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Bukenya J, Kebede D, Mwambi H, Pate M, Adongo P, Berhane Y, Canavan CR, Chirwa T, Fawole OI, Guwatudde D, Jackson E, Madzorera I, Moshabela M, Oduola AMJ, Sunguya B, Sall A, Raji T, Fawzi W. The future of public health doctoral education in Africa: transforming higher education institutions to enhance research and practice. Lancet Public Health 2024; 9:e523-e532. [PMID: 38735302 PMCID: PMC11209668 DOI: 10.1016/s2468-2667(24)00056-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 05/14/2024]
Abstract
The African Union and the Africa Centers for Disease Control and Prevention issued a Call to Action in 2022 for Africa's New Public Health Order that underscored the need for increased capacity in the public health workforce. Additional domestic and global investments in public health workforce development are central to achieving the aspirations of Agenda 2063 of the African Union, which aims to build and accelerate the implementation of continental frameworks for equitable, people-centred growth and development. Recognising the crucial role of higher education and research, we assessed the capabilities of public health doctoral training in schools and programmes of public health in Africa across three conceptual components: instructional, institutional, and external. Six inter-related and actionable recommendations were derived to advance doctoral training, research, and practice capacity within and between universities. These can be achieved through equitable partnerships between universities, research centres, and national, regional, and global public health institutions.
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Affiliation(s)
- Justine Bukenya
- School of Public Health, Makerere University, Kampala, Uganda.
| | - Derege Kebede
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Henry Mwambi
- School of Mathematics, Statistics, and Computer Science, Durban, South Africa
| | - Muhammed Pate
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Philip Adongo
- School of Public Health, University of Ghana, Accra, Ghana; Association of Schools of Public Health in Africa, Accra, Ghana
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Chelsey R Canavan
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Tobias Chirwa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Olufunmilayo I Fawole
- Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - David Guwatudde
- School of Public Health, Makerere University, Kampala, Uganda
| | - Elizabeth Jackson
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Isabel Madzorera
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Mosa Moshabela
- Vice Chancellor's Office, University of KwaZulu-Natal, Durban, South Africa
| | - Ayoade M J Oduola
- University of Ibadan Research Foundation, University of Ibadan, Ibadan, Nigeria
| | - Bruno Sunguya
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Tajudeen Raji
- Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Wafaie Fawzi
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA.
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Michalec B, Price Y, Karamehmedovic N, Thompson J. The next frontier: utilizing eLearning as an innovative approach to advance and sustain interprofessionalism. J Interprof Care 2024; 38:772-781. [PMID: 38722040 DOI: 10.1080/13561820.2024.2345194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 04/09/2024] [Indexed: 05/31/2024]
Abstract
The challenges to sustaining interprofessional education (IPE) are numerous and well-documented. These challenges include crowded curricula, scheduling conflicts, lack of physical space, faculty availability, and financial considerations. In turn, IPE is often viewed and treated as an add-on rather than an integral part of healthcare education, leading to sporadic implementation and vulnerability to institutional changes. The concept of eLearning, utilizing electronic technologies for education, emerges as a potential solution to these challenges and could serve as the "next frontier" for IPE. eLearning offers a flexible and scalable platform to deliver IPE, transcending geographical and time constraints. Recent research highlights the benefits of eLearning-based IPE, including enhanced collaboration, learner satisfaction, and clinical application. eLearning allows learners to engage in virtual simulations, reflexive exercises, and collaborative problem-solving, fostering essential skills for future healthcare teams. Interprofessional eLearning courses can seamlessly integrate into existing health professions curricula, catering to busy professionals and students. Most importantly, eLearning promotes consistent and purposeful embedding of interprofessional values and competencies throughout education, training, and professional development. In this Short Report, we utilize the Center for Advancing Interprofessional Practice, Education, and Research (CAIPER) at Arizona State University as a rudimentary "critical instance" case study for advancing and sustaining IPE through eLearning program development. CAIPER exemplifies this approach by constructing engaging evidence-based eLearning IPE courses ranging from examining and applying interprofessionalism in primary care to empathy and humility team-based training. CAIPER's eLearning courses have reached a global audience of over 65,000 learners highlighting the reach, impact, and viability of eLearning for sustainable IPE. Although further research is needed, eLearning presents a promising solution to the systemic challenges of IPE, and by embracing eLearning and embedding interprofessional eLearning courses in existing curricula, institutions can ensure the consistent, accessible, and sustainable delivery of high-quality IPE experiences.
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Affiliation(s)
- Barret Michalec
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Yvonne Price
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Nina Karamehmedovic
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Jody Thompson
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
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Vipler B, Merritt F, Arnold-Rehring S, Zimmer S, Adams J, Faubel S. Inquiry for the win: Fostering curiosity through a BINGO exercise in a longitudinally integrated clerkship. MEDICAL TEACHER 2024:1-4. [PMID: 38889323 DOI: 10.1080/0142159x.2024.2362905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 05/29/2024] [Indexed: 06/20/2024]
Abstract
EDUCATIONAL CHALLENGE As technological advancements challenge the current roles healthcare workers fill, curiosity and lifelong learning are becoming increasingly important. However, descriptions of specific curricular interventions that successfully develop these attitudes and skills remain limited. PROPOSED SOLUTION We aimed to promote curiosity and advance practical application of evidenced-based medicine through a longitudinal, gamified learning activity within a longitudinal integrated clerkship (LIC). Thirty-seven students across two inquiry-themed LICs based at a university hospital and a community-based integrated healthcare delivery system used BINGO cards containing various assignments designed to develop the skill of asking and answering clinical questions. Assignments included: engaging experts, using evidence-based medical resources, attending education events, utilizing medical library resources, and Phone-a-Scientist. Students shared their experiences in a group setting and wrote a reflection for each assignment that was qualitatively analyzed to determine the perceived educational outcomes according to the Kirkpatrick Evaluation Model. LESSONS LEARNED Results suggest that Inquiry BINGO fosters curiosity and builds skill in applied evidenced-based medicine early in clinical training. Most assignments prompted students to engage in opportunities they might not have otherwise explored. All but three students reported a change in behavior as a result of the assignment and 57% reported positive clinical or research results. NEXT STEPS Future iterations of this activity should be evaluated by obtaining patient and/or preceptor feedback as well as longitudinal evaluations of student behavior to ensure higher level educational outcomes are being met.
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Affiliation(s)
- Benjamin Vipler
- Department of Medicine, University of Colorado School of Medicine, Director, Inquiry Longitudinal Integrated Clerkship, University of Colorado Hospital, CO, USA
| | - Frank Merritt
- Department of Medicine, University of Colorado School of Medicine, Director, Inquiry Longitudinal Integrated Clerkship, University of Colorado Hospital, CO, USA
| | - Sharisse Arnold-Rehring
- Department of Pediatrics, University of Colorado School of Medicine, Director, Inquiry Longitudinal Integrated Clerkship, Kaiser Permanente, CO, USA
| | - Shanta Zimmer
- Department of Medicine, University of Colorado School of Medicine, Senior Associate Dean of Education, CO, USA
| | - Jennifer Adams
- Department of Medicine, University of Colorado School of Medicine, Assistant Dean of Medical Education, Clinical Clerkships, CO, USA
| | - Sarah Faubel
- Department of Medicine, University of Colorado School of Medicine, Director, Inquiry Content, University of Colorado Hospital, CO, USA
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Knox MC, Naehrig D, Chin YS. Communication and collaboration skills training in radiation oncology: A quantitative validation survey. J Med Imaging Radiat Oncol 2024. [PMID: 38874302 DOI: 10.1111/1754-9485.13722] [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: 01/16/2024] [Accepted: 05/31/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION Communication and collaboration are integral in radiation oncology practice. A recently published qualitative study identified several deficiencies in skills development for Australian/New Zealand trainees. We aim to validate these findings to guide curriculum development. METHODS A quantitative survey was developed through an iterative process, using themes identified in the previous qualitative investigation. This survey was distributed to radiation oncologists and trainees across Australia and New Zealand via email. Data collection and management utilised the REDCap system. Question types varied to maximise richness of data, including ranking, likert-scales and free-text questions. Results are primarily reported descriptively. RESULTS Totally 35 participants submitted completed survey responses with broad representation across geography, gender and clinician seniority. To learn communication, participants reported strong preferences towards informal observation (60% agreement) and self-reflection (49% agreement), and against online learning (77% disagreement) methodologies. Nearly 35% acknowledge poor communication at least weekly, with time pressure being a major barrier (63% agreement). Clinical uncertainty and existing patient/family assumptions (both 74% agreement) contribute to difficulties in breaking bad news, with online learning being the only negatively perceived training modality (23% agreement). No participants reported any formal training/mentoring in multi-disciplinary team (MDT) engagement. Conflict was commonly witnessed/experienced (97%) and 26% of participants avoid MDTs due to difficulties experienced. CONCLUSIONS This study validates the themes previously identified. We identified a strong preference for informal learning methodologies and against online modules, discordant to published literature. Effective collaboration within MDTs is identified as a particular area of need. We recommend future curriculum modification considers these results to maximise efficacy.
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Affiliation(s)
- Matthew Charles Knox
- Department of Radiation Oncology, Westmead Hospital, Wentworthville, New South Wales, Australia
- St George and Sutherland Clinical School, UNSW Sydney, Sydney, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Diana Naehrig
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Radioonkologie, Universitaetsspital Basel, Basel, Switzerland
| | - Yaw Sinn Chin
- St George and Sutherland Clinical School, UNSW Sydney, Sydney, New South Wales, Australia
- Department of Radiation Oncology, St George Hospital, Sydney, New South Wales, Australia
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Liu W, Wei H, Wang C, Hua Z. Resilience and adaptation: a mixed-methods exploration of COVID-19's influence on neonatal residency education in China. BMC MEDICAL EDUCATION 2024; 24:654. [PMID: 38862921 PMCID: PMC11167867 DOI: 10.1186/s12909-024-05638-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/06/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND This study aimed to assess the impact of the pandemic of the coronavirus disease 2019 (COVID-19) on neonatology residency training in a tertiary children's hospital in Chongqing, located in southwest China. Specifically, the study encompassed the effects on residents' education, lived experiences, well-being, and the quality of neonatal care delivered. As higher educational institutions adapt to the post-COVID-19 era after the pandemic disruption, it is imperative that educational designers/academics learn from their experiences and challenges in curriculum design and delivery, ensuring quality and relevance in education. METHODS This study employed a mixed-methods approach to investigate the influence of the COVID-19 pandemic on neonatology residency training at a tertiary children's hospital in Chongqing. The first phase surveyed residents' perceptions and experiences of their clinical education and well-being during the crisis. The second phase compared the quality of neonatal care between the pre-pandemic and pandemic periods. RESULTS The survey of 123 neonatology residents examines the effects of COVID-19 on their learning, training, and mental health. The survey showed that most residents adapted well to the situation. Still, some faced challenges in their clinical education and experiences, such as reduced clinical exposure and opportunities to see rare diseases and conditions. A retrospective analysis of clinical data revealed that 7,151 neonates were admitted to the neonatology department during the study period. There was a 27.6% decrease in neonatal admissions during COVID-19, with more premature births and transfers. Residents conducted fewer clinical procedures but managed more complex cases. During COVID, hospital stays and costs were higher, but antibiotic use was lower. Although the case-mix index (CMI) score increased during the pandemic (1.25 vs. 1.18, p < 0.05), there was no significant difference in the rates of readmission within 7 days or poor prognosis. CONCLUSIONS Despite reduced clinical exposure, the quality of neonatal care was maintained through innovative training methods that enhanced comprehensive residency programs. The study suggested that neonatology residency education remained effective and resilient during the crisis. Exceptional health professional education is vital to train qualified physicians and enhance healthcare systems for future challenges.
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Affiliation(s)
- Weiqin Liu
- Department of Neonatology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China
- Faculty of Internal Medicine, The Pediatric College, Chongqing Medical University, Chongqing, China
- National Demonstration Base for Standardized Residency Training, Chongqing, China
| | - Hong Wei
- Department of Neonatology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China
- Faculty of Internal Medicine, The Pediatric College, Chongqing Medical University, Chongqing, China
| | - Chunyi Wang
- Department of Neonatology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- National Demonstration Base for Standardized Residency Training, Chongqing, China
| | - Ziyu Hua
- Department of Neonatology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
- Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China.
- Faculty of Internal Medicine, The Pediatric College, Chongqing Medical University, Chongqing, China.
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Watermeyer J, Kanji A. Lessons From an Exploratory Qualitative Survey on Simulation Opportunities for Clinical Education in Speech-Language Pathology and Audiology in South Africa. TEACHING AND LEARNING IN MEDICINE 2024:1-11. [PMID: 38850212 DOI: 10.1080/10401334.2024.2362878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 05/23/2024] [Indexed: 06/10/2024]
Abstract
Phenomenon: This study explored experiences of simulation-based clinical education in the Speech-Language Pathology and Audiology professions in South Africa, a Global South context where research on this topic is limited. In this context, the COVID-19 pandemic brought simulation to the forefront of clinical education as a training solution when in-person encounters were impossible. As these simulation-based training approaches gain traction, with continued use post-pandemic, it is important to understand how they are currently being used so that appropriate support can be offered to ensure their efficiency and success in the future. Approach: We distributed a survey to South African university departments offering Speech-Language Pathology and Audiology training, inviting participation from students across years of study and clinical educators. Data were collected between October 2022 and February 2023. Twelve responses were received: three from clinical educators and nine from students. We analyzed the responses using descriptive statistics and a domain summary approach. Findings: Simulated activities were implemented as options for clinical education in South African Speech-Language Pathology and Audiology (SLP/A) programs during the pandemic, albeit in a somewhat haphazard way depending on available resources, often with limited preparation or guidance. Some universities have continued using aspects of simulation training post-pandemic. Insights: Our findings, although preliminary, are somewhat consistent with Global North literature, particularly regarding barriers and challenges to implementing these approaches in clinical education. We offer suggestions for enhancing the support of simulation-based clinical education in our context.
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Affiliation(s)
- Jennifer Watermeyer
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Amisha Kanji
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
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Taylor AM, Wessels Q. "Spine to the future"-A narrative review of anatomy engagement. ANATOMICAL SCIENCES EDUCATION 2024; 17:735-748. [PMID: 38587085 DOI: 10.1002/ase.2417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 04/09/2024]
Abstract
Anatomy has been integral to medical and health education for centuries, it has also had a significant role in wider public life, as an educational resource, a link to their health, and also as a darker deterrent. Historically, public engagement in anatomy is hallmarked by public dissections of convicted criminals across the globe. Artists, specifically non-medical men, such as Leonardo da Vinci, are reported to have participated in public dissection. Dissection would later rekindle public interest in anatomy as graverobbing led to the reform and regulation of anatomy in many countries. In recent years, there has been growing interest from the public in learning more about their bodies as health and well-being become of paramount importance, particularly following the COVID-19 pandemic. Anatomy sits in a prime position to direct and instigate conversations around health, well-being, and body image. Every human on earth possesses a perfect resource to look at and learn about. Models, art-based anatomical activities, and crafts provide active learning opportunities for the wider public around anatomy. Most recently, apps, games, and extended reality provide novel and insightful learning opportunities for the public relating to the body. Finally, training and resources must also be made available from institutions and professional bodies to anatomists to enable them to deliver engagement in an already congested and educationally heavy schedule. This resurgence of interest in anatomical public engagement sees anatomy re-enter the public spotlight, with more appropriate resources and educational settings to offer engagement with the aim of benefiting the public.
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Affiliation(s)
- Adam M Taylor
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Quenton Wessels
- Division of Anatomy, School of Medicine, University of Namibia, Windhoek, Namibia
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Al Hakani MA, Grimmett EA, Laios E, Frank J, Srikantha S, Wilson K, Metcalfe K, Hamm C, Porter LA, Cavallo-Medved D. High-impact practices in cancer education and research: Undergraduate students' perceptions of skills and career development. BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION : A BIMONTHLY PUBLICATION OF THE INTERNATIONAL UNION OF BIOCHEMISTRY AND MOLECULAR BIOLOGY 2024. [PMID: 38813762 DOI: 10.1002/bmb.21839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/13/2024] [Accepted: 05/14/2024] [Indexed: 05/31/2024]
Abstract
High-impact practices (HIPs) are educational practices that foster student success. HIPs have not been widely used in cancer education and research despite the need for students to develop key transferable skills and cultivate social responsibility. Our study addresses this need by implementing four community-based learning HIPs within the context of cancer education and research. Each HIP was classified as having low, moderate, or high alignment with the traits of effective HIPs. Undergraduate science students participated in one to four HIPs as a Feedback Participant, General Volunteer, Student Leader, or Cancer Undergraduate Research and Education (CURES) Class Student. We then studied the effect of these HIPs on students' development of knowledge and skills; career interest and preparedness; and social responsibility. Results from self-reported questionnaires showed that HIPs increased students' cancer knowledge and developed their transferable and technical skills. Many students reported that these HIPs strongly impacted their career preparedness; positively influenced their interest in pursuing careers in health or biomedical sciences; and encouraged them to participate in community service activities. Thus, these findings provide new insights into the perceived benefits of HIPs in cancer education and research by undergraduate students.
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Affiliation(s)
- Mohammad A Al Hakani
- Faculty of Science, Department of Biomedical Sciences, University of Windsor, Windsor, Ontario, Canada
- Windsor Cancer Research Group (WCRG), WE-SPARK Health Institute, Windsor, Ontario, Canada
| | - Edward A Grimmett
- Faculty of Science, Department of Biomedical Sciences, University of Windsor, Windsor, Ontario, Canada
- Windsor Cancer Research Group (WCRG), WE-SPARK Health Institute, Windsor, Ontario, Canada
| | - Eleftheria Laios
- Faculty of Science, Department of Biomedical Sciences, University of Windsor, Windsor, Ontario, Canada
| | - Jake Frank
- Faculty of Science, Department of Biomedical Sciences, University of Windsor, Windsor, Ontario, Canada
- Windsor Cancer Research Group (WCRG), WE-SPARK Health Institute, Windsor, Ontario, Canada
| | - Subidsa Srikantha
- Faculty of Science, Department of Biomedical Sciences, University of Windsor, Windsor, Ontario, Canada
- Windsor Cancer Research Group (WCRG), WE-SPARK Health Institute, Windsor, Ontario, Canada
| | - Kaila Wilson
- Faculty of Science, Department of Biomedical Sciences, University of Windsor, Windsor, Ontario, Canada
- Windsor Cancer Research Group (WCRG), WE-SPARK Health Institute, Windsor, Ontario, Canada
| | - Karen Metcalfe
- Faculty of Science, Department of Biomedical Sciences, University of Windsor, Windsor, Ontario, Canada
- Windsor Cancer Research Group (WCRG), WE-SPARK Health Institute, Windsor, Ontario, Canada
| | - Caroline Hamm
- Windsor Cancer Research Group (WCRG), WE-SPARK Health Institute, Windsor, Ontario, Canada
| | - Lisa A Porter
- Faculty of Science, Department of Biomedical Sciences, University of Windsor, Windsor, Ontario, Canada
- Windsor Cancer Research Group (WCRG), WE-SPARK Health Institute, Windsor, Ontario, Canada
| | - Dora Cavallo-Medved
- Faculty of Science, Department of Biomedical Sciences, University of Windsor, Windsor, Ontario, Canada
- Windsor Cancer Research Group (WCRG), WE-SPARK Health Institute, Windsor, Ontario, Canada
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Cockle-Hearne J, Groothuizen JE, Ream E. Helping patients prepare their dependent children for parental death: mixed-methods evaluation of a codeveloped training programme for palliative and allied healthcare professionals in the UK. BMJ Open 2024; 14:e081775. [PMID: 38724050 PMCID: PMC11086417 DOI: 10.1136/bmjopen-2023-081775] [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] [Received: 11/06/2023] [Accepted: 04/11/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES To evaluate how the codesigned training programme, 'No conversation too tough', can help cancer, palliative and wider healthcare professionals support patients to communicate with their dependent children when a parent is dying. We examined perceptions of learning provided by the training, its contribution to confidence in communicating with families when a parent is dying, and subjective experience of, and reactions to, the training. We also explored potential changes in practice behaviours. DESIGN Pre-post, convergent, parallel, mixed-methods study. Motivations for practice change were measured quantitatively, and qualitatively through semi-structured interviews. Non-parametric analysis was conducted for self-efficacy and outcome expectancy measures; descriptive statistics examined perceptions of usefulness; intentions to use learning in practice and reactions to the training. Semi-structured interviews examined motivations and perceptions of learning in depth. A 6-week, practice log recorded immediate practice effects and reflections. SETTING 1-day training delivered 3 times, total delegates 36: online December 2021, February 2022, face-to-face March 2022. Questionnaires delivered correspondingly in online or paper formats, semi-structured interviews online. PARTICIPANTS Pre-post: palliative care professionals (n=14/12), acute cancer clinical nurse specialists (n=16/11), other healthcare professionals (n=5/5). RESULTS Positive changes were observed in self-efficacy (17 of 19 dimensions p<0.003) and outcome expectancies (3 of 14 beliefs p<0.036). Perceptions of usefulness and intentions to use learning in practice mean scores were 82-94 (scales 0=low to 100=high). There was high affirmation for sharing learning and influencing change in the workplace and wider practice. Content, style and delivery were positively endorsed. Further elements to be included in the training were identified. CONCLUSIONS The training programme has the potential to effect change in practice behaviours. A large-scale study will evaluate the roll-out of the training delivered to individual professionals and whole teams across the UK. It will provide longer-term feedback to understand practice behaviour and mediators of change across professional roles.
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Affiliation(s)
- Jane Cockle-Hearne
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Johanna Elise Groothuizen
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Emma Ream
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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Hall M. Commentary on Spadoni et al. 1. Physiother Can 2024; 76:236-237. [PMID: 38725606 PMCID: PMC11078251 DOI: 10.3138/ptc-2022-0027-cc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Affiliation(s)
- Mark Hall
- Teaching Professor and MScPT Program Director, Department of Physical Therapy, University of Alberta, Alberta, Canada;
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Kulju E, Jarva E, Oikarinen A, Hammarén M, Kanste O, Mikkonen K. Educational interventions and their effects on healthcare professionals' digital competence development: A systematic review. Int J Med Inform 2024; 185:105396. [PMID: 38503251 DOI: 10.1016/j.ijmedinf.2024.105396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 02/09/2024] [Accepted: 02/24/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION The digitalisation of healthcare requires that healthcare professionals are equipped with adequate digital competencies to be able to deliver high-quality healthcare. Continuing professional education is needed to ensure these competencies. OBJECTIVE This systematic review aimed to identify and describe the educational interventions that have been developed to improve various aspects of the digital competence of healthcare professionals and the effects of these interventions. METHODS A systematic literature review following the Joanna Briggs Institute's guidelines for Evidence Synthesis was conducted. Five electronic databases (CINAHL, PubMed, ProQuest, Scopus and Medic) up to November 2023 were searched for studies. Two researchers independently assessed the eligibility of the studies by title, abstract and full text and the methodological quality of the studies. Data tabulation and narrative synthesis analysis of study findings were performed. The PRISMA checklist guided the review process. RESULTS This review included 20 studies reporting heterogeneous educational interventions to develop the digital competence of healthcare professionals. The participants were mainly nurses and interventions were conducted in various healthcare settings. The length of the education varied from a 20-minute session to a six-month period. Education was offered through traditional contact teaching, using a blended-learning approach and through videoconference. Learning was enhanced through lectures, slide presentations, group work, case studies, discussions and practical exercises or simulations. Educational interventions achieved statistically significant results regarding participants' knowledge, skills, attitudes, perception of resources, self-efficacy or confidence and output quality. CONCLUSIONS The findings of this review suggest that digital competence education of nurses and allied health professionals would benefit from a multi-method approach. Training should provide knowledge as well as opportunities to interact with peers and instructors. Skills and confidence should be enhanced through practical training. Adequate organisational support, encouragement, and individual, needs-based guidance should be provided.
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Affiliation(s)
- E Kulju
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - E Jarva
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - A Oikarinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - M Hammarén
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - O Kanste
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - K Mikkonen
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Medical Research Center Oulu, Wellbeing Services County of North Ostrobothnia, Oulu, Finland.
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Tackett S, Steinert Y, Mirabal S, Reed DA, Whitehead CR, Wright SM. Blind spots in medical education - International perspectives. MEDICAL TEACHER 2024:1-7. [PMID: 38688493 DOI: 10.1080/0142159x.2024.2345271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND All individuals and groups have blind spots that can create problems if unaddressed. The goal of this study was to examine blind spots in medical education from international perspectives. METHODS From December 2022 to March 2023, we distributed an electronic survey through international networks of medical students, postgraduate trainees, and medical educators. Respondents named blind spots affecting their medical education system and then rated nine blind spot domains from a study of U.S. medical education along five-point Likert-type scales (1 = much less attention needed; 5 = much more attention needed). We tested for differences between blind spot ratings by respondent groups. We also analyzed the blind spots that respondents identified to determine those not previously described and performed content analysis on open-ended responses about blind spot domains. RESULTS There were 356 respondents from 88 countries, including 127 (44%) educators, 80 (28%) medical students, and 33 (11%) postgraduate trainees. At least 80% of respondents rated each blind spot domain as needing 'more' or 'much more' attention; the highest was 88% for 'Patient perspectives and voices that are not heard, valued, or understood.' In analyses by gender, role in medical education, World Bank country income level, and region, a mean difference of 0.5 was seen in only five of the possible 279 statistical comparisons. Of 885 blind spots documented, new blind spot areas related to issues that crossed national boundaries (e.g. international standards) and the sufficiency of resources to support medical education. Comments about the nine blind spot domains illustrated that cultural, health system, and governmental elements influenced how blind spots are manifested across different settings. DISCUSSION There may be general agreement throughout the world about blind spots in medical education that deserve more attention. This could establish a basis for coordinated international effort to allocate resources and tailor interventions that advance medical education.
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Affiliation(s)
- Sean Tackett
- Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Yvonne Steinert
- Faculty of Medicine and Health Sciences, Richard and Sylvia Cruess Chair in Medical Education, McGill University, Montreal, Canada
| | - Susan Mirabal
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Darcy A Reed
- Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
- Division of Community Internal Medicine, Geriatrics and Palliative Care, Mayo Clinic, Rochester, MN, USA
| | - Cynthia R Whitehead
- Department of Family and Community Medicine, Wilson Centre for Research in Education, University Health Network & University of Toronto, Toronto, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Scott M Wright
- Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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13
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Miskeen E. Utilization of Antenatal Care Services Within the Context of COVID-19, Security Challenges, and an Unstable Healthcare System at Primary Health Care Centers. Int J Womens Health 2024; 16:737-747. [PMID: 38686390 PMCID: PMC11057666 DOI: 10.2147/ijwh.s435894] [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: 09/13/2023] [Accepted: 11/25/2023] [Indexed: 05/02/2024] Open
Abstract
Background Utilizing antenatal care (ANC) is vital for maternal and neonatal well-being, especially in low-resource settings with healthcare challenges. Identifying factors impacting antenatal care this context, t of current situation in Sudan is crucial for developing strategies to improve maternal care. This study explores ANC utilization amidst COVID-19, security issues, and healthcare instability in primary health care centers in a resource-constrained environment, aiming to enhance maternal care access and quality. Methods This is a mixed-methods study. Quantitative data were collected through a retrospective analysis of ANC attendance records before and during the pandemic. Demographic variables were analyzed for their association with ANC utilization. In-depth interviews were conducted to collect qualitative data from pregnant women and healthcare providers. These interviews focused on capturing the experiences, perceptions, and obstacles associated with antenatal care services during the pandemic and within the healthcare system challenges. Results Preliminary quantitative analysis revealed a significant decline in ANC utilization during the pandemic. Fear of COVID-19 infection, disrupted transportation, and resource constraints have emerged as significant barriers to ANC attendance. The qualitative findings highlighted the impact of security challenges on healthcare access and the adaptation strategies employed, including mobile ANC clinics and telehealth consultations. Conclusion This study illuminates the intricate landscape of ANC utilization in the face of a pandemic, security instability, and healthcare system vulnerability. Policymakers and stakeholders should collaborate to strengthen healthcare systems and ensure the continued provision of essential maternal health services during challenging times.
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Affiliation(s)
- Elhadi Miskeen
- Department of Obstetrics and Gynaecology, College of Medicine, University of Bisha, Bisha, Saudi Arabia
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14
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Bagenal J. Health-care students: committed to improving health but frustrated. Lancet 2024; 403:1429-1431. [PMID: 38142705 DOI: 10.1016/s0140-6736(23)02757-5] [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: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 12/26/2023]
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15
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Ruttmann K, Albaladejo-Fuertes S, Lindenberg N, Kunst C, Mehrl A, Kindl V, Gülow K, Schlosser-Hupf S, Schmid S, Müller M. Relationship between interprofessional collaboration and psychological distress experienced by healthcare professionals during COVID-19: a monocentric cross-sectional study. Front Med (Lausanne) 2024; 11:1292608. [PMID: 38660424 PMCID: PMC11039835 DOI: 10.3389/fmed.2024.1292608] [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: 09/11/2023] [Accepted: 03/18/2024] [Indexed: 04/26/2024] Open
Abstract
Background Since the onset of the COVID-19 pandemic, global healthcare systems have faced unprecedented challenges, leading to significant psychological distress among healthcare professionals. Recognizing the importance of enhanced interprofessional collaboration in alleviating this burden, as emphasized by the World Health Organization in 2020, we investigated whether such collaboration could mitigate staff psychological distress during crises. To our knowledge, no study has yet explored the role of interprofessional collaboration as a resilience factor in crises. Methods For this monocentric cross-sectional study at a German university hospital, we examined the relationship between the quality of interprofessional collaboration and the psychological distress of healthcare professionals during the initial pandemic wave. We employed validated mental health instruments, such as the GAD-7 and PHQ-2, to assess anxiety and depressive symptoms. Additionally, custom-designed questionnaires evaluated "Pandemic-Associated Burden and Anxiety (PAB; PAA)" and interprofessional crisis management experiences. A novel "Interprofessional collaboration and communication (IPC)" assessment tool was developed based on international competency frameworks, demonstrating strong reliability. Results The study involved 299 healthcare professionals (78.6% in direct contact with COVID-19 patients). Moderate levels of PAB/PAA were reported. However, a significant proportion experienced clinically relevant anxiety, as indicated by GAD-7. Negative IPC perceptions correlated with higher levels of psychological distress. Linear regression analysis showed associations between interprofessional collaboration and anxious and depressive symptoms, and pandemic-related burden. Conclusion Our findings highlight the vital role of enhanced interprofessional collaboration in strengthening the psychological well-being of healthcare professionals during crises. The study underscores the need to foster a collaborative environment and integrate interprofessional education for resilience.
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Affiliation(s)
- Kirstin Ruttmann
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
- Nursing Development Department of the Care Management Head Office, University Hospital Regensburg, Regensburg, Germany
| | - Sheila Albaladejo-Fuertes
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Nicole Lindenberg
- Department of Anaesthesiology, University Hospital of Regensburg, Regensburg, Germany
| | - Claudia Kunst
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Alexander Mehrl
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Vera Kindl
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Karsten Gülow
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Sophie Schlosser-Hupf
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Stephan Schmid
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Martina Müller
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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16
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Volschenk M, Hansen A. Medical teachers' identity learning during major curriculum renewal: A landscapes of practice perspective. MEDICAL TEACHER 2024:1-7. [PMID: 38593840 DOI: 10.1080/0142159x.2024.2337245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/26/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE To explore how medical teachers navigate their professional identities when required to implement critical pedagogy during an undergraduate curriculum renewal initiative. METHODS A qualitative exploratory study was conducted, using focus groups and individual interviews with twenty-six purposively selected undergraduate medical teachers at a South African university. Data were transcribed, coded, and thematically analysed. Concepts of Landscapes of Practice Theory and Teacher Identity Learning provided an interpretive framework. RESULTS Findings show that medical teachers' perceived capacity to implement critical pedagogy was influenced by identities that were constructed within the boundaries of a traditional biomedical curriculum. Three themes were identified, highlighting the inherent liminality of traversing a changing educational landscape: engaging in new practices: moving into the boundary space; attempting alignment: navigating identity in the boundary space; imagining the future: embracing identity in the boundary space. CONCLUSION Globally directed curriculum renewal imperatives may challenge the established pedagogical practices and professional identities of medical teachers. There is a need for institutional spaces that foster collaboration, dialogue, and reflection with a view to supporting the ongoing identity learning and development of knowledgeability of medical teachers responsible for curriculum transformation.
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Affiliation(s)
- Mariette Volschenk
- Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anthea Hansen
- Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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17
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Issenberg SB, Chandran L. Proceedings from the International Conference on the Future of Health Professions Education 2022. MEDICAL TEACHER 2024; 46:438-442. [PMID: 38206903 DOI: 10.1080/0142159x.2023.2298757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 12/20/2023] [Indexed: 01/13/2024]
Affiliation(s)
- S Barry Issenberg
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Latha Chandran
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL, USA
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18
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Pati S, Lindenfeld L, Gropack S, Paz HL. Meeting the Need for Human Connection in Our Health Care Workforce. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:347-348. [PMID: 38166318 DOI: 10.1097/acm.0000000000005624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
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19
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Shen H, Wu H, Zhang N, Zhang Y, Wu Z, Cheng B, Wang M, Liu X. Self-reported perceptions of ethical and professional expectations of medical students in China and the influence of voluntary work during the COVID-19: a survey on "Five Characteristics". Sci Rep 2024; 14:7387. [PMID: 38548870 PMCID: PMC10978824 DOI: 10.1038/s41598-024-57992-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/24/2024] [Indexed: 04/01/2024] Open
Abstract
In the post-pandemic era, there is a need for medical professionals with creativity, clinical expertise, and social responsibility. The Chinese government issued a directive to enhance the "Five Characteristics" perceptions of medical students, incorporating moral integrity and adeptness in saving lives and aiding the injured, embracing a compassionate approach to medical practice, possessing the knowledge essential for academic distinction, mastering technical expertise, and the artistry of applying scientific methodologies. The purpose of this study was to investigate the opinions related to ethics and professional behaviors of medical students at one Chinese medical school using a validated 19-item survey instrument and analyze its influencing factors. We conducted a survey in a medical university in Anhui Province, China, and collected 1966 valid questionnaires using the "Five Characteristics Rating Scale". The results indicated high perceptions of "Five Characteristics" among Chinese medical students (85.42 ± 8.727). Lower-grade-year medical students (86.59 ± 7.888) had higher "Five Characteristics" perceptions than upper-grade-year medical students (84.29 ± 9.327, P < 0.05). In addition, medical students experiencing voluntary work during the COVID-19 pandemic showed higher perceptions (86.21 ± 8.357) than those without such experience (85.13 ± 8.842, P < 0.05). Grade year and voluntary work experience during the COVID-19 pandemic were influencing factors of "Five Characteristics" perceptions. Our research offers a theoretical foundation for governments and medical schools to cultivate doctors with high ethical standards and professional expectations.
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Affiliation(s)
- Hui Shen
- College of Life Sciences, Anhui Medical University, Hefei, 230032, China.
- First School of Clinical Medicine, Anhui Medical University, Hefei, 230032, Anhui, China.
| | - Hongyu Wu
- College of Life Sciences, Anhui Medical University, Hefei, 230032, China
| | - Ning Zhang
- College of Life Sciences, Anhui Medical University, Hefei, 230032, China
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Yuchen Zhang
- Second School of Clinical Medicine, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Zhengyang Wu
- College of Life Sciences, Anhui Medical University, Hefei, 230032, China
| | - Beiping Cheng
- College of Life Sciences, Anhui Medical University, Hefei, 230032, China
| | - Minao Wang
- College of Life Sciences, Anhui Medical University, Hefei, 230032, China
| | - Xuefei Liu
- College of Life Sciences, Anhui Medical University, Hefei, 230032, China
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20
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Khalili H, Lackie K, Langlois S, da Silva Souza CM, Wetzlmair LC. The status of interprofessional education (IPE) at regional and global levels - update from 2022 global IPE situational analysis. J Interprof Care 2024; 38:388-393. [PMID: 38126193 DOI: 10.1080/13561820.2023.2287023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 11/17/2023] [Indexed: 12/23/2023]
Abstract
This short report is based on the 2022 Global IPE Situational Analysis Results e-Book that is available at https://interprofessionalresearch.global/. As an up-to-date global environmental scan of interprofessional education (IPE), this cross-sectional study investigated institutional, administrative, and system-level processes that support IPE program development and implementation globally. Conducted by InterprofessionalResearch.Global (IPR.Global), the survey included 17 quantitative questions that were analyzed at global and regional levels. Three open-text questions were thematically analyzed. In total, 152 institutions from six regions worldwide contributed to this study. Results revealed that only 51.97% of all responding institutions have an established IPE program, with Canada and the USA having the highest (84%) and Africa (26%) having the lowest numbers. Globally, 37.33% of respondents reported no formal leadership positions and 41.33% reported the absence of a designated IPE Director or Coordinator. In addition, IPE funding varies considerably across the world, with 32.65% of institutions reporting no financial support. Over 48.22% of respondents indicated their institutions are rarely or not involved in IPE-related scholarly work or research. The open-text analysis revealed that supportive senior leadership, a culture of collaboration, and recognition of IPE as a strategic direction and/or priority at the institutional level, could foster the successful implementation of IPE. On the other hand, inadequate administrative support, lack of funding, poor attitudes regarding IPE, and limited dedicated time for research, seemed to impair successful implementation of scholarly activities in the field.
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Affiliation(s)
- Hossein Khalili
- InterprofessionalResearch.Global
- School of Health Sciences, Winston-Salem State University, Winston-Salem, North Carolina, USA
| | - Kelly Lackie
- Simulation-based Education and Interprofessional Education, Dalhousie University, Halifax, Canada
| | - Sylvia Langlois
- Academics, Centre for Advancing Collaborative Healthcare and Education, University of Toronto, Toronto, ON, Canada
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21
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Xu Y, Jiang Z, Ting DSW, Kow AWC, Bello F, Car J, Tham YC, Wong TY. Medical education and physician training in the era of artificial intelligence. Singapore Med J 2024; 65:159-166. [PMID: 38527300 PMCID: PMC11060639 DOI: 10.4103/singaporemedj.smj-2023-203] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/08/2024] [Indexed: 03/27/2024]
Abstract
ABSTRACT With the rise of generative artificial intelligence (AI) and AI-powered chatbots, the landscape of medicine and healthcare is on the brink of significant transformation. This perspective delves into the prospective influence of AI on medical education, residency training and the continuing education of attending physicians or consultants. We begin by highlighting the constraints of the current education model, challenges in limited faculty, uniformity amidst burgeoning medical knowledge and the limitations in 'traditional' linear knowledge acquisition. We introduce 'AI-assisted' and 'AI-integrated' paradigms for medical education and physician training, targeting a more universal, accessible, high-quality and interconnected educational journey. We differentiate between essential knowledge for all physicians, specialised insights for clinician-scientists and mastery-level proficiency for clinician-computer scientists. With the transformative potential of AI in healthcare and service delivery, it is poised to reshape the pedagogy of medical education and residency training.
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Affiliation(s)
- Yueyuan Xu
- Tsinghua Medicine, School of Medicine, Tsinghua University, Beijing, China
| | - Zehua Jiang
- Tsinghua Medicine, School of Medicine, Tsinghua University, Beijing, China
- School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Daniel Shu Wei Ting
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Eye Academic Clinical Program, Duke-NUS Medical School, Singapore
- Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Alfred Wei Chieh Kow
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Fernando Bello
- Technology Enhanced Learning and Innovation Department, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Eye Academic Clinical Program, Duke-NUS Medical School, Singapore
- Centre for Innovation and Precision Eye Health and Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tien Yin Wong
- Tsinghua Medicine, School of Medicine, Tsinghua University, Beijing, China
- School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Beijing, China
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
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22
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Snyder J, Alexander LM, Statler M, Straker H, Bowser J, Caruthers K, Murray D, Alesbury E. Time to Pivot: A Guide to Holistic Admissions. J Physician Assist Educ 2024; 35:43-51. [PMID: 38227674 DOI: 10.1097/jpa.0000000000000569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
ABSTRACT As an ever-increasing number of physician assistant (PA) programs moves toward holistic admissions, a better understanding of how to achieve their stated admission goals becomes more important. With the June 2023 US Supreme Court decision effectively ending affirmative action in higher education, navigating holistic admissions is now an even greater challenge. In this article, the PA Education Association's Presidents Commission offers a guide for programs to use in implementing holistic admissions at their institutions and key considerations. Is the process mission-driven? Does it follow principles of quality improvement and incorporate ongoing assessment of that process? Using data can be a constructive and insightful way to inform the process. The authors hope that tools, resources, and recommendations offered in this article will serve as valuable resources for any program attempting to institute or improve its holistic admissions process.
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Affiliation(s)
- Jennifer Snyder
- Jennifer Snyder, PhD, PA-C, is a professor and associate dean for the College of Pharmacy and Health Sciences at Butler University in Indianapolis, Indiana
- Lisa Mustone Alexander, EdD, MPH, PA-C, is a professor and the director of the PA Programme at the Royal College of Surgeons in Ireland in Dublin, Ireland
- Michel Statler, DMSc, PA-C, is an associate professor for the Physician Assistant Department at the University of Texas Southwestern Medical Center in Dallas, Texas
- Howard Straker, EdD, MPH, PA-C, is an assistant professor and director of the Joint Degree PA/MPH Program, Department of PA Studies, School of Medicine & Health Sciences, at George Washington University in Washington, DC
- Jonathan Bowser, MS, PA-C, is an associate professor and director of the Child Health Associate/Physician Assistant Program as well as associate dean of Physician Assistant Studies at the University of Colorado Anschutz Medical Program in Aurora, Colorado
- Kara Caruthers, MSPAS, PA-C, is an associate professor and associate program director for the PA program at Meharry Medical College in Nashville, Tennessee
- Donna Murray, DMSc, MS, PA-C, is the former senior director of Admissions/CASPA for the PA Education Association in Washington, DC
- Elizabeth Alesbury, BA, is the former editorial director for the PA Education Association in Washington, DC
| | - Lisa Mustone Alexander
- Jennifer Snyder, PhD, PA-C, is a professor and associate dean for the College of Pharmacy and Health Sciences at Butler University in Indianapolis, Indiana
- Lisa Mustone Alexander, EdD, MPH, PA-C, is a professor and the director of the PA Programme at the Royal College of Surgeons in Ireland in Dublin, Ireland
- Michel Statler, DMSc, PA-C, is an associate professor for the Physician Assistant Department at the University of Texas Southwestern Medical Center in Dallas, Texas
- Howard Straker, EdD, MPH, PA-C, is an assistant professor and director of the Joint Degree PA/MPH Program, Department of PA Studies, School of Medicine & Health Sciences, at George Washington University in Washington, DC
- Jonathan Bowser, MS, PA-C, is an associate professor and director of the Child Health Associate/Physician Assistant Program as well as associate dean of Physician Assistant Studies at the University of Colorado Anschutz Medical Program in Aurora, Colorado
- Kara Caruthers, MSPAS, PA-C, is an associate professor and associate program director for the PA program at Meharry Medical College in Nashville, Tennessee
- Donna Murray, DMSc, MS, PA-C, is the former senior director of Admissions/CASPA for the PA Education Association in Washington, DC
- Elizabeth Alesbury, BA, is the former editorial director for the PA Education Association in Washington, DC
| | - Michel Statler
- Jennifer Snyder, PhD, PA-C, is a professor and associate dean for the College of Pharmacy and Health Sciences at Butler University in Indianapolis, Indiana
- Lisa Mustone Alexander, EdD, MPH, PA-C, is a professor and the director of the PA Programme at the Royal College of Surgeons in Ireland in Dublin, Ireland
- Michel Statler, DMSc, PA-C, is an associate professor for the Physician Assistant Department at the University of Texas Southwestern Medical Center in Dallas, Texas
- Howard Straker, EdD, MPH, PA-C, is an assistant professor and director of the Joint Degree PA/MPH Program, Department of PA Studies, School of Medicine & Health Sciences, at George Washington University in Washington, DC
- Jonathan Bowser, MS, PA-C, is an associate professor and director of the Child Health Associate/Physician Assistant Program as well as associate dean of Physician Assistant Studies at the University of Colorado Anschutz Medical Program in Aurora, Colorado
- Kara Caruthers, MSPAS, PA-C, is an associate professor and associate program director for the PA program at Meharry Medical College in Nashville, Tennessee
- Donna Murray, DMSc, MS, PA-C, is the former senior director of Admissions/CASPA for the PA Education Association in Washington, DC
- Elizabeth Alesbury, BA, is the former editorial director for the PA Education Association in Washington, DC
| | - Howard Straker
- Jennifer Snyder, PhD, PA-C, is a professor and associate dean for the College of Pharmacy and Health Sciences at Butler University in Indianapolis, Indiana
- Lisa Mustone Alexander, EdD, MPH, PA-C, is a professor and the director of the PA Programme at the Royal College of Surgeons in Ireland in Dublin, Ireland
- Michel Statler, DMSc, PA-C, is an associate professor for the Physician Assistant Department at the University of Texas Southwestern Medical Center in Dallas, Texas
- Howard Straker, EdD, MPH, PA-C, is an assistant professor and director of the Joint Degree PA/MPH Program, Department of PA Studies, School of Medicine & Health Sciences, at George Washington University in Washington, DC
- Jonathan Bowser, MS, PA-C, is an associate professor and director of the Child Health Associate/Physician Assistant Program as well as associate dean of Physician Assistant Studies at the University of Colorado Anschutz Medical Program in Aurora, Colorado
- Kara Caruthers, MSPAS, PA-C, is an associate professor and associate program director for the PA program at Meharry Medical College in Nashville, Tennessee
- Donna Murray, DMSc, MS, PA-C, is the former senior director of Admissions/CASPA for the PA Education Association in Washington, DC
- Elizabeth Alesbury, BA, is the former editorial director for the PA Education Association in Washington, DC
| | - Jonathan Bowser
- Jennifer Snyder, PhD, PA-C, is a professor and associate dean for the College of Pharmacy and Health Sciences at Butler University in Indianapolis, Indiana
- Lisa Mustone Alexander, EdD, MPH, PA-C, is a professor and the director of the PA Programme at the Royal College of Surgeons in Ireland in Dublin, Ireland
- Michel Statler, DMSc, PA-C, is an associate professor for the Physician Assistant Department at the University of Texas Southwestern Medical Center in Dallas, Texas
- Howard Straker, EdD, MPH, PA-C, is an assistant professor and director of the Joint Degree PA/MPH Program, Department of PA Studies, School of Medicine & Health Sciences, at George Washington University in Washington, DC
- Jonathan Bowser, MS, PA-C, is an associate professor and director of the Child Health Associate/Physician Assistant Program as well as associate dean of Physician Assistant Studies at the University of Colorado Anschutz Medical Program in Aurora, Colorado
- Kara Caruthers, MSPAS, PA-C, is an associate professor and associate program director for the PA program at Meharry Medical College in Nashville, Tennessee
- Donna Murray, DMSc, MS, PA-C, is the former senior director of Admissions/CASPA for the PA Education Association in Washington, DC
- Elizabeth Alesbury, BA, is the former editorial director for the PA Education Association in Washington, DC
| | - Kara Caruthers
- Jennifer Snyder, PhD, PA-C, is a professor and associate dean for the College of Pharmacy and Health Sciences at Butler University in Indianapolis, Indiana
- Lisa Mustone Alexander, EdD, MPH, PA-C, is a professor and the director of the PA Programme at the Royal College of Surgeons in Ireland in Dublin, Ireland
- Michel Statler, DMSc, PA-C, is an associate professor for the Physician Assistant Department at the University of Texas Southwestern Medical Center in Dallas, Texas
- Howard Straker, EdD, MPH, PA-C, is an assistant professor and director of the Joint Degree PA/MPH Program, Department of PA Studies, School of Medicine & Health Sciences, at George Washington University in Washington, DC
- Jonathan Bowser, MS, PA-C, is an associate professor and director of the Child Health Associate/Physician Assistant Program as well as associate dean of Physician Assistant Studies at the University of Colorado Anschutz Medical Program in Aurora, Colorado
- Kara Caruthers, MSPAS, PA-C, is an associate professor and associate program director for the PA program at Meharry Medical College in Nashville, Tennessee
- Donna Murray, DMSc, MS, PA-C, is the former senior director of Admissions/CASPA for the PA Education Association in Washington, DC
- Elizabeth Alesbury, BA, is the former editorial director for the PA Education Association in Washington, DC
| | - Donna Murray
- Jennifer Snyder, PhD, PA-C, is a professor and associate dean for the College of Pharmacy and Health Sciences at Butler University in Indianapolis, Indiana
- Lisa Mustone Alexander, EdD, MPH, PA-C, is a professor and the director of the PA Programme at the Royal College of Surgeons in Ireland in Dublin, Ireland
- Michel Statler, DMSc, PA-C, is an associate professor for the Physician Assistant Department at the University of Texas Southwestern Medical Center in Dallas, Texas
- Howard Straker, EdD, MPH, PA-C, is an assistant professor and director of the Joint Degree PA/MPH Program, Department of PA Studies, School of Medicine & Health Sciences, at George Washington University in Washington, DC
- Jonathan Bowser, MS, PA-C, is an associate professor and director of the Child Health Associate/Physician Assistant Program as well as associate dean of Physician Assistant Studies at the University of Colorado Anschutz Medical Program in Aurora, Colorado
- Kara Caruthers, MSPAS, PA-C, is an associate professor and associate program director for the PA program at Meharry Medical College in Nashville, Tennessee
- Donna Murray, DMSc, MS, PA-C, is the former senior director of Admissions/CASPA for the PA Education Association in Washington, DC
- Elizabeth Alesbury, BA, is the former editorial director for the PA Education Association in Washington, DC
| | - Elizabeth Alesbury
- Jennifer Snyder, PhD, PA-C, is a professor and associate dean for the College of Pharmacy and Health Sciences at Butler University in Indianapolis, Indiana
- Lisa Mustone Alexander, EdD, MPH, PA-C, is a professor and the director of the PA Programme at the Royal College of Surgeons in Ireland in Dublin, Ireland
- Michel Statler, DMSc, PA-C, is an associate professor for the Physician Assistant Department at the University of Texas Southwestern Medical Center in Dallas, Texas
- Howard Straker, EdD, MPH, PA-C, is an assistant professor and director of the Joint Degree PA/MPH Program, Department of PA Studies, School of Medicine & Health Sciences, at George Washington University in Washington, DC
- Jonathan Bowser, MS, PA-C, is an associate professor and director of the Child Health Associate/Physician Assistant Program as well as associate dean of Physician Assistant Studies at the University of Colorado Anschutz Medical Program in Aurora, Colorado
- Kara Caruthers, MSPAS, PA-C, is an associate professor and associate program director for the PA program at Meharry Medical College in Nashville, Tennessee
- Donna Murray, DMSc, MS, PA-C, is the former senior director of Admissions/CASPA for the PA Education Association in Washington, DC
- Elizabeth Alesbury, BA, is the former editorial director for the PA Education Association in Washington, DC
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Zhang X, Wang Y, Chen Y, Yang H, Luan X. Role cognition of assigned nurses supporting Hubei Province in the fight against COVID-19 in China: a hermeneutic phenomenological study. Front Psychol 2024; 15:1287944. [PMID: 38487660 PMCID: PMC10939063 DOI: 10.3389/fpsyg.2024.1287944] [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: 09/04/2023] [Accepted: 02/05/2024] [Indexed: 03/17/2024] Open
Abstract
Aims During the COVID-19 epidemic, nurses played a crucial role in clinical treatment. As a special group, front-line nurses, especially those assigned to support Hubei Province in the fight against COVID-19 between February and April 2020, brought diverse experiences from different provinces in China in taking care of COVID-19 patients and role cognition. Therefore, our purpose is to explore the real coping experience and role cognition of front-line nurses during the novel coronavirus outbreak to provide relevant experience references for society and managers in the face of such major public health emergencies in the future. Design This qualitative study was performed using the phenomenological hermeneutics method. Method This is a qualitative phenomenological study. Semi-structured in-depth interviews were used to collect data. The interviewees were 53 front-line nurses who assisted and supported the fight against COVID-19 in Hubei Province during the COVID-19 epidemic. Data were collected through individual online and telephone interviews using a semi-structured interview during March 2020. The COREQ guidance was used to report this study. Results The findings revealed that front-line nurses assisting in the fight against COVID-19 developed a context-specific role cognition of their work and contribution to society. The qualitative analysis of the data revealed 15 sub-categories and 5 main categories. These five themes represented the different roles identified by nurses. The roles included expectations, conflicts, adaptation, emotions, and flow of blessing. Belief in getting better, a sense of honor, and training could help them to reduce feelings of conflict in this role and adapt more quickly. Discussion This article discusses the real coping experience and role cognition of front-line nurses during the novel coronavirus epidemic. It provides relevant experience references for society and managers to face similar major public health emergencies in the future. This study makes a significant contribution to the literature because it demonstrates how non-local nurses sent to Hubei to work perceived their roles as part of a larger narrative of patriotism, duty, solidarity, and hope.
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Affiliation(s)
- Xu Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yaqian Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yuanyuan Chen
- Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Hailing Yang
- Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Xiaorong Luan
- Infection Management Department, Qilu Hospital of Shandong University, Jinan, Shandong, China
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Tao R, Li W, Min K, Mo D, Geng F, Xia L, Liu T, Liu Y, Jiang F, Liu H, Tang YL. Prevalence and associated factors of depression, anxiety and stress among clinical therapists in China in the context of early COVID-19 pandemic. Front Psychiatry 2024; 15:1342528. [PMID: 38463429 PMCID: PMC10920219 DOI: 10.3389/fpsyt.2024.1342528] [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: 11/22/2023] [Accepted: 02/05/2024] [Indexed: 03/12/2024] Open
Abstract
Objectives To study the socio-demographic characteristics and the prevalence of depression, anxiety, and stress among clinical therapists in China during the early Coronavirus disease 2019 (COVID-19) pandemic and to identify associated factors. Method This cross-sectional study was part of a multicenter, nationally representative survey conducted through WeChat from January 2021 to March 2021. Data, including socio-demographics, health-related behaviors, and information on whether they participated in the frontline work of treating COVID-19, were collected anonymously. Respondents also completed the Depression Anxiety Stress Scales-21 (DASS-21). Results In total, 396 clinical therapists in the selected hospitals completed the questionnaires, with a response rate of 89.0%. Respondents were predominantly female (77.3%). About 6.6% of the participants were current tobacco users, and 20.7% had participated in the frontline work of treating COVID-19. Overall, 22.0%, 17.9%, and 8.8% of participants were classified as having clinically meaningful depression, anxiety, and stress, respectively, based on DASS-21 scores. Multiple logistic regression in Model 1 and Model 2 showed that depression, anxiety, and stress were associated with regular physical activity and frequent insomnia (all, p < 0.05). In anxiety model 2, the associated factors for anxiety during the pandemic were identified as education (master's degree or more, OR=0.520; 95% CI=0.283-0.955), marital status (single, OR=2.064; 95% CI=1.022-4.168), tobacco use (OR=4.265; 95% CI=1.352-13.454), regular physical activity (OR=0.357; 95% CI=0.192-0.663), frequent insomnia (OR=6.298; 95% CI =2.522-15.729), and participation in the frontline work of treating COVID-19 (OR=3.179; 95% CI=1.697-5.954). The COVID-19 epidemic did not significantly increase the depression and stress levels among clinical therapists, but it did significantly increase anxiety levels. Conclusion During the COVID-19 pandemic, depression, anxiety and stress were relatively common among clinical therapists in China. Regular physical activity and good sleep were important protective factors against emotional problems. Therefore, encouraging regular physical activity and actively addressing clinical therapists' sleep problems is beneficial to improving the ability to cope with negative emotions. The COVID-19 epidemic significantly increased anxiety, and awareness and interventions should be recommended to reduce anxiety among clinical therapists during the COVID-19 pandemic.
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Affiliation(s)
- Rui Tao
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Hefei, China
| | - Wenzheng Li
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Hefei, China
- Department of Substance-Related Disorders, Hefei Fourth People’s Hospital, Hefei, China
| | - Kaiyuan Min
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Daming Mo
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Hefei, China
- Department of Substance-Related Disorders, Hefei Fourth People’s Hospital, Hefei, China
| | - Feng Geng
- Department of Psychiatry, Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Hefei, China
| | - Tingfang Liu
- Research Department, School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- Research Department, School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Feng Jiang
- Research Department, School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
- Research Department, Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Hefei, China
| | - Yi-lang Tang
- Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
- Mental Health Service Line, Atlanta Veterans Affairs Medical Center, Decatur, GA, United States
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Chickering MJ, Frank E, Caplan AL. Standing on the Shoulders of Giant Artificial Intelligence Bots: Artificial Intelligence Can and Therefore Must Now Elevate Equity in Health Professional Education. AJPM FOCUS 2024; 3:100168. [PMID: 38162400 PMCID: PMC10756954 DOI: 10.1016/j.focus.2023.100168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Affiliation(s)
| | - Erica Frank
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Arthur L. Caplan
- Grossman School of Medicine, New York University, New York, New York
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Collis JM, Barradell S, Broman P, Brownie S. University Staff Insights on Interprofessional Education and Student-Led Clinic Opportunities at an Australian University. J Multidiscip Healthc 2024; 17:305-315. [PMID: 38268850 PMCID: PMC10807446 DOI: 10.2147/jmdh.s447690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/28/2023] [Indexed: 01/26/2024] Open
Abstract
Purpose Organizational and university staff buy-in and advocacy are critical considerations in planning successful interprofessional education (IPE) initiatives in healthcare, such as interprofessional student-led clinics (SLCs). This study was designed with the purpose of gaining deeper insight into current views and perspectives of academic and professional staff at an Australian university, as a precursor to planning IPE and SLC activities. Methods All academic and professional staff from within the School of Health Sciences were invited to participate in the study. In-depth-qualitative interviews were conducted with 16 staff to explore academic and professional staff perspectives on IPE and SLCs. Reflexive thematic analysis was used to analyse the data. Results Findings are grouped within five themes that incorporate broad perspectives on the tensions and possibilities of IPE and establishment of SLCs: Academic and professional staff commitment; Better/smarter IPE; Student-led clinic potential; Vision and innovation; and Strategy and resourcing. The themes reflect the high value placed on IPE by academic and professional staff and incorporate innovative ideas on how to prepare students for a rapidly changing and evolving healthcare environment. A reticence towards standard models of university based SLCs was expressed. Conclusion Academic and professional staff insights suggest university leaders need to develop a greater strategic focus on improving IPE. Effective engagement with staff is required to support IPE planning and implementation. If considering implementation of SLCs, contemporary fit-for-purpose models should be explored such as partnerships with primary healthcare providers, community wellness facilities, and hospital clinics rather than traditional university-based clinics.
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Affiliation(s)
- Julie M Collis
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Sarah Barradell
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Patrick Broman
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
- Centre for Health and Social Practice, Waikato Institute of Technology, Hamilton, New Zealand
| | - Sharon Brownie
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
- Centre for Health and Social Practice, Waikato Institute of Technology, Hamilton, New Zealand
- Griffith Health, Griffith University, Gold Coast, QLD, Australia
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Ghahramanian A, Bagheriyeh F, Aghajari P, Asghari-Jafarabadi M, Abolfathpour P, Rahmani A, Nabighadim A, Hajieskandar A. The intention to leave among academics in Iran: an examination of their work-life quality and satisfaction. BMC Nurs 2024; 23:43. [PMID: 38225614 PMCID: PMC10789055 DOI: 10.1186/s12912-024-01720-7] [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: 08/21/2023] [Accepted: 01/07/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Despite the importance of faculty retention, there is little understanding of how demographic variables, professional and institutional work-life issues, and satisfaction interact to explain faculty intentions to leave. This study aimed to investigate the intention to leave among academics and their Work-Life Quality and Satisfaction. METHODS This is a descriptive cross-sectional study conducted by 8 faculties affiliated to Urmia University of Medical Sciences located in Urmia, West Azarbaijan province, Iran. The participants in the study were 120 faculty members from Nursing and Midwifery, Medicine, Allied health professions, and Health management and medical information faculties. The Work-Life Quality and Satisfaction scale, and the intension to leave scale were used for data collection. Uni- and multivariable linear regression analyses were employed to determine predictors of the intention to leave (P-values < 0.05). RESULTS The mean scores of all dimensions of Work-Life Quality and Satisfaction scale, and intention to leave were in an average level. There is a negative correlation between Work-Life Quality and Satisfaction subscales, along with demographic factors, and the intention to leave (P < 0.05), while multivariate analysis showed that work experience and Discipline were significant independent predictors of intention to leave (P < 0.05). CONCLUSIONS In order to improve education in universities, it is necessary to pay attention to the conditions of creating job satisfaction in academics. Considering the high intention to leave among Nursing lecturers, without sufficient support of nursing schools in terms of human resources, it may suffer by the lack of academic staff; eventually the quality of education will reduce in undergraduate nursing in the long term.
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Affiliation(s)
- Akram Ghahramanian
- The National Agency for Strategic Research in Medical Education, Tehran, Iran
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzaneh Bagheriyeh
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Parvaneh Aghajari
- Department of Pediatric Nursing, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran.
| | - Mohammad Asghari-Jafarabadi
- Cabrini Research, Cabrini Health, Malvern, VIC, 3144, Australia
- Biostatistics Unit, School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, 3004, Australia
- Department of Psychiatry, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, 3168, Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Pedram Abolfathpour
- Student Research Committee, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Azad Rahmani
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amirreza Nabighadim
- Pediatric Urology and Regenerative Medicine Research Center, Children'Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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Simon R, Petrisor C, Bodolea C, Golea A, Gomes SH, Antal O, Vasian HN, Moldovan O, Puia CI. Efficiency of Simulation-Based Learning Using an ABC POCUS Protocol on a High-Fidelity Simulator. Diagnostics (Basel) 2024; 14:173. [PMID: 38248050 PMCID: PMC10814096 DOI: 10.3390/diagnostics14020173] [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: 11/30/2023] [Revised: 12/30/2023] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
Critically ill patients with rapidly deteriorating clinical status secondary to respiratory and cardio-vascular compromise are at risk for immediate collapse if the underlying pathology is not recognized and treated. Rapid diagnosis is of utmost importance regardless of the setting. Although there are data to support the use of point-of-care ultrasound in critical patients, there is no consensus about the best educational strategy to implement. We designed a curriculum based on the ABC (Airway, Breathing, Circulation) protocol that covers essential airway, lung, and cardiac ultrasound skills needed for fast diagnosis in critical patients and applied it in high-fidelity simulation-based medical education sessions for anesthesia and intensive care residents year one and two. After theoretical and practical assessments, our results show statistical differences in the theoretical knowledge and above-average results in practical assessment. Our proposed curriculum based on a simple ABC POCUS protocol, with an Airway, Breathing, and Circulation approach, is useful in teaching ultrasound basics regarding airway, lung, and cardiac examination using high-fidelity simulation training to anesthesia and intensive care residents, but further research is needed to establish the utility of Simulation-Based Medical Education in Point of Care Ultrasound in the critical patient.
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Affiliation(s)
- Robert Simon
- Doctoral School, Faculty of Medicine, University of Oradea, 410087 Oradea, Romania;
- Anesthesia and Intensive Care Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania; (C.P.); (H.N.V.)
- Clinical Institute of Urology and Renal Transplant, 400000 Cluj-Napoca, Romania
| | - Cristina Petrisor
- Anesthesia and Intensive Care Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania; (C.P.); (H.N.V.)
- Clinical County Emergency Hospital, 400347 Cluj-Napoca, Romania;
| | - Constantin Bodolea
- Anesthesia and Intensive Care Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania; (C.P.); (H.N.V.)
- Municipal Clinical Hospital, 400139 Cluj-Napoca, Romania
| | - Adela Golea
- Clinical County Emergency Hospital, 400347 Cluj-Napoca, Romania;
- Emergency Medicine Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Sara Hora Gomes
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- ICVS/3B’s-PT Government Associate Laboratory, 4710-057 Braga, Portugal
| | - Oana Antal
- Anesthesia and Intensive Care Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania; (C.P.); (H.N.V.)
- Clinical Institute of Urology and Renal Transplant, 400000 Cluj-Napoca, Romania
| | - Horațiu Nicolae Vasian
- Anesthesia and Intensive Care Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania; (C.P.); (H.N.V.)
- Regional Institute of Gastroenterology and Hepatology, 400394 Cluj-Napoca, Romania
| | - Orlanda Moldovan
- Clinical Emergency Hospital for Children, 400177 Cluj-Napoca, Romania
| | - Cosmin Ion Puia
- Doctoral School, Faculty of Medicine, University of Oradea, 410087 Oradea, Romania;
- Regional Institute of Gastroenterology and Hepatology, 400394 Cluj-Napoca, Romania
- Surgery Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
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Çakmakkaya ÖS, Meydanlı EG, Kafadar AM, Demirci MS, Süzer Ö, Ar MC, Yaman MO, Demirbaş KC, Gönen MS. Factors affecting medical students' satisfaction with online learning: a regression analysis of a survey. BMC MEDICAL EDUCATION 2024; 24:11. [PMID: 38172870 PMCID: PMC10765570 DOI: 10.1186/s12909-023-04995-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/20/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Medical education requires the implementation of different teaching methods and strategies for future doctors to achieve broad learning objectives. This wide range of methods and strategies includes the use of Information Technologies. For a long time, there was a call for a change in medical education for blending new teaching approaches to lessen medical students' class time. The COVID-19 pandemic then sped up the transition to the new way of medical education and classroom lectures were quickly moved to a virtual environment. We expect that these changes will continue, and online learning will be one of the main teaching strategies in medical education. Therefore, educational experiences during the COVID-19 pandemic will improve our understanding of online learning and will help to develop blended medical school curricula in the future. For this reason, we aimed to determine students' overall satisfaction with their online learning experience and to define the main factors affecting students' satisfaction with their online learning program at Cerrahpaşa Medical Faculty. METHODS A cross-sectional survey study was conducted to determine medical students' overall satisfaction with online learning methods and to identify factors associated with positive and negative satisfaction levels. A questionnaire, consisting of 24 questions to collect demographic characteristics, factors associated with online education experience and overall satisfaction levels was developed and distributed to 1600 medical students. Multivariable linear regression analysis was used to determine the factors associated with positive and negative satisfaction levels. RESULTS Regression analysis showed that being familiar with online teaching techniques (β = 0.19, 95% CI [0.07, 0.30], faculty members' higher online teaching skill levels (β = 0.42, 95% CI [0.32, 0.51], interactive online teaching approaches (β = 0.54, 95% CI [0.41, 0.67], having a personal workspace (β = 0.43, 95% CI [0.19, 0.67], and a self-reported longer attention span (β = 0.75, 95% CI [0.57, 0.92] were associated with higher overall satisfaction with online learning. The occurrence of technical problems (β = -0.19, 95% CI [-0.26, -0.12] was associated with lower overall satisfaction. CONCLUSIONS Higher online teaching skills of faculty members, use of interactive approaches, students' familiarity with online teaching techniques, provision of a personal workspace, and self-reported longer attention spans positively contributed to higher levels of student satisfaction with online learning. Considering the increasing significance of online educational methods, our study identified key components that affect students' level of satisfaction. This information might contribute to the development of online educational programs in the future.
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Affiliation(s)
- Özlem Serpil Çakmakkaya
- Cerrahpaşa Medical Faculty, Department of Medical Education, İstanbul University-Cerrahpaşa, İstanbul, Fatih, 34098, Türkiye.
| | - Elif Güzel Meydanlı
- Cerrahpaşa Medical Faculty, Department of Histology and Embryology, İstanbul University-Cerrahpaşa, İstanbul, Türkiye
| | - Ali Metin Kafadar
- Cerrahpaşa Medical Faculty, Department of Neurosurgery, İstanbul University-Cerrahpaşa, İstanbul, Türkiye
| | - Mehmet Selman Demirci
- Cerrahpaşa Medical Faculty, Department of Anatomy, İstanbul University-Cerrahpaşa, İstanbul, Türkiye
| | - Öner Süzer
- Cerrahpaşa Medical Faculty, Department of Medical Pharmacology, İstanbul University-Cerrahpaşa, İstanbul, Türkiye
| | - Muhlis Cem Ar
- Cerrahpaşa Medical Faculty, Department of Internal Medicine, Division of Haematology, İstanbul University-Cerrahpaşa, İstanbul, Türkiye
| | - Muhittin Onur Yaman
- Vocational School of Health Services, Department of Medical Services and Techniques, İstanbul University-Cerrahpaşa, İstanbul, Türkiye
| | - Kaan Can Demirbaş
- Cerrahpaşa Medical Faculty, İstanbul University-Cerrahpaşa, İstanbul, Türkiye
| | - Mustafa Sait Gönen
- Cerrahpaşa Medical Faculty, Department of Internal Medicine, Division of Haematology, İstanbul University-Cerrahpaşa, İstanbul, Türkiye
- Cerrahpaşa Medical Faculty, Department of Internal Medicine, Division of Endocrinology, İstanbul University-Cerrahpaşa, İstanbul, Türkiye
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Curioso WH, Coronel-Chucos LG, Oscuvilca-Tapia E. Empowering the digital health workforce in Latin America in the context of the COVID-19 pandemic: the Peruvian case. Inform Health Soc Care 2024; 49:73-82. [PMID: 38349775 DOI: 10.1080/17538157.2024.2315266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
The COVID-19 pandemic has exposed significant gaps in healthcare access, quality, and the urgent need for enhancing the capacity of digital health human resources, particularly in Latin America. During the pandemic, online courses and telehealth initiatives supported by governmental agencies, the Pan American Health Organization, and other public and private resources, have played a crucial role in meeting training demands. This article discusses the role of capacity building programs in digital health within the context of Latin America, with a specific focus on the Peruvian case. We highlight the development of digital health competencies and related policies, while also describing selected experiences related to capacity building in this field. Additionally, we discuss the pivotal role of collaborative partnerships among institutions and countries, emphasizing the importance of culturally relevant training programs in digital health. These initiatives have the potential to accelerate training and research opportunities in Latin America, drawing on the involvement of government agencies, non-governmental organizations, industry, universities, professional societies, and communities.
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Affiliation(s)
- Walter H Curioso
- Vicerrectorado de Investigación, Universidad Continental, Lima, Peru
| | | | - Elsa Oscuvilca-Tapia
- Facultad de Medicina Humana, Universidad Nacional José Faustino Sánchez Carrión, Huacho, Peru
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Rony MKK, Parvin MR, Wahiduzzaman M, Debnath M, Bala SD, Kayesh I. "I Wonder if my Years of Training and Expertise Will be Devalued by Machines": Concerns About the Replacement of Medical Professionals by Artificial Intelligence. SAGE Open Nurs 2024; 10:23779608241245220. [PMID: 38596508 PMCID: PMC11003342 DOI: 10.1177/23779608241245220] [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: 11/10/2023] [Revised: 03/08/2024] [Accepted: 03/15/2024] [Indexed: 04/11/2024] Open
Abstract
Background The rapid integration of artificial intelligence (AI) into healthcare has raised concerns among healthcare professionals about the potential displacement of human medical professionals by AI technologies. However, the apprehensions and perspectives of healthcare workers regarding the potential substitution of them with AI are unknown. Objective This qualitative research aimed to investigate healthcare workers' concerns about artificial intelligence replacing medical professionals. Methods A descriptive and exploratory research design was employed, drawing upon the Technology Acceptance Model (TAM), Technology Threat Avoidance Theory, and Sociotechnical Systems Theory as theoretical frameworks. Participants were purposively sampled from various healthcare settings, representing a diverse range of roles and backgrounds. Data were collected through individual interviews and focus group discussions, followed by thematic analysis. Results The analysis revealed seven key themes reflecting healthcare workers' concerns, including job security and economic concerns; trust and acceptance of AI; ethical and moral dilemmas; quality of patient care; workforce role redefinition and training; patient-provider relationships; healthcare policy and regulation. Conclusions This research underscores the multifaceted concerns of healthcare workers regarding the increasing role of AI in healthcare. Addressing job security, fostering trust, addressing ethical dilemmas, and redefining workforce roles are crucial factors to consider in the successful integration of AI into healthcare. Healthcare policy and regulation must be developed to guide this transformation while maintaining the quality of patient care and preserving patient-provider relationships. The study findings offer insights for policymakers and healthcare institutions to navigate the evolving landscape of AI in healthcare while addressing the concerns of healthcare professionals.
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Affiliation(s)
- Moustaq Karim Khan Rony
- Master of Public Health, Bangladesh Open University, Gazipur, Bangladesh
- Institute of Social Welfare and Research, University of Dhaka, Dhaka, Bangladesh
| | - Mst. Rina Parvin
- Armed Forces Nursing Service, Major at Bangladesh Army (AFNS Officer), Combined Military Hospital, Dhaka, Bangladesh
| | - Md. Wahiduzzaman
- School of Medical Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Mitun Debnath
- Master of Public Health, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh
| | - Shuvashish Das Bala
- College of Nursing, International University of Business Agriculture and Technology, Dhaka, Bangladesh
| | - Ibne Kayesh
- Institute of Social Welfare and Research, University of Dhaka, Dhaka, Bangladesh
- Faculty of Graduate Studies, University of Kelaniya, Colombo, Sri Lanka
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Savoldelli GL, Burlacu CL, Lazarovici M, Matos FM, Østergaard D. Integration of simulation-based education in anaesthesiology specialist training: Synthesis of results from an Utstein Meeting. Eur J Anaesthesiol 2024; 41:43-54. [PMID: 37872824 PMCID: PMC10720798 DOI: 10.1097/eja.0000000000001913] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
BACKGROUND Despite its importance in education and patient safety, simulation-based education and training (SBET) is only partially or poorly implemented in many countries, including most European countries. The provision of a roadmap may contribute to the development of SBET for the training of anaesthesiologists. OBJECTIVE To develop a global agenda for the integration of simulation into anaesthesiology specialist training; identify the learning domains and objectives that are best achieved through SBET; and to provide examples of simulation modalities and evaluation methods for these learning objectives. DESIGN Utstein-style meeting where an expert consensus was reached after a series of short plenary presentations followed by small group workshops, underpinned by Kern's six-step theoretical approach to curriculum development. SETTING Utstein-style collaborative meeting. PARTICIPANTS Twenty-five participants from 22 countries, including 23 international experts in simulation and two anaesthesia trainees. RESULTS We identified the following ten domains of expertise for which SBET should be used to achieve the desired training outcomes: boot camp/initial training, airway management, regional anaesthesia, point of care ultrasound, obstetrics anaesthesia, paediatric anaesthesia, trauma, intensive care, critical events in our specialty, and professionalism and difficult conversations. For each domain, we developed a course template that defines the learning objectives, instructional strategies (including simulation modalities and simulator types), and assessment methods. Aspects related to the practical implementation, barriers and facilitators of this program were also identified and discussed. CONCLUSIONS We successfully developed a comprehensive agenda to facilitate the integration of SBET into anaesthesiology specialist training. The combination of the six-step approach with the Utstein-style process proved to be extremely valuable in supporting content validity and representativeness. These results may facilitate the implementation and use of SBET in several countries. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Georges L Savoldelli
- From the Division of Anaesthesia, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine. Geneva University Hospitals and Faculty of Medicine University of Geneva, Geneva, Switzerland (GLS), University College Dublin, School of Medicine, Surgery and Surgical Specialties and Department of Anaesthesia, Intensive Care and Pain Medicine, St. Vincent's University Hospital, Dublin, Ireland (CLB), Institute for Emergency Medicine and Management in Medicine, Ludwig Maximilians University Hospital, Munich, Germany (ML), Anaesthesiology Department, Centro Hospitalar e Universitário de Coimbra, CHUC, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, FMUC, Coimbra, Portugal and Clinic Academic Center of Coimbra, CACC, Coimbra, Portugal (FMM), Copenhagen Academy for Medical Education and Simulation, Capital Region of Denmark and Faculty of Medicine, University of Copenhagen (DO), European Society of Anaesthesiology and Intensive Care (ESAIC) Simulation Committee, https://www.esaic.org/about/committees/simulation-committee/ (GLS, CLB, FMM, DO), Society for Simulation in Europe (SESAM) Executive Committee, https://www.sesam-web.org (ML, FMM), World Federation of Societies of Anaesthesiologists (WFSA) Education Committee, https://wfsahq.org/about/people/committees/education-committee/ (DO), See attached list for the affiliations of the investigators of the Utstein Simulation Study Group (USSG)
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Alkhaaldi SMI, Kassab CH, Dimassi Z, Oyoun Alsoud L, Al Fahim M, Al Hageh C, Ibrahim H. Medical Student Experiences and Perceptions of ChatGPT and Artificial Intelligence: Cross-Sectional Study. JMIR MEDICAL EDUCATION 2023; 9:e51302. [PMID: 38133911 PMCID: PMC10770787 DOI: 10.2196/51302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/10/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Artificial intelligence (AI) has the potential to revolutionize the way medicine is learned, taught, and practiced, and medical education must prepare learners for these inevitable changes. Academic medicine has, however, been slow to embrace recent AI advances. Since its launch in November 2022, ChatGPT has emerged as a fast and user-friendly large language model that can assist health care professionals, medical educators, students, trainees, and patients. While many studies focus on the technology's capabilities, potential, and risks, there is a gap in studying the perspective of end users. OBJECTIVE The aim of this study was to gauge the experiences and perspectives of graduating medical students on ChatGPT and AI in their training and future careers. METHODS A cross-sectional web-based survey of recently graduated medical students was conducted in an international academic medical center between May 5, 2023, and June 13, 2023. Descriptive statistics were used to tabulate variable frequencies. RESULTS Of 325 applicants to the residency programs, 265 completed the survey (an 81.5% response rate). The vast majority of respondents denied using ChatGPT in medical school, with 20.4% (n=54) using it to help complete written assessments and only 9.4% using the technology in their clinical work (n=25). More students planned to use it during residency, primarily for exploring new medical topics and research (n=168, 63.4%) and exam preparation (n=151, 57%). Male students were significantly more likely to believe that AI will improve diagnostic accuracy (n=47, 51.7% vs n=69, 39.7%; P=.001), reduce medical error (n=53, 58.2% vs n=71, 40.8%; P=.002), and improve patient care (n=60, 65.9% vs n=95, 54.6%; P=.007). Previous experience with AI was significantly associated with positive AI perception in terms of improving patient care, decreasing medical errors and misdiagnoses, and increasing the accuracy of diagnoses (P=.001, P<.001, P=.008, respectively). CONCLUSIONS The surveyed medical students had minimal formal and informal experience with AI tools and limited perceptions of the potential uses of AI in health care but had overall positive views of ChatGPT and AI and were optimistic about the future of AI in medical education and health care. Structured curricula and formal policies and guidelines are needed to adequately prepare medical learners for the forthcoming integration of AI in medicine.
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Affiliation(s)
- Saif M I Alkhaaldi
- Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Carl H Kassab
- Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Zakia Dimassi
- Department of Medical Science, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Leen Oyoun Alsoud
- Department of Medical Science, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Maha Al Fahim
- Education Institute, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Cynthia Al Hageh
- Department of Medical Science, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Halah Ibrahim
- Department of Medical Science, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
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Jafari-Oori M, Dehi M, Ebadi A, Moradian ST, Sadeghi H, Jafari M. Lived experience of Iranian pre-hospital medical staff during the COVID-19 pandemic: a descriptive phenomenological study. Front Psychol 2023; 14:1230892. [PMID: 38235282 PMCID: PMC10793261 DOI: 10.3389/fpsyg.2023.1230892] [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: 05/29/2023] [Accepted: 12/06/2023] [Indexed: 01/19/2024] Open
Abstract
Background Pre-hospital medical staff faced numerous challenges during the COVID-19 pandemic. However, these challenges specific to pre-hospital services have not been thoroughly explored in Iran. This qualitative study aimed to examine the essence of pre-hospital care during the COVID-19 pandemic. Methods This phenomenological study was conducted from June to August 2021 in Tehran, Iran. Semi-structured interviews were conducted with pre-hospital medical staff. Data analysis was performed using Colaizzi's approach, and rigor was ensured by adhering to the consolidated criteria for qualitative reporting research. Results A total of 17 pre-hospital medical staff were interviewed, and five themes were extracted from the data: workload and resilience, damage, lack of control, under preparedness, and post-traumatic growth. These themes highlight the resilience demonstrated by pre-hospital medical staff, who faced an unprecedented crisis with limited preparedness and significant damage. Conclusion The findings of this study indicate that pre-hospital medical staff in Iran encountered challenges during the COVID-19 pandemic due to a lack of preparedness and substantial damage. Despite these adversities, the participants exhibited resilience and experienced post-traumatic growth. The study emphasizes the importance of proper planning and preparedness to enhance the resilience of emergency medical services during pandemics. Furthermore, the results underscore the need to address the challenges faced by pre-hospital medical staff and improve the quality of care provided to patients during crises such as the COVID-19 pandemic.
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Affiliation(s)
- Mehdi Jafari-Oori
- Atherosclerosis Research Center, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Manigeh Dehi
- Maragheh University of Medical Sciences, Maragheh, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyed Tayeb Moradian
- Atherosclerosis Research Center, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hajar Sadeghi
- University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Jacobs SM, Lundy NN, Issenberg SB, Chandran L. Reimagining Core Entrustable Professional Activities for Undergraduate Medical Education in the Era of Artificial Intelligence. JMIR MEDICAL EDUCATION 2023; 9:e50903. [PMID: 38052721 PMCID: PMC10762622 DOI: 10.2196/50903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/15/2023] [Accepted: 12/05/2023] [Indexed: 12/07/2023]
Abstract
The proliferation of generative artificial intelligence (AI) and its extensive potential for integration into many aspects of health care signal a transformational shift within the health care environment. In this context, medical education must evolve to ensure that medical trainees are adequately prepared to navigate the rapidly changing health care landscape. Medical education has moved toward a competency-based education paradigm, leading the Association of American Medical Colleges (AAMC) to define a set of Entrustable Professional Activities (EPAs) as its practical operational framework in undergraduate medical education. The AAMC's 13 core EPAs for entering residencies have been implemented with varying levels of success across medical schools. In this paper, we critically assess the existing core EPAs in the context of rapid AI integration in medicine. We identify EPAs that require refinement, redefinition, or comprehensive change to align with the emerging trends in health care. Moreover, this perspective proposes a set of "emerging" EPAs, informed by the changing landscape and capabilities presented by generative AI technologies. We provide a practical evaluation of the EPAs, alongside actionable recommendations on how medical education, viewed through the lens of the AAMC EPAs, can adapt and remain relevant amid rapid technological advancements. By leveraging the transformative potential of AI, we can reshape medical education to align with an AI-integrated future of medicine. This approach will help equip future health care professionals with technological competence and adaptive skills to meet the dynamic and evolving demands in health care.
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Affiliation(s)
- Sarah Marie Jacobs
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Neva Nicole Lundy
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Saul Barry Issenberg
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Latha Chandran
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL, United States
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Zhang P, Li X, Pan Y, Zhai H, Li T. Global trends and future directions in online learning for medical students during and after the COVID-19 pandemic: A bibliometric and visualization analysis. Medicine (Baltimore) 2023; 102:e35377. [PMID: 38115375 PMCID: PMC10727559 DOI: 10.1097/md.0000000000035377] [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: 05/26/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 12/21/2023] Open
Abstract
This study explores the evolution of online learning research in the context of medical education during and following the COVID-19 pandemic. It aims to understand the principal focus areas, and trends that have emerged in this rapidly evolving landscape. A total of 2751 publications related to online learning were retrieved from the Web of Science Core Collection (WoSCC) from 2020 to 2022. Bibliometric analysis and visualization techniques were employed to comprehensively examine the landscape of online learning research. Publications, co-cited references, and keyword co-occurrence were analyzed to identify patterns and trends in research focus and collaboration networks. The significant surge in research output reveals the academic community's response to the pandemic. Various themes have emerged in online learning research, encompassing online teaching, flipped classrooms, mental health, and blended learning. The evolution trajectory of research has traversed 3 stages, reflecting a shift in research focus from immediate pandemic responses to more refined strategies and interdisciplinary perspectives. Keyword co-occurrence analysis was also conducted to show the effects of the COVID-19 pandemic on the research. The study underscores the global scholarly engagement, collaborative networks, and principal themes that have shaped the field. As medical education adapts to the shifting landscape, the trajectory of online learning research points toward increased learner autonomy, integration of advanced technologies, and interdisciplinary collaboration. This transformative shift promises to reshape medical education, equipping learners and educators with the tools needed to navigate the dynamic realm of modern healthcare education.
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Affiliation(s)
- Pei Zhang
- Department of Medicine-Education Coordination and Medical Education Research Center, Hebei Medical University, Shijiazhuang, China
| | - Xiuyuan Li
- Department of Medicine-Education Coordination and Medical Education Research Center, Hebei Medical University, Shijiazhuang, China
| | - Ying Pan
- Department of Medicine-Education Coordination and Medical Education Research Center, Hebei Medical University, Shijiazhuang, China
| | - Haihun Zhai
- Department of Medicine-Education Coordination and Medical Education Research Center, Hebei Medical University, Shijiazhuang, China
| | - Tian Li
- School of Basic Medicine, Fourth Military Medical University, Xi’an, China
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Sullivan LM, Weist EM, Barrington WE, Fairchild AL, Hwang W, Kiviniemi MT, Mohammed SD, Wyant VA, Alexander LA, Magaña L. Education for public health 2030: transformation to meet health needs in a changing world. Front Public Health 2023; 11:1269272. [PMID: 38162596 PMCID: PMC10757328 DOI: 10.3389/fpubh.2023.1269272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Education for public health is at a critical inflection point, and either transforms for success or fails to remain relevant. In 2020, the Association for Schools and Programs of Public Health launched an initiative, Framing the Future 2030: Education for Public Health (FTF 2030) to develop a resilient educational system for public health that promotes scientific inquiry, connects research, education, and practice, eliminates inequities, incorporates anti-racism principles, creates and sustains diverse and inclusive teaching and learning communities, and optimizes systems and resources to prepare graduates who are clearly recognizable for their population health perspectives, knowledge, skills, attitudes, and practices. Three expert panels: (1) Inclusive excellence through an anti-racism lens; (2) Transformative approaches to teaching and learning; and (3) Expanding the reach, visibility, and impact of the field of academic public health are engaged in ongoing deliberations to generate recommendations to implement the necessary change. The article describes the panels' work completed thus far, a "Creating an Inclusive Workspace" guide, and work planned, including questions for self-evaluation, deliberation, and reflection toward actions that support academe in developing a resilient education system for public health, whether beginning or advancing through a process of change. The FTF 2030 steering committee asserts its strong commitment to structural and substantial change that strengthens academic public health as an essential component of a complex socio-political system. Lastly, all are called to join the effort as collaboration is essential to co-develop an educational system for public health that ensures health equity for all people, everywhere.
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Affiliation(s)
- Lisa M. Sullivan
- Boston University School of Public Health, Boston, MA, United States
| | - Elizabeth M. Weist
- Association of Schools and Programs of Public Health, Washington, DC, United States
| | - Wendy E. Barrington
- Center for Anti-Racism and Community Health, Health Systems and Population Health Epidemiology, University of Washington School of Public Health, Seattle, WA, United States
| | - Amy L. Fairchild
- Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, NY, United States
| | - Wenke Hwang
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Marc T. Kiviniemi
- Department of Health, Behavior and Society, University of Kentucky College of Public Health, Lexington, KY, United States
| | - Shan D. Mohammed
- DEI Educational and Student Initiatives, Northeastern University Bouvé College of Health Sciences, Boston, MA, United States
| | - Victoria A. Wyant
- Association of Schools and Programs of Public Health, Washington, DC, United States
| | - Linda A. Alexander
- Association of Schools and Programs of Public Health, Washington, DC, United States
| | - Laura Magaña
- Association of Schools and Programs of Public Health, Washington, DC, United States
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Dimassi Z, Chaiban L, Zgheib NK, Sabra R. Re-conceptualizing medical education in the post-COVID era. MEDICAL TEACHER 2023:1-8. [PMID: 38086531 DOI: 10.1080/0142159x.2023.2290463] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 11/29/2023] [Indexed: 06/30/2024]
Abstract
PURPOSE The COVID-19 pandemic has forced changes in the delivery of medical education. We aimed to explore these changes and determine whether they will impact the future of medical education in any way. METHODS We invited leaders in medical education from all accessible US-based medical schools to participate in an online individual semi-structured interview. RESULTS Representatives of 16 medical schools participated. They commented on the adequacy of online education for knowledge transfer, and the logistical advantages it offered, but decried its negative influence on social learning, interpersonal relationships and professional development of students, and its ineffectiveness for clinical education. Most participants indicated that they would maintain online learning for didactic purposes in the context of flipped classrooms but that a return to in-person education was essential for most other educational goals. Novel content will be introduced, especially in telemedicine and social medicine, and the students' roles and responsibilities in patient care and in curricular development may evolve in the future. CONCLUSIONS This study is the first to document the practical steps that will be adopted by US medical schools in delivering medical education, which were prompted and reinforced by their experience during the COVID-19 pandemic.
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Affiliation(s)
- Zakia Dimassi
- Department of Medical Sciences, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Lea Chaiban
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nathalie K Zgheib
- Department of Pharmacology and Toxicology, and Program for Research and Innovation in Medical Education (PRIME). Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ramzi Sabra
- Department of Pharmacology and Toxicology, and Program for Research and Innovation in Medical Education (PRIME). Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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Ginsburg O, Vanderpuye V, Beddoe AM, Bhoo-Pathy N, Bray F, Caduff C, Florez N, Fadhil I, Hammad N, Heidari S, Kataria I, Kumar S, Liebermann E, Moodley J, Mutebi M, Mukherji D, Nugent R, So WKW, Soto-Perez-de-Celis E, Unger-Saldaña K, Allman G, Bhimani J, Bourlon MT, Eala MAB, Hovmand PS, Kong YC, Menon S, Taylor CD, Soerjomataram I. Women, power, and cancer: a Lancet Commission. Lancet 2023; 402:2113-2166. [PMID: 37774725 DOI: 10.1016/s0140-6736(23)01701-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 06/27/2023] [Accepted: 08/11/2023] [Indexed: 10/01/2023]
Affiliation(s)
- Ophira Ginsburg
- Centre for Global Health, US National Cancer Institute, Rockville, MD, USA.
| | | | | | | | - Freddie Bray
- International Agency for Research on Cancer, Lyon, France
| | - Carlo Caduff
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Narjust Florez
- Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | | | - Nazik Hammad
- Department of Medicine, Division of Hematology-Oncology, St. Michael's Hospital, University of Toronto, Canada; Department of Oncology, Queens University, Kingston, Canada
| | - Shirin Heidari
- GENDRO, Geneva, Switzerland; Gender Centre, Geneva Graduate Institute, Geneva, Switzerland
| | - Ishu Kataria
- Center for Global Noncommunicable Diseases, RTI International, New Delhi, India
| | - Somesh Kumar
- Jhpiego India, Johns Hopkins University Affiliate, Baltimore, MD, USA
| | - Erica Liebermann
- University of Rhode Island College of Nursing, Providence, RI, USA
| | - Jennifer Moodley
- Cancer Research Initiative, Faculty of Health Sciences, School of Public Health and Family Medicine, and SAMRC Gynaecology Cancer Research Centre, University of Cape Town, Cape Town, South Africa
| | - Miriam Mutebi
- Department of Surgery, Aga Khan University, Nairobi, Kenya
| | - Deborah Mukherji
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Clemenceau Medical Center Dubai, Dubai, United Arab Emirates
| | - Rachel Nugent
- Center for Global Noncommunicable Diseases, RTI International, Durham, NC, USA; Department of Global Health, University of Washington, Seattle, WA, USA
| | - Winnie K W So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong Special Administrative Region, China
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, National Institute of Medical Science and Nutrition Salvador Zubiran, Mexico City, Mexico
| | | | - Gavin Allman
- Center for Global Noncommunicable Diseases, RTI International, Durham, NC, USA
| | - Jenna Bhimani
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - María T Bourlon
- Department of Hemato-Oncology, National Institute of Medical Science and Nutrition Salvador Zubiran, Mexico City, Mexico
| | - Michelle A B Eala
- College of Medicine, University of the Philippines, Manila, Philippines; Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Yek-Ching Kong
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Sonia Menon
- Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
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Wu A, Preker A. Identifying International Leadership Competencies in Medical Education. MEDICAL SCIENCE EDUCATOR 2023; 33:1405-1408. [PMID: 38188391 PMCID: PMC10767027 DOI: 10.1007/s40670-023-01897-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 01/09/2024]
Abstract
Internationalization of medical education must be a part of medical education, in order to ensure that worldwide healthcare issues can be solved collaboratively. To date, medical educators have not agreed upon what skills students should obtain via internationalization of medical education. Medical leadership skills are of increasing importance in both academia and clinical practice. In medical education, very little has been reported about international leadership competencies. While leadership skills are outlined for national settings, international leadership skills in medicine require a more expansive set of competencies. Adapted from recommendations for the framework of health-professional competencies, they can be divided into international specialized knowledge and integrated leadership competencies presented in this article.
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Affiliation(s)
- Anette Wu
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, USA
| | - Alexander Preker
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY USA
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Czech H, Hildebrandt S, Reis SP, Chelouche T, Fox M, González-López E, Lepicard E, Ley A, Offer M, Ohry A, Rotzoll M, Sachse C, Siegel SJ, Šimůnek M, Teicher A, Uzarczyk K, von Villiez A, Wald HS, Wynia MK, Roelcke V. The Lancet Commission on medicine, Nazism, and the Holocaust: historical evidence, implications for today, teaching for tomorrow. Lancet 2023; 402:1867-1940. [PMID: 37951225 DOI: 10.1016/s0140-6736(23)01845-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/07/2023] [Accepted: 08/29/2023] [Indexed: 11/13/2023]
Affiliation(s)
- Herwig Czech
- Ethics, Collections, and History of Medicine, Medical University of Vienna, Vienna, Austria
| | - Sabine Hildebrandt
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Shmuel P Reis
- Center for Medical Education, Hebrew University Hadassah Medical School, Jerusalem, Israel; Department of Digital Medical Technologies, Holon Institute of Technology, Holon, Israel
| | - Tessa Chelouche
- Rappaport Faculty of Medicine, Technion Institute, Haifa, Israel
| | - Matthew Fox
- Jakobovits Center for Jewish Medical Ethics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Esteban González-López
- Division of Family Medicine and Primary Care, Department of Medicine, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Etienne Lepicard
- Center for Medical Education, Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Astrid Ley
- Memorial and Museum Sachsenhausen, Oranienburg, Germany
| | - Miriam Offer
- Center of the Study of Jewish Medicine during the Holocaust, Western Galilee College, Acre, Israel
| | - Avi Ohry
- Rehabilitation Medicine, School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maike Rotzoll
- Institute for the History of Pharmacy and Medicine, Marburg University, Marburg, Germany
| | - Carola Sachse
- Institute of Contemporary History, University of Vienna, Vienna, Austria
| | - Sari J Siegel
- Center for Medicine, Holocaust, and Genocide Studies, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Michal Šimůnek
- Institute of Contemporary History of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Amir Teicher
- Department of History, Tel Aviv University, Tel Aviv, Israel
| | - Kamila Uzarczyk
- Department of Humanities and Social Sciences, Wrocław Medical University, Wrocław, Poland
| | - Anna von Villiez
- Memorial Israelitische Töchterschule, Hamburger Volkshochschule, Hamburg, Germany
| | - Hedy S Wald
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Matthew K Wynia
- Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Volker Roelcke
- Institute for the History, Theory and Ethics of Medicine, Giessen University, Gießen, Germany
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Ngene NC. Teaching Philosophy in a Teaching Portfolio: Domain Knowledge and Guidance. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:1231-1248. [PMID: 38028366 PMCID: PMC10640830 DOI: 10.2147/amep.s428897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/21/2023] [Indexed: 12/01/2023]
Abstract
Background Teaching philosophy defines the beliefs and ideas that guide practices in teaching and learning. Writing teaching philosophy statements for promotion or employment is daunting for inexperienced new faculty members. Aim This article aims to discuss the principles of relevant educational domains that academics need to know to be well informed when writing their teaching philosophy. It also provides a new perspective on how to write the personal statements. Methods Journal articles published in English language between 2018 and 2023 (as well as important older ones) in electronic databases (Google Scholar, MEDLINE, PubMed, and SCOPUS) were searched, sifted, reviewed and used for this narrative literature review. Additionally, the websites of educational organisations such as higher education institutions were selected using convenience sampling method and searched to ascertain practices. Results Educators need to link teaching philosophy statements to the literature about teaching. However, there is a scarcity of literature that provides a comprehensive overview of the required domain knowledge. These domains are Supervision, Curriculum development, Assessment, Mentorship, Pedagogy, and Scholarship of teaching and learning (S-CAMPS domains). Conclusion Using various teaching practices and models to achieve the best quality learning and valued transformation is crucial in achieving a comprehensive Scholarship of Teaching and Learning. Therefore, developing a personal philosophy provides the opportunity for reflection on utilizing the theory-practice-philosophy perspective best to serve the students, academic institution, and society.
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Affiliation(s)
- Nnabuike Chibuoke Ngene
- Department of Obstetrics and Gynecology, Leratong Hospital, Krugersdorp, South Africa
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Chen M, Xue P, Li Q, Shen Y, Ye Z, Wang H, Cui X, Zhao T, Li G, Seery S, Wang Y, Lin Q, Zhang W, Zhang X, Jiang Y, Qiao Y. Enhancing colposcopy training using a widely accessible digital education tool in China. Am J Obstet Gynecol 2023; 229:538.e1-538.e9. [PMID: 37516400 DOI: 10.1016/j.ajog.2023.07.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/02/2023] [Accepted: 07/23/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Colposcopy is a cornerstone of cervical cancer prevention; however, there is a global shortage of colposcopists. It is challenging to train a sufficient number of colposcopists through in-person methods, which hinders our ability to adequately diagnose and manage positive cases. A digital platform is needed to make colposcopy training more efficient, scalable, and sustainable; however, current online training programs are generally based on didactic curricula that do not incorporate image analysis training. In addition, long-term assessments of online training are not readily available. Therefore, innovative digital training and an assessment of its effectiveness are needed. OBJECTIVE This study aimed to evaluate the short- and long-term effects of DECO (an online Digital Education Tool for Colposcopy) on trainees' colposcopy competencies and confidence. STUDY DESIGN DECO can be used both on laptops and smartphones and comprises 4 training modules (image interpretation; terminology learning; video teaching; and collection of guidelines and typical cases) and 2 test modules. DECO was tested through a pre-post study between September and November 2022. Participants were recruited in China, and DECO training lasted 12 days. Trainees initially learned basic theory before completing training using 200 image-based cases. Pretest, posttest, and follow-up testing included 20 distinct image-based questions, and was conducted on Days 0, 13, and 60. Primary outcomes were competence and confidence scores. Secondary measures were response distributions for colposcopic diagnoses, biopsies, and DECO training satisfaction. Multilevel modeling was used to determine improvement from baseline to posttraining and follow-up for the outcomes of interest. RESULTS Among 402 participants recruited, 96.8% (n=389) completed pretesting, 84.1% (n=338) posttesting, and 75.1% (n=302) follow-up testing. Colposcopic competence and confidence increased across this study. Diagnostic scores improved on average from 55.3 (53.7-56.9) to 70.4 (68.9-71.9). The diagnostic accuracy for normal/benign lesions, low-grade squamous intraepithelial lesions, and high-grade squamous intraepithelial lesions or worse increased by 16.9%, 13.1%, and 16.9%, respectively. Mean confidence scores increased from 48.1 (45.6-50.6) to 56.2 (54.5-57.9). These improvements remained evident 2 months after training. Trainees were also satisfied with DECO overall. Most found DECO to be scientific (82.5%), easy to use (75.2%), and clinically useful (98.4%), and would recommend it to colleagues (93.2%). CONCLUSION DECO is a useful, acceptable digital education tool that improves colposcopy competencies and confidence. DECO could make colposcopy training more efficient, scalable, and sustainable because there are no geographic or time limitations. Therefore, DECO could be used to alleviate the shortage of trained colposcopists around the world.
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Affiliation(s)
- Mingyang Chen
- Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Peng Xue
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qing Li
- Diagnosis and Treatment for Cervical Lesions Center, Shenzhen Maternity & Child Healthcare Hospital, Shenzhen, China; Shenzhen Hyzen Hospital, Shenzhen, China
| | - Yu Shen
- Zonsun Healthcare, Shenzhen, China
| | - Zichen Ye
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huike Wang
- Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoli Cui
- Department of Gynecologic Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | | | | | - Samuel Seery
- Faculty of Health and Medicine, Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Yanzhu Wang
- Diagnosis and Treatment for Cervical Lesions Center, Shenzhen Maternity & Child Healthcare Hospital, Shenzhen, China
| | - Qiufen Lin
- Diagnosis and Treatment for Cervical Lesions Center, Shenzhen Maternity & Child Healthcare Hospital, Shenzhen, China
| | - Wenhua Zhang
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xun Zhang
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Jiang
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Youlin Qiao
- Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Koh HK, Tso CC, Dougherty CP, Lazowy EE, Heberlein CP, Phelps FA. Exploring the spiritual foundations of public health leadership. Front Public Health 2023; 11:1210160. [PMID: 37954055 PMCID: PMC10634334 DOI: 10.3389/fpubh.2023.1210160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/03/2023] [Indexed: 11/14/2023] Open
Abstract
The Covid-19 pandemic has laid bare the challenges of public health leadership. Faced with criticism, threats, and even violence, many public health leaders have left the field. A healthier future for the nation may well rest on training aspiring public health leaders to build deeper capacity for perseverance, healing, and resilience. Reflecting the growing experience of a team of public health educators at the Harvard T.H. Chan School of Public Health (Harvard Chan), this article offers recommendations for public health schools to recognize, and incorporate into leadership education, themes of spirituality-ie, the way people seek ultimate meaning and purpose and deep connectedness to something larger than themselves. Doing so can serve as a foundation for the lifelong journey of leadership. Over the past decade, Harvard Chan has incorporated meaning, purpose, and connectedness themes to complement more traditional coursework addressing research and translation. While many established leadership frameworks address the "what" and "how" of career development, the spirituality framework can support aspiring leaders to more fully understand their "why" and its alignment with challenging work. Such a deeply personal topic, traditionally kept private, has been shared and nurtured in Harvard Chan classrooms through a range of pedagogical strategies including personal reflection, one-on- one coaching, experiential learning, case discussions, and candid conversations with public health leaders. By encouraging a values-based foundation for decision-making in crises and difficult leadership moments, such grounding can help aspiring leaders navigate the challenges of public health leadership that inevitably lie ahead.
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Affiliation(s)
- Howard K. Koh
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Harvard Kennedy School, Cambridge, MA, United States
| | - Cathy C. Tso
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | | | - Emily E. Lazowy
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | | | - Fawn A. Phelps
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Choi-Lundberg D. Technology-Enhanced Learning in Medical Education Collection: Latest Developments. MEDEDPUBLISH 2023; 13:219. [PMID: 37868339 PMCID: PMC10589622 DOI: 10.12688/mep.19856.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023] Open
Abstract
Technology-enhanced learning (TEL) refers to learning activities and environments that are potentially improved or enhanced with information and communication technologies (Shen and Ho, 2020; Wasson and Kirschner, 2020). TEL may be implemented in face-to-face, distance/remote and blended or hybrid modes; in various environments such as online, classrooms, workplaces, communities, and other built and natural environments; include a range of learning designs and pedagogies/andragogies; involve synchronous and asynchronous interactions amongst students, teachers, workplace staff and clients, and/or community members; and delivered with the support of various technologies (Wasson and Kirschner, 2020). To date, the Technology-Enhanced Learning in Medical Education collection, part of MedEdPublish, has received submissions relating to several technologies to support learning, including web conferencing, web 2.0, e-textbooks, e-portfolios, software, generative artificial intelligence, simulation mannequins and wearables for point-of-view video, often in combination. Learning designs included flipped classroom with interactive case discussions (Imran et al., 2022), e-portfolios (Javed et al., 2023), didactic teaching followed by demonstrations of clinical skills on a simulation mannequin (Zwaiman et al., 2023), interdisciplinary case discussions to promote interprofessional learning (Major et al., 2023), patient panels to share narratives and perspectives (Papanagnou et al., 2023), and team-based learning (Lee & Wong, 2023). In the four papers that included evaluation, participant reaction (feedback on learning activities) and/or learning (self-reported through surveys, with pre- vs post-training comparisons or at different timepoints during learning) were reported, corresponding to levels 1 and 2 of the commonly used outcomes-focused Kirkpatrick model of evaluation (Allen et al., 2022). Two papers focused on the work of health professions educators, including conducting the nominal group technique, a qualitative research method, via web conferencing (Khurshid et al., 2023); and using ChatGPT to assist with various medical education tasks (Peacock et al., 2023).
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Affiliation(s)
- Derek Choi-Lundberg
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, 7000, Australia
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Kuwahara K, Sakamoto M, Ishizuka R, Kato M, Akiyama M, Ishikawa H, Kiyohara K. Effect of digital messages from health professionals on COVID-19-related outcomes: A systematic review of randomized controlled trials. J Infect Public Health 2023; 16:1682-1689. [PMID: 37634322 DOI: 10.1016/j.jiph.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/28/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023] Open
Abstract
Effectiveness of health professionals' messages via digital tools on COVID-19-related outcomes remains unknown. In this systematic review, we examined this issue by searching randomized controlled trials in six databases until August, 2022 (PROSPERO, CRD 42022350788). Risk of bias was assessed using revised Cochrane risk-of-bias tool. Primary outcomes were COVID-19 infections, preventive behaviors, and factors that support behavioral change. Seven trials with 16 reports (some reported two or more outcomes) were included. One trial showed that physician videos distributed by Facebook ads significantly reduced COVID-19 infections. Five of 6 reports showed that interventions can promote non-pharmaceutical preventive behaviors, vaccination, or information-seeking behaviors and half of the results were significant. Interventions improved the factors that support behavioral change. 14 reports had some concerns of bias risk and 2 had high risk of bias. Our findings suggest that digital messages by health professionals may help reduce COVID-19 infections through promoting behavioral change.
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Affiliation(s)
- Keisuke Kuwahara
- Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan; Department of Health Data Science, Graduate School of Data Science, Yokohama City University, 22-2 Seto, Kanazawa-ku, Yokohama, Kanagawa, Japan.
| | - Masahiko Sakamoto
- Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan
| | - Ryohei Ishizuka
- Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan
| | - Mio Kato
- Office of Crisis Communication, Center for Emergency Preparedness and Response, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Miki Akiyama
- Faculty of Environment and Information Studies, Keio University, 5322, Endo, Fujisawa, Kanagawa, Japan
| | - Hirono Ishikawa
- Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan
| | - Kosuke Kiyohara
- Department of Food Science, Faculty of Home Economics, Otsuma Women's University, 12 Sanban-cho, Chiyoda-ku, Tokyo, Japan
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Paina L, Glenn J. Teaching Systems Thinking as a Foundational Public Health Competency Can Be Improved. Am J Public Health 2023; 113:1064-1067. [PMID: 37535893 PMCID: PMC10484120 DOI: 10.2105/ajph.2023.307368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Affiliation(s)
- Ligia Paina
- Ligia Paina is with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Jeffrey Glenn is with the Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT
| | - Jeffrey Glenn
- Ligia Paina is with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Jeffrey Glenn is with the Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT
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Jones MD, Casson SM, Barry BK, Li SH, Valenzuela T, Cassar J, Lamanna C, Lloyd AR, Sandler CX. eLearning improves allied health professionals' knowledge and confidence to manage medically unexplained chronic fatigue states: A randomized controlled trial. J Psychosom Res 2023; 173:111462. [PMID: 37619433 DOI: 10.1016/j.jpsychores.2023.111462] [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: 03/05/2023] [Revised: 08/08/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVES To evaluate the impact of eLearning by allied health professionals on improving the knowledge and confidence to manage people with medically unexplained chronic fatigue states (FS). METHODS Using a parallel randomized controlled trial design, participants were randomized 1:1 to a 4-week eLearning or wait-list control group. Knowledge and self-reported confidence in clinical skills to implement a therapeutic intervention for patients with FS were assessed at baseline, post-intervention and follow-up. Secondary outcomes (adherence and satisfaction with online education, knowledge retention) were also assessed. Data was analyzed using intention-to-treat. RESULTS There were 239 participants were randomized (eLearning n = 119, control n = 120), of whom 101 (85%) eLearning and 107 (89%) control participants completed baseline assessments and were included in the analysis. Knowledge (out of 100) improved significantly more in the eLearning group compared to the control group [mean difference (95% CI) 8.6 (5.9 to 11.4), p < 0.001]. Knowledge was reduced in the eLearning group at follow-up but was still significantly higher than baseline [6.0 (3.7 to 8.3), p < 0.001]. Median change (out of 5) in confidence in clinical skills to implement the FS intervention was also significantly greater in the eLearning group compared to the control group [knowledge: eLearning (1.2), control (0); clinical skills: eLearning (1), control (0.1); both p < 0.001)]. Average time spent on the eLearning program was 8.8 h. Most participants (80%) rated the lesson difficulty as at the "right level", and 91% would recommend it to others. CONCLUSIONS eLearning increased knowledge and confidence to manage FS amongst allied health professionals and was well-accepted. REGISTRATION ACTRN12616000296437 https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370222&isReview=true.
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Affiliation(s)
- Matthew D Jones
- The Kirby Institute, The University of New South Wales, Sydney, Australia; School of Health Sciences, The University of New South Wales, Sydney, Australia; Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Sally M Casson
- The Kirby Institute, The University of New South Wales, Sydney, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Benjamin K Barry
- School of Health Sciences, The University of New South Wales, Sydney, Australia; Medical School, The University of Queensland, Brisbane, Australia; Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Sophie H Li
- Black Dog Institute and School of Psychology, The University of New South Wales Australia, Sydney, Australia
| | - Trinidad Valenzuela
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Joanne Cassar
- The Kirby Institute, The University of New South Wales, Sydney, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Camillo Lamanna
- The Kirby Institute, The University of New South Wales, Sydney, Australia
| | - Andrew R Lloyd
- The Kirby Institute, The University of New South Wales, Sydney, Australia
| | - Carolina X Sandler
- The Kirby Institute, The University of New South Wales, Sydney, Australia; School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia; Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.
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Adongo PR, Epuitai J, Mpagi JL, Nekaka R, Lyagoba I, Odula J, Oboth P. "No PBL is better than online PBL": Qualitative exploration regarding the perceived impact of online problem-based learning on nursing and medical students' learning during COVID-19 lockdown. RESEARCH SQUARE 2023:rs.3.rs-3296163. [PMID: 37790310 PMCID: PMC10543252 DOI: 10.21203/rs.3.rs-3296163/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
The COVID-19 pandemic and its restrictions increased the adoption of online learning even in low-income countries. The adoption of online teaching methods may have affected teaching and learning, particularly in settings where it was used for the first time. This study was conducted to explore the perceptions of medical and nursing students regarding the impact of online delivery of problem-based learning (PBL) on students learning and academic performance during COVID-19 imposed restrictions. Methods and materials This was a qualitative study among fourth and fifth-year nursing and medical undergraduate students at Busitema University Faculty of Health Sciences. Four focused group discussions were conducted and the interviews focused on students' perceptions, experiences, and attitudes toward the PBL process conducted online and its likely impact on their learning. Braun and Clarke's thematic analysis was used for qualitative data analysis. Results Four themes were identified that represented perceptions of online PBL on learning: transition to online learning; perceived benefits of online learning; limited learning and poor performance; and lost soft and practical skills. During the initial stages of introduction to online PBL learning, students transitioning to online had to adapt and familiarize themselves with online learning following the introduction of online learning. Students perceived that learning was less online compared to face-to-face sessions because of reduced learner engagement, concentration, motivation, peer-to-peer learning, and limited opportunities for practical sessions. Online learning was thought to increase students' workload in the form of a number of assessments which was thought to reduce learning. Online tutorials were perceived to reduce the acquisition of soft skills like confidence, communication, leadership, and practical or clinical skills. While learning was thought to be less during online teaching, it was noted to allow continued learning during the lockdown, to be flexible, enhance self-drive and opportunity for work, solve infrastructure problems, and protect them from COVID-19 infection. Conclusion Generally, online learning enabled continuity and flexibility of learning. However, online PBL learning was perceived to be less engaging compared to traditional classroom-based PBL. Online PBL was seen to deter students from acquiring critical generic and clinical skills inherently found in traditional PBL. Innovative pedagogical measures should be adopted to avoid reduced learning noted in the online teaching methods to ensure the successful adoption of online teaching and learning in the post-COVID-19 era.
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Milani C, Naldini G, Baggiani L, Nerattini M, Bonaccorsi G. How to promote changes in primary care? The Florentine experience of the House of Community. Front Public Health 2023; 11:1216814. [PMID: 37732087 PMCID: PMC10508287 DOI: 10.3389/fpubh.2023.1216814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/09/2023] [Indexed: 09/22/2023] Open
Abstract
Primary care (PC) has a central role in promoting health and preventing diseases, even during health emergencies. The COVID-19 pandemic has shown how strengthening comprehensive primary healthcare (c-PHC) services is key to ensuring community health. The Italian government decided to support PHC by investing resources from the Next Generation EU (NextGenEu) plan in the development of local health districts (LHDs) and local PC centers called "Houses of Community (HoC)". The Florence LHD (Tuscany)-in direct collaboration with the University of Florence-has represented the experimental context in which a c-PHC-inspired organizational model has been proposed and included the HoC as the nearest access point to PC services. Through multiprofessional collaboration practices, HoCs provide continuity of care as well as health and social integration. Different levels of action must coexist to initiate, implement, and sustain this new PC model: the organizational and managerial level, the experimentation of a new model of care, and the research level, which includes universities and LHD through participatory research and action approaches. This process benefits from health professionals' (HPs) participation and continuous assessment, the care for working relationships between HPs and services, an appropriate research methodology together with a "permeable" multidisciplinary research group, and educational programs. In this context, the HoC assumes the role of a permanent laboratory of experimentation in PC, supporting the effectiveness of care and answering what the Next Gen EU plan has been foreseeing for the rethinking of Italian territorial services.
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Affiliation(s)
- Chiara Milani
- Department of Health Science, University of Florence, Florence, Italy
| | - Giulia Naldini
- Department of District Healthcare Network, Azienda USL Toscana Centro, Florence, Italy
| | - Lorenzo Baggiani
- Department of District Healthcare Network, Azienda USL Toscana Centro, Florence, Italy
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