercise science as a discipline. This is a call to action to unify exercise scientists around the world to more proactively challenge baseless claims and pseudoscience in the commercial health and wellness industry. Furthermore, we must shoulder the burden of ensuring that the next generation of exercise scientists are sufficiently skilled to distinguish science from pseudoscience, and information from mis- and disinformation. Better population health, sports performance, and the very reputation of the discipline may depend on it.
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Affiliation(s)
- Nicholas B Tiller
- Institute of Respiratory Medicine and Exercise Physiology, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, CDCRC Building, Torrance, CA, 90502, USA.
| | - John P Sullivan
- Department of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
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Gray KD, Nobel TB, Hsu M, Tan KS, Chudgar N, Yan S, Rusch VW, Jones DR, Rocco G, Molena D, Isbell JM. Improved Preoperative Risk Assessment Tools Are Needed to Guide Informed Decision Making before Esophagectomy. Ann Surg 2023; 277:116-120. [PMID: 33351463 PMCID: PMC8211904 DOI: 10.1097/sla.0000000000004715] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We sought to evaluate the performance of 2 commonly used prediction models for postoperative morbidity in patients undergoing open and minimally invasive esophagectomy. SUMMARY BACKGROUND DATA Patients undergoing esophagectomy have a high risk of postoperative complications. Accurate risk assessment in this cohort is important for informed decision-making. METHODS We identified patients who underwent esophagectomy between January 2016 and June 2018 from our prospectively maintained database. Predicted morbidity was calculated using the American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator (SRC) and a 5-factor National Surgical Quality Improvement Programderived frailty index. Performance was evaluated using concordance index (C-index) and calibration curves. RESULTS In total, 240 consecutive patients were included for analysis. Most patients (85%) underwent Ivor Lewis esophagectomy. The observed overall complication rate was 39%; the observed serious complication rate was 33%.The SRC did not identify risk of complications in the entire cohort (C-index, 0.553), patients undergoing open esophagectomy (C-index, 0.569), or patients undergoing minimally invasive esophagectomy (C-index, 0.542); calibration curves showed general underestimation. Discrimination of the SRC was lowest for reoperation (C-index, 0.533) and highest for discharge to a facility other than home (C-index, 0.728). Similarly, the frailty index had C-index of 0.513 for discriminating any complication, 0.523 for serious complication, and 0.559 for readmission. CONCLUSIONS SRC and frailty index did not adequately predict complications after esophagectomy. Procedure-specific risk-assessment tools are needed to guide shared patient-physician decision-making in this high-risk population.
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Affiliation(s)
- Katherine D. Gray
- Department of Surgery, New York Presbyterian Hospital–Weill Cornell Medicine, New York, NY
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Tamar B. Nobel
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Meier Hsu
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kay See Tan
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Neel Chudgar
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Shi Yan
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Valerie W. Rusch
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - David R. Jones
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Gaetano Rocco
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Daniela Molena
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - James M. Isbell
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
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Inside Looking Out: Updated Competency Model for Professional Rehabilitation Nursing Practice. Rehabil Nurs 2023; 48:23-38. [PMID: 36541861 DOI: 10.1097/rnj.0000000000000397] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The original Association of Rehabilitation Nurses (ARN) Competency Model for Professional Rehabilitation Nursing published in 2016, and updated in 2020, provides a framework for rehabilitation nursing practice. AIM This companion, but stand-alone, article to a 2022 publication further explicates and informs the updated Competency Model from inside looking out toward an increasing application for evidence-based practice (EBP). APPROACH An eight-member 2020 ARN Task Force used an iterative process to review the original four domains and related competencies and came to consensus for the updated model. OUTCOME This model provides revised competency role descriptors or behaviors that guide nurses practicing at different proficiency levels in various settings. CLINICAL RELEVANCE The Competency Model for Professional Rehabilitation Nursing is a premier resource that can advance professional rehabilitation nursing and guide EBP, including evaluation, quality improvement, and research. The model describes the nurse's role on the intra/interprofessional team and fosters collaboration with other healthcare professionals to enhance the quality of life for those affected by disability and chronic illness. CONCLUSION The domains and associated competencies of this model clarify nursing roles at different proficiency levels, and role descriptors reflect current practice, supporting advancement of the specialty practice of rehabilitation nursing well into the 21st century.
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Romero-Robles MA, Soriano-Moreno DR, García-Gutiérrez FM, Condori-Meza IB, Sing-Sánchez CC, Bulnes Alvarez SP, Alarcon-Ruiz CA, Taype-Rondan A, Viteri‐García A. Self-perceived competencies on evidence-based medicine in medical students and physicians registered in a virtual course: a cross-sectional study. MEDICAL EDUCATION ONLINE 2022; 27:2010298. [PMID: 34919030 PMCID: PMC8725743 DOI: 10.1080/10872981.2021.2010298] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Evidence-based medicine (EBM) is defined as the integration of the best available evidence from scientific studies with clinical experience (and context) and with patients' values and preferences. The objective of the present study was to describe self-perceived EBM competencies in physicians and medical students enrolled in a massive virtual EBM course. METHODS Analytical cross-sectional study. People interested in a free virtual EBM course fulfilled their data in a virtual form for their registration in September 2020. In this form, 22 competencies related to four dimensions of EBM were evaluated: asking a clinical question, search, analysis, and application; using a 5-option Likert scale. The resulting database was analyzed, selecting people who claimed to be physicians or medical students of 18 years or more. RESULTS 1793 participants were included: 1130 medical students and 663 physicians; more than 80% lived in Peru. The frequency of participants who agreed or strongly agreed with feeling qualified in each competence ranged: from 39.2% to 57.8% for the competencies of the 'Asking a clinical question' dimension, from 39.2% to 56.1% for 'Search,' from 19.9% to 32.0% for 'Analysis,' and from 19.6% to 29.9% for 'Application.' Both in physicians and students, the lowest frequencies were for the competencies of interpretation of impact measures, graphs, and results of systematic reviews; as well as shared decision making and calculation of expected benefit. Physicians who graduated more recently scored better on competencies from search and analysis dimensions. CONCLUSION Among physicians and medical students enrolled in the course, self-perception of competencies was lower in the dimensions of analysis and application. More recently graduated physicians seem to have a greater self-perception of their research and analysis skills, probably due to curricular updates.List of abbreviations: EBM: Evidence-based medicine; CIMBE, for its acronym in Spanish: International Course on Evidence-Based Medicine; SOCIMEP, for its acronym in Spanish: Peruvian Medical Student Scientific Society.
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Affiliation(s)
- Milton A. Romero-Robles
- Escuela de Medicina, Universidad Nacional Del Santa, Nuevo Chimbote, Ancash, Perú
- Comité Permanente Académico, Sociedad Científica Médico Estudiantil Peruana, Lima, Perú
| | - David R. Soriano-Moreno
- Comité Permanente Académico, Sociedad Científica Médico Estudiantil Peruana, Lima, Perú
- Escuela de Medicina, Universidad Peruana Unión, Lima, Perú
| | - Fabrizio M. García-Gutiérrez
- Comité Permanente Académico, Sociedad Científica Médico Estudiantil Peruana, Lima, Perú
- Escuela de Medicina, Universidad Nacional de Trujillo, Trujillo, Perú
| | - I. Benjamín Condori-Meza
- Comité Permanente Académico, Sociedad Científica Médico Estudiantil Peruana, Lima, Perú
- Escuela de Medicina, Universidad Peruana Unión, Lima, Perú
| | - Caroline C. Sing-Sánchez
- Escuela de Medicina, Universidad Nacional Del Santa, Nuevo Chimbote, Ancash, Perú
- Comité Permanente Académico, Sociedad Científica Médico Estudiantil Peruana, Lima, Perú
| | - Sandy P. Bulnes Alvarez
- Comité Permanente Académico, Sociedad Científica Médico Estudiantil Peruana, Lima, Perú
- Escuela de Medicina, Universidad César Vallejo, Piura, Perú
| | - Christoper A. Alarcon-Ruiz
- Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima, Perú
| | - Alvaro Taype-Rondan
- Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima, Perú
| | - Andres Viteri‐García
- Centro de Investigación de Salud Pública Y Epidemiología Clínica (Cispec). Facultad de Ciencias de La Salud Eugenio Espejo, Universidad Ute, Quito, Ecuador
- Fundación Epistemonikos, Santiago, Chile
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Kenney A, Yu C, Sena A, Ghafoor N, Moffett S. Comparison of two validated evidence-based medicine assessments: Do they correlate? AEM EDUCATION AND TRAINING 2022; 6:e10831. [PMID: 36545444 PMCID: PMC9764041 DOI: 10.1002/aet2.10831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 10/13/2022] [Accepted: 11/02/2022] [Indexed: 06/17/2023]
Abstract
UNLABELLED Evidence-based medicine (EBM) has been defined as a process involving five actions: asking, acquiring, appraising, applying, and assessing. Several attempts have been made to create and validate tools to assess EBM aptitude. The newest testing instrument, the ACE tool, which is a 15-question true/false exam, has not been directly compared to the more established Fresno test, which is composed of 12 in-depth short-answer questions. Although both were designed to test Steps 1-4 of the five-step EBM process, it is unclear whether they examine the same things or whether one is superior. To our knowledge there is not a widely used standard for EBM assessment despite the broad requirements for inclusion of EBM in both undergraduate and graduate medical education. HYPOTHESES It was hypothesized that these instruments do not correlate between one another, based on inherent differences between them, including assessment format, grading method, and scoring range. The authors sought to examine whether a correlation between the results of these two instruments exists in a population of U.S. medical students. METHODS A retrospective cohort study of 158 fourth-year U.S. medical students in academic year 2018-2019 was conducted. All students were exposed to a focused EBM curriculum, consisting of three guided discussions of separate journal articles clinically relevant to the practice of emergency medicine. Outcomes measured included scores on both the ACE tool and Fresno test using descriptive statistics. Spearman's rho was used to determine the correlation between the ACE and Fresno scores for each student among the entire group. A subgroup analysis was performed to assess for correlations at more extreme data points. RESULTS The median scores on the ACE tool and Fresno test were 66.7% and 62.7%. There was no statistically significant correlation between the results of these two assessments (Spearman's rho 0.023, p = 0.774) in our population. The scores from the subgroup of advanced performers on the Fresno test showed a weak statistically significant positive correlation (p = 0.045) to advanced scores on the ACE tool. No other subgroups showed statistically significant correlation. CONCLUSIONS In our population of U.S. medical students, the results of two known EBM assessment instruments do not correlate with one another. The assessments may differ in what categories of learning they measure or in generalizability or perhaps in what depth of understanding they test overall. Further study is needed to determine what each instrument is measuring and whether there is demonstrable variation across populations.
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Affiliation(s)
- Adam Kenney
- Englewood HealthEnglewoodNew JerseyUSA
- Department of Emergency MedicineRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Catherine Yu
- Department of Emergency MedicineRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
- Department of Emergency MedicineUniversity of California Los AngelesLos AngelesCaliforniaUSA
| | - Ariel Sena
- Department of Emergency MedicineRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Naila Ghafoor
- Department of Emergency MedicineRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Shannon Moffett
- Department of Emergency MedicineRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
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73
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Aguayo S, Benso B, Cantarutti C, Ortuño D, Véliz C. Case-based learning to teach scientific thinking to dental students. J Dent Educ 2022; 86 Suppl 3:1734-1736. [PMID: 35075648 DOI: 10.1002/jdd.12893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/12/2022] [Accepted: 01/18/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Sebastian Aguayo
- Faculty of Medicine, School of Dentistry, Pontificia Universidad Católica de Chile, Santiago, Chile.,Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Bruna Benso
- Faculty of Medicine, School of Dentistry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cynthia Cantarutti
- Faculty of Medicine, School of Dentistry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Duniel Ortuño
- Faculty of Medicine, School of Dentistry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Véliz
- Faculty of Medicine, School of Dentistry, Pontificia Universidad Católica de Chile, Santiago, Chile
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Evidence-Based Physiotherapy Practice in Paediatric Subdiscipline: A Cross-Sectional Study in Saudi Arabia. Healthcare (Basel) 2022; 10:healthcare10112302. [PMID: 36421625 PMCID: PMC9690659 DOI: 10.3390/healthcare10112302] [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: 10/17/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022] Open
Abstract
This cross-sectional study explored the behaviour, knowledge, skills and resources, opinion, and perceived barriers of paediatric physiotherapists practising in Saudi Arabia regarding evidence-based practice (EBP). Sixty-eight paediatric physiotherapists from Saudi Arabia participated. Data were collected by electronic questionnaire and the Likert scale was used to score knowledge, skills and resources, opinion, and barriers to EBP implementation. Approximately 78% of the participants were motivated to use EBP in their daily practise and 82.3% have reported the use of best scientific evidence in their clinical practise. Participants with higher database usage over the last 6 months showed significant association with EBP knowledge scores (t = 2.46, p = 0.01), skills and resources scores (t = 3.81, p < 0.001), and opinion scores (t = 2.43, p = 0.01). Furthermore, a higher level of education in participants was significantly associated with EBP knowledge scores (t = 2.41, p = 0.01). Most paediatric physiotherapists believed that EBP is essential in their clinical practise as it improves patient care and quality of health services. Difficulty in obtaining full-text papers and lack of time were identified as major barriers to implementing EBP followed by the lack of management support, motivation in research, and EBP training.
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75
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Mumtaz S, Sabir S. Evaluating Critical Appraisal Skills by Introducing Journal Clubs to Preclinical Dental Students Using the Assessing Competency in Evidence-Based Medicine (ACE) Tool Through Pre and Post-testing. Cureus 2022; 14:e31535. [DOI: 10.7759/cureus.31535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 11/16/2022] Open
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76
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Clinical questions in primary care: Where to find the answers - a cross-sectional study. PLoS One 2022; 17:e0277462. [DOI: 10.1371/journal.pone.0277462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 10/27/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction
Clinicians raise at least one question for every two patients they see, but search for an answer to less than half of these questions, and rarely use evidence-based resources. One barrier to evidence-based practice is doubt that the search would yield an answer, and we found insufficient evidence to refute this concern. This study aims to identify what proportion of clinical questions in primary care can be answered with online evidence-based practice resources, and what proportion of these can be answered with pre-appraised evidence.
Materials and methods
Cross-sectional study in two primary care practices. The inclusion criteria were family doctors, generalists and residents working in 2 selected practices. We collected a total of 238 questions from 19 family medicine specialists, 9 family medicine residents and 3 generalist doctors. Doctors were asked to record any clinical question that arose during 4 days of appointments. The primary outcome was the proportion of clinical questions answered with online evidence-based practice resources. The secondary outcome was the level of evidence needed to reach to find the answers (clinical summaries, systematic guidelines, systematic reviews or primary studies), according to Haynes’ pre-appraised evidence pyramid model.
Results
191 of the 206 valid clinical questions could be answered with online evidence-based practice resources (92.7% [95% CI 88.3%-95.9%]). Most of these questions (90.8% CI 95% 85.9%-94.4%) were successfully answered using clinical summaries (BMJ Best Practice, DynaMed or UpToDate), with a median search time of 4 minutes (range 1–16.5).
Conclusions
Contrary to clinician’s beliefs, the majority of clinical questions can be answered with online evidence-based practice resources, and most of them with pre-appraised evidence. This study could encourage family doctors to increase the use of clinical summaries. Furthermore, these results highlight the importance of teaching how to search for and apply pre-appraised evidence.
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Golz C, Oulevey Bachmann A, Defilippis TS, Kobleder A, Peter KA, Schaffert R, Schwarzenbach X, Kampel T, Hahn S. Preparing students to deal with the consequences of the workforce shortage among health professionals: a qualitative approach. BMC MEDICAL EDUCATION 2022; 22:756. [PMID: 36333793 PMCID: PMC9636659 DOI: 10.1186/s12909-022-03819-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/26/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Healthcare is facing a shortage of qualified healthcare professionals. The pandemic has brought to light the fragile balance that affects all healthcare systems. Governments have realized that these systems and the professionals working in them need support at different levels to strengthen the retention of the workforce. Health professionals' education can play an important role in ensuring that new generations of workers have sound personal and professional competencies to successfully face the challenges of professional practice. These challenges are described in the literature, but the extent to which they are considered in health professionals' education is less clear. METHODS This qualitative study compares the professional challenges and educational needs described in the literature with the current curricula for health professionals offered in Switzerland. Data were collected nationally through focus group interviews with 65% of Switzerland's directors of bachelor's and master's programs of health professions (nursing, physiotherapy, occupational therapy, midwifery, nutrition and dietetics, osteopathy, radiologic medical imaging technology, health promotion and prevention, and health sciences). The data attained were analyzed using knowledge mapping. RESULTS The results reveal a gap among education programs with regard to occupational health promotion and cultural diversity. Both topics are taught with a sole focus on patients, and students are expected to adopt similar strategies for their health promotion and stress management. Physicians are insufficiently involved in interprofessional education. The programs fail to enhance health professionals' political, economic and digital competencies. CONCLUSION The results of this study offer clear guidance about what topics need to be integrated into curricula to improve health professionals' well-being at work and their preparedness to face daily professional challenges.
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Affiliation(s)
- Christoph Golz
- Department of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland.
| | - Annie Oulevey Bachmann
- La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Tiziana Sala Defilippis
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Locarno, Switzerland
| | - Andrea Kobleder
- Department of Health, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
| | - Karin Anne Peter
- Department of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | - René Schaffert
- School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Xenia Schwarzenbach
- Department of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | - Thomas Kampel
- La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Sabine Hahn
- Department of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
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Evidence-based Medicine: Perceptions, Attitudes, and Skills Among European Urology Residents. EUR UROL SUPPL 2022; 45:44-49. [DOI: 10.1016/j.euros.2022.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 11/23/2022] Open
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Howard B, Diug B, Ilic D. Methods of teaching evidence-based practice: a systematic review. BMC MEDICAL EDUCATION 2022; 22:742. [PMID: 36289534 PMCID: PMC9607697 DOI: 10.1186/s12909-022-03812-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/13/2022] [Indexed: 06/12/2023]
Abstract
BACKGROUND To identify the effectiveness of different teaching modalities on student evidence-based practice (EBP) competency. METHODS Electronic searches were conducted in MEDLINE, Cochrane central register of controlled trials, PsycINFO, CINAHL, ERIC, A + Education and AEI through to November 2021. We included randomised-controlled trials comparing EBP teaching modes on EBP knowledge, skills, attitudes or behaviour in undergraduate and post-graduate health professions education. Risk of bias was determined using the Cochrane risk of bias tool. RESULTS Twenty-one studies were included in the review. Overall, no single teaching modality was identified as being superior to others at significantly increasing learner competency in EBP. Changes in learner knowledge, skills, attitudes and behaviour were conflicting, with studies either reporting no change, or a moderate increase in EBP behavioural outcomes when directly compared to another intervention. CONCLUSION Current evidence highlights the lack of a single teaching modality that is superior than others regarding learner competency in EBP, regardless of health professions discipline or graduate status. The poor quality, heterogeneity of interventions and outcome measures limited conclusions. Further research should focus on the development of high-quality studies and use of psychometrically validated tools to further explore the impact of different EBP teaching modalities.
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Affiliation(s)
- Bethany Howard
- Medical Education Research & Quality (MERQ) Unit, School of Public Health & Preventive Medicine, Monash University, Level 1, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Basia Diug
- Medical Education Research & Quality (MERQ) Unit, School of Public Health & Preventive Medicine, Monash University, Level 1, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Dragan Ilic
- Medical Education Research & Quality (MERQ) Unit, School of Public Health & Preventive Medicine, Monash University, Level 1, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
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Haavisto E, Siltanen H, Tolvanen A, Holopainen A. Instruments for assessing healthcare professionals' knowledge and skills of evidence-based practice: A scoping review. J Clin Nurs 2022. [PMID: 36229896 DOI: 10.1111/jocn.16506] [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: 05/06/2022] [Revised: 06/27/2022] [Accepted: 08/05/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this scoping review was to describe the instruments used to assess the knowledge and skills of evidence-based practice (EBP) in healthcare settings. METHODS A scoping review was undertaken. Three electronic databases (CINAHL, PubMed and Cochrane) were searched in January 2022. The search phrases consisted of the following terms: healthcare professionals, EBP, competence and instrument and their synonyms, keywords and MeSH terms. The database search was run without any limitations. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to support reporting. RESULTS Ultimately, 39 studies were included; most of them (35) were cross-sectional studies. The studies were conducted in 17 countries. A total of 17 evidence-based knowledge and skills instruments were identified. The Upton and Upton instrument was used in 19 studies. Twelve self-reported instruments were used only once. The psychometric properties of the instruments varied. The reliability was typically reported with Cronbach's alpha coefficient. The content of the EBP knowledge/skills instruments consists of five main categories: EBP, evaluation of current practice, preparation for the implementation of EBP, implementation of evidence and active participation in the development of EBP. CONCLUSION Almost all instruments are self-assessment instruments. Validated knowledge tests should be further developed. The instruments emphasise the preparation for the implementation of EBP. Further research is needed to develop instruments for healthcare professionals to assess the knowledge and skills of the implementation of evidence.
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Affiliation(s)
- Elina Haavisto
- Department of Health Sciences, Nursing, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Hospital District of Satakunta, Pori, Finland.,Tampere University Hospital, Tampere, Finland
| | - Hannele Siltanen
- Nursing Research Foundation, Helsinki, Finland.,The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
| | | | - Arja Holopainen
- Nursing Research Foundation, Helsinki, Finland.,The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
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Schetaki S, Patelarou E, Giakoumidakis K, Trivli A, Kleisiaris C, Patelarou A. Translation and Validation of the Greek Version of the Evidence-Based Practice Competency Questionnaire for Registered Nurses (EBP-COQ Prof©). NURSING REPORTS 2022; 12:693-707. [PMID: 36278762 PMCID: PMC9590042 DOI: 10.3390/nursrep12040069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/10/2022] [Accepted: 09/22/2022] [Indexed: 09/15/2023] Open
Abstract
(1) Background: Evidence-based nursing is the benchmark of the nursing profession. It is widely recognized that evidence enhances knowledge, skills, and competencies in nursing education and thus the quality of patient care. Although several proposals have been introduced to reinforce nurses through education in evidence-based practice (EBP) for clinical practice, there is no validated EBP competence tool to determine how nurses approach evidence-based nursing in healthcare practices in Greece. Therefore, the aim of the present study was to translate and validate the Greek version of the Evidence-Based Practice Competency Questionnaire, Professional version (EBP-COQ Prof©). (2) Methods: A cross-sectional study was conducted in a sample of registered nurses working in the public sector. (3) Results: 414 clinical nurses were recruited in total with a response rate of 75.3% and a mean age of 43 years old. Most of the nursing personnel were females, 354 (85.5%), and there were 60 (14.5%) males. Confirmatory factor analysis (CFA) showed a confirmation of the developer's four-factor design. The estimated association between items on each scale showed a strong relationship. The competence questionnaire showed a high internal consistency between the components of attitude, knowledge, skills, and utilization. (4) Conclusions: The competence questionnaire shows a strong relationship between four the components, highlighting the four factors that should be promoted to improve the use of EBP nursing practices.
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Affiliation(s)
- Stefania Schetaki
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | - Evridiki Patelarou
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | | | | | - Christos Kleisiaris
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | - Athina Patelarou
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece
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Anitha CT, Akter K, Mahadev K. An overview of public health education in South Asia: Challenges and opportunities. Front Public Health 2022; 10:909474. [PMID: 36091506 PMCID: PMC9459163 DOI: 10.3389/fpubh.2022.909474] [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] [Received: 03/31/2022] [Accepted: 08/03/2022] [Indexed: 01/22/2023] Open
Abstract
Over the past two decades, there has been an increased demand for Public Health Education (PHE) in South Asia. While this region has a large number of Public Health (PH) institutions, the quality of PHE has not been aligned with the core PH competencies. In this article, we present an overview of Master of Public Health (MPH) programs across South Asian countries. An extensive systematic search on various web search engines regarding PH course offerings was conducted, including specific institute and educational websites. By 2021, more than 180 institutions in South Asia provided an MPH degree. Most of these institutions/universities were found in India, Pakistan, and Bangladesh, and a few among these institutions were established as independent Schools of Public Health (SPH), separate from medical colleges, and had a multidisciplinary faculty. But, dedicated training facilities in the specialized field of public health were not found in most of these institutions. Generally, a well-defined MPH curriculum is not currently available except in India where the University Grants Commission (UGC) guideline for a model MPH curriculum has been proposed by the Ministry of Health and Family Welfare. The entry criteria for an MPH degree in India is accepting students in multidisciplinary fields, while in other South Asian countries this is primarily restricted to medical/paramedical students with a basic understanding of preventive medicine. The aim of this review was to document the current and future PHE opportunities and challenges in South Asia.
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Affiliation(s)
- Chandanadur Thippaiah Anitha
- School of Medical Sciences, University of Hyderabad, Hyderabad, India,*Correspondence: Chandanadur Thippaiah Anitha
| | - Konok Akter
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Kalyankar Mahadev
- School of Medical Sciences, University of Hyderabad, Hyderabad, India,Kalyankar Mahadev
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Annaswamy TM, Rizzo JR, Schnappinger A, Morgenroth DC, Engkasan JP, Ilieva E, Arnold WD, Boninger ML, Bean AC, Cirstea CM, Dicianno BE, Fredericson M, Jayabalan P, Raghavan P, Sawaki L, Suri P, Suskauer SJ, Wang QM, Hosseini M, Case CM, Whyte J, Paganoni S. Evidence-Based Medicine Training in United States-Based Physiatry Residency Programs. Am J Phys Med Rehabil 2022; 101:S40-S44. [PMID: 33852491 PMCID: PMC9444380 DOI: 10.1097/phm.0000000000001752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Although the physiatric community increasingly embraces evidence-based medicine (EBM), the current state of EBM training for trainees in physiatry is unclear. The purposes of this article are to report the results of the Association of Academic Physiatrists' surveys of physiatry residency programs in the United States, to discuss the implications of their findings, and to better delineate the "baseline" upon which sound and clear recommendations for systematic EBM training can be made. The two Association of Academic Physiatrists surveys of US physiatry residency programs reveal that most survey respondents report that they include EBM training in their programs that covers the five recommended steps of EBM core competencies. However, although most respondents reported using traditional pedagogic methods of training such as journal club, very few reported that their EBM training used a structured and systematic approach. Future work is needed to support and facilitate physiatry residency programs interested in adopting structured EBM training curricula that include recommended EBM core competencies and the evaluation of their impact.
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Affiliation(s)
- Thiru M Annaswamy
- From the PM&R Service, VA North Texas Health Care System, Dallas, Texas (TMA); Department of PM&R, UT Southwestern Medical Center, Dallas, Texas (TMA); Departments of Rehabilitation Medicine and Neurology, New York University Langone Health, New York City, New York (J-RR); Association of Academic Physiatrists, Owings Mills, Maryland (AS); VA RR&D Center for Limb Loss and Mobility (CLiMB), VA Puget Sound Health Care System, Seattle, Washington (DCM); Department of Rehabilitation Medicine, University of Washington, Seattle, Washington (DCM, PS); Department of Rehabilitation Medicine, University of Malaya, Kuala Lumpur, Malaysia (JPE); Department of Physical and Rehabilitation Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria (EI); Departments of Neurology, PM&R, Neuroscience, and Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, Ohio (WDA); Department of PM&R, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (MLB, ACB, BED); Department of Physical Medicine & Rehabilitation, University of Missouri, Columbia, Missouri (CM Cirstea); Division of PM&R, Stanford University School of Medicine, Stanford, California (MF); Shirley Ryan AbilityLab, Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, Illinois (PJ); Johns Hopkins School of Medicine, Baltimore, Maryland (PR); Department of PM&R, University of Kentucky, Lexington, Kentucky (LS); Seattle Epidemiologic Research and Information Center and Division of Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, Washington (PS); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington (PS); Departments of Physical Medicine & Rehabilitation and Pediatrics, Johns Hopkins University School of Medicine, Kennedy Krieger Institute, Baltimore, Maryland (SJS); Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, Massachusetts (QMW, SP); Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York (MH); Creighton University, Omaha, Nebraska (CM Case); Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania (JW); and Healey & AMG Center for ALS and Neurological Clinical Research Institute, Massachusetts General Hospital, Boston, Massachusetts (SP)
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The Application of Rehabilitation Therapy Occupational Competency Evaluation Model in the Improvement of College Students’ Innovation and Entrepreneurship. Occup Ther Int 2022; 2022:7478736. [PMID: 35832098 PMCID: PMC9236807 DOI: 10.1155/2022/7478736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/24/2022] [Accepted: 06/01/2022] [Indexed: 11/18/2022] Open
Abstract
This paper constructs an evaluation model of occupational competency in rehabilitation therapy and applies it to the improvement of college students’ innovative and entrepreneurial competencies. Based on clarifying the connotation of college students’ entrepreneurial competency, this study carries out research on the evaluation system of college students’ entrepreneurial competency. First, the method of qualitative research is used to conduct in-depth interviews with college students and entrepreneurial mentors to understand the views of these groups on college students’ entrepreneurial competency, and the coding of the interview contents is carried out by applying the rooting theory, and finally, a theoretical model of the composition of college students’ entrepreneurial competency is derived. The front-line position of talent cultivation is the construction of faculty, because the faculty with high-quality vocational ability is an indispensable prerequisite for the development of universities, and the teaching level of the faculty is the key factor for the effectiveness of teaching to appear. Based on the perspective of role theory, we analyze the problems and reasons for the lack of competency in the role-playing process; integrate the three stages of understanding the role, playing the role, and adjusting the role with the competency model; and propose strategies to improve the competency of youth social workers in the process of playing the role, to help workers accurately understand the role, correctly play the role, and reasonably adjust the role. The curriculum is designed to cultivate the competency of college student nursing positions, which is conducive to improving the professional quality of college student nursing service providers and regulating college student nursing practice so that they can actively respond to problems. This will strengthen the entire teaching faculty and enhance the professional competence of full-time teachers.
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Alsuwaidi L, Powell L, Alhashmi D, Hassan Khamis A, Zary N. Volunteering among pre-clinical medical students: Study of its association with academic performance using institutional data. MEDEDPUBLISH 2022; 12:24. [PMID: 36168531 PMCID: PMC9370086 DOI: 10.12688/mep.19105.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Participating in volunteering activities during students’ higher education experience is becoming more commonplace. Studies have noted that volunteering has a positive impact on the academic performance of undergraduate medical students. However, most of these studies rely on self-reported data like surveys, interviews, and journals. In this study, we leverage actual institutional data to examine the relationship between volunteering and academic performance among medical students in the pre-clinical phases of the Bachelor of Medicine and Bachelor of Surgery (MBBS) program. The current study also explores the factors that might influence students’ volunteering behaviours. Methods: Analysis based on retrospective data was conducted in the College of Medicine at the Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU) in Dubai, United Arab Emirates. Three years of volunteering records for three cohorts of undergraduate medical students enrolled in the MBBS program between 2016 – 2018 were reviewed and analyzed to complete this study. The correlation between the annual Grade Point Average (GPA) and volunteering was studied across the three cohorts in each study year. Results: Analysis of 153 undergraduate medical students' volunteering records revealed a significant positive relationship between the annual GPA and the number of volunteering in year two. The correlation was insignificant in year one, year three, and across the three cohorts. Conclusions: The association between academic performance and volunteering among undergraduate medical students appeared to be positive. However, this relationship differs across the pre-clinical study years and is likely influenced by factors associated with volunteering that might influence GPA.
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Affiliation(s)
- Laila Alsuwaidi
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Leigh Powell
- Institute for Excellence in Health Professions Education, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Deena Alhashmi
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Amar Hassan Khamis
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Nabil Zary
- Institute for Excellence in Health Professions Education, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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86
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Angus RL, Hattingh HL, Weir KA. Experiences of hospital allied health professionals in collaborative student research projects: a qualitative study. BMC Health Serv Res 2022; 22:729. [PMID: 35650578 PMCID: PMC9161454 DOI: 10.1186/s12913-022-08119-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/20/2022] [Indexed: 11/10/2022] Open
Abstract
Background Active engagement in research by healthcare organisations and clinicians is associated with improvements in healthcare performance. Barriers to research engagement by clinician allied health (AH) professionals include competing priorities from high clinical workloads, lack of research skills and confidence, and lack of supportive research relationships. Collaboration with universities on joint clinical research projects is well recognised as a means of building health service research capacity. Research projects undertaken by students as part of their qualifying degree represent one such opportunity. However, there are few reports evaluating these collaborations from the health service perspective. Methods A qualitative study using semi-structured interviews and thematic analysis to explore the experiences of AH professionals in the co-supervision of students completing research placements as part of their professional degree course. Results Fourteen health service employees from six allied health disciplines described collaborations on research projects with 24 students from four different universities. Student placements and projects varied widely in length of placement, extent of collaboration, supervision structure and study design. Three overarching themes were identified in the AH professional co-supervision experience: 1) Professional growth; 2) Mismatch with expectations; and 3) Focus on the student. Project outcomes were categorised from the health system perspective. These were 1) Healthcare performance improvements, including local increases in staff clinical practice knowledge and wider contributions to the evidence base; 2) Research capacity gains within the health service, including research knowledge and skill development, collaborative linkages and opportunity for future research; and 3) Staff-centred outcomes including increased job satisfaction. Conclusions This study demonstrates the potential for AH professional supervision of students on research placements to contribute to healthcare performance improvements and research capacity gains within health services, alongside providing personal benefits for the AH professionals involved. Early consultation with a health service-employed research specialist may support health professional and student learning, team collaboration and project coordination for these student projects. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08119-7.
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Affiliation(s)
- Rebecca L Angus
- Allied Health and Rehabilitation Services, Gold Coast Hospital and Health Service, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia. .,School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia.
| | - H Laetitia Hattingh
- Medical Services, Clinical Governance and Research, Gold Coast Hospital and Health Service, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia.,School of Pharmacy and Medical Science, Griffith University, Gold Coast, Queensland, Australia
| | - Kelly A Weir
- Allied Health and Rehabilitation Services, Gold Coast Hospital and Health Service, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia.,School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
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87
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Antoun J, Lapin J, Beck D. Information retrieval at the point of care of community family physicians in Arab countries. Health Info Libr J 2022; 39:178-184. [PMID: 35396788 DOI: 10.1111/hir.12429] [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: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/30/2022]
Abstract
This study is based on Jumana Antoun's PhD thesis at Walden University, USA examining the information retrieval behaviour of 72 community family physicians' at the point of care in eight Arab countries in the Eastern Mediterranean. The key findings were that participants looked for digital clinical information at the point of care on average 14.0 times per week with the majority (80.3%) using a mobile phone. Clinical information about medication dosage and side effects was the most sought clinical question, and patient education was the least. Almost half of the participants considered that they often found relevant (55.6%), useful (56.9%) and unbiased (58.3%) information. Whilst none of the factors examined predicted the physicians' self-reported effectiveness and efficiency at information retrieval, the implication for practice points clearly to the barriers and the need for curricula to focus on search strategies using free resources at the point of care.
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Affiliation(s)
- Jumana Antoun
- Department of Family Medicine, American University of Beirut, Beirut, Lebanon
| | - Jennifer Lapin
- Richard W. Riley College of Education and Leadership, Walden University, Minneapolis, Minnesota, USA
| | - Dennis Beck
- Department of Educational Technology, University of Arkansas, Fayetteville, Arkansas, USA
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88
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Tracy MC, Thompson R, Muscat DM, Bonner C, Hoffmann T, McCaffery K, Shepherd HL. Implementing shared decision-making in Australia. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2022; 171:15-21. [PMID: 35562274 DOI: 10.1016/j.zefq.2022.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 03/31/2022] [Accepted: 04/02/2022] [Indexed: 06/15/2023]
Abstract
Person-centred care (PCC) and shared decision-making (SDM) are part of national clinical standards for an increasing number of areas of health care delivery. In addition to existing standards for accrediting hospitals, day surgery facilities, public dental services and medical education in Australia, new standards governing primary health care and digital mental health services have been added. Implementation and measurement of PCC and SDM to comply with standards, and training of health professionals, remain challenges for the Australian health sector. Consumer involvement in health research, policy and clinical service governance continues to increase and the National Health and Medical Research Council has begun to encourage consumer and community involvement in health and medical research. This increased consumer engagement and moves towards more PCC provision is reflected in a focus on encouraging patients to ask questions during their clinical care and supports improvements in consumer health literacy. SDM support tools are now being culturally adapted whilst a need for more systemic approaches to their development and implementation persists. With increasing resources and tools for all aspects of PCC and SDM challenges to find sustainable solutions to ensure tools are kept up to date with the best available evidence remain.
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Affiliation(s)
- Marguerite C Tracy
- Sydney Health Literacy Lab, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Rachel Thompson
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Danielle Marie Muscat
- Sydney Health Literacy Lab, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Carissa Bonner
- Sydney Health Literacy Lab, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Tammy Hoffmann
- Centre for Evidence-Informed Health Decisions in the Institute of Evidence-Based Healthcare, Bond University, Robina, Australia
| | - Kirsten McCaffery
- Sydney Health Literacy Lab, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Heather L Shepherd
- Sydney Health Literacy Lab, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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89
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Huang SM, Fang SC, Hung CT, Chen YH. Psychometric evaluation of a nursing competence assessment tool among nursing students: a development and validation study. BMC MEDICAL EDUCATION 2022; 22:372. [PMID: 35578326 PMCID: PMC9109292 DOI: 10.1186/s12909-022-03439-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 05/09/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND Nursing competence refers to the core abilities that are required for fulfilling one's role as a nurse. A specific instrument comprehensively measuring competence among nursing students has not yet been developed. The purpose of the study was to develop and validate a nursing competence instrument for nursing students in bachelor training. METHODS A descriptive and explorative study design was used. Data were collected from students at one medical college in Taiwan in 2020 and 2021. A total of 241 nursing students participated in this study. We developed the initial instrument through systematic review, expert evaluations, and pilot versions. Its validity was then tested using confirmatory factor analysis (CFA) and criterion-related validity, while its reliability was tested using Cronbach's alpha and test-retest analysis. RESULTS The final fit indexes of CFA were as follows: chi-square = 860.1 (p < 0.01), normed chi-square = 2.24, SRMR = 0.04, RMSEA = 0.07, CFI = 0.94, and TLI = 0.94. Cronbach's alpha values for the subscales observed ranged from 0.91 to 0.98. The test-retest reliability coefficient for the Nurse Competence Scale was 0.515 (n = 30, p < 0.01). CONCLUSIONS The instrument exhibited acceptable psychometric properties, thereby proving itself a valuable tool for evaluating nursing students' competence at bachelor training. Further assessments of its reliability, validity, and generality from mentors' and scholars' views in different contexts and cultures are recommended.
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Affiliation(s)
- Sheng-Miauh Huang
- Department of Nursing, MacKay Medical College, No. 46, Section 3, Zhongzheng Rd., Sanzhi Dist., New Taipei City, 252 Taiwan
| | - Su-Chen Fang
- Department of Nursing, MacKay Medical College, No. 46, Section 3, Zhongzheng Rd., Sanzhi Dist., New Taipei City, 252 Taiwan
| | - Chia-Tai Hung
- Department of Nursing, MacKay Medical College, No. 46, Section 3, Zhongzheng Rd., Sanzhi Dist., New Taipei City, 252 Taiwan
| | - Yi-Heng Chen
- Department of Nursing, MacKay Medical College, No. 46, Section 3, Zhongzheng Rd., Sanzhi Dist., New Taipei City, 252 Taiwan
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90
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Baixinho CL, Ferreira Ó, Medeiros M, de Oliveira ESF. From Evidence Synthesis to Transfer: Results from a Qualitative Case Study with the Perspectives of Participants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095650. [PMID: 35565044 PMCID: PMC9105498 DOI: 10.3390/ijerph19095650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 12/04/2022]
Abstract
The increase in health research brings challenges to the production, synthesis, and use of research findings in clinical practice. In the case of undergraduate training in nursing, it is necessary to think about the curricular contents and create opportunities to develop skills for learning evidence-based practice. The objective of this study was to analyze nurses’ perspectives regarding the effects of their participation in a project of translation of knowledge into clinical practice during undergraduate nursing education, specifically involving knowledge, attitudes, and competencies related to the use of evidence. This is a qualitative case study grounded in the knowledge-to-action theoretical framework. The participants were 13 nurses who were involved in a project about the translation of knowledge into clinical practice during the last term of their undergraduate course. The data were collected by applying interviews between December 2020 and April 2021. Content analysis was carried out by using the qualitative data analysis software tool webQDA®. The following categories emerged from the content analysis carried out on the material gathered during the interviews: understanding evidence; learning how to use evidence; transferring evidence; adjusting to the context; and observing the advantages of evidence-based practice. Extracurricular activities were perceived as an opportunity to understand what evidence is and observe in loco the advantages of health care for clients, teams, and services. During the project, the participants developed cross-sectional competencies and envisaged changes to their professional activity as a result of changes in their attitude regarding evidence and its use. We concluded that the opportunity to develop evidence-related activities allows for the development of skills and influences the attitude towards evidence-based practice and knowledge use.
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Affiliation(s)
- Cristina Lavareda Baixinho
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, 1900-160 Lisbon, Portugal;
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2410-541 Leiria, Portugal
- Correspondence: ; Tel.: +351-933254269
| | - Óscar Ferreira
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, 1900-160 Lisbon, Portugal;
| | - Marcelo Medeiros
- Nursing School, Federal University of Goiás, Goiânia 74690-900, Brazil;
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92
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Fisch C, Whelan J, Evans S, Whitaker LA, Gajjar S, Ali L, Fugate C, Puhl R, Hartwell M. Use of person-centred language among scientific research focused on childhood obesity. Pediatr Obes 2022; 17:e12879. [PMID: 34928545 DOI: 10.1111/ijpo.12879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/23/2021] [Accepted: 12/03/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Stigma towards children with obesity can begin as early as 3 years old, leading to increased risk for poorer mental health outcomes and lower quality of life. This includes discriminatory language used by peers and adults, which may be compounded by use within the medical community and in published research. OBJECTIVES Our primary objective was to investigate adherence to person-centred language (PCL) in childhood obesity-related medical publications. METHODS We searched PubMed for childhood obesity-related articles from 2018 through 2020, from journals frequently publishing childhood-obesity-related research. Articles were randomized and searched for a list of predetermined, stigmatizing terms. RESULTS Of the sample of 300 articles, only 21.7% were adherent to PCL guidelines. The most frequent labels found were 'obese' appearing in 70.33% of articles and 'overweight' in 63.7%. Labels such as 'chubby', 'large', and 'fat' were less common, but still appeared in the medical literature. CONCLUSIONS A majority of childhood obesity-related articles did not adhere to PCL guidelines. Given the negative effects of stigma among children with obesity, it is imperative to advocate for PCL use within the medical community. Increased stringency by journal editors and publishers may be the next step in this process.
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Affiliation(s)
- Claudia Fisch
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - John Whelan
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Sheridan Evans
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Liza-Ann Whitaker
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences at Cherokee Nation, Tulsa, Oklahoma, USA
| | - Swapnil Gajjar
- Department of Industrial Engineering & Management, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Lamiaa Ali
- Department of Pediatrics, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, USA
| | - Colony Fugate
- Department of Pediatrics, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Rebecca Puhl
- Department of Human Development & Family Sciences, Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.,Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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93
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Wenke R, Wiseman J, Brandenburg C, Stehlik P, Hughes I, Richards K, Mickan S. Long term tailored implementation of structured "TREAT" journal clubs in allied health: a hybrid effectiveness-implementation study. BMC MEDICAL EDUCATION 2022; 22:307. [PMID: 35459187 PMCID: PMC9030678 DOI: 10.1186/s12909-022-03333-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/23/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Allied Health Professionals (AHPs) commonly use journal clubs (JCs) to support Evidence-Based Practice (EBP). There is however little research regarding implementing and sustaining JCs in the long term, and their impact on EBP use and skills in AHPs. This study investigated the impact of implementing a structured JC format, called "TREAT" (previously only investigated across 6 sessions), over a longer period of 16 sessions for AHPs in a public health service. The study also investigated AHP's attendance, adherence, satisfaction and barriers and enablers to implementing the format. METHODS A mixed methods hybrid-effectiveness implementation design was employed, guided by the Knowledge-to-Action cycle. EBP skills, confidence, use, and attitudes were assessed (Adapted Fresno Test, EBPQ, tailored journal club culture questionnaire) at baseline, and after 10 and 16-monthly sessions. Satisfaction and impact on clinical practice were explored using questionnaires at 10 and 16-months, with free-form responses identifying enablers and barriers to EBP culture and implementation. Data on attendance and adherence to the TREAT format were also collected. RESULTS Six JCs comprising a total of 132 unique participants from seven Allied Health professions were assessed across three time points. EBP skills improved on the Adapted Fresno Test after 10-monthly (6.6 points: 95% CI, 0.43 to 12.7) and 16-monthly sessions (7.8 points, 95% CI, 0.85 to 14.7), and on self-reported total EBPQ ratings of confidence at 10-months (4.9 points: 95% CI, 2.2 to 7.5) and 16-months (5.7 points: 95% CI 2.7 to 8.7). Of 132 AHPs, 88 reported adopting new treatments/resources and 64 reported updating clinical procedures. Mean attendance was 5.7 sessions (SD = 3.8). Adherence to TREAT components in each session was 86% (95% CI, 83% to 89%). Most participants recommended the format and reported a desire to continue. Enablers to the JC included using clinically relevant topics and active participation while reported barriers included limited time to prepare. CONCLUSIONS Despite variable attendance, TREAT JCs can continue to be implemented within a service for 16 monthly-sessions, and may contribute to improved EBP skills and confidence and changes in clinical practice over time. Tailoring of implementation strategies was shown to be important to address local enablers and barriers.
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Affiliation(s)
- Rachel Wenke
- Gold Coast Hospital and Health Service, 1 Hospital Boulevard, Southport Queensland, 4215, Australia.
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Gold Coast, Queensland, 4222, Australia.
| | - Jodie Wiseman
- Occupational Therapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Caitlin Brandenburg
- Gold Coast Hospital and Health Service, 1 Hospital Boulevard, Southport Queensland, 4215, Australia
| | - Paulina Stehlik
- Gold Coast Hospital and Health Service, 1 Hospital Boulevard, Southport Queensland, 4215, Australia
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | - Ian Hughes
- Gold Coast Hospital and Health Service, 1 Hospital Boulevard, Southport Queensland, 4215, Australia
| | - Katherine Richards
- Gold Coast Hospital and Health Service, 1 Hospital Boulevard, Southport Queensland, 4215, Australia
| | - Sharon Mickan
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
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Green P, Edwards EJ, Tower M. Core procedural skills competencies and the maintenance of procedural skills for medical students: a Delphi study. BMC MEDICAL EDUCATION 2022; 22:259. [PMID: 35397566 PMCID: PMC8994896 DOI: 10.1186/s12909-022-03323-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 03/28/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND It is well recognised that medical students need to acquire certain procedural skills during their medical training, however, agreement on the level and acquisition of competency to be achieved in these skills is under debate. Further, the maintenance of competency of procedural skills across medical curricula is often not considered. The purpose of this study was to identify core procedural skills competencies for Australian medical students and to establish the importance of the maintenance of such skills. METHODS A three-round, online Delphi method was used to identify consensus on competencies of procedural skills for graduating medical students in Australia. In Round 1, an initial structured questionnaire was developed using content identified from the literature. Respondents were thirty-six experts representing medical education and multidisciplinary clinicians involved with medical students undertaking procedural skills, invited to rate their agreement on the inclusion of teaching 74 procedural skills and 11 suggested additional procedures. In Round 2, experts re-appraised the importance of 85 skills and rated the importance of maintenance of competency (i.e., Not at all important to Extremely important). In Round 3, experts rated the level of maintenance of competence (i.e., Observer, Novice, Competent, Proficient) in 46 procedures achieving consensus. RESULTS Consensus, defined as > 80% agreement, was established with 46 procedural skills across ten categories: cardiovascular, diagnostic/measurement, gastrointestinal, injections/intravenous, ophthalmic/ENT, respiratory, surgical, trauma, women's health and urogenital procedures. The procedural skills that established consensus with the highest level of agreement included cardiopulmonary resuscitation, airway management, asepsis and surgical scrub, gown and gloving. The importance for medical students to demonstrate maintenance of competency in all procedural skills was assessed on the 6-point Likert scale with a mean of 5.03. CONCLUSIONS The findings from the Delphi study provide critical information about procedural skills for the Clinical Practice domain of Australian medical curricula. The inclusion of experts from medical faculty and clinicians enabled opportunities to capture a range of experience independent of medical speciality. These findings demonstrate the importance of maintenance of competency of procedural skills and provides the groundwork for further investigations into monitoring medical students' skills prior to graduation.
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Affiliation(s)
- Patricia Green
- School of Education, Faculty of Humanities and Social Sciences, The University of Queensland, Brisbane, Q 4072, Australia.
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Q 4229, Australia.
| | - Elizabeth J Edwards
- School of Education, Faculty of Humanities and Social Sciences, The University of Queensland, Brisbane, Q 4072, Australia
| | - Marion Tower
- School of Nursing, Midwifery and Social Work, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Q 4072, Australia
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Akers KG, Hu E, Rehman N, Yun HJ, Hoofman J, Monconduit R, Mendez J. Building First-Year Medical Students' Skills in Finding, Evaluating, and Visualizing Health Information Through a "Debunking Medical Myths" Curricular Module. MEDICAL SCIENCE EDUCATOR 2022; 32:309-313. [PMID: 35399162 PMCID: PMC8980765 DOI: 10.1007/s40670-022-01541-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 06/14/2023]
Abstract
UNLABELLED To provide an online service learning opportunity for medical students during the COVID-19 pandemic, medical faculty and librarians developed and implemented a "Debunking Medical Myths" module in which students learned to search for emerging medical literature, evaluate evidence, and use that evidence to create an infographics debunking a COVID-19-related myth for a non-medical audience. The resultant infographics are visually appealing and designed to make complex health information easy to understand. The module was well-received by students, who demonstrated a nuanced understanding of the use of infographics to convey health information, and students' work was evaluated highly by community members. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-022-01541-w.
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Affiliation(s)
| | - Ella Hu
- Shiffman Medical Library, Wayne State University, Detroit, MI USA
| | - Narmeen Rehman
- School of Medicine, Wayne State University, Detroit, MI USA
| | - Ho Jun Yun
- School of Medicine, Wayne State University, Detroit, MI USA
| | - Jacob Hoofman
- School of Medicine, Wayne State University, Detroit, MI USA
| | | | - Jennifer Mendez
- Internal Medicine, School of Medicine, Wayne State University, Detroit, MI USA
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Thomas A, Chin-Yee B, Mercuri M. Thirty years of teaching evidence-based medicine: have we been getting it all wrong? ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022; 27:263-276. [PMID: 34559327 DOI: 10.1007/s10459-021-10077-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/19/2021] [Indexed: 06/13/2023]
Abstract
Evidence based medicine (EBM) has been synonymous to delivery of quality care for almost thirty years. Since the movement's inception, the assumption has been that decisions based on high quality evidence would translate to better care for patients. Despite EBM's many attractive features and the substantive attention it has received in the contemporary clinical and medical education literature, how it is defined and operationalized as a component of training is often unclear and problematic. How to practice EBM is not well articulated in the literature; therefore, it becomes difficult to teach and equally challenging to assess. In this paper, we put forward a call for deeper consideration of how EBM is taught, and for clarification on how it is defined and operationalized in medical education. In preparing this paper, we considered questions such as what it means to practice EBM, the role that medical education plays in helping realize EBM, how the teaching of EBM can change to reflect recent developments in clinical practice and education, and whether transformations in the practice of medicine necessitate a change in how we teach EBM. We end with four avenues that may be pursued to advance the teaching of EBM in medical education: (1) consensus on what we mean by EBM; (2) clear articulation of EBM-associated competencies; (3) empirically and theoretically supported means of promoting EBM competencies; (4) ways to assess both skill acquisition and use of EBM. We discuss implications for educators of EBM.
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Affiliation(s)
- Aliki Thomas
- School of Physical and Occupational Therapy and Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University and Centre for Interdisciplinary Research in Rehabilitation (CRIR), 3654 Promenade Sir William Osler, Montreal, QC, H3G-1Y5, Canada.
| | - Benjamin Chin-Yee
- Division of Hematology, Department of Medicine and Rotman Institute of Philosophy, Western University, London, ON, Canada
| | - Mathew Mercuri
- Department of Medicine, McMaster University, Hamilton, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Institute for the Future of Knowledge, University of Johannesburg, Johannesburg, South Africa
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97
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Schooley SP, Tackett S, Peraza LR, Shehadeh LA. Development and piloting of an instructional video quality checklist (IVQC). MEDICAL TEACHER 2022; 44:287-293. [PMID: 34666585 DOI: 10.1080/0142159x.2021.1985099] [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: 06/13/2023]
Abstract
PURPOSE Medical education instructional videos are more popular and easier to create than ever before. Standard quality measures for this medium do not exist, leaving educators, learners, and content creators unable to assess these videos. MATERIALS AND METHODS Drawing from the literature on video quality and popularity, reusable learning objects, and multimedia and curriculum development principles, we developed a 26-item instructional video quality checklist (IVQC), to capture aspects of educational design (six items), source reliability (four items), multimedia principle adherence (10 items), and accessibility (six items). Two raters applied IVQC to 206 videos from five producers across topics from two organ systems (cardiology and pulmonology) encompassing four disciplines (anatomy, physiology, pathology, and pharmacology). RESULTS Inter-rater reliability was strong. According to two-rater means, eight multimedia items were present in over 80% of videos. A minority of videos included learning objectives (46%), alternative language translations (41%), when the video was updated (40%), analogies (37%), or references (9%). Producer ratings varied significantly (p < .001) across 17 of 26 items. There were no significant differences according to the video topic. CONCLUSIONS IVQC detected differences in elements of instructional video quality. Future work can apply this instrument to a broader array of videos and in authentic educational settings.
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Affiliation(s)
- Sean P Schooley
- Department of Medical Education, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sean Tackett
- Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Lazaro R Peraza
- Reno School of Medicine, University of Nevada, Reno, NV, USA
| | - Lina A Shehadeh
- Department of Medical Education, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
- Interdisciplinary Stem Cell Institute, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
- Department of Medicine, Division of Cardiology, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
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Torres M, Ragusa M, Abdala V, Brocard E, Schunemann H, Garcia-Saiso S, Reveiz L. BIGG, the international database of GRADE Guidelines. THE LANCET REGIONAL HEALTH - AMERICAS 2022; 6:None. [PMID: 35233554 PMCID: PMC8863112 DOI: 10.1016/j.lana.2021.100099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Marcela Torres
- Evidence and Intelligence for Action in Health Department, Pan American Health Organization
| | - Martin Ragusa
- Evidence and Intelligence for Action in Health Department, Pan American Health Organization
| | - Veronica Abdala
- Evidence and Intelligence for Action in Health Department, Pan American Health Organization
| | - Eva Brocard
- Evidence and Intelligence for Action in Health Department, Pan American Health Organization
| | - Holger Schunemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St West, Hamilton, ON, L8S 4L8, Canada
- Michael G. DeGroote Cochrane Canada & McMaster GRADE Centres; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Dipartimento di Scienze Biomediche Humanitas University, Milan, Italy
- Institute for Evidence in Medicine, Medical Center & Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian Garcia-Saiso
- Evidence and Intelligence for Action in Health Department, Pan American Health Organization
| | - Ludovic Reveiz
- Evidence and Intelligence for Action in Health Department, Pan American Health Organization
- Corresponding author: Ludovic Reveiz, Evidence and Intelligence for Action in Health Department, Pan American Health Organization
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Braun T, Ehrenbrusthoff K, Bahns C, Happe L, Kopkow C. [Adherence to and influencing factors of evidence-based practice in physiotherapeutic care in Germany: a cross-sectional study]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2022; 168:8-20. [PMID: 35027312 DOI: 10.1016/j.zefq.2021.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The implementation of evidence-based practice (EBP) is a central goal in health care. As in other areas, the transfer of scientific knowledge into clinical practice is very delayed or incomplete in physiotherapy. The primary aim of the present study is to describe the adherence to EBP among physiotherapists working in Germany. The secondary goal is the exploratory analysis of selected factors influencing the implementation of EBP. METHODS The present exploratory analysis is based on the data of physiotherapists who participated in a cross-sectional study on the use of EBP by health care professionals (study registration no.: DRKS00013792). The participants in the online survey completed the "Evidence-based Practice Inventory", a questionnaire with five dimensions used to quantify the adherence to EBP. Univariable and multivariable regression analysis was used to examine the associations between various sociodemographic characteristics and EBP. RESULTS 318 physiotherapists participated in the survey (age: 37±12 years; 60 % female; professional experience: 14±11 years). Approximately 70-80 % of the participants, in principle, had a positive attitude towards EBP and perceived EBP as helpful and useful in clinical practice. About 60 % of the respondents felt able to apply the principles of the EBP (e. g., acquisition, appraisal and application of external evidence). However, the data also showed that the implementation of EBP in clinical physiotherapeutic care is insufficient. For example, only 20 % of the respondents reported that their facility paid great attention to applying the principles of the EBP in decision-making, and only about a third of the respondents said that they frequently searched for or used external evidence. The strongest facilitators of EBP include the participation in scientific publications and more than one hour per week to read scientific literature at work. CONCLUSION In principle, physiotherapists in Germany have a positive attitude towards EBP, but currently do not adequately take into account the principles of EBP. These factors should be further analyzed and targeted through effective interventions.
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Affiliation(s)
- Tobias Braun
- Hochschule für Gesundheit Bochum, Department für Angewandte Gesundheitswissenschaften, Studienbereich Physiotherapie, Bochum, Deutschland; HSD Hochschule Döpfer, Fachbereich Gesundheit und Soziales, Köln, Deutschland.
| | - Katja Ehrenbrusthoff
- Hochschule für Gesundheit Bochum, Department für Angewandte Gesundheitswissenschaften, Studienbereich Physiotherapie, Bochum, Deutschland
| | - Carolin Bahns
- Brandenburgische Technische Universität Cottbus-Senftenberg, Fachgebiet Therapiewissenschaften I, Senftenberg, Deutschland
| | - Lisa Happe
- Carl von Ossietzky Universität Oldenburg, Department für Versorgungsforschung, Abteilung für Assistenzsysteme und Medizintechnik, Oldenburg, Deutschland
| | - Christian Kopkow
- Brandenburgische Technische Universität Cottbus-Senftenberg, Fachgebiet Therapiewissenschaften I, Senftenberg, Deutschland
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100
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Approach to Developing a Core Competency Framework for Student Nurses in Saudi Arabia: Results from Delphi Technique. NURSING REPORTS 2022; 12:29-38. [PMID: 35225890 PMCID: PMC8884004 DOI: 10.3390/nursrep12010004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 11/28/2022] Open
Abstract
Background: Competence, while firmly established as a primary conceptual framework in nursing education, continues to lack clarity and uniformity across borders and contexts. While a wealth of research has been carried out on the various dimensions of this concept, including the drafting and implementation of frameworks for nursing competence, no unifying international framework has been forthcoming. Indeed, the continued development of more localized approaches, based on geography or specialization, would appear to be the most realistic objective. It is incumbent on nurse educationalists and researchers to build on existing frameworks and develop evidence-based tested methodologies for competence assessment in localized contexts. Currently, there is a dearth of such evidence-based frameworks in the Middle East and in the Kingdom of Saudi Arabia (KSA) in particular. This study aimed to formulate and validate a competence framework for undergraduate nursing students in KSA. Results: Following documentary analysis, framework drafting and a three round Delphi process, a consensus was reached as to elements, comprising six discrete domains, to be included. The identified competence domains provide a framework to guide the implementation of a competence-based assessment and move towards a competency-based curriculum for nursing education in KSA. Conclusions: The study concluded that providing a competency-based model and expanding and standardization of competency concept in different dimensions of nursing profession is a necessity; considering that clarification of the concept of competency, the recognition of its dimensions, characteristics and the factors affecting it help in determining the criteria and standardizing the competency tools.
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