Academic Health Science Centre Research Articles

Evaluation of virtual training delivery for health information systems implementation in Canada: A qualitative study.

As health information systems (HIS) become a critical part of patient care, it is crucial to build an effective education strategy that facilitates the adoption and sustained use of these systems. The COVID-19 pandemic (2019-2023) has contributed to the rapid shift in virtual education and training for healthcare staff. We sought to evaluate the efficacy and long-term sustainability of virtual training for using a HIS by examining opportunities and challenges. An exploratory, multimethods study was conducted with staff who had taken part in a virtual HIS training program as part of the clinical transformation journey at a large academic health science center in Canada. The study was guided by the Accelerating the Learning Cycle framework. Data were collected through pre- and post-training surveys, as well as semi-structured interviews. An iterative, inductive, constant comparative analysis approach, outlined by Braun and Clarke, was taken to thematically analyse the data. Of the 33 participants in this study, 13 were educational champions, and 20 were end-users. The pre- and post-training surveys yielded a total of 1479 responses in both groups. Three prominent themes emerged from this study: (1) fostering dynamic facilitation techniques to cultivate an inclusive culture and adapt to diverse learning needs; (2) integrating practical learning activities that contribute to knowledge retention; and (3) ensuring training resources are accessible and consistent for an optimal training experience. As HIS continue to be part of the transformation of the healthcare ecosystem, education is vital in preparing healthcare providers to perform their clinical tasks and effectively use these technologies. Findings from this study can be used to inform the development of virtual training that is inclusive and addresses the needs of care providers.

An innovative Doctor of Nursing Practice scholarly project curriculum model: Strategies for supporting learners at various entry levels

The Doctor of Nursing Practice (DNP) Program curriculum must address the challenge of developing Competency Based Education (CBE) curriculum for DNP Scholarly Projects tailored to meet variations in nursing learner preparation and practice, from novice bachelor's entry level and master's advanced nurse practice expert entry level pathways. The recent Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity report by the National Academy of Medicine advocates that competency-based education (CBE) approaches in nursing schools should focus upon the advanced practice nursing population within collaborative academic practice partnerships. This article describes an innovative DNP Scholarly Project Curriculum model at an academic health science center that integrates academic partnerships and CBE strategies that have been developed for second degree Bachelor's direct entry to nursing (direct entry), post BS in nursing to DNP (BS to DNP), Post Master's to DNP (PM DNP) entry levels of preparation. The DNP Scholarly Project Curriculum utilizes an innovative, scaffolded approach to fostering CBE for the assessment of learning activities at the doctoral level. The DNP Scholarly Project Curriculum includes domains of quality improvement, critical appraisal of the literature, evidence-based practice models, implementation practice models, policy analysis, and process/outcome evaluations. Preliminary alumni and stakeholder feedback suggests that these projects are not only impacting practice but improving learner competency in quality improvement science. Implementation of this model has led to enhanced CBE-driven curriculum teaching and learning strategies, and sustainable collaborative academic partnerships.

A Faculty-Centered Career Consultation Service in an Academic Health Sciences Center: Five Years of Presenting Problems, Demographics, and Recommendations.

Psychologists in faculty affairs/faculty development (FAFD) roles can contribute to faculty vitality in academic health centers (AHCs) and mitigate barriers to advancement and retention. We describe a novel psychologist-led consultation service within an Office for Faculty Success (OFS) to support faculty across their career trajectories. We used 5 years of consultation data including faculty demographics, presenting concerns, and post-consultation evaluation data on consultation satisfaction and perceived benefits to examine trends and demographic group differences in consultation frequency, presenting concerns, and perceived benefits. From 2018 to 2023, 434 individuals presented for 683 consultations. Promotion in rank was the most frequent presenting concern. Women and racially/ethically minoritized faculty were found to present more frequently for repeat consultations, for concerns related to careers negotiation and advancement, and for intersectionality issues specific to gender and/or racial minority identities. From years one to five, there was a 93% increase in number of annual consultations performed and users were highly satisfied with the service (3.86/4). The consultation service is a unique, highly acceptable addition to interventions focused on career satisfaction and retention for AHC faculty, especially for women, early career, and minoritized faculty, and can serve as a model for other institutions.

Evaluation of alternate form reliability for the 9-item versions of the interprofessional socialization and valuing scale (ISVS-9A/9B)

BackgroundThe Interprofessional Socialization and Valuing Scale (ISVS) was developed to measure interprofessional socialization as one adopts and integrates learning into practice. While items for the ISVS-9A and 9B were drawn from three subscales of the original 24-item tool, these parallel forms were validated as a unidimensional measure using Canadian health professional and student populations. ObjectivesThe aim was to investigate if the ISVS-9A and ISVS-9B forms are interchangeable and examine their internal structure. DesignStudents completed an 18-question survey that included the nine items from the ISVS-9A followed by the nine items for ISVS-9B. SettingsTwo U.S. academic health science centers provided longitudinal interprofessional education (IPE) in a classroom setting. Participants625 students representing 13 programs from one institution and 512 students representing 7 health professions programs from the second institution were included in the study. MethodsParticipants completed the ISVS-9A and 9B as a single form. Intraclass correlation coefficients (ICC) and corresponding 95 % confidence intervals were calculated to measure the absolute agreement between the scores from the ISVS-9A and 9B forms. A factor analysis considering the original tool's three subscales was conducted. Results592 responses from one institution and 500 responses from the second institution were analyzed. ICC for the ISVS total scores demonstrated good reliability (0.75–0.90). However, the internal structure of the three factors demonstrated moderate reliability (0.5–0.75) and may need further investigation. ConclusionsThis study confirms the use of the ISVS-9A and 9B total score to measure interprofessional socialization in health professional students attending U.S. institutions. Additional research is needed to determine potential reasons for mixed outcomes from studies using ISVS-9A and 9B parallel forms.

Developing a customised set of evidence-based quality indicators for measuring workplace violence towards healthcare workers: a modified Delphi method

BackgroundWorkplace violence (WPV) is a complex global challenge in healthcare that can only be addressed through a quality improvement initiative composed of a complex intervention. However, multiple WPV-specific quality indicators...

Nurses' experiences of hospital‐acquired pressure injury prevention in acute healthcare services in Victoria, Australia: A qualitative study using the Theoretical Domains Framework

AbstractWe investigated nurses' experiences of hospital‐acquired pressure injury (PI) prevention in acute care services to better understand how PI prevention may be optimised. We used the Theoretical Domains Framework to systematically identify barriers and enablers to evidence‐based preventive practices as required by the International Guideline. This study was one element of a complex capacity building project on PI surveillance and prevention within the acute health service partners of Monash Partners Academic Health Science Centre, an accredited academic health partnership located in Melbourne, Australia. We adopted a qualitative descriptive design. We interviewed 32 nurses that provided care in intensive care units, general wards and COVID wards of four acute care services. Nurses were recruited from four large acute care services (three public, one private) located in Melbourne. Most of them worked with patients who were at high risk of hospital‐acquired PI on a daily basis. Interview transcripts were coded and analysed using thematic analysis guided by the Theoretical Domains Framework. The domains referred to most frequently by all participants included: Knowledge, Skills, Social/Professional Role and Identity, Beliefs about Capabilities, and Environmental Context and Resources. The key barriers discussed by nurses included gaps in nurses' knowledge and skills related to identification and staging of PI, heavy nursing workload and inadequate staffing levels, stigma and self‐blame related to PI identification, and exacerbating impacts of the COVID‐19 pandemic. Main facilitators discussed were training programmes, nursing audits and feedback, and teamwork. Participants suggested improvements including accessible and tailored training, visual reminders, and addressing heavy workloads and emotional barriers nurses face. Investing in tailored training initiatives to improve nurses' knowledge and organisational changes to address low level staffing and heavy workloads are urgently needed to support nurses in delivering optimal care and preventing hospital‐acquired PI.

CSP2023: 451 - Standardising physiotherapy practice in critical care: An overview of the integration journey across an academic health science centre

CSP2023: 451 - Standardising physiotherapy practice in critical care: An overview of the integration journey across an academic health science centre

Sociotechnical imaginaries in academic medicine strategic planning: a document analysis

Purpose Along with other industries, healthcare is becoming increasingly digitized. Our study explores how the field of academic medicine is preparing for this digital future. Method Active strategic plans available in English were collected from faculties of medicine in Canada (n = 14), departments in medical schools (n = 17), academic health science centres (n = 23) and associated research institutes (n = 5). In total, 59 strategic plans were subjected to a practice-oriented form of document analysis, informed by the concept of sociotechnical imaginaries. Results On the one hand, digital health is discursively treated as a continuation of the academic medicine vision, with expansions of physician competencies and of research institutes contributions. These imaginaries do not necessarily disrupt the field of academic medicine as currently configured. On the other hand, there is a vision of digital health pursuing a robust sociotechnical future with transformative implications for how care is conducted, what forms of knowledge are prioritized, how patients and patienthood will be understood, and how data work will be distributed. This imaginary may destabilize existing distributions of knowledge and power. Conclusions Looking through the lens of sociotechnical imaginaries, this study illuminates strategic plans as framing desirable futures, directing attention towards specific ways of understanding problems of healthcare, and mobilizing the resources to knit together social and technical systems in ways that bring these visions to fruition. There are bound to be tensions as these sociotechnical imaginaries are translated into material realities. Many of those tensions and their attempted resolutions will have direct implications for the expectations of health professional graduates, the nature of clinical learning environments, and future relationships with patients. Sociology of digital health and science and technology studies can provide useful insights to guide leaders in academic medicine shaping these digital futures.

374 Operationalization of a Translational Ethics Program

OBJECTIVES/GOALS: Within our CTSA hub, greater emphasis is on understanding innovation and human health impact of translational science writ large rather than focus on translational research projects. Our program is restructured to reflect distinguishing ethical features of translational science which are complimentary to traditional research ethics issues. METHODS/STUDY POPULATION: This descriptive analysis depicts the development of our ethics program as an exemplar of how to integrate into the research enterprise of an academic health science center that engages in translational research. Our relational approach is predicated on the embodiment of ethical values by all who are involved in research committed to proactive dialog, team building, and collaboration. This translational research culture is facilitated by a multidisciplinary ethics team who are embedded throughout the translational research enterprise. RESULTS/ANTICIPATED RESULTS: Our program is integrated into a translational science enterprise within a CTSA hub in four areas: relational structure (from leadership team to community engagement), education (from trainees to the research community to the public), support (through ethics consultation with multiple touchpoints in the translational science pathway), and team science (from team on-boarding and communication to D&I research of team science interventions). We have developed a research agenda examining research ethics topics that increase quality, applicability and downstream social impact of research; understanding translational science through historical and science & technologies studies lenses, and ethnographic and mixed-method approaches to understanding team science and the science of team science. DISCUSSION/SIGNIFICANCE: The integration of a translational ethics program provides attention to traditional research ethics issues regarding study conduct and integrity but also transcends those concerns to focus on the translational science enterprise itself through relationships, cultivating trust, team science, DEIA, and social responsibility.

How can academic health science centers help to increase diversity in the STEM professions?

In the United States, great inequities exist within the science, technology, engineering, and math (STEM) fields in individuals who self-identify as belonging to underrepresented groups (e.g., from socioeconomically disadvantaged backgrounds, people with disabilities, and Black/African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander). Underrepresentation in STEM careers has been documented to be due to a lack of qualified and diverse teaching personnel, limited access to resources in disadvantaged schools, and implicit bias within US institutions. In recognition of these inequities, an interprofessional team of biomedical faculty members and diversity, equity and inclusion (DEI) educators from the Louisiana State University Health Science Center (LSUHSC) in New Orleans developed and implemented a STEM educational training pipeline for elementary, middle, and high school (K-12), undergraduate, and medical students, with accompanying DEI training for LSUHSC mentors and staff to mitigate implicit bias and promote a welcoming environment for participants from different backgrounds. Our findings focus on one social determinant of health: access and quality of education. Other institutions can implement a program as described in the present study to address the educational and health inequities in their own communities.

Long-term impact of COVID-19 pandemic: Moral tensions, distress, and injuries of healthcare workers.

Given the longevity of the COVID-19 pandemic, it is important to address the perceptions and experiences associated with the progression of the pandemic. This narrative can inform future strategies aimed at mitigating moral distress, injury, and chronic stress that restores resilience and well-being of HCWs. In this context, a longitudinal survey design was undertaken to explore how health care workers are experiencing the COVID-19 pandemic over time. A qualitative design was employed to analyze the open ended survey responses using a thematic analysis approach. All physicians and staff at an academic health science centre in Toronto, Ontario, Canada were invited to participate in the survey. The majority of survey respondents were nurses and physicians, followed by researchers/scientists, administrative assistants, laboratory technicians, managers, social workers, occupational therapists, administrators, clerks and medical imaging technologists. The inductive analysis revealed three themes that contributed to moral tensions and injury: 1) experiencing stress and distress with staffing shortages, increased patient care needs, and visitor restrictions; 2) feeling devalued and invisible due to lack of support and inequities; and 3) polarizing anti- and pro-public health measures and incivility. Study findings highlight the spectrum, magnitude, and severity of the emotional, psychological, and physical stress leading to moral injury experienced by the healthcare workforce. Our findings also point to continued, renewed, and new efforts in enhancing both individual and collective moral resilience to mitigate current and prevent future moral tensions and injury.

Community Engagement Studios to advance multi-site research with older adults.

Operationalizing multi-site Community Engagement (CE) Studios to inform a research program is valuable for researchers. We describe the process and outcomes of hosting three CE Studios with Community Experts aged 65 years or older with chronic conditions and care partners of older adults. Experts gave feedback about processes for testing the feasibility, efficacy, effectiveness, and implementation of audio recording clinic visits and sharing recordings with patients who have multimorbidity and their care partners. The CE Cores of the Clinical and Translational Science Awards Programs at three academic health science centers created a joint CE Studio guide. Studios were conducted iteratively by site. Following receipt of the final reports, responses were compared to find themes, similarities, and differences on four topics in addition to overall commentary: Recruitment and Retention, Study Protocol, Study Reminders and Frequency, and Recording Technology. Eighteen older adults and care partners in three states provided valuable feedback to inform multi-site trials. Feedback influenced multiple aspects of trials in process or subsequently funded. Experts provided critique on the wording of study invitations, information sheets, and reminders to engage in study procedures. Experts were concerned for participants being disappointed by randomization to a control arm and advised how investigators should prepare to address that. Multi-site CE Studios should be consecutive, so each team can learn from the previous teams. Using the CES Toolkit ensures that final reports were easily comparable and utilized to develop a research program that now includes three federally funded clinical trials.

Comparison of electrodiagnostic findings in acute traumatic versus chronic non-traumatic ulnar neuropathy at the elbow.

A common concept is that traumatic nerve injuries are more likely axonal, and that compressive neuropathies are more likely demyelinating. The purpose of this study was to compare traumatic versus non-traumatic ulnar neuropathy at the elbow (UNE) to look for electrodiagnostic differences between the two groups. A retrospective 3 year review of UNE patients at two academic health science centers was conducted. Patients were grouped into acute traumatic UNE versus chronic non-traumatic UNE based on clinical history. Electrodiagnostic measurements were compared between the two groups. There were 50 subjects with acute traumatic UNE and 41 with chronic non-traumatic UNE. Mean age and sex distribution were similar but those with traumatic UNE had a 7 month duration of symptoms, while those with chronic UNE had 29 month duration (p < .001). All electrodiagnostic measurements were similar between the two groups including compound muscle action potential amplitudes, motor conduction velocities, frequency of conduction block, sensory nerve studies, and needle electromyography. We did not find a difference between the two groups. One should not make inferences regarding acuity or etiology based on electrodiagnostic features alone.

Effect of Mixed Reality on Delivery of Emergency Medical Care in a Simulated Environment

Mixed-reality (MR) technology has the potential to enhance care delivery, but there remains a paucity of evidence for its efficacy and feasibility. To assess the efficacy and feasibility of MR technology to enhance emergency care delivery in a simulated environment. This pilot randomized crossover trial was conducted from September to November 2021 at a single center in a high-fidelity simulated environment with participants block randomized to standard care (SC) or MR-supported care (MR-SC) groups. Participants were 22 resident-grade physicians working in acute medical and surgical specialties prospectively recruited from a single UK Academic Health Sciences Centre. Data were analyzed from September to December 2022. Participants resuscitated a simulated patient who was acutely unwell, including undertaking invasive procedures. Participants completed 2 scenarios and were randomly assigned to SC or MR-SC for the first scenario prior to crossover. The HoloLens 2 MR device provided interactive holographic content and bidirectional audiovisual communication with senior physicians in the MR-SC group. The primary outcome was error rate assessed via the Imperial College Error Capture (ICECAP) multidimensional error-capture tool. Secondary outcomes included teamwork (Observational Teamwork Assessment for Surgery [OTAS]; range, 0-6 and Teamwork Skills Assessment for Ward Care [T-SAW-C]; range, 1-5), scenario completion, stress and cognitive load (NASA Task Load Index [NASA-TLX; range 0-100]), and MR device user acceptability. A total of 22 physicians (15 males [68.2%]; median [range] age, 28 [25-34] years) were recruited. MR technology significantly reduced the mean (SD) number of errors per scenario compared with SC (5.16 [3.34] vs 8.30 [3.09] errors; P = .003), with substantial reductions in procedural (0.79 [0.75] vs 1.52 [1.20] errors; P = .02), technical (1.95 [1.40] vs 3.65 [2.03] errors; P = .01), and safety (0.37 [0.96] vs 0.96 [0.85] errors; P = .04) domains. MR resulted in significantly greater scenario completion rates vs SC (22 scenarios [100%] vs 14 scenarios [63.6%]; P = .003). It also led to significant improvements in the overall quality of teamwork and interactions vs SC as measured by mean (SD) OTAS (25.41 [6.30] vs 16.33 [5.49]; P < .001) and T-SAW-C (27.35 [6.89] vs 18.37 [6.09]; P < .001) scores. As reported via mean (range) NASA-TLX score, there were significant reductions for MR-SC vs SC in participant temporal demands (38 [20-50] vs 46 [30-70]; P = .03) and significant improvements in self-reported task performance (50 [30-60] vs 39 [10-70]; P = .01). Overall, 19 participants (86.4%) reported that they were more confident in making clinical decisions and undertaking clinical procedures with MR support. This study found that the use of MR technology reduced error, improved teamwork, and enhanced practitioner confidence when used to support the delivery of simulated emergency medical care. ClinicalTrials.gov Identifier: NCT05870137.

Effect of colchicine on perioperative atrial fibrillation and myocardial injury after non-cardiac surgery in patients undergoing major thoracic surgery (COP-AF): an international randomised trial

Higher levels of inflammatory biomarkers are associated with an increased risk of perioperative atrial fibrillation and myocardial injury after non-cardiac surgery (MINS). Colchicine is an anti-inflammatory drug that might reduce the incidence of these complications. COP-AF was a randomised trial conducted at 45 sites in 11 countries. Patients aged 55 years or older and undergoing major non-cardiac thoracic surgery were randomly assigned (1:1) to receive oral colchicine 0·5 mg twice daily or matching placebo, starting within 4 h before surgery and continuing for 10 days. Randomisation was done with use of a computerised, web-based system, and was stratified by centre. Health-care providers, patients, data collectors, and adjudicators were masked to treatment assignment. The coprimary outcomes were clinically important perioperative atrial fibrillation and MINS during 14 days of follow-up. The main safety outcomes were a composite of sepsis or infection, and non-infectious diarrhoea. The intention-to-treat principle was used for all analyses. This trial is registered with ClinicalTrials.gov, NCT03310125. Between Feb 14, 2018, and June 27, 2023, we enrolled 3209 patients (mean age 68 years [SD 7], 1656 [51·6%] male). Clinically important atrial fibrillation occurred in 103 (6·4%) of 1608 patients assigned to colchicine, and 120 (7·5%) of 1601 patients assigned to placebo (hazard ratio [HR] 0·85, 95% CI 0·65 to 1·10; absolute risk reduction [ARR] 1·1%, 95% CI -0·7 to 2·8; p=0·22). MINS occurred in 295 (18·3%) patients assigned to colchicine and 325 (20·3%) patients assigned to placebo (HR 0·89, 0·76 to 1·05; ARR 2·0%, -0·8 to 4·7; p=0·16). The composite outcome of sepsis or infection occurred in 103 (6·4%) patients in the colchicine group and 83 (5·2%) patients in the placebo group (HR 1·24, 0·93-1·66). Non-infectious diarrhoea was more common in the colchicine group (134 [8·3%] events) than the placebo group (38 [2·4%]; HR 3·64, 2·54-5·22). In patients undergoing major non-cardiac thoracic surgery, administration of colchicine did not significantly reduce the incidence of clinically important atrial fibrillation or MINS but increased the risk of mostly benign non-infectious diarrhoea. Canadian Institutes of Health Research, Accelerating Clinical Trials Consortium, Innovation Fund of the Alternative Funding Plan for the Academic Health Sciences Centres of Ontario, Population Health Research Institute, Hamilton Health Sciences, Division of Cardiology at McMaster University, Canada; Hanela Foundation, Switzerland; and General Research Fund, Research Grants Council, Hong Kong.

Seeking Education, Equity, and Diversity (SEED)

Introduction Health care work cultures that embrace diversity, equity, and inclusion (DEI) foster innovations, synergy, and appreciation for differences. To promote DEI, health care systems have encouraged professional development on cultural humility, which is awareness of one’s values, beliefs, and social position, given the current cultural context while mindful of history. The national SEED Project (Seeking Educational Equity and Diversity) is a professional development program that prompts reflection and perspective shifting about workplace culture and systemic change. However, reports that examine the SEED learning experience and the participants’ intention for behavior change are lacking. The purpose of our study was to examine: (a) The SEED learning experience, (b) How personal views can foster cultural humility, and (c) The impact of SEED on intentions to effect change. Methods A purposive sample of eight (N = 8) faculty and staff from a SEED cohort at an academic health science center, with regional programs, participated in in-depth interviews to explore their personal views of how to foster cultural humility in health care and the impact of SEED to prompt intentions for behavior change. The investigators conducted a thematic analysis using an inductive, iterative method. Independently, they read each transcript and created codes for each comment. Subsequently, they compared findings, developed a coding frame, and grouped codes into potential themes. They then individually applied the coding frame to the data and considered themes. Finally, they built consensus on codes and synthesized codes into themes. Results Thematic analysis indicated the participants had a profound learning experience, which prompted them to develop cultural humility by re-framing cultural experiences and resolving to become more proactive about DEI in the workplace. They found small group discussions were insightful and provocative. These discussions led to new perspectives and behavior change or intentions for behavior change. Our analysis generated three themes: (1) Connecting with diverse perspectives, (2) Developing new perspectives, and (3) Being proactive with advocacy and new strategies. Conclusion Health care professionals and organizations can use our findings to encourage professional development that potentially stimulates behavior change, the ultimate goal of professional development, related to DEI. Future studies should examine the impact of this professional development within their organization and in the delivery of health care.

The effects of nordic walking, high-intensity interval training, and moderate-to-vigorous intensity continuous training on arterial stiffness in patients with coronary artery disease

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): The investigator-initiated research was supported by the Innovations Fund of the Alternate Funding Plan for the Academic Health Sciences Centres of the Ministry of Ontario (PIs: Pipe, Reed) and Heart and Stroke Foundation of Canada (PI: Reid). Background Coronary artery disease (CAD) is a leading cause of mortality worldwide. Arterial stiffness, a process associated with aging, arteriosclerosis, and arterial remodeling, is a strong and independent predictor of cardiovascular and all-cause mortality in patients with CAD. Moderate-to-vigorous intensity continuous training (MICT) has been shown to improve arterial stiffness parameters, including pulse wave velocity (PWV, i.e., the speed at which arterial pressure waves travel along the aorta and large arteries) and augmentation index (AIx: i.e., aortic pressure waveform) in the CAD population. Yet, the role of alternative exercise training approaches on arterial stiffness in patients with CAD has not been elucidated. Our recent study demonstrated greater improvements following Nordic walking (NW) compared to high-intensity interval training (HIIT) and MICT in functional capacity, quality of life, and depression severity in patients with CAD. No previous trial has compared the efficacy of NW, HIIT, and MICT in improving arterial stiffness in patients with CAD. Alternatives to traditional MICT, such as NW and HIIT, may provide superior understudied benefits on vascular health in patients with CAD. Purpose We compared the effects of 12 weeks of NW, HIIT, and MICT on arterial stiffness in patients with CAD. Methods Patients with CAD were randomly assigned to: (1) NW (walking with NW poles at a resting heart rate [RHR] + 20–40 bpm), (2) HIIT (aerobic exercise equipment: 4 × 4-min of high-intensity work periods at 85%–95% peak HR), or (3) MICT (aerobic exercise equipment: RHR + 20–40 bpm) twice weekly for 12 weeks. At baseline and week 12, aortic stiffness parameters were measured using a non-invasive device by stroke volume (SV), total vascular resistance (TVR), AIx with and without normalization for a HR of 75 bpm (AIX@75), and PWV. Linear mixed-effects models with repeated measures were used to compare groups over time. Results A total of 130 patients with CAD (aged 61 ± 7 years; male: 85%) were randomized to NW (n = 43), HIIT (n = 43), or MICT (n = 44). Table 1 shows that significant main effects of time were observed for SV (∆: 5.485 m/L, F = 8.530, p = 0.004), with a time × group interaction (F = 3.710, p = 0.027) revealing a greater improvement in SV following NW compared to HIIT (F = 5.748, p = 0.019) and MICT (F = 5.494, p = 0.022). A significant time × group interaction (F = 3.700, p = 0.028) was observed in AIx@75, with a greater reduction following NW than MICT (F = 7.388, p = 0.008). No significant differences were observed in TVR, AIx, and PWV. Conclusion Our findings show that NW facilitated greater improvements in SV and AIx@75 parameters of arterial stiffness, an important predictor of future cardiovascular events, when compared to HIIT and MICT in patients with CAD. NW may be considered as an alternative exercise training to improve vascular health in those with CAD.

The effects of high-intensity interval training and moderate-to-vigorous intensity on cardiorespiratory fitness in patients with permanent or persistent atrial fibrillation

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): the Innovations Fund of the Alternate Funding Plan for the Academic Health Sciences Centre of the Ministry of Ontario. Background Lower cardiorespiratory fitness (CRF) in atrial fibrillation (AF) is associated with higher risk of mortality. Moderate-to-vigorous intensity continuous training (MICT) increases CRF; however, growing evidence indicates that high-intensity interval training (HIIT) elicits similar or greater improvements in CRF in people with cardiovascular disease. Purposes The purposes of this study were to: (1) compare the effects of HIIT and MICT on CRF in patients with persistent and permanent AF; and, (2) assess the proportion of participants who achieved a clinically meaningful increase in CRF (i.e., 3.5 mL/kg/min, associated with significant reduction in mortality in AF). Methods This was a subanalysis of an RCT to examine the effects of HIIT and MICT on functional capacity. Participants completed cardiopulmonary exercise test (CPET) and were randomly assigned to 12-week, twice weekly supervised HIIT or MICT. Each HIIT session was 23 min in duration, completed on a stationary bike, and consisted of: (1) a 2-min warm up; (2) two blocks of 8 x 30-sec high-intensity work periods at 80-100% peak power output interspersed with 30-sec active recovery periods, with 4 min active recovery between the blocks; and, a 1-min cooldown. Each MICT session consisted of (1) a 15-min warm up; (2) 30-min of continuous aerobic exercise; and, (3) a 15-min cooldown. A subset of willing participants completed follow-up CPET. Repeated measures ANOVA was used to compare the changes in CRF between HIIT and MICT. Descriptive statistics was used to assess the proportion of patients meeting the clinically meaningful increase in CRF. Results Of 94 patients consented, 13 in HIIT (67±4 years old, 26% females) and 10 in MICT (71±9 years old, 40% females) completed pre and post CPET. Exercise adherence (i.e., % of sessions attended) was 91% for HIIT and 85% for MICT, respectively, and did not differ between the groups. At week 12, 76% of participants in HIIT and 80% in MICT achieved the prescribed exercise intensity targets. Our per-protocol analysis showed no overall change in CRF (pre: 19.0±5.1 vs. post: 19.4±4.6 mL/kg/min, p=0.461). No significant differences in changes in CRF were observed between HIIT (pre: 20.1±5.3 vs. post: 20.3±4.5 mL/kg/min) and MICT (pre: 17.6±4.8 vs. post: 18.4±4.7 mL/kg/min, interaction effect p=0.681). Two participants in HIIT (15.4%) and two in MICT (20.0%) achieved clinically meaningful increases. Conclusions Twice weekly HIIT or MICT for 12 weeks did not improve CRF in patients with persistent and permanent AF who completed CPET. Further, a small proportion of these patients (≤ 20%) achieved clinically meaningful increase in CRF. Considering a greater increase in CRF (3.2±2.5 mL/kg/min) in patients with non-permanent AF following high-volume HIIT (a total of 16 min at high intensity per session, three times per week) in a previous RCT, a larger exercise volume may be required to improve the CRF of patients with persistent and permanent AF.

480 Integrating a Research Ethics Program within an Academic Health Science Center

OBJECTIVES/GOALS: Research ethics services are critical to the clinical, research, and educational missions of an academic health science center. Our ethics program aims to develop a culture where investigators are as intellectually engaged in ethical issues of scientific integrity as they are in study design, data collection, and implementation. METHODS/STUDY POPULATION: This descriptive analysis depicts the historical development, from 2010 to 2022, of our research ethics program as an exemplar of ethics integration into the research enterprise of an academic health science center that engages in translational research. In this culture, clinicians, translational researchers and their scientific peers, research participants, and community members become involved in ethics investigation, deliberation, and innovation. RESULTS/ANTICIPATED RESULTS: There are four pillars to our research ethics program: 1) research ethics consultation service, which fosters the development of ethical best practices and standards for the practice of translational research; 2) education, which provides customized training and educational opportunities in research ethics to diverse stakeholders; 3) leadership, through collaboration and partnerships; 4) scholarly engagement, in the pursuit of innovative ethics research and professional development. Through these initiatives we can engage a broad constituency of stakeholders, become an integral component of research oversight, engage as active participants in the research enterprise, and have a critical role in guiding institutional culture. DISCUSSION/SIGNIFICANCE: The integration of our ethics program mirrors the translational science continuum which promotes the multidirectional flow of ideas among ethics consultants, laboratory/clinical scientists, implementation researchers and the community.

Interprofessional Pain Curriculum for an Academic Health Science Center

AIMThe aim of this project is to develop a comprehensive pain curriculum to educate a diverse group of students across health care disciplines who care for those in pain. The outcome goals for participants of this educational program are to have increased knowledge and skills associated with the management of pain. This poster will describe the process of team development, development of the grant proposal, conducting a gap analysis, designing and developing the content of the program, and finally the integration of technology as we prepare for program delivery. METHODSThe team developing the program include representatives from the disciplines of nursing, physical therapy, social work, and psychology. The curriculum is based on the Interprofessional Pain Curriculum developed by the International Association for the Study of Pain. Holographic technology will be used to optimize participant engagement and interest. Additional modes of content delivery include synchronous video meetings, asynchronous discussions, and the use of case studies in both modes, all completed in multidisciplinary teams. RESULTSContent has been developed and loaded into a Canvas course shell. Delivering parts of the program via hologram technology will be recorded within the next 3 months. CONCLUSIONSThis content will be delivered to student groups in the Spring 2023 semester during an Interprofessional Education (IPE) event focused on the management of pain. Health disciplines represented at the IPE event will include Medicine, Nursing, Physical Therapy, Psychology, Social Work, and Pharmacy. Outcome assessments related to knowledge, beliefs and attitudes about pain from IPE participants will be collected. Based on that data, further tweaking of the education program will be considered. ACKNOWLEDGEMENTThis project was made possible through funding from the Elizabeth Morse Genius Foundation, Grant number: AWD00001443