Care Curriculum Research Articles

PP186 Topic: AS16–Medical, Nursing and AHP Workforce & Education: Staff Education and Development/Equity, Diversity, Inclusion/Other: DEVELOPMENT OF OPEN ACCESS APRN PEDIATRIC CRITICAL CARE CURRICULUM AT BOSTON CHILDREN’S HOSPITAL

PP186 Topic: AS16–Medical, Nursing and AHP Workforce & Education: Staff Education and Development/Equity, Diversity, Inclusion/Other: DEVELOPMENT OF OPEN ACCESS APRN PEDIATRIC CRITICAL CARE CURRICULUM AT BOSTON CHILDREN’S HOSPITAL

Filling the void: Expanding the role of PAs in palliative care.

Palliative care, which focuses on symptom management, quality of life, and communication, is appropriate for patients at any age and any stage in the disease process. Because of increased patient demand, the United States faces a shortage of palliative care specialists. Expansion of palliative care curriculum in physician associate/assistant (PA) programs, on-the-job training, and improvement of regulatory practice guidelines can help PAs alleviate the shortage of palliative care professionals.

More Than Body Parts: A New Ethos of Anatomy Education

Abstract A new ethos of anatomy education goes beyond the learning of body parts in the traditional curriculum. In the traditional curriculum, the focus of only providing information on the structure of the human body left certain learning opportunities overlooked, marginalized, or dismissed as irrelevant; thus, opportunities to foster and shape professional attributes in health care learners were lost. Furthermore, changes in curricula structures and reductions in anatomy teaching hours have necessitated a transformation in how anatomy education is perceived and delivered. This article presents an examination of a contemporary ethos of anatomy education that draws together concepts from teaching theory, educational trends, and emerging research to maximize the anatomy learning experience with body donors. Social constructivism, the spiral curriculum, and the hidden curriculum can be leveraged to facilitate a unique educational experience. Furthermore, contemporary perspectives on the ethics and history of anatomy that support contextual learning indicate how these subjects are well suited to authenticate and consolidate learning, while supporting the relational and humanistic delivery of health care education. When anatomy education is conceptualized as a first clinical experience in a health care curriculum, it provides the opportunity to develop and enhance professional identity formation at a foundational stage. By embracing and incorporating a wider range of considerations into educational practice, a new ethos for anatomy education fosters history-informed professional identity formation that offers transformative learning opportunities for an ethical practice in the art of healing.

508 Implementation of a Palliative Care Curriculum for Emergency Medicine Residents

508 Implementation of a Palliative Care Curriculum for Emergency Medicine Residents

Developing an Interprofessional Palliative Care Curriculum to Train Future Health Professionals

Developing an Interprofessional Palliative Care Curriculum to Train Future Health Professionals

Implementation and Evaluation of a Pediatric Palliative Care Curriculum for Adult-Track HPM Fellows

IntroductionHospice and Palliative Medicine (HPM) fellowship training provides education on caring for patients from early childhood through adulthood. Yet, there are few guidelines about how to teach these key components, and more specifically the components of Pediatric Palliative Care (PPC), to fellows who have a variety of backgrounds prior to entering HPM fellowship. MethodsWe created a curriculum in PPC that could be used with adult-track HPM fellows. We developed an outline for material to cover during each of the three weeks of PPC clinical rotations. We also created a longitudinal lecture series encompassing several foundational topics and concepts in PPC. We conducted “Just-in-Time” evaluation of the clinical rotation curriculum utilizing a critical reflection model as well as focus groups with fellows and faculty members to further explore the knowledge, attitudes, and perceptions of the entire PPC curriculum. Transcripts were coded Nvivo and template analysis was used to understand code distribution between and within focus groups. ResultsEight overarching codes emerged from the focus groups: “Staffing Issues,” “Learning Structure,” “Useful Material,” “Topics Attending Contingent,” “Time Management,” “Teachable Moment,” “Not Useful Material,” and ”Adherence to Teaching Materials.” ConclusionThe study revealed some limitations in the current curriculum design, such as its lack of consistency. However, it also highlighted several strengths, including the importance of flexibility and personal responsibility for learning. The results provide valuable insights into the experiences among fellows and educators at a single institution with a PPC Curriculum for adult-track HPM fellows.

음악교육가들의 교육내용을 반영한 음악 교수내용지식에 따른 유아 음악교육 대학교재 분석: Orff, Dalcroze, Kodály를 중심으로

Objectives The purposes of this study were to analyze university textbooks in early childhood music education utilized within early childhood teacher training courses, according to the music pedagogical content knowledge that reflects the educational content of music educators. Methods For this study, seven early childhood music education university textbooks suitable for research were selected as the research subjects. Next, these textbooks were analyzed and categorized into music pedagogical content knowledge domains: subject content, teaching and learning methods, curriculum, and learner knowledge. The results were presented. Results First, the analysis of the subject content knowledge revealed that there is a noticeable deficiency in content related to traditional Korean music in the textbook. Second, the analysis of the teaching and learning method knowledge in the textbook showed that the included plans for early childhood music activities predominantly focus on music appreciation and activities following the principle of gradual deepening. Activities such as singing with inner hearing, harmony-linked activities, and singing by note or scale are less frequently presented. Third, upon analyzing the curriculum knowledge within the textbooks, the music education content linked to the Nuri curriculum is presented more frequently on average than the content linked to the standard child care curriculum. Fourth, as a result of analyzing the knowledge of leaners in the textbook, the target age for the included plans for early childhood music activities tended to center around young children or toddler-young children integration. Conclusions The significance of this study lies in its proposals for future enhancements and revisions of university textbooks for early childhood music education.

The Development of Elderly Care Curriculum for Undergraduate Students in Sichuan Province, China: Current Status, Challenges and Prospects

This article is a literature review on the development of elderly care courses for undergraduate students in Sichuan Province's music teacher profession. Through a review of relevant literature, the study finds that music education positively impacts the mental health and social participation of elderly individuals. However, there are shortcomings in curriculum design, personalized teaching, and interdisciplinary integration. This paper aims to explore how to effectively integrate music education with elderly care knowledge, optimize curriculum design, and establish scientific assessment mechanisms to enhance the practical effectiveness of the courses. This study provides theoretical support and practical guidance for developing elderly care courses for music teacher undergraduates in Sichuan Province. This paper draws its content from the doctoral thesis, "The Development of Subject Curriculum for Caring for the Elderly Among Music Teacher Profession Students at the Undergraduate Level in Sichuan Province, China."

A Palliative Care Curriculum May Promote Resident Self-Reflection and Address Moral Injury

IntroductionThere is a lack of formal palliative care education for surgical trainees, and the demanding nature of surgical training and exposure to challenging clinical scenarios can contribute to moral injury. We developed a palliative care curriculum to promote self-reflection, aiming to address moral injury in residents. MethodsFive 1-h palliative care sessions were delivered over the academic year to all post-graduate year (PGY) levels covering the following topics: personal awareness, delivering bad news, surgical palliation for cancer pathology, surgical palliation for noncancer pathology, and urgent palliative care. The curriculum focused on reflection and small group discussions. The Moral Injury Symptom Scale-Health Professional was administered to assess feelings of moral injury. Descriptive statistics, chi-squared analysis, and Mann–Whitney U-test were used to compare the demographics and survey responses. Results23 participants completed the preintervention survey, and 9 participants completed it postintervention. Over 50% of participants were PGY1 or PGY2 residents. Preintervention, 52% of participants reported feeling guilt over failing to save someone from being seriously injured or dying. 30% of participants reported that the feelings of guilt, shame, or distrust impaired their ability to function in relationships, at work, or other areas of life to at least a moderate degree. ConclusionsThe described palliative care curriculum accomplishes several goals as follows: it educates residents on palliative care topics, teaches communication tools, encourages self-reflection, and provides space for building peer relationships. The ease of implementation makes this curriculum applicable across various types of institutions, offering the potential to positively impact surgical training on a national scale.

Learning for children in an educational enrichment: a perspective derived from Taiwan's Early Childhood Education & Care Curriculum Framework

Anchored in the educational philosophy of “benevolence,” the Taiwan's Early Childhood Education & Care Curriculum Framework establishes nine learning goals and emphasizes the cultivation of six core competencies in young children. Recognizing that young children have potential for development, imagination, and creativity, the framework encourages young learners to engage with their surroundings, exhibit curiosity, and explore through play. The curriculum framework highlights the multifaceted roles of teachers, including their roles in shaping class culture and learning environments, partnering in the lives and learning journeys of children, guiding in their educational development, and collaborating with families. This curriculum framework emphasizes a child-centered approach to course development, integrating diverse activities that are reflective of and relevant to children's life experiences. It prioritizes maintaining the physical and mental health and safety of young children and introduces them to the meaning of life and the phenomenon of multiculturalism. The type of this study is a conceptual analysis, and it is a study from a reflective model on the implementation of the curriculum in Taiwan. Through this curriculum framework, children are encouraged to appreciate life's beauty and interact with others effectively and empathetically. Therefore, the curriculum framework emphasizes life education, multicultural education, aesthetic education, and moral education as essential components in the holistic development of young children. The curriculum framework is an educational enrichment for children's learning. This study explores the concept of early childhood learning as conceptualized by Taiwan's Early Childhood Education & Care Curriculum Framework. It is hoped that such an exploration can broaden young children's learning horizons, and enhance the quality of early childhood education.

Creating indoor learning areas to implement the Early Childhood Care and Education Curriculum

Background: A safe and inclusive indoor learning environment reflects different ways of knowing, actuality and thinking. In the Early Childhood Care and Education (ECCE) context, indoor learning areas influence the exploration of teaching and learning activities.Aim: This article explored rural ECCE teachers’ experiences of creating indoor learning areas as required by the National Curriculum Framework (NCF) for children from birth to 4 years.Setting: Six purposively selected teachers from the three rural ECCE centres in KwaZulu-Natal province that transitioned to using the NCF participated in the study.Methods: A qualitative case study located within the interpretive paradigm was employed. Data that were inductively analysed were collected through semi-structured interviews with two teachers in each of the three centres. Transformative learning theory underpinned the study.Results: The study found that six teachers who desired to learn from each other engaged in a collaborative learning venture within their centres and complied with the NCF to create indoor learning areas in the interest of young children.Conclusion: The study argues that teachers shifted their insights from the challenges to achieving the objectives of the NCF. Thus, it questioned the assumption that rural teachers lack the knowledge to design learning areas.Contribution: Rural ECCE teachers are committed to learning for the development of young children.

Developing a module on the care of LGBTQIA+ individuals for health professionals: Research protocol.

Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual (LGBTQIA+) people struggle to identify a healthcare service that understands their problems and needs. Additionally, healthcare professionals also find it difficult to care for LGBTQIA+ as very little is studied or heard about management. The article presents a protocol for a pilot study aimed at the development of an LGBTQIA+ care curriculum for health science professionals. The study includes Phase I: The development of a curriculum based on a literature review and focus group discussion among LGBTQIA+ individuals, and Phase II: Pilot testing of LGBTQIA+ care curriculum. The study outcome will reflect the improvement in the knowledge of healthcare professionals on LGBTQIA+ care.

Who needs a tourniquet? And who does not? Lessons learned from a review of tourniquet use in the Russo-Ukrainian war.

Extremity tourniquets have proven to be lifesaving in both civilian and military settings and should continue to be used by first responders for trauma patients with life-threatening extremity bleeding. This is especially true in combat scenarios in which both the casualty and the first responder may be confronted by the imminent threat of death from hostile fire as the extremity hemorrhage is being treated. Not every extremity wound, however, needs a tourniquet. One of the most important aspects of controlling life-threatening extremity bleeding with tourniquets is to recognize what magnitude of bleeding requires this intervention and what magnitude of bleeding does not. Multiple studies, both military and civilian, have shown that tourniquets are often applied when they are not medically indicated. Overuse of extremity tourniquets has not caused excess morbidity in either the recent conflicts in Iraq and Afghanistan or in the US urban civilian setting. In the presence of prolonged evacuation, however, applying a tourniquet when it is not medically indicated changes tourniquet application from being a lifesaving intervention to one that may cause an avoidable amputation and the development of an array of metabolic derangements and acute kidney injury collectively called prolonged tourniquet application syndrome. The recent literature was reviewed for papers that documented the complications of tourniquet use resulting from the prolonged casualty evacuation times being seen in the current Russo-Ukrainian war. The literature was also reviewed for the incidence of tourniquet application that was found to not be medically indicated, in both the US civilian setting and from Ukraine. Finally, an in-person meeting of the US/Ukraine Tourniquet Working Group was held in Warsaw, Poland, in December of 2023. Unnecessary loss of extremities and life-threatening episodes of prolonged tourniquet application syndrome are currently occurring in Ukrainian combat forces because of nonindicated tourniquet use combined with the prolonged evacuation time seen in the Russo-Ukrainian war. Specific numbers of the complications experienced as a result of tourniquet use by Ukrainian forces in the current conflict are treated as classified information and are not available, but multiple sources from the Ukrainian military medical personnel and from the US advisors providing medical assistance to Ukraine have all agreed that the problem is substantial. Unnecessary tourniquet morbidity might also occur in US forces in a variety of potential future combat scenarios in which evacuation to surgical care is delayed. Prehospital trauma training programs, including but not limited to tactical combat casualty care, place insufficient emphasis on the need to avoid leaving tourniquets in place when they are not medically indicated. This aspect of training should receive emphasis in future Tactical Combat Casualty Care (TCCC) and civilian first responder curriculum development. An interim ad hoc training solution on this topic is available at the websites noted in this articles. Additional training modalities may follow in the near future. Therapeutic/Care Management; Level V.

Online palliative care curriculum: contextual adaptation for Nigerian healthcare workers

ObjectivesThis study reports on a yearlong sequence of three periodic, virtual trainings in primary palliative care for healthcare professionals across Nigeria. Our overall objective was to determine the impact of...

Operationalizing a 3-year standalone, accelerated medical school curriculum to nurture physicians to become primary care and health system leaders

The United States faces a shortage of primary care physicians. To address this, there have been pioneering efforts to develop accelerated pathways with a primary care focused curriculum for undergraduate medical education. The New York University Grossman Long Island School of Medicine (NYU GLISOM) was conceptualized as the first standalone, accelerated, tuition-free program in the US in over 100 years, with mission-centered curriculum on primary care and health system leadership. The aim of this article is to map the process for the development of a three-year integrated curriculum, describe the pedagogical approach that guided the design of the longitudinal courses, share the student and faculty’s perspective about the curriculum, and describe the early outcomes of the first two graduate classes. A major key driver for curricular design is integrating longitudinal courses of Clinical Ambulatory Practice Experience (CAPE), Health Systems Science (HSS), and Learning Community - Social Sciences, Humanities, Ethics and Professionalism (LC-SHEP) over three years and active learning through Problem Based Learning (PBL). We have successfully operationalized an accelerated, standalone, integrated medical school curriculum mission-centered on primary care and health system leadership. Our outcomes reveal a higher percentage (76% N =45) of NYU GLISOM students entering primary care compared to national benchmarks. The integration of the longitudinal courses of HSS, LC-SHEP, and CAPE is a key pillar to reinforce the tenants of primary care and health system leadership. Focused interview of graduates from the pioneer cohort consistently stated that the longitudinal courses prepared them well for residency in primary care and as a health systems’ change agent. Despite the challenges of an accelerated program, NYU GLISOM successfully integrated the longitudinal courses with optimal performance and achievement of educational program objectives. Our experience can serve as a model for innovation and design of an accelerated three-year primary care curriculum.

“So we brought these players together”: a qualitative study of educators’ experiences to analyze the challenges of creating an e-learning program for neuropalliative care

BackgroundIn recent years, the subspecialty of neuropalliative care has emerged with the goal of improving the quality of life of patients suffering from neurological disease, though gaps remain in neuropalliative care education and training. E-learning has been described as a way to deliver interactive and facilitated lower-cost learning to address global gaps in medical care. We describe here the development of a novel, international, hybrid, and asynchronous curriculum with both self-paced modules and class-based lectures on neuropalliative care topics designed for the neurologist interested in palliative care, the palliative care physician interested in caring for neurological patients, and any other physician or advanced care providers interested in neuropalliative care.MethodsThe course consisted of 12 modules, one per every four weeks, beginning July 2022. Each module is based on a case and relevant topics. Course content was divided into three streams (Neurology Basics, Palliative Care Basics, and Neuropalliative Care Essentials) of which two were optional and one was mandatory, and consisted of classroom sessions, webinars, and an in-person skills session. Evaluation of learners consisted of multiple choice questions and written assignments for each module. Evaluation of the course was based on semi-structured qualitative interviews conducted with both educator and learner, the latter of which will be published separately. Audio files were transcribed and underwent thematic analysis. For the discussion of the results, Khan’s e-learning framework was used.ResultsTen of the 12 participating educators were interviewed. Of the educators, three identified as mid-career and seven as senior faculty, ranging from six to 33 years of experience. Nine of ten reported an academic affiliation and all reported association with a teaching hospital. Themes identified from the educators’ evaluations were: bridging the global gap, getting everybody on board, defining the educational scope, investing extensive hours of voluntary time and resources, benefiting within and beyond the curriculum, understanding the learner’s experience, creating a community of shared learning, adapting future teaching and learning strategies, and envisioning long term sustainability.ConclusionsThe first year of a novel, international, hybrid, and asynchronous neuropalliative care curriculum has been completed, and its educators have described both successes and avenues for improvement. Further research is planned to assess this curriculum from the learner perspective.

Feasibility of a Telemedicine-Based Principal Illness Navigation (PIN) Service for Complex Populations Following Hospital Discharge After Acute Stroke

Background Principal Illness Navigation (PIN) services may play an important role in helping patients through important transitions in care following acute hospitalization. We evaluated a novel PIN telemedicine approach to understand the feasibility of providing these services to diverse patient cohorts. Methods A single-arm, retrospective observational study of Kandu Health’s post-acute PIN service was conducted in patients experiencing ischemic or hemorrhagic stroke in California and New Jersey. The technology-enabled program offered remote healthcare support led by occupational therapists and licensed clinical social workers that was tailored to individual patient needs to facilitate transition to community settings post-discharge. Barriers to recovery were addressed through patient education, one-on-one guidance, and specialized referrals. Patient outcomes were assessed through in-app assessments and clinician-assessed modified Rankin Scores conducted via video consultation. Readmissions were monitored through both patient reporting and admission/discharge/transfer feeds from health information exchanges. Results A total of 111 patients were enrolled between June 22, 2022 and January 11, 2024. Patients were onboarded an average of 29 ± 40 days (median 18, IQR 8-32) after acute care hospital discharge and spent an average of 81 ± 21 days (median 90, IQR 75-90) in the program. During that time, the average enrollee spent 333 ± 156 minutes (median 350, IQR 205-435) of 1:1 time interacting with their dedicated navigator, and navigators spent an additional 113 ± 87 minutes (median 95, IQR 61-140) per patient on care coordination and curriculum curation. Patients with 5 or more social determinants of health (SDOH) needs required over 50% more navigator time than those without any SDOH needs. Within 6 weeks of hospital discharge, 8.5% experienced an inpatient hospital all-cause readmission that was not associated with race, ethnicity, or SDOH. Conclusions High rates of enrollment and extensive patient engagement in both navigator-facilitated and self-directed program elements can be achieved using the Kandu program. Our findings indicate that telemedicine facilitated, app-supported PIN is feasible to deliver following acute stroke discharge across diverse ages, races, ethnicities, functional status (mRS), and social needs.

Pediatricians' Perspectives on Introducing Transitional Care into Handover Between Pediatric Intensive Care Units and General Wards.

Despite the availability of a considerable number of studies on transitional care, few qualitative studies have synthesized physicians' perspectives on PICU-to-ward transition to develop a comprehensive transitional care curriculum. The aim of this study is to explore physicians' perceptions and management of the transition of critically ill children from the PICU to the general ward, with the aim of providing an evidence-based curriculum. A qualitative study was conducted between July and August 2022. The study involved semi-structured interviews with 11 participants, and data analysis was carried out using NVivo 12.0 software through thematic analysis method. Based on the data analysis, three main themes were identified: recognition of professional roles during transition, difficulties during implementation transitional care and suggestions for improving transitional care. The insights of doctors can be valuable in improving transitional care for critically ill children during PICU-to-Ward transition and in developing relevant curricula. It is essential to introduce standardized clinical pathways and strengthen curricula on critical elements, including communication and follow-up.

Beyond the Incision: A Palliative Care Curriculum for General Surgery Residents

Beyond the Incision: A Palliative Care Curriculum for General Surgery Residents

Closing the Gaps: Designing an Accessible Palliative Care Curriculum for Resident Physicians

Closing the Gaps: Designing an Accessible Palliative Care Curriculum for Resident Physicians