Baseline Knowledge Research Articles

Animated Videos as a Tool for Teaching Uncommon ENT Diagnoses.

The purpose of this study was to evaluate the knowledge of healthcare professionals and learners regarding the diagnosis and management of nasal septal hematomas (NSH). The secondary objective was to evaluate the effectiveness of a short-form animated video as an educational tool. Methods: A cross-sectional survey study of healthcare professionals and medical students in the United States was undertaken from October 2022 to June 2023. A pre-test survey was distributed to assess participants' baseline knowledge of NSH management. An educational video on nasal septal hematoma management was presented, followed by a post-test survey to measure the effectiveness of the video. Results: A total of 142 participant results were collected, 62 (43.7%) of which were attending physicians.There was a significant improvement in knowledge scores across the sample, with a median pre-test score of 83.0% (interquartile range (IQR) 33) and a median post-test score of 100.0% (IQR 17, p<0.001). Additionally, on a visual analog scale (VAS), comfort levels in managing NSH improved from 3.20 to 4.82 (p<0.001) for the entire sample. Conclusion: NSH is a rare yet potentially devastating otolaryngologic emergency that requires prompt diagnosis and management. A short-form animated video can be an effective tool for educating emergency professionals on diagnosing and managing NSH.

Development and implementation of a geriatric oncology interprofessional case-based educational intervention for cancer care providers.

9020 Background: Geriatric assessment (GA) is recommended as part of the standard of care for older adults with cancer. However, the GA has not been fully adopted as part of routine practice in oncology in Mexico, mainly due to lack of qualified personnel and limited knowledge. We designed an interprofessional case-based educational intervention to address the main barriers for implementation of GA in oncology. Methods: We followed Kern’s six-step approach to design a continuing professional development (CPD) activity. Our targeted learners consisted of teams comprised of one oncologist and one geriatrician who practiced at the same site in Mexico. By the end of the intervention, participants would be able to perform GA in older adults with cancer, and to integrate information obtained through a GA in a cancer treatment plan through adequate interventions. We used Project ECHO’s model to create a CPD activity consisting of 12 weekly 75-minute online sessions via Zoom, with content selected from international geriatric oncology guidelines. At baseline, and at the end of the course, participants answered a 36-item multiple choice knowledge assessment (scale 0-100), a survey on self-perceived competence in GA skills (scale 0-10), and an adaptation of the Association for Community Cancer Centers Geriatric Oncology Gap Assessment Tool, which assesses subjective performance of the GA (scale 0-4). Participants also completed a satisfaction questionnaire. We compared baseline and post-intervention scores through paired t tests; results from the satisfaction questionnaire are reported descriptively. Results: We included 56 participants (28 geriatricians and 28 oncologists). Median participant attendance was 10 sessions (IQR 9-11). Thirty-eight participants completed the satisfaction questionnaire: median satisfaction was 10/10 (range 8-10). There was no difference in satisfaction scores between oncologists and geriatricians. Mean baseline knowledge score was 59.5±12.8 and mean post-intervention knowledge score was 74.4±9.7 (p&lt;0.001, effect size 1.14). Mean baseline competence score was 6.42±2.5 and mean post-intervention competence score was 9.02±0.78 (p&lt;0.001, effect size 1.03). Mean baseline performance score was 2.58±0.65 and mean post-intervention knowledge score was 3.29±0.5 (p&lt;0.001, effect size 1.64). Increases in knowledge, competence, and performance scores were observed both in oncologists and in geriatricians separately. Conclusions: This interprofessional curriculum on GA in oncology was feasible and acceptable, and led to significant increases in knowledge, competence, and performance among participants. Project ECHO’s case-based learning model is adequate to provide interprofessional education, which is crucial in multidisciplinary areas such as geriatric oncology.

Developing behavioral intervention to support molecular testing of patients with biliary tract cancer.

TPS1641 Background: Biliary tract cancer (BTC) represents 7% of gastrointestinal malignancies in the United States, with an incidence of 0.5 to 2.0 cases per 100,000 individuals. Standard care involves systemic chemotherapy, predominantly gemcitabine and cisplatin. Recent advancements in immunotherapy, as evidenced by the TOPAZ-1 trial and KN966, support the use of durvalumab, and pembrolizumab as treatment options. Genetic tumor testing identifies up to 40% of BTC patients with targetable mutations, leading to recent FDA approvals for FGFR2 inhibitors - pemigatinib, infigratinib, futibatinib, and IDH1 inhibitor ivosidenib. The emerging data on inhibitors targeting the BRAF mutation, together with HER2 amplification, underscore the importance of understanding the tumor's molecular profile. Navigating this evolving treatment landscape emphasizes an unmet need for patients to comprehend the pivotal significance of tumor molecular profiling in formulating effective and personalized treatment plans. Identifying knowledge gaps among BTC patients concerning tumor genetic testing and precision medicine, along with strategies to address these gaps, holds promise for improving the management and the outcome of patients with BTC. Methods: This is a behavioral intervention study where participants will undergo two in-person survey interviews before and after an educational intervention. The initial survey aims to establish baseline knowledge about the BTC diagnosis and treatment and ascertain preferences for various educational interventions. Patients’ knowledge gap will be determined by comparing their responses to the initial survey and medical history documented by their treating physicians. They will then be provided with a 10-minute educational video. Participants will have the flexibility to access the video multiple times. Within 6 weeks from enrollment, they will have a post-education survey to determine the effectiveness of the education intervention. Following completion of baseline surveys, collaboration with key stakeholders including medical oncology and community perspectives will be initiated to identify knowledge gaps and inform the design of an educational intervention. The study enrollment will be targeted at BTC patients receiving systemic therapy at Georgetown University Hospital, Fox Chase Cancer Center, and Hackensack Meridian Health. Ten participants are enrolled and have completed the first survey and intervention. This study is currently enrolling participants: GUIRB: STUDY00007119.

How do young identify plants? Using the drawing method to explore early ethnobotanical knowledge in Madagascar

Abstract In small‐scale societies, people learn to identify plant species during childhood. Plant recognition is an important baseline knowledge, immediately useful to avoid intoxication risk due to wrong identification. Plant recognition is the basis of other ethnobotanical knowledge essential for safeguarding biocultural diversity. However, despite many studies on folk classification, we still have a narrow understanding of the criteria locally used for species identification; the gap being even larger regarding children's plant identification criteria. Here, we study the criteria used by Betsileo children and adolescents to identify wild edible plant (WEP) species using a child‐adapted method including drawings and follow‐up interviews. We worked with 80 teenagers (from 12 to 17 years old; 51 girls, and 29 boys). Our results suggest that teenagers use a large spectrum of visual criteria to identify plants and that these criteria match with botanical and ecological knowledge documented in the literature and herbarium vouchers. We found that 35% of the identification criteria used were non‐morphological (e.g. phenology, biotic interactions), suggesting deep ecological knowledge. On average, teenagers use more than nine distinct criteria per plant, which allows them to identify most plant species with a very high level of precision. The precision level of plant representation increases with age for boys, but remains constant for girls, suggesting different dynamics in plant identification knowledge acquisition. We also found that boys and girls use different identification criteria: girls focus on morphological criteria while boys also incorporate ecological criteria, such as landscape features and biotic interactions, in their spectrum of identification keys. Our results highlight the complexity of teenagers' plant knowledge and the importance of the ecological context and gender in plant identification's knowledge acquisition. This knowledge acquired very early in childhood, constitutes the foundation of future interactions with nature and should be at the heart of environmental humanities studies and knowledge co‐production projects to tackle socio‐ecological concerns. Hence, we urge further research to explore innovative methods that complement traditional ethnoecological tools and capture complex sensory aspects of folk children's taxonomy to better understand human‐plant interactions and knowledge. Read the free Plain Language Summary for this article on the Journal blog.

Are we just talking in circles? Impact of psychoeducation on disease knowledge and relapse in severe alcohol use disorder.

Psychoeducation constitutes a routine therapeutic practice in most treatment settings for severe alcohol use disorder (sAUD). This technique is considered an efficient way to help patients to learn more about their disease and achieve therapeutic objectives. However, this approach capitalizes on three untested assumptions: namely, that (1) patients with sAUD possess insufficient knowledge about sAUD at treatment entry; (2) patients with sAUD have the cognitive resources to learn new information and benefit from psychoeducation; and (3) psychoeducation positively impacts clinical outcomes. We tested these assumptions in two experimental studies. In the first experiment in 66 recently detoxified patients with sAUD and 102 matched healthy controls, we measured baseline knowledge on sAUD through self-reported questionnaires, determined whether an up-to-date psychoeducation program can improve this knowledge, explored the role of cognitive abilities in such learning, and established the impact of psychoeducation on relapse rates. In a second experiment in 23 patients and 17 healthy controls, we examined whether the increased knowledge following psychoeducation is alcohol specific, and whether the motivation to change influences the relation between psychoeducation and clinical outcomes. At treatment entry, patients with sAUD presented with more sAUD-related knowledge than healthy controls, and were able to increase this knowledge following psychoeducation, independently of their cognitive status. However, psychoeducation did not impact either the motivation to change or relapse rates. Psychoeducation can increase patients' knowledge about sAUD, but it does not increase the likelihood of abstinence or controlled low consumption after discharge. Thus, clinicians should question whether psychoeducation should occupy a central position in the therapeutic programs and reconsider what can be expected from psychoeducation in terms of achieving therapeutic objectives.

Process evaluation of implementation of the early stages of a whole systems approach to obesity in a small Island.

The small Atlantic island of St Helena is a United Kingdom Overseas Territory (UKOT) with a high prevalence of childhood obesity (over a quarter of 4-5 and 10-11 year olds) and, anecdotally, adulthood obesity and its associated health detriments. St Helena have taken a whole systems approach to obesity (WSAO) to address the issue. A WSAO recognises the factors that impact obesity as a complex system and requires a 'health in all policies' approach. UK academic and public health technical support was provided to the local St Helena delivery team. This process evaluation sought to explore the early stages of the WSAO implementation and implications for the transferability of the approach to other small island developing states and UKOT. Data was collected via eight semi-structured interviews, paper based and online surveys, and document analysis. Thematic analysis was used to analyse the data. The analysis identified three factors which aided the first phase of WSAO implementation: (1) senior leaders support for the approach; (2) the academic support provided to establish and develop the approach; and (3) effective adaptation of UK Government resources to suit the local context. Key challenges of early implementation included: maintaining and broadening stakeholder engagement; limited local workforce capacity and baseline knowledge related to obesity and systems thinking; and limited capacity for support from the UK-based academic team due to contract terms and COVID-19 restrictions. Early stages of implementation of a WSAO in a UKOT can be successful when using UK's resources as a guide and adapting them to a small island context. All participants recommended other small islands adopt this approach. Continued senior support, dedicated leadership, and comprehensive community engagement is needed to progress implementation and provide the foundation for long-term impact. Small island developing states considering adopting a WSAO should consider political will, senior level buy-in and support, funding, and local workforce knowledge and capacity to enable the best chances of successful and sustainable implementation.

Addressing Culturally Based Hidden Bias and RacisM (A-CHARM) Using Simulation Experiences, Nik's Story: A Quasi-Experimental Study.

Racism and hidden bias experienced by underrepresented nursing students contribute to a loss of confidence and anxiety. The A-CHARM nursing project developed virtual simulation experiences for nursing students to practice how to address racism. 'Nik's Story' virtual simulation was created as part of the A-CHARM project. The purpose of this study was to examine the effectiveness of an education intervention, that included Nik's story, on cultural humility and cultural diversity awareness. This quasi-experimental study included a convenience sample of final year nursing students. After informed consent, participants completed a pre-intervention questionnaire that included the Cultural Humility Scale "context for difference in perspective" subscale, and the Cultural Diversity Awareness questionnaire to assess baseline knowledge. Students participated in an education intervention that included a lecture, Nik's story virtual simulation experience, a debrief and then completed a post-education/simulation questionnaire that included usability/learner engagement questions and the Cultural Humility Scale "context for difference in perspective" subscale, and the Cultural Diversity Awareness questionnaire. Forty-seven students consented and completed the pre/post intervention questionnaire. Participants rated the effectiveness, engagement and usability of the simulation experience highly. There was a significant positive change in cultural humility "context for difference in perspective" subscale (pre-scores = 6.9, SD = 3.3; post-scores = 31.0, SD = 3.8, p < 0.001), and cultural diversity awareness (pre-scores = 95.4, SD = 8.9; post-scores = 103.4, SD = 9.8, p < 0.001). This intervention was effective in improving cultural humility and cultural diversity awareness in nursing students. Simulation experiences regarding racism in the clinical setting provide a strategy for students to learn how to professionally navigate unwanted experiences.

Individual empowerment and community norm effects of engaging young husbands in reproductive health in rural India: findings from a pilot study.

Despite decades of a call to action to engage men in reproductive health, men are often left out of programs and interventions. In India, where half of pregnancies are reported as unintended, patriarchal gender norms and still dominant patterns of arranged marriages make engaging men in family planning and strengthening couples communication critical in increasing reproductive autonomy and helping young couples meet their reproductive goals. This study explores the feasibility and acceptability from the men's perspective of the pilot of a gender transformative intervention for newly married couples in India. A pilot study was conducted of TARANG, a 4-month intervention for newly married women, with light touch engagement of husbands (4 sessions). A total of 41 husbands participated in the pilot, and we collected baseline knowledge and endline feasibility and acceptability data from them, along with in depth qualitative interviews with 13 men. The study was conducted in June-January, 2023. Men had low levels of knowledge about biology, family planning, with the majority of men reporting that no one had provided them information about these topics. Most men wanted to delay the first birth by at least 2 years, yet less than a quarter had discussed childbearing plans with their partner or engaged in family planning methods. While all men reported high acceptability (satisfaction and usefulness), feasibility (participation) was low, with only 43% attending 2 or more sessions. Main barriers to participation included commitments due to work and migration. Men reported that the intervention led to improvements in their relationships with their wives, gave them a sense of empowerment, and led them to become resources for other men in their community. Men in these rural communities are not receiving the information that they need to meet their reproductive goals, however, they greatly desire this information and ways to improve relationships with their new wives. Such an intervention appears to have the potential to help change norms and spread information in the community and provide men with positive, life affirming feelings. Providing information through technology could address barriers to in-person engagement. clinicaltrials.gov (NCT06320964), 03/13/24.

Soil mycobiomes in native European aspen forests and hybrid aspen plantations have a similar fungal richness but different compositions, mainly driven by edaphic and floristic factors.

The cultivation of short-rotation tree species on non-forest land is increasing due to the growing demand for woody biomass for the future bioeconomy and to mitigate climate change impacts. However, forest plantations are often seen as a trade-off between climate benefits and low biodiversity. The diversity and composition of soil fungal biota in plantations of hybrid aspen, one of the most planted tree species for short-rotation forestry in Northern Europe, are poorly studied. The goal of this study was to obtain baseline knowledge about the soil fungal biota and the edaphic, floristic and management factors that drive fungal richness and communities in 18-year-old hybrid aspen plantations on former agricultural soils and compare the fungal biota with those of European aspen stands on native forest land in a 130-year chronosequence. Sites were categorized as hybrid aspen (17-18-year-old plantations) and native aspen stands of three age classes (8-29, 30-55, and 65-131-year-old stands). High-throughput sequencing was applied to soil samples to investigate fungal diversity and assemblages. Native aspen forests showed a higher ectomycorrhizal (EcM) fungal OTU richness than plantations, regardless of forest age. Short-distance type EcM genera dominated in both plantations and forests. The richness of saprotrophic fungi was similar between native forest and plantation sites and was highest in the middle-aged class (30-55-year-old stands) in the native aspen stands. The fungal communities of native forests and plantations were significantly different. Community composition varied more, and the natural forest sites were more diverse than the relatively homogeneous plantations. Soil pH was the best explanatory variable to describe soil fungal communities in hybrid aspen stands. Soil fungal community composition did not show any clear patterns between the age classes of native aspen stands. We conclude that edaphic factors are more important in describing fungal communities in both native aspen forest sites and hybrid aspen plantation sites than forest thinning, age, or former land use for plantations. Although first-generation hybrid aspen plantations and native forests are similar in overall fungal diversity, their taxonomic and functional composition is strikingly different. Therefore, hybrid aspen plantations can be used to reduce felling pressure on native forests; however, our knowledge is still insufficient to conclude that plantations could replace native aspen forests from the soil biodiversity perspective.

Abstract PO1-10-07: A Video Intervention to Improve Patient Understanding of Tumor Genomic Testing in Patients with Metastatic Breast Cancer: Primary Results of a Prospective Intervention Trial

Abstract Background: Tumor genomic testing (TGT) has become standard-of-care for all patients with metastatic breast cancer (MBC). American Society of Clinical Oncology (ASCO) and American College of Medical Genetics (ACMG) guidelines for patient education prior to TGT are not widely followed. We have previously demonstrated disparities in general genomic knowledge across race and income. The purpose of this study was to develop a concise (3-4 minute) video for patient education prior to TGT and evaluate the video’s impact in a prospective interventional trial. We report the results of the primary endpoint of the MBC cohort (ClinicalTrials.gov NCT05215769). Methods: We previously published our internal quality improvement cycle involving provider surveys, patient focus groups, and adult learning theory-based content development for TGT educational videos. An animated video incorporating culturally diverse images available in English and Spanish was created to be applicable to any cancer type, with MBC-specific content included for patients with breast cancer. A total of 150 participants were enrolled at a single tertiary academic institution, of whom 53 were diagnosed with MBC. Participants completed validated survey instruments immediately prior to video viewing (T1), immediately post-viewing (T2) and 60-90 days later, after TGT results were documented (T3). Instruments included: 1) 10-question objective genomic knowledge/understanding (GKU); 2) 10-question video message-specific knowledge/recall (VMSK); 3) 11-question Trust in Physician/Provider (TIPP); 4) attitudes regarding TGT. The primary objective was to assess change in VMSK between T1 and T2 and a cohort of 50 participants provided 90% power to detect an effect size of 0.47 from pre- to post-video using two-sided Wilcoxon signed-rank test with alpha of 0.05. Associations of VMSK, GKU, and TIPP with categorical demographic variables were explored with Kruskal-Wallis test. Results: From April 2022 to May2023, a total of 150 participants were enrolled (MBC n=53, lung cancer n=38, metastatic cancer of any type n=59). The MBC cohort analysis is presented. The MBC cohort had a median age of 59; all were female; majority Caucasian (48/53, 91%); most were married/in domestic partnership (35/53, 66%). For the primary endpoint, there was a significant increase in video message-specific knowledge (Wilcoxon signed rank p&amp;lt; 0.0001) but there was no significant change in general genomic knowledge (p=0.89) or trust in provider (p=0.59). Improvement of video message-specific knowledge was consistent across demographic groups, including age, income, and education. Of the 10-questions in the VMSK survey, results for four questions significantly improved after viewing the video, including questions informing the likelihood of TGT impact on treatment decision, incidental germline findings, and cost of testing (Table 1). Baseline genomic knowledge was significantly associated with income (nominal p=0.028), with higher income associated with higher baseline knowledge. Conclusions: A concise, 3-4 minute, broadly applicable video incorporating culturally diverse images administered prior to TGT significantly improved video message-specific knowledge across all demographic groups. Ongoing work includes analysis of additional cohorts (lung, any type) and evaluation in community oncology setting with a goal to provide a paradigm to efficiently educate and empower patients while addressing ASCO/ACMG guidelines within the flow of clinical practice. Table 1. Response to video message-specific questions before versus after tumor genomic testing educational video intervention Citation Format: Daniel Stover, Deloris Veney, Lai Wei, Amanda Toland, Carolyn Presley, Tasleem Padamsee, Clara Lee, Heather Hampel, William Irvin, Jawad Francis, Michael Bishop, Shelly Hovick, Leigha Senter. A Video Intervention to Improve Patient Understanding of Tumor Genomic Testing in Patients with Metastatic Breast Cancer: Primary Results of a Prospective Intervention Trial [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-10-07.

Improvement of knowledge following diabetes self-management education with respect to socioeconomic status: A retrospective cohort study among type 2 diabetes in Eastern India.

We assessed the baseline knowledge and the improvement and retention of knowledge after attending diabetes self-management education (DSME) programs with respect to different socioeconomic status (SES). We also looked into the change in body mass index (BMI), blood pressure, and glycemic parameters after attending the DSME sessions. This was a retrospective, cohort study carried out via chart review based on data collected from manual or electronic medical records (EMR) and questionnaire responses of 160 adult patients with type 2 diabetes (T2D) who attended two DSME sessions with a gap of at least six months. Baseline knowledge on diabetes was uniform (P = 0.06), irrespective of differences in SES, and DSME sessions significantly improved the knowledge in all socioeconomic classes (P value < 0.05 in each SES group). However, SES did have a significant influence on the finally acquired knowledge of diabetes as was evident from the final score after attending two DSME sessions. A significant number of patients (48.1%) from our cohort either improved or retained their knowledge of diabetes over a mean follow-up of 15.5 months. The BMI of our cohort was significantly reduced from baseline to final follow-up (P = 0.016). DSME sessions were effective in improving knowledge and awareness among T2D patients, irrespective of socioeconomic classes in Eastern India. The acquired knowledge from DSME sessions was retained over a long time.

Assessing the gut microbiome and the influence of host genetics on a critically endangered primate, the northern muriqui (Brachyteles hypoxanthus)

AbstractThe Northern muriqui (Brachyteles hypoxanthus) is one of the world's most critically endangered primates, with only ~1000 mature individuals remaining in the wild. Habitat loss and hunting have led to its sharp decline, making conservation efforts crucial. Analyses of gut microbiomes in wild populations can provide valuable information on host health and vulnerability, and ultimately, contribute to baseline knowledge toward improving conservation programs and reintroduction efforts. In this study, we analyzed the microbiome (16S rRNA metabarcoding) of fecal samples belonging to 53 uniquely genotyped individuals from three social groups from the Caparaó National Park, aiming to provide the first assessment of the microbiome diversity and composition for this species. Our results showed the muriqui gut microbiome was predominantly composed of the phyla Bacteroidetes and Firmicutes, with the dominant classes represented by Bacteroidia and Clostridia. High similarity in bacterial diversity and composition was found for individuals from distinct groups, suggesting a negligible geographical effect at the fine spatial scale analyzed. No significant effect of host genotype heterozygosity levels on microbiota diversity was recovered, but a significant influence of genetic distance on microbiota community structure and composition was demonstrated. Our findings stress the importance of considering associations between host genetics and the microbiome and suggest that the analyzed populations host a similar microbiome composition. This detailed microbiome assessment can aid conservation actions, including future anthropogenic impact assessments and animal reintroductions.

Assessment of Second Victim Trauma Resources for Obstetrics and Gynecology Residents [ID 2683424

INTRODUCTION: Second victim trauma (SVT) encompasses psychological, cognitive, or physical symptoms experienced by health care providers after adverse events. Obstetrics and gynecology trainees may be more vulnerable to SVT given their exposure to adverse events and lack of experience. Our objective was to assess the background knowledge of SVT among obstetrics and gynecology residency program directors (PDs) and the curricula and resources available to support obstetrics and gynecology trainees. METHODS: An 18-question survey was developed and disseminated to all 295 obstetrics and gynecology PDs. The survey assessed baseline knowledge of SVT, psychological resources available, knowledge regarding the SVT validated screening tool, and personal experiences. Descriptive and statistical analysis was performed using STATA, Version 12. RESULTS: A total of 99 PDs completed the survey (34% response rate). 92% of PDs had heard of SVT, and 82% felt they could identify its signs/symptoms. 41% of programs had SVT in the curricula. 28% of programs exist in hospitals with an SVT program, and 60% have trained clinician peer supports. Program directors who have an SVT curriculum were twice as likely to be familiar with validated survey tools for SVT (P=.004), and 2.7 times more likely to identify warning signs that a resident may need additional support (P&lt;.001). 86% of PDs would like additional education on SVT. CONCLUSION: The majority of obstetrics and gynecology residency PDs are aware of SVT and have an idea of how to identify this in their residents. The rates of embedded resources vary across the country. Additional education and curriculum development focused on SVT may benefit obstetrics and gynecology PDs and trainees.

Patient Understanding of Carrier Screening With an Educational Video Intervention [ID 2683583

INTRODUCTION: Carrier screening allows patients to understand their risk of passing on a recessive genetic disease. Clinical visits have limited time to explain concepts behind carrier screening and access to genetic counseling may not be available. We sought to understand patient's baseline knowledge of carrier screening and whether an educational video intervention can improve understanding of this test. METHODS: This was a pilot randomized controlled trial administered between July 1, 2023 and July 31, 2023, where participants were recruited at their first obstetrics visit. They were randomized in 1:1 ratio to watch a short video on carrier screening versus routine care. A 10-question true/false questionnaire on basic concepts of carrier screening was administered to all participants. Demographic data including race, age, ethnicity, gravity, and parity were collected. Two-tailed t-test and Fisher's exact test were used for continuous and categorical variables, respectively. RESULTS: In total, 40 participants were recruited and 20 were randomized to view an educational video. The cohort identified as 60% Black or African American; average age, 30.2; and 32.5% completed a graduate degree. There were no significant demographic differences between the groups. The average knowledge score in the video and nonvideo groups was similar (61% versus 63%; P=.69). However, most participants felt that an educational video was helpful (84.6%). CONCLUSION: This pilot study did not find a significance in knowledge score after the video intervention. Our results highlight the need for additional patient resources and face-to-face interventions to improve patient education on carrier screening.

Nurses’ Knowledge on the Prevention of Ventilator-Associated Pneumonia (VAP) among Critically Ill Patients

Background: Ventilator-associated pneumonia (VAP) is a significant concern in healthcare settings, particularly among critically ill patients who require mechanical ventilation. Nurses play a vital role in preventing VAP through their knowledge and implementation of evidence-based practices. However, there exists a notable gap in the research regarding nurses’ knowledge of preventing VAP to improve patient outcomes and reduce healthcare costs.Purpose: This study aimed to assess nurses’ knowledge of preventing VAP among critically ill patients using the ventilator bundle checklist.Methods: This study used a one-group pretest-posttest design to test the change in the nurses’ knowledge scores on VAP working in two government hospitals in Buraidah, Al Qassim Region, Saudi Arabia. The study covered 250 purposively and conveniently sampled nurses from intensive care units. Data collection was performed in three phases: pre-test, VAP educational program, and post-test. Data were collected using self-administered questionnaires on nurses’ socio-demographics, a 20-item self-made survey about the knowledge of VAP and its prevention and the adapted ventilator bundle checklist. The collected data were entered, prepared, and analyzed using SPSS version 25.0. Relevant ethical issues were strictly considered.Results: The results showed that during the pre-test, correct responses were accounted for but showed low scores in the following areas: general knowledge of VAP (27.6%), factors associated with VAP (36%), international guidelines for prevention (20.8%), and nurses’ roles in prevention (16.4%). However, in the post-test, there was a remarkable increase in the knowledge scores in the same categories (95.2%) on general knowledge, on factors associated with VAP (74.8%), on international guidelines (73.6%) and on nurses’ roles in prevention (61.6%). The program significantly improved overall VAP knowledge and knowledge in specific areas like general VAP, associated factors, international guidelines, and nurses’ roles in prevention (p&lt;0.000).Conclusion: A pre-test revealed low baseline knowledge across all four areas assessed: general VAP knowledge, factors associated with VAP, international VAP prevention guidelines, and nurses’ roles in VAP prevention. However, post-test scores markedly increased in all areas, indicating the educational program’s effectiveness. Hence, the findings suggest that educational intervention focused on VAP screening and bundle protocols could be beneficial to address the gap in knowledge on VAP.

Curriculum content for Environmental Sustainability in Dentistry

Objectives(i) To identify suitable strategies and opportunities to embed Environmental Sustainability (ES) within an existing Oral Health Professional (OHP) curriculum through a series of focus groups with students and academic staff and (ii) To create high-level evidence-based and subject-specific ES content through an approach grounded in evidence and collaboration with key stakeholders in OHP education. MethodsFocus groups were used to explore academic staff and student views on appropriate teaching and assessment methods for ES. Content statements were developed from an extensive literature search, mapped to curriculum subjects, and validated through consultation with students, discipline-experts and education-experts. ResultsFive themes were identified from the focus groups: ES transcends all disciplines of dentistry and oral healthcare; baseline knowledge transmission with relevant practical application; viewing and modifying existing teaching and assessment events through a different lens; normalising the topic of ES to support attitude and behaviour change and safeguarding against misinformation and disinformation. Forty-four content statements were developed and mapped to nineteen curriculum subjects. ConclusionsThis study identifies for the first time a comprehensive strategy for the inclusion and delivery of ES (method and content) in the curriculum. A novel method to define and map curriculum content has been explored and validated using a range of complementary methodologies. A comprehensive and robust list of evidence-based and subject-specific educational content statements have been defined in the field of Environmental Sustainability in dentistry and oral healthcare. Clinical SignificanceOral healthcare has a significant environmental impact, the key to all mitigation strategies is educating the profession at all levels.

ELAKT: Enhancing Locality for Attentive Knowledge Tracing

Knowledge tracing models based on deep learning can achieve impressive predictive performance by leveraging attention mechanisms. However, there still exist two challenges in attentive knowledge tracing (AKT): First, the mechanism of classical models of AKT demonstrates relatively low attention when processing exercise sequences with shifting knowledge concepts (KC), making it difficult to capture the comprehensive state of knowledge across sequences. Second, classical models do not consider stochastic behaviors, which negatively affects models of AKT in terms of capturing anomalous knowledge states. This article proposes a model of AKT, called Enhancing Locality for Attentive Knowledge Tracing (ELAKT), that is a variant of the deep KT model. The proposed model leverages the encoder module of the transformer to aggregate knowledge embedding generated by both exercises and responses over all timesteps. In addition, it uses causal convolutions to aggregate and smooth the states of local knowledge. The ELAKT model uses the states of comprehensive KCs to introduce a prediction correction module to forecast the future responses of students to deal with noise caused by stochastic behaviors. The results of experiments demonstrated that the ELAKT model consistently outperforms state-of-the-art baseline KT models.

Integrating learning factors and Bayesian network for interpretable knowledge tracing

Knowledge tracing aims to model learners’ knowledge mastery based on their historical interaction records and predict their future performance. Due to its great potential in enabling personalized learning in intelligent tutoring systems, it has received extensive attention. However, most deep learning-based knowledge tracing methods have significant predictive performance. It is difficult to extract meaningful interpretations from the thousands of parameters in neural networks. The interpretability of knowledge tracing refers to the ability of learners to easily understand the predicted results.To address this problem, based on learning factors that influence the learner’s exercise performance, this paper proposes a novel knowledge tracing model which is named Integrating Learning factors and Bayesian network for interpretable Knowledge Tracing (LBKT). Firstly, meaningful learning factors, including knowledge mastery, learning ability, and exercise difficulty, are calculated from learners’ historical interaction records using deep learning and statistical methods. Then, Bayesian network is constructed to capture the causal relation between the three learning factors and exercise response. Finally, the Bayesian network is generated through structure and parameter learning to obtain interpretable prediction of future exercise performance. The proposed model named LBKT is evaluated on three public real-world educational datasets. The experiment results demonstrate that our approach achieves better predictive performance compared to baseline knowledge tracing methods, while also exhibiting significant superiority in model interpretability.

Managing the Lactating Patient Receiving Anesthesia: An Innovative Educational Initiative.

Background: Breastfeeding has numerous health benefits for patients and their infants. There are inconsistencies in how anesthesia providers care for lactating patients undergoing anesthesia. Providers may be cautious and have patients "pump and dump" instead of following current evidence-based recommendations. Video-based education provides a novel reference for health care providers in their fast-paced work environments. This project evaluated the effectiveness of an online video module and resources accessed at the bedside for anesthesia providers caring for lactating patients. Materials and Methods: A preintervention survey was sent to anesthesia providers at a large academic institution to assess baseline knowledge of current recommendations for caring for lactating patients having anesthesia. A quick response code-linked video module and references were created and disseminated to all anesthesia providers. A postsurvey was sent to assess knowledge and satisfaction with the educational approach. Postsurvey data were compared with presurvey data. Results: All who watched the educational video found the education helpful to care for lactating patients undergoing surgery. In the posteducation group, 93% of providers selected the correct recommendation to continue breastfeeding or pumping after general anesthesia or sedation once the patient is awake and alert, compared with 48% in the pre-education group. After education, 92% would recommend preoperative feeding or pumping prior to transport to the operating room, compared with the 50% in the pre-education group. Conclusions: Video-based, just-in-time education is an effective way to deliver updated information to anesthesia providers. This format is conducive to just-in-time delivery, and there may be implications for other patient populations that present infrequently but require population-specific care.

Physical and occupational therapists' learning needs and preferences for education on functional electrical stimulation: A qualitative descriptive study.

Functional electrical stimulation (FES) is an evidence-based intervention that is rarely used by Canadian physical therapists (PTs) and occupational therapists (OTs). A common barrier to FES implementation is a lack of knowledge and training. FES learning resources that meet therapists' learning needs and preferences may address this barrier. To explore OTs' and PTs' perspectives on the utility of FES e-learning resources, including whether the resources met their learning needs and preferences. Through this qualitative descriptive study, feedback on FES e-learning resources was solicited from 5 PTs and 18 OTs who work clinically, but do not use FES. Participants reviewed ≥3 prerecorded lectures on FES topics and then completed a semi-structured interview. Participants were asked about the lectures' content, delivery, ease of use and comprehensibility, and were asked to suggest modifications to facilitate self-directed learning about FES. Interviews were analyzed using conventional content analysis. Three themes were identified. (1) Feedback on FES e-learning: the content and delivery of the prerecorded lectures facilitated participants' learning, although opportunities to improve content and delivery were identified. (2) Factors influencing FES learning needs and preferences: Participants identified internal (i.e., baseline knowledge, learning style) and external (i.e., learning with colleagues, practice setting) factors that affected learning. Themes 1 and 2 impacted (3) the effects of FES e-learning: Participants described the outcomes of their FES e-learning, including increases in FES knowledge, confidence, and use in clinical practice. Therapists' perceived the FES e-learning resources to be useful and to address their learning needs and preferences.