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Bussard ME, Jessee MA, El-Banna MM, Cantrell MA, Alrimawi I, Marchi NM, Gonzalez LI, Rischer K, Coy ML, Poledna M, Lavoie P. Current practices for assessing clinical judgment in nursing students and new graduates: A scoping review. Nurse Educ Today 2024; 134:106078. [PMID: 38184981 DOI: 10.1016/j.nedt.2023.106078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To map current assessment practices for learning outcomes related to nurses' clinical judgment from undergraduate education to entry to practice. DESIGN Scoping review using the Joanna Briggs Institute guidelines and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). DATA SOURCES Electronic databases-Cumulative Index of Nursing and Allied Health Literature (CINAHL Complete; EBSCOhost), EMBASE (Ovid), MEDLINE (Ovid), PsycINFO (Ovid), and Web of Science (Social Sciences Citation Index, Citation Index Expanded)-using a combination of descriptors and keywords related to nursing students, newly graduated nurses, clinical judgment and related terms (e.g., critical thinking, clinical reasoning, clinical decision-making, and problem-solving), and assessment. METHODS Two reviewers independently extracted study characteristics and, for each outcome relevant to clinical judgment, the concept, definition and framework, assessment tool, and the number and schedule of assessments. Data were synthesized narratively and using descriptive statistics. RESULTS Most of the 52 reviewed studies examined the outcome of a discrete educational intervention (76.9 %) in academic settings (78.8 %). Only six studies (11.5 %) involved newly graduated nurses. Clinical judgment (34.6 %), critical thinking (26.9 %), and clinical reasoning (9.6 %) were the three most frequent concepts. Three assessment tools were used in more than one study: the Lasater Clinical Judgment Rubric (n = 22, 42.3 %), the California Critical Thinking Skills Test (n = 9, 17.3 %), and the Health Science Reasoning Test (n = 2, 3.8 %). Eleven studies (21.2 %) used assessment tools designed for the study. CONCLUSION In addition to a disparate understanding of underlying concepts, there are minimal published studies on the assessment of nursing students and nurses' clinical judgment, especially for longitudinal assessment from education to clinical practice. Although there is some existing research on this topic, further studies are necessary to establish valid and reliable clinical competency assessment methods that effectively integrate clinical judgment in clinical situations at relevant time points.
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Affiliation(s)
- Michelle E Bussard
- School of Nursing, Bowling Green State University, 924 Ridge St., Bowling Green, OH 43403, USA.
| | - Mary Ann Jessee
- School of Nursing, Vanderbilt University, 461 21(st) Avenue South, Nashville, TN 37240, USA.
| | - Majeda M El-Banna
- School of Nursing, George Washington University, 45085 University Drive, Innovation Hall, Ashburn, VA 20147, USA.
| | - Mary Ann Cantrell
- College of Nursing, Villanova University, 800 E. Lancaster Ave., Villanova, PA 19085, USA.
| | - Intima Alrimawi
- School of Nursing, Georgetown University, St. Mary's Hall, 3700 Reservoir Rd. NW, Washington, DC 20057, USA.
| | - Nadine M Marchi
- Inova Health System, 3300 Gallows Road, Falls Church, VA 22042-3300, USA.
| | - Lisa I Gonzalez
- College of Southern Maryland, 8730 Mitchell Rd, La Plata, MD 20646, USA.
| | - Keith Rischer
- KeithRN, 6417 Penn Ave S, Ste 8, iPMB 1383, Minneapolis, MN 55423, USA.
| | - Michelle L Coy
- Mayo Clinic College of Medicine and Science, 200 First Street Southwest, Rochester, MN 55905, USA.
| | - Mari Poledna
- Arizona State University, 411 North Central Ave, Phoeniz, AZ 85004, USA.
| | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, 2375 Chemin De la Côte-Sainte-Catherine, Montreal, Quebec H3C 3J7, Canada; Montreal Heart Institute Research Center, 5000 rue Bélanger, Montreal, Quebec H1T 1C8, Canada.
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Deschênes MF, Fernandez N, Lechasseur K, Caty MÈ, Azimzadeh D, Mai TC, Lavoie P. Transformation and Articulation of Clinical Data to Understand Students' and Health Professionals' Clinical Reasoning: Protocol for a Scoping Review. JMIR Res Protoc 2023; 12:e50797. [PMID: 38090795 PMCID: PMC10753415 DOI: 10.2196/50797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/02/2023] [Accepted: 11/23/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND There are still unanswered questions regarding effective educational strategies to promote the transformation and articulation of clinical data while teaching and learning clinical reasoning. Additionally, understanding how this process can be analyzed and assessed is crucial, particularly considering the rapid growth of natural language processing in artificial intelligence. OBJECTIVE The aim of this study is to map educational strategies to promote the transformation and articulation of clinical data among students and health care professionals and to explore the methods used to assess these individuals' transformation and articulation of clinical data. METHODS This scoping review follows the Joanna Briggs Institute framework for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist for the analysis. A literature search was performed in November 2022 using 5 databases: CINAHL (EBSCOhost), MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), and Web of Science (Clarivate). The protocol was registered on the Open Science Framework in November 2023. The scoping review will follow the 9-step framework proposed by Peters and colleagues of the Joanna Briggs Institute. A data extraction form has been developed using key themes from the research questions. RESULTS After removing duplicates, the initial search yielded 6656 results, and study selection is underway. The extracted data will be qualitatively analyzed and presented in a diagrammatic or tabular form alongside a narrative summary. The review will be completed by February 2024. CONCLUSIONS By synthesizing the evidence on semantic transformation and articulation of clinical data during clinical reasoning education, this review aims to contribute to the refinement of educational strategies and assessment methods used in academic and continuing education programs. The insights gained from this review will help educators develop more effective semantic approaches for teaching or learning clinical reasoning, as opposed to fragmented, purely symptom-based or probabilistic approaches. Besides, the results may suggest some ways to address challenges related to the assessment of clinical reasoning and ensure that the assessment tasks accurately reflect learners' developing competencies and educational progress. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50797.
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Affiliation(s)
| | | | | | - Marie-Ève Caty
- Département d'orthophonie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Dina Azimzadeh
- Faculté des sciences infirmières, Université de Montréal, Montréal, QC, Canada
| | - Tue-Chieu Mai
- Faculté des sciences infirmières, Université de Montréal, Montréal, QC, Canada
| | - Patrick Lavoie
- Faculté des sciences infirmières, Université de Montréal, Montreal, QC, QC, Canada
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Lapierre A, Lavoie P. To die or not to die: manikin death in resuscitation simulation does not impact nursing students' self-efficacy. Evid Based Nurs 2023; 26:154. [PMID: 37197911 DOI: 10.1136/ebnurs-2022-103671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 05/19/2023]
Affiliation(s)
| | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
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Blanchet Garneau A, Lavoie P, Sit V, Laurent Sédillot C. Core components of an anti-racist approach among health professions educators: an integrative review. Int J Med Educ 2023; 14:131-136. [PMID: 37715998 PMCID: PMC10693961 DOI: 10.5116/ijme.64e9.b6b4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 08/26/2023] [Indexed: 09/18/2023]
Abstract
Objectives This integrative literature review aimed to identify the core elements of an anti-racist approach among health professions educators. Methods We searched five databases CINAHL (EBSCOhost), ERIC (ProQuest Dissertations & Thesis Global), EMBASE (Ovid), MEDLINE (Ovid), and Web of Science (Social Sciences Citation Index, Citation Index Expanded) in March 2021. The search strategy combined concepts related to anti-racist pedagogies in the context of health professions education by educators in any capacity. From 1,755 results, we selected 249 manuscripts published in English or French between 2008 and 2021 based on titles and abstracts. After reviewing the full texts, we selected the 48 most relevant sources. We extracted data regarding knowledge, skills, and attitudes in reference to anti-racist approaches or surrogate terms. Within each category, we grouped similar data using a conceptual map. Results Analysis of the selected sources revealed that, for health professions educators, engaging in an anti-racist pedagogical approach requires more than incorporating racialized perspectives and content into the classroom. It rather rests on three interrelated components: developing a critical understanding of power relationships, moving toward a critical consciousness, and taking action at individual and organizational levels. Conclusions This review sheds light on knowledge, attitudes and skills that educators must deploy to adopt an anti-racist approach competently. This approach is a learned, intentional, and strategic effort in which health professions educators incorporate anti-racism into their teaching and apply anti-racist values to their various spheres of influence. This ongoing process strives for institutional and structural changes and requires whole-system actions.
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Affiliation(s)
| | | | - Vanessa Sit
- Faculty of Nursing, Université de Montréal, Canada
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Maheu-Cadotte MA, Dubé V, Lavoie P. Development and Contribution of a Serious Game to Improve Nursing Students' Clinical Reasoning in Acute Heart Failure: A Multimethod Study. Comput Inform Nurs 2023; 41:410-420. [PMID: 36729896 DOI: 10.1097/cin.0000000000000966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Clinical reasoning is essential for nurses and nursing students to recognize and intervene when hospitalized patients present acute heart failure. Serious games are digital educational interventions that could foster the development of clinical reasoning through an engaging and intrinsically motivating learning experience. However, elements from a playful approach (eg, rewards, narrative elements) are often absent or poorly integrated in existing serious games, which may limit their contribution to learning. Thus, we developed and studied the contribution of a novel serious game on nursing students' engagement, intrinsic motivation, and clinical reasoning in the context of acute heart failure. We adopted a multimethod design and randomized 28 participants to receive two serious game prototypes in a different sequence, one that fully integrated elements of a playful approach (SIGN@L-A) and one that offered only objectives, feedback, and a functional aesthetic (SIGN@L-B). Through self-reported questionnaires, participants reported higher levels of engagement and intrinsic motivation after using SIGN@L-A. However, negligible differences in clinical reasoning scores were found after using each serious game prototype. During interviews, participants reported on the contribution of design elements to their learning. Quantitative findings should be replicated in larger samples. Qualitative findings may guide the development of future serious games.
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Affiliation(s)
- Marc-André Maheu-Cadotte
- Author Affiliations: Faculty of Nursing, Université de Montréal (Drs Maheu-Cadotte, Dubé, and Lavoie); Montreal Heart Institute Research Center (Drs Maheu-Cadotte and Lavoie); CHUM Research Center (Drs Maheu-Cadotte and Dubé); and Center for Innovation in Nursing Education (Dr Lavoie), Montreal, Quebec, Canada
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6
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Boisseau W, Darsaut TE, Fahed R, Drake B, Lesiuk H, Rempel JL, Gentric JC, Ognard J, Nico L, Iancu D, Roy D, Weill A, Chagnon M, Zehr J, Lavoie P, Nguyen TN, Raymond J. Stent-Assisted Coiling in the Treatment of Unruptured Intracranial Aneurysms: A Randomized Clinical Trial. AJNR Am J Neuroradiol 2023; 44:381-389. [PMID: 36927759 PMCID: PMC10084896 DOI: 10.3174/ajnr.a7815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 02/16/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND AND PURPOSE Stent-assisted coiling may improve angiographic results of endovascular treatment of unruptured intracranial aneurysms compared with coiling alone, but this has never been shown in a randomized trial. MATERIALS AND METHODS The Stenting in the Treatment of Aneurysm Trial was an investigator-led, parallel, randomized (1:1) trial conducted in 4 university hospitals. Patients with intracranial aneurysms at risk of recurrence, defined as large aneurysms (≥10 mm), postcoiling recurrent aneurysms, or small aneurysms with a wide neck (≥4 mm), were randomly allocated to stent-assisted coiling or coiling alone. The composite primary efficacy outcome was "treatment failure," defined as initial failure to treat the aneurysm; aneurysm rupture or retreatment during follow-up; death or dependency (mRS > 2); or an angiographic residual aneurysm adjudicated by an independent core laboratory at 12 months. The primary hypothesis (revised for slow accrual) was that stent-assisted coiling would decrease treatment failures from 33% to 15%, requiring 200 patients. Primary analyses were intent to treat. RESULTS Of 205 patients recruited between 2011 and 2021, ninety-four were allocated to stent-assisted coiling and 111 to coiling alone. The primary outcome, ascertainable in 203 patients, was reached in 28/93 patients allocated to stent-assisted coiling (30.1%; 95% CI, 21.2%-40.6%) compared with 30/110 (27.3%; 95% CI, 19.4%-36.7%) allocated to coiling alone (relative risk = 1.10; 95% CI, 0.7-1.7; P = .66). Poor clinical outcomes (mRS >2) occurred in 8/94 patients allocated to stent-assisted coiling (8.5%; 95% CI, 4.0%-16.6%) compared with 6/111 (5.4%; 95% CI, 2.2%-11.9%) allocated to coiling alone (relative risk = 1.6; 95% CI, 0.6%-4.4%; P = .38). CONCLUSIONS The STAT trial did not show stent-assisted coiling to be superior to coiling alone for wide-neck, large, or recurrent unruptured aneurysms.
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Affiliation(s)
- W Boisseau
- From the Department of Radiology (W.B., D.I., D.R., A.W., J.R.), Service of Neuroradiology, Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada
| | - T E Darsaut
- Department of Surgery (T.E.D.), Division of Neurosurgery
| | - R Fahed
- Departments of Neurology (R.F.)
| | - B Drake
- Neurosurgery (B.D., H.L.), University of Ottawa, the Ottawa Hospital, Ottawa, Ontario, Canada
| | - H Lesiuk
- Neurosurgery (B.D., H.L.), University of Ottawa, the Ottawa Hospital, Ottawa, Ontario, Canada
| | - J L Rempel
- Department of Radiology and Diagnostic Imaging (J.L.R.), University of Alberta Hospital, Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada
| | - J-C Gentric
- Department of Radiology (J.-C.G., J.O.), University Hospital of Brest, Brest, France
| | - J Ognard
- Department of Radiology (J.-C.G., J.O.), University Hospital of Brest, Brest, France
| | - L Nico
- Departement of Radiology (L.N.), Service of Interventional Neuroradiology, Centre Hospitalo-universitaire de Saint-Etienne, Saint-Etienne, France
| | - D Iancu
- From the Department of Radiology (W.B., D.I., D.R., A.W., J.R.), Service of Neuroradiology, Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada
| | - D Roy
- From the Department of Radiology (W.B., D.I., D.R., A.W., J.R.), Service of Neuroradiology, Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada
| | - A Weill
- From the Department of Radiology (W.B., D.I., D.R., A.W., J.R.), Service of Neuroradiology, Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada
| | - M Chagnon
- Department of Mathematics and Statistics (M.C., J.Z.), Pavillon André-Aisenstadt, Montreal, Québec, Canada
| | - J Zehr
- Department of Mathematics and Statistics (M.C., J.Z.), Pavillon André-Aisenstadt, Montreal, Québec, Canada
| | - P Lavoie
- Department of Neurosurgery (P.L.), Centre Hospitalier Universitaire de Québec-Université Laval, Québec, Canada
| | - T N Nguyen
- Departments of Neurology (T.N.N.)
- Radiology (T.N.N.), Boston Medical Center, Boston, Massachusetts
| | - J Raymond
- From the Department of Radiology (W.B., D.I., D.R., A.W., J.R.), Service of Neuroradiology, Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada
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Mailhot T, Maheu-Cadotte MA, Bourbonnais A, Yevchak Sillner A, Charchalis M, Rodriguez D, Lavoie P. Unlicensed assistive personnel's care for persons with or at risk of delirium: a scoping review protocol. JBI Evid Synth 2023:02174543-990000000-00138. [PMID: 36876454 DOI: 10.11124/jbies-22-00248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
OBJECTIVE The objective of this review is to describe the nature and extent of the literature regarding unlicensed assistive personnel's involvement in delivering care to persons with or at risk of delirium. INTRODUCTION Initiatives that promote the involvement of unlicensed assistive personnel in providing additional supervision and care to persons with or at risk of delirium have been developed. Since no standardized approach guides unlicensed assistive personnel's involvement with persons with or at risk of delirium, and since inconsistent training and expectations may pose a threat to the safety and quality of care, it is essential to clarify their role with persons with or at risk of delirium. INCLUSION CRITERIA This review will consider articles published in peer-reviewed journals, dissertations, theses, book chapters, and conference papers in French or English. Quantitative, qualitative, or mixed method studies that report on the development, implementation, or evaluation of the role of unlicensed assistive personnel in contexts of delirium will be included. We will consider editorials and opinion papers only if they report on the development, implementation, or evaluation of the role of unlicensed assistive personnel. METHODS Records will be identified via CINAHL, ProQuest Dissertations & Theses Global, Embase, MEDLINE, APA PsycINFO, and Web of Science. Two independent reviewers will select studies and extract data using a piloted form. Data will be synthesized narratively, using descriptive statistics and a tabular format. A consultation phase will include approximately 24 unlicensed assistive personnel and registered nurses who will be invited to comment on the review findings.
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Affiliation(s)
- Tanya Mailhot
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Montreal Heart Institute, Montreal, QC, Canada
| | - Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Montreal Heart Institute, Montreal, QC, Canada
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Andrea Yevchak Sillner
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | | | | | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Montreal Heart Institute, Montreal, QC, Canada
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Lavoie P, Boyer L, Pepin J, Déry J, Lavoie-Tremblay M, Paquet M, Bolduc J. Multicentre implementation of a nursing competency framework at a provincial scale: A qualitative description of facilitators and barriers. J Eval Clin Pract 2023; 29:263-271. [PMID: 36099281 DOI: 10.1111/jep.13760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/23/2022] [Accepted: 08/27/2022] [Indexed: 11/30/2022]
Abstract
RATIONALE Nurses are responsible for engaging in continuing professional development throughout their careers. This implies that they use tools such as competency frameworks to assess their level of development, identify their learning needs, and plan actions to achieve their learning goals. Although multiple competency frameworks and guidelines for their development have been proposed, the literature on their implementation in clinical settings is sparser. If the complexity of practice creates a need for context-sensitive competency frameworks, their implementation may also be subject to various facilitators and barriers. AIMS AND OBJECTIVES To document the facilitators and barriers to implementing a nursing competency framework on a provincial scale. METHODS This multicentre study was part of a provincial project to implement a nursing competency framework in Quebec, Canada, using a three-step process based on evidence from implementation science. Nurses' participation consisted in the self-assessment of their competencies using the framework. For this qualitative descriptive study, 58 stakeholders from 12 organizations involved in the first wave of implementation participated in group interviews to discuss their experience with the implementation process and their perceptions of facilitators and barriers. Data were subjected to thematic analysis. RESULTS Analysis of the data yielded five themes: finding the 'right unit' despite an unfavourable context; taking and protecting time for self-assessment; creating value around competency assessment; bringing the project as close to the nurses as possible; making the framework accessible. CONCLUSION This study was one of the first to document the large-scale, multi-site implementation of a nursing competency framework in clinical settings. This project represented a unique challenge because it involved two crucial changes: adopting a competency-based approach focused on educational outcomes and accountability to the public and valorizing a learning culture where nurses become active stakeholders in their continuing professional development.
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Affiliation(s)
- Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montreal, Québec, Canada.,Montreal Heart Institute Research Center, Montreal, Québec, Canada
| | - Louise Boyer
- Faculty of Nursing, Université de Montréal, Montreal, Québec, Canada
| | - Jacinthe Pepin
- Faculty of Nursing, Université de Montréal, Montreal, Québec, Canada
| | - Johanne Déry
- Faculty of Nursing, Université de Montréal, Montreal, Québec, Canada
| | | | - Maxime Paquet
- Department of Psychology, Université de Montréal, Montreal, Québec, Canada
| | - Jolianne Bolduc
- Faculty of Nursing, Université de Montréal, Montreal, Québec, Canada
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Lapierre A, Lavoie P, Castonguay V, Lonergan AM, Arbour C. The influence of the simulation environment on teamwork and cognitive load in novice trauma professionals at the emergency department: Piloting a randomized controlled trial. Int Emerg Nurs 2023; 67:101261. [PMID: 36804137 DOI: 10.1016/j.ienj.2022.101261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 12/16/2022] [Accepted: 12/29/2022] [Indexed: 02/20/2023]
Abstract
INTRODUCTION This pilot study aimed to test the feasibility of conducting a randomized controlled trial to examine how simulation environments (in situ versus laboratory) influence teamwork skills development and cognitive load among novice healthcare trauma professionals in the emergency department. METHOD Twenty-four novice trauma professionals (nurses, medical residents, respiratory therapists) were assigned to in situ or laboratory simulations. They participated in two 15-minute simulations separated by a 45-minute debriefing on teamwork. After each simulation, they completed validated teamwork and cognitive load questionnaires. All simulations were video recorded to assess teamwork performance by trained external observers. Feasibility measures (e.g., recruitment rate, randomization procedure and intervention implementation) were recorded. Mixed ANOVAs were used to calculate effect sizes. RESULTS Regarding feasibility, several difficulties were encountered, such as a low recruitment rate and the inability to perform randomization. Outcome results suggest that the simulation environment does not affect novice trauma professionals' teamwork performance and cognitive load (small effect sizes), but a large effect size was observed for perceived learning. CONCLUSION This study highlights several barriers to conducting a randomized study in the context of interprofessional simulation-based education in the emergency department. Suggestions are made to guide future research in the field.
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Affiliation(s)
- Alexandra Lapierre
- Faculty of Nursing, Université de Montréal, 2375 Chem. de la Côte-Sainte-Catherine, Montréal, QC H3T 1A8, Canada; Research center, Hôpital du Sacré-Coeur de Montréal, 5400 Boul Gouin O, Montréal, QC H4J 1C5, Canada.
| | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, 2375 Chem. de la Côte-Sainte-Catherine, Montréal, QC H3T 1A8, Canada
| | - Véronique Castonguay
- Research center, Hôpital du Sacré-Coeur de Montréal, 5400 Boul Gouin O, Montréal, QC H4J 1C5, Canada
| | - Ann-Marie Lonergan
- Research center, Hôpital du Sacré-Coeur de Montréal, 5400 Boul Gouin O, Montréal, QC H4J 1C5, Canada
| | - Caroline Arbour
- Faculty of Nursing, Université de Montréal, 2375 Chem. de la Côte-Sainte-Catherine, Montréal, QC H3T 1A8, Canada; Research center, Hôpital du Sacré-Coeur de Montréal, 5400 Boul Gouin O, Montréal, QC H4J 1C5, Canada
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Cyr S, Marcil MJ, Houchi C, Marin MF, Rosa C, Tardif JC, Guay S, Guertin MC, Genest C, Forest J, Lavoie P, Labrosse M, Vadeboncoeur A, Selcer S, Ducharme S, Brouillette J. Evolution of burnout and psychological distress in healthcare workers during the COVID-19 pandemic: a 1-year observational study. BMC Psychiatry 2022; 22:809. [PMID: 36539718 PMCID: PMC9763813 DOI: 10.1186/s12888-022-04457-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Long-term psychological impacts of the COVID-19 pandemic on healthcare workers remain unknown. We aimed to determine the one-year progression of burnout and mental health since pandemic onset, and verify if protective factors against psychological distress at the beginning of the COVID-19 pandemic (Cyr et al. in Front Psychiatry; 2021) remained associated when assessed several months later. METHODS We used validated questionnaires (Maslach Burnout Inventory, Hospital Anxiety and Depression and posttraumatic stress disorder [PTSD] Checklist for DSM-5 scales) to assess burnout and psychological distress in 410 healthcare workers from Quebec, Canada, at three and 12 months after pandemic onset. We then performed multivariable regression analyses to identify protective factors of burnout and mental health at 12 months. As the equivalent regression analyses at three months post-pandemic onset had already been conducted in the previous paper, we could compare the protective factors at both time points. RESULTS Prevalence of burnout and anxiety were similar at three and 12 months (52% vs. 51%, p = 0.66; 23% vs. 23%, p = 0.91), while PTSD (23% vs. 11%, p < 0.0001) and depression (11% vs. 6%, p = 0.001) decreased significantly over time. Higher resilience was associated with a lower probability of all outcomes at both time points. Perceived organizational support remained significantly associated with a reduced risk of burnout at 12 months. Social support emerged as a protective factor against burnout at 12 months and persisted over time for studied PTSD, anxiety, and depression. CONCLUSIONS Healthcare workers' occupational and mental health stabilized or improved between three and 12 months after the pandemic onset. The predominant protective factors against burnout remained resilience and perceived organizational support. For PTSD, anxiety and depression, resilience and social support were important factors over time.
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Affiliation(s)
- Samuel Cyr
- grid.482476.b0000 0000 8995 9090Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada ,grid.14848.310000 0001 2292 3357Faculty of Pharmacy, Université de Montréal, P.O. Box 6128, Downtown Branch, Montreal, Québec, H3C 3J7 Canada
| | - Marie-Joelle Marcil
- grid.482476.b0000 0000 8995 9090Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada ,grid.14848.310000 0001 2292 3357Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, Québec, H3C 3J7 Canada
| | - Cylia Houchi
- grid.482476.b0000 0000 8995 9090Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada ,grid.14848.310000 0001 2292 3357Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, Québec, H3C 3J7 Canada
| | - Marie-France Marin
- grid.14848.310000 0001 2292 3357Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, Québec, H3C 3J7 Canada ,grid.38678.320000 0001 2181 0211Department of Psychology, UQAM, 100 Sherbrooke Street West, Montréal, Québec, H2X 3P2 Canada ,grid.414210.20000 0001 2321 7657Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montreal, Québec, H1N 3V2 Canada
| | - Camille Rosa
- Montreal Health Innovations Coordinating Centre, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada
| | - Jean-Claude Tardif
- grid.482476.b0000 0000 8995 9090Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada ,grid.14848.310000 0001 2292 3357Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montreal, Québec, H3C 3J7 Canada
| | - Stéphane Guay
- grid.14848.310000 0001 2292 3357Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, Québec, H3C 3J7 Canada ,grid.414210.20000 0001 2321 7657Centre d’étude sur le Trauma, Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montreal, Québec, H1N 3V2 Canada
| | - Marie-Claude Guertin
- Montreal Health Innovations Coordinating Centre, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada
| | - Christine Genest
- grid.414210.20000 0001 2321 7657Centre d’étude sur le Trauma, Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montreal, Québec, H1N 3V2 Canada ,grid.14848.310000 0001 2292 3357Faculty of Nursing, Université de Montréal, Marguerite-d’Youville Pavilion, P.O. Box 6128, Downtown Branch, Montreal, Québec, H3C 3J7 Canada
| | - Jacques Forest
- Department of Organization and Human Resources, ESG UQAM, P.O. Box 8888, Downtown Branch, Montreal, Québec, H3C 3P8 Canada
| | - Patrick Lavoie
- grid.482476.b0000 0000 8995 9090Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada ,grid.14848.310000 0001 2292 3357Faculty of Nursing, Université de Montréal, Marguerite-d’Youville Pavilion, P.O. Box 6128, Downtown Branch, Montreal, Québec, H3C 3J7 Canada
| | - Mélanie Labrosse
- grid.14848.310000 0001 2292 3357Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montreal, Québec, H3C 3J7 Canada ,grid.411418.90000 0001 2173 6322Department of Pediatrics, Division of Emergency Medicine, Centre Hospitalier Universitaire Sainte-Justine, 3175 Côte-Sainte-Catherine Road, Montreal, Québec, H3T 1C5 Canada
| | - Alain Vadeboncoeur
- grid.482476.b0000 0000 8995 9090Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada ,grid.14848.310000 0001 2292 3357Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montreal, Québec, H3C 3J7 Canada
| | - Shaun Selcer
- grid.482476.b0000 0000 8995 9090Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8 Canada ,grid.14848.310000 0001 2292 3357Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montreal, Québec, H3C 3J7 Canada
| | - Simon Ducharme
- grid.412078.80000 0001 2353 5268Department of Psychiatry, Douglas Mental Health University Institute, McGill University, 6875 LaSalle Boulevard, Verdun, Québec, H4H 1R3 Canada ,grid.416102.00000 0004 0646 3639McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University St, Montreal, Québec, H3A 2B4 Canada
| | - Judith Brouillette
- Research Centre, Montreal Heart Institute, 5000 Belanger street, Montreal, Québec, H1T 1C8, Canada. .,Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, Québec, H3C 3J7, Canada.
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11
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Fontaine G, Maheu‐Cadotte M, Lavallée A, Mailhot T, Lavoie P, Rouleau G, Vinette B, García MR, Bourbonnais A. Designing, planning, and conducting systematic reviews and other knowledge syntheses: Six key practical recommendations to improve feasibility and efficiency. Worldviews Evid Based Nurs 2022; 19:434-441. [DOI: 10.1111/wvn.12609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 08/02/2022] [Accepted: 08/27/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Guillaume Fontaine
- Clinical Epidemiology Program Ottawa Hospital Research Institute Ontario Ottawa Canada
- Faculty of Medicine University of Ottawa Ontario Ottawa Canada
- Centre for Nursing Research Jewish General Hospital Quebec Montreal Canada
| | - Marc‐André Maheu‐Cadotte
- Faculty of Nursing Université de Montréal Quebec Montréal Canada
- Research Centre Centre Hospitalier de l'Unibersité de Montréal Quebec Montréal Canada
- Research Centre Montreal Heart Institute Quebec Montréal Canada
| | - Andréane Lavallée
- Nurture Science Program, Department of Pediatrics Columbia University Medical Center New York New York City USA
| | - Tanya Mailhot
- Faculty of Nursing Université de Montréal Quebec Montréal Canada
- Research Centre Montreal Heart Institute Quebec Montréal Canada
| | - Patrick Lavoie
- Faculty of Nursing Université de Montréal Quebec Montréal Canada
- Research Centre Montreal Heart Institute Quebec Montréal Canada
| | - Geneviève Rouleau
- Institute for Health System Solutions and Virtual Care Women's College Hospital Ontario Toronto Canada
| | - Billy Vinette
- Faculty of Nursing Université de Montréal Quebec Montréal Canada
- Research Centre Hôpital Maisonneuve‐Rosemont Québec Montréal Canada
| | - Maria‐Pilar Ramírez García
- Faculty of Nursing Université de Montréal Quebec Montréal Canada
- Research Centre Centre Hospitalier de l'Unibersité de Montréal Quebec Montréal Canada
| | - Anne Bourbonnais
- Faculty of Nursing Université de Montréal Quebec Montréal Canada
- Research Center Institut Universitaire de Gériatrie de Montréal Québec Montréal Canada
- Canada Research Chair in Care for Older People Québec Montréal Canada
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12
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Laflamme M, Carrondo-Cottin S, Valdès MM, Simonyan D, Audet MÈ, Gariépy JL, Camden MC, Gariépy C, Verreault S, Lavoie P. Association between Early Ischemic Changes and Collaterals in Acute Stroke: A Retrospective Study. AJNR Am J Neuroradiol 2022; 43:1424-1430. [PMID: 36137656 PMCID: PMC9575540 DOI: 10.3174/ajnr.a7632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 07/13/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE The quality of leptomeningeal collaterals may influence the speed of infarct progression in acute stroke. Our main objective was to evaluate the association of leptomeningeal collateral score and its interaction with time with ischemic changes on CT in patients with acute stroke. MATERIALS AND METHODS Adult patients with acute stroke symptoms and anterior circulation large-vessel occlusion on CTA from 2015 to 2019 were included. Routinely performed NCCT and multiphase CTA were reviewed to assess ASPECTS and the leptomeningeal collateral score. We built multivariate regression models to assess the association between leptomeningeal collateral score and its interaction with time and ASPECTS. Performance measures to predict poor ASPECTS at different time thresholds (identified with receiver operating characteristic curve analysis) were estimated in a subgroup of patients with poor leptomeningeal collateral scores. RESULTS Leptomeningeal collateral scores 0-1 were associated with lower ASPECTS, and the model with dichotomized and trichotomized leptomeningeal collateral score showed a significant multiplicative interaction between time and the leptomeningeal collateral score. The negative predictive value for poor ASPECTS was >0.9 for at least the first 3 hours from stroke onset to imaging, and the positive predictive value was <0.5 for every time threshold tested in the subgroup of patients with leptomeningeal collateral scores 0-3. CONCLUSIONS Poor (0-1) leptomeningeal collateral scores were associated with lower ASPECTS, and an increase in time has a multiplicative interaction with the leptomeningeal collateral score on ASPECTS.
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Affiliation(s)
- M Laflamme
- Form the Division of Neurosurgery, Department of Surgery (M.L., C.G., P.L.)
| | - S Carrondo-Cottin
- Department of Neurosciences, Centre Hospitalier Universitaire de Québec -Université Laval Research Center (S.C.C.), Quebec, Canada
| | - M-M Valdès
- Department of Radiology (M.-M.V., M.-È.A, J.-L.G.)
| | - D Simonyan
- Clinical and Evaluative Research Platform (D.S.)
| | - M-È Audet
- Department of Radiology (M.-M.V., M.-È.A, J.-L.G.)
| | - J-L Gariépy
- Department of Radiology (M.-M.V., M.-È.A, J.-L.G.)
| | - M-C Camden
- Division of Neurology, Department of Medicine (M.-C.C., S.V.), Centre Hospitalier Universitaire de Québec -Université Laval, Quebec, Canada
| | - C Gariépy
- Form the Division of Neurosurgery, Department of Surgery (M.L., C.G., P.L.)
| | - S Verreault
- Division of Neurology, Department of Medicine (M.-C.C., S.V.), Centre Hospitalier Universitaire de Québec -Université Laval, Quebec, Canada
| | - P Lavoie
- Form the Division of Neurosurgery, Department of Surgery (M.L., C.G., P.L.)
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13
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Lavoie P, Lapierre A, Maheu-Cadotte MA, Rodriguez D, Lavallée A, Mailhot T. Improving the recognition and management of hemorrhage: A scoping review of nursing and midwifery education. Nurse Educ Today 2022; 113:105361. [PMID: 35429750 DOI: 10.1016/j.nedt.2022.105361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/16/2022] [Accepted: 04/01/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Hemorrhage is a frequent complication that nurses and midwives must recognize and manage to avoid life-threatening consequences for patients. There is currently no synthesis of evidence on educational interventions in nursing and midwifery regarding hemorrhage, thus limiting the definition of best practices. OBJECTIVE To map the literature on nursing and midwifery education regarding the recognition and management of hemorrhage. DESIGN Scoping review based on the Joanna Briggs Institute guidelines. DATA SOURCES Quantitative studies evaluating the effect of educational interventions with students, nurses, or midwives published in English or French, with no time limit. REVIEW METHODS Study selection, data extraction, and quality assessment were conducted by two independent reviewers. We characterized educational interventions based on the Guideline for Reporting Evidence-Based Practice Educational Interventions and Teaching. We categorized learning outcomes using the New World Kirkpatrick Model. Methodological quality appraisal was performed with tools from the Joanna Briggs Institute. Findings were synthesized using descriptive statistics and graphical methods RESULT: Most of the 38 studies used a single-group design (n = 26, 68%) and were conducted with professionals (n = 28, 74%) in hospital settings (n = 20, 53%). Most were of low (n = 14; 37%) or moderate (n = 18, 47%) methodological quality. Most interventions focused on postpartum hemorrhage (n = 34, 89%) and combined two or more teaching strategies (n = 25, 66%), often pairing an informational segment (e.g., lecture, readings) with a practical session (e.g., workshop, simulation). Learning outcomes related to the management (n = 27; 71%) and recognition of hemorrhage (n = 19, 50%), as well as results for patients and organizations (n = 9, 24%). CONCLUSION Considerable heterogeneity in interventions and learning outcomes precluded conducting a systematic review of effectiveness. High-quality, controlled studies are needed, particularly in surgery and trauma. Reflection on the contribution of nurses and midwives to the detection, monitoring, and management of hemorrhage could enrich the content and expected outcomes of hemorrhage education.
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Affiliation(s)
- Patrick Lavoie
- Faculty of Nursing, Université de Montréal, 2375 Chemin De la Côte-Sainte-Catherine, Montreal, Quebec H3C 3J7, Canada; Montreal Heart Institute Research Center, 5000 rue Bélanger, Montreal, Quebec H1T 1C8, Canada.
| | - Alexandra Lapierre
- Faculty of Nursing, Université de Montréal, 2375 Chemin De la Côte-Sainte-Catherine, Montreal, Quebec H3C 3J7, Canada
| | - Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, 2375 Chemin De la Côte-Sainte-Catherine, Montreal, Quebec H3C 3J7, Canada; Montreal Heart Institute Research Center, 5000 rue Bélanger, Montreal, Quebec H1T 1C8, Canada
| | - Dora Rodriguez
- Faculty of Nursing, Université de Montréal, 2375 Chemin De la Côte-Sainte-Catherine, Montreal, Quebec H3C 3J7, Canada
| | - Andréane Lavallée
- Department of Pediatrics, Columbia University Medical Center, 51 Audubon Ave, Suite 100, New York, NY 10032, United States
| | - Tanya Mailhot
- Faculty of Nursing, Université de Montréal, 2375 Chemin De la Côte-Sainte-Catherine, Montreal, Quebec H3C 3J7, Canada; Montreal Heart Institute Research Center, 5000 rue Bélanger, Montreal, Quebec H1T 1C8, Canada
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14
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Lavoie P, Lapierre A, Maheu-Cadotte MA, Fontaine G, Khetir I, Bélisle M. Transfer of Clinical Decision-Making-Related Learning Outcomes Following Simulation-Based Education in Nursing and Medicine: A Scoping Review. Acad Med 2022; 97:738-746. [PMID: 34789663 DOI: 10.1097/acm.0000000000004522] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Simulation is often depicted as an effective tool for clinical decision-making education. Yet, there is a paucity of data regarding transfer of learning related to clinical decision-making following simulation-based education. The authors conducted a scoping review to map the literature regarding transfer of clinical decision-making learning outcomes following simulation-based education in nursing or medicine. METHOD Based on the Joanna Briggs Institute methodology, the authors searched 5 databases (CINAHL, ERIC, MEDLINE, PsycINFO, and Web of Science) in May 2020 for quantitative studies in which the clinical decision-making performance of nursing and medical students or professionals was assessed following simulation-based education. Data items were extracted and coded. Codes were organized and hierarchized into patterns to describe conceptualizations and conditions of transfer, as well as learning outcomes related to clinical decision-making and assessment methods. RESULTS From 5,969 unique records, 61 articles were included. Only 7 studies (11%) assessed transfer to clinical practice. In the remaining 54 studies (89%), transfer was exclusively assessed in simulations that often included one or more variations in simulation features (e.g., scenarios, modalities, duration, and learner roles; 50, 82%). Learners' clinical decision-making, including data gathering, cue recognition, diagnoses, and/or management of clinical issues, was assessed using checklists, rubrics, and/or nontechnical skills ratings. CONCLUSIONS Research on simulation-based education has focused disproportionately on the transfer of learning from one simulation to another, and little evidence exists regarding transfer to clinical practice. The heterogeneity in conditions of transfer observed represents a substantial challenge in evaluating the effect of simulation-based education. The findings suggest that 3 dimensions of clinical decision-making performance are amenable to assessment-execution, accuracy, and speed-and that simulation-based learning related to clinical decision-making is predominantly understood as a gain in generalizable skills that can be easily applied from one context to another.
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Affiliation(s)
- Patrick Lavoie
- P. Lavoie is assistant professor, Faculty of Nursing, Université de Montréal, and researcher, Montreal Heart Institute, Montreal, Quebec, Canada; ORCID: https://orcid.org/0000-0001-8244-6484
| | - Alexandra Lapierre
- A. Lapierre is a doctoral candidate, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada; ORCID: https://orcid.org/0000-0002-8704-4940
| | - Marc-André Maheu-Cadotte
- M.-A. Maheu-Cadotte is a doctoral candidate, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada; ORCID: https://orcid.org/0000-0003-3190-0901
| | - Guillaume Fontaine
- G. Fontaine is a postdoctoral research fellow, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; ORCID: https://orcid.org/0000-0002-7806-814X
| | - Imène Khetir
- I. Khetir is a master's student, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
| | - Marilou Bélisle
- M. Bélisle is associate professor, Faculty of Education, Université de Sherbrooke, Longueuil, Quebec, Canada
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Mailhot T, Cossette S, Lavoie P, Maheu‐Cadotte M, Fontaine G, Bourbonnais A, Côté J. The development of the MENTOR_D nursing intervention: Supporting family involvement in delirium management. Int J Older People Nurs 2022; 17:e12462. [DOI: 10.1111/opn.12462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 02/15/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Tanya Mailhot
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut de Cardiologie de Montréal Montréal QC Canada
| | - Sylvie Cossette
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut de Cardiologie de Montréal Montréal QC Canada
| | - Patrick Lavoie
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut de Cardiologie de Montréal Montréal QC Canada
- Centre d’innovation en Formation Infirmière Université de Montréal Montréal QC Canada
| | - Marc‐André Maheu‐Cadotte
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut de Cardiologie de Montréal Montréal QC Canada
- Research Centre of the Centre Hospitalier de l’Université de Montréal Montréal QC Canada
| | - Guillaume Fontaine
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut de Cardiologie de Montréal Montréal QC Canada
| | - Anne Bourbonnais
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut Universitaire de Gériatrie de Montréal Montréal QC Canada
| | - José Côté
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Centre Hospitalier de l’Université de Montréal Montréal QC Canada
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16
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Marcil MJ, Cyr S, Marin MF, Rosa C, Tardif JC, Guay S, Guertin MC, Genest C, Forest J, Lavoie P, Labrosse M, Vadeboncoeur A, Selcer S, Ducharme S, Brouillette J. Hair cortisol change at COVID-19 pandemic onset predicts burnout among health personnel. Psychoneuroendocrinology 2022; 138:105645. [PMID: 35134663 PMCID: PMC8697418 DOI: 10.1016/j.psyneuen.2021.105645] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/23/2021] [Accepted: 12/21/2021] [Indexed: 12/05/2022]
Abstract
BACKGROUND The COVID-19 pandemic has put chronic pressure on worldwide healthcare systems. While the literature regarding the prevalence of psychological distress and associated risk factors among healthcare workers facing COVID-19 has exploded, biological variables have been mostly overlooked. METHODS 467 healthcare workers from Quebec, Canada, answered an electronic survey covering various risk factors and mental health outcomes three months after the onset of the COVID-19 pandemic. Of them, 372 (80%) provided a hair sample, providing a history of cortisol secretion for the three months preceding and following the pandemic's start. We used multivariable regression models and a receiver operating characteristic curve to study hair cortisol as a predictor of burnout and psychological health, together with individual, occupational, social, and organizational factors. RESULTS As expected, hair cortisol levels increased after the start of the pandemic, with a median relative change of 29% (IQR = 3-59%, p < 0.0001). There was a significant association between burnout status and change in cortisol, with participants in the second quarter of change having lower odds of burnout. No association was found between cortisol change and post-traumatic stress disorder, anxiety, and depression symptoms. Adding cortisol to individual-occupational-socio-organizational factors noticeably enhanced our burnout logistic regression model's predictability. CONCLUSION Change in hair cortisol levels predicted burnout at three months in health personnel at the onset of the COVID-19 pandemic. This non-invasive biological marker of the stress response could be used in further clinical or research initiatives to screen high-risk individuals to prevent and control burnout in health personnel facing an important stressor.
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Affiliation(s)
- Marie-Joëlle Marcil
- Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada,Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada
| | - Samuel Cyr
- Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada,Faculty of Pharmacy, Université de Montréal, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada
| | - Marie-France Marin
- Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada,Department of Psychology, UQAM, 100 Sherbrooke Street West, Montréal, H2X 3P2 Québec, Canada,Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montréal, H1N 3V2 Québec, Canada
| | - Camille Rosa
- Montreal Health Innovations Coordinating Centre, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada
| | - Jean-Claude Tardif
- Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada,Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada
| | - Stéphane Guay
- Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada,Centre d’étude sur le Trauma, Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montréal, H1N 3V2 Québec, Canada
| | - Marie-Claude Guertin
- Montreal Health Innovations Coordinating Centre, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada
| | - Christine Genest
- Centre d’étude sur le Trauma, Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montréal, H1N 3V2 Québec, Canada,Faculty of Nursing, Université de Montréal, Marguerite-d'Youville Pavilion, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada
| | - Jacques Forest
- Department of Organization and Human Resources, ESG UQAM, P.O. Box 8888, Downtown Branch, Montréal, H3C 3P8 Québec, Canada
| | - Patrick Lavoie
- Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada,Faculty of Nursing, Université de Montréal, Marguerite-d'Youville Pavilion, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada
| | - Mélanie Labrosse
- Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada,Division of Emergency Medicine, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, 3175 Côte-Sainte-Catherine Road, Montréal, H3T 1C5 Québec, Canada
| | - Alain Vadeboncoeur
- Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada,Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada
| | - Shaun Selcer
- Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada,Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada
| | - Simon Ducharme
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, 6875 LaSalle Boulevard, Verdun, H4H 1R3 Québec, Canada,McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University St, Montréal, H3A 2B4 Québec, Canada
| | - Judith Brouillette
- Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada; Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada.
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17
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Lawrence S, Shire Z, Reicherz F, Lavoie P, Jacobson K. A45 INFLIXIMAB IN COMBINATION WITH AN IMMUNOMODULATOR IS ASSOCIATED WITH AN ATTENUATED ANTIBODY RESPONSE TO BNT162B2 SARS-COV-2 VACCINE IN PEDIATRIC INFLAMMATORY BOWEL DISEASE PATIENTS. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859343 DOI: 10.1093/jcag/gwab049.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Adult data have shown that Infliximab (IFX) impairs the antibody response to a single dose of the mRNA-BNT162b2 SARS-CoV-2 vaccine in patients with inflammatory bowel disease (IBD). The true impact of IFX on SARS-CoV-2 vaccine efficacy in pediatric IBD (PIBD) patients is unknown.
Aims
To evaluate the humoral immune response to the BNT162b2 SARS-CoV-2 in PIBD patients treated with anti-tumor necrosis factor (TNF) therapy.
Methods
PIBD patients treated with anti-TNF therapy either alone or in combination with an immunomodulator, who received at least one dose of the BNT162b2 SARS-CoV-2 vaccine, were prospectively enrolled from 1st June 2021 at BC Children’s Hospital. Serum antibody levels for [spike (S) protein and receptor-binding domain (RBD)] were determined at baseline and 28 days after their first and second vaccine doses. Antibody responses were assessed using multiplex serology IgG assay against four SARS-CoV-2 antigens: S-protein, RBD, N-terminal domain (NTD) and N-protein using the SARS-CoV-2 Panel 2 (Meso Scale Diagnostics).
Results
Forty-two PIBD patients received a single dose of BNT162b2 (median age 14.5yrs (IQR 14–16); 43% female; 79% crohn’s disease, 21%, ulcerative colitis). Of those on IFX monotherapy (43%), both S-protein and RBD antibody concentrations 28 days post BNT162b2 were comparable to healthy adult controls (n=20, median age: 36yrs (IQR 29–40); 65% female) who had received one dose of BNT162b2 (p = 0.07) [Figure 1]. In PIBD patients on IFX in combination with either azathioprine or methotrexate (57%) both S-protein and RBD antibody concentrations were significantly lower than controls after 1 dose of BNT162b2 (p = 0.0003) [Figure 1].
In the PIBD cohort (n=27) who received 2 doses of BNT162b2 vaccine (median age 14yrs (IQR 14–16);41% female;63% crohn’s disease, 37% ulcerative colitis; median interval between doses 56 days (IQR 22–105)), there was no difference in antibody response after 2 doses compared to healthy adult controls (n=14, median age: 44 years (IQR 36–51); 29% female) whether they were on IFX monotherapy (41%) or in combination with an immunomodulator (59%) [Figure 1].
Conclusions
We provide evidence of an attenuated antibody response in PIBD patients on IFX in combination with an immunomodulator after a single dose of BNT162b2. However, our data show a robust antibody response in PIBD patients, despite their infliximab treatment, after two doses of BNT162b2 vaccine. Our results are consistent with adult IBD data and highlight the importance of administering the second vaccine dose to achieve protection in this vulnerable patient population. Long-term follow-up to assess longevity of vaccine protection is warranted.
Funding Agencies
None
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Affiliation(s)
- S Lawrence
- Pediatric Gastroenterology, Hepatology and Nutrition, BC Children’s Hospital, Vancouver, BC, Canada
| | - Z Shire
- Pediatric Gastroenterology, Hepatology and Nutrition, BC Children’s Hospital, Vancouver, BC, Canada
| | - F Reicherz
- Pediatric Gastroenterology, Hepatology and Nutrition, BC Children’s Hospital, Vancouver, BC, Canada
| | - P Lavoie
- Pediatric Gastroenterology, Hepatology and Nutrition, BC Children’s Hospital, Vancouver, BC, Canada
| | - K Jacobson
- BC Children’s Hospital, Vancouver, BC, Canada
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18
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Allaire JM, Sharafianardakani Z, Poon B, Piper H, Jacobson K, Lavoie P, Vallance B. A1 USING HUMAN NEONATAL ORGANOIDS TO EXPLORE GUT-IMMUNE SYSTEM INTERACTIONS OF THE NEONATAL INTESTINE. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859236 DOI: 10.1093/jcag/gwab049.000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Necrotizing Enterocolitis (NEC) affects around 10% of preterm babies and is one of the leading causes of death for newborns. NEC is characterized by exaggerated inflammation of the intestinal mucosa, possibly triggered by aberrant exposure to gut microbes, leading to hypoxic conditions and the death of intestinal tissues. It has been hypothesized that NEC develops when the immature intestine (epithelium and immune system) is unable to properly balance these new microbial interactions. To date, NEC is poorly understood and due to the difficulty of modeling the human neonatal intestine, few therapeutic options are available. Intestinal epithelial cells (IEC) are important players in promoting beneficial host-microbe interactions in the gut, being the primary barrier that separates the host’s mucosal immune system from luminal microbiota, as well as key players in mediating signaling between microbes and the host. Based on their location, IEC are also subject to injury associated with maladaptive immune responses against gut microbes. Many studies have shown that immune cells (such as T helper 17 cells) interact with IEC to promote gut health and function. These interactions include educating IEC on how to respond to, and fight pathogenic microbes, yet also remain tolerant to commensal microbes. Aims This project seeks to develop an in vitro human neonatal intestinal organoid model to study developmental changes in IEC and their functional interactions with neonatal Th17 cells. Methods 3D organoids were established from human neonatal intestinal biopsies and then co-cultured with the supernatant of differentiated Th17 cells or with recombinant cytokines, IL-17 and IL-22. Changes in barrier function, cell proliferation, production of mucins and anti-microbial peptides (AMP) were analyzed by qPCR and immunostaining. Results Using 3D neonatal organoids we observed that the supernatants from neonatal Th17 cells (containing IL-17, IL-22 etc.) promoted the proliferation, differentiation and barrier function of the neonatal epithelium. By using specific recombinant cytokine (IL22, IL17) and neutralizing IL-22 antibodies in parallel, we demonstrated that the high levels of IL-22 produced by neonatal Th17 cells specifically induced proliferation of IEC, AMP and mucus production as compared to control media treated organoids, as shown by increases in Ki67, Reg3γ and Muc2 markers. Conclusions This experimental model mimicking the neonatal intestinal environment can be used to study interactions between neonatal IEC and immune cells. Our findings can provide clinically relevant information and clues to how developmental changes in the newborn intestine can influence susceptibility to NEC while demonstrating our development of a simple, yet accurate and clinically applicable model of the neonatal gut. Funding Agencies CAG, CIHRBCCHRI, CCC, C.H.I.L.D. Fdn
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Affiliation(s)
- J M Allaire
- Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | | | - B Poon
- Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - H Piper
- BC Children’s Hospital, Vancouver, BC, Canada
| | - K Jacobson
- BC Children’s Hospital, Vancouver, BC, Canada
| | - P Lavoie
- BC Children’s Hospital, Vancouver, BC, Canada
| | - B Vallance
- BC Children’s Hospital, Vancouver, BC, Canada
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19
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Fontaine G, Zagury-Orly I, Maheu-Cadotte MA, Lapierre A, Thibodeau-Jarry N, Denus SD, Lordkipanidzé M, Dupont P, Lavoie P. A Meta-Analysis of the Effect of Paper Versus Digital Reading on Reading Comprehension in Health Professional Education. Am J Pharm Educ 2021; 85:8525. [PMID: 34301544 PMCID: PMC8715975 DOI: 10.5688/ajpe8525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/21/2021] [Indexed: 06/13/2023]
Abstract
Objective. Despite a rise in the use of digital education in health professional education (HPE), little is known about the comparative effectiveness of paper-based reading and its digital alternative on reading comprehension. The objectives of this study were to identify, appraise, and synthesize the evidence regarding the effect of how media is read on reading comprehension in the context of HPE.Methods. Observational, quasi-experimental, and experimental studies published before April 16, 2021, were included if they compared the effectiveness of paper-based vs digital-based reading on reading comprehension among HPE students, trainees, and residents. Random-effects meta-analyses were performed using standardized mean differences.Results. From a pool of 2,208 references, we identified and included 10 controlled studies that had collectively enrolled 817 participants. Meta-analyses revealed a slight but nonsignificant advantage to students reading paper-based HPE texts rather than digital text (standardized mean difference, -0.08; 95% CI -0.28 to 0.12). Subgroup analyses revealed that students reading HPE-related texts had better reading comprehension when reading text on paper rather than digitally (SMD = -0.36; 95% CI -0.69 to -0.03). Heterogeneity was low in all analyses. The quality of evidence was low because of risks of bias across studies.Summary. Current evidence suggests little to no difference in students' comprehension when reading HPE texts on paper vs digitally. However, we observed effects favoring reading paper-based texts when texts relevant to the students' professional discipline were considered. Rigorous studies are needed to confirm this finding and to evaluate new means of boosting reading comprehension among students in HPE programs.
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Affiliation(s)
- Guillaume Fontaine
- Université de Montréal, Faculty of Nursing, Montréal, Canada
- Montreal Heart Institute, Research Center, Montréal, Canada
| | | | - Marc-André Maheu-Cadotte
- Université de Montréal, Faculty of Nursing, Montréal, Canada
- Montreal Heart Institute, Research Center, Montréal, Canada
- Université de Montréal Hospital Center, Research Center, Montréal, Canada
| | - Alexandra Lapierre
- Université de Montréal, Faculty of Nursing, Montréal, Canada
- Hôpital du Sacré-Cœur de Montréal, Research Center, Montréal, Canada
| | - Nicolas Thibodeau-Jarry
- Montreal Heart Institute, Research Center, Montréal, Canada
- Université de Montréal, Faculty of Medicine, Montréal, Canada
| | - Simon de Denus
- Montreal Heart Institute, Research Center, Montréal, Canada
- Université de Montréal, Faculty of Pharmacy, Montréal, Canada
| | - Marie Lordkipanidzé
- Montreal Heart Institute, Research Center, Montréal, Canada
- Université de Montréal, Faculty of Pharmacy, Montréal, Canada
| | - Patrice Dupont
- Université de Montréal, Health Sciences Library, Montréal, Canada
| | - Patrick Lavoie
- Université de Montréal, Faculty of Nursing, Montréal, Canada
- Montreal Heart Institute, Research Center, Montréal, Canada
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20
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Lavoie P, Clausen C, Purden M, Emed J, Frunchak V, Clarke SP. Nurses' experience of handoffs on four Canadian medical and surgical units: A shared accountability for knowing and safeguarding the patient. J Adv Nurs 2021; 77:4156-4169. [PMID: 34414589 DOI: 10.1111/jan.14997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/15/2021] [Accepted: 07/24/2021] [Indexed: 11/30/2022]
Abstract
AIMS To explore nurses' experience and describe how they manage various contextual factors affecting the nurse-to-nurse handoff at change of shift. DESIGN Qualitative descriptive study. METHODS A convenience sample of 51 nurses from four medical and surgical care units at a university-affiliated hospital in Montreal, Canada, participated in one of the 19 focus group interviews from November 2017 to January 2018. Data were analysed through a continuous and iterative process of thematic analysis. RESULTS Analysis of the data generated a core theme of 'sharing accountability for knowing and safeguarding the patient' that is achieved through actions related to nurses' role in the exchange. Specifically, the outgoing nurse takes actions to ensure continuity of care when letting go, and the incoming nurse takes actions to provide seamless care when taking over. In both roles, nurses navigate each handoff juncture by mutually adjusting, ensuring attentiveness, managing judgements, keeping on track, and venting and debriefing. Handoff is also shaped by contextual conditions related to handoff norms and practices, the nursing environment, individual nurse attributes and patient characteristics. CONCLUSIONS This study generated a conceptualization of nurses' roles and experience that details the relationship among the elements and conditions that shape nurse-to-nurse handoffs. IMPACT Nursing handoff involves the communication of patient information and relational behaviours that support the exchange. Although many factors are known to influence handoffs, little was known about nurses' experience of dealing with these at the point of care. This study contributed a comprehensive conceptualization of nursing handoff that could be useful in identifying areas for quality improvement and guiding future educational efforts.
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Affiliation(s)
- Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada.,Montreal Heart Institute Research Centre, Montreal, Quebec, Canada
| | - Christina Clausen
- Centre for Nursing Research, Jewish General Hospital, Montreal, Quebec, Canada.,Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.,Department of Nursing, Jewish General Hospital, Montreal, Quebec, Canada
| | - Margaret Purden
- Centre for Nursing Research, Jewish General Hospital, Montreal, Quebec, Canada.,Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Jessica Emed
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.,Department of Nursing, Jewish General Hospital, Montreal, Quebec, Canada
| | - Valerie Frunchak
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.,Department of Nursing, Jewish General Hospital, Montreal, Quebec, Canada
| | - Sean P Clarke
- Rory Meyers College of Nursing, New York University, New York, New York, USA
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21
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Maheu-Cadotte MA, Dubé V, Cossette S, Lapierre A, Fontaine G, Deschênes MF, Lavoie P. Involvement of End Users in the Development of Serious Games for Health Care Professions Education: Systematic Descriptive Review. JMIR Serious Games 2021; 9:e28650. [PMID: 34129514 PMCID: PMC8414295 DOI: 10.2196/28650] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND On the basis of ethical and methodological arguments, numerous calls have been made to increase the involvement of end users in the development of serious games (SGs). Involving end users in the development process is considered a way to give them power and control over educational software that is designed for them. It can also help identify areas for improvement in the design of SGs and improve their efficacy in targeted learning outcomes. However, no recognized guidelines or frameworks exist to guide end users' involvement in SG development. OBJECTIVE The aim of this study is to describe how end users are involved in the development of SGs for health care professions education. METHODS We examined the literature presenting the development of 45 SGs that had reached the stage of efficacy evaluation in randomized trials. One author performed data extraction using an ad hoc form based on a design and development framework for SGs. Data were then coded and synthesized on the basis of similarities. The coding scheme was refined iteratively with the involvement of a second author. Results are presented using frequencies and percentages. RESULTS End users' involvement was mentioned in the development of 21 of 45 SGs. The number of end users involved ranged from 12 to 36. End users were often involved in answering specific concerns that arose during the SG design (n=6) or in testing a prototype (n=12). In many cases, researchers solicited input from end users regarding the goals to reach (n=10) or the functional esthetics of the SGs (n=7). Most researchers used self-reported questionnaires (n=7). CONCLUSIONS Researchers mentioned end users' involvement in the development of less than half of the identified SGs, and this involvement was also poorly described. These findings represent significant limitations to evaluating the impact of the involvement of end users on the efficacy of SGs and in making recommendations regarding their involvement.
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Affiliation(s)
- Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Center, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada.,Research Center, Montreal Heart Institute, Montreal, QC, Canada
| | - Véronique Dubé
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Center, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Center, Montreal Heart Institute, Montreal, QC, Canada
| | | | - Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Center, Montreal Heart Institute, Montreal, QC, Canada
| | | | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Center, Montreal Heart Institute, Montreal, QC, Canada
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22
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Lapierre A, Arbour C, Maheu-Cadotte MA, Radermaker M, Fontaine G, Lavoie P. Effect of simulation on cognitive load in health care professionals and students: protocol for a systematic review and meta-analysis. JBI Evid Synth 2021; 19:1394-1403. [PMID: 33769335 DOI: 10.11124/jbies-20-00213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this review is to assess the effect of simulation activities and their design features on cognitive load in health care professionals and students. INTRODUCTION Simulation activities are now widely implemented in health care professionals' education. However, the mechanisms by which simulations and their design features lead to health care professionals' and students' learning remains unclear. Still, because of their high interactivity and complexity, simulation activities have the potential to impact the cognitive load of learners. Synthesizing evidence regarding this phenomenon could help simulation educators identify the design features that affect learners' cognitive load, and explain why some simulation activities are more effective than others. INCLUSION CRITERIA This review will consider experimental and quasi-experimental studies in which the effect of a simulation activity on cognitive load in health care professionals or students from any discipline or level of practice is evaluated. All academic and health settings will be included. METHODS Following the guidelines of the JBI methods for systematic reviews of effectiveness, CINAHL, Embase, ERIC, MEDLINE, PsycINFO, and Web of Science will be searched for studies published in English or French, without a date limit. Retrieved studies will be independently screened for inclusion, then critically appraised for methodological quality by two reviewers using standardized JBI tools. Data extraction will be done independently using adapted tools from JBI. Where possible, data will be pooled using meta-analytical methods. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020187723.
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Affiliation(s)
- Alexandra Lapierre
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Montreal Sacré-Coeur Hospital, Montréal, QC, Canada.,Center for Innovation in Nursing Education, Montréal, QC, Canada
| | - Caroline Arbour
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Montreal Sacré-Coeur Hospital, Montréal, QC, Canada
| | - Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada.,Research Center, Montreal Heart Institute, Montréal, QC, Canada
| | - Mélanie Radermaker
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Center for Innovation in Nursing Education, Montréal, QC, Canada
| | - Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Montreal Heart Institute, Montréal, QC, Canada
| | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Center for Innovation in Nursing Education, Montréal, QC, Canada.,Research Center, Montreal Heart Institute, Montréal, QC, Canada
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23
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Maheu-Cadotte MA, Cossette S, Dubé V, Fontaine G, Lavallée A, Lavoie P, Mailhot T, Deschênes MF. Efficacy of Serious Games in Healthcare Professions Education: A Systematic Review and Meta-analysis. Simul Healthc 2021; 16:199-212. [PMID: 33196609 DOI: 10.1097/sih.0000000000000512] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
SUMMARY STATEMENT Serious games (SGs) are interactive and entertaining software designed primarily with an educational purpose. This systematic review synthesizes evidence from experimental studies regarding the efficacy of SGs for supporting engagement and improving learning outcomes in healthcare professions education. Randomized controlled trials (RCTs) published between January 2005 and April 2019 were included. Reference selection and data extraction were performed in duplicate, independently. Thirty-seven RCTs were found and 29 were included in random-effect meta-analyses. Compared with other educational interventions, SGs did not lead to more time spent with the intervention {mean difference 23.21 minutes [95% confidence interval (CI) = -1.25 to 47.66]}, higher knowledge acquisition [standardized mean difference (SMD) = 0.16 (95% CI = -0.20 to 0.52)], cognitive [SMD 0.08 (95% CI = -0.73 to 0.89)], and procedural skills development [SMD 0.05 (95% CI = -0.78 to 0.87)], attitude change [SMD = -0.09 (95% CI = -0.38 to 0.20)], nor behavior change [SMD = 0.2 (95% CI = -0.11 to 0.51)]. Only a small SMD of 0.27 (95% CI = 0.01 to 0.53) was found in favor of SGs for improving confidence in skills.
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Affiliation(s)
- Marc-André Maheu-Cadotte
- From the Faculty of Nursing of the Université de Montréal (S.C., V.D., G.F., A.L., P.L., M.-F.D.); Montreal Heart Institute Research Center (S.C., P.L., T.M.); Research Center of the Université de Montréal Hospital Center (V.D.); CHU Ste-Justine Research Center (AL), Montreal, Quebec, Canada; Department of Pharmacy and Health Systems Sciences, Bouvé College of Health Sciences (T.M.), Boston, MA; and Center for Innovation in Nursing Education (M.-F.D.), Montreal, Quebec, Canada
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24
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Blanchet Garneau A, Bélisle M, Lavoie P, Laurent Sédillot C. Integrating equity and social justice for indigenous peoples in undergraduate health professions education in Canada: a framework from a critical review of literature. Int J Equity Health 2021; 20:123. [PMID: 34020674 PMCID: PMC8139059 DOI: 10.1186/s12939-021-01475-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/10/2021] [Indexed: 11/16/2022] Open
Abstract
Understanding how to create structural change by actively counteracting racialized ways of interacting with Indigenous peoples at an individual and organizational level within health care systems and health professions education is essential for creating a more inclusive, equitable, and healthier society. In health professions education, the primary means of teaching about health inequities has been to frame them as stemming from culturally or ethnically based issues. While attention to culturally specific practices can be valuable to health and healing in some contexts, education that solely focuses on Indigenous cultures risks perpetuating cultural stereotypes and othering, rather than focusing on how Eurocentric systems continue to exert oppressive effects on Indigenous peoples. We present an organizational transformation framework grounded in equitable partnerships from a comprehensive critical review of the literature on the integration of equity and social justice in undergraduate health professions education with a focus on Indigenous health. We did a thematic analysis of the results and discussions presented in the 26 selected articles to identify promising practices and challenges associated with the integration of equity and social justice in undergraduate health professions education. The framework resulting from this analysis is composed of three interrelated components: 1) adopt critical pedagogical approaches that promote Indigenous epistemologies; 2) partner with Indigenous students, educators and communities; 3) engage educators in critical pedagogical approaches and health equity issues. This framework could guide the development of contextually tailored interventions that contribute to decolonizing health professions education.
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Affiliation(s)
- Amélie Blanchet Garneau
- Faculty of Nursing, Université de Montréal, 2375, chemin de la Côte-Sainte-Catherine, Montreal, Quebec, H3T 1A8, Canada.
| | - Marilou Bélisle
- Faculty of education, Université de Sherbrooke, 2500, boul. de l'Université, Sherbrooke, Quebec, J1K 2R1, Canada
| | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, 2375, chemin de la Côte-Sainte-Catherine, Montreal, Quebec, H3T 1A8, Canada
| | - Catherine Laurent Sédillot
- Department of anthropology, Cégep Édouard-Montpetit, 945, chemin de Chambly, Longueuil, Quebec, J4H 3M6, Canada
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25
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Proulx LAB, Doherty A, Nicolas RS, Doucet S, Ly HQ, Lavoie P, Thibodeau-Jarry N. USE OF SIMULATION FOR ADVANCED RESUSCITATION OF IN-HOSPITAL CARDIAC ARREST PATIENTS WITH SUSPECTED OR CONFIRMED COVID-19. J Am Coll Cardiol 2021. [PMCID: PMC8091431 DOI: 10.1016/s0735-1097(21)04408-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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26
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Boivin-Proulx LA, Doherty A, Rousseau-Saine N, Doucet S, Ly HQ, Lavoie P, Thibodeau-Jarry N. Use of Simulation-Based Medical Education for Advanced Resuscitation of In-Hospital Cardiac Arrest Patients With Suspected or Confirmed COVID-19. Can J Cardiol 2021; 37:1267-1270. [PMID: 33775876 PMCID: PMC7997306 DOI: 10.1016/j.cjca.2021.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 11/13/2022] Open
Abstract
Cardiac arrest is common in critically ill patients with coronavirus disease 2019 (COVID-19) and is associated with poor survival. Simulation is frequently used to evaluate and train code teams with the goal of improving outcomes. All participants engaged in training on donning and doffing of personal protective equipment for suspected or confirmed COVID-19 cases. Thereafter, simulations of in-hospital cardiac arrest of patients with COVID-19, so-called protected code blue, were conducted at a quaternary academic centre. The primary endpoint was the mean time-to-defibrillation. A total of 114 patients participated in 33 “protected code blue” simulations over 8 weeks: 10 were senior residents, 17 were attending physicians, 86 were nurses, and 5 were respiratory therapists. Mean time-to-defibrillation was 4.38 minutes. Mean time-to-room entry, time-to-intubation, time-to-first-chest compression and time-to-epinephrine were 2.77, 5.74, 6.31, and 6.20 minutes, respectively; 92.84% of the 16 criteria evaluating the proper management of patients with COVID-19 and cardiac arrest were met. Mean time-to-defibrillation was longer than guidelines-expected time during protected code blue simulations. Although adherence to the modified advanced cardiovascular life-support protocol was high, breaches that carry additional infectious risk and reduce the efficacy of the resuscitation team were observed.
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Affiliation(s)
| | | | | | - Serge Doucet
- Montréal Heart Institute, Montréal, Québec, Canada
| | - Hung Q Ly
- Montréal Heart Institute, Montréal, Québec, Canada
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27
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Bélisle M, Lavoie P, Pepin J, Fernandez N, Boyer L, Lechasseur K, Larue C. A conceptual framework of student professionalization for health professional education and research. Int J Nurs Educ Scholarsh 2021; 18:ijnes-2020-0104. [PMID: 33660493 DOI: 10.1515/ijnes-2020-0104] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/03/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To present a conceptual framework of student professionalization for health professional education and research. METHODS Synthesis and discussion of a program of research on competency-based education. RESULTS Competency-based education relies on active, situation-based group learning strategies to prepare students to become health professionals who are connected to patient and population needs. Professionalization is understood as a dynamic process of imagining, becoming, and being a member of a health profession. It rests on the evolution of three interrelated dimensions: professional competencies, professional culture, and professional identity. Professionalization occurs throughout students' encounters with meaningful learning experiences that involve three core components: the roles students experience in situations bounded within specific contexts. Educational practices conducive to professionalization include active learning, reflection, and feedback. CONCLUSIONS This conceptual framework drives a research agenda aimed at understanding how students become health professional and how learning experiences involving action, reflection, and feedback foster that process and the advancement of professional practices.
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Affiliation(s)
- Marilou Bélisle
- Faculty of Education, Université de Sherbrooke, Longueuil, QC, Canada
| | - Patrick Lavoie
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montreal QC, Canada.,Montreal Heart Institute Research Center, Montreal, QC, Canada
| | - Jacinthe Pepin
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montreal QC, Canada
| | - Nicolas Fernandez
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Louise Boyer
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montreal QC, Canada
| | - Kathleen Lechasseur
- Faculty of Nursing, Université Laval, Pavillon Ferdinand-Vandry, Québec QC, Canada
| | - Caroline Larue
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montreal QC, Canada
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Cyr S, Marcil MJ, Marin MF, Tardif JC, Guay S, Guertin MC, Rosa C, Genest C, Forest J, Lavoie P, Labrosse M, Vadeboncoeur A, Selcer S, Ducharme S, Brouillette J. Factors Associated With Burnout, Post-traumatic Stress and Anxio-Depressive Symptoms in Healthcare Workers 3 Months Into the COVID-19 Pandemic: An Observational Study. Front Psychiatry 2021; 12:668278. [PMID: 34305675 PMCID: PMC8295587 DOI: 10.3389/fpsyt.2021.668278] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/31/2021] [Indexed: 12/25/2022] Open
Abstract
Objective: This study examined how best to identify modifiable protective and risk factors for burnout in healthcare workers in the face of the COVID-19 pandemic. Individual, occupational, organizational and social factors were investigated. The study also assessed the impact of these factors on post-traumatic stress disorder (PTSD), anxiety, and depression. Methods: Healthcare workers in the Quebec (Canada) healthcare system were recruited between May 21 to June 5, 2020. Participants answered an electronic survey 3 months after the COVID-19 epidemic outbreak began in Canada. Using the Maslach Burnout Inventory, PTSD Checklist for DSM-5, and Hospital Anxiety and Depression Scale, we studied the prevalence of burnout, PTSD, anxiety and depression in this cohort. Multivariable logistic or linear regression models including resilience, social and organizational support, workload and access to mental health help, simulation techniques and protective personal equipment (PPE) as well as perception of PPE security were conducted for each outcome. Results: In mid-June 2020, 467 participants completed the survey. We found that half (51.8%) of the respondents experienced burnout characterized by emotional exhaustion and/or depersonalization at least once a week. In total, 158 healthcare workers (35.6%) displayed severe symptoms of at least one of the mental health disorders (24.3% PTSD, 23.3% anxiety, 10.6% depression). Resilience (OR = 0.69, 95% CI: [0.55-0.87]; p = 0.002) and perceived organizational support (OR = 0.75, 95% CI: [0.61-0.93]; p = 0.009) were significantly associated with burnout and other outcomes. Social support satisfaction, perception of PPE security, work type and environment, mental health antecedents and reassignment were associated with PTSD and/or anxiety and/or depression, but not burnout. Conclusion: Future studies should address primarily resilience and perceived organizational support to promote mental health and prevent burnout, PTSD, anxiety and depression.
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Affiliation(s)
- Samuel Cyr
- Research Center, Montreal Heart Institute, Montreal, QC, Canada.,Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada
| | - Marie-Joelle Marcil
- Research Center, Montreal Heart Institute, Montreal, QC, Canada.,Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
| | - Marie-France Marin
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada.,Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada.,Research Center, Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
| | - Jean-Claude Tardif
- Research Center, Montreal Heart Institute, Montreal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Stéphane Guay
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada.,Centre D'étude sur le Trauma, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | | | - Camille Rosa
- Montreal Health Innovations Coordinating Center, Montreal, QC, Canada
| | - Christine Genest
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Jacques Forest
- Department of Organization and Human Resources, ESG UQAM, Montreal, QC, Canada
| | - Patrick Lavoie
- Research Center, Montreal Heart Institute, Montreal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Mélanie Labrosse
- Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Division of Emergency Medicine, Department of Pediatrics, Centre hospitalier universitaire Sainte-Justine, Montreal, QC, Canada
| | - Alain Vadeboncoeur
- Research Center, Montreal Heart Institute, Montreal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Shaun Selcer
- Research Center, Montreal Heart Institute, Montreal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Simon Ducharme
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Judith Brouillette
- Research Center, Montreal Heart Institute, Montreal, QC, Canada.,Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
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29
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Charette M, McKenna LG, Deschênes MF, Ha L, Merisier S, Lavoie P. New graduate nurses' clinical competence: A mixed methods systematic review. J Adv Nurs 2020; 76:2810-2829. [PMID: 32869369 DOI: 10.1111/jan.14487] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 05/19/2020] [Accepted: 07/07/2020] [Indexed: 12/30/2022]
Abstract
AIM To appraise and synthesize evidence of empirical studies reporting assessment of new graduate nurses' clinical competence in clinical settings. DESIGN Mixed methods systematic review. DATA SOURCES The search strategy included keywords relevant to: new graduate nurse; clinical competence; and competence assessment. The searched literature databases included CINAHL, MEDLINE, Embase, PsycINFO and Web of Science. The search was limited to full-text papers in English or French, published between 2010 -September 2019. REVIEW METHODS Inclusion criteria were: 1) empirical studies; 2) detailed method and complete results sections; 3) competence assessment in clinical settings; and 4) new graduate nurses (≤24 months). Two independent reviewers screened eligible papers, extracted data and used the Mixed Methods Appraisal Tool framework for quality appraisal. Divergences were solved through discussion. RESULTS About 42 papers were included in this review: quantitative (N = 31), qualitative (N = 7) and mixed methods (N = 4). Findings suggest that new graduate nurses exhibit a good or adequate level of competence. Longitudinal studies show a significant increase in competence from 0-6 months, but findings are inconsistent from 6-12 months. CONCLUSION There are a multitude of quantitative tools available to measure clinical competence. This suggests a need for a review of their rigor. IMPACT No recent reviews comprehensively synthesized the findings from new graduate nurses' clinical competence. This review has found that new graduate nurses' competence has been mostly assessed as good, despite the expectation that they should be more competent. Longitudinal studies did not always show a significant increase in competence. These findings can help nurse educators in providing more support to new graduate nurses throughout the transition period or design improved transition programme. This review also identified quantitative tools and qualitative methods that can be used for competence assessment.
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Affiliation(s)
- Martin Charette
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
| | - Lisa G McKenna
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Marie-France Deschênes
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
| | - Laurence Ha
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
| | - Sophia Merisier
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
| | - Patrick Lavoie
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
- Montreal Heart Institute, Montréal, Québec, Canada
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30
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Pepin J, Lavoie P, Boyer L. [In Canada, one hundred years of university teaching and consultation]. Soins 2020; 65:45-47. [PMID: 33012420 DOI: 10.1016/s0038-0814(20)30118-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Education in nursing science began in Canadian universities in 1919. Thanks to inter-university groups, it has never stopped evolving, making it possible to delimit and define different nursing knowledge. All stakeholders work together to meet the complex socio-political issues that affect the profession.
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Affiliation(s)
- Jacinthe Pepin
- Faculté des sciences infirmières, Université de Montréal, 2375 chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1A8, Canada.
| | - Patrick Lavoie
- Faculté des sciences infirmières, Université de Montréal, 2375 chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1A8, Canada
| | - Louise Boyer
- Faculté des sciences infirmières, Université de Montréal, 2375 chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1A8, Canada
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31
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Fontaine G, Zagury-Orly I, de Denus S, Lordkipanidzé M, Beauchesne MF, Maheu-Cadotte MA, White M, Thibodeau-Jarry N, Lavoie P. Effects of reading media on reading comprehension in health professional education: a systematic review protocol. JBI Evid Synth 2020; 18:2633-2639. [PMID: 32813413 DOI: 10.11124/jbisrir-d-19-00348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE To evaluate the effect of digital-based reading versus paper-based reading on reading comprehension among students, trainees, and residents participating in health professional education. INTRODUCTION Several reviews have examined the effects of reading media on reading comprehension; however, none have considered health professional education specifically. The growing use of electronic media in health professional education, as well as recent data on the consequences of digital-based reading on learning, justify the necessity to review the current literature to provide research and educational recommendations. INCLUSION CRITERIA Studies conducted with health professions students, trainees, and residents individually receiving educational material written in their first language in a paper-based or a digital-based format will be considered. Studies conducted among participants with cognitive impairment or reading difficulties will be excluded. Observational, experimental and quasi-experimental studies that assess reading comprehension measured by previously validated or researcher-generated tests will be considered. METHODS Relevant studies will be sought from CINAHL, Embase, ERIC, Google Scholar, MEDLINE, PsycINFO, and Web of Science (SCI and SSCI), without date or language restrictions. Two independent reviewers will perform title and abstract screening, full-text review, critical appraisal, and data extraction. Disagreements will be resolved through discussion or with a third independent reviewer. Synthesis will occur at four levels (i.e., study, participant, intervention, and outcome levels) in a table format. Data will be synthesized descriptively and with meta-analyses if appropriate. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020154519.
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Affiliation(s)
- Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Montreal Heart Institute, Montréal, QC, Canada
| | - Ivry Zagury-Orly
- Research Center, Montreal Heart Institute, Montréal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.,Harvard Medical School, Boston, MA, USA
| | - Simon de Denus
- Research Center, Montreal Heart Institute, Montréal, QC, Canada.,Faculty of Pharmacy, Université de Montréal, Montréal, QC, Canada
| | - Marie Lordkipanidzé
- Research Center, Montreal Heart Institute, Montréal, QC, Canada.,Faculty of Pharmacy, Université de Montréal, Montréal, QC, Canada
| | | | - Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Montreal Heart Institute, Montréal, QC, Canada.,Research Center, Université de Montréal Hospital Center, Montréal, QC, Canada
| | - Michel White
- Research Center, Montreal Heart Institute, Montréal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Nicolas Thibodeau-Jarry
- Research Center, Montreal Heart Institute, Montréal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Montreal Heart Institute, Montréal, QC, Canada
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Lavoie P, Clarke SP, Clausen C, Purden M, Emed J, Cosencova L, Frunchak V. Nursing handoffs and clinical judgments regarding patient risk of deterioration: A mixed-methods study. J Clin Nurs 2020; 29:3790-3801. [PMID: 32644241 DOI: 10.1111/jocn.15409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 06/09/2020] [Accepted: 06/21/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore how change-of-shift handoffs relate to nurses' clinical judgments regarding patient risk of deterioration. BACKGROUND The transfer of responsibility for patients' care comes with an exchange of information about their condition during change-of-shift handoff. However, it is unclear how this exchange affects nurses' clinical judgments regarding patient risk of deterioration. DESIGN A sequential explanatory mixed-methods study reported according to the STROBE and COREQ guidelines. METHODS Over four months, 62 nurses from one surgical and two medical units at a single Canadian hospital recorded their handoffs at change of shift. After each handoff, the two nurses involved each rated the patient's risk of experiencing cardiac arrest or being transferred to an intensive care unit in the next 24 hr separately. The information shared in handoffs was subjected to content analysis; code frequencies were contrasted per nurses' ratings of patient risk to identify characteristics of information that facilitated or hindered nurses' agreement. RESULTS Out of 444 recorded handoffs, there were 125 in which at least one nurse judged that a patient was at risk of deterioration; nurses agreed in 32 cases (25.6%) and disagreed in 93 (74.4%). These handoffs generally included information on abnormal vital signs, breathing problems, chest pain, alteration of mental status or neurological symptoms. However, the quantity and seriousness of clinical cues, recent transfers from intensive care units, pain without a clear cause, signs of delirium and nurses' knowledge of patient were found to affect nurses' agreement. CONCLUSIONS Nurses exchanged more information regarding known indicators of deterioration in handoffs when they judged that patients were at risk. Disagreements most often involved incoming nurses rating patient risk as higher. RELEVANCE TO CLINICAL PRACTICE This study suggests a need to sensitise nurses to the impact of certain cues at report on their colleagues' subsequent clinical judgments. Low levels of agreement between nurses underscore the importance of exchanging impressions regarding the likely evolution of a patient's situation to promote continuity of care.
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Affiliation(s)
- Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Montreal Heart Institute Research Center, Montreal, QC, Canada
| | - Sean P Clarke
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Christina Clausen
- Center for Nursing Research, Jewish General Hospital, Montreal, QC, Canada.,Ingram School of Nursing, McGill University, Montreal, QC, Canada.,Department of Nursing, Jewish General Hospital, Montreal, QC, Canada
| | - Margaret Purden
- Center for Nursing Research, Jewish General Hospital, Montreal, QC, Canada.,Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Jessica Emed
- Ingram School of Nursing, McGill University, Montreal, QC, Canada.,Department of Nursing, Jewish General Hospital, Montreal, QC, Canada
| | - Lidia Cosencova
- Center for Nursing Research, Jewish General Hospital, Montreal, QC, Canada
| | - Valerie Frunchak
- Ingram School of Nursing, McGill University, Montreal, QC, Canada.,Department of Nursing, Jewish General Hospital, Montreal, QC, Canada
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33
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Lavoie P, Clarke SP, Clausen C, Purden M, Emed J, Mailhot T, Fontaine G, Frunchak V. Nurses' judgments of patient risk of deterioration at change-of-shift handoff: Agreement between nurses and comparison with early warning scores. Heart Lung 2020; 49:420-425. [PMID: 32111344 DOI: 10.1016/j.hrtlng.2020.02.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/07/2020] [Accepted: 02/11/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Nurses begin forming judgments regarding patients' clinical stability during change-of-shift handoffs. OBJECTIVES To examine the agreement between incoming and outgoing nurses' judgments of deterioration risk following handoff and compare these judgments to commonly used early warning scores (MEWS, NEWS, ViEWS). METHODS Following handoffs on three medical/surgical units, nurses completed the Patient Acuity Rating. Nurse ratings were compared with computed early warning scores based on clinical data. In follow-up interviews, nurses were invited to describe their experiences of using the rating scale. RESULTS Sixty-two nurses carried out 444 handoffs for 158 patients. While the agreement between incoming and outgoing nurses was fair, correlations with early warning scores were low. Nurses struggled with predicting risk and used their impressions of differential risk across all the patients to whom they had been assigned to arrive at their ratings. CONCLUSION Nurses shared information that influenced their clinical judgments at handoff; not all of these cues may necessarily be captured in early warning scores.
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Affiliation(s)
- Patrick Lavoie
- Faculty of Nursing, Université de Montréal, C.P. 6128, succ. Centre-Ville, Montreal, QC H3C 3J7, Canada; Montreal Heart Institute Research Center, 5000 rue Bélanger, Montreal, QC H1T 1C8, Canada.
| | - Sean P Clarke
- Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY 10010, USA.
| | - Christina Clausen
- Center for Nursing Research, Jewish General Hospital, Montreal, Canada, 3755 ch. Côte-Ste-Catherine, Montreal, QC H3T 1E2, Canada; Department of Nursing, Jewish General Hospital, Montreal, Canada, 3755 ch. Côte-Ste-Catherine, Montreal, QC H3T 1E2, Canada.
| | - Margaret Purden
- Center for Nursing Research, Jewish General Hospital, Montreal, Canada, 3755 ch. Côte-Ste-Catherine, Montreal, QC H3T 1E2, Canada; Ingram School of Nursing, McGill University, Montreal, Canada, 680 Sherbrooke West #1800, Montreal, QC H3A 2M7, Canada.
| | - Jessica Emed
- Ingram School of Nursing, McGill University, Montreal, Canada, 680 Sherbrooke West #1800, Montreal, QC H3A 2M7, Canada; Department of Nursing, Jewish General Hospital, Montreal, Canada, 3755 ch. Côte-Ste-Catherine, Montreal, QC H3T 1E2, Canada.
| | - Tanya Mailhot
- Faculty of Nursing, Université de Montréal, C.P. 6128, succ. Centre-Ville, Montreal, QC H3C 3J7, Canada.
| | - Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, C.P. 6128, succ. Centre-Ville, Montreal, QC H3C 3J7, Canada; Montreal Heart Institute Research Center, 5000 rue Bélanger, Montreal, QC H1T 1C8, Canada.
| | - Valerie Frunchak
- Ingram School of Nursing, McGill University, Montreal, Canada, 680 Sherbrooke West #1800, Montreal, QC H3A 2M7, Canada; Department of Nursing, Jewish General Hospital, Montreal, Canada, 3755 ch. Côte-Ste-Catherine, Montreal, QC H3T 1E2, Canada.
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Abstract
A gliding bird's ability to stabilize its flight path is as critical as its ability to produce sufficient lift. In flight, birds often morph the shape of their wings, but the consequences of avian wing morphing on flight stability are not well understood. Here, we investigate how morphing the gull elbow joint in gliding flight affects their static pitch stability. First, we combined observations of freely gliding gulls and measurements from gull wing cadavers to identify the wing configurations used during gliding flight. These measurements revealed that, as wind speed and gusts increased, gulls flexed their elbows to adopt wing shapes characterized by increased spanwise camber. To determine the static pitch stability characteristics of these wing shapes, we prepared gull wings over the anatomical elbow range and measured the developed pitching moments in a wind tunnel. Wings prepared with extended elbow angles had low spanwise camber and high passive stability, meaning that mild perturbations could be negated without active control. Wings with flexed elbow angles had increased spanwise camber and reduced static pitch stability. Collectively, these results demonstrate that gliding gulls can transition across a broad range of static pitch stability characteristics using the motion of a single joint angle.
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Affiliation(s)
- C Harvey
- 1 Department of Zoology, University of British Columbia , Vancouver, British Colombia , Canada V6T 1Z4
| | - V B Baliga
- 1 Department of Zoology, University of British Columbia , Vancouver, British Colombia , Canada V6T 1Z4
| | - P Lavoie
- 2 Institute for Aerospace Studies, University of Toronto , Toronto, Ontario , Canada M3H 5T6
| | - D L Altshuler
- 1 Department of Zoology, University of British Columbia , Vancouver, British Colombia , Canada V6T 1Z4
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Raymond J, Ghostine J, van Adel BA, Shankar JJS, Iancu D, Mitha AP, Kvamme P, Turner RD, Turk A, Mendes-Pereira V, Carpenter JS, Boo S, Evans A, Woo HH, Fiorella D, Alaraj A, Roy D, Weill A, Lavoie P, Chagnon M, Nguyen TN, Rempel JL, Darsaut TE. Does Increasing Packing Density Using Larger Caliber Coils Improve Angiographic Results of Embolization of Intracranial Aneurysms at 1 Year: A Randomized Trial. AJNR Am J Neuroradiol 2020; 41:29-34. [PMID: 31896568 DOI: 10.3174/ajnr.a6362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 11/06/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The impact of increased aneurysm packing density on angiographic outcomes has not been studied in a randomized trial. We sought to determine the potential for larger caliber coils to achieve higher packing densities and to improve the angiographic results of embolization of intracranial aneurysms at 1 year. MATERIALS AND METHODS Does Embolization with Larger Coils Lead to Better Treatment of Aneurysms (DELTA) was an investigator-initiated multicenter prospective, parallel, randomized, controlled clinical trial. Patients had 4- to 12-mm unruptured aneurysms. Treatment allocation to either 15- (experimental) or 10-caliber coils (control group) was randomized 1:1 using a Web-based platform. The primary efficacy outcome was a major recurrence or a residual aneurysm at follow-up angiography at 12 ± 2 months adjudicated by an independent core lab blinded to the treatment allocation. Secondary outcomes included indices of treatment success and standard safety outcomes. Recruitment of 564 patients was judged necessary to show a decrease in poor outcomes from 33% to 20% with 15-caliber coils. RESULTS Funding was interrupted and the trial was stopped after 210 patients were recruited between November 2013 and June 2017. On an intent-to-treat analysis, the primary outcome was reached in 37 patients allocated to 15-caliber coils and 36 patients allocated to 10-caliber coils (OR = 0.931; 95% CI, 0.528-1.644; P = .885). Safety and other clinical outcomes were similar. The 15-caliber coil group had a higher mean packing density (37.0% versus 26.9%, P = .0001). Packing density had no effect on the primary outcome when adjusted for initial angiographic results (OR = 1.001; 95% CI, 0.981-1.022; P = .879). CONCLUSIONS Coiling of aneurysms randomized to 15-caliber coils achieved higher packing densities compared with 10-caliber coils, but this had no impact on the angiographic outcomes at 1 year, which were primarily driven by aneurysm size and initial angiographic results.
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Affiliation(s)
- J Raymond
- From the Department of Radiology (J.R., J.G., D.R., A.W.), Service of Interventional Neuroradiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - J Ghostine
- From the Department of Radiology (J.R., J.G., D.R., A.W.), Service of Interventional Neuroradiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - B A van Adel
- Department of Surgery/Medicine (B.A.v.A), McMaster University, Hamilton, Ontario, Canada
| | - J J S Shankar
- Department of Radiology (J.J.S.S.), University of Manitoba, Winnipeg, Manitoba, Canada
| | - D Iancu
- Department of Radiology, Service of Interventional Neuroradiology (D.I.), University of Ottawa Hospitals, Civic Campus, Ottawa, Ontario, Canada
| | - A P Mitha
- Department of Clinical Neurosciences (A.P.M.), University of Calgary, Calgary, Alberta, Canada
| | - P Kvamme
- Department of Radiology (P.K.), University of Tennessee Medical Center, Knoxville, Tennessee
| | - R D Turner
- Department of Neurosurgery (R.D.T., A.T.), Prisma Health-Upstate, Greenville, South Carolina
| | - A Turk
- Department of Neurosurgery (R.D.T., A.T.), Prisma Health-Upstate, Greenville, South Carolina
| | - V Mendes-Pereira
- Division of Neuroradiology (V.M.-P.), Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - J S Carpenter
- Department of Neuroradiology (J.S.C., S.B.), West Virginia University, Rockefeller Neuroscience Institute, Morgantown, West Virginia
| | - S Boo
- Department of Neuroradiology (J.S.C., S.B.), West Virginia University, Rockefeller Neuroscience Institute, Morgantown, West Virginia
| | - A Evans
- Department of Interventional Neuroradiology (A.E.), University of Virginia Medical Center, Charlottesville, Virginia
| | - H H Woo
- Departments of Neurosurgery and Radiology, Northwell Health System (H.H.W., D.F.), Manhasset, New York
| | - D Fiorella
- Departments of Neurosurgery and Radiology, Northwell Health System (H.H.W., D.F.), Manhasset, New York
| | - A Alaraj
- Department of Neurosurgery (A.A.), University of Illinois Hospital and Health Sciences System, Chicago, Illinois
| | - D Roy
- From the Department of Radiology (J.R., J.G., D.R., A.W.), Service of Interventional Neuroradiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - A Weill
- From the Department of Radiology (J.R., J.G., D.R., A.W.), Service of Interventional Neuroradiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - P Lavoie
- Department of Neurosurgery (P.L.), Hôpital Enfant-Jésus, Quebec City, Quebec, Canada
| | - M Chagnon
- Department of Mathematics and Statistics (M.C.), University of Montreal, Montreal, Quebec, Canada
| | - T N Nguyen
- Departments of Neurology, Neurosurgery, and Radiology (T.N.N.), Boston Medical Center, Boston, Massachusetts
| | - J L Rempel
- Department of Radiology and Diagnostic Imaging (J.L.R.)
| | - T E Darsaut
- Division of Neurosurgery (T.E.D.), Department of Surgery, Mackenzie Health Sciences Centre, University of Alberta Hospital, Edmonton, Alberta, Canada
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Fontaine G, Cossette S, Maheu-Cadotte MA, Deschênes MF, Rouleau G, Lavallée A, Pépin C, Ballard A, Chicoine G, Lapierre A, Lavoie P, Blondin J, Mailhot T. Effect of implementation interventions on nurses' behaviour in clinical practice: a systematic review, meta-analysis and meta-regression protocol. Syst Rev 2019; 8:305. [PMID: 31806051 PMCID: PMC6896305 DOI: 10.1186/s13643-019-1227-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 11/11/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Practitioner-level implementation interventions such as audit and feedback, communities of practice, and local opinion leaders have shown potential to change nurses' behaviour in clinical practice and improve patients' health. However, their effectiveness remains unclear. Moreover, we have a paucity of data regarding the use of theory in implementation studies with nurses, the causal processes-i.e. mechanisms of action-targeted by interventions to change nurses' behaviour in clinical practice, and the constituent components-i.e. behaviour change techniques-included in interventions. Thus, our objectives are threefold: (1) to examine the effectiveness of practitioner-level implementation interventions in changing nurses' behaviour in clinical practice; (2) to identify, in included studies, the type and degree of theory use, the mechanisms of action targeted by interventions and the behaviour change techniques constituting interventions and (3) to examine whether intervention effectiveness is associated with the use of theory or with specific mechanisms of action and behaviour change techniques. METHODS We will conduct a systematic review based on the Cochrane Effective Practice and Organization of Care (EPOC) Group guidelines. We will search six databases (CINAHL, EMBASE, ERIC, PsycINFO, PubMed and Web of Science) with no time limitation for experimental and quasi-experimental studies that evaluated practitioner-level implementation interventions aiming to change nurses' behaviour in clinical practice. We will also hand-search reference lists of included studies. We will perform screening, full-text review, risk of bias assessment, and data extraction independently with the Covidence systematic review software. We will assess the quality of evidence using the GRADEpro software. We will code included studies independently for theory use (Theory Coding Scheme), mechanisms of action (coding guidelines from Michie) and behaviour change techniques (Behaviour Change Technique Taxonomy v1) with QSR International's NVivo qualitative data analysis software. Meta-analyses will be performed using the Review Manager (RevMan) software. Meta-regression analyses will be performed with IBM SPSS Statistics software. DISCUSSION This review will inform knowledge users and researchers interested in designing, developing and evaluating implementation interventions to support nurses' behaviour change in clinical practice. Results will provide key insights regarding which causal processes-i.e. mechanisms of action-should be targeted by these interventions, and which constituent components-i.e. behaviour change techniques-should be included in these interventions to increase their effectiveness. SYSTEMATIC REVIEW REGISTRATION The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42019130446).
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Affiliation(s)
- Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Montreal Heart Institute, Montréal, Canada
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Montreal Heart Institute, Montréal, Canada
| | - Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Montreal Heart Institute, Montréal, Canada
- Research Center, Université de Montréal Hospital Center, Montréal, Canada
| | - Marie-France Deschênes
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Center for Innovation in Nursing Education, Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Geneviève Rouleau
- Research Center, Université de Montréal Hospital Center, Montréal, Canada
- Faculty of Nursing, Université Laval, Québec, Canada
| | - Andréane Lavallée
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, CHU Sainte-Justine, Montréal, Canada
| | - Catherine Pépin
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Institute of Public Health Research, Université de Montréal, Montréal, Canada
| | - Ariane Ballard
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, CHU Sainte-Justine, Montréal, Canada
| | - Gabrielle Chicoine
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Université de Montréal Hospital Center, Montréal, Canada
| | - Alexandra Lapierre
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Montreal Heart Institute, Montréal, Canada
- Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
| | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Montreal Heart Institute, Montréal, Canada
- Center for Innovation in Nursing Education, Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Jérémie Blondin
- School of Librarianship and Information Science, Université de Montréal, Montréal, Canada
| | - Tanya Mailhot
- Department of Pharmacy and Health Systems Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, USA
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Mailhot T, Goulet MH, Maheu-Cadotte MA, Fontaine G, Lequin P, Lavoie P. Methodological reporting in feasibility studies: a descriptive review of the nursing intervention research literature. J Res Nurs 2019; 25:460-472. [PMID: 34394661 DOI: 10.1177/1744987119883404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background In reaction to weaknesses in feasibility studies reporting, the Consolidated Standards of Reporting Trials (CONSORT) statement published an extension for feasibility studies in 2016. Aim The aim of this study was to systematically review and appraise the reporting of feasibility studies in the nursing intervention research literature based on the CONSORT statement extension for feasibility studies. Method Papers published prior to January 2018 that described feasibility studies of nursing interventions were retrieved. Components of feasibility studies were coded, and code frequencies were analysed. Results The review included 186 papers. Although most papers (n = 142, 76.3%) included the label 'pilot' or 'feasibility' in their title, reporting for other components generally did not adhere to one or several CONSORT recommendations. Most papers reported objectives (n = 116, 62.4%), designs (n = 95, 51%), or rationales for sample size (n = 165, 88.7%) that were incongruent with the purpose of feasibility studies. Discussion This review results in two main implications for nursing research. First, we noted that the reporting of feasibility studies is weak. While all papers described feasibility studies, almost half focused exclusively on testing the effectiveness of an intervention. Second, we identified rationales for sample size along with key references that could offer guidance in reporting feasibility studies while being coherent with the CONSORT recommendations.
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Affiliation(s)
- Tanya Mailhot
- Postdoctoral Fellow, Bouvé College of Health Sciences, Northeastern University, USA
| | - Marie-Hélène Goulet
- Assistant Professor, Faculty of Nursing, Université de Montréal, Canada; Researcher, Quebec Network on Nursing Intervention Research, Canada
| | - Marc-André Maheu-Cadotte
- Doctoral Candidate, Faculty of Nursing, Université de Montréal, Montreal, Canada; Research Assistant, Montreal Heart Institute Research Center, Canada; Doctoral Student, CHUM Research Center, Canada
| | - Guillaume Fontaine
- Doctoral Candidate, Faculty of Nursing, Université de Montréal, Canada; Research Assistant, Montreal Heart Institute Research Center, Canada
| | - Pierre Lequin
- Clinician Nurse Specialist, Department of Psychiatry, Centre Hospitalier Universitaire, Vaudois, Switzerland
| | - Patrick Lavoie
- Assistant Professor, Faculty of Nursing, Université de Montréal, Canada; Researcher, Montreal Heart Institute Research Centre, Canada
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Castonguay V, Lavoie P, Karazivan P, Morris J, Gagnon R. Perceptions of Emergency Medicine Residents of Multisource Feedback: Different, Relevant, and Useful Information. Ann Emerg Med 2019; 74:660-669. [PMID: 31280923 DOI: 10.1016/j.annemergmed.2019.05.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/06/2019] [Accepted: 05/09/2019] [Indexed: 11/18/2022]
Abstract
STUDY OBJECTIVE Multisource feedback is a process through which different members of the care team assess and provide feedback on residents' competencies, usually those that are less often addressed by traditional assessment methods (ie, communication, collaboration, and professionalism). Feasibility and reliability of multisource feedback have been addressed in previous research. The present study explores emergency residents' perceptions of multisource feedback provided by teaching physicians, nurses, and patients they have worked with during a rotation in an emergency department (ED). METHODS A multisource feedback intervention was proposed to residents during 9 months in the ED of a tertiary care university hospital. Residents distributed feedback questionnaires to physicians, nurses, and patients that focused on competencies (collaboration, communication, and professionalism) from the CanMEDS framework. Responses were compiled and reported to participating residents. To assess residents' perceptions of multisource feedback, semistructured group and individual interviews were held 3 months after the intervention. Transcripts were analyzed qualitatively, following Miles and Huberman's method for intrasite case analysis. RESULTS According to residents (n=10), each source (physicians, nurses, and patients) provided relevant comments that differed significantly in their content. Physicians focused primarily on medical expertise; nurses addressed competencies related to leadership, collaboration, and communication; and patients commented on the competencies of professionalism and communication. Residents concluded that obtaining feedback from nurses and patients was acceptable and useful. They reported modifying certain behaviors after receiving the multisource feedback. CONCLUSION Residents perceived the multisource feedback to be acceptable and useful for the assessment of medical competencies such as communication, collaboration, professionalism, and leadership.
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Affiliation(s)
- Véronique Castonguay
- Department of Emergency Medicine, Research Center, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
| | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada; Research Center, Institut de Cardiologie de Montréal, Montréal, Quebec, Canada
| | - Philippe Karazivan
- Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada; Direction of Collaboration and Patient Partnership, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Judy Morris
- Department of Emergency Medicine, Research Center, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Robert Gagnon
- Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
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Lavoie P, Clarke SP, Clausen C, Purden M, Emed J, Mailhot T, Frunchak V. Acceptability and feasibility of recruitment and data collection in a field study of hospital nurses' handoffs using mobile devices. Pilot Feasibility Stud 2018; 4:163. [PMID: 30386630 PMCID: PMC6199701 DOI: 10.1186/s40814-018-0353-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 10/03/2018] [Indexed: 12/30/2022] Open
Abstract
Background The portability and multiple functionalities of mobile devices make them well suited for collecting field data for naturalistic research, which is often beset with complexities in recruitment and logistics. This paper describes the implementation of a research protocol using mobile devices to study nurses’ exchanges of patient information at change of shift. Methods Nurses from three medical and surgical units of an acute care teaching hospital in Montreal, Canada, were invited to participate. On 10 selected days, participants were asked to record their handoffs using mobile devices and to complete paper questionnaires regarding these exchanges. Nurse acceptance of mobile devices was assessed using a 30-item technology acceptance questionnaire and focus group interviews. The principal feasibility indicator was whether or not 80 complete handoffs could be collected on each unit. Results From October to December 2017, 63 of 108 eligible nurses completed the study. Results suggest that the use of mobile devices was acceptable to nurses, who felt that the devices were easy to use but did not improve their job performance. The principal feasibility criterion was met, with complete data collected for 176, 84, and 170 of the eligible handoffs on each unit (81% of eligible handoffs). The research protocol was acceptable to nurses, who felt the study’s demands did not interfere with their clinical work. Conclusions The research protocol involving mobile devices was feasible and acceptable to nurses. Nurses felt the research protocol, including the use of mobile devices, required minimal investment of time and effort. This suggests that their decision to participate in research involving mobile devices was based on their perception that the study protocol and the use of the device would not be demanding. Further work is needed to determine if studies involving more sophisticated and possibly more demanding technology would be equally feasible and acceptable to nurses. Electronic supplementary material The online version of this article (10.1186/s40814-018-0353-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Patrick Lavoie
- 1William F. Connell School of Nursing, Boston College, Chestnut Hill, MA USA.,Faculty of Nursing, Pavillon Marguerite d'Youville, C.P. 6128 succ. Centre-ville, Montreal, QC H3C 3J7 Canada
| | - Sean P Clarke
- 1William F. Connell School of Nursing, Boston College, Chestnut Hill, MA USA
| | - Christina Clausen
- 3Center for Nursing Research, Jewish General Hospital, Montreal, Canada.,4Ingram School of Nursing, McGill University, Montreal, Canada.,5Department of Nursing, Jewish General Hospital, Montreal, Canada
| | - Margaret Purden
- 3Center for Nursing Research, Jewish General Hospital, Montreal, Canada.,4Ingram School of Nursing, McGill University, Montreal, Canada
| | - Jessica Emed
- 4Ingram School of Nursing, McGill University, Montreal, Canada.,5Department of Nursing, Jewish General Hospital, Montreal, Canada
| | | | - Valerie Frunchak
- 4Ingram School of Nursing, McGill University, Montreal, Canada.,5Department of Nursing, Jewish General Hospital, Montreal, Canada
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Boulanger JM, Lindsay MP, Gubitz G, Smith EE, Stotts G, Foley N, Bhogal S, Boyle K, Braun L, Goddard T, Heran MKS, Kanya-Forster N, Lang E, Lavoie P, McClelland M, O’Kelly C, Pageau P, Pettersen J, Purvis H, Shamy M, Tampieri D, vanAdel B, Verbeek R, Blacquiere D, Casaubon L, Ferguson D, Hegedus Y, Jacquin GJ, Kelly M, Kamal N, Linkewich B, Lum C, Mann B, Milot G, Newcommon N, Poirier P, Simpkin W, Snieder E, Trivedi A, Whelan R, Eustace M, Smitko E, Butcher K. Canadian Stroke Best Practice Recommendations for Acute Stroke Management: Prehospital, Emergency Department, and Acute Inpatient Stroke Care, 6th Edition, Update 2018. Int J Stroke 2018; 13:949-984. [DOI: 10.1177/1747493018786616] [Citation(s) in RCA: 191] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The 2018 update of the Canadian Stroke Best Practice Recommendations for Acute Stroke Management, 6th edition, is a comprehensive summary of current evidence-based recommendations, appropriate for use by healthcare providers and system planners caring for persons with very recent symptoms of acute stroke or transient ischemic attack. The recommendations are intended for use by a interdisciplinary team of clinicians across a wide range of settings and highlight key elements involved in prehospital and Emergency Department care, acute treatments for ischemic stroke, and acute inpatient care. The most notable changes included in this 6th edition are the renaming of the module and its integration of the formerly separate modules on prehospital and emergency care and acute inpatient stroke care. The new module, Acute Stroke Management: Prehospital, Emergency Department, and Acute Inpatient Stroke Care is now a single, comprehensive module addressing the most important aspects of acute stroke care delivery. Other notable changes include the removal of two sections related to the emergency management of intracerebral hemorrhage and subarachnoid hemorrhage. These topics are covered in a new, dedicated module, to be released later this year. The most significant recommendation updates are for neuroimaging; the extension of the time window for endovascular thrombectomy treatment out to 24 h; considerations for treating a highly selected group of people with stroke of unknown time of onset; and recommendations for dual antiplatelet therapy for a limited duration after acute minor ischemic stroke and transient ischemic attack. This module also emphasizes the need for increased public and healthcare provider’s recognition of the signs of stroke and immediate actions to take; the important expanding role of paramedics and all emergency medical services personnel; arriving at a stroke-enabled Emergency Department without delay; and launching local healthcare institution code stroke protocols. Revisions have also been made to the recommendations for the triage and assessment of risk of recurrent stroke after transient ischemic attack/minor stroke and suggested urgency levels for investigations and initiation of management strategies. The goal of this updated guideline is to optimize stroke care across Canada, by reducing practice variations and reducing the gap between current knowledge and clinical practice.
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Affiliation(s)
- JM Boulanger
- Charles-LeMoyne Hospital, Neurology, Longueuil, Quebec, Canada
- Université de Sherbrooke, Faculty of Medicine, Sherbrooke, Quebec, Canada
| | - MP Lindsay
- Heart and Stroke Foundation of Canada, Toronto, Ontario, Canada
| | - G Gubitz
- Queen Elizabeth II Health Sciences Center, Halifax, Nova Scotia, Canada
- Department of Medicine (Neurology), Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Stroke Consortium, Oakville, Ontario, Canada
| | - EE Smith
- Calgary Stroke Program, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - G Stotts
- Canadian Stroke Consortium, Oakville, Ontario, Canada
- Ottawa Stroke Program, Ottawa Hospital, Ottawa, Ontario, Canada
| | - N Foley
- workHORSE Consulting Services, London, Ontario, Canada
| | - S Bhogal
- workHORSE Consulting Services, London, Ontario, Canada
| | - K Boyle
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - L Braun
- Emergency Medical Services, Winnipeg, Manitoba, Canada
| | - T Goddard
- Department of Medicine (Neurology), Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Emergency Medicine, Valley Regional Hospital, Kentville, Nova Scotia, Canada
| | - MKS Heran
- Vancouver General Hospital, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - N Kanya-Forster
- Northern Ontario School of Medicine, Sudbury, Ontario, Canada
- Timmins & District Hospital, Timmins, Ontario, Canada
| | - E Lang
- Department of Emergency Medicine, University of Calgary, Calgary, Alberta, Canada
- Canadian Association of Emergency Physicians, Ottawa, Ontario, Canada
| | - P Lavoie
- Department of Surgery, Laval University, Quebec, Canada
| | - M McClelland
- Interior Health Research Department, Kelowna General Hospital, Kelowna, British Columbia, Canada
| | - C O’Kelly
- Division of Neurosurgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - P Pageau
- Canadian Association of Emergency Physicians, Ottawa, Ontario, Canada
- Department of Emergency Medicine, Ottawa Hospital, Ottawa, Ontario, Canada
| | - J Pettersen
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - H Purvis
- Cancer Care Manitoba, Winnipeg, Manitoba, Canada
| | - M Shamy
- Ottawa Stroke Program, Ottawa Hospital, Ottawa, Ontario, Canada
| | - D Tampieri
- Montreal Neurological Hospital and Institute, Montreal, Quebec, Canada
| | - B vanAdel
- Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - R Verbeek
- Canadian Association of Emergency Physicians, Ottawa, Ontario, Canada
- Department of Emergency Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - D Blacquiere
- Canadian Stroke Consortium, Oakville, Ontario, Canada
- Saint John Regional Health Centre, Saint John, New Brunswick, Canada
| | - L Casaubon
- Canadian Stroke Consortium, Oakville, Ontario, Canada
- University Health Network (Toronto Western Hospital) Stroke Program, Toronto, Ontario, Canada
| | - D Ferguson
- Saint John Regional Health Centre, Saint John, New Brunswick, Canada
| | - Y Hegedus
- Vancouver Island Health Authority, Vancouver, British Columbia, Canada
| | - GJ Jacquin
- Centre hospitalier de l’université de Montréal, Montreal, Quebec, Canada
| | - M Kelly
- Division of Neurosurgery, Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - N Kamal
- Calgary Stroke Program, Calgary, Alberta, Canada
| | - B Linkewich
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - C Lum
- Ottawa Stroke Program, Ottawa Hospital, Ottawa, Ontario, Canada
| | - B Mann
- Alberta Health Services, Edmonton, Alberta, Canada
| | - G Milot
- CHU de Québec, Laval University, Laval, Quebec, Canada
| | - N Newcommon
- Calgary Stroke Program, Calgary, Alberta, Canada
| | - P Poirier
- Paramedic Association of Canada, Ottawa, Ontario, Canada
| | - W Simpkin
- Queen Elizabeth II Health Sciences Center, Halifax, Nova Scotia, Canada
| | - E Snieder
- Ottawa Stroke Program, Ottawa Hospital, Ottawa, Ontario, Canada
| | - A Trivedi
- Section of Neurology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - R Whelan
- University Hospital, Saskatoon, Saskatchewan, Canada
| | - M Eustace
- Health Sciences Centre, St. Johns, Newfoundland, Canada
| | - E Smitko
- Heart and Stroke Foundation of Canada, Toronto, Ontario, Canada
| | - K Butcher
- Division of Neurology, University of Alberta, Edmonton, Alberta, Canada
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Lavoie P. Web-based educational intervention improves enrolled nurses' knowledge and performance with deteriorating patients. Evid Based Nurs 2018; 21:55. [PMID: 29437693 DOI: 10.1136/eb-2017-102832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2017] [Indexed: 06/08/2023]
Affiliation(s)
- Patrick Lavoie
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
- Faculty of Nursing, Universite de Montreal, Montreal, Quebec, Canada
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Maheu-Cadotte MA, Cossette S, Dubé V, Fontaine G, Mailhot T, Lavoie P, Cournoyer A, Balli F, Mathieu-Dupuis G. Effectiveness of serious games and impact of design elements on engagement and educational outcomes in healthcare professionals and students: a systematic review and meta-analysis protocol. BMJ Open 2018; 8:e019871. [PMID: 29549206 PMCID: PMC5857654 DOI: 10.1136/bmjopen-2017-019871] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Serious games (SGs) are interactive and entertaining digital software with an educational purpose. They engage the learner by proposing challenges and through various design elements (DEs; eg, points, difficulty adaptation, story). Recent reviews suggest the effectiveness of SGs in healthcare professionals' and students' education is mixed. This could be explained by the variability in their DEs, which has been shown to be highly variable across studies. The aim of this systematic review is to identify, appraise and synthesise the best available evidence regarding the effectiveness of SGs and the impact of DEs on engagement and educational outcomes of healthcare professionals and students. METHODS AND ANALYSIS A systematic search of the literature will be conducted using a combination of medical subject headings terms and keywords in Cumulative Index of Nursing and Allied Health, Embase, Education Resources Information Center, PsycInFO, PubMed and Web of Science. Studies assessing SGs on engagement and educational outcomes will be included. Two independent reviewers will conduct the screening as well as the data extraction process. The risk of bias of included studies will also be assessed by two reviewers using the Effective Practice and Organisation of Care criteria. Data regarding DEs in SGs will first be synthesised qualitatively. A meta-analysis will then be performed, if the data allow it. Finally, the quality of the evidence regarding the effectiveness of SGs on each outcome will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION As this systematic review only uses already collected data, no Institutional Review Board approval is required. Its results will be submitted in a peer-reviewed journal by the end of 2018. PROSPERO REGISTRATION NUMBER CRD42017077424.
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Affiliation(s)
- Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Montreal Heart Institute Research Center, Montreal, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, Canada
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
| | - Véronique Dubé
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Montreal Heart Institute Research Center, Montreal, Canada
| | - Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Montreal Heart Institute Research Center, Montreal, Canada
| | - Tanya Mailhot
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Department of Anesthesiology, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Patrick Lavoie
- William F Connell School of Nursing, Boston College, Boston, Massachusetts, USA
| | - Alexis Cournoyer
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Resident in Medicine, Clinician-Scientist Program, Université de Montreal, Montréal, Montreal, Canada
- Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
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Fontaine G, Maheu-Cadotte MA, Mailhot T, Laflamme K, Lavoie P, Heppell S. [Not Available]. Perspect Infirm 2018; 15:44-52. [PMID: 29698593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
| | | | | | - Kim Laflamme
- Institut de Cardiologie de Montréal, Québec, Canada
| | - Patrick Lavoie
- William F. Connell School of Nursing of Boston College, USA
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44
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Fontaine G, Laflamme K, Lavoie P, Maheu-Cadotte MA, Mailhot T, Heppell S. [Not Available]. Perspect Infirm 2018; 15:38-44. [PMID: 29342335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | - Kim Laflamme
- Institut de Cardiologie de Montréal, Québec, Canada
| | - Patrick Lavoie
- William F. Connell School of Nursing of Boston College, USA
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Lavoie P, Michaud C, Bélisle M, Boyer L, Gosselin É, Grondin M, Larue C, Lavoie S, Pepin J. Learning theories and tools for the assessment of core nursing competencies in simulation: A theoretical review. J Adv Nurs 2017; 74:239-250. [PMID: 28815750 DOI: 10.1111/jan.13416] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2017] [Indexed: 11/26/2022]
Abstract
AIM To identify the theories used to explain learning in simulation and to examine how these theories guided the assessment of learning outcomes related to core competencies in undergraduate nursing students. BACKGROUND Nurse educators face the challenge of making explicit the outcomes of competency-based education, especially when competencies are conceptualized as holistic and context dependent. DESIGN Theoretical review. DATA SOURCES Research papers (N = 182) published between 1999-2015 describing simulation in nursing education. REVIEW METHODS Two members of the research team extracted data from the papers, including theories used to explain how simulation could engender learning and tools used to assess simulation outcomes. Contingency tables were created to examine the associations between theories, outcomes and tools. RESULTS Some papers (N = 79) did not provide an explicit theory. The 103 remaining papers identified one or more learning or teaching theories; the most frequent were the National League for Nursing/Jeffries Simulation Framework, Kolb's theory of experiential learning and Bandura's social cognitive theory and concept of self-efficacy. Students' perceptions of simulation, knowledge and self-confidence were the most frequently assessed, mainly via scales designed for the study where they were used. Core competencies were mostly assessed with an observational approach. CONCLUSION This review highlighted the fact that few studies examined the use of simulation in nursing education through learning theories and via assessment of core competencies. It also identified observational tools used to assess competencies in action, as holistic and context-dependent constructs.
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Affiliation(s)
- Patrick Lavoie
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
| | - Cécile Michaud
- School of Nursing, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Marilou Bélisle
- School of Nursing, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Louise Boyer
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
| | - Émilie Gosselin
- School of Nursing, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Myrian Grondin
- Allied Health Sciences Library, Université de Montréal, Montréal, QC, Canada
| | - Caroline Larue
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
| | - Stéphan Lavoie
- School of Nursing, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jacinthe Pepin
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
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Pepin J, Goudreau J, Lavoie P, Bélisle M, Blanchet Garneau A, Boyer L, Larue C, Lechasseur K. A nursing education research framework for transformative learning and interdependence of academia and practice. Nurse Educ Today 2017; 52:50-52. [PMID: 28249197 DOI: 10.1016/j.nedt.2017.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 02/02/2017] [Indexed: 06/06/2023]
Affiliation(s)
- Jacinthe Pepin
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, Canada.
| | - Johanne Goudreau
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, Canada.
| | - Patrick Lavoie
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, Canada; William F. Connell School of Nursing, Boston College, United States.
| | - Marilou Bélisle
- Faculty of Education, Université de Sherbrooke, Sherbrooke, Canada.
| | - Amélie Blanchet Garneau
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, Canada; Critical Research in Health and Healthcare Inequities, UBC School of Nursing, University of British Columbia, Vancouver, Canada.
| | - Louise Boyer
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, Canada.
| | - Caroline Larue
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, Canada.
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Lavoie P. Simulated patient deterioration situations reveals taxonomy of the decisions made by nursing students. Evid Based Nurs 2017; 20:61. [PMID: 28255074 DOI: 10.1136/eb-2016-102519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Patrick Lavoie
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
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Lavoie P, Pepin J, Cossette S. Contribution of a reflective debriefing to nursing students' clinical judgment in patient deterioration simulations: A mixed-methods study. Nurse Educ Today 2017; 50:51-56. [PMID: 28012979 DOI: 10.1016/j.nedt.2016.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 11/21/2016] [Accepted: 12/08/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND While reflection is a hallmark of debriefing, there is little understanding of how it contributes to nursing students' clinical judgment. OBJECTIVES The aim of this study was to describe how nursing students perceived that the Reflective dEbriefing after a PatieNt Deterioration simulation (REsPoND) fostered learning and how it contributed to their clinical judgment in patient deterioration simulations. DESIGN A sequential explanatory mixed-methods study. PARTICIPANTS Nineteen students who showed the greatest clinical judgment score variation in a randomized controlled trial of the effectiveness of REsPoND. METHODS Students participated in interviews on their learning experience in REsPoND. Data were subjected to thematic analysis and themes were contrasted according to students' score variations. RESULTS Through guided exchanges with their peers, students configured a causes-observations-interventions framework that embodied their understanding of the patient's situation. They evaluated their own simulation performance based on that framework. The contribution of REsPoND to students' clinical judgment differed depending on (1) the value placed on the review of the simulation through a systematic assessment approach; (2) their focus on anticipating the situation or on performing in the simulation; and (3) their preference for who participated more in debriefing. CONCLUSION Clinical judgment might be improved when a systematic assessment approach is used to structure debriefing. The relationship between reflection and self-assessment during debriefing remains to be disentangled.
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Affiliation(s)
- Patrick Lavoie
- William F. Connell School of Nursing, Boston College, Boston, USA.
| | - Jacinthe Pepin
- Faculty of Nursing, Université de Montréal, Montréal, Canada.
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montréal, Canada; Montreal Heart Institute, Montréal, Canada.
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Affiliation(s)
- Patrick Lavoie
- Patrick Lavoie is a postdoctoral fellow at the Boston College William F. Connell School of Nursing in Chestnut Hill, Mass. Sean P. Clarke, professor and associate dean of undergraduate programs at the Boston College William F. Connell School of Nursing and a Nursing Management editorial board member, is the coordinator of the bimonthly Higher Learning column
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Blanchet Garneau A, Lavoie P, Grondin M. Dichotomy and dialogue in conceptualizations of competency in health professionals’ education. ACTA ACUST UNITED AC 2017. [DOI: 10.5430/jnep.v7n6p18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Most research on the definition of competency and its application in health professionals’ education programs is focused on semantic matters, while contextual influences are rarely discussed or solely presented as background context. The aim of this article is to gain a comprehensive understanding of the issues raised by definitions of competency and to describe the contextual factors that have given rise to those definitions. This is achieved by presenting the results of a literature review that synthesized different conceptualizations of competency. We analyzed relevant literature listed in the CINAHL, Embase, MEDLINE, and PsycINFO databases as of 2015. The results show that authors define competency based on two diverging driving forces: one aimed at professional regulation and the other at professional emancipation. The analysis revealed common grounds between these perspectives. From these common grounds we discuss the possibility of conceptualizing competency on a continuum instead of perpetuating the dichotomized discourses presented in the current literature. The integration of both perspectives gives the opportunity to rethink policies, structures and strategies of professional education toward an integrated perspective of professional development situated in a lifelong learning enterprise, achieving both minimal professional standards and excellence in healthcare practices from initial education throughout a career.
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