Participatory Design of an Electronic Cross-Facility Health Record (ECHR) System for Pediatric Palliative Care: A Think-Aloud Study

Codesigning a user-centred digital psychoeducational tool for youth mental well-being with families in Canada: study protocol for a sequential exploratory mixed methods study

INTRODUCTION

On 11 March 2020, WHO declared the novel coronavirus (COVID-19) disease a global pandemic. Governments globally implemented physical distancing measures and closure of public institutions that resulted in varying implications to youth mental well-being (eg, social isolation, reduced extracurricular activities). These impacts may have detrimental short-term and long-term effects on youth mental well-being; care for youth with mental health disorders was already overstretched, underfunded and fragmented before the pandemic and youth are not often considered in mental health initiatives. There is a pressing need to partner with youth and families to target and improve youth mental well-being prior to the onset of a mental health disorder, as well as to conduct research on youth mental well-being needs related to pandemic recovery. Here we present a protocol for partnering with youth and families to codesign a user-centred digital tool for youth mental well-being.

METHODS AND ANALYSIS

We will conduct a national research study to develop a catalogue of recommendations specific to supporting youth mental well-being, and a digital tool to support youth mental well-being through three phases of work: (1) expert consultation on data related to supporting youth mental well-being existing within our Pandemic Preparedness Research Program; (2) codesign of an innovative digital tool for youth mental well-being; and (3) assessment of the tool's usability and acceptability.

ETHICS AND DISSEMINATION

This study has been approved by the Dalhousie Research Ethics Board (2023-6538) and the Conjoint Health Research Ethics Board (23-0039). This study will complement ongoing foundational research in youth conducted by our team that involves partnering with youth and families to understand the unique implications of the pandemic on this population.

Millennials Medical Students Generation at the Crosswalks: Motivations and Attitudes Towards Study and Future Career - A Mixed-Method Study

BACKGROUND AND OBJECTIVES

The aim of this study was to investigate in the millennium medical student generation the influence of the curriculum (problem-based curriculum [PBC] vs science-based curriculum [SBC]), gender and semester level on medical students' motives to study medicine, their attitudes toward their career and in this regard their view about their study condition in university.

METHODS

Semi-structured qualitative interviews with 28 medical students were performed and analyzed using Mayring's content analysis. Based on these results, a quantitative questionnaire for a nationwide survey was developed using a mixed-method-approach and send to most medical faculties in Germany. Data from n=1053 students entered statistical analysis.

RESULTS

Humanistic ideals prevailed in the choice to enter medical school and to become a physician. PBC students were found to be significantly (p<0.001) more idealistic and patient oriented, and they regard their curriculum more competitive than SBC-students (p<0.001). A balanced work and family life is essential for all students but particularly important for the PBC - group, male and undergraduate students. The majority of students wanted to work with patients and omitted patient-distant line of work. Undergraduate SBC-students saw their studies as old-fashioned citing lack of patient contact (p<0.001 compared to PBC), which eased in the graduate study part.

CONCLUSION

This study found major differences in student's perceptions depending on curriculum type. PBC-students were more idealistic, and humanistic ideals prevailed in comparison to SBC. For both, close patient contact is essential in their training. Particularly for female students, lifestyle factors and a balanced work-life-integration outweigh career ambitiousness. This study offers an important insight to policy makers and educators to understand the motivation and perceptions of the millennial student generation regarding their studies and future career plans, which should be considered in educational policies.

Evaluation of an Electronic Medical Record Module for Nursing Documentation in Paediatric Palliative Care: Involvement of Nurses with a Think-Aloud Approach

Background: Paediatric palliative care (PPC) is a noncurative approach to the care of children and adolescents with life-limiting and life-threatening illnesses. Electronic medical records (EMRs) play an important role in documenting such complex processes. Despite their benefits, they can introduce unintended consequences if future users are not involved in their development. Aim: The aim of this study was to evaluate the acceptance of a novel module for nursing documentation by nurses working in the context of PPC. Methods: An observational study employing concurrent think-aloud and semi-structured qualitative interviews were conducted with 11 nurses working in PPC. Based on the main determinants of the unified theory of acceptance and use of technology (UTAUT), data were analysed using qualitative content analysis. Results: The main determinants of UTAUT were found to potentially influence acceptance of the novel module. Participants perceived the module to be self-explanatory and intuitive. Some adaptations, such as the reduction of fragmentation in the display, the optimization of confusing mouseover fields, and the use of familiar nursing terminology, are reasonable ways of increasing software adoption. Conclusions: After adaptation of the modules based on the results, further evaluation with the participation of future users is required.

Planning for Implementation Success of an Electronic Cross-Facility Health Record for Pediatric Palliative Care Using the Consolidated Framework for Implementation Research (CFIR)

Pediatric palliative care (PPC) patients require years of care across professions and sectors. Sharing treatment-related information and communicating among different PPC professionals is critical to ensure good quality of care. In Germany, this communication is mostly paper-based and prone to errors. Therefore, an electronic cross-facility health record (ECHR) was participatorily designed with users, wherein information can be shared and PPC professionals can communicate with each other. As this form of electronic health record differs from existing models in Germany, there is a need for successful implementation to ensure a positive impact. Therefore, the facilitators and barriers to the implementation of ECHR in PPC were examined. Using the consolidated framework for implementation research (CFIR), transcripts of 32 interviews, 3 focus groups, and 20 think-aloud studies with PPC professionals were analyzed. CFIR indicated that the ECHR-design was viewed positively by users and can be a facilitator for implementation. Barriers exist, mainly due to the fact that the implementation is not planned, the use of the ECHR involves effort, costs are not covered, and all users must be motivated to use the ECHR for functionality. CFIR helps uncover the crux of the issues that need to be considered when planning ECHR implementation to improve care in PPC.