Methods to assess adults' learning styles and factors affecting learning in health education: A scoping review

How to master point-of-care ultrasound as an advanced paediatric nurse practitioner in critical care

Point-of-care ultrasound (POCUS) offers diagnostic insights, safety enhancements and increased procedural success in neonatal and paediatric care. However, POCUS use among Advanced Nurse Practitioners (ANPs) in the United Kingdom is limited. This study outlines a roadmap for ANPs to develop POCUS competence in Paediatric Critical Care (PCC), improving diagnostic efficiency, management and procedural success. POCUS integration in paediatric ANP roles enhances patient care. A structured training pathway and supportive team environment are crucial for skill acquisition. ANPs can potentially participate in POCUS-related quality improvement and research projects as well. ANPs are well positioned to deliver POCUS skilfully, and its integration into clinical practice can lead to improved patient outcomes and enhanced health care delivery.

Initiating an Insulin Safety Campaign to reduce the incidence of glycemic harm events for hospitalized adults 65 and older

BACKGROUND

During calendar years 2021 through 2023, our health system admitted 200,837 persons 18 years and older with diabetes, of which 61% (n = 123,393) were 65 years and older with orders for insulin administration. The incidence of diabetes among hospitalized persons 65 and older continues to increase in the United States, with 24 million adults 65 and older with diabetes reported in 2020. Insulin, a high-risk medication, has the potential for adverse drug events, which can cause significant harm to patients, potentially resulting in death. With the 2023 initiation of voluntary electronic clinical quality measures reporting for severe glycemic harm events from the Centers for Medicare Services, the study team saw an opportunity to evaluate and standardize insulin-related practices across the system.

METHODS

We implemented an Insulin Safety Campaign (ISC), to review, evaluate, and standardize insulin-related processes across our health system. The primary goal was to reduce severe glycemic harm events system-wide. Insulin-related practices were reviewed for best practice alignment and standardized. Outcomes were measured according to the Centers for Medicare and Medicaid Services' electronic clinical quality measures reporting guidelines.

RESULTS

Comparing pre-and post-implementation results, all five medical centers achieved statistically significant reductions in sever hyper- and hypoglycemic harm events.

CONCLUSIONS

Through a collaborative effort, we were able to identify, address, and reduce insulin-related process variabilities through standardization, reducing the percentage of severe glycemic harm events and improving blood glucose management in our hospitalized persons 65 and older.

Understanding the Determinants and Outcomes of Education in Pulmonary Rehabilitation: Moving Toward Person-Centered Care

TOPIC IMPORTANCE

Education and psychosocial support are essential components of pulmonary rehabilitation (PR). However, the delivery of education often follows a one-size-fits-all approach, with individual factors that influence learning rarely considered. Moreover, education-related outcomes are frequently overlooked in PR assessments, and their inconsistent use has limited our understanding of education's impact on people with chronic respiratory diseases. There is a clear need for practical guidance to identify key learning determinants and to define targeted education outcomes, ultimately optmizing PR and establishing quality standards.

REVIEW FINDINGS

Cognitive function, health literacy, psychological status, and social connection can influence an individual's ability to learn. Without proper consideration and assessment, these factors can otherwise become barriers to education and effective self-management. Education in PR should aim to: (1) improve individuals' knowledge to foster informed and active participants; (2) develop their skills to enable autonomy and competence; and (3) enhance their confidence to apply this knowledge and skills in daily life.

SUMMARY

This review emphasizes the importance of person-centered education in PR, provides a framework for understanding which education-related outcomes to target, and highlights the need for future research to enhance this essential component.

Educational needs of people with COPD or asthma entering pulmonary rehabilitation and their significant others: A cross-sectional study

Objectives: This study aimed to identify educational needs of people with COPD or asthma referred for pulmonary rehabilitation and their significant others. Methods: In this cross-sectional study, information needs were assessed by the Lung Information Needs Questionnaire. Learning styles were assessed with a multiple-choice question (visual, aural, read/write and kinaesthetic - multiple choices were possible). Psychological profiles were assessed by an instrument distinguishing four profiles: fighter, analyst, optimist or sensitive. Results: 121 patients (57% female; age: 65 ± 10 years; 81% COPD) and 67 significant others (55% female; age: 61 ± 12 years) were included. Patients and their significant others had a variety of information needs. Patients and their significant others mostly preferred the aural (39% and 49%, respectively) and read/write learning styles (31% and 36%, respectively) as unimodal learners. 49% of patients and 51% of significant others preferred more than one learning style. Most prevalent psychological profiles were optimist in patients (36%) and fighter in significant others (59%). Discussion: The identified variety in educational needs among people with COPD or asthma and their significant others underlines the importance of addressing this diversity of individual needs in education. Learners should have the opportunity to choose among a variety of topics and have access to multiple learning styles. Furthermore, educational interventions should consider to incorporate different communication strategies.

Education for people with serious chronic respiratory diseases and their informal caregivers: how to address challenges that impact learning

PURPOSE OF REVIEW

Shared decision making is crucial in palliative care for people with serious chronic respiratory diseases and their informal caregivers. Patient education is a critical component in this process, as it provides patients and their informal caregivers the necessary knowledge for informed decisions regarding symptom management, coping with breathlessness, and advance care planning. However, education does not automatically lead to acquiring knowledge. This review describes challenges for education for people with serious chronic respiratory diseases and their informal caregivers and describes how learner-centered education can address these.

RECENT FINDINGS

People with serious chronic respiratory diseases and their informal caregivers face diverse information needs and learning challenges, with low health literacy and cognitive problems being common. Healthcare professionals can facilitate learner-centered education by enhancing motivation for knowledge acquisition by meeting information needs and learning preferences of patients and their informal caregivers, and by ensuring that information is understandable and readable for those with low health literacy and cognitive problems. E-health applications may serve as valuable tools in this process.

SUMMARY

Learner-centered education may enhance knowledge acquisition in people with serious chronic respiratory diseases and their informal caregivers aiming to gain control over symptoms and optimize shared decision making and advance care planning.

What do patients want from a digital device that supports heart failure self-management?

OBJECTIVE

To assess patients' needs and the factors determining their acceptance of an e-Health intervention.

METHODS

Purposive sample of patients with heart failure, attending an outpatient consultation were invited to complete a questionnaire designed to assess their needs and acceptance of an e-Health intervention. Data analysis was performed using Chi-square tests with post-hoc corrections.

RESULTS

Response rate was 61 % (n = 101), with most patients (>70 %) indicating they could see themselves using an e-Health intervention to manage their heart failure. Participants with a healthy lifestyle (i.e., non-smoker and consumed alcohol < once/week) were more likely to have a positive attitude towards technology (p adj.=0.013). Those willing to use an e-Health intervention were convinced of its advantages by other patients with heart failure (p adj.=0.013). Advanced age, education level, employment or marital status did not influence patient attitudes toward health technology.

CONCLUSIONS & PRACTICE IMPLICATIONS

Results indicate patients have a positive attitude towards the use of e-Health interventions to enable their self-management of heart failure. These findings will inform further development and delivery strategies of e-Health interventions.

The Perception and Understanding of the Terminology Used to Describe Malnutrition From the Perspective of Patients and Health Workers: A Meta-Synthesis of Qualitative Studies

BACKGROUND

Malnutrition is prevalent across health care settings and has adverse outcomes for patients and the health system. However, some patients do not recall being informed about their malnutrition risk/diagnosis.

OBJECTIVE

This meta-synthesis of qualitative studies aimed to identify and synthesize patient, carer, and health worker perceptions and understanding of the terminology used by health workers for malnutrition risk/malnutrition.

METHODS

Four databases were searched (Medline, Cumulated Index in Nursing and Allied Health Literature, PsycINFO, and Embase) up until August 2023. Title, abstract, and full text screening were independently completed by 2 reviewers. The quality of the included studies was assessed using the Critical Appraisal Skills Programme Qualitative Studies Checklist. Data were analyzed by the review team using thematic synthesis. The resulting themes informed review findings. The confidence in each finding was assessed using GRADE-Confidence in the Evidence from Reviews of Qualitative Research.

RESULTS

Seventeen studies were included, contributing perspectives from patients (n = 7 studies), health workers (n = 5 studies), or both patients and health workers (n = 5 studies); no studies included carer perspectives. There were 5 themes: patients have differing understanding, interpretation of, and identification with, malnutrition risk and malnutrition terminology (very low confidence); health workers perceive that patients do not identify with or understand malnutrition risk and malnutrition terminology (low confidence); Patients do not routinely perceive their malnutrition risk or malnutrition diagnosis as problematic (low confidence); health workers use varied terminology for malnutrition risk and malnutrition (low confidence); and action is required to improve malnutrition diagnostic communication (low confidence).

CONCLUSIONS

Findings highlighted disparity in patients' perspectives regarding the terms used for malnutrition risk and malnutrition. Varied terms were used by health workers, and patients did not often associate these terms with a health condition that required treatment. Health workers and patients called for action to improve the communication of malnutrition. To do this, further research exploring malnutrition terminology and the broader concept of malnutrition communication is required with patients, carers and health workers.

Correlation of health literacy and learning style preference in persons with heart failure

OBJECTIVE

The purpose of the study was to describe demographic and health literacy correlates of learning style in older adults with heart failure (HF).

METHODS

Cross sectional data on learning styles (VARK Questionnaire, 16 items) and health literacy (S-TOFHLA, 36 items) were collected. Preferred learning style was determined and correlated to health literacy and demographic measures.

RESULTS

116 participants with heart failure (M age = 75.1 (SD 12.5) years, M health literacy of 19 (SD 11.5). Most identified as male (59 %); with inadequate health literacy (67 %). Thirty percent reported a multimodal learning style preference with a kinesthetic (r = .33, p = .03) and not a visual preference (r = -.49, p < .001). Among unimodal learning styles, the most frequent was kinesthetic (26.7 %). Those with lower literacy levels were older (r = -.44, p = <.001), had less education (r = .48, p < .001) and reported a kinesthetic learning preference (r = .37, p = .001).

CONCLUSION

Older individuals identifying as male, with low health literacy, preferred a kinesthetic approach to HF education. Future research should consider the linkage between education tailored to learning style, health literacy and outcomes.

PRACTICE IMPLICATIONS

Assessment of learning style should be completed prior to an educational encounter.

Influence of applying VARK learning styles on enhancing teaching skills: application of learning theories

BACKGROUND

Social media in our networks have been exploited as dynamic learning tools and free platforms.

AIMS

The main objective of this study is to determine the impact of VARK learning styles (visual (V), aural (A), read/write (R), and kinesthetic (K)) in enhancing parasitological laboratory skills using social media and various learning theories.

METHODS

A research sample of 100 chemists working in Mega Alfa labs underwent online learning of laboratory parasitology skills via Facebook posts and WhatsApp dictated messages for an average of 7 weeks. All posts served various VARK learning styles and were designed based on Zeigarnik's effect (conducting information with tactical breaks), memory storage and retrieval strength theories (repetition of information). Trainees were classified according to their VARK learning style preferences and were evaluated through pre/post-tests. Data on VARK learning styles were summarized using frequency (count) and relative frequency (percentage). Data of pre-test and post-test scores were summarized using mean and standard deviation. T-test was used to compare pre-test and post-test scores. The difference between the pre-test results, the post-test results and the preferred learning style was analyzed using ANOVA with Tukey's post-hoc testing. P-values less than 0.05 were considered statistically significant.

RESULTS

In a total of 100 trainees, tri-modal and multimodal learning styles were preferred by 40% and 30% of the trainees respectively; on the contrary, the unimodal and bimodal learning styles were the least preferred. In the trimodal and multimodal groups, the post-test results showed significant increase when compared with the pre-test results. Also, using the ANOVA test and a Tukey's post-hoc comparison, the assemblage of multiple learning styles (tri-modal and multimodal) appeared to significantly improve the learning performance in the post-test results when compared with the unimodal and bimodal groups.

CONCLUSION

The tri-modal and multimodal learning styles were found to influence the acquirement of the laboratory parasitology skills much better than the unimodal and bimodal learning styles. Kinesthetic learning should have a special emphasis in training.

Exploring adult inpatients' perceptions, understanding and preferences regarding the term 'malnutrition': A qualitative study

AIMS

To explore adult inpatients' perceptions, understanding and preferences regarding the term 'malnutrition' and to identify the terms that adult inpatients report are used by themselves and health workers to describe malnutrition.

DESIGN

This qualitative study was conducted using data collected for a separate qualitative study that investigated factors that influence the dietary intake of long-stay, acute adult inpatients.

METHODS

Semi-structured interviews were conducted with a purposive sample of current inpatients. Data were analysed using inductive content analysis.

RESULTS

Nineteen interviews were included (mean age 64 years (standard deviation ±17), 10 female (53%), 12 malnourished (63%)). Four categories were identified. 'Variation in patients' recognition of malnutrition' represents the differing abilities of patients to understand and identify with the term 'malnutrition'. 'Recognising individuals' needs and preferences' highlights patients' varying beliefs regarding whether 'malnutrition' is or is not an appropriate term and participants' suggestion that health workers should tailor the term used to each patient. 'Inconsistencies in health workers' and patients' practice regarding malnutrition terminology' encapsulates the multiple terms that were used to describe malnutrition by health workers and patients. 'Importance of malnutrition education' summarises patients' views that health workers should provide patient education on malnutrition prevention, management and complications.

CONCLUSION

Findings highlight variations in patients' perceptions and understanding of the term 'malnutrition' and differences in the terms used by patients and health workers to describe malnutrition.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

The terminology used by health workers to describe malnutrition risk or malnutrition to their patients can influence patients' recognition of their nutritional status and thus the multidisciplinary management of the condition. To ensure that patients receive information about their malnutrition risk or diagnosis in a way that meets their needs, health workers' practices must be revised. To do this, it is imperative to conduct further collaborative research with patients and health workers to identify optimum terms for 'malnutrition' and how health workers should communicate this to patients.

IMPACT

There is a disparity in patients' perceptions, understanding and preferences for the term 'malnutrition' and there are inconsistencies in how health workers communicate malnutrition to patients. To support patients' recognition and understanding of their nutritional status, it is imperative for health workers to consider how they discuss malnutrition with patients.

REPORTING METHOD

Adheres to the Consolidated Criteria for Reporting Qualitative Research (Tong et al., 2007).

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Motivation and preferences for learning of patients with COPD or asthma and their significant others in pulmonary rehabilitation: a qualitative study

Introduction

An in-depth understanding of educational needs from the perspective of learners in pulmonary rehabilitation is lacking. To improve learning in pulmonary rehabilitation, understanding of factors that induce or enhance intrinsic motivation in both patients and their significant others is needed. Therefore, this study aims to gain in-depth understanding of what motivates patients with COPD or asthma referred for pulmonary rehabilitation and their significant others to learn and what their preferences are for education.

Methods

For this qualitative study, a sample was taken from a previous quantitative study. Data was collected through one-time face-to-face semi-structured interviews. The interviews were transcribed and independently analysed by two researchers using thematic analyses.

Results

Twelve patients and four significant others (56% female; age: 63±11 years) were interviewed. Participants expressed a variety of information needs and learning preferences. Subthemes that emerged within the theme of motivation for learning were: 1) curiosity, such as knowledge gaps and hope for new information; and 2) values and goals, such as own health, caring for loved ones and spending time with family.

Discussion

To enhance intrinsic motivation for learning within pulmonary rehabilitation, autonomy of individuals should be supported by offering several learning topics and education adapted to preferences, while curiosity should be fostered by targeting information needs. Moreover, health education programmes should match with the personal values and goals of individuals, such as own health, caring for loved ones and spending time with family.

Patient's and Consultant's Views and Perceptions on Switching from an Originator Biologic to Biosimilar Medication: A Qualitative Study

The aim of this study was to describe the opinions of patients undergoing treatment with originator biologics and medical consultants managing their conditions and identify the barriers and enablers to transitioning from originator biologics to equivalent biosimilars. This study was undertaken prior to biosimilar switching at a large teaching hospital in the United Kingdom. Five gastroenterology, rheumatology, and dermatology consultants were interviewed. Two focus groups were conducted with patients prescribed infliximab (n = 2) and etanercept originators (n = 7). Four main themes emerged, as follows: (1) 'Benefit to the NHS'; (2) 'Evidence for efficacy and safety'; (3) 'Team roles'; and (4) 'Effective communication during switching', with sub-themes such as (4a) 'What patients want to know' and (4b) 'How it should be communicated'. Recognition of the ability to save NHS money was an enabler for both patients and consultants, with patients wanting to be reassured that the money saved would be used to benefit other patients. Consultants did not always believe that biosimilars had similar efficacy as the originators or that the manufacturing standards were the same. Effective interventions to address these concerns are required. Offering patients the opportunity to revert back to their originator if necessary was seen as an enabler, as was the provision of readily available mechanisms for reporting suspected adverse events resulting from switching. The role of pharmacy in the process of switching from originator biologics to biosimilars can range from educating consultants regarding the safety and efficacy of biosimilars, explaining the rationale for switching patients, and providing a route for reporting adverse events.

Perceptions of transitional care services among patients with percutaneous transhepatic biliary drainage and multicentre health professionals: A qualitative study

BACKGROUND

Patients with percutaneous transhepatic biliary drainage (PTBD) need regular drainage tube care after discharge, and transitional care can help solve this problem. However, few studies have focused on the quality of transitional care, the perceptions of patients with drainage tubes after discharge and those of healthcare professionals.

AIM

This study is aimed at exploring the real experience and perceptions of transitional care services among healthcare professionals and PTBD patients who have been discharged with tubes and at providing references for future transitional care service development.

DESIGN

The study uses a qualitative descriptive design. The reporting method followed Consolidated Criteria for Reporting Qualitative Research guidelines.

METHODS

Semistructured interviews were conducted with PTBD patients who had been discharged with tubes and multicentre healthcare professionals using the purpose sampling method. The thematic analysis method was used for analysis.

RESULTS

Thirteen PTBD patients from one hospital and 12 healthcare professionals from three hospitals were interviewed. The analysis of the patient interview data revealed three themes, namely, recognition of the value of transitional care services, patients have some unmet needs and perception of transitional care service pathways. Six subthemes were also identified. The analysis of the interview data of healthcare professionals revealed two themes, namely, harvest and challenges in transitional care services work and expectations for future development of transitional care services. Four subthemes were also identified.

CONCLUSIONS

The transitional care of discharged patients with PTBD tubes deserves the attention of clinical workers, and a series of measures should be taken to improve transitional care services.

PATIENT/PUBLIC CONTRIBUTION

Patients were involved in the formulation of interview questions for this study, and during the interviews, patients presented their suggestions for transitional care services. Healthcare professionals participated in this study as interviewees, and no members of the public were involved in this study.