The Impact of the COVID-19 Pandemic on Educational and Academic Activities of Healthcare Professionals in Bahrain

INTRODUCTION

Since its emergence, the COVID-19 pandemic has had a radical effect on different aspects of health worldwide. The burden created by the COVID-19 pandemic on healthcare systems has also involved educational and academic activities among healthcare professionals.

OBJECTIVES

This study aimed to explore the effect of the COVID-19 pandemic on the participation of doctors and nurses in educational and academic activities in Bahrain.

METHODS

A cross-sectional survey was conducted through an online questionnaire that was distributed among 204 healthcare providers (HCPs) in the Kingdom of Bahrain.

RESULTS

Out of 204 HCPs, 110 (53.9%) were doctors and 94 (46.1%) were nurses. A total of 154 responses were received (100 (64%) doctors and 54 (35.1%) nurses) with an overall response rate of 75.5%. Seventy-four (74%) doctors and 32 (59.2%) nurses stated that their overall academic activities had decreased since the start of the pandemic, yet this was not statistically significant (P=0.059). Unlike nurses, doctors attended more webinars 54 (54%) and online courses 47 (47%), compared to the time before the pandemic (P=0.022, P=0.014, respectively).

CONCLUSION

The COVID-19 pandemic had a negative impact on educational and academic activities among healthcare workers. However, it created an opportunity to expand the use of electronic and online methods in those activities.

Glucocorticoid-Induced Osteoporosis: Increased Awareness as a Management Strategy for Prevention of this Complication in Patients with Systemic Autoimmune Rheumatic Disease

BACKGROUND

It has been estimated that about 1% of the US population is treated with long-term glucocorticoids. High doses of glucocorticoids particularly those used by rheumatologists and oth- ers for systemic autoimmune rheumatic disease result in bone loss, causing glucocorticoid-induced osteoporosis and an increase in the risk of fractures. The increased risk is related to both the daily dose and the cumulative dose of the glucocorticoids. Despite the availability of effective preventative and treatment options, glucocorticoid-induced osteoporosis is often not mitigated with the use of these preventive therapies. The risk of glucocorticoid-induced osteoporosis often also goes under- recognized, because it occurs in a different group of patients compared to age-related osteoporosis. As a result, glucocorticoid-induced osteoporosis is not always treated until after fractures may have occurred. Our objective is to determine if a structured health-care provider's educational interven- tion with intermittent educational updates would lead to improvement in the identification, evalu- ation, and prevention of glucocorticoid-induced osteoporosisin those patients at the highest risk of glucocorticoid-induced osteoporosis.

METHODS

In this single-center, prospective study, patients over 40 years of age, receiving a total cumu- lative dose of glucocorticoids of >5 g or a single dose of >30 mg of prednisone or its equivalent was enrolled. All providers attended an academic Journal Club, where the current American College of Rheumatology guidelines regarding glucocorticoid-induced osteoporosiswas reviewed. All providers received monthly reminders during academic meetings within the department.

RESULTS

There was a statistically significant improvement between pre- and post-educational data, with increasing use of glucocorticoid-induced osteoporosis preventive measures, which was sus- tained over the 12-month duration of the study.

CONCLUSION

This research shows the importance of provider education as a means of disseminating information and improving the quality of patient care.

The Role of Technology-Based Education and Teacher Professional Development in English as a Foreign Language Classes

The swift development of technology has had a considerable effect on teaching, especially in foreign language classes, and the rising procedure of using creative technology to help teachers’ instruction and learning indicates the growing domination of technology in academic environments. In addition, teacher professional development significantly affects enhancing the teaching quality, especially the quality of educational activities within the class. Nevertheless, the shortage of workshops on professional development education made educators reliant on informal education where they worked and learned collectively with classmates in mini-groups to enhance their technology usage. The functions of technology-based instruction in the process of learning have not been taken into account in the professional development programs in the Chinese context so far, and consequently, this review takes a look at this issue. In a nutshell, this review of literature has suggestions for academics, theoreticians, and experts in search of inspecting the roles of technology in teacher professional development programs.

Crossword Puzzles and Knowledge Retention

Students perceive crossword puzzles as enjoyable. In addition to students' perceptions, crossword puzzles actually improve knowledge retention. However, crossword puzzles increased exam scores for some students but not others. Recommendations have been made for students to create puzzles for their classmates to complete with the rationale that students are encouraged to research and understand the material in order to write meaningful clues for the puzzle. While students enjoy creating their own crossword puzzles, the association between students creating crossword puzzles and knowledge retention is unknown. The purpose of this project was to determine if creating crossword puzzles and completing peers' crossword puzzles were associated with improved knowledge retention indicated by higher scores on quizzes. Students in a research course from two institutions across three semesters had the option each week to upload a blank puzzle they created prior to completing each other's puzzles and taking a quiz. Quiz scores were compared between those who did versus did not create their own puzzles and complete their peers' puzzles. Results varied by institution and programs, as well as the same program within the same institution but different semesters. Results highlight the importance of moving beyond student perceptions and towards assessing knowledge retention while taking into consideration institution, program, and semester.

Perspectives Against Racism: educational and socialization efforts at the departmental level

The current heightened social awareness and anxiety triggered by escalating violence against Black Americans in the United States demands a safe space for reflection, education, and civil discourse within the academic setting. Too often there is an unmet need paired with a collective urgent desire to better understand the chronic existing structural, social, educational, and health inequities affecting disadvantaged populations, particularly Black Americans. In this perspective, the authors provide insight into a shared learning approach that provided a forum to discuss Perspectives Against Racism (PAR). Unlike existing top-down approaches, faculty, trainees, and staff were engaged in leading a series of focused discussions to examine unconscious bias, promote awareness of implicit biases, and reflect on individual and collective roles and responsibilities in working toward becoming antiracist. An existing 1-h graduate elective seminar course was dedicated to creating a space for learning, discussion, and exchange of ideas related to the experience and existence of racism (personal and institutional/systemic). A goal of each session was to go beyond didactics and identify mechanisms to implement change, at the level of the individual, department, and institution. This perspective of the shared experience may provide an adaptable framework that can be implemented in an academic setting at the departmental, center, or institutional level.

Towards epistemic justice doing: Examining the experiences and shifts in knowledge of lived experience researchers over the course of a mental health research training programme

Participation of people with lived experience (LE) in mental health research is vital for improving the quality and relevance of research priorities, outcomes, and knowledge translation. Inclusion of people with LE is also recognized as central for achieving health service reform including commitments to human rights, social, and epistemic justice. Although a lack of research training is cited as a barrier to LE participation, few studies have examined the value of training for, or the specific requirements of, people with LE. This study seeks to address this gap. It reports on a longitudinal, qualitative study examining shifts in experience and knowledge, and unmet needs, of people with LE over the course of a coproduced research training programme. Findings indicate that the programme enabled participants to understand the role, value, and levels of LE participation in research. Participants also stressed the importance of the 'embodied lived expertise' of LE researchers who co-delivered the training programme. Nonetheless, participants indicated that they felt unprepared for the challenges of working in systems where LE knowledge is subordinated, and experiences of being silenced and powerless could mirror those previously experienced in mental health services and the community. Participants indicated a need for training that provided them with the epistemic resources to render such experiences intelligible. Findings also indicate that training in participatory research is required for conventional mental health researchers, to support them to navigate power asymmetries and value LE knowledge contributions.

Otolaryngology Residents' Attitudes, Experiences, and Barriers Regarding the Medical Research

Objective:

It was aimed to investigate the attitudes, experiences, and barriers towards scientific research among otolaryngology residents in Turkey.

Methods:

Anonymous data were collected via an online survey. The demographic characteristics and experience in scientific research were investigated in the first section of the survey. The attitudes of participants towards scientific research and the barriers to the scientific research were examined in the second section of the survey using 17 items.

Results:

The present study involved 119 otolaryngology residents continuing their education. It was determined that 68.1% of participants think that “participating in scientific research” is a part of otolaryngology training. In the present study, it was shown that the residents having journal club hours in clinics on regular basis participated in various steps of scientific research projects (p<0.05). Residents stated that they participated in the “literature review” stage of the preparation of a scientific publication (mean value of 2.58±1.88) most and in “verbal presentation in a congress” least (mean value of 0.74±1.44). It was determined that 80.7% of participants have not attended in any training on scientific research. It was found that the residents receiving structured scientific research training participated more in steps of scientific research projects which was statistically significantly (p<0.05).

Conclusion:

In our country, otolaryngology residents are very enthusiastic about having research education and participating in researches. However, residency students frequently have time deficiency, lack of knowledge-skill, and lack of financial support. Dedicated time should be allocated for research training and practice in specialty programs. Journal club activities should be organized on regular basis and integrated with research education. On the other hand, the scholarly activities of residents should be supported by means of various countrywide educational activities on research training.

Assessment of Government Intervention Effectiveness in Scrubbing COVID-19 Pandemic and Its Pros and Cons on Educational Activities, the Case of Dire Dawa City

BACKGROUND

Coronaviruses are known as a large family of viruses known to cause respiratory infections which are considered as a pandemic by WHO and widely distributed all over the globe; causing several damages to all aspects of human being's life.

OBJECTIVE

To assess and identify the determinants of government intervention effectiveness in scrubbing COVID-19 and its pros and cons on educational activity in Dire Dawa City.

METHODS

Stratified random sampling was hired to draw a sample of teachers from a list of teachers that were taught at both selected private and public educational institutes.

RESULTS

A 57.6% of educators responded as the government was effective in mitigating the pandemic. Out of 250 educators, 9.6%, 10.8%, 8.4%, 38.4%, and 32.8% were reported that they have very poor, poor, neutral, good, and very good level of knowledge about COVID-19, respectively. The respondents' perceptions about the pandemic were rated as not very fear inducing, not fear inducing, neutral, fear inducing, and very fear inducing 3.2%, 6.4%, 6.8%, 55.2% and 28.4%, respectively. Logistic regression indicates nine predictors were significant: avoiding touching one's body with unwashed hands, disinfecting surfaces, fatigue, getting flu vaccine, individual limitation in cooperating to cease the disease, how to maintain one's mental health during the isolation, and washing for at least 20 seconds, family care, and self-isolation.

PROS

Reading, family care, watching movies and physical exercise were importance brought by the pandemic to the educators.

CONS

Teachers are obligated to stay at home, unemployment, stress, unable to conduct professional activities, cancellation of training, and loss of motivation.

CONCLUSION

The results implied us eighty-four variables were significantly associated with government intervention effectiveness, and nine predictors were significantly related with the government's intervention effectiveness in halting the pandemic from logistic regression model.

Training the Next Industrial Engineers and Managers about Industry 4.0: A Case Study about Challenges and Opportunities in the COVID-19 Era

Training the next generation of industrial engineers and managers is a constant challenge for academia, given the fast changes of industrial technology. The current and predicted development trends in applied technologies affecting industry worldwide as formulated in the Industry 4.0 initiative have clearly emphasized the needs for constantly adapting curricula. The sensible socioeconomic changes generated by the COVID-19 pandemic have induced significant challenges to society in general and industry. Higher education, specifically when dealing with Industry 4.0, must take these new challenges rapidly into account. Modernization of the industrial engineering curriculum combined with its migration to a blended teaching landscape must be updated in real-time with real-world cases. The COVID-19 crisis provides, paradoxically, an opportunity for dealing with the challenges of training industrial engineers to confront a virtual dematerialized work model which has accelerated during and will remain for the foreseeable future after the pandemic. The paper describes the methodology used for adapting, enhancing, and evaluating the learning and teaching experience under the urgent and unexpected challenges to move from face-to-face university courses distant and online teaching. The methodology we describe is built on a process that started before the onset of the pandemic, hence in the paper we start by describing the pre-COVID-19 status in comparison to published initiatives followed by the real time modifications we introduced in the faculty to adapt to the post-COVID-19 teaching/learning era. The focus presented is on Industry 4.0. subjects at the leading edge of the technology changes affecting the industrial engineering and technology management field. The manuscript addresses the flow from system design subjects to implementation areas of the curriculum, including practical examples and the rapid decisions and changes made to encompass the effects of the COVID-19 pandemic on content and teaching methods including feedback received from participants.

Tertiary center referral delay of patients with dementia in Southern Brazil: associated factors and potential solutions

Early dementia diagnosis has many benefits and is a priority. In Brazil, most cases are diagnosed by a specialist.

Implementation of an Online Multimedia Pediatric Tracheostomy Care Module for Healthcare Providers

OBJECTIVES/HYPOTHESIS

To investigate the effect of a multimedia educational module on provider attitudes toward pediatric tracheostomy care. We also describe the process of module development and dissemination at an academic children's hospital.

STUDY DESIGN

Prospective observational study.

METHODS

The pediatric airway committee at an urban tertiary care center developed a multimedia pediatric tracheostomy care module. Nurses, respiratory therapists, as well as resident, fellow, and attending physicians caring for pediatric patients with tracheostomies were eligible. Managers and clinical supervisors from various units recruited participants to complete the pediatric tracheostomy care electronic module and pre- and postassessment knowledge quizzes and surveys. Provider confidence was analyzed using Kruskal-Wallis H-test and Mann-Whitney U-test, and paired t-test was used to compare pre- and postmodule quiz scores.

RESULTS

A total of 422 participants completed the module. A total of 275 participants completed the premodule survey, 385 completed the premodule quiz, 253 completed the postmodule survey, and 233 completed the postmodule quiz. Participants included providers in the neonatal intensive care unit, pediatric intensive care unit, pediatric emergency department, and pediatric wards. Postmodule surveys demonstrated a significant reduction in the average percentage of participants indicating lack of confidence with regards to changing an established tracheostomy, responding to accidental decannulation of established tracheostomy, and responding to accidental decannulation of fresh tracheostomy (P < .001). Average quiz scores increased by 5.6 points from 83.0% to 88.6% (P < .00001).

CONCLUSIONS

A multimedia educational module can improve provider perception of their knowledge and confidence surrounding pediatric tracheostomy management.

LEVEL OF EVIDENCE

3 Laryngoscope, 131:1893-1901, 2021.

A national survey evaluating the effect of COVID-19 pandemic on the teaching and training of anaesthesiology postgraduate students in India

BACKGROUND AND AIMS

Anaesthesiologists have been in the forefront of managing patients of the novel coronavirus disease 19 (COVID-19) globally. The rearrangement of duties of anaesthesiology professionals and trainees along with the enforced containment measures like cessation of gatherings (for classroom teaching), cancellation of large number of elective cases and restricted number of procedures that are being performed have adversely affected the training of anaesthesiology postgraduate students across the country.

METHODS

An electronic survey to assess the effect of the measures taken by hospitals due to COVID-19 on postgraduate teaching was undertaken using a validated questionnaire. We used snowball sampling, and the survey invitation with the web link was shared through freeware WhatsApp. The participation in the survey was voluntary and anonymity was maintained. Data obtained from the responses was collated and analysed.

RESULTS

A total of 595 anaesthesiology postgraduate students (males = 298, females = 297) responded to the survey. Majority of the participants reported a steep depreciation (>50%) in the quality and quantity of academic activities (57.47%), major changes or cessation of clinical rotations (73.61%) and inability to conduct thesis-related cases (55.29%). In total, 56.97% of the students reported the rise in usage of online platforms like "Zoom" for conduct of routine academic activities.

CONCLUSION

Teaching and training schedules of anaesthesiology postgraduate students have undergone major modifications following the COVID 19 pandemic. Resourcefulness and ingenuity in teaching methods is the need of the hour to sustain the desired standards of training courses and to maintain the quality of the budding anaesthesiologists.

What Is the Educational Value of a Student-Led Conference in Dental Education?

Student-led conferences are a type of inquiry learning and student-led pedagogy. They have the potential to foster learning across many of the domains required for professional dental practice including communication and interpersonal skills, adaptive capability, professional attitude and ethical judgment, entrepreneurship, and a social and community orientation. A student-led conference, which provided a framework for students studying oral biosciences to create and host a conference focused on contemporary issues in oral biosciences, was introduced into the Bachelor of Oral Health program at the University of Sydney in Australia in 2017 and 2018. The aim of this qualitative study was to examine the educational purposes that the student-led conference satisfied. Data were collected from the 2017 cohort of students in the form of reflective essays. In 2018, students' experience of the conference was recorded from a focus group discussion. In both years, reflective accounts written by attendees were collected. The thematic analysis generated four themes: integration of learning, personal learning, student resourcefulness through peer relationships, and deep commitment to delivering an excellent conference. The learning project served as a platform for students to display their professionalism and skills gained in entrepreneurship, communication, and adaptive capability. This study provided an example of a participatory curriculum approach with the potential to help students generate a working understanding of knowledge structures and how knowledge is created and circulates in the discipline.

Nationwide survey on activities of regional core centers for the management of liver disease in Japan: Cumulative analyses by the Hepatitis Information Center 2009-2017

AIM

Regional core centers for the management of liver disease, which are located in every prefecture in Japan, not only take the lead in hepatitis care in their respective regions, but also serve a wide range of other functions, such as education, promotion of hepatitis testing, treatment, and research.

METHOD

Since fiscal year 2010, the Hepatitis Information Center has conducted surveys of regional core centers throughout Japan regarding information about their facilities, programs for patient support, training, and education of medical personnel.

RESULTS

By compiling and analyzing the results of these surveys, we have elucidated the status of regional core centers and the issues they currently have. We found that regional core centers have come to play widely varied roles in hepatitis treatment and have expanded their programs. These surveys also suggest that uniform accessibility of hepatitis treatment has been implemented throughout Japan.

CONCLUSION

To continue serving their diverse roles, regional core centers require further development of hepatitis care networks that include specialized institutions, primary care physicians, and local and central governments; as well as collaboration with other professions and groups.

Enriching Medical Student Learning Experiences

OBJECTIVE

Medical students should develop skills in assessing their own learning needs and developing strategies to meet those needs. Medical curricula should be designed to provide active and enriching ways to explore medicine beyond the classroom. The program should enrich the elements of motivation, discovery, innovation, social services, cultural exploration, and personal development. The University of Kansas School of Medicine instituted a new curriculum in 2017 called ACE (Active, Competency-based, and Excellence-driven). Eight 1-week courses of enrichment experiences are embedded within the first 2 years of the curriculum.

METHODS

After each of 8 medical content blocks, students are required to participate in a 1-week, nongraded enrichment experience according to their own learning needs and interests. Students choose the type of enrichment activities including clinical experiences, professional development, leadership development, research and scholarly activity, and community engagement. Students select their top enrichment choices and a computer lottery makes the assignments from their designations. Students engaged in research and scholarly activity are guided to appropriate research mentors.

RESULTS

A total of 196 enrichment activities at 3 campuses were developed for 211 students during the first 2 years of medical school. Most students selected clinical experiences with enrichments available in most medical specialties and subspecialties. Students also use enrichment weeks to conduct research/scholarly activity, particularly those students pursuing the Honors Track. A total of 2071 enrichment experiences were completed in the first 2 years.

CONCLUSIONS

Most enrichments involved clinical experiences, although research/scholarly activity and professional development enrichments also were popular. Evaluations from students and antidotal data suggested enrichments are popular among students and a good change of pace from the usual rigorous activities of the curriculum. Because of the large number of experiences required to conduct the enrichment weeks, a continuous process of evaluation is required to maintain the program. Therefore, flexibility is required to administer the program.

Contemporary activities of Toxicologic Pathology Societies

Educational activities and training opportunities in toxicologic pathology are major goals of 9 formally established Toxicologic Pathology Societies and the International Academy of Toxicologic Pathology. Some Toxicologic Pathology Societies have examination-based certification programs while others accept certification or registration by veterinary pathology organizations including the American College of Veterinary Pathologists, the European College of Veterinary Pathologists. We summarize here the membership numbers and current activities of formally established Toxicologic Pathology Socities.

Contemporary Activities of Toxicologic Pathology Societies

Educational activities and training opportunities in toxicologic pathology are major goals of 9 formally established Toxicologic Pathology Societies and the International Academy of Toxicologic Pathology. Some Toxicologic Pathology Societies have examination-based certification programs while others accept certification or registration by veterinary pathology organizations including the American College of Veterinary Pathologists, the European College of Veterinary Pathologists. We summarize here the membership numbers and current activities of formally established Toxicologic Pathology Socities.

"It made me feel Brazilian!": Addressing prejudice through Capoeira classes in a school in Western Australia

ISSUE ADDRESSED

Social inclusion is important for mental health, and schools are important settings for creating positive attitudes against prejudice. Capoeira is a Brazilian traditional culture that is a mixture of dance, martial arts and games, and has many educational possibilities. Since it arose from and helped people rise above black oppression, the purpose of the project was introducing the content of capoeira to primary school students with the aim of promoting of mental health and preventing prejudice behaviours using an intercultural perspective in a school where nearly half the students are Aboriginal.

METHODS

Five capoeira classes were conducted in a primary school located in a regional city in Western Australia, with two Year 5-6 classes and boys and girls aged 11-12 years old. Activities were meant to create an environment of dialogue, joy and empathy towards a different culture. Feedback from 31 of 34 students were collected and analysed, dealing with their impressions, positive and negative aspects.

RESULTS

The results were positive, with aspects of movement, joy, dance and music identified as important experiences. Empathy towards the new culture was written and drawn by many of the students. Joint work with teachers improved engagement and feedback from students.

CONCLUSION

Capoeira can be an inspiring vehicle in intercultural education, promoting mental health and empathy for different cultures. SO WHAT?: Broad intercultural education which embraces positive cultural experiences and stories from elsewhere, delivered in schools can contribute to children's intercultural competence. Longer interventions with follow-up to measure changes in students' attitudes are required.

Effectiveness of a Flipped Classroom in Learning Periodontal Diagnosis and Treatment Planning

The aim of this study was to assess whether a flipped classroom was an effective model for dental students to learn periodontal diagnosis and treatment planning (DTP). Participants were all third-year students in three academic years (2015-17) at Harvard School of Dental Medicine: two groups that experienced the flipped classroom (Classes of 2017 and 2018), and a control group (Class of 2019) that received the same content in traditional lecture format. All three groups completed a DTP knowledge quiz before and after the educational experience; the flipped classroom groups also completed pre and post surveys of their opinions about flipped classrooms. The flipped classroom group received a 23-minute video and corresponding PowerPoint presentation to view on their own time. In class, these students were divided into groups to diagnosis and treatment plan cases and discuss them with the instructor. Of 71 students in the two flipped classroom groups, 69 pre and post quizzes were returned (response rate 97%), and 61 pre and post surveys were returned (response rate 86%). Of 35 students in the lecture group, 34 completed pre and post quizzes (response rate 97%). The mean pre scores on the knowledge quiz in the flipped classroom groups and the conventional lecture group were 64% and 54%, respectively. After the DTP education, students' quiz scores improved in all three groups, but only the difference in the flipped classroom groups was statistically significant (p<0.01). After the flipped classroom session, 84% of the students agreed or strongly agreed that this methodology was effective for learning periodontal DTP, and 90% agreed or strongly agreed they understood the fundamentals of periodontal DTP-both increases over their pre survey scores. Overall, this flipped classroom model was effective in educating students on periodontal DTP and was well received by the students.

Training of workplace-based clinical trainers in family medicine, South Africa: Before-and-after evaluation

BACKGROUND

The training of family physicians is a relatively new phenomenon in the district health services of South Africa. There are concerns about the quality of clinical training and the low pass rate in the national examination.

AIM

To assess the effect of a five-day course to train clinical trainers in family medicine on the participants' subsequent capability in the workplace.

SETTING

Family physician clinical trainers from training programmes mainly in South Africa, but also from Ghana, Uganda, Kenya, Malawi and Botswana.

METHODS

A before-and-after study using self-reported change at 6 weeks (N = 18) and a 360-degree evaluation of clinical trainers by trainees after 3 months (N = 33). Quantitative data were analysed using the Statistical Package for Social Sciences, and qualitative data wereanalysed thematically.

RESULTS

Significant change (p < 0.05) was found at 6 weeks in terms of ensuring safe and effective patient care through training, establishing and maintaining an environment for learning, teaching and facilitating learning, enhancing learning through assessment, and supporting and monitoring educational progress. Family physicians reported that they were better at giving feedback, more aware of different learning styles, more facilitative and less authoritarian in their educational approach, more reflective and critical of their educational capabilities and more aware of principles in assessment. Despite this, the trainees did notreport any noticeable change in the trainers' capability after 3 months.

CONCLUSION

The results support a short-term improvement in the capability of clinical trainers following the course. This change needs to be supported by ongoing formative assessment and supportive visits, which are reported on elsewhere.

Impact of Virtual Patients as Optional Learning Material in Veterinary Biochemistry Education

Biochemistry and physiology teachers from veterinary faculties in Hannover, Budapest, and Lublin prepared innovative, computer-based, integrative clinical case scenarios as optional learning materials for teaching and learning in basic sciences. These learning materials were designed to enhance attention and increase interest and intrinsic motivation for learning, thus strengthening autonomous, active, and self-directed learning. We investigated learning progress and success by administering a pre-test before exposure to the virtual patients (vetVIP) cases, offered vetVIP cases alongside regular biochemistry courses, and then administered a complementary post-test. We analyzed improvement in cohort performance and level of confidence in rating questions. Results of the performance in biochemistry examinations in 2014, 2015, and 2016 were correlated with the use of and performance in vetVIP cases throughout biochemistry courses in Hannover. Surveys of students reflected that interactive cases helped them understand the relevance of basic sciences in veterinary education. Differences between identical pre- and post-tests revealed knowledge improvement (correct answers: +28% in Hannover, +9% in Lublin) and enhanced confidence in decision making ("I don't know" answers: -20% in Hannover, -7.5% in Lublin). High case usage and voluntary participation (use of vetVIP cases in Hannover and Lublin >70%, Budapest <1%; response rates in pre-test 72% and post-test 48%) indicated a good increase in motivation for the subject of biochemistry. Despite increased motivation, there was only a weak correlation between performance in final exams and performance in the vetVIP cases. Case-based e-learning could be extended and generated cases should be shared across veterinary faculties.

Utilization and acceptance of virtual patients in veterinary basic sciences - the vetVIP-project

Context: In medical and veterinary medical education the use of problem-based and cased-based learning has steadily increased over time. At veterinary faculties, this development has mainly been evident in the clinical phase of the veterinary education. Therefore, a consortium of teachers of biochemistry and physiology together with technical and didactical experts launched the EU-funded project "vetVIP", to create and implement veterinary virtual patients and problems for basic science instruction. In this study the implementation and utilization of virtual patients occurred at the veterinary faculties in Budapest, Hannover and Lublin. Methods: This report describes the investigation of the utilization and acceptance of students studying veterinary basic sciences using optional online learning material concurrently to regular biochemistry and physiology didactic instruction. The reaction of students towards this offer of clinical case-based learning in basic sciences was analysed using quantitative and qualitative data. Quantitative data were collected automatically within the chosen software-system CASUS as user-log-files. Responses regarding the quality of the virtual patients were obtained using an online questionnaire. Furthermore, subjective evaluation by authors was performed using a focus group discussion and an online questionnaire. Results: Implementation as well as usage and acceptance varied between the three participating locations. High approval was documented in Hannover and Lublin based upon the high proportion of voluntary students (>70%) using optional virtual patients. However, in Budapest the participation rate was below 1%. Due to utilization, students seem to prefer virtual patients and problems created in their native language and developed at their own university. In addition, the statement that assessment drives learning was supported by the observation that peak utilization was just prior to summative examinations. Conclusion: Veterinary virtual patients in basic sciences can be introduced and used for the presentation of integrative clinical case scenarios. Student post-course comments also supported the conclusion that overall the virtual cases increased their motivation for learning veterinary basic sciences.

Effects of Enhancing School-Based Body Mass Index Screening Reports with Parent Education on Report Utility and Parental Intent To Modify Obesity Risk Factors

BACKGROUND

School-based body mass index screenings (SBMIS) have been controversial. We aimed to determine if parents would indicate improved utility with SBMIS when the report included parent education and whether parental intent to modify obesity risk factors would vary with report type or child weight.

METHODS

A cluster-controlled trial was conducted with 31 elementary schools randomized to distribute a standard SBMIS report or the standard report plus education (SBMIS+). A random subsample of parents completed a mailed survey (731 SBMIS, 738 SBMIS+). Using a two-stage cluster sampling design, logistic regression models with school-level random effect were used to assess differences between conditions and by weight category.

RESULTS

Parents in the SBMIS+ condition vs. the standard condition were more likely to indicate that the report provided useful information (not significant) and an intent to help their child get enough sleep (p < 0.001). Parents of children who were overweight or obese were less likely than parents of children who were not to indicate that the report provided useful information about their child's weight status (p < 0.001) or access to resources (p < 0.05). However, these parents were more likely to plan a visit to healthcare provider (p < 0.001) and to intend to limit sugar-sweetened beverages (p < 0.05).

CONCLUSIONS

Parental education can enhance the utility of the SBMIS report and parental intention to modify at least one obesity risk factor. SBMIS reports prompted parents of children with overweight and obesity to seek clinical care and limit sugar-sweetened drinks.

Clinical adherence to thrombophilia screening guidelines at a major tertiary care hospital

Essentials Thrombophilia screening has significantly increased but has limited clinical utility. We evaluated the positive rate of thrombophilia screening and adherence to published guidelines. Both the positive rate for thrombophilia screening and the adherence to guidelines were low. Guidance implementation is essential to improve current thrombophilia screening practice.

SUMMARY

Background Thrombophilia screening is widely performed but provides limited clinical utility in managing patients predisposed to venous thromboembolism. Although guidelines to limit testing have been published, adherence to those guidelines in the outpatient clinical setting has not been assessed. Objective To evaluate outpatient thrombophilia screening practices at a tertiary academic medical center. Methods We performed a retrospective review of the electronic medical records and a computational analysis of thrombophilia tests collected during a 3-year period (August 2010 to June 2013) at a large teaching hospital. Our primary outcome measures were positive diagnostic yield for thrombophilia and clinician adherence to published thrombophilia screening guidelines in the outpatient setting. Results and Conclusions We found a positive diagnostic yield of 13.8% (95% confidence interval 12.3% to 15.3%) for outpatient thrombophilia screening at our institution. Of the screening tests requiring a second confirmatory assay for definitive diagnosis, only 12% (95% confidence interval 10.3% to 13.7%) were appropriately obtained. We also observed that 73% of patients in our electronic medical record review were inappropriately tested based on existing screening guideline criteria. When parsed by specialty, we identified that hematologists had a higher adherence rate to guideline criteria than do physicians from other specialties. Our study confirms low adherence to thrombophilia screening guidelines across disciplines and indicates the need for continued clinician education.

Developing new pathways into the biomedical informatics field: the AMIA High School Scholars Program

Increasing access to biomedical informatics experiences is a significant need as the field continues to face workforce challenges. Looking beyond traditional medical school and graduate school pathways into the field is crucial for expanding the number of individuals and increasing diversity in the field. This case report provides an overview of the development and initial implementation of the American Medical Informatics Association (AMIA) High School Scholars Program. Initiated in 2014, the program's primary goal was to provide dissemination opportunities for high school students engaged in biomedical informatics research. We discuss success factors including strong cross-institutional, cross-organizational collaboration and the high quality of high school student submissions to the program. The challenges encountered, especially around working with minors and communicating program expectations clearly, are also discussed. Finally, we present the path forward for the continued evolution of the AMIA High School Scholars Program.

Towards tailored teaching: using participatory action research to enhance the learning experience of Longitudinal Integrated Clerkship students in a South African rural district hospital

BACKGROUND

The introduction of Stellenbosch University's Longitudinal Integrated Clerkship (LIC) model as part of the undergraduate medical curriculum offers a unique and exciting training model to develop generalist doctors for the changing South African health landscape. At one of these LIC sites, the need for an improvement of the local learning experience became evident. This paper explores how to identify and implement a tailored teaching and learning intervention to improve workplace-based learning for LIC students.

METHODS

A participatory action research approach was used in a co-operative inquiry group (ten participants), consisting of the students, clinician educators and researchers, who met over a period of 5 months. Through a cyclical process of action and reflection this group identified a teaching intervention.

RESULTS

The results demonstrate the gaps and challenges identified when implementing a LIC model of medical education. A structured learning programme for the final 6 weeks of the students' placement at the district hospital was designed by the co-operative inquiry group as an agreed intervention. The post-intervention group reflection highlighted a need to create a structured programme in the spirit of local collaboration and learning across disciplines. The results also enhance our understanding of both students and clinician educators' perceptions of this new model of workplace-based training.

CONCLUSIONS

This paper provides practical strategies to enhance teaching and learning in a new educational context. These strategies illuminate three paradigm shifts: (1) from the traditional medical education approach towards a transformative learning approach advocated for the 21(st) century health professional; (2) from the teaching hospital context to the district hospital context; and (3) from block-based teaching towards a longitudinal integrated learning model. A programme based on balancing structured and tailored learning activities is recommended in order to address the local learning needs of students in the LIC model. We recommend that action learning sets should be developed at these LIC sites, where the relevant aspects of work-place based learning are negotiated.

Using robots in "Hands-on" academic activities: a case study examining speech-generating device use and required skills

PURPOSE

A 12-year-old girl, Emily, with complex communication needs and severe physical limitations, controlled a Lego robot from a speech-generating device (SGD) to do various "hands-on" academic activities. Emily's teacher and assistive technology (AT) team thought that controlling a robot would motivate Emily to "use her SGD more".

METHOD

A descriptive case study was used because the integration of communication and manipulation technologies is not yet understood. Target activities and goals were chosen by Emily's teacher and AT team. Emily performed several manipulative math activities and engaged in an "acting" activity aimed at increasing her message length. The competency skills needed to control a robot from the SGD were examined, as well as stakeholder satisfaction with the robot system.

RESULTS

Emily generated up to 0.4 communication events and 7 robot commands per minute in the activities. Her length of utterance was usually one-word long, but she generated two- and three-word utterances during some activities. Observations of Emily informed a framework to describe the competency skills needed to use SGDs to control robots. Emily and her teacher expressed satisfaction with robot use.

CONCLUSION

Robot use could motivate students to build SGD operational skills and learn educational concepts. Implications for Rehabilitation Controlling a robot from a speech-generating device (SGD) could increase students' motivation, engagement and understanding in learning educational concepts, because of the hands-on enactive approach. The robot and SGD system was acceptable to the participant and teacher and elicited positive comments from classmates. Thus, it may provide a way for children with disabilities to link with the curriculum and with other students in the classroom. Controlling a robot via SGD presents opportunities to improve augmentative and alternative communication operational, linguistic, social and strategic skills. Careful choice of activities will ensure that the activity requirements focus on the desired target skill, e.g. drawing or playing board games could be helpful to build operational skills and acting out stories could be helpful for building linguistic skills.

The effects of suicide prevention measures reported through a psychoeducational video: a practice in Japan

BACKGROUND

As the suicide rate in Japan has remained high since 1998, various suicide prevention measures have been implemented in Japanese local communities.

AIMS

To report our findings on the effect of a psychoeducational video as a suicide prevention measure in a Japanese rural town.

METHODS

Questionnaires were randomly mailed to 2,000 residents aged between 30 and 79 years. Within 4 weeks, volunteers in the town visited the residents individually and collected the questionnaires. The variables reported in this study are demographics, awareness of suicide prevention measures available in the town, whether the residents watched the video, help-seeking from advisers regarding suicidal ideation and financial problems and attitudes towards suicide.

RESULTS

We analysed data collected from 1,118 people who reported their demographics (i.e. sex, age, and job) and whether they had watched the video. By conducting a series of logistic regression and multiple regression analyses and controlling for demographic variables, we found that watching the video had substantial psychoeducational effects.

CONCLUSION

Despite conducting a cross-sectional study, our new suicide prevention measures were considered effective for psychoeducation. However, further studies using a longitudinal design are needed.

Farm to elementary school programming increases access to fruits and vegetables and increases their consumption among those with low intake

OBJECTIVE

To assess the effectiveness of Wisconsin Farm to School (F2S) programs in increasing students' fruit and vegetable (FV) intake.

DESIGN

Quasi-experimental baseline and follow-up assessments: knowledge and attitudes survey, food frequency questionnaire (FFQ), and lunch tray photo observation.

SETTING

Wisconsin elementary schools: 1 urban and 8 rural.

PARTICIPANTS

Children, grades 3-5 (n = 1,117; 53% male, 19% non-Caucasian).

INTERVENTION(S)

Farm to School programming ranging from Harvest of the Month alone to comprehensive, including school garden, locally sourced produce in school meals, and classroom lessons.

MAIN OUTCOME MEASURES

Knowledge, attitudes, exposure, liking, willingness; FFQ-derived (total), and photo-derived school lunch FV intake.

ANALYSIS

t tests and mixed modeling to assess baseline differences and academic-year change.

RESULTS

Higher willingness to try FV (+1%; P < .001) and knowledge of nutrition/agriculture (+1%; P < .001) (n = 888), and lunch FV availability (+6% to 17%; P ≤ .001) (n = 4,451 trays), both with increasing prior F2S program exposure and across the year. There was no effect on overall dietary patterns (FFQ; n = 305) but FV consumption increased among those with the lowest intakes (FFQ, baseline very low fruit intake, +135%, P < .001; photos: percentage of trays with no FV consumption for continuing programs decreased 3% to 10%, P ≤ .05).

CONCLUSIONS AND IMPLICATIONS

Farm to School programming improved mediators of FV consumption and decreased the proportion of children with unfavorable FV behaviors at school lunch. Longer-term data are needed to further assess F2S programs.

Quality evaluation of portal sites in health system, as a tool for education and learning

BACKGROUND

The main objective of creating a portal is to make information service available for users who need them for performance of duties and responsibilities regardless of the sources. This article is attempted to consider the parameters that can evaluate these sites since these criteria can be effective in designing and implementing such portals. On the other hand, portal sites in health systems of every country make it possible for leaders, policy makers, and directors to system education as a tool for new learning technologies. One of the main decisions each manager has to make is precise selection of appropriate portal sites.

MATERIALS AND METHODS

This is a descriptive and qualitative study. The research sample was 53 computer professional working in the area of computer programming and design. In the first part of the study a questionnaire was send to the participants and in the second part of the study based on their response to the questionnaire the participant was interviewed and the main themes of the studies were formulated. The validity and the reliability of the questionnaire were confirmed.

RESULTS

The study results were summarized in 10 themes and 50 sub-categories. The main themes included were portal requirements, security, management, and efficiency, user friendliness, built-in applications, portal flexibility, interoperability, and support systems.

CONCLUSION

Portal sites in any education systems make it possible for health system leaders and policy makers to manage their organization information system efficiently and effectively. One of the major decisions each manager has to make is precise selection of an appropriate portal sites design and development. The themes and sub-categories of this study could help health system managers and policy makers and information technology professionals to make appropriate decisions regarding portal design and development.

Standardized patient practices: initial report on the survey of US and Canadian medical schools

BACKGROUND

There is currently a lack of information about the ways in which standardized patients (SPs) are used, how programs that facilitate their use are operated, the ways in which SP-based performance assessments are developed, and how assessment quality is assured. This survey research project was undertaken to describe the current practices of programs delivering SP-based instruction and/or assessment.

METHOD

A structured interview of 61 individual SP programs affiliated with the Association of Standardized Patient Educators (ASPE) was conducted over a 7-month period. A web-based data entry system was used by the 11 trained interviewers.

RESULTS

The two most common reported uses of SPs were learner performance assessment (88% of respondents) and small-group instruction (84% of respondents). Fifty-four percent of programs hired 51-100 SPs annually and paid an average of $15 and $16 per hour for training time and portraying a case, respectively. The average reported number of permanent program employees, excluding SPs and temporary staff, was 4.8 (sd = 3.6). The most frequently reported salary range was $30,001-$45,000.

CONCLUSION

We intend for these preliminary results to inform the medical education community about the functions of SPs and the structures of programs that implement these complex educational endeavors.