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Fayyaz J, Jaeger M, Takundwa P, Iqbal AU, Khatri A, Ali S, Mukhtar S, Saleem SG, Whitfill T, Ali I, Duff JP, Kardong‐Edgren S(S, Gross IT. Exploring cultural sensitivity during distance simulations in pediatric emergency medicine. AEM Educ Train 2023; 7:e10908. [PMID: 37997591 PMCID: PMC10664395 DOI: 10.1002/aet2.10908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 11/25/2023]
Abstract
Background Cultural sensitivity (CS) training is vital to pediatric emergency medicine (PEM) curricula. This study aimed to explore CS in Yale PEM fellows and emergency medicine (EM) residents at Indus Hospital and Health Network (IHHN) in Pakistan through distance simulation activities. Methods This mixed-methods analysis of an educational intervention was conducted at Yale University in collaboration with IHHN. We approached seven U.S. PEM fellows and 22 Pakistani EM residents. We performed a baseline CS assessment using the Clinical Cultural Competency Questionnaire (CCCQ). Afterward, the U.S. PEM fellows facilitated the Pakistani EM residents through six distance simulation sessions. Qualitative data were collected through online focus groups. The CCCQ was analyzed using descriptive statistics, and content analysis was used to analyze the data from the focus groups. Results Seven U.S. PEM fellows and 18 of 22 Pakistani EM residents responded to the CCCQ at the beginning of the module. The mean (±SD) CCCQ domain scores for the U.S. PEM fellows versus the Pakistani EM residents were 2.56 (±0.37) versus 2.87 (±0.72) for knowledge, 3.02 (±0.41) versus 3.33 (±0.71) for skill, 2.86 (±0.32) versus 3.17 (±0.73) for encounter/situation, and 3.80 (±0.30) versus 3.47 (±0.47) for attitude (each out of 5 points). Our qualitative data analysis showed that intercultural interactions were valuable. There is a common language of medicine among the U.S. PEM fellows and Pakistani EM residents. The data also highlighted a power distance between the facilitators and learners, as the United States was seen as the standard of "how to practice PEM." The challenges identified were time differences, cultural practices such as prayer times, the internet, and technology. The use of local language during debriefing was perceived to enhance engagement. Conclusion The distance simulation involving U.S. PEM fellows and Pakistani EM residents was an effective approach in assessing various aspects of intercultural education, such as language barriers, technical challenges, and religious considerations.
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Affiliation(s)
- Jabeen Fayyaz
- University of TorontoTorontoOntarioCanada
- The Hospital for Sick ChildrenTorontoOntarioCanada
- Pediatric Emergency MedicineYale School of MedicineNew HavenConnecticutUSA
- Department of Pediatrics, Division of Pediatric Critical Care (PICU), Faculty of Medicine & DentistryUniversity of AlbertaEdmontonAlbertaCanada
| | - Margret Jaeger
- Research DepartmentEducation Centre of Social Fund ViennaViennaAustria
| | - Prisca Takundwa
- Pediatric Emergency MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Ammarah U. Iqbal
- Pediatric Emergency MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Adeel Khatri
- Emergency MedicineIndus Hospital and Health NetworkKarachiPakistan
| | - Saima Ali
- Emergency MedicineIndus Hospital and Health NetworkKarachiPakistan
| | - Sama Mukhtar
- Emergency MedicineIndus Hospital and Health NetworkKarachiPakistan
| | | | - Travis Whitfill
- Pediatric Emergency MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Inayat Ali
- Department of Public Health and Allied Sciences, Department of AnthropologyFatima Jinnah Women's UniversityRawalpindiPakistan
| | - Jonathan P. Duff
- Department of Pediatrics, Division of Pediatric Critical Care (PICU), Faculty of Medicine & DentistryUniversity of AlbertaEdmontonAlbertaCanada
| | - Suzan (Suzie) Kardong‐Edgren
- Health Professions Education Program, Center for Interprofessional Studies and InnovationMGH Institute of Health ProfessionBostonMassachusettsUSA
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Abstract
ABSTRACT The cause of acute onset hip pain in children can be difficult to determine. Once trauma is excluded, the workup revolves around determining whether there is a hip effusion and eliminating orthopedic emergencies. Point-of-care-ultrasound can be used as an adjunct in the workup. In this article, we review (1) differential diagnosis of hip pain, with a focus on toxic synovitis; (2) the evaluation of a hip for the presence of effusion, including the point-of-care ultrasound technique; and (3) the management of toxic synovitis.
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Affiliation(s)
- Prisca Takundwa
- From the Fellow and Associate Professor, Department of Pediatric Emergency Medicine, Yale University School of Medicine, New Haven, CT
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Mapp L, Klonicki P, Takundwa P, Hill VR, Schneeberger C, Knee J, Raynor M, Hwang N, Chambers Y, Miller K, Pope M. Use of Enterococcus faecalis and Bacillus atrophaeus as surrogates to establish and maintain laboratory proficiency for concentration of water samples using ultrafiltration. J Microbiol Methods 2015; 118:133-42. [PMID: 26306940 DOI: 10.1016/j.mimet.2015.08.013] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 08/18/2015] [Accepted: 08/18/2015] [Indexed: 11/17/2022]
Abstract
The U.S. Environmental Protection Agency's (EPA) Water Laboratory Alliance (WLA) currently uses ultrafiltration (UF) for concentration of biosafety level 3 (BSL-3) agents from large volumes (up to 100-L) of drinking water prior to analysis. Most UF procedures require comprehensive training and practice to achieve and maintain proficiency. As a result, there was a critical need to develop quality control (QC) criteria. Because select agents are difficult to work with and pose a significant safety hazard, QC criteria were developed using surrogates, including Enterococcus faecalis and Bacillus atrophaeus. This article presents the results from the QC criteria development study and results from a subsequent demonstration exercise in which E. faecalis was used to evaluate proficiency using UF to concentrate large volume drinking water samples. Based on preliminary testing EPA Method 1600 and Standard Methods 9218, for E. faecalis and B. atrophaeus respectively, were selected for use during the QC criteria development study. The QC criteria established for Method 1600 were used to assess laboratory performance during the demonstration exercise. Based on the results of the QC criteria study E. faecalis and B. atrophaeus can be used effectively to demonstrate and maintain proficiency using ultrafiltration.
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Affiliation(s)
- Latisha Mapp
- United States Environmental Protection Agency, Office of Water, 1200 Pennsylvania Ave NW, Washington, DC 20460, USA.
| | - Patricia Klonicki
- CSC, Science and Engineering, 255 East Fifth St, 27th Floor, Cincinnati, OH 45202, USA
| | - Prisca Takundwa
- United States Environmental Protection Agency, Office of Water, 1200 Pennsylvania Ave NW, Washington, DC 20460, USA
| | - Vincent R Hill
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Foodborne, Waterborne and Environmental Diseases, 1600 Clifton Rd NE, Mailstop D66, Atlanta, GA 30329, USA
| | - Chandra Schneeberger
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Foodborne, Waterborne and Environmental Diseases, 1600 Clifton Rd NE, Mailstop D66, Atlanta, GA 30329, USA; IHRC, Inc., 2 Ravinia Drive NE, Atlanta, GA 30346, USA
| | - Jackie Knee
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Foodborne, Waterborne and Environmental Diseases, 1600 Clifton Rd NE, Mailstop D66, Atlanta, GA 30329, USA
| | - Malik Raynor
- United States Environmental Protection Agency, Office of Water, 1200 Pennsylvania Ave NW, Washington, DC 20460, USA
| | - Nina Hwang
- United States Environmental Protection Agency, Office of Water, 1200 Pennsylvania Ave NW, Washington, DC 20460, USA
| | - Yildiz Chambers
- CSC, Science and Engineering, 6361 Walker Lane, Suite 300, Alexandria, VA 22310, USA
| | - Kenneth Miller
- CSC, Science and Engineering, 6361 Walker Lane, Suite 300, Alexandria, VA 22310, USA
| | - Misty Pope
- CSC, Science and Engineering, 6361 Walker Lane, Suite 300, Alexandria, VA 22310, USA
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