The Impact of a Web-Based Restorative Dentistry Course on the Learning Outcomes of Dental Graduates: Pre-Experimental Study

BACKGROUND

Restorative dentistry plays a crucial role in dental practice, necessitating professionals to stay abreast with the latest advancements in the field. The advancement of technology has made web-based learning a widely used method of education delivery in dentistry, providing learners with extensive information and flexibility.

OBJECTIVE

This study aims to evaluate how effective an online educational course in restorative dentistry is for dental graduates in Syria.

METHODS

This study used a pre-experimental study design, with pretest and posttest assessments to measure changes in participants' knowledge and skills. A total of 21 dental graduates completed the online course in restorative dentistry, which was hosted on Moodle, using the learning management system of the Syrian Virtual University. Participants were provided with a suggested learning sequence and had the flexibility to navigate the course on their own and at their own pace. The course was developed based on the principles of web course design and web-based course development using the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) general instructional design model. The pretest and posttest assessments consisted of 50 multiple-choice questions with a single correct answer, aligning with the course content. Furthermore, participants were asked to complete a course acceptance survey upon finishing the course.

RESULTS

The results showed a significant improvement in the participants' knowledge of restorative dentistry, supported by a statistically significant P value of less than .05. The effect size of the difference between the pre and posttest indicated that the effect size, as indicated by ω2, demonstrated a significant 62.1% difference between the pre and posttest, indicating a high and statistically significant effect. Furthermore, the value derived from the Haridy obtained work ratio formula indicated that the educational program was effective, with an effectiveness amount of 3.36%. Additionally, 93% (n=19) of respondents expressed confidence in having gained the expected benefits from the educational course upon its completion.

CONCLUSIONS

The findings indicated a notable enhancement in the participants' understanding of restorative dentistry. The participants' high satisfaction rate and positive feedback from the course acceptance survey further emphasize the favorable reception of the web-based learning approach. This study highlights the potential of web-based learning in dental education, opening the door for future research in this area. The findings of this study carry important implications for the design and implementation of web-based educational programs in dentistry, suggesting that such programs can serve as an effective tool for continuous professional development in the field.

Gamification as a Tool for Promoting Physical Exercise and Healthy Eating Habits in Healthcare Worker Women: Effects on Cardiometabolic Health and Physical Fitness at Workplace

PURPOSE

To evaluate the effectiveness of gamified versus nongamified health promotion interventions on cardiometabolic health and fitness parameters in healthcare worker women.

DESIGN

Randomized parallel group trial.

SETTING

A public outpatient health center in Brazil.

SUBJECTS

Women employees (included: n = 29; lost to follow-up: n = 1; analyzed: n = 28).

INTERVENTIONS

8 weeks of gamified (n = 15) or nongamified (n = 13) interventions, consisting of health lectures, nutritional counseling, and supervised exercise training. The gamified group was divided into teams that received points based on completion of health goals/tasks.

MEASURES

Anthropometric, cardiometabolic and physical fitness parameters.

ANALYSIS

Two-way ANOVA with repeated measures (group vs. time), and Bonferroni post hoc tests.

RESULTS

Body mass (-1.5 ± 1.5 kg), waist circumference (-1.6 ± 3.0 cm), HbA1C (-.2 ± .3%), triglycerides (-21.5 ± 48.2 mg/dl), systolic (-11.1 ± 7.9 mmHg) and diastolic (-7.1 ± 5.8 mmHg) blood pressure, as well as sit and reach (3.9 ± 3.0 cm) and six-minute walking (56 ± 37 m) performance improved (P < .05) only after the gamified intervention. Sit-to-stand performance improved after both the gamified (-1.18 ± 1.24 s) and nongamified (-1.49 ± 1.87 s) interventions.

CONCLUSION

The gamified intervention was more effective than the nongamified intervention for improving cardiometabolic and physical fitness parameters, suggesting that gamification may be an effective tool for promoting health in healthcare worker women.

Enhancing Nurses' Disaster Management and Preparedness: Evaluating the Effectiveness of an Online Educational Program Through a Quasi-Experimental Study

Background

Disaster management is an ongoing international concern, and nurses play essential roles in minimizing negative impacts on the health of communities. However, many nurses have limited knowledge and skills on how to respond to disasters effectively. Therefore, this study was conducted to determine the effectiveness of a newly developed educational program on improving nurses' disaster management and preparedness.

Methods and Design

A quasi-experimental study was conducted on 88 nurses working at a public hospital. The educational program included six modules covering various aspects of disaster management. Pre-and post-tests were administered to evaluate changes in perceptions of disaster management competencies. Independent sample t-test, Pearson coefficient correlation, and One-way ANOVA tests were all run using SPSS.

Results

A significant proportion of nurses (78.4%) reported ongoing training in disaster management, while a smaller percentage (21.6%) expressed a contrary opinion. Nurses also had a moderate level of agreement with the disaster preparedness program (Pretest: 2.26 ± 0.34; post-test: 2.29 ± 0.31). Further, the results showed small improvements in nursing perceptions of the operational plan after the educational program (Pretest: M=2.76, SD=0.63; Post-test: M=2.89, SD=0.44), although the differences between pre-and-post assessments were not significant (P > 0.05). The mean values for overall familiarity in the pre-test were 3.16 ± 1.39, while in the post-test, they slightly increased to 3.26 ± 1.18. The findings also showed no statistically significant differences reported in nurses' attitudes and familiarity towards disaster preparedness based on the gender, marital status, nationality, working shifts, and working hours variables (P > 0.05).

Conclusion

This study demonstrated the significance of providing nurses with the essential knowledge that helps respond to disasters. Online educational programs can help improve nurses' preparedness to better manage disasters. Future research should investigate additional variables that could enhance nurses' knowledge and skills related to disaster response.

Developing an Educational Program for Ultrasound Hip Screening during Newborn and Infant Home Visits: A Protocol Paper

Ultrasound hip screening is suitable for the early identification of developmental dysplasia of the hip (DDH). Newborn and infant home visits are good opportunities for hip screening in the community, but studies focusing on nurse-led screenings are lacking. Based on a pre-post design, this study aims to develop and evaluate an ultrasound training program to improve nurses' assessment skills in detecting DDH cases during newborn and infant home visits. Said educational program will include e-learning, hands-on seminars, and clinical training. The primary outcome will be the success rate of imaging standard planes (standardized images for hip assessment) in clinical training. The secondary outcomes will include knowledge test results, objective structured clinical examination scores, time required for imaging, and inter-rater reliability between nurses and physicians. The educational program will address the issue of missed and late detection of DDH cases in resource-limited communities. This study will demonstrate the feasibility of procedures and the effectiveness of the educational program in 2024. The protocol was registered in the University Hospital Medical Information Network Clinical Trial Registry before starting the study (no. UMIN000051929, 16 August 2023).

Effect of e-learning program for improving nurse knowledge and practice towards managing pressure injuries: A systematic review and meta-analysis

AIM

The aim of this review was to determine the effectiveness of the e-learning programs for improving the knowledge and professional practices of nursing personnel in managing pressure injuries patients.

DESIGN

Systematic review and meta-analysis.

METHODS

Systematic search was done in EMBASE, SCOPUS, Cochrane library, MEDLINE, Google Scholar, ScienceDirect and Clinicaltrials.gov databases until August 2022. Meta-analysis was carried out using random-effects model, and the results were reported as pooled standardized mean differences (SMD), or odds ratios (OR) with 95% confidence intervals (CIs).

RESULTS

Eight studies were included in the analysis. Most of the studies had higher risk of bias. The pooled SMD for knowledge score and for the classification skill were 1.40 (95%CI: 0.45-2.35; I2  = 93.1%) and 1.75 (95%CI: 0.94-3.24; I2  = 78.3%) respectively. The pooled OR for the classification skills was 1.75 (95%CI: 0.94-3.24; I2  = 78.3%).

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Efficiency of an intervention study on nursing students' knowledge and practices regarding nutrition and dietary habits

Poor eating habits and hazardous weight-control measures are prevalent among university students. Hence, practical and efficient intervention programs are necessary to enhance nutritional awareness and promote healthy dietary practices encompassing food choices and diet quality. This study aims to evaluate the efficiency of an intervention study on nursing students' knowledge and practices regarding nutrition and dietary habits. A quasi-experimental research design with pre-post phases was used to study 250 nursing students at the College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, in the Kingdom of Saudi Arabia. The sample was non-randomized and taken from March 2023 until the end of May of the same year. The closed-ended questionnaire focused on participant demographics, knowledge, and practices relating to nutrition and eating habits. The survey was divided into three main sections. Technical terms were consistently defined throughout the questionnaire, and the language used was clear and objective. The research adhered to conventional academic structure and formatting, following the guidelines of the relevant style manual. Grammatical correctness and precise word choice were ensured, and filler words were avoided. The participants in the study displayed an increase in knowledge scores from 33.7 ± 4.6 in the pre-test to 52.6 ± 7.2 in the post-test. Moreover, prior to program implementation, their overall nutrition practice scores stood at 64 ± 9.5, but after the program, the score had risen to 107.7 ± 4.22. A significant difference in the total knowledge and practice scores was identified between the pre- and post-test phases, with an a p-value of 0.001. The nursing students' scores for both knowledge and practical application of nutrition and eating habits showed a significant increase following the implementation of the program. Therefore, it is imperative to introduce well-structured training programs on nutrition and promote healthy diet habits for all medical faculties, paramedics, and applied health institutions across Saudi Arabia.

Wellness Achieved Through Changing Habits: A Randomized Controlled Trial of an Acceptance-Based Intervention for Adolescent Girls With Overweight or Obesity

Background: Obesity prevalence among adolescent girls continues to rise. Acceptance-based therapy (ABT) is effective for weight loss in adults and feasible and acceptable for weight loss among adolescents. This pilot randomized controlled trial (RCT) assessed effectiveness of an adolescent-tailored ABT intervention on decreasing weight-related outcomes and improving psychological outcomes compared with enhanced care. Methods: In this 6-month, two-arm pilot RCT, participants were randomized to the ABT intervention or to enhanced care. The ABT intervention condition attended 15 virtual, 90-minute group sessions. The enhanced care comparison received 15 healthy lifestyle handouts and virtually met twice with a registered dietitian. The primary outcome assessed was change in BMI expressed as a percentage of the 95th percentile (%BMIp95). Results: Participants included 40 girls (ages 14-19) assigned to ABT (n = 20) or enhanced care (n = 20). A decrease in %BMIp95 was observed within the ABT intervention [d = -0.19, 95% confidence interval, CI: (-0.36 to -0.02)], however, not within the enhanced care comparison [d = -0.01, 95% CI: (-0.09 to 0.07)]. The ABT group showed slight changes in psychological flexibility [d = -0.34, 95% CI: (-0.62 to -0.06)] over enhanced care [d = -0.11, 95% CI: (-0.58 to 0.37)]. There was no significant intervention effect noted between groups. Conclusion: In this pilot RCT, the ABT intervention was as effective as enhanced care for weight loss. However, previous ABT studies occurred in person, and this study was conducted virtually due to COVID-19. Thus, future research investigating the potential effectiveness of ABT in-person among adolescents and optimization of virtual interventions is needed.

Knowledge and attitudes towards mpox and effect of intervention among College of Applied Medical Sciences students

Objectives: This research aims to assess the base level of knowledge and attitude of Applied Medical Sciences Students regarding mpox and whether an educational intervention could improve their knowledge and attitude. Methods: A quasi-experimental research was used, involving 960 medical students from Applied Medical Sciences College at Prince Sattam Bin Abdulaziz University, KSA. They were recruited from the beginning of November 2022 till the mid of January 2023 based on the non-randomized sampling method. A standardized, anonymous, and closed-ended questionnaire was used, compromising three main sections: participants' demographics, knowledge, and attitudes toward the mpox epidemic. Results: Total knowledge scores of the studied sample in the pretest phase were 45.43 ± 6.29 compared to 65.03 ± 2.93 in the post-test phase. Besides, total attitude scores were 48.62 ± 4.78 before program implementation, while after conducting the program reached 70.65 ± 5.13. There was a notable improvement in the total knowledge score of the sample studied after the intervention was implemented, particularly for neurological manifestations. Conclusion: After the program's implementation, there was an obvious improvement in the medical students' total knowledge and attitude scores concerning the mpox epidemic. It is necessary to initiate well-organized training initiatives for all other medical faculties, paramedics, and applied health institutions in Saudi Arabia.

Effects of an educational intervention on frailty status, physical function, physical activity, sleep patterns, and nutritional status of older adults with frailty or pre-frailty: the FRAGSALUD study

Introduction

The prevalence of frailty is increasing worldwide, emphasizing the importance of prioritizing healthy ageing. To address this, cost-effective and minimally supervised interventions are being sought. This study aimed to assess the impact of an educational program on frailty status, physical function, physical activity, sleep patterns, and nutritional status in community-dwelling older adults with at least 1 Fried's frailty criteria.

Methods

A 6-month multicentre randomized controlled trial was conducted from March 2022 to February 2023 in 14 health centres located in Cadiz and Malaga, Spain. The educational intervention consisted of 4 group sessions and 6 follow-up phone calls spread over 6 months. The program focused on educating participants about frailty and its impact on health, providing guidelines for physical activity, healthy dietary habits, cognitive training, psychological well-being and social activities. A total of 163 participants, divided into control (n = 80) and educational groups (n = 83) were assessed before and after the intervention.

Results

The results showed a significant group-time interaction in the physical function evaluated with a large effect on Short Physical Performance Battery score (η2p = 0.179, -0.1 [-1.2-1.0] points for control group vs. 1.0 [0.0-3.0] points for educational group, p < 0.001), and an effect on the 4-meter gait test ((η2p = 0.122, 0.5 [0.1-0.0] s for control group vs. -0.4 [-0.5- -0.3] s for educational group, p < 0.001), and the 5-repetition sit-to-stand test (η2p = 0.136, 1.0 [0.0-1.2] s for control group vs. -4.3 [-7.0- -2.3] for educational group, p < 0.001). Additionally, the use of accelerometers to assess physical activity, inactivity, and sleep patterns revealed a significant small effect in the number of awakenings at night ((η2p = 0.040, 1.1 [-0.5-3.4] awakenings for control group vs. 0.0 [-2.2-0.0] awakenings for educational group, p = 0.009). The findings also highlighted a significant medium effect regarding malnutrition risk, which was assessed using the Mini-Nutritional Assessment score (η2p = 0.088, -0.7 [-2.3-1.5] points for control group vs. 1.5 [-0.5-3.0] points for educational group, p < 0.001).

Discussion

Thus, the 6-month educational program effectively improved physical function, sleep patterns, and nutritional status compared to usual healthcare attendance in community-dwelling older adults with frailty or pre-frailty. These findings underscore the potential of minimally supervised interventions in promoting a healthy lifestyle in this vulnerable population.

Pupils' Attitudes toward Inclusive Education

The presented research is a study of the attitudes of adolescents toward individuals with disabilities and a description of the level of knowledge about this issue among a selected group of adolescents. The study is focused on the school social environment, specifically on pupils without disabilities and their attitudes toward pupils with disabilities, which is one of the factors influencing their school success. The target group was 1806 pupils between the ages of 11 and 16 from the entire Czech Republic, approached by random selection. The research tool for the quantitative approach was a questionnaire developed by the authors of this article. The questionnaire section with open questions served for the qualitative part of the research. The results show that 70% of the respondents have basic knowledge about people with disabilities. Furthermore, it was shown that these adolescents have an overall positive attitude toward people with disabilities. This attitude is statistically significantly better among the girls than the boys, and the girls are also more open to discussing individuals with disabilities. At the same time, even if attitudes are positive, they still depend on the type of disability. The greatest uncertainty or discomfort is manifested when interacting with individuals with intellectual disabilities.

Attendance-Based Adherence and Outcomes of Obesity Management Program in Arab Adolescents

Pediatric obesity has become a global pandemic in the last century, contributing to short and long-term medical conditions that heighten the risk of morbidity and mortality in children. The 12-month school-based obesity management educational program aims to assess the effect of adherence to the lifestyle educational program and target outcomes, obesity, and hypertension. A total of 363 (nonadherent, N = 179; adherent, N = 184) Saudi school adolescents aged 12-18 were recruited from 60 schools in Riyadh City, Saudi Arabia. Anthropometrics, lipid profile, and blood glucose were measured at baseline and post-intervention. The level of adherence was based on the number of attended educational sessions, and participants were grouped accordingly into two groups: adherent group (attended ≥ 3 sessions) and nonadherent group (attended 1-2 sessions) out of a total of five sessions. Results demonstrated that significantly more participants in the adherent group achieved the primary program goal of reducing obesity indices [body weight, body mass index (BMI), and BMI z-score] than the nonadherent group. Additionally, among adherent obese participants, BMI z-score significantly decreased after the 12-month intervention (post-intervention: 1.5 ± 0.7 vs. baseline: 1.7 ± 0.6, p < 0.05), while the trend in BMI z-score modestly increased in the nonadherent obese participants post-intervention (post-intervention: 1.8 ± 0.7 vs. baseline: 1.7 ± 0.6, p > 0.05). Moreover, there was a substantial reduction in hypertension prevalence only in the adherent group (p = 0.003) and among adherent obese participants in particular (p = 0.03). Furthermore, adherence to session attendance was higher in girls than boys, which led to better outcomes among girls than boys. For the secondary outcomes, lipid profile indices increased in both groups, while no changes were observed in the glycemic profile. In conclusion, greater adherence to educational sessions achieved modest but favorable weight changes and improved blood pressure among obese adolescents. Future intervention studies should take into consideration the need to improve attendance to enhance adherence to the program among adolescents at risk.

Design and Development of an Objective Evaluation System for a Web-Based Simulator for Trauma Management

BACKGROUND

Trauma injuries are one of the main leading causes of death in the world. Training with guidelines and protocols is adequate to provide a fast and efficient treatment to patients that suffer a trauma injury.

OBJECTIVES

This study aimed to evaluate deviations from a set protocol, a new set of metrics has been proposed and tested in a pilot study.

METHODS

The participants were final-year students from the Universidad Autónoma de Madrid and first-year medical residents from the Hospital Universitario La Paz. They were asked to train four trauma scenarios with a web-based simulator for 2 weeks. A test was performed pre-training and another one post-training to evaluate the evolution of the treatment to those four trauma scenarios considering a predefined trauma protocol and based on the new set of metrics. The scenarios were pelvic and lower limb traumas in a hospital and in a prehospital setting, which allow them to learn and assess different trauma protocols.

RESULTS

The results show that, in general, there is an improvement of the new metrics after training with the simulator.

CONCLUSION

These new metrics provide comprehensive information for both trainers and trainees. For trainers, the evaluation of the simulation is automated and contains all relevant information to assess the performance of the trainee. And for trainees, it provides valuable real-time information that could support the trauma management learning process.

An educational intervention to improve health and nutrition literacy in hypertensive patients in Greece

BACKGROUND

Suboptimal control of blood pressure (BP) is a public health challenge in Greece. This educational intervention attempts to improve health literacy (HL) and nutrition literacy (NL) in primary healthcare (PHC) patients with hypertension (HTN).

MATERIALS AND METHODS

This was a proof-of-concept (PoC) educational intervention. Twenty-four patients with HTN and low or medium levels of HL agreed to participate in this 6-week educational intervention. The program was delivered by a general practitioner (GP) in group A and by a qualified nurse in group B. Group C was the control group. The levels of HL of NL, adherence to the Mediterranean diet, and perceived stress were assessed using the European Health Literacy Survey Questionnaire 16 (HLS_EU_Q16) and part B (reading a medication label) of the High Blood Pressure-Health Literacy Scale (HBP-HLS), the Nutrition Literacy Scale-Greek (NLS-Gr), the Mediterranean Diet Adherence Screener (MEDAS), and the Perceived Stress Scale (PSS-14), respectively, together with certain socioeconomic, dietary, and lifestyle characteristics. The Kruskal-Wallis and Wilcoxon nonparametric, the Chi-square, and the McNemar-Bowker tests were used. The analysis was done with the STATA software, version 14 (MP & Associates, Sparta, Greece).

RESULTS

No statistically significant differences were found in the total score of HL and NL before and after the intervention; however, the results indicate a slight improvement in HL and NL levels in the two intervention groups, together with small improvements in knowledge and behaviors related to HTN and dietary salt. A trend of improvement in the MEDAS levels in the GP's group and the HBP-HLS levels in the nurse's group was also reported.

CONCLUSION

A slight improvement in HL and NL levels in the two intervention groups has been reported, and the changes, however, were not statistically significant.

Combined Exercise and Education Program: Effect of Smaller Group Size and Longer Duration on Physical Function and Social Engagement among Community-Dwelling Older Adults

Background

Exercise, education, and social engagement are critical interventions for older adults for a healthy life expectancy and to improve their physical function.

Objective

To conduct a combined exercise and education (CEE) program for improved social engagement and physical function of older adults.

Design

Based on a short-term program we conducted in our previous study, in this study, the program was conducted for half the number of participants of the earlier study but for a longer duration.

Setting

A community of older adults in Ami, Japan, was the setting of the study.

Participants

23 healthy older adults >65 years living in the community were the participants in the study.

Interventions

Five 80-minute sessions conducted once in two weeks comprised 60-min exercise instruction and 20-min educational lectures per session on health. We examined the improvement in physical and social engagement before and after participation. Physical function and health-related questionnaire data were collected before and after the program.

Results

Data analysis from 15 participants showed improved physical performance but no effect on social engagement.

Conclusions

A higher program frequency, rather than program duration, may be vital to improving exercise performance and social engagement and maximizing the effects of high group cohesion in small groups. Further studies are needed to develop more effective interventions to extend healthy life expectancy.

Development and Validation of Epilepsy Life Skills Guidelines for Primary School Learners and Teachers in Limpopo and Mpumalanga Provinces

Epilepsy is a disorder that disturbs nerve cell activity in the brain, resulting in seizures. It was noted that it occurs mostly in children, especially at the primary school level, and could result from a genetic condition. The aim of this study was to develop and validate life skills education guidelines for primary school learners of Limpopo and Mpumalanga provinces in South Africa to educate them about epilepsy with the aim of reducing stigma and discrimination towards people with epilepsy. The guidelines were developed by adapting the World Health Organization (WHO) guideline development guide, which included the formulation of PICOS (population, intervention, comparison, outcome, study design) questions, conducting a systematic review of the literature, and using GRADE (grading of recommendations assessment, development, and evaluation) to develop evidence-based recommendations. The recommendations that informed the guideline development were that epilepsy education should be included in the primary school life skills curriculum to improve learners' understanding, attitudes, and skills related to epilepsy. This epilepsy education should be tailored to the needs of primary school learners and cover topics such as seizure recognition, management, medication, and coping strategies. Collaboration between healthcare providers, educators, and policymakers is crucial to developing culturally appropriate and evidence-based epilepsy education guidelines. Teachers and healthcare providers should also receive training on how to support learners living with epilepsy. The resulting guidelines provide clear and concise guidance on epilepsy education in life skills for primary school learners, caregivers, and teachers. The guidelines are expected to improve the quality of epilepsy life skills education and contribute to the overall well-being and inclusion of learners with epilepsy in Mpumalanga and Limpopo provinces, South Africa.

Effect of Educational Intervention Program on Self-Efficacy of Individuals with Type 2 Diabetes Mellitus in South-East, Nigeria

Objectives

Diabetes Mellitus is a chronic disease, which requires a level of confidence among the sufferers in its management. This study investigated the effect of an educational intervention program on self-efficacy (SE) in diabetic individuals with type 2 diabetes mellitus in South-East, Nigeria.

Methods

The study was a quasi-experimental controlled study, comprising 382 individuals with type 2 DM selected, and assigned to intervention (IG) and control groups (CG). The instrument for data collection was the Stanford Chronic Disease Self-Efficacy Scale (SCDS). Pretest data were collected, and thereafter education on diabetes management was given to the IG group. The IG was followed up for 6 months. At the end of 6 months, post-test data were collected using the same instrument. Data were analyzed using Pearson Chi-square test statistics. A P-value less than .05 alpha level was considered significant.

Results

There was no statistically significant difference between the two groups before intervention. However, after 6 months of intervention, a significant proportion of participants' scores in IG moved from low to either moderate, or high SE in almost all the SE domains (P < .05.

Conclusions

There was an improvement in most domains of self-efficacy in the intervention group after 6 months of educational intervention.

A Case Study of 21st Century Cognitive, Social and Emotional Competencies Using Online-Learning

Based on the conceptualisation of the 21st Century Competencies Framework from the Center for Curriculum Redesign (CCR) we developed an online program to enable school-age students to increase their level on several social-emotional competencies. BE organized is a program that aims to help students to better organize themselves to be more efficient in today's and tomorrow's world. To do so, 12 individual sessions were designed to develop 4 out of the twelve 21st century competencies: Critical Thinking, Mindfulness, Resilience and Metacognition; collective sessions (action lab) to develop others such as Creativity. We used a mixed methodology, i.e., quantitative (two questionnaires) and qualitative (reflective questions) evaluation to test whether the targeted competencies have been developed during this program. Preliminary results (since it involves only a small number of participants, n = 27) partially confirm our hypotheses. Both qualitative and quantitative data show a development of critical thinking; the cross-sectional results are more mixed for the other three targeted competencies. Moreover, some other competencies, such as Creativity and Growth Mindset, seem to be developed during this program. However, it is difficult to determine whether it is the group and/or individual sessions that are responsible for these non-targeted competencies development. These results will be discussed in relation to the youth literature on 21st century competency and the broader literature on socio-emotional learning (SEL) and/or emotional intelligence (EI).

Evaluation of the Effectiveness of a Structured Educational Program on Improving the Knowledge of COVID-19 Among the Vaccine-Reluctant Population in a Block of Jharkhand, India

Background Low vaccination uptake is a major public health concern and is more prevalent in rural areas. Educational interventions have been proposed as an effective strategy to increase vaccine acceptance. The objective of this study was to assess the impact of an educational program on acquiring knowledge for promoting vaccination uptake among a sample of participants. Methodology This study was conducted in a rural area in the state of Jharkhand, India. The study period was from July 2022 to September 2022. The area was surveyed for COVID-19 vaccination and a total of 510 people did not take any dose or took only the first dose and then skipped the second dose. An educational program was designed in the local language. The knowledge of the sample was assessed before and after a week of intervention with a surveyor-administered questionnaire. The vaccination status before and after the intervention was also recorded. We used the chi-square test, Fisher's exact test, and binomial test for comparing the categorical variables. Results A total of 178 participants' data were analyzed. The majority of the participants were in the age group of 18-25 years. The pre-intervention score regarding the knowledge of COVID-19 and vaccination was 18.93 ± 5.10 which significantly increased after the intervention to 25.06 ± 4.35 (p <0.0001). The number of individuals receiving vaccination significantly increased. Before the program, 95 participants did not take the vaccine and 83 received the first dose and did not take the second dose. After the program, 17 participants did not take the vaccine, 161 completed the first dose, and 112 completed the second dose (p <0.0001). Conclusions The educational program was successful in improving knowledge and awareness about vaccination, leading to an increase in the number of individuals receiving vaccination. These findings suggest the importance of educational interventions in the local language in promoting vaccination uptake and can be used to design effective public health campaigns to increase vaccine acceptance.

Effect of an Educational Program on Nurses' Knowledge and Practice of Oxygen Therapy

INTRODUCTION

Past studies have shown that healthcare professionals may lack awareness and knowledge regarding oxygen therapy, and its implementation often has several obstacles. This study was carried out to investigate the effect of an educational program about oxygen therapy on nurses' knowledge and practices.

METHODS

This cross-sectional, quasi-experimental study was conducted in 2022 at the pediatric department of Nishtar Hospital, Multan, where 160 nurses from primary and secondary health centers attended an educational program delivered in the pediatric department. The pre-test-post-test approach was used to evaluate the effectiveness of the structured educational program. The independent variable was the educational program, and the dependent variable was the nurses' knowledge and practice about oxygen toxicity. Data analysis was performed using SPSS version 23 (IBM Corp., New York, USA). The data were tabulated as means and standard deviations for numerical values and frequency percentages for categorical values. The student's t-test and the chi-square test were applied to investigate any associations among variables.

RESULTS

The average test scores before and after the implementation of the educational program were 10.75±2.65 and 17.52±2.04, respectively. The average post-test score was greater than that of the pre-test, and the difference was statistically significant (p<0.001).

CONCLUSION

The study found that after the implementation of the educational program, the knowledge and practices of nurses regarding oxygen therapy improved significantly, with the majority showing a positive attitude toward the program.

Insights into Mesalazine Use in Clinical Practice of Young Gastroenterologists

BACKGROUND

Mesalazine is among the medications most prescribed by gastroenterologists, with variable and controversial use in different settings. We aimed to explore the use of mesalazine in the clinical practice of young gastroenterologists.

METHODS

A web-based electronic survey was distributed to all participants of the National Meeting of the Italian Young Gastroenterologist and Endoscopist Association.

RESULTS

A total of 101 participants took part in the survey, with a majority (54.4%) being aged >30 years, 63.4% of whom were trainees in academic hospitals, and 69.3% of whom were involved in the clinical management of inflammatory bowel disease (IBD). While both non-dedicated and IBD physicians generally agreed on the appropriate dose of mesalazine for mild ulcerative colitis (UC), significant differences were observed between the two groups for moderate-severe ulcerative colitis (UC). Additionally, in IBD patients who were starting immuno-modulators and/or biologics, 80% of IBD-dedicated physicians continued to prescribe mesalazine, compared to 45.2% of non-dedicated physicians (p = 0.002). Indeed, 48.4% of non-dedicated IBD physicians did not acknowledge mesalazine for colorectal cancer chemoprevention. With regards to Crohn's disease, it is mainly used by 30.1% of IBD physicians for preventing postoperative recurrence of Crohn's disease. Finally, 57.4% used mesalazine for symptomatic uncomplicated diverticular disease, and 84.2% did not recommend its use for irritable bowel syndrome.

CONCLUSIONS

This survey showed heterogeneous behaviors in the daily use of mesalazine, mainly in the management of IBD. Educational programs and novel studies are needed to clarify its use.

[Treatment of patients with chronic nonspecific lumbalgia with various pain triggers]

OBJECTIVE

To evaluate the effectiveness of complex therapy in patients with chronic nonspecific lumbalgia associated with various pain triggers.

MATERIAL AND METHODS

There were 121 patients with chronic nonspecific lumbalgia (average duration of pain 8.0±5.0 months) aged 22 to 59 years (average age 42.1±10.5). The lesion of the facet joints (24.8%), sacroiliac joint (23.2%), muscles (16.5%) or their combined lesion (35.5%) was established as pain triggers of lumbalgia. The patients underwent complex therapy, including medications, kinesiotherapy and cognitive therapy. Before and after the course of therapy (on average 3 weeks), a digital rating scale for pain assessment, the Oswestry Disability Index and the Hospital Anxiety and Depression Scale (HADS) were used.

RESULTS

After treatment, there was a significant (p<0.01) decrease in pain (6.1±1.1 to 1.13±0.37 points, p<0.01), disability (40.09±3.56 to 22.15±13.20%), anxiety (8.98±0.50 to 6.46±0.34 points) and depression (8.72±0.17 to 6.02±0.26 points). A significant improvement in the condition was found in all pain triggers of chronic lumbalgia. The duration of chronic lumbalgia, the severity of life limitations on the Oswestry Disability Index and anxiety on HADS were the reliable predictors of the low effectiveness of complex therapy.

CONCLUSION

Complex therapy, including medications, kinesiotherapy and cognitive therapy, is effective for various pain triggers of chronic lumbalgia.

Implementing a Palliative Care Education Program in the NICU and Why It Is so Important: A Literature Review

Aim: To review the literature relevant to palliative care educational programs for nursing staff and families in the NICU. Background: Few hospitals have a palliative care educational program that is in place despite the increasing need for one. Neonatal staff are not educated or prepared to provide end-of-life care (EOLC) and support to family members. There is a lack of literature that looks at parents' perception of EOLC and the potential benefit that proper education may have had on their experience. Methods: Sixteen articles were reviewed, including 7 cohort studies, 5 expert opinions, 1 experimental trail, 1 case-controlled study, 1 literature review, and 1 case study. Conclusion: Implementation of a palliative care education program can provide the necessary tools for neonatal staff to provide EOLC. This education can reduce the stress and anxiety that staff feel about EOLC. With proper education, the neonatal staff can then provide the necessary support for family members. Relevance to Clinical Practice: EOLC is part of all NICUs, and neonatal staff should receive proper education on how to handle such situations.

The effectiveness of an interactive digital-based educational program in improving breastfeeding knowledge, attitudes and self-efficacy among primiparous women in Egypt

Malnutrition is the main cause of two-thirds of deaths among Egyptian under five children, which could be due to reduced rates of breastfeeding, as it is one of the contributing factors. Breastfeeding is the optimal solution for health promotion to mothers and their infants. It has various benefits not only for the mother and infant but also for society. Breastfeeding educational programs are essential for the enhancement of knowledge and self-efficacy of new mothers, and to ensure a longer duration of breastfeeding. Therefore, this study aims to evaluate the effects of an interactive digital-based educational program about breastfeeding on the knowledge, attitudes, and self-efficacy of primiparous women in Egypt. A quasi-experimental study design was adopted. The study was held in Itay El-baroud maternal and child health center, whereby 120 pregnant women were purposively selected. Then, they were randomly assigned to either a study group (60) or control group (60). The derived data were statistically analysed using SPSS version 20, Pearson correlation coefficient, chi-square test and independent sample t test were utilized. Four tools were utilized for data collection. A statistically significant mean difference was found concerning total breastfeeding knowledge scores after one month and three months. The total attitude and self-efficacy scores showed highly statistically significant differences after one month and three months from the start of the program. Moreover, breastfeeding self-efficacy was found to be positively correlated with knowledge and attitude. In conclusion, the interactive digital-based educational program about breastfeeding was suggested to be effective in enhancing the knowledge, attitude and self-efficacy of the primiparous women, in combination with other health education activities. Therefore, it is recommended that web-based educational sites are created for first-time mothers.

Effect of Educational Program on Knowledge, Skills, and Personal Preparedness for Disasters Among Emergency Nurses: A Quasi-Experimental Study

Continuous nursing education has a significant correlation with increasing knowledge, improving skills, and personal preparedness for disasters among nurses which leads to a decrease in mortality rate and enhances the quality of care. However, there is limited literature evaluating the effect of educational programs on the knowledge, skills, and personal preparedness for disaster preparedness among emergency nurses at Arab countries including, Jordan. This study evaluated the effect of an educational program on knowledge, skills, and personal preparedness for disasters among emergency nurses. A quasi-experimental study and one-group pretest-posttest design was used. A convenience sample was adopted to recruit registered nurses who are working in emergency rooms in the private and government health sectors in Jordan (N = 50). This study was conducted between May and June 2021. The intervention included an educational program consisting of 5 topics about disasters. The participants attended this program for 8 h over 1 week via Zoom application. There were significant differences between the pre-post educational intervention for knowledge (t = 4.79, P ≤ .001), skills (t = 6.66, P ≤ .001), and personal preparedness (t = 9.56, P ≤ .001) for disasters. These findings suggested the importance of implementing continuous education and training programs for emergency nurses about disasters due to increasing frequency of disasters worldwide.

Effectiveness of an educational program for reducing mental illness stigma targeting family medicine trainees in Tunisia: A quasi-experimental study

Reducing stigma among mental health and health professionals has been an ultimate priority in many countries worldwide. This study aimed to evaluate the effectiveness of a four-session educational intervention for reducing stigma of mental illness targeting family medicine trainees in Tunisia. A quasi-experimental design was adopted with an intervention group (N = 51) and a control group (N = 56). Pre-intervention data were collected using an online survey. A four-session seminar series was implemented and organized. Post-intervention data were collected immediately after the end of the intervention then 2 months thereafter. Instruments included Attribution Questionnaire (AQ-27), Self-Determination Scale (SDS), Empowerment Scale (ES), and Recovery Scale (RS). Repeated measures analysis of covariance and multiple analysis of covariance tests were carried out. Results revealed that the intervention had moderate effects on the AQ-27 score and on six of its stigma factors including factors of the dangerousness model. The intervention improved SDS score, but not ES or RS scores. Positive effects were observed immediately after the intervention and 2 months thereafter. Regular implementation of educational programs in clinical practice would be beneficial. Developing other anti-stigma methods is needed to address the concepts of recovery and responsibility of patients with mental illness.

A Stroke Rehabilitation Educational Program for Occupational Therapy Students and Practitioners: Usability Study

BACKGROUND

There are gaps in knowledge translation (KT) of current evidence-based practices regarding stroke assessment and rehabilitation delivered through teletherapy. A lack of this knowledge can prevent occupational therapy (OT) students and practitioners from implementing current research findings.

OBJECTIVE

The aim of this pilot study was to create an educational program to translate knowledge into practice regarding the remote delivery of stroke assessment and rehabilitation to OT students and practitioners. Four areas of focus were addressed in the educational program, including KT, task-oriented training, stroke assessments, and telerehabilitation.

METHODS

Two pilot studies were conducted to assess the knowledge gained via pretests and posttests of knowledge, followed by a System Usability Scale and general feedback questionnaire. Participants in study 1 were 5 OT practitioners and 1 OT assistant. Participants in study 2 were 9 current OT students. Four 1-hour modules were emailed weekly to participants over the course of 4 weeks, with each module covering a different topic (KT, task-oriented training, stroke assessments, and telerehabilitation). Preliminary results were reviewed using descriptive statistics.

RESULTS

Statistically significant results were found with increased scores of knowledge for both students and practitioners. Most of the educational modules had an above-average score regarding value and positive feedback for the educational program as a whole from the participants.

CONCLUSIONS

Overall, the results of this pilot study indicate that a web-based educational program is a valuable, informational method of increasing the translation of knowledge in the remote delivery of stroke assessment and rehabilitation. OT students and practitioners found the information presented to be valuable and relevant to their future profession and current practice.

Effects and implementation of a minimized physical restraint program for older adults in nursing homes: A pilot study

Purpose

Physical restraint (PR) reduction interventions are currently exploring in developed regions with well-established welfare systems, whereas developing countries with fast population aging have not attracted enough attention. This China's pilot study evaluated the effects of a minimized PR program on restraint reduction and nursing assistants' knowledge, attitudes, intention, and practice toward PR and explored nursing assistants' experience of the program.

Patients and methods

This was a one-group, pretest, and posttest pilot trial with a nested qualitative descriptive study. A minimized PR program was obtained by summarizing the best evidence and was implemented in one Chinese nursing home with 102 older adults from December 18, 2020, to March 21, 2021. An educational program including three theoretical lectures and one operation training was first conducted for nursing assistants one-month period. The primary outcome was PR rate at 3 months. The secondary outcomes contained duration of restraints, types of restraints, the rate of correct PR use, the incidence of falls and/or fall-related injuries, and antipsychotics use at 3 months. Data on PR use and older adults' characteristics were collected through physical restraints observation forms and older adults' medical records. Nursing assistants' knowledge, attitude, intention, and practice toward PR were measured using the Staff Knowledge, Attitudes, and Practices Questionnaire regarding PR at 1 month. A semi-structured interview for two administrative staff and a focus group discussion with 13 nursing assistants were analyzed using content analysis to explore perspectives of intervention implementation at 3 months.

Results

There were a significant increase in knowledge, attitude, and practice and a decrease in intention of nursing assistants after 1-month educational intervention (P < 0.001). Furthermore, only the rate of correct PR increased and the duration of restraint in the daytime decreased significantly at 3 months (P < 0.05). There were no significant effects on PR rate and other secondary outcomes at follow-up. Qualitatively, nursing assistants demonstrated overtly supportive perspectives and that assistance from the program enhanced their knowledge and practice. They noted several challenges that impeded implementation.

Conclusion

The intervention has acknowledged some benefits and was valued by nursing assistants. Implementation barriers should be addressed before delivering in larger trials.

Electrocardiogram interpretation competency among undergraduate nursing students: A quasi-experimental study

BACKGROUND

Cardiac diseases are highly prevalent. Electrocardiogram (ECG) is a noninvasive, rapid, safe, and low-cost procedure that is commonly used by nurses in clinical settings to diagnose a variety of cardiac arrhythmia. However, there is a limited number of studies that have assessed nursing students' competencies in electrocardiogram interpretation in Saudi Arabia. This study aimed to assess the electrocardiogram interpretation competency among undergraduate nursing students and to evaluate the effectiveness of the electrocardiogram interpretation educational program.

METHODS

A quasi-experimental pre-post-test design was conducted. A pre-post-test self-administered standardized questionnaire was completed by a convenient sample of 79 nursing students who enrolled in an educational program. Data were analyzed using descriptive and inferential statistics with p < .05 was assumed. The study hypothesized that ECG competency scores of nursing students who are enrolled in an educational program will be higher in post-test than their pre-test scores.

RESULTS

The vast majority of students (96.2%) expressed their interest to enroll in more ECG training sessions. The study results showed that students' mean ECG interpretation competency was 4.16 (1.88) and 7.43 (2.38) in pre- and post-tests, respectively, with a statistical significance of p < .001.

CONCLUSION

Overall performance of nursing students was limited. Study results confirm the primary hypothesis that the educational program was effective in improving students' ECG interpretation competencies. More ECG contents and programs should be integrated into nursing curricula and more follow-up studies are recommended. This study highlighted the significance of equipping nursing students with ECG interpretation competencies through education and training to ensure safe practice.

Maternal Kangaroo care education program in the neonatal intensive care unit improved mothers' perceptions, knowledge, perceived barriers and stress relates to premature infant

AIM

To assess the effectiveness of the maternal kangaroo care education programme over 1 month and 3 months on the mother's perception, knowledge, perceived barriers and stress.

DESIGN

A quasi-experimental and longitudinal study was conducted among mothers with premature infants.

METHODS

Forty-eight mother-infant dyads were enrolled per arm in the control and experimental groups. The control group received standard routine care, while the experimental group received a maternal kangaroo care education program. Data were collected through self-administered Kangaroo Care Questionnaires. Chi-square, the general linear model and repeated measures ANOVA were used to analyse data.

RESULTS

The demographics are a majority of Malay mothers with multipara, a caesarean delivery with prematurity. At 3 months post-intervention, the experimental group reported a significant reduction in stress, a positive perception and good knowledge towards kangaroo care implementation. The mothers' perceived barriers towards kangaroo care significantly decreased after 3 months in the experimental group.

Procedural-based Specialties Benefit from a Formal Informed Consent and Disclosures Educational Program

OBJECTIVE

At our tertiary academic center, residents undergo formalized training in obtaining informed consent and disclosing a complication. The informed consent portion has previously been shown to benefit a group of surgical and emergency medicine residents. We aimed to determine if the benefits from training persist across a larger number of procedural-based specialties and to ascertain the benefit of training in disclosing complications.

DESIGN

This retrospective cohort study examined first-year residents from seven procedural-based specialties who participated in a formal informed consent and disclosures training program, consisting of a didactic lecture and two-part simulation. Two years after the start of the program, the disclosure scenario was added. Participants were given pre- and post-surveys assessing comfort and confidence in the informed consent and disclosure scenarios. Survey results were compared using the signed-rank test and Kruskal-Wallis test as appropriate.

SETTING

This study occurred at Temple University Hospital, a tertiary academic institution in Philadelphia, PA.

PARTICIPANTS

First-year residents from 2014 to 2020 in seven procedural-based specialties, including general surgery, orthopedic surgery, otolaryngology, obstetrics and gynecology, emergency medicine, radiology, and anesthesia, participated in this study. One hundred and ninety-three residents completed the program and surveys.

RESULTS

Residents reported improved confidence in filling out an informed consent form (p = 0.036) and more comfortable in obtaining informed consent (p = 0.041), as well as more confidence (p = 0.018) and comfort (p = 0.001) in disclosing a complication. Surgical residents demonstrated greater confidence in obtaining informed consent (p = 0.009) and disclosing a complication (p = 0.0002) after training than non-surgical residents.

CONCLUSIONS

Across multiple procedural-based specialties, formal training in informed consent and disclosure of complications increases resident ability to perform these tasks. A formal training program is valuable for residents who are expected to perform these tasks across various specialties.

Implementation and evaluation of a virtual dental home educational program

AIMS

A Virtual Dental Home (VDH) is an alternative care model using teledentistry technology to provide care in community settings for special care populations. The Dental Hygiene Department at Idaho State University developed a VDH educational program to deliver preventive and therapeutic care at an assisted-living (AL) facility for memory care residents. The purpose of the educational program was to design and implement a VDH model for AL residents, and subsequently to evaluate the effectiveness of the educational program through students' knowledge, clinical confidence, and perspectives.

METHODS AND RESULTS

Senior dental hygiene students (n = 32) completed didactic, laboratory, and clinical experiences on implementing an VDH. Using a pretest/posttest design, data were collected using a self-generated questionnaire; validity and reliability of the questionnaire were established prior to administration. Likert data were analyzed (n = 22, 69%) using the Wilcoxon Signed Rank test and Bonferroni correction. The change in scores of all three variables was statistically significant. The educational program was effective for increasing knowledge, clinical confidence, and perspectives of the dental hygiene students.

CONCLUSION

Educational programs that include didactic, laboratory, and clinical experiences prepare graduates for using alternative care models, thereby, enhancing the potential to improve access to care for vulnerable populations in community settings.

Effect of a weekly functional independence measure scale on the recovery of patient with acute stroke: A retrospective study

ABSTRACT

Excessive assistance may decrease stroke patients' physical activity and make them more dependent on assistance. We have structured a system that provides an ADL (activities of daily living) educational program that focuses on stroke patients' toileting in our daily clinical practice. Here, we investigated the effect of a functional independence measure (FIM) scale on the recovery of patients with acute stroke.We retrospectively collected the data of 407 stroke patients from the medical record system of our emergency hospital in Tsukuba, Japan. The enrolled stroke patients (n = 373) were divided into FIM and control groups. Both groups received the standard treatment, but for the FIM group, ward and rehabilitation staff calculated the toilet FIM score for patients 1 ×/wk. The FIM scale measures the amount of assistance a patient needs to perform activities of daily living and is often used in rehabilitation settings. The rehabilitation staff then instructed the ward staff about better assistance methods based on each patient's physical function and executive dysfunction. We evaluated the usefulness of the FIM scale was based on the patients' FIM scores at discharge and improvements in their scores.The recoveries of the total, motor, and cognitive FIM scores recovery at discharge were significantly greater in the FIM group compared with the control group (68.0 vs 45.0, P = .004; 41.0 vs 24.0, P = .005; and 24.0 vs 20.0, P = .007, respectively). The use of the FIM scale contributes to the patients' recovery of physical function and cognitive function.The FIM scale can contribute to stroke patients' recovery of activities of daily living.

Evaluating Long-Term Outcomes of a High School-Based Impaired and Distracted Driving Prevention Program

Motor vehicle crashes are one of the leading causes of death among teenagers. Many of these deaths are due to preventable causes, including impaired and distracted driving. You Drink, You Drive, You Lose (YDYDYL) is a prevention program to educate high school students about the consequences of impaired and distracted driving. YDYDYL was conducted at a public high school in Southern Nevada in March 2020. A secondary data analysis was conducted to compare knowledge and attitudes of previous participants with first-time participants. Independent-samples-t test and χ2 test/Fisher’s exact test with post-contingency analysis were used to compare pre-event responses between students who had attended the program one year prior and students who had not. Significance was set at p < 0.05. A total of 349 students participated in the survey and were included for analysis; 177 had attended the program previously (50.7%) and 172 had not (49.3%). The mean age of previous participants and first-time participants was 16.2 (SD ± 1.06 years) and 14.9 (SD ± 0.92 years), respectively. Statistically significant differences in several self-reported baseline behaviors and attitudinal responses were found between the two groups; for example, 47.4% of previous participants compared to 29.4% of first-time participants disagreed that reading text messages only at a stop light was acceptable. Students were also asked how likely they were to intervene if a friend or family member was practicing unsafe driving behaviors; responses were similar between the two groups. The baseline behaviors and attitudes of participants regarding impaired and distracted driving were more protective among previous participants compared to first-time participants, suggesting the program results in long-term positive changes in behaviors and attitudes. The results of this secondary retrospective study may be useful for informing the implementation of future impaired and distracted driving prevention programs.

A Continuing Educational Program Supporting Health Professionals to Manage Grief and Loss

Health professionals working in oncology face the challenge of a stressful work environment along with impacts of providing care to those suffering from a life-threatening illness and encountering high levels of patient loss. Longitudinal exposure to loss and suffering can lead to grief, which over time can lead to the development of compassion fatigue (CF). Prevalence rates of CF are significant, yet health professionals have little knowledge on the topic. A six-week continuing education program aimed to provide information on CF and support in managing grief and loss and consisted of virtual sessions, case-based learning, and an online community of practice. Content included personal, health system, and team-related risk factors; protective variables associated with CF; grief models; and strategies to help manage grief and loss and to mitigate against CF. Participants also developed personal plans. Pre- and post-course evaluations assessed confidence, knowledge, and overall satisfaction. A total of 189 health professionals completed the program (90% nurses). Reported patient loss was high (58.8% > 10 deaths annually; 12.2% > 50). Improvements in confidence and knowledge across several domains (p < 0.05) related to managing grief and loss were observed, including use of grief assessment tools, risk factors for CF, and strategies to mitigate against CF. Satisfaction level post-program was high. An educational program aiming to improve knowledge of CF and management of grief and loss demonstrated benefit.

Do Patients and Relatives Have Different Dispositions When Challenging Healthcare Professionals About Patient Safety? Results Before and After an Educational Program

BACKGROUND

There is a universal interest in evaluating the new roles of patients to improve patient safety. However, relatively little is known about the contribution of family caregivers. The purposes of this study was to determine whether patients and relatives (P&Rs) have different dispositions when challenging healthcare professionals about patient safety and to measure the influence of an educational program.

METHODS

An interventional before-and-after design was used to determine the P&Rs' basal level of willingness and the influence of a training program. One hundred thirty-six participants were recruited, 90 patients and 46 relatives, from the Day Hospital of a Tertiary Hospital in Spain, in 2018.The safe practices selected were as follows: patient identification, hand hygiene, blood or chemotherapy identification, and secondary effects of treatment. The educational materials comprised brochures and story-type videos. A questionnaire measured participants' willingness to speak up before and after the training.

RESULTS

One hundred thirty-six P&Rs (63% response rate) agreed to participate. The hypothesis that relatives are more willing to challenge healthcare professionals could not be proven. Their willingness to speak up depended on the type of safe practice both before and after training, ranging from 42% to 87%. The percentage of items that P&Rs were willing to challenge increased after the training among both the patients and the relatives, but statically significant differences were only seen among patients.

CONCLUSIONS

After the training, participants' willingness to challenge healthcare workers was high for all safe practices analyzed but hand hygiene. Patients and relatives had very similar willingness. After the training, participants felt confident with their knowledge about safe practices, thereby increasing their challenging attitude.

Consensus on the Objectives of an Educational Intervention for Patients with Oropharyngeal Dysphagia and Their Informal Caregivers: A Delphi Study

PURPOSE

In the absence of literature allowing for an evidence-based approach to therapeutic patient education (TPE) in Oropharyngeal Dysphagia (OD), this study aims to reach a consensus of experts on the content of a competency framework of an educational program for OD patients and their informal caregivers (ICGs).

METHODS

We used the Delphi consensus-building method. Four categories of experts were recruited: 12 patients, 17 ICGs, 46 healthcare professionals (HCP) (experienced in OD, not necessarily certified in TPE), and 19 experts in TPE (trained individuals to set up and run TPE programs not necessarily HCPs). The content of the questionnaire of the first round (R) was established according to the result of a scoping review and the opinion of an expert committee. We carried out three rounds. In R1 and R2, we collected the opinions on the relevance (7-point Likert-type scale) and on comprehensiveness (YES/No question and asking participants to propose additional content). Participants were also invited to leave comments on each objective. In R3, we asked the participants to give their opinion about the relevance of the objectives again and asked them to rank the themes from highest to lowest priority.

RESULTS

Objectives were considered relevant for all participants if they reached consensus when the interquartile (IQR) ≤ 1, and if the median indicated agreement (Mdn ≥ 6) (6= appropriate, 7 = totally appropriate). Following three rounds, the final content of the educational program is composed of 23 educational objectives organized in 13 themes with an agreement about relevance amongst all participants (Mdn ≥ 6; IQR ≤ 1). The comprehensiveness criterion received also a consensus (IQR ≤ 1). The participants ranked the theme "normal swallowing vs difficulty swallowing" as the highest priority.

CONCLUSION

This Delphi study resulted in a consensus, on the content of a competency framework of an educational program for OD patients and their ICGs. Further steps are needed to construct learning activities based on these objectives before testing their feasibility and efficacy.

Management of Hypothyroidism in Internal Medicine: Patient Profile and Effects of an Educational Programme in the Cluster-Randomized FADOI TIAMO Study

BACKGROUND AND AIMS

There is still limited knowledge regarding the clinical profile and appropriateness of treatment in patients with hypothyroidism hospitalized in Internal Medicine (IM) Departments in Italy. The aim of this study is to evaluate: 1) the characteristics of patients and possible deviations from national and international clinical practice recommendations (CPRs) in evidence-based guidelines (EBGs); 2) the improvement of patient management by means of a standardized educational programme (EP).

METHODS

A nationwide multicentre study, comprising two replications of a retrospective survey (phases 1 and 3) with an intervening EP (phase 2) in half of the centres and no EP in the other half, was conducted. The EP was based on outreach visits. Centres were assigned to the two arms of the study, labelled the training group (TG) and control group (CG) respectively, by cluster randomization. Four EBGs and 39 CPRs provided the basis on which 22 treatment management indicators were identified (7 referring to the time of hospital admission, 15 to post-admission).

RESULTS

The 21 participating centres recruited 587 hospitalized patients with hypothyroidism, 421 of which were females (71.7%, mean age 74.1 + 14.4 yrs): 318 in phase 1 and 269 in phase 3. The cause of hypothyroidism was unknown in 282 patients (48%). Evaluation at the time of admission identified satisfactory adherence to CPRs (>50%) for 63.6% of the indicators. In the phase 3, TG centres showed significant improvement vs CG in 4 of the 15 post-admission indicators, while 1 out of 15 was significantly worse.

CONCLUSIONS

The EP based on outreach visits significantly improved some indicators in the management of patients with hypothyroidism, with specific reference to appropriateness of TSH dosage and levothyroxine (LT4) treatment modality.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, identifier NCT05314790.

Educational Program Using Robots for Preventing Cognitive Decline of Elderly Persons

An expected surge of dementia patients in Japan indicates a pressing need to establish countermeasures. As described herein, by developing an educational program for elderly people using robots, we performed a demonstration experiment. Results revealed that involvement of elderly people with robots enhances their enjoyment, indicating a future direction of cognitive decline prevention education for elderly people.

Public health nurse education in the Nordic countries

BACKGROUND

Higher education should promote critical reflection and guide students towards international activities. In the Nordic countries public health nurse educational programmes are mostly based on guidelines issued by national educational authorities, which describe students' learning outcomes.

AIM

The aim of this paper is twofold: to give an overview of public health nurse education and service in the Nordic countries and thereby discuss opportunities for collaboration within the programmes.

DATA SOURCES AND COMPILATION OF DATA

National legislations for public health nurse education and services are used as data. Since all sources are written in the language of each country, all the authors wrote the parts that describe each countries conditions in English and contributed to the compilation of data.

RESULTS

We found both similarities and differences in public health nurse education and services. Opportunities for collaboration between the programmes are discussed.

CONCLUSION

Critical reflection by the public health nurse students can be enhanced by arranging collaboration projects, an exchange of clinical placement, and joint master projects. Collaboration among academic staff within the educational programmes, in education and research, have the potential to enhance quality both within public health nurse education and in developing the profession of public health nursing.

Decreasing the incidence of anal sphincter tears in instrumental delivery in Hudiksvall, Sweden

PURPOSE

The primary aim of this study was to observe the change in obstetric anal sphincter tear rates in instrumental deliveries during one decade. Secondly, the changes in non-instrumental deliveries were followed.

METHODS

Data from all deliveries at Hudiksvall Hospital, Sweden 2010-2011 and 2016-2017 were collected. The change of OASIS rate during instrumental deliveries was the most important. Statistical significances were calculated by using chi-square test, test for relative proportions, and Students t-test, where appropriate.

RESULTS

The total incidence of OASIS decreased significantly (from 2.54% to 0.73%, p < .001). Even the OASIS rate in instrumental deliveries decreased substantially from 15.1% to 3.0% (p = .002) but the decrease was statistically insignificant in spontaneous deliveries (from 1.22% to 0.60%, p = .065).

CONCLUSION

Based on the results of our study the manual protection of the perineum reduces the risk of OASIS in instrumental delivery significantly.

Delay in seeking medical care after the onset of symptoms in patients with sight-threatening diabetic retinopathy

Objective

To investigate the reasons for delays in seeking medical care in patients with diabetic retinopathy and associated risk factors.

Methods

We retrospectively reviewed data for patients with sight-threatening diabetic retinopathy (STDR) who attended a hospital in China. Various forms of STDR were identified, including severe non-proliferative DR, clinically significant macular edema and proliferative DR. Demographic, clinical and socioeconomic information was collected and the associated risk factors were evaluated.

Results

Of the 127 patients with STDR, 89.2% sought medical care within 1 month of developing symptoms. Those who sought treatment ≥6 months after symptoms developed had significantly lower income and less knowledge of diabetic complications than those who attended earlier. Multivariate logistic regression analysis showed that no or infrequent routine examination for diabetic complications were associated with long delays in seeking medical care (odds ratio (OR) 3.06, 95% confidence interval (CI) 1.05–9.19; and OR 2.91, 95% CI 1.04–8.40, respectively).

Conclusions

Most patients with STDR sought medical care within 1 month of symptoms developing, but no or infrequent routine examination for diabetic complications was associated with long delays. These results stress the importance of educational programs regarding diabetic complications to encourage timely medical care and prevent poor outcomes.

Burden of an educational program on end of life management in a Internal Medicine ward: a real life report

Background and aim

Appropriate end of life (EOL) management in Internal Medicine wards is challanging. The aim of this study was to analyze the burden of an educational program on EOL management in a Internal Medicine ward. Materials and methods: We retrospectively analysed characteristics and management of patients consecutively died in an italian Internal Medicine ward along one year. We compared demographic, co-morbidity, pharmacological treatment in the last 48-hours of life and procedures during hospital stay in patients died six months before and after an educational program on palliative cares and EOL management addressed to a team of physicians and nurses.

Results

Study population was composed by 354 patients (190 females), with mean age ± DS 83.5 ± 10.6 years, one half admitted after the educational program. Eighty-four percent of deaths was exepected in the last 48 hours before exitus. Demographic characteristics and causes of hospitalization were not different before and after educational program. After the educational program the sharing of palliative care program with patient, relatives and/or caregivers (97.7% vs 85.8%, p=0.0001) and written order to withdrawal vital parameters relevation (39.5% vs 22%, p=0.0005) significantly increased, while difference in pharmacological classes prescribed in the last 48 hours of life was not find. Blood (54.8% vs 67.2%, p=0.0219) and arterial gas analysis (28.8% vs 39.5%, p=0.0435) samples in the last 48 hours of life were significantly reduced. Radiological and/or endoscopic examinations, red cells or platelets transfusion were reduced and palliative therapy was increased, despite difference between the two periods was not statistically significant.

Conclusion

Educational program in Internal Medicine wards aimed to improve skills could contribute to make EOL management more appropriate and patient-oriented and it should be strongly encour-aged.

Multi-source evaluation of an educational program aimed at medical students for interviewing/taking the clinical history using standardized patients

Introduction: Simulations with standardized patients (SP) have long been used for teaching/assessing communication skills. The present study describes and evaluates an experiential training methodology aimed at medical students and based on interviews with standardized simulated patients. The training was focused on developing basic communication skills and taking medical histories. Methods: Longitudinal observational study of a cohort of third-year medical students. Three interviews with SP were carried out and videotaped. These interviews were assessed by the students, the SPs and the professors of the relevant subject areas. Results: 83 students conducted the interviews. The self-evaluations performed by the students showed an improvement between the first and third interviews, as demonstrated by the increase of 6.7% (CI 95%=3.6-10.0%) (p<0.001) in the percentage of detected items. The SPs stated an improvement of 8.5% (CI 95%=2.9-14.1) (p=0.003) from the first to the third interview regarding the percentage of students that showed a level of interest in, and ease with, the patients' concerns. Finally, the teachers found a mean percentage of items identified in the third written clinical history of 61.4% (CI 95%=59.1-63.7) of the total available. Conclusions: This educational program, carried out with standardized simulated patients, showed positive signs of improvement from the first to the third interview, in both the student self-evaluations and the level of interest and ease perceived by the SPs. Additionally, the mean level of information recorded in the written medical histories was considered to be acceptable.

Evaluation of knowledge and competency among nurses after a brief suicide prevention educational program: A pilot study

Background

Suicide is major public health issue worldwide. The educational interventions in enhancing the knowledge, modifying the attitudes, and raising the competence levels of healthcare professionals to prevent suicides have shown positive results. However, these education programs are under-evaluated, especially in India.

Aim

The aim was to evaluate the effect on suicide prevention and management-related knowledge among nursing staff, attitudes, and competence for suicidal patients and their family members.

Methods

A brief suicide educational intervention training program was prepared for the study participants. The outcomes of this study were evaluated through a single group pre-test-post-test questionnaire.

Result

The mean age of the participants was 28.74 ± 5.73 years. Participants reported significant improvement in their attitude and knowledge about suicide after attending the training program.

Conclusion

Empowering primary health care staff including nurses to identify, assess, manage, and refer the suicidal person should be considered as an important step in suicide prevention.

Impact of a Postoperative Intervention Educational Program on the Quality of Life of Patients with Hip Fracture: A Randomized, Open-Label Controlled Trial

The objective of this study was to determine the impact of a postoperative educational intervention program on the health-related quality of life (HRQoL) of patients with hip fracture using a controlled clinical trial in a randomized, multicenter study. In total, 102 patients (45.5%) from trauma units at the two University Hospitals of the province of Cáceres received the educational program, whereas 122 (54.5%) did not. Patients were consecutively included in either an intervention or a control group. Patients from the intervention group received an educational program during admission and the postoperative period. Patients from the control group did not receive any educational program. These patients were managed according to routine protocols. The patients were predominantly female (76.3%), aged 84.6 years (SD 6.1). All dimensions in both groups at 12 months showed a significant decrease with respect to baseline, except for bodily pain in both groups (p = 0.447; p = 0.827) and social functioning in the intervention group (p = 0.268). Patients receiving the educational program showed higher levels in the dimensions of the Mental Component Summary (MCS-12) (p = 0.043), vitality (p = 0.010), and social functioning (p < 0.001), as well as in the dimensions of the SF-12 health survey questionnaire of HRQoL 12 months after surgery. In conclusion, our study of the intervention group showed that there were significant improvements in MCS-12, vitality, and social function dimensions compared to the control group.

Effect of an Ergonomics Educational Program on Musculoskeletal Disorders in Nursing Staff Working in the Operating Room: A Quasi-Randomized Controlled Clinical Trial

Background: Nursing staff working in the operating room are exposed to risk factors that can cause musculoskeletal disorders (MSDs) and work-related disabilities. The use of ergonomics principles can help with the prevention of MSDs. This study aimed to examine the effect of an ergonomics educational program on MSDs among nursing staff working in the operating room. Methods: In this pragmatic parallel group quasi-randomized controlled clinical trial, 74 nursing staff working in the operating rooms of two teaching hospitals participated. The hospitals were randomly assigned to either the intervention or the control group and all nursing staff working in the operating room of each hospital were invited to take part in this research. They were initially assessed for the prevalence and risk of MSDs by using the Nordic questionnaire and the rapid entire body assessment (REBA) checklist. The intervention group received the ergonomics educational program and were assessed in two-week intervals over a period of three months. At the end of the study, the risk and prevalence of MSDs were compared between the intervention and control groups. Results: Statistically significant differences were reported between the groups in terms of the prevalence and risk of MSDs. The overall risk of MSDs decreased in the intervention group after the educational program (p = 0.03). The reduction in the prevalence of MSDs in the different parts of the body in the intervention group was as follows: ankle (p = 0.005), hand/wrist (p = 0.041), low back (p = 0.000), the neck (p = 0.003), hip (p = 0.001) and shoulder (p = 0.043). Conclusion: The education of nursing staff about ergonomics can influence the prevalence and risk of MSDs. Therefore, it should be incorporated into the degree education and on-the-job training initiatives for nurses working in the operating theatre in order to reduce workplace injuries and associated absences, and increase the quality of care delivered by them. This clinical trial has been registered in the Iranian Registry of Clinical Trials: IRCT2015081823677N1.

Development and Evaluation of an Educational Program for Community Pharmacists on Cardiovascular Risk Assessment

Purpose

Cardiovascular disease (CVD) risk assessment is an important strategy for the prevention of CVD. Pharmacists play an important role in CVD risk assessment and management (CVDRAM). Our previous study identified gaps in knowledge among community pharmacists for the provision of CVDRAM services as assessed through patient simulation. Therefore, our objectives were: a) to develop and evaluate an educational program on CVD risk assessment for community pharmacists, b) to assess the knowledge and skills of participating pharmacists in assessing and managing CVD risk before and after enrolling in the educational program and c) to explore pharmacists’ satisfaction and perceived effectiveness of the educational program.

Methods

Using a blended learning instructional approach, the educational program for a subset of 25 community pharmacists recruited from our previous study consisted of two face-to-face workshops, and an online 5-module course on CVD risk factors such as hyperlipidemia, hypertension, diabetes, obesity, and smoking cessation based on principles of adult learning. A repeated measures study design was utilized by measuring participants’ knowledge on pre- and post-questionnaires and an objective structured clinical examination (OSCE) at the conclusion of the educational program was also used to assess its impact on the knowledge and skills of community pharmacists in the provision of CVD risk assessment and management (CVDRAM) services. The knowledge questionnaire was completed by 23 pharmacists while the OSCE was completed by 8 pharmacists. In addition, a survey assessed the pharmacists’ level of satisfaction with the educational program.

Results

At the conclusion of the educational program, the participating pharmacists achieved knowledge and skills for the provision of CVDRAM services. Knowledge scores in relation to CVDRAM significantly improved after the educational program [out of a maximum of 20 points, the median (interquartile range) = 9 (7–9) at pre- vs 12 (12–13) at post-educational program], p<0.001. On the OSCE, the median (interquartile range) scores for Stations 1 and 2 were 66 (63–71) and 71 (67–76), respectively. Out of the 21 pharmacists that completed the satisfaction survey, 71% were very satisfied and 29% were satisfied with the educational program.

Conclusion

The educational program improved pharmacists’ knowledge and skills for the provision of CVDRAM services.

Building Capacity for Caregiver Education in Yap, Micronesia

The US Affiliated Pacific Islands have an urgent need for family caregiver education to prevent caregiver burnout and strengthen the existing culture where seniors are cared for at home by their families. The Pacific Islands Geriatric Education Center conducted a 32-hour family caregiver train-thetrainer workshop in partnership with the Yap Department of Health Services and the Yap Area Health Education Center (AHEC) from October 16 - 20, 2017. Twenty-seven participants including community health workers, peer educators, health assistants, nurses, and physicians were trained as instructors. Confidence in caregiving increased following the training and feedback was extremely positive. Competence in geriatric syndromes was improved after attending the workshop (P < .001). Lessons from the field revealed an immense value of adding home visits to the training practicum as well as the need to translate caregiving handouts into the outer island languages. Yap AHEC is committed to offering this course as part of caregiver education at the hospital and in the community.

Developing and Evaluating an Educational Program for Respiratory Infection Prevention among Rural Elderly Residents in South Korea

Based on social cognitive theory (SCT), an educational program was developed to prevent rural elderly residents from respiratory infections in South Korea. The effectiveness of the program was investigated in terms of knowledge, attitudes, and practices about respiratory infection prevention, as well as social capital. A pretest–posttest nonequivalent control group quasi-experimental design was used to test the short-term effect of this program. In addition, 1- and 6-month follow-up surveys were administered to evaluate the long-term effects. A total of 69 subjects (37 in the experimental group and 32 in the control group) participated in the experiment. The results showed that knowledge about respiratory infection prevention, respiratory infection prevention practices, and social capital were enhanced among the elderly residents who participated in the educational program. The educational effects differed significantly across time periods (pretest, posttest, 1- and 6-month follow up) in all the above variables. In particular, the program remained effective 1 month after the intervention, but a reinforcement session extended the program’s effects up to 6 months later. This educational program would be used as an effective intervention to help rural elderly residents prevent respiratory infections.

Broadening and Strengthening Underrepresented Group Inclusion in Immunological Research

Promoting diversity across biomedical fields is crucial for building comprehensive and innovative research programs, as well as providing trainees from underrepresented groups (URGs) the ability to establish agency and develop skills in a culturally and structurally supportive environment. Despite this awareness, there is still a lack of students from URGs being trained for independent research careers. The Immunology, Microbiology, and Virology (IMV) graduate program at the University of Rochester School of Medicine and Dentistry (URSMD) has been working for the last 13 years to increase diversity through an NIH funded Post-baccalaureate Research Education Program (PREP). Historically, our program has trained URG scholars in Immunology, but as we have progressed we have embraced the understanding that both the scholars and the institution benefit from expanding the interdisciplinary nature of our program. Over the last 3 years, we have integrated a broader and highly collaborative faculty mentor pool, including representation from Immunology, Microbiology, Virology, Neuroscience, Genetics, Biochemistry, Biophysics, Toxicology, and Biomedical Engineering. This expansion, coupled with changes in our education program, including skill building workshops and cross campus integration with our student diversity groups and the Office of Diversity and Inclusion, has strengthened the competitiveness and success of our cohorts. These improvements are enhancing the diversity of our graduate school, creating a research environment that retains students from URGs in biomedical research. We attribute our success to the interdisciplinary and team-building nature of our pipeline program, as well as the URSMD's initiatives to be a more inclusive and equitable institution.