1
|
Adirim Z, Sockalingam S, Thakur A. Post-graduate Medical Training in Intellectual and Developmental Disabilities: a Systematic Review. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2021; 45:371-381. [PMID: 33433827 DOI: 10.1007/s40596-020-01378-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 11/24/2020] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Despite the increasing number of people with autism-spectrum disorder (ASD), intellectual disabilities (ID), and developmental disabilities (DDs), individuals with these conditions continue to have high levels of unmet physical and mental health needs. Robust training of health professionals can help bridge this gap. A systematic review was conducted to describe the features and educational outcomes of existing postgraduate medical education curricula to inform the development of future training to address the growing unmet care needs of people with intellectual and developmental disabilities (IDD) such as ASD and ID. METHODS Four major databases were searched for peer-reviewed, English-language research focusing on post-graduate training in IDD education. Educational curricula and outcomes were summarized including Best Evidence in Medical Education (BEME) Quality of Evidence and Kirkpatrick training evaluation model. RESULTS Sixteen studies were identified with a majority published after 2000 (69%). Pediatric departments were involved in 69%, Psychiatry 19%, Medicine-Pediatrics 19%, and Family Medicine 6.3%. Analysis of Kirkpatrick outcomes showed 31% were level 1 (satisfaction or comfort); 38% level 2 (change in objective knowledge or skills); 13% level 3 (change in behavior); and none at level 4. BEME analysis showed 19% of studies were grade 1 (no clear conclusions), 31% grade 2 (ambiguous results), and half (50%) grade 3 (conclusions can probably be based on findings), with none scoring four or higher. CONCLUSIONS There is a paucity of objectively evaluated research in the area. Studies reviewed show clear promise for specialized, interdisciplinary, competency-based education which may be foundational for future curriculum development.
Collapse
Affiliation(s)
| | | | - Anupam Thakur
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| |
Collapse
|
2
|
Tortosa-Alted R, Reverté-Villarroya S, Martínez-Segura E, López-Pablo C, Berenguer-Poblet M. Emergency handover of critical patients. A systematic review. Int Emerg Nurs 2021; 56:100997. [PMID: 33887611 DOI: 10.1016/j.ienj.2021.100997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 02/12/2021] [Accepted: 03/02/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Emergency handover of critical patients is used to describe the moment of union between prehospital and hospital health team. However, the literature shows several definitions leading to great heterogeneity. PURPOSE To study the emergency handover of critical patients between two critical-emergency care wards performed by emergency nurses worldwide and to identify the features of these processes. METHODS We conducted an integrative review in eleven databases published from 2010 to 2019. Quality criteria and PRISMA checklist were applied. The protocol is registered with PROSPERO (CRD42020182335). RESULTS A total of 22 studies included and the following factors were identified: variability vs standardization, identification, professionals' behavior, localization, environmental factors, patient participation, clinical records, education/training, responsability, and communication. CONCLUSIONS The actual emergency handover occurs under conditions quite contrary to those recommended by experts so that it is neither safe nor effective, leading a serious problem for patient safety and quality care.
Collapse
Affiliation(s)
- Ruth Tortosa-Alted
- Hospital de Tortosa Verge de la Cinta, Catalan Institute of Health, Pere Virgili Institute, Carretera Esplanetes, 14, 43500 Tortosa, Tarragona, Spain; Nursing Department, Universitat Rovira Virgili, Campus Terres de l'Ebre, Avenue Remolins, 13-15, 43500 Tortosa, Tarragona, Spain.
| | - Sílvia Reverté-Villarroya
- Hospital de Tortosa Verge de la Cinta, Catalan Institute of Health, Pere Virgili Institute, Carretera Esplanetes, 14, 43500 Tortosa, Tarragona, Spain; Nursing Department, Universitat Rovira Virgili, Campus Terres de l'Ebre, Avenue Remolins, 13-15, 43500 Tortosa, Tarragona, Spain.
| | - Estrella Martínez-Segura
- Hospital de Tortosa Verge de la Cinta, Catalan Institute of Health, Pere Virgili Institute, Carretera Esplanetes, 14, 43500 Tortosa, Tarragona, Spain; Nursing Department, Universitat Rovira Virgili, Campus Terres de l'Ebre, Avenue Remolins, 13-15, 43500 Tortosa, Tarragona, Spain.
| | - Carlos López-Pablo
- Nursing Department, Universitat Rovira Virgili, Campus Terres de l'Ebre, Avenue Remolins, 13-15, 43500 Tortosa, Tarragona, Spain; Department of Pathology, Hospital de Tortosa Verge de la Cinta, Catalan Institute of Health, Pere Virgili Institute, Carretera Esplanetes, 14, 43500, Tortosa, Tarragona, Spain.
| | - Marta Berenguer-Poblet
- Nursing Department, Universitat Rovira Virgili, Campus Terres de l'Ebre, Avenue Remolins, 13-15, 43500 Tortosa, Tarragona, Spain.
| |
Collapse
|
4
|
Sultan N, Torti J, Haddara W, Inayat A, Inayat H, Lingard L. Leadership Development in Postgraduate Medical Education: A Systematic Review of the Literature. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:440-449. [PMID: 30379659 DOI: 10.1097/acm.0000000000002503] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE To evaluate and interpret evidence relevant to leadership curricula in postgraduate medical education (PGME) to better understand leadership development in residency training. METHOD The authors conducted a systematic review of peer-reviewed, English-language articles from four databases published between 1980 and May 2, 2017 that describe specific interventions aimed at leadership development. They characterized the educational setting, curricular format, learner level, instructor type, pedagogical methods, conceptual leadership framework (including intervention domain), and evaluation outcomes. They used Kirkpatrick effectiveness scores and Best Evidence in Medical Education (BEME) Quality of Evidence scores to assess the quality of the interventions. RESULTS Twenty-one articles met inclusion criteria. The classroom setting was the most common educational setting (described in 17 articles). Most curricula (described in 13 articles) were isolated, with all curricula ranging from three hours to five years. The most common instructor type was clinical faculty (13 articles). The most commonly used pedagogical method was small group/discussion, followed by didactic teaching (described in, respectively, 15 and 14 articles). Study authors evaluated both pre/post surveys of participant perceptions (n = 7) and just postintervention surveys (n = 10). The average Kirkpatrick Effectiveness score was 1.0. The average BEME Quality of Evidence score was 2. CONCLUSIONS The results revealed that interventions for developing leadership during PGME lack grounding conceptual leadership frameworks, provide poor evaluation outcomes, and focus primarily on cognitive leadership domains. Medical educators should design future leadership interventions grounded in established conceptual frameworks and pursue a comprehensive approach that includes character development and emotional intelligence.
Collapse
Affiliation(s)
- Nabil Sultan
- N. Sultan is nephrologist and assistant professor, Department of Nephrology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. J. Torti is research associate, Centre for Education Research & Innovation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; ORCID: https://orcid.org/0000-0003-4518-0255. W. Haddara is associate professor, Division of Endocrinology and Metabolism, Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; ORCID: https://orcid.org/0000-0002-9817-5524. A. Inayat is a neuroscience student, University of Toronto, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0002-1685-9616. H. Inayat is a neuroscience student, University of Toronto, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0003-1601-5269. L. Lingard is professor, Department of Medicine, and director, Centre for Education Research & Innovation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | | | | | | | | | | |
Collapse
|