Clinical Mentors Research Articles

A qualitative enquiry of health care workers' narratives on knowledge and sources of information on principles of Respectful Maternity Care (RMC).

Research from sub-Saharan Africa indicate that many women experience varied forms of disrespectful maternity care, which amount to a violation of their rights and dignity. Notably, there is little research that sheds light on health care workers (HCWs) training and knowledge of principles of respectful maternity care (RMC). Formulating appropriate interventional strategies to promote the respectful provision of services for women during pregnancy, childbirth, and postpartum period requires an understanding of the current state of knowledge and sources of information on respectful maternity care among HCWs. This paper reports findings from a qualitative study that examined the knowledge and sources of information on the Respectful Maternity Care Charter among HCWs in rural Kisii and Kilifi counties in Kenya. Between January and March 2020, we conducted 24 in-depth interviews among HCWs in rural Kisii and Kilifi health facilities. Data were analyzed using a mixed deductive and inductive thematic analysis guided by Braun's [2006] six stages of analysis. We found that from the seven globally accepted principles of respectful maternity care, at least half of the HCWs were aware of patients right to consented care, confidentiality and privacy, and the right to non-discriminatory care based on specific attributes. Knowledge of the right to no physical and emotional abuse, abandonment of care, and detentions in the facilities was limited to a minority of health care workers but only after prompting. Sources of information on respectful maternity care were largely limited to continuous medical and professional training and clinical mentorship. The existing gap shows the need for training and mentorship of HCWs on the Respectful Maternity Care Charter as part of pre-service medical and nursing curricula and continuing clinical education to bridge this gap. At the policy level, strategies are necessary to support the integration of respectful maternity care into pre-service training curricula.

Factors influencing the clinical mentoring of nursing students at a hospital in the North West Province

IntroductionClinical mentoring is a strategy designed to improve the clinical competencies of nursing students after completion of their training. Effective clinical mentoring of nursing students during training leads to highly competent and skilled professional nurses which ultimately leads to quality nursing care of patients. However, clinical mentoring has been confronted with challenges globally which could have severe implications on the competency of nursing students as future professionals and consequently affects the nursing profession. PurposeThe purpose of the study was to explore and describe the factors influencing the clinical mentoring of nursing students at a hospital in the North West Province. MethodsThe research employed a qualitative, exploratory and descriptive research design. The population of the study were all professional nurses working at a hospital in the North West Province. A non-probability purposive sampling technique was used to select participants. Data were collected through individual semi-structured interviews. The research sample was determined by data saturation which was reached after interviewing fourteen participants. The researchers, supervisor and co-coder separately analysed data using Tesch's eight steps in the Coding Process. ResultsTwo main themes were extracted from the data: student and mentors related factors. Both themes emerged as the promoters and hindrances of clinical mentoring. ConclusionsGrounded in the findings of this research it can be concluded that there are factors promoting and hindering clinical mentoring of nursing students. However, the findings suggest that there is a need for in-service training for professional nurses on the concept clinical mentoring, as it is not clearly understood.

Medical dosimetry virtual clinical education: Mentors' perspectives.

The COVID-19 pandemic affected the United States in early 2020, and many universities began offering their curriculum remotely. The majority of medical dosimetry programs started to offer both didactic and clinical education in a virtual setting. With COVID-19 social distancing and patient protective measures, many clinical medical dosimetrists also began to work in a remote or hybrid setting. Medical dosimetry students interact and learn from their clinical mentors in this remote clinical environment. The purpose of this study was to investigate the perspective of medical dosimetry mentors concerning the effectiveness of virtual clinical education for medical dosimetry students as a result of COVID-19. The Medical Dosimetry Mentor Perspective on Virtual Clinical Education (MedDos_VCE) survey measured medical dosimetry mentors' perceptions of the students' virtual clinical experience during the COVID-19 pandemic. The subject of the study was medical dosimetry mentors who participated in a remote clinic due to the COVID-19 pandemic since March 2020. The MedDos_VCE questionnaire measured (1) the mentors' assessment of instructional quality in remote clinical education; (2) opportunities for and quality of interaction between students and medical dosimetry mentors; and (3) suggestions for success from medical dosimetry mentors for students and other mentors who are participating in virtual clinical education. The majority of the clinical mentors were satisfied with the quality of virtual clinical education and students' learning outcomes. They felt that students experienced a good mix of patients, problems, and clinical experience and engaged in the day-to-day activities of a medical dosimetrist. Challenges exist and mentors offered practical suggestions for success for students and mentors in the virtual clinical environment.

An innovative longitudinal nurse-midwife mentorship program in rural Malawi: The Global Action in Nursing (GAIN) project

The Global Action in Nursing (GAIN) project is a partnership between University of California, San Francisco, Partners In Health, and the Ministry of Health, Neno District, Malawi that aims to reduce maternal and neonatal morbidity and mortality by improving the quality of perinatal care rendered by nurse-midwives. In this report, we describe the design and implementation of a nursing training and mentorship program for frontline nurse-midwives in leadership, quality improvement, and midwifery skills, including the implementation of the World Health Organization Safe Childbirth Checklist and Respectful Maternity Care. Short course trainings were followed by one year of on-site clinical mentorship with the goal of improving systems factors (such as ensuring adequate availability of supplies) as well as reinforcing clinical skills.The program was implemented in Neno District, Malawi, a rural district in southwestern Malawi where approximately 5,000 births occur annually. The program is now in its fifth year of implementation and has become well-embedded in the district. Key lessons learned included stakeholder involvement; flexible and responsive program design; nurse-centered model for mentorship; and program transition to local leadership. Since nurses and midwives are the frontline providers of reproductive health care in Malawi, sustained investment in clinical and leadership training for nurse-midwives, accompanied by health systems strengthening, has the potential to improve quality deficits and therefore the health of mothers and babies in low-resource settings.

Transversal Competencies of a Clinical Mentor in Nursing Graduate Studies

Transversal Competencies of a Clinical Mentor in Nursing Graduate Studies

The effect of catchment based mentorship on quality of maternal and newborn care in primary health care facilities in Tigray Region, Northern Ethiopia: A controlled quasi-experimental study.

In Ethiopia, quality of maternal and newborn care is poor. This situation has persisted, despite the wide implementation of several capacity building-oriented interventions including clinical mentoring for skilled birth attendants that were anticipated to translate in to high-quality maternal and newborn care on each encounter. The effectiveness of mentoring programs is not yet well documented in the research literature. Therefore, we evaluated the effect of a catchment based clinical mentorship in improving the quality of maternal and newborn care in primary level facilities of Tigray, Northern Ethiopia. We conducted a controlled quasi-experimental pre-post study among 19 primary health care facilities, with 10 facilities assigned to the group where the catchment based clinical mentorship program was implemented (intervention group), and 9 facilities to the control group. We assigned the group based on administrative criteria, number of deliveries in each facility, accessibility, and ease of implementation of the intervention. A sample of 1320 women(662 at baseline; 658 at post intervention) and 233 skilled birth attendants(121 at baseline and 112 at end line) were included. We collected data from mothers, skilled birth attendants and facilities. The first round of data collection (baseline) took place two weeks prior the inauguration of the intervention, 05 October to 04 November 2019. The end line data collection occurred from 22 May to 03 July 2020. The primary Outcome was "receipt quality of maternal/newborn care". We analyzed the data using difference in differences (DiD) and logistic regression with Generalized Estimating Equation. The level of significance of predictors was declared at p-value less than 0.05in the multivariable analysis. We deployed a team of local clinical mentors working at primary hospitals to provide clinical mentorship, and direct feedback in routine and emergency obstetrical and newborn care to the mentees (all skilled birth attendants performing maternal and newborn health services) functioning in their catchment rural health centers for duration of six months. While visiting a facility, mentors remain at the facility each lasting at least five to seven days per month, over the course of intervention period. A significantly higher proportion of women at intervention facilities received quality of care services, compared with women at comparison facilities. (DiD = 18.4%, p<0.001). Moreover, following the implementation of the intervention we detected a difference in the occurrences of maternal complication outcome during delivery and immediately after birth. This was decreased by 4.5%, with significant differences between intervention and comparison sites (DiD = 4.5%, p = 0.013). We also found a favorable difference in occurrences of neonatal obstetric complications, with a decrease of 4.8% in the intervention site and almost no change in the comparison site (DiD = 4.8%, p = 0.002). Among the determinants of quality of care, we found that providers' job satisfaction (AoR = 2.95, 95%CI: 1.26 to 6.91), and making case presentation at regular basis(AoR = 1.89, 95%CI: 1.05 to 3.39) were significantly associated to improve the quality of care. However, delivery load(AoR = 0.95, 95%CI: 0.93 to 0.98) was negatively associated with quality of care. We conclude that the catchment based clinical mentorship intervention is effective to improve quality of care and reduce childbirth complications in northern Ethiopia. This finding further elaborated that incorporating maternal and newborn health catchment based clinical mentorship activities into the existing health system strengthening strategies can catalyze improvement processes to quality practice and health systems. This is seen as a necessary step to achieve the effective quality universal health care required to meet the health-related Sustainable Development Goals. Besides, more attention needs to be given to develop interventions and strategies that directly enhance providers' job satisfaction and reduce delivery work load.

Availability of comprehensive emergency obstetric and neonatal care in developing regions in Ethiopia: lessons learned from the USAID transform health activity

BackgroundIn collaboration with its partners, the Ethiopian government has been implementing standard Emergency Obstetric and Neonatal Care Services (CEmONC) since 2010. However, limited studies documented the lessons learned from such programs on the availability of CEmONC signal functions. This study investigated the availability of CEmONC signal functions and described lessons learned from Transform Health support in Developing Regional State in Ethiopia.MethodAt baseline, we conducted a cross-sectional study covering 15 public hospitals in four developing regions of Ethiopia (Somali, Afar, Beneshangul Gumz, and Gambella). Then, clinical mentorship was introduced in ten selected hospitals. This was followed by reviewing the clinical mentorship program report implemented in all regions. We used the tool adapted from an Averting Maternal Death and Disability tools to collect data through face-to-face interviews. We also reviewed maternal and neonatal records. We then descriptively analyzed the data and presented the findings using text, tables, and graphs.ResultAt baseline, six out of the 15 hospitals performed all the nine CEmONC signal functions, and one-third of the signal functions were performed in all hospitals. Cesarean Section service was available in eleven hospitals, while blood transfusion was available in ten hospitals. The least performed signal functions were blood transfusion, Cesarean Section, manual removal of placenta, removal of retained product of conceptus, and parenteral anticonvulsants. After implementing the clinical mentorship program, all CEmONC signal functions were available in all hospitals selected for the mentorship program except for Abala Hospital; the number of Cesarean Sections increased by 7.25% at the last quarter of 2021compared to the third quarter of 20,219; and the number of women referred for blood transfusions and further management of obstetric complications decreased by 96.67% at the last quarter of 2021 compared to the third quarter of 20,219. However, the number of women with post-cesarean Section surgical site infection, obstetric complications, facility maternal deaths, neonatal deaths, and stillbirths have not been changed.ConclusionThe availability of CEmONC signal functions in the supported hospitals did not change the occurrence of maternal death and stillbirth. This indicates the need for investigating underlying and proximal factors that contributed to maternal death and stillbirth in the Developing Regional State of Ethiopia. In addition, there is also the need to assess the quality of the CEmONC services in the supported hospitals, institutionalize reviews, surveillance, and response mechanism for maternal and perinatal or neonatal deaths and near misses.

Undergraduate nursing students' mentoring experiences in the clinical practicum: The United Arab Emirates (UAE) perspective.

This study explored undergraduate nursing students' mentoring experiences during their final clinical practicum as they prepared to enter the workforce. We used a qualitative case study design with data collected in two focus group discussions involving 19 students. Data were analysed using inductive thematic analysis. Students' descriptions of their mentoring experiences fell under three themes: 'great experience', 'being treated like part of the family', and 'gaining confidence and skills'. Students described their mentors as having critical roles in providing feedback and learning opportunities to interns. Students also reported that ungraded initial assessment, friendlier workplaces, and mentors with patience were required to strengthen their professional learning at the workplace. These results suggest that prompt and constructive feedback, warmer workplace environments, and passionate mentors' involvement may help enhance students' mentoring experiences during their clinical practicum. Management and academia should work jointly to develop mentorship programs to achieve better student outcomes. Doing this will lead to role clarity, higher levels of satisfaction, and increased productivity. Management needs to consider compensating mentors for their time in student learning and select experienced nurses willing to mentor others to promote enjoyable relationships and effective mentoring engagements. Management needs to find creative ways to build mentoring into appraisals, for at present, it is considered a voluntary activity for educating the next generation of nurses. Management should ensure adequate training and ongoing support for mentors and mentees in clinical mentoring.

Implementation of a Near-Peer Surgical Anatomy Teaching Program into the Surgery Clerkship

The objective of this study was to describe theimplementation of Clinical Anatomy Mentorship Program (CAMP), a novel near-peer surgical anatomy teaching program, into the KU School of Medicine (KUSOM) Surgery Clerkship curriculum. Prospective qualitative and quantitative study. Single institution, tertiary care hospital. All M3s at KUSOM on their surgery clerkship were eligible for inclusion for the learner cohort, n = 106. A group of M4s self-identified as CAMP mentors were eligible for inclusion for the teacher cohort, n = 40. M3s have statistically significant higher self-efficacy(p < 0.001)scores after participating in CAMP. Among open-ended comments written by M3s, significant themes highlighted that CAMP taught them a much-needed refresher on anatomy, gave them an introduction to surgical anatomy, and felt peer-to-peer teaching created a safe environment to ask questions. M4 mentors reported statistically significant (p < 0.001) increases in self-efficacy andconfidence in teaching skills after teaching CAMP sessions. Among open-ended comments written by M4 mentors, significant themes highlighted that CAMP helped them develop their teaching skills and confidence in the operating room. In line with current medical education practices, KUSOM has significantly decreased anatomy in the curriculum. We responded to this shift by implementing CAMP, designed to address specific medical student needs for a surgically oriented anatomy instruction. CAMP has been effective at addressing student concerns about anatomy knowledge gaps. CAMP has enhanced self-efficacy, anatomy knowledge, and operating room exposure in M3s, and self-efficacy, teaching skills, surgical anatomy knowledge, and surgical confidence in M4s.

NURSING STUDENTS’ PERCEPTION ON CLINICAL TEACHING AND LEARNING AT KENYA METHODIST UNIVERSITY, KENYA

Purpose: To explore RN-BSN students’ perception on clinical placements, mentorship and supervision in clinical teaching and learning.&#x0D; Methodology: The study adopted a descriptive cross-sectional survey design among RN-BSN students studying at Kenya Methodist University. The sample size was determined by Fisher et al., formula and the participants were selected through simple random sampling, those who met the eligibility criteria were included in the study. Data was collected through a self-administered questionnaire and data was analysed by use of SPSS version 26, where descriptive data was presented by the use of tables and figures.&#x0D; Findings: This study revealed that 61.7% of the students were satisfied with the clinical placements as it provided a positive learning environment, while 84% reported they had the opportunity to transfer theory into practice. In addition, 59.1% were satisfied with the hands-on experience they had in the clinical area however, 58.3% were dissatisfied with the use of Evidence-based practice and 54.8% were dissatisfied with the involvement of lecturers in clinical training.&#x0D; Unique Contribution to Theory, Practice and Policy: This study tested the Kolb Experiential model where for learning to take place the students need to go through concrete experience, reflective observation, abstract conceptualization and active experimentation. This study is in support of this model that for effective learning to take place the student has to undergo all the learning cycle. In policy, this study recommends the need to equip health facilities and employ more nurses in the hospitals who will also act as mentors to students and improve these facilities into teaching and referral centres. In practice, hospitals should identify clinical mentors who will oversee the implementation of Evidence-Based Practice and critical thinking into the nursing practice, while, institutions should employ more clinical instructors, and identify clinical mentors and preceptors in the clinical learning environments.

Use of Project ECHO in Response to COVID-19 in Countries Supported by US President's Emergency Plan for AIDS Relief.

The US Centers for Disease Control and Prevention, with funding from the US President's Plan for Emergency Relief, implements a virtual model for clinical mentorship, Project Extension for Community Healthcare Outcomes (ECHO), worldwide to connect multidisciplinary teams of healthcare workers (HCWs) with specialists to build capacity to respond to the HIV epidemic. The emergence of and quick evolution of the COVID-19 pandemic created the need and opportunity for the use of the Project ECHO model to help address the knowledge requirements of HCW responding to COVID-19 while maintaining HCW safety through social distancing. We describe the implementation experiences of Project ECHO in 5 Centers for Disease Control and Prevention programs as part of their COVID-19 response, in which existing platforms were used to rapidly disseminate relevant, up-to-date COVID-19-related clinical information to a large, multidisciplinary audience of stakeholders within their healthcare systems.

Mentoring future mentors in undergraduate medical education

BackgroundEfforts to support flagging mentoring programs facing shortages of experienced clinical mentors have had an unexpected and welcome effect. Supplementing traditional mentoring programs with peer-mentoring have not only addressed gaps in practice, structure, support and mentee oversight but have offered mentees charged with peer-mentoring duties the opportunity to take on mentoring roles under senior supervision. This study evaluates the experiences of peer-mentors within a local research mentoring program to better understand and advance this endeavor.MethodsSemi-structured interviews and post-interview surveys based on recent reviews on mentoring were employed. Adapting the Systematic Evidence Based Approach, data was analysed using thematic and content analysis. Results were combined using the Jigsaw Perspective to ensure that key elements of the different mentoring stages were identified.ResultsThe interviews and surveys revealed the following domains: Motivation, Initiation, Practicing, and Mentoring Environment.ConclusionThese findings provide novel insight into a structured framework that may help guide the experiences, training, assessment, and oversight of peer-mentors beyond the auspices of our local program. These general observations will equip host organizations with the direction they need to take in designing and executing peer-mentoring training and assessment programs of their own. Whilst the stages of peer-mentoring need further evaluation and an effective means of assessment and support pivotal, we believe our findings suggest that peer-mentoring may not only help to address the shortfall in mentors but is an invaluable learning experience that prepares and instils key values, beliefs and principles in young would-be mentors.

Chronic disease care integration into primary care services in sub-Saharan Africa: a ‘best fit’ framework synthesis and new conceptual model

ObjectiveTo examine the relevance of existing chronic care models to the integration of chronic disease care into primary care services in sub-Saharan Africa and determine whether additional context-specific model elements...

Institutionalising maternal and newborn quality-of-care standards in Bangladesh, Ghana and Tanzania: a quasi-experimental study

IntroductionFacility interventions to improve quality of care around childbirth are known but need to be packaged, tested and institutionalised within health systems to impact on maternal and newborn outcomes.MethodsWe conducted...

Competencies and needs of nurse educators and clinical mentors for teaching in the digital age – a multi-institutional, cross-sectional study

BackgroundThe impact of technology and digitalization on health care systems will transform the nursing profession worldwide. Nurses need digital competencies to integrate new technology in their professional activities. Nurse educators play a crucial role in promoting the acquisition of digital competences and therefore need to be digitally competent themselves. Research on digital competencies of nursing educators is scarce but suggests lack of digital knowledge and skills and support needs. Although digitalization is to be seen as a global process, regional contexts need to be taken into account, such as pre-existing competencies, local conditions, and individual needs. Thus, it remains unclear which competencies nurse educators possess and which support needs they have.Aim of this study was to assess nurse educators’ and clinical mentors’ digital competencies and explore their needs and requirements concerning the digital aspects of their pedagogy and teaching activities in Germany.MethodsA descriptive exploratory study with a cross-sectional design was conducted. Participants were identified using a convenience sampling approach. Data were collected during July and September 2020 using a standardized self-reported questionnaire that was developed specifically for this study. The questionnaire was provided in a paper and online format and participants could decide which format to use. It contained open- and closed-ended questions. Data were analyzed using descriptive and content analysis. Additionally, explorative subgroup analyses based on job designation, age, and gender were performed. Reporting of this study adhered to the STROBE checklist.ResultsA total of 169 educating nurses participated in the survey. The respondents considered themselves as digitally competent and showed a positive attitude towards the integration of digital technology in their teaching activities. Their perceived preparedness to integrate digital technology into teaching and training varied. Almost all respondents (98%) declared a need for further training and seemed motivated to participate in corresponding educational events. There were some indications for differences in competencies or needs between subgroups.ConclusionsEducating nurses appear to possess basic digital competencies but there is a need to support their professional development in terms of new technologies. Findings can be used as a basis for developing supportive interventions. Further qualitative investigations could inform the design and content of such interventions.

Catalyzing Quality Improvement in the HIV Control Programme of Rivers State: Evidence of the Impact of Clinical Mentorship Programme

Background: Rivers State had a huge burden of PLHIV, and the UNAIDS Spectrum 2019 model projected the total number of PLHIV in the State in 2020 to be 184,551. The semblance of HIV treatment care and support program, commencing after the diagnosis of the first reported case of HIV, dates as far back as 1989 when HIV was first diagnosed in the State. However, thirty years later, the treatment coverage had remained poor, despite the support of development partners. So, there was a strong need to strengthen the capacity of all critical actors in the program to achieve the objectives around the three-95s of the End AIDS Strategy, using strategic yet novel interventions such as the CMP. This research aims to determine how much of an effect a clinical mentorship program has had on enhancing Rivers State's HIV control efforts.&#x0D; Methodology: The clinical mentorship framework was implemented and amortized to strengthen all layers of ongoing interventions to catalyze better quality improvement. Clinical Mentors were recruited as indigenous medical experts knowledgeable in HIV service delivery and trained on quality improvement strategies and the use of virtual audiovisual systems, data management, team command system, and problem-solving models for the timeous impact of achieving key programme targets.&#x0D; Results: The Clinical Mentorship Programme (CMP) supported the achievement of a 690% &amp; 23% increase in TX_CURR &amp; PVLS, respectively, 27 months after its introduction. The TX_CURR improved by a factor of 7.9, and the PVLS increased by a factor of 1.23. The TX_CURR and PVLS achieved &gt;100% of the target. The CMP was a success in the Rivers State HIV Control Programme.&#x0D; Conclusion: Though other ongoing cross-cutting interventions may mask any reported advances in key performance indicators, the introduction of the CMP appears to have corresponded with and largely (but not entirely) stimulated the observed achievements and impact on the monitored key program metrics. It is recommended for similar contexts and public health programs in places with limited resources and significant unmet needs.

The Joy of Clinical Trials.

“But I only received the placebo,” commented a research participant sitting next to me during our trial update and appreciation event. During an evening when the positive results of the active intervention arms were being celebrated and research participants were ecstatically sharing their trial experiences, his disappointment caught me off guard, giving me pause. When it was my turn to take the stage and present the trial update to the group, I took a detour and first asked for a show of hands to demonstrate which arm they believed was most important in the study—the active intervention arm(s) or the placebo arm. The vast majority raised their hands for the active interventions. And that is when I shared the enlightenment inspired by our brief interaction—that those in the placebo arm represent, for patients around the world, the very best care that we have in the present, while those in the active intervention arm are testing our hopes and the unknown. It is only with both, equally, that we can map our collective path forward toward a better future. My introduction to clinical trials began with the most generous mentors, who openly shared their world and provided the freedom to explore with the hope of seeing a spark ignite. I found myself gravitating toward the collaborative spirit embraced in clinical trials. I did not realize that when patients accepted the invitation to become research participants, we would learn as much from them—their individual stories, past struggles, and future hopes—as from their data. It has been transforming to experience the dedication of our research participants, to realize that it is our mutual commitment to each other that enables us to learn the full truth of what we set out to answer. Once we, both investigators and participants, commit to the journey of a clinical trial, there is a certain element of being all in, of committing to learning the answers together, whatever they may be—whether we uncover exciting advances in therapy or come across an unanticipated safety issue that we need to investigate. While research participants represent future patients, as an investigator, I have come to appreciate that I too represent physicians who face the decisional dilemma studied in each trial. Ironically, while our research teams worked ardently to retain our participants, subtly, our participants have reciprocally retained our research teams on this broader journey in clinical research. Acting as an investigator on clinical trials also taught me that careers in clinical research are not a straight path. Each study lands us at a different vantage point from the one where we began, feeding our continual curiosity and learning. Each new therapy and trial has contributed one more piece to an ever-expanding puzzle. Each advance we have collectively been a part of brings greater hope that the best is still yet to come and is within the grasp of our lifetimes, moving us forward with a renewed sense of optimism and confidence. Having served as an investigator on over 100 trials now, I can say this: It changes you. It has changed who I am as a person and how I approach so many other people in my life, including patients, colleagues, trainees, and yes, even my own children. Whereas before I placed a greater emphasis on knowing and demonstrating knowledge of the “best” paths and the “right” answers, I find that now my approach in life is largely inspired by the shared investigator–participant journey, one recognizing the value of nonjudgmental equipoise and unconditional partnership imbued with passion and commitment. To the participant who caught me off guard that evening—thank you. This one, brief moment opened me up to the greatest sense of appreciation; regardless of the treatment arm, role, or results, it is the journey we embark on together, side by side with our participants, teams, and peers, that will contribute to our greater collective knowledge, advances in care, and a better future. And that, is pure joy. Acknowledgments: The author wishes to extend deep personal gratitude to her lifelong clinical research mentors, Robert R. Henry, MD, and Robert E. Ratner, MD; adviser, Jason G. Umans, MD, PhD; John B. Buse, MD, PhD, for encouragement in sharing this personal narrative; and to all the research participants who selflessly share of themselves to better our collective future.

Direct and Indirect Effects of a Project ECHO Longitudinal Clinical Tele-Mentoring Program on Viral Suppression for Persons With HIV: A Population-Based Analysis.

Project Extension for Community Health Outcomes (ECHO) aims to connect community providers to academic specialists, deliver longitudinal clinical mentorship and case consultations, plus encourage dissemination of knowledge and resources. The impact on outcomes for persons with HIV (PWH) is uncertain. PWH in Washington and Oregon outside of the Seattle and Portland metro areas, January 2011 to March 2018. Using viral load (VL) surveillance data, we assessed difference in the percentage of PWH who were virally suppressed among PWH whose providers participated versus did not participate in Project ECHO. Analyses included multiple mixed-effects regression models, adjusting for time and for patient, provider, and clinic characteristics. Based on 65,623 VL results, Project ECHO participation was associated with an increase in the percentage of patients with VL suppression (13.7 percentage points greater; P < 0.0001), although the effect varied by estimated provider PWH patient volume. The difference was 14.7 percentage points ( P < 0.0001) among patients of providers who order <20 VL's/quarter and 2.3 and -0.6 percentage points among patients of providers who order 20-40 or >40 VL's/quarter, respectively ( P > 0.5). The magnitude of difference in VL suppression was associated with the number of sessions attended. Among patients of lower-volume providers who did not participate, VL suppression was 6.2 percentage points higher if providers worked in a clinic where another provider did participate ( P < 0.0001). Project ECHO is associated with improvement in VL suppression for PWH whose providers participate or work in the same clinic system as a provider who participates, primarily because of benefits for patients of lower-volume providers.

Global child and family-centered care fellowship, education and mentorship for pediatric healthcare professionals: A literature review

Child- and family-centered care (FCC) is increasingly accepted and implemented to optimize the healthcare experience for patients, their families, and healthcare professionals. Standish Foundation for Children, a 501(c)(3) non-profit, has designed and piloted a fellowship to educate pediatric healthcare professionals in FCC & psychosocial care via an inquiry and mentorship model in Tbilisis, Georgia. This review aimed to evaluate and synthesize existing literature on psychosocial and FCC mentorship for pediatric healthcare professionals in four parts: ongoing need, effects on healthcare professionals, effects on children and their families and/or caregivers, and in cross-country healthcare settings. Reviewers searched open-source databases for articles in English published between 2010 and 2021. Opportunities for psychosocial and FCC skills development is both desired and needed by pediatric healthcare professionals, a viewpoint shared by families of pediatric patients. Existing mentorship models varied in design but overall improved provider confidence and ability to provide FCC in clinical settings. Some support for these interventions improving patient and family clinical outcomes is documented, although further research is necessary. In cross-country healthcare settings with varying resource levels, clinical mentorship in general can improve quality and delivery of care without requiring entirely new approaches. This review supports psychosocial mentorship models as an effective tool for child- and family-centered care delivery. Future research into long-term professional and patient outcomes, FCC impact on pediatric patients with non-traditional family units, and in cross-country settings is recommended to gain a more comprehensive understanding of how FCC can improve quality of healthcare.

“Feminism is Intersectional”: Interview with Evan Imber-Black, PhD on Feminism and Marriage and Family Therapy

ABSTRACT Evan Imber-Black, Ph.D. is a prominent figure and has made major contributions in the field of family therapy since the 1980s. Currently, she serves as a Professor and the Program Director of the MFT Program at Mercy College in Dobbs Ferry, New York. Dr. Imber-Black is internationally recognized for her scholarly commitment to systemic research and therapy. She served as editor-in-chief of Family Process and has authored many original papers and books that have influenced models of practice, including family rituals and family secrets. Dr. Imber-Black’s career demonstrates the power of leadership in family therapy, and that within this field one can succeed and impact families through all sectors of systemic therapy: clinical practice, research, teaching, and mentorship. This interview explored the history of a powerful woman who rose to the ranks of a boy’s club in the MFT field and discusses the gender and racial/ethnic disparities within the field today. She shared her perspective of intersectionality in contemporary feminist family therapy practice and education.