AO pelvic fracture classification: can an educational package improve orthopaedic registrar performance?

Automated Association for Osteosynthesis Foundation and Orthopedic Trauma Association classification of pelvic fractures on pelvic radiographs using deep learning

High-energy impacts, like vehicle crashes or falls, can lead to pelvic ring injuries. Rapid diagnosis and treatment are crucial due to the risks of severe bleeding and organ damage. Pelvic radiography promptly assesses fracture extent and location, but struggles to diagnose bleeding. The AO/OTA classification system grades pelvic instability, but its complexity limits its use in emergency settings. This study develops and evaluates a deep learning algorithm to classify pelvic fractures on radiographs per the AO/OTA system. Pelvic radiographs of 773 patients with pelvic fractures and 167 patients without pelvic fractures were retrospectively analyzed at a single center. Pelvic fractures were classified into types A, B, and C using medical records categorized by an orthopedic surgeon according to the AO/OTA classification system. Accuracy, Dice Similarity Coefficient (DSC), and F1 score were measured to evaluate the diagnostic performance of the deep learning algorithms. The segmentation model showed high performance with 0.98 accuracy and 0.96-0.97 DSC. The AO/OTA classification model demonstrated effective performance with a 0.47-0.80 F1 score and 0.69-0.88 accuracy. Additionally, the classification model had a macro average of 0.77-0.94. Performance evaluation of the models showed relatively favorable results, which can aid in early classification of pelvic fractures.

Workshop and package education intervention to knowledge, attitude and practice of ICU nurses on the use of physical restraints

Background The purpose of this study was to compare the effect of the two training methods: educational workshop and electronic package on the knowledge, attitude and practice of nurses in intensive care units (ICUs). Materials and Methods In this experimental study, 64 nurses working in ICU at Imam Hossein and Bahar Hospitals in 2017 in Shahroud were randomly selected into two groups of training: workshops and educational package. At first, knowledge, attitude and performance of the two groups were measured and then 2 weeks after the post-test training. Data were analyzed by Fisher exact, Wilcoxon, independent t-test, Mann-Whitney test with a significance level ≤0.05. Results A significant difference was found between knowledge score in the workshop (10.40 ± 1.41) and educational package (11.25 ± 0.95) (p=0.007). However, No significant difference was found between the nurses attitude in the workshop group (28.59 ± 2.74) and the trained by educational package (28.25 ± 2.85) (p=0.617). Also, no significant difference was found between the mean practice scores in two groups (p=0/143). Conclusion The results of this study indicated that the educational package was more effective than the workshop on improving the level of knowledge of nurses about physical restriction, but both methods increased the attitude and practice of nurses.

A Delphi study to establish consensus on an educational package of musculoskeletal clinical prediction rules for physiotherapy clinical educators

BACKGROUND

Clinical prediction rules (CPRs) are evidence-based tools to aid clinical decision-making, and there are many that are relevant for physiotherapists, especially in the musculoskeletal field. However, a lack of awareness and understanding by physiotherapy clinical educators could limit students' exposure to these potentially valuable tools. An educational package tailored for clinical educators could help them recognise the value of CPRs and implement them in clinical practice with students.

OBJECTIVES

To determine consensus on the essential content and optimal delivery of an educational package on musculoskeletal CPRs for physiotherapy clinical educators.

DESIGN

An online survey of physiotherapy experts who have published on CPRs, using a Delphi approach.

METHOD

Sixteen experts were recruited for a two-round reactive Delphi study in which they rated previously identified elements, as well as suggesting new items for an educational package.

FINDINGS

A pre-defined consensus of ≥70% identified that the content of an educational package should cover fundamental aspects of CPRs including why, when and how to use them clinically, and their limitations. Information on the evidence-base of different types of CPRs, with specific examples, was also identified as important. Online delivery was recommended via self-directed learning and webinars, along with electronic versions of actual CPRs. A self-assessment component was also supported.

CONCLUSIONS

An educational package on musculoskeletal CPRs for clinical educators was supported with key elements outlined by an international panel of experts.

IMPLICATIONS

Improving clinical educators' knowledge of CPRs may lead to physiotherapy students having a greater understanding and ability to use CPRs.

The preferences of physiotherapy clinical educators on a learning package for teaching musculoskeletal clinical prediction rules - A qualitative study

BACKGROUND

There is a growing number of clinical prediction rules (CPRs) relevant to physiotherapy, particularly in the musculoskeletal area, but many students are not learning about them due to lack of awareness or understanding by clinical educators. An educational package specifically designed for physiotherapy clinical educators would aid their understanding of CPRs and ability to utilise them clinically, and also to be able to teach them to students.

OBJECTIVES

To determine the desired content and preferred methods of delivery of an educational package for clinical educators on musculoskeletal CPRs.

DESIGN

A qualitative descriptive approach using semi-structured group and individual interviews with clinical educators.

METHOD

Educators working in the clinical area of musculoskeletal physiotherapy who had an awareness of or interest in CPRs were recruited and interviewed on their views regarding the content and delivery of an educational package on musculoskeletal CPRs. Audio files were transcribed and analysed using framework analysis to explore and develop themes and subthemes.

FINDINGS

Content of an educational package should include general information on CPRs to improve familiarity and understanding, including a brief description, purpose, stages of development, application, limitations, and Information to dispel common myths and misunderstandings, as well as some specific examples of commonly-used CPRs. The package should be available in multiple formats to allow for different learning styles, both online via video, webinars, and podcasts, and face-to-face in practical sessions.

CONCLUSIONS

Clinical educators would find an educational package useful in assisting them to learn about musculoskeletal CPRs and to teach them to students.