A Scoping Review of Educator Proficiency Interventions in Pharmacy Education Illustrated by an Interdisciplinary Model Integrating Pedagogical Theories into Practice

Pharmacy schools recognize the need for flexibility and comprehensive curricular transformation with a competency-based focus to effectively prepare for the evolving practitioner competencies and challenges of the pharmacy profession. The curricular implementation of evidence-based teaching and learning theories and practices demands educator proficiency through skills development with indispensable faculty leadership support. Our scoping review of online databases and pharmacy education-related journals aims to identify faculty development interventions or teaching proficiency programs that integrate educational and pedagogical theories. Original studies and reviews published between 2010 and 2022 were screened based on four inclusion criteria. Thirty-four manuscripts were eligible for full-text analysis, of which seven results referenced target faculty pedagogy knowledge development. Nine key messages, as Results Statements, synthesize and provide a framework for our results analysis. An ongoing Hungarian intervention model of comprehensive faculty development with strong interdisciplinary cooperation is discussed in our study to illustrate the applicability of the Results Statements through each stage of the process. Educator motivation and relatedness to students or awareness of the educator roles are intrinsic factors, which may not be easily detectable yet significantly impact teaching proficiency and student learning outcomes. The integration of evidence-based pedagogical knowledge and training in educator proficiency development contributes to the sustainability and cost-effectiveness of faculty interventions.

Immune Thrombocytopenia Purpura Associated With COVID-19 Infection: A Challenging Diagnosis and Management

The COVID-19 pandemic has posed unprecedented challenges in the field of medicine. Among its diverse manifestations, immune thrombocytopenia purpura (ITP) has emerged as a complication associated with COVID-19 infection. This case report presents a 90-year-old Caucasian male with a history of COVID-19 infection who developed acute hemoptysis, thrombocytopenia, and purpura. The diagnosis of ITP confirmed through exclusion criteria and clinical evaluation, occurred several weeks after the initial COVID-19 diagnosis. Differential diagnoses, including drug-induced thrombocytopenia, were carefully considered and excluded. The reported case highlights the importance of vigilance in identifying ITP as a potential complication of COVID-19 infection, even in the post-infection period. The timely initiation of appropriate treatment proved effective in managing the patient's condition. Collaboration among medical specialties facilitated comprehensive patient care, thereby reducing hospitalization periods. This case report serves as a crucial alert to physicians, underlining the need for ongoing monitoring of COVID-19 complications, especially as testing dwindles. By fostering interdisciplinary cooperation, healthcare professionals can optimize patient outcomes and effectively manage the multifaceted challenges associated with COVID-19 infection.

Implementing an Interdisciplinary Procedure Curriculum

INTRODUCTION

This curriculum was designed to improve access to procedures for our internal medicine residents.

METHODS

We created an interdisciplinary procedure course (IDPC) composed of two simulation sessions and a one-week procedural rotation supervised by multiple specialties including nephrology, cardiology, cardiothoracic anesthesiology, general anesthesiology, and interventional radiology. After the course, residents completed two surveys documenting the number of procedures and their level of confidence on a Likert scale (1 = very unconfident to 5 = very confident) prior to and after completing the curriculum.

RESULTS

Sixteen residents participated in the course from September 2021 to June 2022. The collective number of procedures performed by these 16 residents increased from 176 to 343 after a one-week rotation. For arterial lines, the proportion of residents that reported an improvement in confidence scores was 0.44 (95% confidence interval 0.23 to 1, p-value of 0.60). The proportion of residents that had an increase in their confidence performing central lines was 0.63 (95% confidence interval 0.39 to 1, p-value of 0.23). For intubations, the proportion of residents that reported an improvement in confidence was 0.94 (95% confidence interval 0.72 to 1, p-value of 0.0006).

CONCLUSION

By collaborating with multiple specialties, residents almost doubled the number of procedures performed during training and reported an increased level of confidence in procedural performance for airway intubation. We learned residents want to improve their access to procedures and described a curriculum that was easily implemented.

Exploring Nursing Students' Learning Experiences in Improving Their Health Information Technology Competency in Interdisciplinary Cooperation: An Innovative Pilot Study

This study aims to explore nursing students' learning experiences in improving their health information technology competency in interdisciplinary cooperation. Through the nursing student training for designing thinking focused on smart health, we revealed the profound learning experience through interdisciplinary cooperation as well as the practice of problem solving, not only strengthens the students' health information technology competency, but ignites their creative thinking and creativity, altogether enhances their competitiveness in health care industry.

Standardized, Coordinated Care in Nursing Homes Lowers Rehospitalization After Hip Fracture

OBJECTIVES

To assess the effect of enhanced standardized interdisciplinary cooperation between the orthogeriatric ward, municipality, and nursing home facility (NHF) on readmission rates in patients with hip fracture.

DESIGN

Quasi-experimental design with a nonequivalent control group.

SETTING AND PARTICIPANTS

From January 2018 to July 2020, patients with hip fracture who were admitted to the department of orthopedic surgery and traumatology at Lillebaelt Hospital, and later discharged to NHF were included.

INTERVENTION

The intervention consisted of a safety program to the NHF for the first 14 days postdischarge and included assessment of vital signs, weight, pain, signs of constipation, hours of mobilization, and daily intake of fluids and high-protein beverages. Acute team nurses undertook visits (planned and unplanned) and could take blood samples and administer intravenous fluids or antibiotics at the NHF. Control participants received usual care.

METHODS

The intervention was performed in 2 municipalities with an acute team; the remaining 3 municipalities comprised the control group. The primary outcome was 30-day readmission, and secondary outcomes were mortality, mobility, and quality of life.

RESULTS

There were 100 patients in the intervention group and 152 in the control group. The median age was 86 years, 68% were female, and more than 60% had a low mental score; there were no statistical differences between groups in baseline variables. The 30-day readmission rate was 14% in the intervention group and 30% in the control group (P = .004). The 30-day mortality rate was 6% in the intervention group and 13% in the control group (P = .07). There was no statistically significant difference in mobility between the 2 groups but there was a higher health-related quality of life score in the intervention group (P = .045).

CONCLUSIONS AND IMPLICATIONS

Enhanced standardized interdisciplinary cooperation between hospital, NHF teams, and visiting acute team nurses can lower readmissions and potentially mortality.

Case Report of a 23-year-old first gravida presenting with breathlessness and oxygen saturation of 80

Central principles are interdisciplinary teamwork and keeping the ratio between pulmonary vascular resistance (PVR) and systemic vascular resistance (SVR) balanced to avoid vicious circle with right heart failure and hypoxia.

New Scopes for Practice - Interdisciplinary Webinars for Emergency Medicine and Biomedical Informatics - Health Informatics

This paper presents the early outcomes of the educational cooperation between two European academic associations, namely the European Federation of Medical Informatics (EFMI) and European Society of Emergency Medicine (EUSEM). Two webinars were organized in December 2019 and June 2020 to explore areas where mutual education would be beneficial for interdisciplinary cooperation to advance the digitization of emergency departments for the benefit of patients, health professionals and the health system as a whole. Preliminary findings from the analysis of these two webinars are presented and the steps for further cooperation are outlined.

Benefits of medication charts provided at transitions of care: a narrative systematic review

OBJECTIVES

Particularly at transitions of care points information concerning current medication tends to be incomplete. A medication chart that contains all essential information on current therapy is likely to be a helpful tool for patients and healthcare providers. We aimed to investigate any type of benefits associated with medication charts provided at transition points.

METHODS

A systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. Two databases, two online journals and two association websites dedicated to biomedicine and pharmacy issues were consulted to identify studies for the review using the search term 'medication chart' and synonyms. We run our search from database inception up to March 2019. Studies of any study design, intervention and population which examined the effect of paper-based medication charts were included. We extracted study results narratively and coded and classified them by themes and categories inductively by using the 'framework method' with content analysis. The methodological quality of the studies was assessed using the Effective Public Health Practice Project (EPHPP) tool.

RESULTS

From the 846 retrieved articles, 30 studies met the inclusion criteria, mostly from Germany (18 studies) and the USA (5 studies). Thirteen studies reported a statistically significant result. In the 'patient theme', the most obvious benefits were an increase in medication knowledge, a reduction of medication errors and higher medication adherence. In the 'interdisciplinary theme', a medication chart represented a helpful tool to increase communication and inter-sectoral cooperation between healthcare providers. In the 'theme of terms and conditions', accuracy and currency of data are prerequisites for any positive effect. The quality of the studies was classified predominantly weak mainly due to unmet good quality criteria (no randomised controlled trials study design, no reported dropouts).

CONCLUSION

Overall, the reviewed studies suggested some benefits when using medication charts. Healthcare providers could consider using medication charts in their counselling practice. However, it is unknown whether the reported benefits lead to measurable improvement in clinical outcomes. PROSPERO REGISTRATION NUMBER.

The impact of pre-round meetings on quality of care: A qualitative study

Aim

This study's aim was to improve our understanding of the impact of pre-round meetings before ward rounds on hospital wards.

Design

Qualitative study.

Method

Focus group interviews were conducted with nurses and doctors.

Results

Participants reported that pre-round meetings provide opportunities for interdisciplinary cooperation and have a positive impact on the quality of treatment and care. These meetings offer a forum for health professionals to develop a shared understanding and to convey congruent information to the patient. However, there may be reasons for omitting the pre-round meetings before ward rounds on wards with acute admissions and high patient turnover. Continuity of those attending the meetings and attendance by consultants are needed for timely decision-making and hence, successful pre-round meetings. If health trusts establish systems promoting successful pre-round meetings, the quality of treatment received by patients has potential for improvement.

Obstacles and problems in global elimination of viral hepatitis C

The global elimination of viral hepatitis C (HCV) infection according to WHO plan 2016 is conditioned by controlling the HCV epidemic among people who inject drug (PWID). This high-risk subpopulation has no interest in prevention, diagnostic or treatment of HCV infection. The problem is not only the lack of interest in changing their behaviour pattern, but also inability of health care professionals to conduct efficient assistance to PWID. The key to any successful intervention or treatment is to master the communication with problem patients. Providing efficient care of PWID with HCV is the most important step to successful HCV elimination.

Postoperative Risk Factors and Outcome of Patients With Liver Transplantation Who Were Admitted to Pediatric Intensive Care Unit: A 10-Year Single-Center Review in China

INTRODUCTION

The aim of this study was to present our 10-year experience of pediatric intensive care unit (PICU) management with pediatric liver recipients and to understand the importance of close interdisciplinary cooperation in 2 hospitals.

METHODS

A retrospective chart review study was performed according to our hospital's medical records and the pediatric liver transplant database of Renji hospital.

RESULTS

A total of 767 patients received liver transplantation (LT) performed in Renji hospital between October 2006 and December 2016, of which 97 of them were admitted to PICU in our center for various complications developed after transplantation. 8.8% (16/208) and 14.4% (81/559) of patients were transferred to PICU in stages I and II, respectively, and was comparable in the 2 stages (P = .017). The majority of patients was late postoperative children (median 185 post-LT days) in stage I. More patients were transferred to PICU directly in stage II. PICU admitted more younger (median 8.2 months) and early postoperative patients in stage II. The median length of PICU stay was 11.0 (6.0-20.5) days. The median length of mechanical ventilation was 5.0 (0.0-12.0) days. The most frequent complications were pulmonary complications (52 [53.6%] patients), surgical complications (22 [22.7%] patients), sepsis (7 [7.2%]), and other miscellaneous complications (16 [16.5%] patients). The overall 28-day PICU mortality was 25.8% (n = 25) and 64.0% (n = 16) of the deaths happened in the early postoperative period. There was significant difference concerning mortality in children with surgical complications and medical problems (54.5% [12/22] vs 17.3% [13/75], P = .001). Multivariate analysis by regression showed that the pediatric risk of mortality III score was the only independent prognostic factor (P = .031).

CONCLUSIONS

Multiple complications occur in children with LT. Although challenging, interdisciplinary cooperation between different hospitals is an effective mean to enable children to maximize the benefit gained from LT in China.

Interdisciplinary cooperation for a maximum acceleration of availability of modern therapy for ischemic stroke for all patients in need of endovascular thrombectomy

Catheter-based (endovascular) thrombectomy is class I.A indication for the treatment of acute ischemic stroke. However, its availability in most countries is extremely low due to the lack of trained staff. Even the countries with best stroke services (e.g. Czech Republic) currently treat only one third of patients, who would be indicated to such therapy and in many countries the treatment simply is not available. It is estimated, that on the European level only 10% of the suitable patients are currently treated. This review manuscript is written by representatives of the three main specializations dealing with acute ischemic stroke treatment and prevention: a neurologist, a radiologist and a cardiologist. The aim is to demonstrate, that only close interdisciplinary cooperation may improve the outcomes of this devastating disease.

The differential diagnostic of pelvic pain at children

The low abdominal pain is one of the most common complaints of child patients. To establish the proper diagnosis might be often difficult. Due to their age children are not able to specify the intensity of pain, its localization, character and duration. Therefore, the final diagnosis is often based on the results of examinations by others specialists: (surgeons, oncologists, nephrologists, neurologists etc.; even doctors from branches that are not directly focused on the abdomen may contribute to set the proper diagnosis. Keywords: abdominal pain, pelvic pain, childhood, puberty, psychological aspects, interdisciplinary cooperation.

A call for Applied Knowledge and Lived Interdisciplinarity in the medical care of depressed employees: a cross-sectional survey with German occupational physicians and psychotherapists

OBJECTIVES

To identify approaches for an effective patient-centred care of depressed employees, we investigated occupational physicians' (OPs) and psychotherapists' (PTs) knowledge about job stressors on the development of depression, application of this knowledge, interdisciplinary cooperation and perceived barriers.

STUDY DESIGN

A cross-sectional online survey.

PARTICIPANTS

OPs (163; 48.5% male) and PTs (69; 43.5% male) providing complete data on the survey out of 257 OPs and 112 PTs who started the survey. There have been 458 (OPs) and 821 (PTs) initial clicks.

METHODS

Main outcome measures were the importance ratings of specific job stressors, the frequency of asking patients about those stressors, the need for interdisciplinary cooperation, as well as perceived barriers for cooperation. We performed multivariate analysis of variance, intraclass correlation coefficients (ICCs) and Spearman's rank-order correlations.

RESULTS

The achieved response rate for OPs was 56.1% and for PTs 13.6%. Both disciplines agreed on the importance of job stressors regarding depression (ICC=0.90; 95% CI: 0.54 to 0.98), but both ranked these factors differently from the current state of research. As to knowledge application, OPs showed positive associations between the importance of job stressors and the frequency of asking employees about them (eg, job insecurity (r_s=0.20, p=0.005)) and PTs for social stressors (eg, interpersonal conflicts (r_s=0.38, p=0.001)). OPs (mean=3.41) reported a higher necessity of interdisciplinary cooperation than PTs (mean=3.17; F(1,230)=7.02, p=0.009). Furthermore, cooperation was reported as difficult to implement. PTs perceived barriers (eg, time restriction) as more hindering (mean=3.2) than OPs (mean=2.8; F(1,171)=8.16, p=0.005).

CONCLUSIONS

Both disciplines are aware of the relevance of job stressors as risk factors for depression, but should be encouraged to ask employees more frequently about them. The need for interdisciplinary cooperation and possible barriers are discussed. It is crucial to emphasise the meaning of sufficient cooperation, since closing this gap for improving patient-centred care especially for employees suffering from depression is necessary.

[Increasing Complexity in Performance Delivery - Management Approach for Tertiary Care Centers]

Increasing Complexity in Performance Delivery - Management Approach for Tertiary Care Centers Abstract. General social trends such as individualization and female shift increase the complexity for management in both technical and system management in addition to the inherent development in the hospital industry such as subspecialization, ageing societies and multimorbidity. Reduction of complexity is therefore absolutely necessary in order to be able to manage in a patient-friendly way as a maximum care provider. Reducing complexity means resolving therapeutic conflicts. Essential tools for this are digitization, a comprehensive quality paradigm that includes patient experience, patient assessment of treatment outcomes, indication and service quality, and good management. The latter integrates the fragmentation of skills and knowledge of a subspecialized medicine through appropriate system design. This requires the appropriate functional strategies and a comprehensive process management competence that can transform the numerous interfaces into seams.

[School Attendance of Children with Mental Health Problems]

School Attendance of Children with Mental Health Problems School can support a child's resilience as well as be a risk to the child's mental health. However school is an indicator of social participation, an aspect that flourished especially in the debate about inclusion. In this paper assistance opportunities are being discussed that are established to support children with a psychological disease in school. Three of the different concepts of funding priorities for special educational needs in the German system will be presented: "Förderschwerpunkt emotionale und soziale Entwicklung" (special needs in emotional and social development), "besonderer Förderbedarf "(special needs) and "Schulbegleitung" (school assistants). Also, the conditions for students of schools in hospitals and clinics will be analyzed and the reintegration process back to home school will be considered. It becomes unequivocal that there is little data about special assistance opportunities and that law structures in the federal states of Germany differ from each other and are partly unclear. The involvement of the three systems school, child and youth welfare service and child and youth psychiatry demands solid structures of communication and cooperation and a common continuous work across systems' borders during the child's school years.

It is the Cooperation, Stupid!

The rise of aesthetics in medicine has resulted from society's acknowledgement of the importance of physical beauty. This has led to an emerging conflict between allied specialties. The author introduces the concept of "Aesthetic Socialism" according to which everyone should have an opportunity to enhance or restore the beauty where it is missing or when it is lost due to disease, trauma or ageing. However, there are multiple aspects of aesthetics, which can not be addressed by a single specialty, therefore author recommends interdisciplinary cooperation rather than conflict to achieve aesthetic socialism.

Interdisciplinary trauma management in an elderly patient, a case report

The current report reviews a case of mixed dental trauma consequent to a fall by an older patient. The patient’s teeth were forced out of alignment by the trauma and suffered pulpal necrosis. Treatment involved not only healing the acute injuries, but also attending to some subtle delayed problems that became apparent during treatment. Treatments involving endodontics, periodontics, orthodontics, and restorative dentistry were used to address all of the patient’s concerns. This insured that the traumatic occlusion was corrected, appropriate esthetics was restored and normal speech and function was regained. All signs of trauma were recognized, every treatment step was documented, and appropriate follow-up was provided throughout the recovery period.

Management of sterno-mediastinitis

With an incidence rate of 1-4%, mediastinitis following cardiac surgery is a rarely occurring complication, but may show a mortality rate of up to 50%. Risk factors for sternal instability are insulin-dependent diabetes mellitus, obesity, immunosuppressed state, chronic obstructive pulmonary disease, osteoporosis, history of radiation, renal failure, body height, smoking and nutritional state. The aim of this paper is to show an overview of this clinical picture, present the risk factors and elucidate the therapy options chronologically. As a result of interdisciplinary cooperation, a therapy concept has developed which is adapted to the patient individually. Therapy begins with the simplest measures and, if deemed necessary, this is then escalated step by step. The aim of the treatment is to bring the infection under control, which requires radical surgical debridement, removal of infected and necrotic tissue, removal of all foreign bodies (including wires and osteosynthesis material) and the removal of all infected, necrotic osseous material if necessary followed by vacuum-assisted closure therapy. The reconstruction of defects of the anterior chest wall is achievable using different muscle flaps. Mostly the muscle pectoralis major is used unilaterally or bilaterally with or without disinsertion of the tendon. Other options are the omental flap, the muscle latissimus dorsi flap or the muscle rectus abdominis flap. A combined approach comprising surgical debridement, short-term vacuum therapy and subsequent myoplastic coverage has proved successful and can be carried out with a high standard of safety.

Interdisciplinary cooperation of GPs in palliative care at home: a nationwide survey in The Netherlands

OBJECTIVE

To investigate the occurrence and predictors of interdisciplinary cooperation of GPs with other caregivers in palliative care at home.

DESIGN

In a prospective study among 96 general practices, the GPs involved identified all dying patients during the study period of 12 months. The GPs received an additional post-mortem questionnaire for each patient who died during the study period, and registered the healthcare providers with whom they cooperated. Multivariable logistic regression analysis was used to identify the predictors of GP cooperation with other caregivers.

SETTING

Second Dutch National Survey in General Practice.

SUBJECTS

A total of 743 patients who received palliative care according to their GP.

MAIN OUTCOME MEASURES

Interdisciplinary cooperation between GP and other healthcare providers.

RESULTS

During the study period, 2194 patients died. GPs returned 1771 (73%) of the questionnaires. According to the GPs, 743 (46%) of their patients received palliative care. In 98% of these palliative care patients, the GP cooperated with at least one other caregiver, with a mean number of four. Cooperation with informal caregivers (83%) was most prevalent, followed by cooperation with other GPs (71%) and district nurses (63%). The best predictors of cooperation between GPs and other caregivers were the patient's age, the underlying disease, and the importance of psychosocial care.

CONCLUSION

In palliative care patients, GP interdisciplinary cooperation with other caregivers is highly prevalent, especially with informal caregivers and other primary care collaborators. Cooperation is most prevalent in younger patients, patients with cancer as underlying disease, and if psychosocial care is important.