1
|
Bamgboje-Ayodele A, McPhail SM, Brain D, Taggart R, Burger M, Bruce L, Holtby C, Pradhan M, Simpson M, Shaw TJ, Baysari MT. How digital health translational research is prioritised: a qualitative stakeholder-driven approach to decision support evaluation. BMJ Open 2023; 13:e075009. [PMID: 37931965 PMCID: PMC10632864 DOI: 10.1136/bmjopen-2023-075009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/26/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVES Digital health is now routinely being applied in clinical care, and with a variety of clinician-facing systems available, healthcare organisations are increasingly required to make decisions about technology implementation and evaluation. However, few studies have examined how digital health research is prioritised, particularly research focused on clinician-facing decision support systems. This study aimed to identify criteria for prioritising digital health research, examine how these differ from criteria for prioritising traditional health research and determine priority decision support use cases for a collaborative implementation research programme. METHODS Drawing on an interpretive listening model for priority setting and a stakeholder-driven approach, our prioritisation process involved stakeholder identification, eliciting decision support use case priorities from stakeholders, generating initial use case priorities and finalising preferred use cases based on consultations. In this qualitative study, online focus group session(s) were held with stakeholders, audiorecorded, transcribed and analysed thematically. RESULTS Fifteen participants attended the online priority setting sessions. Criteria for prioritising digital health research fell into three themes, namely: public health benefit, health system-level factors and research process and feasibility. We identified criteria unique to digital health research as the availability of suitable governance frameworks, candidate technology's alignment with other technologies in use,and the possibility of data-driven insights from health technology data. The final selected use cases were remote monitoring of patients with pulmonary conditions, sepsis detection and automated breast screening. CONCLUSION The criteria for determining digital health research priority areas are more nuanced than that of traditional health condition focused research and can neither be viewed solely through a clinical lens nor technological lens. As digital health research relies heavily on health technology implementation, digital health prioritisation criteria comprised enablers of successful technology implementation. Our prioritisation process could be applied to other settings and collaborative projects where research institutions partner with healthcare delivery organisations.
Collapse
Affiliation(s)
- Adeola Bamgboje-Ayodele
- Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Steven M McPhail
- Australian Centre for Health Service Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - David Brain
- Australian Centre for Health Service Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Richard Taggart
- Sydney Local Health District, NSW Health, Camperdown, New South Wales, Australia
| | - Mitchell Burger
- Sydney Local Health District, NSW Health, Camperdown, New South Wales, Australia
| | - Lenert Bruce
- Murrumbidgee Local Health District, NSW Health, Wagga Wagga, New South Wales, Australia
| | - Caroline Holtby
- Murrumbidgee Local Health District, NSW Health, Wagga Wagga, New South Wales, Australia
| | | | - Mark Simpson
- eHealth NSW, Chatswood, New South Wales, Australia
| | - Tim J Shaw
- Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Melissa T Baysari
- Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
2
|
Revising the Academy’s Research Priorities: Methods of the Research Priorities and Strategies Development Task Force, 2017-2019. J Acad Nutr Diet 2021; 121:2275-2286.e2. [DOI: 10.1016/j.jand.2020.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/14/2020] [Accepted: 10/14/2020] [Indexed: 11/22/2022]
|
3
|
Cardenas D, Díaz G, Cadavid J, Lipovestky F, Canicoba M, Sánchez P, Álvarez L, Duarte Y, Reyes JGG, de Noyola GM, Maza C, Porbén SS, Bermúdez CE, García Y, Calvo I, Arenas H. Nutrition in medical education in Latin America: Results of a cross-sectional survey. JPEN J Parenter Enteral Nutr 2021; 46:229-237. [PMID: 33735516 DOI: 10.1002/jpen.2107] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/07/2021] [Accepted: 03/14/2021] [Indexed: 12/21/2022]
Abstract
RATIONALE The gap between the nutrition education provided to medical students and the nutrition competences and attitudes needed for doctors to provide effective nutrition care is a global concern. The goal of this study was to investigate the curricular content on nutrition education in Latin American medical schools and to evaluate the self-perceived knowledge, attitudes, and barriers to nutrition practice of final-year medical students. METHODS Eighty-five public and private medical schools from 17 Latin American countries were invited to participate in the study. Two close-ended online questionnaires consisting of 25 and 43 questions were sent to medical school directors. Quantitative variables were expressed as frequencies, percentages, mean ± standard deviation, medians, and ranges. RESULTS A total of 22 (26%) medical school directors responded, of which 11 schools (50%) offered stand-alone mandatory nutrition courses in preclinical and 8 (36%) in clinical years. The mean hours dedicated to nutrition education was 47 (range: 0-150). A total of 1530 of 1630 (94%) students from 12 countries responded. Students' average age was 25 ± 3 years, and 59% were female. Most students agreed that improving patients' health through nutrition (91%) is important and that nutrition counseling and assessment should be part of routine care provided by all physicians (89%), but they lack the level of education and training required to address nutrition-related issues. CONCLUSIONS Positive attitude and interest in nutrition among final-year medical students is high, but nutrition education is not perceived as sufficient to adequately prepare doctors in the field of nutrition.
Collapse
Affiliation(s)
- Diana Cardenas
- Faculty of Medicine, Research Institute on Nutrition, Genetics and Metabolism, Universidad El Bosque, Bogotá, Colombia
| | - Gustavo Díaz
- Faculty of Medicine, Research Institute on Nutrition, Genetics and Metabolism, Universidad El Bosque, Bogotá, Colombia
| | - Jessika Cadavid
- Faculty of Medical Sciences, Federal University of Mato Grosso, Cuiaba, Brazil
| | - Fernando Lipovestky
- Faculty of Medicine, Universidad Abierta Interamericana, Buenos Aires, Argentina
| | - Marisa Canicoba
- Faculty of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Paola Sánchez
- Faculty of Medicine, Universidad Latina de Costa Rica, San José, Costa Rica
| | - Ludwig Álvarez
- Nutrition department, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Yan Duarte
- Faculty of Medicine, Universidad Estatal de Guayaquil, Guayaquil, Ecuador
| | | | | | - Claudia Maza
- Faculty of Nutrition, Centro Médico Militar, Ciudad de Guatemala, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Sergio Santana Porbén
- Nutrition department, Hospital Pediatrico Docente "Juan Manuel Marquez,", La Habana, Cuba
| | - Charles Elleri Bermúdez
- Surgery and Nutrition Department, Clínica La Colina and Clínica del Country, Bogotá, Colombia
| | - Yawelida García
- Faculty of Nutrition, Universidad O&M, Santo Domingo, Dominican Republic
| | - Isabel Calvo
- Nutrition service, Hospital General de Tijuana, Tijuana, Mexico
| | - Humberto Arenas
- Integrated Practice Unit on Intestinal Failure, Hospital San Javier, Guadalajara, Mexico
| |
Collapse
|
4
|
Monrouxe LV, Liu GRJ, Yau SY, Babovič M. A scoping review examining funding trends in health care professions education research from Taiwan (2006–2017). Nurs Outlook 2020; 68:417-429. [DOI: 10.1016/j.outlook.2020.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/23/2020] [Accepted: 02/23/2020] [Indexed: 12/14/2022]
|
5
|
Martin S, Sturgiss E, Douglas K, Ball L. Hidden curriculum within nutrition education in medical schools. BMJ Nutr Prev Health 2020; 3:18-23. [PMID: 33235967 PMCID: PMC7664483 DOI: 10.1136/bmjnph-2019-000059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 11/27/2019] [Accepted: 12/11/2019] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Previous attempts to enhance medical nutrition education have typically focussed on students' acquiring nutrition knowledge or skills. Given that medical training uses an apprenticeship model of training, surprisingly few studies have explored the 'hidden curriculum' that students experience regarding expectations of behaviour, roles and responsibilities regarding nutrition. This study explored medical students' perceptions and experiences regarding medical nutrition education, focussing on the context in which nutrition teaching has been provided, the presented place of nutrition within medicine and their subsequent views on their role in providing nutrition care. METHODS Individual semi-structured qualitative interviews were conducted with 14 postgraduate medical students at different stages of their medical degree in Australia. The interviews were conducted using case studies followed by interview questions. Data were audio recorded, transcribed, coded and then underwent inductive thematic analysis. RESULTS Three themes were discovered (i) Valuing nutrition in the medical management of patients whereby students perceived nutrition to be a foundational and central component of ideal medical management for patients, particularly those with chronic disease; (ii) Fluctuating emphasis on nutrition which showed that students experienced diversity in the importance placed on nutrition by others and (iii) Working with others whereby students expressed their understanding of their role in nutrition and the roles of team members such as dietitians. CONCLUSION To enhance medical nutrition education, consideration needs to extend beyond counting dedicated teaching hours and mapping nutrition content, to a more contextual understanding of the situated learning that occurs for medical students.
Collapse
Affiliation(s)
- Stephen Martin
- Academic Unit of General Practice, Australian National University Medical School, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Elizabeth Sturgiss
- Academic Unit of General Practice, Australian National University Medical School, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
- Department of General Practice, Monash University, Melbourne, Victoria, Australia
| | - Kirsty Douglas
- Academic Unit of General Practice, Australian National University Medical School, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Lauren Ball
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- NNEdPro Global Centre for Nutrition and Health, Cambridge, UK
| |
Collapse
|
6
|
Dumic A, Miskulin I, Pavlovic N, Cacic Kenjeric D, Orkic Z, Miskulin M. Attitudes toward Nutrition Care among General Practitioners in Croatia. J Clin Med 2018; 7:jcm7040060. [PMID: 29561751 PMCID: PMC5920434 DOI: 10.3390/jcm7040060] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 03/14/2018] [Accepted: 03/15/2018] [Indexed: 11/16/2022] Open
Abstract
Nutrition care should be an integral part of general practitioners' (GPs') daily work with patients. The aim of this study was to assess the attitudes of Croatian GPs toward nutrition and nutrition care, and to evaluate the interconnection between their attitudes and implementation of nutrition care in GPs offices. A cross-sectional study was conducted among 17.0% of randomly selected GPs, from May to July of 2013, via a specially designed anonymous questionnaire. The study showed that 36.0% of the Croatian GPs had satisfactory number of positive attitudes (5 or more) toward nutrition and nutrition care. There was statistically significant difference in the median number of positive attitudes based on the additional education of GPs in nutrition and their ailment from chronic diseases (p < 0.001 and p = 0.022, respectively). The Spearman rank correlation between GPs' attitudes toward nutrition and nutrition care and their practice, i.e., the implementation of nutrition care in GPs' everyday work with patients was rs = -0.235 (p < 0.001). In order to provide nutrition care in GPs' offices in Croatia, strategies for changing GPs' attitudes toward nutrition and nutrition care are needed.
Collapse
Affiliation(s)
- Albina Dumic
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia.
| | - Ivan Miskulin
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia.
| | - Nika Pavlovic
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia.
| | - Daniela Cacic Kenjeric
- Faculty of Food Technology, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia.
| | - Zelimir Orkic
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia.
| | - Maja Miskulin
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia.
| |
Collapse
|