Global assessment of the knowledge and confidence in managing allergic disorders among primary care pediatricians across Europe: An EAACI task force report

BACKGROUND

Pediatricians are often the first point of contact for children in Primary Care (PC), but still perceive gaps in their allergy knowledge. We investigated self-perceived knowledge gaps and educational needs in pediatricians across healthcare systems in Europe so that future educational initiatives may better support the delivery of allergy services in PC.

METHOD

A multinational survey was circulated to pediatricians who care for children and adolescents with allergy problems in PC by the EAACI Allergy Educational Needs in Primary Care Pediatricians Task Force from February to March 2023. A 5-point Likert scale was used to assess the level of agreement with questionnaire statements. Thirty surveys per country were the cut-off for inclusion and statistical analysis.

RESULTS

In this study, 1991 respondents were obtained from 56 countries across Europe and 210 responses were from countries with a cut-off below 30 participants per country. Primary care pediatricians (PCPs) comprised 74.4% of the respondents. The majority (65.3%) were contracted to state or district health services. 61.7% had awareness of guidelines for onward allergy referral in their countries but only 22.3% were aware of the EAACI competencies document for allied health professionals for allergy. Total sample respondents versus PCPs showed 52% and 47% of them have access to allergy investigations in their PC facility (mainly specific IgE and skin prick tests); 67.6% and 58.9% have access to immunotherapy, respectively. The main barrier to referral to a specialist was a consideration that the patient's condition could be diagnosed and treated in this PC facility, (57.8% and 63.6% respectively). The main reasons for referral were the need for hospital assessment, and partial response to first-line treatment (55.4% and 59.2%, 47% and 50.7%, respectively). Learning and assessment methods preference was fairly equally divided between Traditional methods (45.7% and 50.1% respectively) and e-learning 45.5% and 44.9%, respectively. Generalist physicians (GPs) have the poorest access to allergy investigations (32.7%, p = .000). The majority of the total sample (91.9%) assess patients with allergic pathology. 868 (43.6%) and 1117 (46.1%), received allergy training as undergraduates and postgraduates respectively [these proportions in PCPs were higher (45% and 59%), respectively]. PCPs with a special interest in allergology experienced greater exposure to allergy teaching as postgraduates. GPs received the largest amount of allergy teaching as undergraduates. Identifying allergic disease based on clinical presentation, respondents felt most confident in the management of eczema/atopic dermatitis (87.4%) and rhinitis/asthma (86.2%), and least confident in allergen immunotherapy (36.9%) and latex allergy (30.8%).

CONCLUSION

This study exploring the confidence of PCPs to diagnose, manage, and refer patients with allergies, demonstrated knowledge gaps and educational needs for allergy clinical practice. It detects areas in need of urgent improvement especially in latex and allergen immunotherapy. It is important to ensure the dissemination of allergy guidelines and supporting EAACI documents since the majority of PCPs lack awareness of them. This survey has enabled us to identify what the educational priorities of PCPs are and how they would like to have them met.

Interprofessional education: a necessity in Alzheimer's dementia care-a pilot study

Introduction

Interprofessional collaboration is seen as an indispensable prerequisite for high-quality health services and patient care, especially for complex diseases such as dementia. Thus, the current project aimed to extend interprofessional and competency-based education in the field of dementia care to the previously understudied therapy professions of nutrition, speech-language pathology, and physiotherapy.

Methods

A three-day workshop was designed to provide specific learning objectives related to patient-centered dementia care, as well as competences for interprofessional collaboration. Teaching and learning approaches included case-based learning in simulated interprofessional case-conferences and peer-teaching. A total of 42 students (n = 20 nutrition therapy and counseling, n = 8 speech-language pathology, n = 14 physiotherapy), ranging from first to seventh semester, finished the whole workshop and were considered in data analysis. Changes in self-perceived attitudes toward interprofessional collaboration and education were measured by the German version of the UWE-IP. An in-house questionnaire was developed to evaluate knowledge and skills in the field of dementia, dementia management and interprofessional collaboration.

Results

Participation in the workshop led to significant improvements in the total scores of the UWE-IP-D and the in-house questionnaire, as well as their respective subscales. Moderate to large effect sizes were achieved. All professions improved significantly in both questionnaires with large effect sizes. Significant differences between professions were found in the UWE-IP-D total score between students of speech-language pathology and physiotherapy in the posttest. Students of nutrition therapy and counseling revealed a significant lower level of self-perceived knowledge and skills in the in-house questionnaire pre- and post-testing.

Discussion

The pilot-study confirms the effectiveness of interprofessional education to promote generic and interprofessional dementia care competencies and to develop positive attitudes toward interprofessional learning and collaboration in the therapy professions, thus increasing professional diversity in interprofessional education research. Differences between professions were confounded by heterogenous semester numbers and participation conditions. To achieve a curricular implementation, interprofessional education should be expanded to include a larger group of participants belonging to different professions, start early in the study program, and be evaluated over the long term.

[Trouble neurocognitif majeur et méthodes optimisant l'apprentissage]

Les difficultés cognitives consécutives aux troubles neurocognitifs majeurs (TNCM) engendrent des enjeux dans la réalisation d'activités de la vie quotidienne. Ce projet visait à identifier auprès des proches aidants et des intervenants des situations nécessitant des méthodes optimisant l'apprentissage pour faciliter l'engagement de personnes vivant avec un TNCM dans leurs activités de la vie quotidienne. Des entrevues individuelles semi-dirigées, d'une durée de 60 à 90 minutes, ont été menées auprès de proches aidants et d'intervenants. Les résultats montrent que les activités quotidiennes et domestiques sont notamment affectées par les difficultés à repérer ou à utiliser les objets, à garder en tête la tâche en cours, à mettre en séquences des étapes, à ne pas se laisser distraire par autre chose et à constater ses difficultés pour s'y adapter. Les proches aidants souhaitent du soutien dans l'application des méthodes optimisant l'apprentissage pour contribuer au maintien de l'autonomie des personnes vivant avec un TNCM.

Nursing Students' Preferences for Learning Medical and Bioscience Subjects: A Qualitative Study

(1) Background: There are considerable challenges and concerns related to learning medical and bioscience subjects (MBS) in nursing education and integrating this knowledge into nursing. The aim of this study was to explore what learning methods nursing students prefer when studying MBS, and how this learning may be enhanced to facilitate the integration of these subjects into nursing. (2) Methods: Individual interviews with 10 nursing students. Transcripts from the interviews were analysed by systematic text condensation and the COREQ checklist for qualitative studies was completed. (3) Results: Students prefer varied and active learning methods in MBS. The participants in the study highlighted both organised tutorials in groups and working with fellow students outside of organised teaching. All participants used educational videos. Learning MBS by drawing was appreciated both during lectures and in student-initiated colloquia. Strategies that favour in-depth learning were appreciated, and it was found that lectures did not have to cover the entire curriculum. Teachers' attitudes toward students also were seen to have a considerable impact on students' motivation for learning. (4) Conclusion: Applying active learning methods and focusing on the most relevant topics in MBS appears to improve students' ability to integrate this knowledge into nursing; teachers should also be aware of their role as a motivator.

Current allergy educational needs in primary care. Results of the EAACI working group on primary care survey exploring the confidence to manage and the opportunity to refer patients with allergy

The aim of this survey was to explore the specific educational needs of a cohort of European GPs with regards to allergy training so that future educational initiatives may better support the delivery of allergy services in primary care.

METHOD

This study took the form of a cross-sectional observational study in which a structured electronic questionnaire was distributed to primary care providers, in eight languages, across 8 European countries between September 2019 and November 2019. Data associated with demographic parameters, professional qualifications, type of employment, level of confidence regarding competencies for diagnosis and treatment of allergic diseases, referral of patients to allergist and preferred method of learning and assessment were collected. A 5-point Likert scale was used to assess level of confidence. Exploratory analysis was carried out.

RESULTS

A total of 687 responses were available for analysis, with 99.3% of responders working within Europe. 70.1% of participants were female; and 48.0% and 48.0% of participants respectively had received some undergraduate and/or postgraduate allergy education. Confidence in dealing with different aspect of allergy management differed between countries. The main reason for specialist referral was a perceived need for tertiary assessment (54.3%), and the main barrier for referral was the consideration that the patient's condition could be appropriately diagnosed and treated in a primary care facility. Up to 44.7% and 55.3% of participants reported that they preferred e-Learning over traditional learning.

CONCLUSIONS

This study identified the specific areas of skills training and educational needs of GPs in managing allergic conditions in primary care, and provided insights into possible strategies for more feasible and cost-effective approaches.

Learning Methods During School Closure and Its Correlation With Anxiety and Health Behavior of Thai Students

BACKGROUND

The sequential waves of epidemic spread of COVID-19 in Thailand have caused periodic closures of schools, and exposed students to different learning methods that require multiple adjustment strategies. This study aimed to examine how different learning methods may correlate with anxiety and health behavior (e.g., physical activity, active play, screen time, sleep) of primary and secondary school students in Thailand.

METHODS

Thailand Report Card (TRC) Data (2021) was employed. The sample of the TRC was drawn by multi-stages random sampling stratified by region, district, urban/rural, school size, sex, and age to ensure national representativeness. A total of 6,078 Thai primary (64%) and secondary (36%) school students were included in the analysis.

RESULTS

About two-thirds (66.4%) of the sample experienced a shift from traditional classroom to fully online learning, 6.9% experienced partial online instruction, 23.6% received handouts or written assignments, and 3.1% resumed traditional classroom learning. Compared to fully online learning, students who experienced traditional classroom (onsite) teaching were 37.8% less likely to report moderate-to severe anxiety (OR 0.6; p-value 0.021). There was no significant correlation between school closure-induced anxiety with overall physical activity (PA) and active play, but anxiety was significantly associated with screen time and sleep duration. Receiving handouts/written assignments only as the learning method was significantly correlated with PA, but two methods (handouts and onsite/traditional classroom) was significantly correlated with active play. Students who experienced classroom learning were also more likely to comply with recommended durations of screen time and sleep.

CONCLUSION

Although online learning was probably the most convenient choice during COVID-19 containment measures in Thailand, this method did not provide sufficient opportunity for PA and play. Online learning also encouraged an excessive use of screen media, and disrupted sleeping patterns. Online learning also pressured Thai students to make various adjustments in their daily routines that may have further aggravated anxiety.

Students' preferences regarding teaching methodology in dental education - a cross-sectional study

INTRODUCTION

The goal of dental education is to prepare competent ethical professionals with critical thinking, reasoning and analyzing skills along with ability of application of clinical skills and judgement in treating a patient. The present study was designed with the objective to elicit the preferences of dental students regarding the utility of the prevailing teaching and learning methods and teaching aids.

MATERIAL AND METHODS

A cross-sectional study was conducted among undergraduate dental students. Study population consisted of 382 dental students. A self-designed close-ended questionnaire written in English was constructed specifically for the study. The questionnaire was divided into two sections. Information regarding various teaching and learning methods both in theory and practical/clinical classes was obtained from the students. Results were calculated using numbers and percentages only.

RESULTS

The mean age of the students was 20.49 + 2.4 years. Problem based learning (PBL) was rated very useful by 76% (290) and useful by 24% (92) of subjects. Performing clinical/practical procedure individually rather than in group was rated very useful by 31% (118) of subjects. Use of power-point along with the blackboard was rated as the most useful method by 95% (363) of subjects. Majority of subjects (61%, 233) felt that 40 minutes duration of lecture was more useful as compared to 30 minutes.

CONCLUSIONS

Our study concludes that dental students prefer active teaching learning methodologies and combination of audiovisual aids. Hence it is suggested that collaboration of different active teaching methods and aids should be adopted by the teachers in order to enhance the student learning process.

Photograph method fosters direct access to second-language word meaning: Direct evidence from a word-picture matching task

This experiment was designed to investigate conceptual links directly through a word-picture matching task in children. Participants were asked to indicate between two pictures the one depicting the same concept as the newly learned L2 word (target). One of the two pictures was the target, while the other was either semantically related to it or was unrelated. To investigate whether learning methods modulate L2 word processing, two learning methods were compared: an L2-photograph method and an L1-L2 method. Results showed a semantic interference effect only with the L2-photograph method: Children responded more slowly in the related condition than in the unrelated one. The learning method modulated L2 word processing and L2 word meaning was not necessarily accessed through L1 mediation in the first steps of learning. The method used paves the way for the direct investigation of conceptual links.

Impact of Learning Methods on Spatial Knowledge Acquisition

Research on the acquisition of spatial knowledge not only enriches our understanding of the theory of spatial knowledge representation but also creates practical value for the application of spatial knowledge. The aim of this study is to understand the impact of different learning methods on the acquisition of spatial knowledge, including the role of 2D maps, the difference between physical interaction and virtual interaction, and whether passive learning can replace active learning in virtual environments. One experiment was conducted, in which landmark knowledge and configurational knowledge were measured. Results indicate that 2D maps play a supporting role in acquiring both landmark knowledge and configurational knowledge. In addition, physical learning was associated with better spatial knowledge representation compared with virtual learning. An analysis of observational data in the third comparison found no significant difference between passive learning and active learning using virtual street view maps. However, with high-quality learning materials, passive learning can contribute to the acquisition of spatial knowledge more efficiently than active learning.

Results of an allergy educational needs questionnaire for primary care

It is well recognized that knowledge of allergic conditions is suboptimal in primary care. The Primary Care Interest Group of the European Academy of Allergy and Clinical Immunology undertook an educational needs survey to better understand what they were and how best to meet them, in the primary care environment. An electronic questionnaire was devised and distributed as widely as possible. A total of 2226 people from 63 countries opened the e-questionnaire of which 692 provided evaluable responses. In total, 81% were medical doctors with 299 possessing additional qualifications. Self-declared gaps in knowledge were expressed for most manifestations of allergy with a correspondingly high self-expressed educational need. The preferred learning modalities were online guidelines (69.6%) and courses (68.8%) followed closely by workshops (68%), structured online modules (63.9%) and small local working groups (59.75%). Podcasts and webinars scored poorly with only 25% expressing these as preferred learning modes although there was an age gradient. The preferred electronic platform was the personal computer (82.6%). A better understanding of the needs of primary care should help guide the design of educational initiatives to meet those needs.

The interplay between experiential and traditional learning for competency development

Extensive research demonstrated that firms may pursue several advantages in hiring individuals with the set of emotional, social, and cognitive (ESC) competencies that are most critical for business success. Therefore, the role of education for competency development is becoming paramount. Prior studies have questioned the traditional methods, grounded in the lecture format, as a way to effectively develop ESC competencies. Alternatively, they propose experiential learning techniques that involve participants in dedicated courses or activities. Despite the insights provided by these studies, they do not take into account a comprehensive set of learning methods and their combined effect on the individual's competency portfolio within educational programs that aim to transfer primarily professional skills. Our study aims to fill these gaps by investigating the impact of the interplay between different learning methods on ESC competencies through a sample of students enrolled in the first year of a master's degree program. After providing a classification of three learning methods [traditional learning (TL), individual experiential learning (IEL), and social experiential learning (SEL)], the study delves into their combined influence on ESC competencies, adopting the Artificial Neural Network. Contrary to prior studies, our results provide counterintuitive evidence, suggesting that TL needs to be implemented together, on the one hand, with IEL to achieve a significant effect on emotional competencies and, on the other hand, with SEL to have an impact on social competencies. Moreover, IEL plays a prominent role in stimulating cognitive competencies. Our research contributes to educational literature by providing new insights on the effective combination of learning methods that can be adopted into programs that transfer technical knowledge and skills to promote behavioral competencies.

Reaction of medical students to experiences in dissection room

Background

As preclinical medical students start and/or enter the course, they go through the anatomy curriculum, which involves interaction with cadavers and cadaveric material. The objective of this study was to determine the reactions of preclinical medical students from year two and year three to the dissecting room.

Methods

Questionnaire was distributed to all second and third year medical students. The questionnaire was designed with the objective of identifying specific patterns of attitudes held and problems faced by the students in their first exposure to the human cadaver. The results are analyzed statistically using the SPSS 16.0 software and P< 0.05 was considered statistically significant.

Results

The commonest symptoms experienced were loss of appetite (43.29% year 2 and 34.86 % third year students). The commonest cause of their symptoms was studied and the result shows that it was the smell of the dissection room, as reported by 67.01% of year two students; and 54.12% for year 3 students.

Conclusion

The present study findings show that smell of the dissection room, touch and fear of cadaver were the commonest cause of their symptoms experienced while study in dissection room for the majority of students. Thus, instructors are should give awareness raising education before the commencement of the dissection session to the students both mentally and emotionally ready to do their work enthusiastically and confidently. Moreover, it is necessary to make the laboratory tidy for the students so that they develop a love for the dissection room.

Computed tomography-enhanced anatomy course using enterprise visualization

Rapid changes in medical knowledge are forcing continuous adaptation of the basic science courses in medical schools. This article discusses a three-year experience developing a new Computed Tomography (CT)-based anatomy curriculum at the Sackler School of Medicine, Tel Aviv University, including describing the motivations and reasoning for the new curriculum, the CT-based learning system itself, practical examples of visual dissections, and student assessments of the new curriculum. At the heart of this new curriculum is the emphasis on studying anatomy by navigating inside the bodies of various living individuals utilizing a CT viewer. To assess the students' experience with the new CT-based learning method, an anonymous questionnaire was administered at the end of the course for three consecutive academic years: 2008/2009, 2009/2010, 2010/2011. Based upon the results, modifications were made to the curriculum in the summers of 2009 and 2010. Results showed that: (1) during these three years the number of students extensively using the CT system quadrupled (from 11% to 46%); (2) students' satisfaction from radiologists involvement increased by 150%; and (3) student appreciation of the CT-based learning method significantly increased (from 13% to 68%). It was concluded that discouraging results (mainly negative feedback from students) during the first years and a priori opposition from the teaching staff should not weaken efforts to develop new teaching methods in the field of anatomy. Incorporating a new curriculum requires time and patience. Student and staff satisfaction, along with utilization of the new system, will increase with the improvement of impeding factors.

Learning styles and approaches to learning among medical undergraduates and postgraduates

BACKGROUND

The challenge of imparting a large amount of knowledge within a limited time period in a way it is retained, remembered and effectively interpreted by a student is considerable. This has resulted in crucial changes in the field of medical education, with a shift from didactic teacher centered and subject based teaching to the use of interactive, problem based, student centered learning. This study tested the hypothesis that learning styles (visual, auditory, read/write and kinesthetic) and approaches to learning (deep, strategic and superficial) differ among first and final year undergraduate medical students, and postgraduates medical trainees.

METHODS

We used self administered VARK and ASSIST questionnaires to assess the differences in learning styles and approaches to learning among medical undergraduates of the University of Colombo and postgraduate trainees of the Postgraduate Institute of Medicine, Colombo.

RESULTS

A total of 147 participated: 73 (49.7%) first year students, 40 (27.2%) final year students and 34(23.1%) postgraduate students. The majority (69.9%) of first year students had multimodal learning styles. Among final year students, the majority (67.5%) had multimodal learning styles, and among postgraduates, the majority were unimodal (52.9%) learners.Among all three groups, the predominant approach to learning was strategic. Postgraduates had significant higher mean scores for deep and strategic approaches than first years or final years (p < 0.05). Mean scores for the superficial approach did not differ significantly between groups.

CONCLUSIONS

The learning approaches suggest a positive shift towards deep and strategic learning in postgraduate students. However a similar difference was not observed in undergraduate students from first year to final year, suggesting that their curriculum may not have influenced learning methodology over a five year period.