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Faulkner JW, Callagher E, Snell D, Nielsen K, Cairncross M, Theadom A. Evaluation of a biopsychosocial education resource for mild traumatic brain injury: a mixed method exploratory study. Front Neurol 2024; 15:1429928. [PMID: 39268065 PMCID: PMC11390456 DOI: 10.3389/fneur.2024.1429928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 08/15/2024] [Indexed: 09/15/2024] Open
Abstract
Introduction Education is strongly advocated as a key component of treatment for mild traumatic brain injury (mTBI) in clinical guidelines. However, there is mixed evidence on the benefit of education. This study aimed to evaluate a new education resource for mTBI. CLARITY is a freely available animated video based on a biopsychosocial conceptualization of mTBI, explaining the complex psychological, environmental and biological mechanisms behind symptoms and recovery. Methods 24 adults with a history of mTBI participated in this mixed method study to examine prior experience of mTBI education and to evaluate CLARITY. Following viewing of the education video participants' were invited to engage in a semi-structured interview and to share their perceptions of it via an online anonymous questionnaire. Results Thematic analysis of semi-structured interviews revealed one overarching theme: education is the foundation of recovery. Participants emphasised the critical role of coherent education in facilitating understanding, engagement in rehabilitation, and positive expectations during recovery. However, the first subtheme was that existing foundations are weak. Participants' previous education was often limited in scope, inconsistent, and delivered in inaccessible ways. The second subtheme was that new foundations are stronger. Participants responded positively to CLARITY, highlighting its explanatory biopsychosocial approach, focus on mental health factors and accessible delivery methods as key strengths. Questionnaire responses revealed favourable endorsement of CLARITY's utility, comprehensibility and accessibility. Discussion Recommendations for minor refinements to CLARITY were provided and made, as well as for its use in health care services.
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Affiliation(s)
- Josh W Faulkner
- Te Herenga Waka-Victoria University of Wellington, Wellington, New Zealand
| | - Elise Callagher
- Te Herenga Waka-Victoria University of Wellington, Wellington, New Zealand
| | - Deborah Snell
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Kristopher Nielsen
- Te Herenga Waka-Victoria University of Wellington, Wellington, New Zealand
| | - Molly Cairncross
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
| | - Alice Theadom
- TBI Network, Auckland University of Technology, Auckland, New Zealand
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Ibsen H, Ahrenfeldt LJ, Lykkegaard J, Søndergaard J, Švab I, Kjaer NK. Barriers for continuous medical education: a cross-sectional questionnaire study among Danish GPs. BJGP Open 2024:BJGPO.2023.0228. [PMID: 38490677 DOI: 10.3399/bjgpo.2023.0228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/15/2024] [Accepted: 03/11/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND GPs' participation in continuous medical education (CME) is essential for patient care, GPs' wellbeing, and healthcare expenditure. However, one-quarter of Danish GPs did not use their reimbursement for CME in 2022. Knowledge of barriers for participating in CME is limited. AIM To analyse the barriers GPs face to participation in CME, and patterns in perceived barriers. DESIGN & SETTING A cross-sectional questionnaire study design was used. The study population comprised all 3257 GPs in Denmark who, in May 2023, were registered as entitled to reimbursement for CME. METHOD The response rate was n = 1303/3257 (40%). Based on a question about use of CME, the responders were divided into 'frequent', 'partial', and 'seldom' users. Partial and seldom users answered questions about barriers related to CME (n = 726). The presence of barriers was quantified, and a latent class analysis (LCA) was used to stratify GPs according to their barrier patterns. RESULTS The most frequent barriers were as follows: too busy (67%); fully booked courses (45%); and no substitute or locum doctor (39%). Based on the LCA, we found three distinctive patterns, clustering around the following: GPs from clinics with no tradition for CME (class 1, 17%); GPs who used time on professional work outside clinic (teaching, organisational work) (class 2, 43%); and GPs who were personally or professionally affected (class 3, 40%). Singled-handed and male GPs were slightly overrepresented among seldom users. CONCLUSION We have identified barriers for CME. We found three different profiles of GPs who perceived different patterns of barriers. Identified patterns in barriers should be considered in future CME initiatives.
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Affiliation(s)
- Helle Ibsen
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Linda Juel Ahrenfeldt
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Jesper Lykkegaard
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Jens Søndergaard
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Igor Švab
- Department of Family Medicine, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Niels Kristian Kjaer
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
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Ku CW, Ng RRG, Chang TY, Lim CHF, Zheng RT, Ma W, Chua MC, Chan JKY, Yap FKP, Loy SL. Preliminary assessment of the Healthy Early Life Moments (HELMS) webinars in empowering Developmental Origins of Health and Disease (DOHaD) concept among healthcare professionals - a pragmatic serial cross-sectional study. J Perinat Med 2024; 52:406-415. [PMID: 38407193 DOI: 10.1515/jpm-2023-0549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/06/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES The Developmental Origins of Health and Disease (DOHaD) concept has gained prominence in maternal and child health (MCH), emphasizing how early-life factors impact later-life non-communicable diseases. However, a knowledge-practice gap exists in applying DOHaD principles among healthcare professionals. Healthy Early Life Moments in Singapore (HELMS) introduced webinars to bridge this gap and empower healthcare professionals. We aimed to conduct a preliminary assessment to gain early insights into the outreach and effectiveness of the educational initiative offered with the HELMS webinars. METHODS We employed a pragmatic serial cross-sectional study approach and targeted healthcare professionals involved in MCH care. We also collected and analyzed data on webinar registration and attendance, participants' profession and organizational affiliations, and post-webinar survey responses. RESULTS The median webinar attendance rate was 59.6 % (25th-75th percentile: 58.4-60.8 %). Nurses represented 68.6 % of attendees (n=2,589 out of 3,774). Post-webinar surveys revealed over 75 % of the participants providing positive responses to 14 out of 15 survey questions concerning content, delivery, applicability to work, and organization. CONCLUSIONS Assessment of the HELMS webinars provided insight into the outreach and early effectiveness in enhancing healthcare professionals' knowledge and confidence in delivering DOHaD education. Bridging the knowledge-practice gap remains a crucial goal.
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Affiliation(s)
- Chee Wai Ku
- Department of Reproductive Medicine, 37579 KK Women's and Children's Hospital , Singapore, Singapore
- 37579 Duke-NUS Medical School , Singapore, Singapore
| | - Roderica R G Ng
- Department of Anaesthesiology, 37581 Singapore General Hospital , Singapore, Singapore
| | - Ting Yu Chang
- Yong Loo Lin School of Medicine, 63751 National University of Singapore , Singapore, Singapore
| | - Celeste H F Lim
- Yong Loo Lin School of Medicine, 63751 National University of Singapore , Singapore, Singapore
| | - Ruther Teo Zheng
- Department of Paediatrics, 37579 KK Women's and Children's Hospital , Singapore, Singapore
| | - Weini Ma
- Office of Strategy Management & Population Health, 37579 KK Women's and Children's Hospital , Singapore, Singapore
| | - Mei Chien Chua
- 37579 Duke-NUS Medical School , Singapore, Singapore
- Department of Neonatology, 37579 KK Women's and Children's Hospital , Singapore, Singapore
| | - Jerry K Y Chan
- Department of Reproductive Medicine, 37579 KK Women's and Children's Hospital , Singapore, Singapore
- 37579 Duke-NUS Medical School , Singapore, Singapore
- Yong Loo Lin School of Medicine, 63751 National University of Singapore , Singapore, Singapore
| | - Fabian K P Yap
- 37579 Duke-NUS Medical School , Singapore, Singapore
- Department of Paediatrics, 37579 KK Women's and Children's Hospital , Singapore, Singapore
- Lee Kong Chian School of Medicine, 37579 Nanyang Technological University , Singapore, Singapore
| | - See Ling Loy
- Department of Reproductive Medicine, 37579 KK Women's and Children's Hospital , Singapore, Singapore
- 37579 Duke-NUS Medical School , Singapore, Singapore
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Alayande BT, Forbes C, Kingpriest P, Adejumo A, Williams W, Wina F, Agbo CA, Omolabake B, Bekele A, Ismaila BO, Kerray F, Sule A, Abahuje E, Robertson JM, Yule S, Riviello R, Isichei M. Non-technical skills training for Nigerian interprofessional surgical teams: a cross-sectional survey. BMC MEDICAL EDUCATION 2024; 24:547. [PMID: 38755653 PMCID: PMC11097506 DOI: 10.1186/s12909-024-05550-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/10/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION Non-technical skills (NTS) including communication, teamwork, leadership, situational awareness, and decision making, are essential for enhancing surgical safety. Often perceived as tangential soft skills, NTS are many times not included in formal medical education curricula or continuing medical professional development. We aimed to explore exposure of interprofessional teams in North-Central Nigeria to NTS and ascertain perceived facilitators and barriers to interprofessional training in these skills to enhance surgical safety and inform design of a relevant contextualized curriculum. METHODS Six health facilities characterised by high surgical volumes in Nigeria's North-Central geopolitical zone were purposively identified. Federal, state, and private university teaching hospitals, non-teaching public and private hospitals, and a not-for-profit health facility were included. A nineteen-item, web-based, cross-sectional survey was distributed to 71 surgical providers, operating room nurses, and anaesthesia providers by snowball sampling through interprofessional surgical team leads from August to November 2021. Data were analysed using Fisher's exact test, proportions, and constant comparative methods for free text responses. RESULTS Respondents included 17 anaesthesia providers, 21 perioperative nurses, and 29 surgeons and surgical trainees, with a 95.7% survey completion rate. Over 96% had never heard of any NTS for surgery framework useful for variable resource contexts and only 8% had ever received any form of NTS training. Interprofessional teams identified communication and teamwork as the most deficient personal skills (38, 57%), and as the most needed for surgical team improvement (45, 67%). There was a very high demand for NTS training by all surgical team members (64, 96%). The main motivations for training were expectations of resultant improved patient safety and improved interprofessional team dynamics. Week-long, hybrid training courses (with combined in-person and online components) were the preferred format for delivery of NTS education. Factors that would facilitate attendance included a desire for patient safety and self-improvement, while barriers to attendance were conflicts of time, and training costs. CONCLUSIONS Interprofessional surgical teams in the Nigerian context have a high degree of interest in NTS training, and believe it can improve team dynamics, personal performance, and ultimately patient safety. Implementation of NTS training programs should emphasize interprofessional communication and teamworking.
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Affiliation(s)
- Barnabas Tobi Alayande
- Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.
- Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria.
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States of America.
- Surgical Equity Research Hub, Jos, Nigeria.
| | - Callum Forbes
- Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States of America
| | | | | | - Wendy Williams
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, United States of America
| | - Felix Wina
- Department of Surgery, Bingham University Teaching Hospital, Jos, Nigeria
| | - Christian Agbo Agbo
- Department of Surgery, Benue State University Teaching Hospital, Markudi, Nigeria
| | - Bamidele Omolabake
- Department of Surgery, Benue State University Teaching Hospital, Markudi, Nigeria
| | - Abebe Bekele
- Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda
| | - Bashiru O Ismaila
- Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Fiona Kerray
- Department of Clinical Surgery, The University of Edinburgh, Edinburgh, UK
| | - Augustine Sule
- Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Egide Abahuje
- University of Rwanda, Kigali, Rwanda
- Department of Surgery, Northwestern University, Evanston, Ilinois, United States of America
| | - Jamie M Robertson
- Department of Surgery, Brigham and Women's Hospital, Boston, MA, United States of America
| | - Steven Yule
- Department of Clinical Surgery, The University of Edinburgh, Edinburgh, UK
| | - Robert Riviello
- Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States of America
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, United States of America
- Department of Surgery, Brigham and Women's Hospital, Boston, MA, United States of America
| | - Mercy Isichei
- Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
- The Faith Alive Foundation, Jos, Nigeria
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Eickmann S, Wolff D, Kobbe G, Dreger P, Kröger N, Herrmann-Johns A. Barriers and Facilitators in Continuous Medical Education Related to Allogeneic Stem Cell Transplantation: A Qualitative Study of Physicians. Oncol Res Treat 2024; 47:136-144. [PMID: 38266509 PMCID: PMC10997258 DOI: 10.1159/000536429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 01/17/2024] [Indexed: 01/26/2024]
Abstract
INTRODUCTION This study explored qualitatively, in a sample of German hematologists working in clinical allogeneic hematopoietic stem cell transplantation (alloHSCT), perceptions of barriers and facilitators to participate in continuous medical education (CME), to provide detailed information on how to improve participation in CME activities related to alloHSCT, which may also be applicable to other areas of medicine. METHODS Based on a recruitment campaign of the German Association for Hematopoietic Stem Cell Transplantation (DAG-HSZT), 21 semi-structured telephone interviews were conducted, transcribed, and analyzed using framework analysis. RESULTS Three clusters of barriers were identified that explain why alloHSCT physicians may or may not participate in CME: individual constraints (e.g., better networking, young physicians being overwhelmed by the complexity of alloHSCT), structural constraints (e.g., time and financial issues, tailoring CME courses according to the targeted audience), and content-related constraints (e.g., requirement of CME sessions, provision of an overview of CME courses, more flexible offers). We discuss the ten most frequently raised issues, including the use of incentives and the need for support at the start of residency, staff shortages, and requirements for learning sessions. CONCLUSION There is a need for a paradigm shift in CME related to alloHSCT toward a more individualized and needs-based approach. Close monitoring of residents' needs and learning progress, as well as feedback systems, could help identify appropriate CME courses that should be integrated into a tiered learning system. CME should be more targeted to specific audiences (i.e., residents, fellows, and attendees) to provide training that is tailored to individual CME needs. On-demand courses can help balance work and family obligations. Finally, peer-reviewed, up-to-date information platforms should be expanded.
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Affiliation(s)
- Sascha Eickmann
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University Regensburg, Regensburg, Germany
| | - Daniel Wolff
- Department of Medicine III, University Hospital Regensburg, Regensburg, Germany
| | - Guido Kobbe
- Department of Hematology, Oncology and Clinical Immunology, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Peter Dreger
- Department of Hematology, Oncology, and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Nicolaus Kröger
- Department for Stem Cell Transplantation, University Medical Center Hamburg, Hamburg, Germany
| | - Anne Herrmann-Johns
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University Regensburg, Regensburg, Germany
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
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Phillips E, de Cock C, Hanger B, Kolanko C. The Design and Evolution of an Adaptable CME Programme to Suit the Changing Educational Needs of the Clinical Community. JOURNAL OF CME 2023; 12:2195332. [PMID: 37025357 PMCID: PMC10071951 DOI: 10.1080/28338073.2023.2195332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Continuing medical education (CME) plays a critical role in healthcare, helping to ensure patients receive the best possible care and optimal disease management. Considering the obstacles to engaging in CME activities faced by the clinical community, as well as employing learning theory, Liberum IME developed Classroom to Clinic™ - a bespoke, accredited learning format that can be tailored to individuals' educational needs and time constraints. Through monitoring use, and incorporating qualitative and quantitative feedback, we continuously evaluate the usability, value and accessibility of this programme and adapt subsequent iterations accordingly. An example of this is the way we adapted our engagement of facilitators. Originally this was accomplished by targeting individuals for train-the-trainer events, but it was clear this was more effective in some countries than in others. To address this variability, we piloted launching a new module at a relevant large international congress. This aimed to instigate a cascade in education sharing, from congress attendees to peers at their clinics and across departments and hospitals. So far, the programme has reported encouraging improvements in uptake, as well as knowledge, competence and clinical practice, while qualitative feedback has allowed for the identification of further educational needs and continued evolution of the programme.
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Kirk BO, Khan R, Davidov D, Sambamoorthi U, Misra R. Exploring facilitators and barriers to patient-provider communication regarding diabetes self-management. PEC INNOVATION 2023; 3:100188. [PMID: 37457669 PMCID: PMC10339241 DOI: 10.1016/j.pecinn.2023.100188] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023]
Abstract
Objective Long-term type 2 diabetes management requires open communication between a patient and their provider for self-care adherence. This study explored facilitators and barriers to diabetes-specific communication in West Virginia, a medically underserved state with the highest prevalence of diabetes (16.2%) in the U.S. Methods A secondary qualitative analysis was conducted using data from semi-structured interviews (n = 34) and 4 focus groups (n = 23) with participants of a diabetes education program. Transcripts were analyzed using thematic analysis. Results Three facilitators to patient-provider communication emerged: "Patient-Provider Partnership", "Provider Accessibility", and "Empowerment Through Education". Partnership with providers, especially those who were accessible outside of scheduled appointments, and empowerment obtained through diabetes education facilitated diabetes-specific patient-provider communication. However, barriers included "Providers' Focus on 'Numbers' Rather than Patient Concerns", "Patient Lack of Preparation for Appointments", and "Providers 'Talking Down to' Patients". Conclusion The findings highlight patient- and provider-related factors that impact diabetes-specific communication. Innovation Previous interventions have trained providers in communication skills. Despite some success, challenges in implementation remain considering providers' limited time and overwhelming demands. This study suggests that diabetes education programs incorporating communication and self-advocacy skills could be a promising alternative as they can empower patients to communicate their diabetes-specific needs/preferences with providers.
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Affiliation(s)
- Brenna O. Kirk
- Department of Social and Behavioral Sciences, West Virginia University School of Public Health, 64 Medical Center Dr., Morgantown, WV 26506-9190, United States of America
| | - Raihan Khan
- Department of Health Sciences, College of Health and Behavioral Studies, James Madison University, Harrisonburg, VA 22807, United States of America
| | - Danielle Davidov
- Department of Social and Behavioral Sciences, West Virginia University School of Public Health, 64 Medical Center Dr., Morgantown, WV 26506-9190, United States of America
| | - Usha Sambamoorthi
- College of Pharmacy, University of North Texas Health Science System, Fort Worth, TX, United States of America
| | - Ranjita Misra
- Department of Social and Behavioral Sciences, West Virginia University School of Public Health, 64 Medical Center Dr., Morgantown, WV 26506-9190, United States of America
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Al-Sheikhly D, Ali S, Navti PSM, Mahfoud ZR, Mattar L, Aboulsoud S, Khandakji M, Al Hakim L, Arayssi T. Self-reported preferences and barriers to continued professional development in primary care physicians: a cross-sectional web-based survey in Qatar. BMC PRIMARY CARE 2023; 24:273. [PMID: 38093187 PMCID: PMC10717340 DOI: 10.1186/s12875-023-02235-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION High quality and effective primary healthcare is a national priority in Qatar. Continuing professional development (CPD) for physicians is a cornerstone of this objective, yet little is known about physicians' preferences or barriers to CPD participation. METHOD A needs assessment was conducted using a cross-sectional web-based survey of primary care physicians registered with the Department of Healthcare Practitioners (DHP) between March and June 2017. RESULTS Two-hundred-and-eighty-one complete surveys were submitted representing physicians in both public (N = 129) and private sectors (N = 152). Physicians completed medical degrees and postgraduate training across multiple countries, and most had been practicing in Qatar for 5 years or less. 'Activities during working hours', 'cost' and 'work commitments' were the most common barriers. There was little consensus regarding the optimal timing of CPD activities, although public sector physicians were more likely to indicate weekend activities as a barrier to participation (30% vs. 9%). Over 90% of participants preferred traditional lectures, workshops, case-based sessions, small group and online self-paced learning as formats for CPD delivery, however alternative modes of delivery were also deemed acceptable (> 80% agreement). CONCLUSION Understanding primary care physicians' barriers and preferences is an essential component of a larger necessitated needs assessment of CPD in primary care practitioners in Qatar. Further research is warranted to understand the underlying beliefs driving physicians' choices and the apparent variation between those working in the public and private sectors. CPD developers should consider approaches to mitigate perceived barriers and understand preferences to maximize the quality of participation.
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Affiliation(s)
- Deema Al-Sheikhly
- Medical Education and Continuing Professional Development Weill-Cornell Medicine- Qatar Education City, Doha, Qatar.
| | - Saima Ali
- Division of Continuing professional development,, Weill-Cornell Medicine- Qatar, Doha, Qatar
| | | | | | - Laudy Mattar
- Division of Continuing professional development,, Weill-Cornell Medicine- Qatar, Doha, Qatar
| | | | | | - Lara Al Hakim
- Clinical Research Institute (CRI), American University of Beirut (AUB), Beirut, Lebanon
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Miskeen E, Al-Shahrani AM. The Primary Healthcare Physician's Awareness and Engagement in Community-Based Medical Education: A Mixed Qualitative and Quantitative Study. Healthcare (Basel) 2023; 11:2676. [PMID: 37830713 PMCID: PMC10572629 DOI: 10.3390/healthcare11192676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/20/2023] [Accepted: 08/22/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Community-based medical education (CBME) is an essential component of medical education, where primary healthcare physicians (PCPs) play a crucial role. This study explores PCPs' awareness and engagement in CBME and investigates the factors influencing their participation. METHODS This mixed study was conducted in two phases. In the first phase, a qualitative study was conducted using semi-structured interviews with PCPs as well as thematic analysis related to their awareness and engagement in CBME. In the second phase, a quantitative survey was conducted on 72 PCPs' pre- and post-training programs. RESULTS Primary healthcare physicians had a positive attitude toward community-based medical education. The participants had an acceptable level of awareness and engagement, which increased substantially by (p-value = 0.03) and (p-value = 0.003), respectively. Logistical analysis indicated that non-Saudi physicians were more likely to participate in the CBME (p-value = 0.001). Professions and academic experiences influenced their willingness to engage and participate in CBME (OR = 7.5, p-value = 0.001) and (OR = 0.21, p-value = 0.001), respectively. CONCLUSION The study findings highlighted the importance of increased awareness and the factors that enhance PCPs' engagement in CBME. This positive perspective of the PCPs will help build effective partnerships and facilitate the extension of the curriculum to apply CBME.
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Affiliation(s)
- Elhadi Miskeen
- Department of Obstetrics and Gynecology, College of Medicine, University of Bisha, Bisha 67714, Saudi Arabia
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Gezira, Wad Medani 21111, Sudan
| | - Abdullah M. Al-Shahrani
- Department of Family Medicine, College of Medicine, University of Bisha, Bisha 67714, Saudi Arabia;
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Sachidanandan G, Sud A. From Two Dimensions to Multidimensions: A Mechanistic Model to Support Deliberate CPD Development, Coordination, and Evaluation. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023:00005141-990000000-00099. [PMID: 37782259 DOI: 10.1097/ceh.0000000000000527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
INTRODUCTION The effectiveness of continuing professional development as an intervention to improve health professional behavior and patient health is variable and contentious. To clarify the causal relationships underlying program outcomes and facilitate a necessary shift from outcomes-only-based approaches to outcome-based and theory-based approaches in program development and evaluation, we developed a model of mechanisms mapped to relevant outcomes. METHODS Mechanisms identified in a prior realist synthesis of opioid agonist therapy continuing professional development programs were iteratively tested and refined using purposive and opportunistic sampling and realist approaches against two systematic reviews of programs in analgesic prescribing and palliative care. Further testing involved practical application within programs in sustainable health care and pain management. RESULTS Ninety reports on 75 programs and practical application to multiple additional programs informed the final model consisting of five distinct mechanisms: motivation transformation, expert influence, confidence development, self-efficacy facilitation, and community of practice expansion. The mechanisms and related analysis emphasize that continuing professional development is heterogeneous, complex, and context dependent. DISCUSSION Shifting toward outcome-based and theory-based approaches facilitates further conceptual shifts at intraprogram and interprogram and interintervention levels toward more deliberate program development and evaluation, increased program complementarity and subsequent collaboration. It clarifies opportunities for intercalation of continuing professional development with other intervention sciences. The model presents a resource for practitioners, researchers, and policymakers to advance continuing professional development planning, coordination, and evaluation.
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Affiliation(s)
- Grahanya Sachidanandan
- Ms. Sachidanandan: Medical Student, Temerty Faculty of Medicine, University of Toronto. Dr. Sud: Research Chair, Primary Care & Population Health Systems, Humber River Hospital, and Assistant Professor, Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto
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Ibsen H, Lillevang G, Søndergaard J, Kjaer NK. "We don't need no education" - a qualitative study of barriers to continuous medical education among Danish general practitioners. BMC MEDICAL EDUCATION 2023; 23:450. [PMID: 37337212 DOI: 10.1186/s12909-023-04432-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 06/07/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Continuous medical education is essential for the individual patient care, the society, and the wellbeing of the general practitioner. There has been research into the reasons for participation in continuous medical education, but little is known about the barriers to participation. To tailor continuous medical education targeting general practitioners who are currently deselecting education, systematic knowledge of the barriers is needed. Continuous medical education can in addition to professional growth stimulate job satisfaction, diminish burnout, and reinforce feelings of competence. Continuous medical education may have positive implications for patients and for healthcare expenditures. Despite renumeration and a comprehensive continuous education model some Danish general practitioners do not participate in continuous medical education. METHODS From a total of 3440 Danish general practitioners 243 did not apply for reimbursement for accredited continuous medical education in a two-year period. Ten general practitioners were selected for an interview regarding maximum variation in practice form, number of listed patients, seniority as a general practitioner, geography, gender, and age. All ten selected general practitioners accepted to be interviewed. The interviews were analysed using Systematic Text Condensation. RESULTS Each of the ten interviewed general practitioners mentioned several barriers for participating in continuous education. The barriers fell into three main categories: barriers related to the individual general practitioner barriers related to the clinic barriers related to the accredited continuous medical education offered CONCLUSIONS: Approximately 7% of the Danish general practitioners did not participate in accredited remunerated continuous medical education. A knowledge of the barriers for participating in accredited continuous medical education can be used to better target continuous medical education to the general practitioners.
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Affiliation(s)
- Helle Ibsen
- Department of Public Health, Research Unit of General Practice, University of Southern Denmark, Finsensvej 35, 6700, Esbjerg, Denmark.
| | - Gunver Lillevang
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| | - Jens Søndergaard
- Department of Public Health, Research Unit of General Practice, University of Southern Denmark, WP 9, 5000, Odense, Denmark
| | - Niels Kristian Kjaer
- Department of Public Health, Research Unit of General Practice, University of Southern Denmark, Finsensvej 35, 6700, Esbjerg, Denmark
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Devji J, Karmali S, Turcotte K, Babul S. Barriers and facilitators to the uptake of the Concussion Awareness Training Tool as continuing medical education in primary care. Concussion 2023; 8:CNC106. [PMID: 37287885 PMCID: PMC10242435 DOI: 10.2217/cnc-2022-0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/06/2023] [Indexed: 06/09/2023] Open
Abstract
Aim Continuing medical education (CME) informs physicians on current research. The Concussion Awareness Training Tool (CATT) provides education on concussion diagnosis and treatment. The aims of this study were to explore physician CME practices and preferences, understand barriers and facilitators to implementing the CATT as CME, and provide recommendations. Materials & methods Physicians in British Columbia, Canada participated in an online survey and telephone interview. Descriptive analysis of quantitative data, and text-based data analysis were undertaken to identify themes. Results Barriers included lack of time and awareness of the resource. Facilitators were its ease of use, accessibility, conciseness and comprehensiveness. Conclusion The perceptions of barriers and facilitators reported by physicians are important to understand and better promote the use of the CATT.
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Affiliation(s)
- Jalila Devji
- Faculty of Medicine Undergraduate Program, University of British Columbia, Vancouver, V6T 1Z3, Canada
| | - Shazya Karmali
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, V6H 3V4, Canada
| | - Kate Turcotte
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, V6H 3V4, Canada
| | - Shelina Babul
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, V6H 3V4, Canada
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, V6T 1Z3, Canada
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13
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Qin H, Li S, Liu J, Ren J, Yu M. Follow-up survey of general practitioners in Zhejiang Province post-completion of position transition training in 2017-2020. BMC MEDICAL EDUCATION 2023; 23:182. [PMID: 36964607 PMCID: PMC10038699 DOI: 10.1186/s12909-023-04151-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 03/11/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Position transition training for general practitioners in Zhejiang Province started in 2017 and has since been held once a year. By the beginning of 2022, four training sessions were completed. The purpose of this survey was to establish the current situation of trainees after their graduation and provide reference for the evaluation of the training effect. METHODS Of the 738 trainees who completed the training, 253 were contacted and followed up. A self-designed questionnaire was used to conduct the survey through online filling in. The content included questions to elucidate the following information: whereabouts after the training, registration as a general practitioner, undertaken general practice teaching and scientific research work, current occupational environment, improvement of post competence after receiving position transition training, willingness to complete survey, willingness to participate in future training programs, etc. RESULTS: A number of 253 valid questionnaires were collected with a recovery rate of 100%. Notably, 93.68% of the participants successfully completed their training and obtained the Training Certificate of General Practitioners. Further, 83.4% were registered as general practitioners, 82.94% of which added on the basis of the original registered scope of practice. Currently, most of them work in primary health care institutions, primarily occupied with medical treatment, chronic disease management, COVID-19 prevention and control, health education, and prevention and health care. Of them, 27.01% were currently undertaking teaching work, and only 3.32% of them were conducting scientific research work related to general practice. The overall satisfaction of the trainees in the three theoretical training bases was above 90%, with no statistically significant difference among them (P > 0.05). Importantly, 84.11% of the followed-up personnel hoped to continue to participate in similar training in the future to improve their general practitioner core competences. CONCLUSION The position transition training in Zhejiang Province has achieved good results, but the details of training and the implementation of policies in individual regions need to be improved. Most of the graduates were willing to continue their education, especially in general practitioners with special interests.
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Affiliation(s)
- Hongli Qin
- Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Shuai Li
- Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Juanjuan Liu
- Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Jingjing Ren
- Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
| | - Meiyue Yu
- Zhejiang University, Hangzhou, 310003, China
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14
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Petch J, Kempainnen J, Pettengell C, Aviv S, Butler B, Pond G, Saha A, Bogach J, Allard-Coutu A, Sztur P, Ranisau J, Levine M. Developing a Data and Analytics Platform to Enable a Breast Cancer Learning Health System at a Regional Cancer Center. JCO Clin Cancer Inform 2023; 7:e2200182. [PMID: 37001040 PMCID: PMC10281330 DOI: 10.1200/cci.22.00182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/10/2023] [Indexed: 04/03/2023] Open
Abstract
PURPOSE This study documents the creation of automated, longitudinal, and prospective data and analytics platform for breast cancer at a regional cancer center. This platform combines principles of data warehousing with natural language processing (NLP) to provide the integrated, timely, meaningful, high-quality, and actionable data required to establish a learning health system. METHODS Data from six hospital information systems and one external data source were integrated on a nightly basis by automated extract/transform/load jobs. Free-text clinical documentation was processed using a commercial NLP engine. RESULTS The platform contains 141 data elements of 7,019 patients with newly diagnosed breast cancer who received care at our regional cancer center from January 1, 2014, to June 3, 2022. Daily updating of the database takes an average of 56 minutes. Evaluation of the tuning of NLP jobs found overall high performance, with an F1 of 1.0 for 19 variables, with a further 16 variables with an F1 of > 0.95. CONCLUSION This study describes how data warehousing combined with NLP can be used to create a prospective data and analytics platform to enable a learning health system. Although upfront time investment required to create the platform was considerable, now that it has been developed, daily data processing is completed automatically in less than an hour.
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Affiliation(s)
- Jeremy Petch
- Centre for Data Science and Digital Health, Hamilton Health Sciences, Hamilton, Canada
- Institute for Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Division of Cardiology, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada
- Population Health Research Institute, Hamilton Health Sciences, Hamilton, Canada
| | - Joel Kempainnen
- Centre for Data Science and Digital Health, Hamilton Health Sciences, Hamilton, Canada
| | | | | | | | - Greg Pond
- Escarpment Cancer Research Institute, Hamilton Health Sciences, Hamilton, Canada
| | - Ashirbani Saha
- Centre for Data Science and Digital Health, Hamilton Health Sciences, Hamilton, Canada
- Escarpment Cancer Research Institute, Hamilton Health Sciences, Hamilton, Canada
- Department of Oncology, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jessica Bogach
- Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | | | - Peter Sztur
- Centre for Data Science and Digital Health, Hamilton Health Sciences, Hamilton, Canada
| | - Jonathan Ranisau
- Centre for Data Science and Digital Health, Hamilton Health Sciences, Hamilton, Canada
| | - Mark Levine
- Hamilton Health Sciences, Hamilton, Canada
- Escarpment Cancer Research Institute, Hamilton Health Sciences, Hamilton, Canada
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Fiuzzi M. Outcomes and Observations of On-line CME Activities during the Pandemic. JOURNAL OF CME 2023; 12:2167286. [PMID: 36969485 PMCID: PMC10031771 DOI: 10.1080/28338073.2023.2167286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 01/06/2023] [Accepted: 01/06/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic created an environment where the majority of continuing medical education (CME) and continuing professional development (CPD) activities needed to be delivered digitally. Producing digital materials for 16 separate learning activities (four learning journeys for each of four topic areas) in 2021 provided challenges and raised points of interest and discussion for a small, Italy-based provider of CME and CPD. This study presents outcome metrics from four live, interactive webinars. A variety of promotional efforts, including the strategic use of social media, generated interest and participation; feedback from the European Accreditation Council for Continuing Medical Education standard questionnaire to participants provided rates of satisfaction; subject knowledge and self-reported competence was measured by responses to pre- and post-event and follow-up (after 3 months) questionnaires. Post-event analysis of processes prompted introspection on the learning journey outcomes and methods of analysis. This paper discusses these observations, including potential innovations for future activities (e.g. reconfiguring the e-learning platform to capture time spent on learning activities), and also discusses issues in learner behaviour that impact CME provision and evaluation.
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Affiliation(s)
- Michela Fiuzzi
- Scientific Seminars International Foundation, Rome, Italy
- Scientific Seminars International Foundation, Via di Porta Pinciana, 6, 00185Rome, Italy
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Wang H, Zhang Z, Chen J, Dong H, Zou Y, Wang W, Zheng Q, Feng Y, Tan Z, Zeng X, Zhao Y, Wang Y, Sun A. Current Situation and Demand for Continuing Medical Education (CME) for Obstetricians and Gynecologists. J Multidiscip Healthc 2022; 15:2311-2319. [PMID: 36259073 PMCID: PMC9572484 DOI: 10.2147/jmdh.s382473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
Objective To explore the needs of obstetricians and gynecologists with different working years for the contents and forms of CME. Methods The online questionnaire was distributed on the largest academic training platform for obstetrics and gynecology in China from April 2020 to May 2020. The survey contents mainly included the training forms and training contents of CME, as well as the mastery of diseases by doctors with different working years. Results 4458 questionnaires were returned, of which 3954 questionnaires were included in the study. There was a significant (p < 0.001) positive correlation between the mastery of 19 diseases by obstetricians and gynecologists with different working years. After adjusting for specialist departments, hospital grades, nature of units and ages, it was found that there was no statistically significant difference between the groups in gynecological endocrine-related diseases, such as precocious puberty/delayed puberty, and there was also no statistically significant difference between the groups of shorter working years in infertility, menopausal syndrome, hyperprolactinemia and premature ovarian failure. Conclusion The most popular training content for obstetricians and gynecologists with different working years is common gynecological endocrine diseases, of which abnormal uterine bleeding, menopausal syndrome, polycystic ovarian syndrome and cervical lesions are the most selected diseases, and the most popular form of training is online.
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Affiliation(s)
- Hanbi Wang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
| | - Zhiyuan Zhang
- Department of International Medical Service, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Jie Chen
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
| | - Han Dong
- Department of Obstetrics and Gynecology, Women and Children’s Hospital of Jinzhou, Jinzhou, Liaoning, People’s Republic of China
| | - Ying Zou
- Department of Obstetrics and Gynecology, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, People’s Republic of China
| | - Wei Wang
- Department of Reproductive Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Qingmei Zheng
- Department of Gynecology, the Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
| | - Ying Feng
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China
| | - Zhangyun Tan
- Department of Obstetrics and Gynecology, Xinhui Maternity and Children’s Hospital, Nanning, People’s Republic of China
| | - Xiaoqin Zeng
- Department of Gynecology, Guangzhou Women and Children’s Medical Center, Guangzhou, People’s Republic of China
| | - Yinqing Zhao
- Department of Obstetrics and Gynecology, Xinhui Maternity and Children’s Hospital, Nanning, People’s Republic of China
| | - Yanfang Wang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
| | - Aijun Sun
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of China,Correspondence: Aijun Sun, Email
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