Willingness to support neighbours practically or emotionally: a cross-sectional survey among the general public

Background

Wider social networks are increasingly recognized for supporting people with care needs. Health-promoting initiatives around the end of life aim to foster these social connections but currently provide little insight into how willing people are to help neighbours facing support needs.

Objectives

This study describes how willing people are to help neighbours who need support practically or emotionally, whether there is a difference in willingness depending on the type of support needed and what determines this willingness.

Design

We applied a cross-sectional survey design.

Methods

We distributed 4400 questionnaires to a random sample of people aged >15 across four municipalities in Flanders, Belgium. These surveys included attitudinal and experiential questions related to serious illness, caregiving and dying. Respondents rated their willingness (scale of 1-5) to provide support to different neighbours in hypothetical scenarios: (1) an older person in need of assistance and (2) a caregiver of a dying partner.

Results

A total of 2008 questionnaires were returned (45.6%). The average willingness to support neighbours was 3.41 (case 1) and 3.85 (case 2). Helping with groceries scored highest; cooking and keeping company scored lowest. Factors associated with higher willingness included an optimistic outlook about receiving support from others, family caregiving experience and prior volunteering around serious illness or dying.

Conclusion

People are generally willing to support their neighbours who need help practically or emotionally, especially when they have prior experience with illness, death or dying and when they felt supported by different groups of people. Community-based models that build support around people with care needs could explore to what extent this willingness translates into durable community support. Initiatives promoting social connection and cohesion around serious illness, caregiving and dying may harness this potential through experiential learning.

Belongingness, Well-Being and an Interview With Dr Pauline Dow

The Supreme Court decision that race conscious admissions policies in universities are unconstitutional has created questions and concerns about the sustainability of diversity, equity and inclusion programs in many organizations and across sectors. This editorial provides hopeful examples of how belongingness is being embraced as a core value in many organizations. In an interview with education expert, Dr Pauline Dow, we discuss ways that the education sector creates trust and belongingness and explore best practices and leadership development methods that allow teachers to thrive. Lessons learned in the educator sector offer insights into how belongingness can be cultivated in other sectors, organizations and communities.

Is everything everywhere? A hands-on activity to engage undergraduates with key concepts in quantitative microbial biogeography

The ubiquity and ease with which microbial cells disperse over space is a key concept in microbiology, especially in microbial ecology. The phenomenon prompted Baas Becking's famous "everything is everywhere" statement that now acts as the null hypothesis in studies that test the dispersal limitation of microbial taxa. Despite covering the content in lectures, exam performance indicated that the concepts of dispersal and biogeography challenged undergraduate students in an upper-level Microbial Ecology course. Therefore, we iteratively designed a hands-on classroom activity to supplement the lecture content and reinforce fundamental microbial dispersal and biogeography concepts while also building quantitative reasoning and teamwork skills. In a class period soon after the lecture, the students formed three-to-five-person teams to engage in the activity, which included a hands-on dispersal simulation and worksheet to guide discussion. The simulation involved stepwise neutral immigration or emigration and then environmental selection on a random community of microbial taxa represented by craft poms. The students recorded the results at each step as microbial community data. A field guide was provided to identify the taxonomy based on the pom phenotype and a reference to each taxon's preferred environmental niches. The worksheet guided a reflection of student observations during the simulation. It also sharpened quantitative thinking by prompting the students to summarize and visualize their and other teams' microbial community data and then to compare the observed community distributions to the idealized expectation given only selection without dispersal. We found that the activity improved student performance on exam questions and general student satisfaction and comfort with the biogeography concepts. Activity instructions and a list of needed materials are included for instructors to reproduce for their classrooms.

Integrating hands-on practical and reflective feedback in teaching dental materials science to undergraduate dental students

INTRODUCTION

This study aimed to develop a module that incorporates hands-on and reflective feedback in teaching dental materials science and subsequently analyse undergraduate dental students' learning experiences with the module.

MATERIALS AND METHODS

The module was developed based on the ADDIE (Analyse, Design, Develop, Implement, Evaluate) model. First, a need analysis was conducted, followed by designing the module to address the needs. Next, the module sought experts' feedback and was piloted. The revised module was implemented among all second-year undergraduate dental students. Finally, a validated questionnaire (5-point Likert scale items and open-ended questions) was used to evaluate students' learning experiences. The questionnaire Likert scale items were analysed descriptively, whereas open-ended responses were analysed using content analysis.

RESULTS

In the analysis phase, a slight misalignment in cognitive competency levels was observed, alongside a need for the inclusion of more hands-on activities. In the design phase, learning objectives and resources were listed. Subsequently, a module consisting of four teaching sessions (3 h each) was developed, and the pilot test showed favourable feedback. The module was then implemented in small groups of 10-12 students. In the evaluation phase, 72 students (97% response rate) completed the questionnaire. The majority of students agreed with all items, with mean scores ranging from 4.53 to 4.72. Open-ended responses highlighted that hands-on activities and reflective feedback sessions were useful.

CONCLUSION

Students demonstrated positive learning experiences after participating in the module, advocating for dental educators to consider more hands-on activities and reflective feedback sessions in teaching dental materials science.

DNA at the whim of the water: environmental DNA as a course-based undergraduate research experience

Course-based undergraduate research experiences (CUREs) increase student access to high impact research experiences. CUREs engage students in the scientific process by learning how to pose scientific questions, develop hypotheses, and generate data to test them. Environmental DNA (eDNA) is a growing field of research that is gaining accessibility through decreasing laboratory costs, which can make a foundation for multiple, engaging CUREs. This manuscript describes three case studies that used eDNA in an upper year undergraduate course. The first focusses on a systematic literature review of eDNA metadata reporting. The second describes the biomonitoring of brook trout in southern Ontario using eDNA. The third involves eDNA metabarcoding for freshwater fish detection in southern Ontario. Undergraduates were involved in the development and execution of experiments, scientific communication, the peer review process, and fundraising. Through this manuscript, we show the novel application of eDNA CUREs and provide a roadmap for other instructors interested in implementing similar projects. Interviews with seven students from these courses indicate the benefits experienced from taking these courses. We argue that the use of eDNA in CUREs should be expanded in undergraduate biology programs due to the benefit to students and the increasing accessibility of this technology.

Impact of a short-duration experiential learning activity on DPT students' attitudes toward patients living with a dementia

Healthcare practitioners (HCP) have expressed inadequate preparation in providing care to patients living with a dementia. Research suggests experiential learning activities (ELAs) can improve HCP knowledge and comfort toward this population. The purpose of this study was to evaluate the impact of a short-duration (2-hour) dementia ELA on Doctor of Physical Therapy (DPT) students' knowledge and comfort toward individuals living with a dementia. Participants included a sample of first-year DPT students (n=82).  In this pre-experimental, single-site, longitudinal study, students participated in an ELA at a memory care facility. They completed a dementia knowledge and comfort survey pre-(T1) and post-ELA(T2), as well as prior to their first clinical experience (nine months post-ELA; T3). Pre- and post-survey analysis demonstrated significant improvements between T1 to T2 and T1 to T3 with overall effect sizes ranging from very large (d=1.256) to huge (d=1.520). There were no significant differences between T2 to T3 analysis. Students demonstrated positive improvements in attitudes toward individuals living with a dementia following this ELA. Improvements were maintained over time. An ELA as short as two hours may improve person-centered care for patients living with a dementia. These types of activities should be considered for inclusion in DPT curricula.

Effectiveness of a self-assessment application in evaluating the care coordination competency of intensive care unit nurses in managing patients on life support: An intervention study

AIM

To examine the effectiveness of the feedback from the Nurses' Care Coordination Competency Scale (NCCCS) application (app) used for self-assessing the care coordination competency of intensive care unit (ICU) nurses in managing patients on life support.

METHODS

A non-randomized open-label study was conducted in Japan from November 2021 to March 2022. Participants were 318 ICU nurses from acute hospitals in Japan. They were divided manually into two groups based on their certification status. The intervention was immediate feedback on the results of the care coordination competency self-assessment through the NCCCS app; the control group performed the NCCCS survey with no feedback. The primary outcome was an increase in the NCCCS score 1 month after the intervention. Mann-Whitney U test was used to compare the scores of the intervention and control groups. Wilcoxon's signed rank sum test was used to compare the scores in the first and second NCCCS surveys.

RESULTS

Forty-one participants were lost to follow-up, leaving 277 participants (intervention = 141, control = 136) for analysis. One month later, NCCCS scores similarly increased in both groups. For nurses with at least 5 years of ICU experience (n = 152), the NCCCS score increased in the intervention group (n = 75) (rising point mean: 4.8, standard deviation [SD]: 9.8) compared with that in the control group (n = 77) (rising point mean: 1.3, SD: 8.3) (p = .048).

CONCLUSIONS

Feedback from the NCCCS app can improve care coordination behavior. However, a certain level of ICU experience may be required to translate feedback into improved behavior.

Prospective comparative study on enhancing geometrical mental representation and anatomical learning in medical students through modeling clay as an assessment tool

While traditional anatomy education often emphasizes passive learning and rote memorization, it seldom employs constructivist theories that focus on active, hands-on experiences for effective learning. This study tests the hypothesis that tactile experiences with modeling clay enhance geometric mental representation more effectively than verbal descriptions. We examine the potential of clay modeling to reflect and evaluate students' mental representation of anatomical structures. Utilizing a prospective randomized, open, blind endpoint (PROBE) design, we engaged 36 participants divided into three groups: blind, visually impaired, and a control group. The primary outcome measure was the difference between post-touch score and pre-touch score, which gauged the efficacy of tactile intervention in enhancing the participants' capacity to mentally reconstruct a well-designed anatomical fiction structure. Scoring was executed using a double-blind double-evaluation methodology, positioning clay model reconstruction as both an objective reliable assessment and a pedagogical tool. The analysis demonstrated a pronounced improvement in mental representation of anatomical structures, particularly in spatial comprehension and detailed textural discernment, with the mean score soaring from 47.81 pre-touch to 85.09 post-touch. Distinct cognitive processing adaptations were evident across groups, with the blind group excelling in tactile acuity and the visually impaired group showing the most significant gains in spatial understanding post-intervention (Cohen's d = 2.74). The application of modeling clay as a tactile intervention tool can significantly improve the learning of anatomy among medical students. The study underscores the value of active, multisensory engagement and customized teaching strategies for effective anatomy education among this demographic.

Training factors that influence electrodiagnostic medicine knowledge

INTRODUCTION/AIMS

Self-assessment examinations (SAEs) help trainees assess their progress in education. SAEs also provide feedback to training programs as to how factors in training influence examination performance. This study's goal was to examine the relationship between the number of months of training in electrodiagnostic (EDx) medicine, the number of EDx studies during training, and scores on the American Association of Neuromuscular and Electrodiagnostic Medicine SAE.

METHODS

This was a retrospective study of the 2023 AANEM-SAE results. In addition to the examination score, participants were asked approximately how many EDx studies they performed in training and how many months of training they had completed. Analysis included correlation of the examination scores with months of training as well as number of EDx studies. In addition, a multivariate linear regression model was developed.

RESULTS

A total of 756 participants completed the proctored examination in May 2023. Examination score was moderately and positively correlated with the number of months of training (Pearson r = .5; p < .001) as well as the number of EDx studies during training (Pearson r = .55; p < .001). Scores steadily improved with additional months of training, but leveled off after 300-400 EDx studies. Regression analysis indicated that higher numbers of EDx studies were correlated with a higher examination score even after accounting for the number of months of study.

DISCUSSION

We believe that a greater number of months of training is associated with better performance on the AANEM-SAE and that greatest improvement in examination performance occurs during the first 300-400 EDx studies.

Rolling the evolutionary dice: Neisseria commensals as proxies for elucidating the underpinnings of antibiotic resistance mechanisms and evolution in human pathogens

Species within the genus Neisseria are adept at sharing adaptive allelic variation, with commensal species repeatedly transferring resistance to their pathogenic relative Neisseria gonorrhoeae. However, resistance in commensals is infrequently characterized, limiting our ability to predict novel and potentially transferable resistance mechanisms that ultimately may become important clinically. Unique evolutionary starting places of each Neisseria species will have distinct genomic backgrounds, which may ultimately control the fate of evolving populations in response to selection as epistatic and additive interactions coerce lineages along divergent evolutionary trajectories. Alternatively, similar genetic content present across species due to shared ancestry may constrain existing adaptive solutions. Thus, identifying the paths to resistance across commensals may aid in characterizing the Neisseria resistome-or the reservoir of alleles within the genus as well as its depth. Here, we use in vitro evolution of four commensal species to investigate the potential and repeatability of resistance evolution to two antimicrobials, the macrolide azithromycin and the β-lactam penicillin. After 20 days of selection, commensals evolved resistance to penicillin and azithromycin in 11/16 and 12/16 cases, respectively. Almost all cases of resistance emergence converged on mutations within ribosomal components or the mtrRCDE efflux pump for azithromycin-based selection and mtrRCDE, penA, and rpoB for penicillin selection, thus supporting constrained adaptive solutions despite divergent evolutionary starting points across the genus for these particular drugs. Though drug-selected loci were limited, we do identify novel resistance-imparting mutations. Continuing to explore paths to resistance across different experimental conditions and genomic backgrounds, which could shunt evolution down alternative evolutionary trajectories, will ultimately flesh out the full Neisseria resistome.IMPORTANCENeisseria gonorrhoeae is a global threat to public health due to its rapid acquisition of antibiotic resistance to all first-line treatments. Recent work has documented that alleles acquired from close commensal relatives have played a large role in the emergence of resistance to macrolides and beta-lactams within gonococcal populations. However, commensals have been relatively underexplored for the resistance genotypes they may harbor. This leaves a gap in our understanding of resistance that could be rapidly acquired by the gonococcus through a known highway of horizontal gene exchange. Here, we characterize resistance mechanisms that can emerge in commensal Neisseria populations via in vitro selection to multiple antimicrobials and begin to define the number of paths to resistance. This study, and other similar works, may ultimately aid both surveillance efforts and clinical diagnostic development by nominating novel and conserved resistance mechanisms that may be at risk of rapid dissemination to pathogen populations.

Bodily contrast experiences in cultivating character for care

Since 2008, in Flanders, we organize immersion sessions in a simulated context with the aim of stimulating student nurses and health professionals to learn virtuous caring. In this contribution, we first outline the purpose of this experiential learning: the cultivation of moral character. We come to the core of what we mean by moral character for care. We refer to Joan Tronto and Stan van Hooft to claim that caring is central to all aspects of nursing practice and is the basis of its moral quality. We also stipulate that caring involves the integration of action with emotions, motivations, and knowledge. Second, we briefly explain how the immersion sessions in the care ethics lab take place and, in particular, reflect on what it yields in terms of experiences for the participants who take on the role of simulant patients in this experiential learning process. We focus on the significant role contrast experiences play in these experiences. Especially the negative contrast experiences do not wear off easily; care professionals remember even long after the immersion session and continue to carry them with them as a "corporeal built-in alarm." Third, we discuss the role of contrast experiences in cultivating moral character for care. In particular, we explore the role of the body in the kind of knowing it cultivates and, by extension, its role in cultivating virtuous caring. By referring to specific philosophical ideas of Gabriël Marcel, Hans Jonas and Emmanuel Levinas, we try to understand how contrast experiences bring about an integration of virtuous action into knowledge, motivation, and emotion. We conclude that we need more space for contrast experiences in cultivating moral character. More attention should be paid to the role of the body in this learning process.

Innovative and Effective Education Strategies for Adult Learners in the Perioperative Setting

Ongoing nursing education is vital for keeping nurses' knowledge and skills current and promoting positive patient outcomes. Providing meaningful, quality nursing education in the perioperative setting requires the development and implementation of innovative and effective teaching strategies. Adult learning theory is complex, and it can be challenging to engage multigenerational perioperative staff members in education-often, a variety of creative teaching modalities are required to bridge the gaps among learning styles. This article reviews the use of experiential learning, various kinesthetic activities, advanced technology, microlearning, and other methods that may be helpful to overcome the challenges of providing education to adult learners in the perioperative setting. Educators should promote critical thinking and student engagement to encourage adult learners to be active participants in their continuing education.

Comparative Analysis of the Impact of Training through Simulation Using the Crisis Resource Management Tool for Primary Care Professionals

This was a prospective observational study based on clinical simulation courses taught in 2017 at the IDEhA Simulation Center of Alcorcón Foundation University Hospital. Two courses in metabolic emergencies (MEs) and respiratory emergencies (REs) were offered to primary care physicians all over Spain. The main objective was to teach nontechnical skills (crisis resource management). Using a modified five-level Kirkpatrick-Phillips education evaluation model, level I (reaction, K1), level II (learning, K2) and level III (behavioral change, K3) changes were evaluated through surveys at the end of the courses and one year later. Thirty courses were held (15 ME courses and 15 RE courses) with 283 primary care physicians. The overall satisfaction (K1) was high: ME courses, 9.5/10; RE courses, 9.6/10. More than 80% of the participants rated the organization, resources, content, debriefing and scenarios as excellent, with no significant differences between the two courses. After one year (156 responses), the respondents for both courses reported that they would repeat the training annually (K2), encourage debriefing with colleagues (K3) and have modified some aspects of their workplace (K3), citing improvements in procedures and in the organization of the health team as the most important. After the ME course, few participants, i.e., 5 (6%), reported providing improved care to patients; after the RE course, 15 (19%) participants reported providing improved care; the difference between groups was significant (p < 0.05). Compared with the ME course, the RE course imparted greater knowledge about patient safety (K2) (38 (49%) vs. 24 (31%) (p < 0.05)) and more useful tools for daily clinical practice (K3) (67% vs. 56.4%) and resulted in participants paying more attention to personal performance and to colleagues when working as a team (K2) (64% vs. 50%). Clinical simulation courses are highly valued and potentially effective for training primary care physicians in patient safety and CRM tools. Future studies with objective measures of long-term impact, behavior in the workplace (K3) and benefits to patients (K4) are needed. Based on the results of our study, the areas that are important are those aimed at improving procedures and the organization of health teams.

A Carnegie perspective on intermittent risk taking in entrepreneurship

Varying risk-taking tendency is an important area of inquiry for the Carnegie perspective. Drawing on organizational learning literature, we develop a model to illuminate the mechanisms that can underlie time-varying risk taking tendency in entrepreneurship. In particular, we delineate conditions under which abrupt risk taking punctuates periods of risk-avoiding behaviors, a pattern that we call "intermittent risk taking." We use serial entrepreneurs whose bouts with risk taking are often depicted as driven by an entrepreneurial itch to illustrate our model. In our conceptualization, decision makers engage in an interplay of experiential and vicarious learning as they move into and out of higher-risk self-employment (i.e., venture creation) with in-between stints in lower-risk wage-employment. Using a computational model to simulate the dynamics of this conceptualization, we find that vicarious learning from satisfied risk-avoiding peers can exert a pull that draws disappointed entrepreneurs into periods of risk avoidance (i.e., wage-employment). However, the moment that the satisfaction of these peers fails to convince, this pull wanes. In effect, the entrepreneur vicariously learns that the grass may not be greener on the other side which then leads them to return into self-employment. The itch for risk taking then recurs not necessarily because risky venture creation offers higher payoffs than risk-avoiding options but because decision makers come to see that risk avoidance may not be a satisfactory alternative either - a conceptualization that adds nuance to prior notions of varying risk tendencies and serial entrepreneurship.

Shifting perspectives: Unveiling the transformative potential of home visits to persons living with disability in rural settings for medical students

PURPOSE

This study aims to examine the transformative learning experiences of medical students participating in home visits to persons living with disabilities in rural areas of South Africa, in order to explore the potential of such experiences to shape their beliefs about their professional development and clinical practice.

METHODS

Qualitative data was collected from the students through written reflections and semi-structured interviews. The data were analyzed thematically using a phenomenological approach guided by Mezirow's theory of transformative learning.

RESULTS

The findings reveal a three-stage process of transformative learning for the students. Firstly, students held predominantly negative views towards the learning activity, prior to the home visits. Secondly the role of critical reflection facilitated a change in students' perspectives. Finally, there was a change in perspective towards a predominantly positive valuing of the activity to their learning and approach to clinical practice.

DISCUSSION

This study highlights the significance of incorporating home visits and structured critical reflection into undergraduate medical curricula. It underscores the need for further research in this area and contributes to the understanding of transformative learning in healthcare education. The findings emphasize the potential of community-based activities to shape inclusive practices and foster holistic patient care.

Using an experiential learning model to teach clinical reasoning theory and cognitive bias: an evaluation of a first-year medical student curriculum

BACKGROUND

Most medical students entering clerkships have limited understanding of clinical reasoning concepts. The value of teaching theories of clinical reasoning and cognitive biases to first-year medical students is unknown. This study aimed to evaluate the value of explicitly teaching clinical reasoning theory and cognitive bias to first-year medical students.

METHODS

Using Kolb's experiential learning model, we introduced dual process theory, script theory, and cognitive biases in teaching clinical reasoning to first-year medical students at an academic medical center in New York City between January and June 2020. Due to the COVID-19 pandemic, instruction was transitioned to a distance learning format in March 2020. The curriculum included a series of written clinical reasoning examinations with facilitated small group discussions. Written self-assessments prompted each student to reflect on the experience, draw conclusions about their clinical reasoning, and plan for future encounters involving clinical reasoning. We evaluated the value of the curriculum using mixed-methods to analyze faculty assessments, student self-assessment questionnaires, and an end-of-curriculum anonymous questionnaire eliciting student feedback.

RESULTS

Among 318 total examinations of 106 students, 254 (80%) had a complete problem representation, while 199 (63%) of problem representations were considered concise. The most common cognitive biases described by students in their clinical reasoning were anchoring bias, availability bias, and premature closure. Four major themes emerged as valuable outcomes of the CREs as identified by students: (1) synthesis of medical knowledge; (2) enhanced ability to generate differential diagnoses; (3) development of self-efficacy related to clinical reasoning; (4) raised awareness of personal cognitive biases.

CONCLUSIONS

We found that explicitly teaching clinical reasoning theory and cognitive biases using an experiential learning model provides first-year medical students with valuable opportunities for developing knowledge, skills, and self-efficacy related to clinical reasoning.

Student Experiential Activities: A Novel Strategy to Teach Neuroanatomy in Lectures

Introduction Activity-based teaching is a widely used pedagogical tool for enhancing anatomy learning. However, involving the learner in experiential activities in lectures is an unexplored area in medical research. The present study aims to determine whether incorporating student experiential activities into lectures impacts student's learning of neuroanatomy. Materials and methods We used a pre-test/post-test experimental study design to compare the learning outcome between the experiential activity based lecture and traditional lectures. We divided 150 students into control (75 students) and intervention groups (75 students). To assess the baseline knowledge on the subject, the students attended 20 clinical scenario-based multiple-choice questions two weeks before the lectures. Then, both groups attended two lecture sessions on the functional areas of the brain. In the control group, the students drew the boundaries of a particular cerebral area and labeled its function and clinical symptoms. In the intervention group, the learners participated in experiential activities while following the instructions. The lecturer used their response as a scaffold to explain the function and clinical correlation of a specific part of the cerebral cortex. The same test questions were given to the students one week after the final lecture session to evaluate their level of understanding. We analyzed the scores of 111 students (57 students in the control group and 54 students in the interventional group) who attended the two lectures and pre- and post-test sessions. Students also completed a validated 10-item feedback questionnaire regarding their perception of the teaching sessions. Results The mean score improvement for the control and intervention groups was 4.86 ± 1.53 and 6.39 ± 2.93, respectively. The score improvement of the activity group was significantly higher than that of the control group (p = 0.006; d = 0.65). The perception scores of interest, knowledge attainment, and satisfaction were significantly higher in the intervention group compared to the control group. Conclusion The findings of this study suggest that experiential activities facilitate better comprehension of abstract neuroanatomical concepts as compared to traditional didactic teaching.

Qualitative Evaluation of University Students' Experience Delivering an Obesity Prevention Programme in Elementary Schools

The Coordinated Approach to Child Health (CATCH) programme is an accredited obesity prevention programme in the United States, teaching children about nutrition, physical activity, and screen time limits. This study aimed to evaluate the perceptions of undergraduate and graduate student leaders' about their experience delivering the CATCH programme in elementary schools in Northern Illinois school districts during the 2019-2020 school year and its impact on their personal and professional skills and on programme participants. An email questionnaire was sent to eligible students. Grounded theory was used to analyze the students' responses. Two researchers assigned codes to the data and identified themes. Twenty-one students responded (50% response rate). Six identified themes include "purpose of CATCH programme," "school facilities and resources," "university students experience with CATCH lessons and activities," "benefits to university student," "benefits to children and teachers," and "identified weaknesses and suggested improvements to CATCH." University students delivering the CATCH programme appreciated the opportunity to practice in a real-world setting, gained transferable professional skills, increased programme content knowledge, identified CATCH programme benefits/strengths, and planned to apply lessons learned to future practice.

Evaluation of a student clinical research education program in addiction medicine

OBJECTIVE

To evaluate an experiential student clinical addiction research program by analyzing its components, evaluation survey data, and scientific outputs.

METHODS

In 1995, we established a summer research program supporting trainees to gain exposure to clinical addiction research careers. This curriculum employed a three-pronged approach that combined mentored research training, didactic education, and clinical observerships for medical students and other trainees to acquire experience with addiction medicine and research. Utilizing the Kirkpatrick model as program evaluation framework, we analyzed evaluation data from programmatic surveys (didactic seminar evaluations, overall program surveys) and conducted qualitative feedback exploration.

RESULTS

Between 2007 and 2019, 56 trainees and 26 faculty mentors participated in the curriculum. To date, 25 students published 38 papers with their faculty mentor. Analysis of the past 12 years of program evaluation data demonstrated that students highly valued individually-mentored research experiences. They indicated that seminars familiarized them with the foundations of different clinical care models and career trajectories in addiction medicine. Clinical observerships provided students with patient contacts in various multidisciplinary addiction treatment settings. These experiences, perhaps most importantly hearing about patients' lived experiences, meaningfully informed various research and didactic activities.

CONCLUSIONS

This summer student research program successfully introduced students to addiction medicine and research, manifested by high peer-reviewed publication productivity. While our program engaged and involved committed mentors and inspired mentees to pursue professional paths in addiction research, it did not specifically incorporate attention to equity and diversity into program planning and implementation. Going forward, the program will improve equity by increasing the recruitment of trainees from disadvantaged groups and engaging underrepresented faculty.KEY MESSAGESSummer programs can be effective in engaging medical students and trainees in research early in their trajectory and inspire them to incorporate research into their careers.Programs that integrate experiential addiction research learning, i.e. mentored research activities, didactic sessions, and clinical observerships, can provide trainees with a profound understanding of substance use disorder treatment and research.

The Learning Collaboratory: developing and evaluating public health students' skills while promoting community health

Introduction

Complex and continuous developments in health and healthcare require innovative changes in programs that educate public health scientists and professionals. Public health change agents need critical competencies to confront today and tomorrow's leading problems including leadership, communication, interprofessional practice, and systems thinking.

The context challenges in public health education

Public Health training programs teach competencies through their applied field experience and culminating project, typically late in the program, and often implemented in isolation from peers and faculty. Objectives and skills do not always align closely with community-based program needs. Students pursuing a degree in science in public health need to deeply comprehend multi-dimensional and interconnected systemic problems and communicate with diverse stakeholders across disciplines to produce relevant community-engaged research. The University of Miami Public Health Learning Collaboratory (LC) was established to transform the learning experience of public health master's students by providing opportunities to develop necessary core skills for effective public health practice early in their training, while applying these skills to address real-world public health needs in the community.

The Learning Collaboratory structure pedagogical approach and programmatic details

Spanning an average of 3 semesters, the LC promotes student involvement in collaborative and impactful capstone and thesis projects. Practice-based teaching and service learning are central approaches to teaching cross-cutting competencies of leadership, communication, problem solving, collaboration, and systems thinking in public health. Significant to the approach is the engagement of previous cohorts of senior students to teach back to junior students, further integrating concepts learned. Long term alumni feedback recognized strengths of the program, including its structure, teamwork & collaboration, critical thinking & problem solving, guidance, nurture & support, teaching back, and content & curriculum. Community partners agreed the LC prepared students to practice in the field of public health.

Discussion

The LC is a promising model for master's level public health education and community application, given the opportunities it provides to strengthen and integrate students' public health skills in a supportive environment, and enhance the transferability and sustainability of student and faculty's community public health work.

More Diverse and Equal: Insights on Moving From "Real-Life" to "Remote" Practicum Experiences and Career Development From Undergraduate Global Public Health Students During COVID-19

A key facet to typical undergraduate or graduate global public health programs is an applied practice experience (a practicum) that culminates in shared results and public presentations (e.g., research posters, conference and working papers, needs assessments). Requirements vary by program but may be between 80 and 200 hours of experiential learning. While not required by all undergraduate programs in global public health, a practicum occurs as part of a semester of coursework or internship experience after students have declared the major/minor or have completed an expected number of courses. Some students report that the practicum experience, while essential to their career development and future opportunities, presents certain challenges in terms of access. Practicum opportunities can be rife with assumptions that social networks, privilege, and implicit bias affect and even predict the ability to secure an effective, doable, and career-advantageous project. In 2020, the COVID-19 pandemic meant that much of the applied and experiential aspects of a practicum were necessarily shifted from "realworld" experiences to virtual and "remote" contexts. This article highlights insights from students enrolled in undergraduate global public health programs who were planning "real-life", more "traditional" practicum experiences, and had to necessarily move to "remote" and online engagement. These cases suggest that participation in virtual fieldsites is seen as legitimate, fulfilling for students and stakeholders, and can increase diversity, equity, and inclusion in the public health curricula; fostering best practices in career development.

Enhancing Physician Advocacy Through Collaboration With Government Relations: Report From the Health Policy Scholars Program

OBJECTIVE

To explore barriers, facilitators, and benefits of collaboration between academic pediatricians and institutional offices of government relations (OGR) to enhance policy advocacy efforts.

METHODS

The Academic Pediatric Associations' Health Policy Scholars met with the government relations team in their affiliated institutions as part of their experiential learning curriculum. Afterward, they submitted written reflections, which were coded and analyzed using inductive qualitative content analysis to identify key themes.

RESULTS

Reflections were completed by 21 of 23 (91.3%) participants. Most participants (76.2%) were faculty at free-standing children's hospitals and had been at their institutions <5 years (52.3%) or 5 to 10 years (33.3%). Institutional OGR structure varied widely and not all institutions had well-defined priorities. Key themes of the reflections included that OGRs often had dynamic priorities and fiscal considerations frequently took precedence. Barriers to physician involvement with OGR are often related to difficulty identifying the correct staff contact and not having the time and support for advocacy work. Facilitators included leveraging existing relationships and collaborations, including those of peer or mentor connections to the OGR staff. Anticipated benefits to both OGR and physicians included improved knowledge of advocacy opportunities, enhanced advocacy efforts leveraging physicians' expertise and patient stories, and message alignment and amplification of physician and institutional advocacy work.

CONCLUSIONS

Collaboration between physician-advocates and institutional OGR is feasible and, with orientation and mentorship, may facilitate improved physician and institutional policy advocacy efforts. Supporting this type of collaboration may enhance physician and institutional advocacy on behalf of their shared patients and communities.

A patient-centered approach to learning social determinants of health for first year medical students

INTRODUCTION

To address health disparities, future physicians must understand the role of social determinants of health (SDH). Teaching SDH can be challenging. We created an authentic SDH curriculum using four real myocardial infarction (MI) patients.

METHODS

During the three academic years from 2019-2020 to 2021-2022, 579 first year medical students participated in the four day curriculum. Day 1: students interviewed and learned about their patient's MI. Day 2: students met in small groups and shared their patient's history. At session end, students were familiar with four patient stories. Day 3: students explored their patient's neighborhood and then interviewed their patient again, focusing on SDH. Day 4: students gave formal patient presentations that highlighted SDH. Group discussion followed and reinforced the role of SDH. Students wrote reflections on SDH that were read and graded. End of course evaluations were reviewed.

RESULTS

Five hundred and seventy-nine students completed the curriculum. Course directors graded SDH reflections on a six-point rubric for the years of 2020-2021 and 2021-2022. Ninety percent and 96% of the SDH reflections during the respective years contained 5-6/6 of the rubric components. Ninety-six percent to 98% of students 'agreed' or 'strongly agreed' that the curriculum was effective for their learning.

DISCUSSION

For educators in need of an SDH curriculum that is both engaging and effective, we have found this activity to be feasible, low cost, and highly impactful for first year medical students.[Box: see text].

A collaborative approach to promote use of 3D printing in a biology research laboratory

Three dimensional (3D) design and printing are customizable and cost-effective approaches to developing small equipment and other items for use in various interdisciplinary applications. However, many pedagogical approaches to 3D printing focus more on the generation of artifacts than on the involvement of students as creators. Moreover, library makerspaces offer 3D printing services but cannot always engage the students with practical applications of their designs. We sought to determine if promoted use of 3D printing could be developed in biology laboratory trainees, ranging from undergraduate students to postdoctoral fellows. We combined two instructional workshops in the San Diego State University Library build IT makerspace, with two individual assignments to build items for the research laboratory. Evaluation of the course revealed that participants had expected the design and print processes to be of high complexity, but learned that the necessary skills could be acquired and applied in a relatively short period of time. Also, we found that trainees became proficient in 3D design and printing, and that a majority of individuals used 3D printing for subsequent applications. This effective translation of 3D printing to the research laboratory can be a paradigm for how 3D fabrication is taught. Moreover, this approach required the collaboration of library makerspace and research faculty, underlining the value of embedded librarianship in enhancing training and knowledge.

Pilot Study of a Motivational Interviewing Training on Practitioners' Skill Set for Patient Centered Communication

PURPOSE

Increase practitioners' Motivational Interviewing (MI) skill set to develop intrinsic motivation and behavior change competencies.

DESIGN

Pilot comparing intervention group with waitlist-control group.

SETTING

Health Plan in northeast of U.S.

INTERVENTION

Training program including a 3 day 19 hour MI training intensive, 1.5 hour follow-up skill-building trainings, and quality assurance review using an MI assessment tool paired with strengths-based mentoring. Cohort 1 (experimental group) received the intervention for 6-months and cohort 2 for 3 months (control group).

MEASURES

Practitioners' MI skill set was assessed pre- and post-intervention using Motivational Interviewing Competency Assessment (MICA). Practitioners' MI knowledge and attitudes were assessed pre- and post-training using adapted Motivational Interviewing Knowledge and Attitudes Test (MIKAT). Active learning and confidence questionnaires were administered post-training.

ANALYSIS

A generalized linear mixed model with repeated measures to analyze difference in MICA growth rates; paired T-test for MIKAT pre/post training analysis. Descriptive statistics for active learning and confidence.

RESULTS

MICA scores significantly improved for both cohorts (P < .0001). Practitioners had significant increase in knowledge and attitudes for MI (P < .001) and confidence in using MI (P < .01). High levels of active learning were observed (93-100%).

CONCLUSION

With planning, adequate resources/support, and iterative processes for adjustment, practitioners can improve their MI skill set in a short period of time with modest investment of practitioner resources.

Personal protection equipment: Preliminary evidence of effectiveness from a three-phase simulation program

Background

Healthcare providers carry the occupational risk of being exposed to pathogens. Personal Protection Equipment (PPE) requires proficiency whenever used. Yet, evidence shows significant errors and variation in competency when applying PPE.

Objective

In this study, we developed a three-phase intervention to promote PPE proficiency.

Methods

Education and assessment of participants' PPE knowledge and skills occurred at a large academic university in Western Canada. Participants first completed an online module; second, they experienced one-on-one coaching and deliberate practice with infection control professionals; and third, participants managed a COVID-19 clinical simulation scenario. The measured outcomes include a 15-item pre- and post-knowledge test and a pre- and post-skills assessment of donning and doffing behaviors. These behaviors were observed from video recordings and were assessed using two standardized checklists.

Results

Knowledge and donning/doffing post-test scores (11.73, 0.95, and 0.96, respectively) were significantly higher after completing all three phases of the educational intervention, p < .001.

Conclusions

An online module alone is insufficient for PPE knowledge and skill development. Rather, a module followed by practice and simulation allows learners to gain proficiency.

What Do Medical Students Learn about Community Care from Discussions with General Physicians? A Thematic Analysis

Background and Objectives: Sustainable healthcare is fundamentally rooted in community medicine education. The COVID-19 pandemic disrupted global advancement in integrating traditional teaching and experiential learning. Additionally, an alarming decline in interest in community care has been observed among senior medical students. Here, we examined the perspectives on community care obtained from conversations with general physicians in rural medical universities. Materials and Methods: Using a constructivist lens, a qualitative methodology was employed to examine the perceptions of second-year medical students from Shimane University Medical School regarding community care, informed by dialogues with general physicians. We conducted a thematic analysis at Shimane University, Japan, an area known for its aging population. In 2023, 116 second-year students participated, none of whom had prior formal training in community care. The study was structured into three phases: (1) Pre-education: Students wrote essays about their initial understanding of community care, its advantages, disadvantages, and potential improvements; (2) Dialogue: Grouped by topic, students engaged in discussions that culminated in a comprehensive session with general physicians; and (3) Reflection: After discussions, students wrote essays reflecting any shift in their views on community care. A thematic analysis of essays from the pre-education and reflection phases provided a comparative perspective on the students' understanding. Results: Five dominant themes emerged from the thematic analysis: (1) Re-evaluating community care: Recognizing diversity and addressing societal challenges; (2) Interdisciplinary collaboration: Promoting shared roles and teamwork; (3) Learning and practice: Emphasizing hands-on experience and self-reflection; (4) Technological influence: The mutual relationship between community care and technological advancements; and (5) Challenges and resolutions: Identifying problems and crafting solutions. Conclusions: This study sheds light on the evolution of medical students' views on community care and underscores the importance of continuous adaptation in medical education programs.

Healthcare Profession Students' Motivations for Learning About Community Organizing: A Thematic Analysis

Background Medical care now emphasizes community health, prevention, health promotion, and collaboration. Integrating medical students into community health initiatives enhances their community health and student skills. In an aging multicultural population, the involvement of healthcare professionals in community health management is vital. However, medical education in Japan lacks sufficient exposure to community health issues. A program in Shimane Prefecture aimed to address this gap by revolutionizing medical education through community organizations. Methods This study employed a reflexive thematic analysis based on relativist ontology and constructivist epistemology. Participants aspiring to be healthcare professionals from Japanese high schools and universities were recruited from rural Shimane Prefecture. Computer-based questionnaires were used to collect data on participants' reasons, motivations, and visions for community-organizing education. The thematic analysis followed Braun and Clarke's approach and involved systematic coding, theme identification, and refinement. Results Three themes emerged from the analysis. In expanding hopes for unknown potential, participants sought improved communication skills, real-world understandings, and fresh perspectives and aimed to promote personal growth through community engagement. In acquiring activeness and new perspectives through connections with peers, hands-on learning and collaboration with peers with shared interests were motivating factors. Participants sought to generate inquiries and discover their activities. Regarding the desire to connect with diverse individuals driven by a strong curiosity about the community, participants aimed to learn community engagement techniques, understand community involvement methods, and explore the relationship between social issues and health. Conclusion Community-organizing education plays a pivotal role in shaping future healthcare professionals. Our analysis underscores the need for curriculum reform, including experiential learning and peer interaction, to facilitate a comprehensive understanding of health and community dynamics. Future studies should assess the long-term impacts of these experiences on students' careers and community health to contribute to advancements in medical education and community-oriented healthcare professionalism.

Rolling the evolutionary dice: Neisseria commensals as proxies for elucidating the underpinnings of antibiotic resistance mechanisms and evolution in human pathogens

Species within the genus Neisseria are especially adept at sharing adaptive allelic variation across species' boundaries, with commensal species repeatedly transferring resistance to their pathogenic relative N. gonorrhoeae. However, resistance in commensal Neisseria is infrequently characterized at both the phenotypic and genotypic levels, limiting our ability to predict novel and potentially transferable resistance mechanisms that ultimately may become important clinically. Unique evolutionary starting places of each Neisseria species will have distinct genomic backgrounds, which may ultimately control the fate of evolving populations in response to selection, as epistatic and additive interactions may coerce lineages along divergent evolutionary trajectories. However alternatively, similar genetic content present across species due to shared ancestry may constrain the adaptive solutions that exist. Thus, identifying the paths to resistance across commensals may aid in characterizing the Neisseria resistome - or the reservoir of alleles within the genus, as well as its depth. Here, we use in vitro evolution of four commensal species to investigate the potential for and repeatability of resistance evolution to two antimicrobials, the macrolide azithromycin and the β-lactam penicillin. After 20 days of selection, commensals evolved elevated minimum inhibitory concentrations (MICs) to penicillin and azithromycin in 11/16 and 12/16 cases respectively. Almost all cases of resistance emergence converged on mutations within ribosomal components or the mtrRCDE efflux pump for azithromycin-based selection, and mtrRCDE or penA for penicillin selection; thus, supporting constrained adaptive solutions despite divergent evolutionary starting points across the genus for these particular drugs. However, continuing to explore the paths to resistance across different experimental conditions and genomic backgrounds, which could shunt evolution down alternative evolutionary trajectories, will ultimately flesh out the full Neisseria resistome.

Enhancing Food Literacy and Food Security through School Gardening in Rural and Regional Communities

A qualitative case study approach with in-depth, semi-structured interviews of key school staff, and student feedback was used to assess a school kitchen and garden program in the regional area of North-West Tasmania, Australia. A detailed program description was produced to conduct a realist evaluation with a Context-Mechanism-Outcome configuration, followed by a program theory evaluation through the construction of a retrospective program logic model. Dedicated kitchen and garden spaces, knowledgeable teachers committed to the program, provision of sufficient materials and consumables, and support from the school and community were found to be the basic requirements to establish a program. Additionally, it is essential to integrate both the kitchen and garden teaching components into the school curriculum. The positive outcomes (e.g., engagement, participation, knowledge, skills, behavioral change) of the program were dependent on the underlying factors, including dedicated support of school leadership, teaching staff, and the parent body for effective student engagement in the teaching spaces and for wider engagement from families and the community. The students' feedback provided supporting evidence of increased food literacy with improvements in their understanding, abilities, and attitudes towards gardening, producing healthy food, and preparing food. This may further lead to enhanced food security for students' families and the broader community.

Using Zoom and Card Game to Conduct Advance Care Planning Classes: An Innovative Practice

BACKGROUND

This article demonstrates the innovative practice of using a card game to teach participants about Advance Care Planning (ACP) and palliative care in Thailand via Zoom during the COVID-19 pandemic.

AIMS

To assess the feasibility of using online workshops to conduct sensitive topics of palliative care and death and dying.

METHODS

The interactive online workshops were conducted after imposition of the COVID-19 restriction and national lockdown in Thailand between March and September 2020. The sessions were conducted via Zoom meetings and Facebook secret group. Trained facilitators plus one IT team member hosted each workshop. Participants were given an anonymous post-course evaluation with open-ended written feedback form. Content analysed was used.

RESULTS

Eleven sessions were conducted. 103 participants joined the online classes. Participants gave an overwhelmingly positive of the workshops, emphasising on: (i) convenient; (ii) social connectedness during the lockdown; (iii) bichronous element of the activities.

Roles and Responsibilities in the Transition to Working Independently: A Qualitative Study of Recently Graduated Radiographers' Perspectives in Australia

Background

Medical imaging features along the entire healthcare continuum and is known for its fast-paced technological evolution which enables it to keep up with the demands of the healthcare system to provide safe, quality services. The overall efficacy and efficiency of the system depends on practitioners' clinical competence, achieved through professional education and continuous professional development. Recent studies have revealed concerns regarding newly graduated healthcare professionals' preparedness and readiness to handle actual practice.

Methods

We conducted qualitative face-to-face and telephonic interviews with a convenient and purposive sample of 23 participants consisting of recently graduated radiographers (n=14), radiography students (n=5) and supervising radiographers (n=4) in Australia. Verbatim transcriptions were analyzed inductively to identify themes pertaining to perspectives and experiences of the work readiness of novice radiographers.

Results

The findings of our study suggest that the workplace immersion and transitioning of recently graduated radiographers into their professional roles requires a process of experiential learning and honing of knowledge and skills if they are to function efficiently and independently in a team-oriented workplace. Radiographic services are spread across various levels of care and are an integral part of the organizational structure of a healthcare system. Maladaptive transitions to the workplace may be the result of low self-confidence, a lack of support, uncertainty in inter-collegial interactions, or unrealistic performance expectations. The overarching themes of communication and interaction emerged clearly as recently graduated radiographers navigated the four roles of coordinator, collaborator, mediator, and advocate.

Conclusion

The application of radiographic skills is embedded in a workplace culture of communication and safety. Transitioning to independent practice takes place in a complex, multifaceted environment and is accompanied by internal and external expectations. Because each workplace has a unique context, system and culture, no novice radiographic professional can ever be fully prepared through pre-service training and workplace induction.

Exploring the impact of a 'Clients-as-Tutors Program on speech-language pathology students' and graduates understanding of client-centred practice

PURPOSE

This study explored the impact of an Australian regional university's Clients-as-Tutors Program (CTP) on speech-language pathology students' perception and understanding of client-centred practice.

METHOD

Two focus group interviews comprising three final-year students and four newly graduated speech-language pathologists who had completed the CTP. An inductive thematic analysis was undertaken to identify salient themes.

RESULT

Three themes were identified: (a) learning from theory, (b) learning from others, and (c) learning from yourself. These themes represented all participants' experiences in the CTP, yet there were unique, individual journeys that each participant experienced.

CONCLUSION

Findings from this study have the capacity to affect change in how client-centred practice is taught at universities across speech-language pathology and other health courses, to disrupt the traditional power structure between client and clinician, and to provide an evidence base for the role of experiential learning in this area.

The Effect of STEAM Activities Based on Experiential Learning on Ninth Graders' Mental Motivation

The impact of STEAM (Science, Technology, Engineering, Arts, and Math) on pupils' learning has been increasingly highlighted recently. This study aims to shed light on the effect of STEAM activities based on experiential learning on ninth graders' mental motivation and learning. The present research adopted a mixed methodology (quantitative and qualitative). The study sample consisted of 90 students divided into three groups. The tools utilized in conducting the study included California Measurement Mental Motivation, and semi-structured interviews with (10) participants. The tools' validity and reliability were verified. After data were analyzed, the findings showed statically significant differences between students' post average scores regarding mental motivation due to teaching method, and in favor of the experimental groups (face-to-face STEAM activities, online STEAM activities). This provides tangible proof for the need to include STEAM activities in school curricula to enhance learners' curiosity, problem-solving skills and self-confidence through learning, as well as their task accomplishment ability.

Mobile application-assisted graded exercise practical: a remote teaching strategy to promote motivation and experiential learning in exercise physiology

Practical classes are critical instructional activities in facilitating learning and motivation in health sciences education. With increasing pedagogical activities being conducted in virtual or remote settings, this study assessed how a remote practical assisted by physiological monitoring smartphone applications impacted student motivation and the achievement of intended learning outcomes in exercise physiology teaching. A total of 24 students (out of 30; 80%) were surveyed via a mixed-methods questionnaire containing 27 closed-ended, and 3 the traditional in-class practical in randomized order. Unpaired Student's t tests were performed for comparisons between interventions with a significance level set at P < 0.05. Students reported that both remote and in-class practicals strongly facilitated the achievement of learning outcomes. Self-reported scores for student satisfaction and perceived achievement of learning outcomes were similar between the two practical methodologies. Student motivation scores assessed using the Lab Motivation Scale revealed that students were more motivated during the remote practical, particularly in the effort domain (P < 0.05). This was in line with the identified themes from the qualitative responses that indicated that the remote practical was more engaging than the in-person practical, with greater opportunities for experiential learning and class involvement being the main factors underlying these findings. Taken together, remote practicals can be critical aspects of a blended learning curriculum that encourages student engagement and experiential learning. With further advancements in physiological monitoring wearables and smartphone technologies, remote practicals can be potential alternatives to traditional in-person practicals in exercise physiology teaching.NEW & NOTEWORTHY Remote practical classes, supported by physiological monitoring smartphone applications, were assessed for their utility in facilitating learning and raising student motivation in health sciences education in this study. A comparison of remote practicals with traditional in-class practicals revealed that a remote practical is an effective method for reinforcing physiology learning objectives with the added advantage of increased student motivation. The added value of remote practicals may be attributed to more experiential learning opportunities and increased engagement levels.

Fostering weight status understanding among exercise science and health students by simulating common physical activities with additional body mass

Overweight and obesity rates continue to rise and appear unlikely to abate. While physical activity (PA) is an important contributor to health and successful weight maintenance, exercise science and health students (ESHS) often endorse negative weight status biases that could undermine PA promotion. This experiential learning activity was intended to help foster weight status understanding among ESHS. Nine ESHS completed the learning activity across two 75-minute class periods. During the initial didactic lesson, the instructor presented on psychophysiological responses to PA among normal and overweight individuals. During the second simulation lesson, the students first responded with their predictions of how the experience of four common physical activities, including shoe tying, brisk walking, running, and climbing and descending stairs, could differ with additional body mass. Next, students twice completed each of the four physical activities while first wearing a weighted vest that simulated 16 lb followed by 32 lb of additional mass. At the beginning, middle, and end of the stair climb and descent, the students provided ratings of affective valence (i.e., pleasure-displeasure). Following the PA simulations, the students wrote about their experiences and how their PA promotion strategies could be modified for overweight clients. The changes in student qualitative responses, particularly following the 32 lb simulations, suggested an increased understanding of the psychophysiological experiences of PA while carrying additional mass. Learning activities like this one may be meaningful additions to ESHS curricula aiming to mitigate weight status bias and improve PA promotion among overweight clients.

Experiences of Student Nurses Regarding Experiential Learning in Specialized Psychiatric Hospitals in South Africa, a Qualitative Study

BACKGROUND

Experiential learning in specialized psychiatric hospitals is as essential as other learning in any discipline in nursing education as it allows student nurses to correlate theory to practice. Experiential learning in the mental health environment has been identified as a significant factor in promoting a more favorable attitude among student nurses toward mental health nursing.

AIM

The study explored student nurses' personal experiences regarding experiential learning in specialized psychiatric hospitals.

METHODS

A qualitative approach using explorative, descriptive, and contextual designs was used, and 51 student nurses were purposively sampled. Data were collected through six focus group interviews and analyzed using a thematic approach. Measures to ensure trustworthiness were also enhanced. Ethical considerations were adhered to throughout the study.

RESULTS

One theme and four sub-themes on the experiences of student nurses regarding experiential learning in specialized psychiatric hospitals were revealed, namely: theme: personal factors; sub-themes: fear of mental healthcare users, anxiety about clinical assessment, lack of interest in psychiatric nursing science, and stress due to social problems.

CONCLUSIONS

Based on the findings, student nurses experience many things during experiential learning, including personal factors. A further qualitative study should be conducted on strategies to support student nurses during experiential learning in the specialized psychiatric hospitals of Limpopo Province.

Hands-on program evaluation training: The evolution of a doctoral course

This article provides details of the background for the focus of this special issue-the accounts from groups of students who conducted evaluations of a local agency while enrolled in a Program Evaluation course in a Psy.D program. These projects were a part of the 5th year that students in the course worked explicitly with an agency on a Program Evaluation. Important themes and insights from the experiences of all 5 years are presented. Analysis of course evaluation data indicates these evaluation group projects were associated with a significant increase in the rating students gave the course. Comments from students on the evaluation forms likewise support the value of this experience, as well as pointing out some additional areas for consideration.

Formulating interprofessional anesthesiology and operating room clinical management pathway during COVID-19 pandemic using experiential learning theory in a university hospital in Saudi Arabia

As the number of COVID-19 cases is rapidly increasing internationally, management, recommendations and guidelines of COVID-19 are rapidly evolving and changing. Formulating local clinical management policies among institutions adopting these recommendations is vital to staff as well as the patients' safety. Also, training multidisciplinary teams on these policies is an important, yet challenging, part of the process. The purpose of this paper is to present the process that has been followed to formulate COVID-19-specific response anesthesiology and operating room (OR) policies at King Abdulaziz University Hospital, by applying David A. Kolb's experiential learning theory during simulation-based training. This project had a total of six simulation-based sessions (four simulation scenarios and two clinical drills) designed to test the efficacy and efficiency of the then current practice in the hospital, facing the COVID-19 pandemic. Qualitative data analysis was completed using qualitative thematic data analysis. To apply experiential Kolb's theory, session's checklist (two raters per session), outcomes, and participants' feedback to develop and improve clinical management pathway in the department were used. The 12 reports and participants' feedback highlighted three main areas for improvement. These are Personal Protective Equipment implementation, team dynamics, and airway management. This process then guided in creating a new understanding of the multidisciplinary clinical management pathway, in addition to enhancing viability of the current practice and clinical management guidelines and protocols, which were already established and adapted at the hospital before the COVID-19 pandemic crisis. The alignment with Kolb's experiential theory helped formulate anesthesiology and OR effective clinical management pathway has been demonstrated. Applying experiential learning theory by a clinical institute using interprofessional, multidisciplinary simulations and clinical drills can guide the process of formulating clinical management pathways during pandemic outbreaks.

In-Person or Online? Exploring Student Pharmacists' Perceived Change in Interprofessional Skills between Two Delivery Formats

The COVID-19 pandemic drastically changed how education is delivered. Many academic programs quickly transformed their curriculum to online distance learning. This rapid transition may have compromised the rigor and fidelity of these activities. The Interprofessional Standardized Patient Experience (ISPE) is an interprofessional education activity (IPE) involving a team of students from six different healthcare professions that switched to an online delivery format. This manuscript compares pharmacy students' perceived change in interprofessional skills between the two formats. Following the ISPE, second-year pharmacy students completed the revised Interprofessional Collaborative Competencies Attainment Survey (ICCAS-R). The ICCAS-R assesses the change in interprofessional collaboration-related competencies in healthcare students before and after IPE training using a retrospective pre-post approach. For each ICCAS-R item and each delivery format (44 in-person and 51 online), paired Student's t-test on pre- and post-ISPE scores, and Cohen's d were calculated. Every item of the ICCAS-R was significant (p < 0.001), regardless of delivery format. Nearly all ICCAS-R items had a large effect size, and the remaining items had a medium effect size. The amount of change pre- and post-ISPE for each ICCAS-R item was calculated. Student's t-test was used to compare the magnitude of change in interprofessional skills between the two delivery formats. Only one difference was noted between the two delivery formats-ICCAS-R item 16, which measured actively listening to interprofessional team members (p = 0.0321). When switching to an online format, the high-fidelity dimension of the ISPE was retained. The ISPE is an effective IPE activity at increasing pharmacy students' self-perceived interprofessional collaboration skills regardless of delivery format. Even though students reported the ISPE increased their ability to actively listen to the perspectives of interprofessional team members in both formats, the magnitude of the benefit was more profound in the in-person group.

The Effect of Service Learning on the Development of Trait Emotional Intelligence and Adversity Quotient in Youths: An Experimental Study

This study aims to determine the effect of service learning (SL) on the trait emotional intelligence and adversity quotient of Chinese undergraduate students in Hong Kong. The SL programme lasted six months (at least 80 service hours). In a pre-test-post-test experimental design, students who participated in the SL during that time period were classified as the experimental group (n = 139; 69 male, 70 female), whereas students who never participated in SL were classified as the comparison group (n = 133; 66 male, 67 female). Both groups of participants were asked to finish the Wong and Law Emotional Intelligence Scale (WLEIS) and the Adversity Response Profile^® (ARP) before and after the SL programme. The results showed that there were no significant differences in WLEIS and ARP scores (at the pre-test) between the experimental and comparison groups. The results further revealed that students in the experimental group had better improvements in WLEIS and ARP than those in the comparison group after they completed SL. These findings provide valuable insights and implications for incorporating components of SL into interventions for youths to improve their ability to process emotions and overcome adversity.

Precepting strategies to develop trainee resilience and overcome unexpected challenges in experiential learning

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

School Gardening and Health and Well-Being of School-Aged Children: A Realist Synthesis

School environments can create healthy settings to foster children's health and well-being. School gardening is gaining popularity as an intervention for healthier eating and increased physical activity. We used a systematic realist approach to investigate how school gardens improve health and well-being outcomes for school-aged children, why, and in what circumstances. The context and mechanisms of the specific school gardening interventions (n = 24) leading to positive health and well-being outcomes for school-aged children were assessed. The impetus of many interventions was to increase fruit and vegetable intake and address the prevention of childhood obesity. Most interventions were conducted at primary schools with participating children in Grades 2 through 6. Types of positive outcomes included increased fruit and vegetable consumption, dietary fiber and vitamins A and C, improved body mass index, and improved well-being of children. Key mechanisms included embedding nutrition-based and garden-based education in the curriculum; experiential learning opportunities; family engagement and participation; authority figure engagement; cultural context; use of multi-prong approaches; and reinforcement of activities during implementation. This review shows that a combination of mechanisms works mutually through school gardening programs leading to improved health and well-being outcomes for school-aged children.

Digesting Digestion: An Educational Laboratory to Teach Students about Enzymes and the Gastrointestinal Tract

Digestion is a fundamentally important process for an individual's life. However, the physical process of digestion is hidden inside the body, making it challenging to understand and a particularly difficult topic for students to learn in the classroom. Traditional approaches to teaching body processes include a mixture of textbook teaching and visual learning. However, digestion is not particularly visual. This activity is designed to engage students using a combination of visual, inquiry-based, and experiential learning approaches and introduces the scientific method to students in secondary school. The laboratory simulates digestion, creating a "stomach" inside of a clear vial. Students fill the vials with a protease solution and visually observe the digestion of food. By making predictions about the types of biomolecules that will be digested, students begin to learn and understand basic biochemistry in a relatable context, while simultaneously understanding anatomical and physiological concepts. We trialled this activity at two schools, where we received positive feedback from teachers and students, indicating that the practical enhanced student understanding of the digestion process. We see this lab as a valuable learning activity that can be extended broadly across multiple classrooms around the world.

An unexpected visitor and a sword play: a randomized controlled trial of collective narrative therapy groups for primary carers of people with schizophrenia

BACKGROUND

Most family carer support programs focus on supporting carers with caregiving-related knowledge and skills to help their family members who suffer from schizophrenia in their recovery process while carers' inner resources and preferred identities are less emphasized in the existing studies.

AIMS

The present study uses collective narrative therapy groups (CNTG) to promote the inner strengths and agency of family carers and help them to explore their preferred identities while caring for family members with schizophrenia.

METHOD

To ensure an evidence-based intervention, 89 Chinese family carers of people with schizophrenia took part in this three-wave longitudinal program evaluation study using a randomized controlled trial design.

RESULTS

Compared with the control group, family carers in CNTG reported better family relationships, a lesser caregiving burden, and more perceived inner resources. Repeated one-way ANOVA revealed that CNTG improved family relationships, the caregiving burden, the level of hope and inner resources in the posttest, and a statistically significantly better mental health condition in the follow-up.

CONCLUSION

This study shows that collective narrative psychotherapy is effective in supporting family carers of people with schizophrenia in Hong Kong. Based on the research findings, we discuss the strengths of the program and its implications for practitioners.