Collaborative Education Initiative Research Articles

Abstract 18751: Emerging Frontiers in Hypertension Management: Consensus on Novel Approaches for Optimal Control

Introduction: To establish a comprehensive consensus statement on hypertension management, incorporating contemporary evidence and drawing from the valuable real-world experiences of Indian physicians and cardiologists Methods: A virtual collaborative educational initiative was convened in May 2023, through a series of 8 nationwide virtual interactive meetings (n=87) at the forefront of hypertension care (3B Consensus Group). The cumulative clinical experience was approximately 2,500-man-years, who rated their level of agreement for 10 questions with each item on a 5-point Likert scale. This was preceded by a contemporary evidence-based discussion on the contemporary updates for hypertension. Weighted mean for the Likert scale was calculated and consensus was pre-defined as a score > 100. GraphPad 9.5.1 and ANOVA were used for statistical analysis. Results: The highest agreement score was for, hypertension is an important cardiovascular risk factor in CKD (127.1), bisoprolol with conventional treatment is efficacious for managing MI and cardiac insufficiency (126.8), because of considerable variability in BP response to different drugs, personalized treatment approaches are essential to optimize the effectiveness of BP reduction (118.3), research is warranted to explore the importance of salt awareness in patients with hypertension (117.4), beta blockers including bisoprolol in the treatment of MI complicated with cardiac insufficiency effectively reduce cardiotoxicity, enhance myocardial response (114.4), treatment guided by ABPM can enhance outcomes (102.7) (Figure). The highest mean response scores (±SD, 95% CI) for consensus were for strongly agree (52.6±28.6, 95% CI 32.1 to 73) followed by agree (50.8±13.4, 95% CI 41.2 to 60.4) Conclusions: The physicians and cardiologists establish hypertension management consensus, emphasizing cardiovascular risk, bisoprolol efficacy, personalized treatment, salt awareness, and ABPM

Abstract 18290: Enhancing Outcomes in Dyslipidemia Management: Contemporary Insights and Perspectives From the Indian Consensus

Introduction: To establish a comprehensive consensus statement on dyslipidemia management, incorporating contemporary evidence and drawing from the valuable real-world experiences of Indian physicians and cardiologists Methods: A virtual collaborative educational initiative was convened in May 2023, through a series of 13 nationwide virtual interactive meetings (n=238) at the forefront of dyslipidemia management (STRATIFY 2 Consensus Group). The cumulative clinical experience was approximately 6,000 man years, who rated their level of agreement for 10 questions with each item on a 5-point Likert scale. This was preceded by a contemporary evidence-based discussion on the updates for dyslipidemia including statins. Weighted mean for the Likert scale was calculated and consensus was pre-defined as a score > 100. GraphPad 9.5.1 and ANOVA were used for statistical analysis. Results: The highest agreement score was for, using LDL-C as a performance measure enhances cholesterol control in high-risk groups, leading to reduced cardiovascular disease morbidity and mortality (119), attainment of LDL-C goals in patients receiving high-intensity statin therapy needs improvement in real-world settings (116), combination of short-term DAPT and intensive rosuvastatin reduces the risk of recurrent stroke (113), validated risk calculators such as QRISK3 are valuable tools for guiding clinical decisions regarding the initiation of statin therapy (112), rosuvastatin 40 mg daily is more effective in reducing LDL-C levels as compared to atorvastatin 80 mg (110), Rosuvastatin is more effective than Atorvastatin in reducing LDL-C levels in diabetes mellitus (104) (Figure). The highest mean response scores (±SD, 95% CI) for consensus were for agree (61±25, 95% CI 44 to 80) followed by strongly agree (32±17, 95% CI 20 to 44) Conclusions: The consensus findings contribute to advancing dyslipidemia management and guiding evidence-based practices for improved patient outcomes.

Promoting integration of industry and vocational education: Exploring stakeholder intentions of hydrogen energy industry

The integration of industry and education plays a crucial role in facilitating the transfer of research outcomes from universities to industrial applications, promoting technology exchange and innovation, and fostering the development of skilled professionals in the hydrogen sector. However, the lack of motivation among hydrogen enterprises to engage in this integration process poses a pressing challenge. This paper presents a theoretical model based on a cost-benefit driving analysis framework, aiming to explore the relationship between resource income from universities, hydrogen enterprises' cost risks, policy subsidies, and their willingness to integrate. Through the use of questionnaire data collected from 184 hydrogen enterprises, this study examines the underlying mechanisms among these variables. The findings reveal that resource benefit (β = 0.632, p < 0.01) has a significantly positive correlation with the companies' willingness to participate in collaborative education. Higher levels of resource benefit are associated with greater willingness. Policy subsidies were found to moderate the relationship between resource benefits and integration willingness, as evidenced by the positive interaction effects of resource income and policy subsidies (β = 0.4, p < 0.01; β = 0.129, p < 0.01). This indicates that policy subsidies play a positive role in fostering collaboration between enterprises and educational institutions. On the other hand, cost risk (β = 0.575, p < 0.01) showed a significantly negative correlation with the enterprises' willingness to engage in collaborative education. Higher levels of cost risk hinder the company's willingness to participate. These findings highlight the importance of resource benefits and policy subsidies in promoting collaborative education initiatives for hydrogen enterprises. The findings contribute to the understanding of factors influencing enterprise engagement and have practical implications for fostering fruitful collaborations between educational institutions and hydrogen enterprises.

Institutional Innovation in University-based Experimental Spaces: the Case of Oulu Game Lab

Abstract This article explores preconditions and developmental dynamics of institutional innovation in higher education organizations as an outcome of a collaborative educational initiative – a university-based experimental space. Such collaborative learning configurations are often designed to stimulate local economic development after a downturn in regional industrial landscapes. The experimental space studied here had a twofold mission: providing re-skilling and re-education opportunities for unemployed ICT professionals and equipping them with business and employment bonds with regional game industry companies. To imbue a static outcome of institutional innovation with dynamic features, and to further develop the concept of Triple Helix spaces, we incorporated three sequential forms of institutional work in our analysis: boundary work, distancing work, and anchoring work.

CONSENSUS TOWARDS THE UTILISATION OF BISOPROLOL IN COMBINATION WITH TELMISARTAN IN INDIAN PATIENTS WITH HYPERTENSION

Objective: To formulate a consensus statement for the utilization of bisoprolol in combination with telmisartan based on the contemporary evidence and the real-world experiences of the Indian cardiologists Design and method: A virtual collaborative educational initiative was convened from November 2022, to December 2022, through a series of 8 nationwide virtual interactive meetings by leading cardiologists (n = 90) at the forefront of cardiovascular care (CERTAIN Study Group). The cumulative clinical experience was approximately 2,500-man-years, who rated their level of agreement for 14 questions with each item on a 5-point Likert scale. This was preceded by a contemporary evidence-based discussion on the contemporary updates for hypertension and for the combination of bisoprolol (beta blocker) and telmisartan (ARB). Weighted mean for the Likert scale was calculated and consensus was pre-defined as a score &gt; 100. GraphPad 9.4.0 and ANOVA were used for statistical analysis. Results: The highest agreement score was for the concurrence for the diabetes have consistently higher risks over the whole BP range (127), bisoprolol is a suitable choice for management of Left Ventricular Dysfunction post MI (124), bisoprolol has impactful clinical implications for modulation of resting heart rate in patients with CAD (123), telmisartan has a distinctive pharmacological properties that translate into a clinically relevant approach for management of hypertension (122), bisoprolol is beneficial in patients with hemodialysis (120), bisoprolol in combination with telmisartan is useful in patients with co-morbidities (115), bisoprolol has modulatory properties for the impact of remodelling in patients with heart failure (111), bisoprolol in combination with telmisartan is a useful tool to manage hypertension. (Figure). The highest mean response scores (±SD, 95% CI) for consensus were for agree (25±10, 95% CI 19 to 31) followed by strongly agree (14±11, 95% CI 7.6 to 20) Conclusions: We observed a high preference for the combination of bisoprolol with telmisartan for use in patients with hypertension with comorbidities. We attribute this to a high level of perceived effectiveness, based on the recent clinical trials.

Assessing the effectiveness of a collaborative educational initiative engaging different learners.

Journal of Dental EducationAccepted Articles ADVANCING THROUGH INNOVATION Assessing the effectiveness of a collaborative educational initiative engaging different learners Chih-Yun Tao DDSMS, Corresponding Author Chih-Yun Tao DDSMS [email protected] Assistant Clinical Professor of Periodontology, University of Missouri Kansas City, Kansas City, MO, USA Correspondence Dr. Chih-Yun Tao, Assistant Clinical Professor of Periodontology, University of Missouri Kansas City, Room 3113, 650 E 25th Street, Kansas City – MO, 64108, United States. Email: [email protected]Search for more papers by this authorKeerthana Satheesh DDSMSFACD, Keerthana Satheesh DDSMSFACD Associate Professor and Chair of Periodontology, University of Missouri Kansas City, Kansas City, MO, USASearch for more papers by this authorRobert A. Levine DDS, Robert A. Levine DDS Clinical Professor in Periodontology & Implantology, Kornberg School of Dentistry at Temple University, Philadelphia, PA, USASearch for more papers by this authorIrina F. Dragan DDSDMDMS, Irina F. Dragan DDSDMDMS orcid.org/0000-0002-4045-8564 Adjunct Associate Professor of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USASearch for more papers by this author Chih-Yun Tao DDSMS, Corresponding Author Chih-Yun Tao DDSMS [email protected] Assistant Clinical Professor of Periodontology, University of Missouri Kansas City, Kansas City, MO, USA Correspondence Dr. Chih-Yun Tao, Assistant Clinical Professor of Periodontology, University of Missouri Kansas City, Room 3113, 650 E 25th Street, Kansas City – MO, 64108, United States. Email: [email protected]Search for more papers by this authorKeerthana Satheesh DDSMSFACD, Keerthana Satheesh DDSMSFACD Associate Professor and Chair of Periodontology, University of Missouri Kansas City, Kansas City, MO, USASearch for more papers by this authorRobert A. Levine DDS, Robert A. Levine DDS Clinical Professor in Periodontology & Implantology, Kornberg School of Dentistry at Temple University, Philadelphia, PA, USASearch for more papers by this authorIrina F. Dragan DDSDMDMS, Irina F. Dragan DDSDMDMS orcid.org/0000-0002-4045-8564 Adjunct Associate Professor of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USASearch for more papers by this author First published: 02 April 2023 https://doi.org/10.1002/jdd.13213 This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as https://doi.org/10.1002/jdd.13213 AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Accepted ArticlesAccepted, unedited articles published online and citable. The final edited and typeset version of record will appear in the future. RelatedInformation

Bempedoic Acid for Management of Dyslipidemia from an Indian Perspective: An Expert Consensus Report

ObjectiveBempedoic acid has recently been made available for Indian patients. To formulate a consensus statement to utilize Bempedoic acid in the Indian context based on the contemporary evidence MethodsA virtual collaborative educational initiative was convened from May 17, 2022, to June 14, 2022, through a series of 6 nationwide virtual interactive meetings by leading cardiologists (n=99), who are at the forefront of dyslipidemia management. The cumulative clinical experience was approximately 3,000-man-years, who rated their level of agreement for 9 questions with each item on a 5-point Likert scale. This was preceded by a contemporary evidence-based discussion on the contemporary updates for Bempedoic acid. The focus of the discussion was Bempedoic acid and its pertinent evidence for scientific and therapeutic approaches. The consensus was pre-defined as > 75% of the panel agreeing/disagreeing on any item. There was one objective choice -best-suited response-based question. GraphPad 9.4.0 and ANOVA were used for statistical analysis. ResultsThere was unanimous agreement (100%) for the clinical distinctiveness of Bempedoic acid to cause fewer skeletal muscle side effects. The agreement score (%) in the Indian setting for the clinical relevancy were as follows: CLEAR Wisdom trial for patients on a maximally tolerated dose of statin (93.5%), CLEAR Harmony trial for high CV risk patients (92.8%), CLEAR Serenity trial in statin-intolerant patients (92.3%); evidence from landmark trials of Bempedoic acid can be replicated into patient benefits in the real-world setting (91.1%), minimal drug-drug interactions as an attractive scientific reason to choose Bempedoic acid (90.4%), CLEAR tranquillity for Bempedoic acid as add on to ezetimibe (89.6%), efficacy to lower the TGs (76.6%). (p<0.0001) (table, figure). 63.3 % opined that the efficacy to lower LDL-C was the most promising reason to choose Bempedoic acid. ConclusionsIn this pioneering attempt, our mapping exercise provides expert consensus-based statements to identify the unmet gaps in the management of dyslipidemia, and guide and align clinicians on the appropriate use of Bempedoic acid, including patients with diabetes, who have high cardiovascular risk. Our results shall lay the foundation for developing robust Indian guidelines for the use of Bempedoic acid in Indian settings.

Addressing gaps in care for patients with rare cancers and blood disorders: The impact of a collaborative digital education initiative.

e23005 Background: Clinicians are uniquely challenged to manage patients with rare cancers and blood disorders due to a lack of knowledge of diagnosis and management guidelines for these conditions. These conditions comprise a larger proportion of diagnosed cancers in minority populations, among whom a worse 5-year survival is realized in adults versus adolescents and children. Patients often experience delayed diagnoses, have limited treatment options, access to specialists, and limited clinical trials. Education surrounding rare cancers and blood disorders, diagnostic criteria, approved agents, and emerging novel agents is essential to improve treatment outcomes for patients with these rare malignancies. Methods: A 2-part CE and American Board of Internal Medicine (ABIM) Maintenance of Certification activity was launched live-online in October and November, 2020, and remains on-demand through November, 2021 at OMedLive.com, comprising 9 hours of virtual education. This first annual activity was launched in partnership with National Organization for Rare Disorders (NORD), and featured key opinion leaders with extensive expertise in rare cancers and blood disorders. Session components included case presentations, downloadable resources, live polling, and audience real-time Q&amp;A. Knowledge and competence questions were administered pre- and immediate post-activity. Patient and clinical practice impact questions were also asked at 2-month follow-up. Data from these questions were analyzed to determine engagement, remaining gaps, and the unique challenges of managing rare cancers and blood disorders. Results: 996 clinicians have participated in the activity to date. All 28 CE test questions reflected improvements in knowledge and competence regarding symptom recognition, diagnosis, clinical trial data, guidelines, treatment options, and adverse event management. At 2-mos. follow up, 71% reported improvements in clinical practice and 67% reported improvements in patient impact (n = 66). Almost half (48%) indicated diagnosis as their most significant challenge, with other noted barriers including: limited access to molecular testing (29%) and limited knowledge of tests to order (17%). The top 3 reported treatment challenges were: a lack of clinical evidence (24%), limited treatment options (22%), and high treatment cost (16%). Updated and expanded data will be shared. Conclusions: Following the targeted collaborative educational initiative, clinicians demonstrated clear knowledge and competency improvements in critical areas such as recognition, diagnosis, and management, and reported significant improvements in patient outcomes and clinical practice. The results of the two-month impact survey demonstrated a need for further tailored education on diagnostic testing and clinical evidence on treatment options for rare malignancies.

CURRENT PERSPECTIVES FROM THE 2020 VIRTUAL INTERNATIONAL HEART FAILURE SUMMIT FOR THERAPEUTIC HEART RATE REDUCTION WITH CARVEDILOL AND IVABRADINE IN THE FOREFRONT

Objective: Disseminate the contemporary global evidences and practices among experts for management of management of (reduced) HFrEF, (mid-range) HFmrEF/ (recovered) HFrecEF and the role of Carvedilol and Ivabradine in the forefront through live webinar Design and method: A virtual learning collaborative educational initiative was convened on September 27, 2020 by Prof Michael Bohm live from Germany with high expertise rank within 0.02% of 158,672 published authors worldwide on heart failure in last one decade, with 1853 continuous active participants at forefront of HF management across India. The first module focused on need to target Ejection Fraction (EF) as a measure for improvement in outcomes in HF and second for evidence for the novel combination approach to utilise beta blockers with Ivabradine to improvise the outcomes in HF Results: Analysis of ESC HF long term registry represents diverse phenotypes of demography, clinical presentation, aetiology with continuum in HFmrEF and HFrEF. Elevated HR in failing heart is a maladaptation which when lowered to 55 to 65 beats per minute (bpm), with beta blockers, helps improve myocardial oxygen demand and coronary perfusion time with independent effects on heart failure. Therapeutic heart rate reduction is strongly correlated with reduced mortality and HR reduction of 5 bpm using beta blockers provide 14% risk reduction in mortality. Ivabradine mechanistically enables unloading of heart by facilitating the acceptance of higher doses of carvedilol as the drop in HR in tolerated better by conserving energy during systolic phase and improves contractility during diastolic phase. Pharmacokinetic properties of extended release formulation through logical technological innovation enhances the release of Ivabradine which mitigates the levels to fall below the critical levels. Secondary analysis of large trials show that combination works efficiently, and this is substantiated by the 2016 ESC guidelines for acute and chronic HF, which suggests higher level of evidence for the rationale Conclusions: Ivabradine improves uptitration of beta blockers in HF. Distinctive pharmacological properties of Carvedilol for unloading the heart makes it an evidence-based choice for the combination with Ivabradine, which antagonises spontaneous depolarisation for effective therapeutic heart rate reduction for managing heart failure.

Design to improve patients' sleep experience in NHS hospital wards: involving students in solving 'real world' problems

This article presents a collaborative educational initiative designed to enhance the learning experience for undergraduate product design students and boost their employability through an introduction to ‘real-world’ design challenges in healthcare settings. The initiative centred upon enhancing the learning experience for a cohort of 38 product design undergraduate students across a 3-year programme through interdisciplinary research-informed teaching. We started with a student project in year one designed to help learners to understand the complexities and opportunities when designing for healthcare environment, as well as the importance of understanding stakeholders' needs (public involvement). This paper addresses the three steps taken to involve them in the project: (1) the research used to guide the selection of the problem; (2) the approaches we used to engage the students with an unfamiliar scenario, and(3) the involvement of students and stakeholders. The results of the student projects are discussed with some reflection on ways to improve teaching. In this way our ideas contribute to new and innovative approaches to learning and teaching in design through cross-disciplinary collaborations with healthcare researchers, academics, practitioners and patients. These approaches can help to overcome common challenges that might hinder design educators in proposing human-centred healthcare projects to students.

19 Collaborative Application of Guidelines Changes Imaging Utilization and Impacts Length of Stay in Acute Renal Colic

Applying guidelines to the management of acute renal colic in the emergency department (ED) provides an opportunity to improve resource utilization and clinical care for this patient population. We engaged in a collaborative effort across specialties within our academic institution to influence practice patterns in the ED through the formation of diagnostic and treatment algorithms that incorporated guidelines from multiple specialty societies and Choosing Wisely statements. We sought to investigate the changes in imaging utilization and ED length of stay (LOS) before and after the employment of these efforts. We conducted a before and after study following introduction of a renal colic order set and evaluation algorithm (Figure 1). A retrospective chart review was completed of patients diagnosed with nephrolithiasis in the ED at a single academic institution. Two reviewers were utilized to identify renal colic patients by searching final ED diagnosis. Individual patient encounters were subsequently analyzed for rates of imaging utilization and ED LOS. The pre-intervention and post-intervention cohorts included 456 and 174 patients respectively. The utilization of imaging and ED LOS are summarized in Table 1. There was a statistically significant decrease from 57% to 44% in CT utilization after the intervention. The average ED LOS for patients receiving bedside ultrasound was 199 minutes (95% CI 182 to 216 minutes), while average ED LOS for patients receiving CT imaging was 336 minutes (95% CI 316 to 356 minutes). Overall ED LOS for the pre-intervention cohort was 291 minutes (95% CI 277 to 305 minutes), while overall ED LOS for the post-intervention cohort was 269 minutes (95% CI 250 to 288 minutes). Our collaborative educational initiative and employment of evidence-based algorithms impacted imaging utilization in our ED patients with nephrolithiasis. The CT utilization rate was reduced in a statistically significant manner. Patients who had bedside US performed had a significantly decreased LOS, as compared with those receiving CT. The average overall ED LOS was lower in the post-protocol group, though this reduction did not reach statistical significance. Further study will involve the evaluation of impacts in clinical outcomes, as well as predictive factors for downstream urological intervention.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Blood transfusion knowledge of surgical residents: is an educational intervention effective?

Evidence-based transfusion education for surgical residents is crucial to improving practice. A pilot study was undertaken to assess the effectiveness of an education module for improving transfusion knowledge among surgical residents. Modules were developed and delivered by experts in surgery and transfusion medicine. They were delivered to residents in their first 2 years of training (Surgical Foundations), and to General Surgery residents across all years of training. Premodule and postmodule and retention knowledge assessments were used to assess efficacy. Median assessment scores for each group were compared using a two-sample Wilcoxon rank-sum analysis. Chi-square tests were used to compare each group's correct response rates for each question across the three tests. Median assessment scores of residents in the Surgical Foundations program improved from a mean of 60% premodule to 80% postmodule and remained at 80% in the retention assessment (p < 0.01). Improvements were seen in the areas of transfusion dose, preoperative blood management, management of reactions, and informed consent (p < 0.01). Assessment scores of General Surgery residents also improved from 59%, to 73%, and to 82%, with significant improvement (p < 0.01) between premodule and postmodule scores. Improvements in correct response rates were seen in the areas of management of anemia and permissive hypotension in trauma (p < 0.01). Transfusion knowledge of surgical residents was improved by a collaborative educational initiative. This could serve as a model for other training programs to improve resident knowledge of evidence-based transfusion practices. The efficacy of such interventions in changing practice remains untested.

Collaborative Educational Initiative: Developing and Implementing a Perioperative Nursing Course for Baccalaureate Nursing Students

Baccalaureate nursing curricula provide minimal exposure to the perioperative specialty area despite the fact that students are often very interested in this area of nursing. Usually the baccalaureate learning experience is that of a single passive observation rather than actively participating in care of perioperative patients. There are many reasons for this lack of exposure including the focus on preparation of nurse "generalists" for practice. This article will highlight the collaborative effort between nursing education and perioperative staff development to meet the essentials of baccalaureate education requirements as well as the challenges and positive outcomes of introducing this course.

Integrative Medicine in Residency Education: Developing Competency Through Online Curriculum Training

The Integrative Medicine in Residency (IMR) program, a 200-hour Internet-based, collaborative educational initiative was implemented in 8 family medicine residency programs and has shown a potential to serve as a national model for incorporating training in integrative/complementary/alternative medicine in graduate medical education. The curriculum content was designed based on a needs assessment and a set of competencies for graduate medical education developed following the Accreditation Council for Graduate Medical Education outcome project guidelines. The content was delivered through distributed online learning and included onsite activities. A modular format allowed for a flexible implementation in different residency settings. TO ASSESS THE FEASIBILITY OF IMPLEMENTING THE CURRICULUM, A MULTIMODAL EVALUATION WAS UTILIZED, INCLUDING: (1) residents' evaluation of the curriculum; (2) residents' competencies evaluation through medical knowledge testing, self-assessment, direct observations, and reflections; and (3) residents' wellness and well-being through behavioral assessments. The class of 2011 (n = 61) had a high rate of curriculum completion in the first and second year (98.7% and 84.2%) and course evaluations on meeting objectives, clinical utility, and functioning of the technology were highly rated. There was a statistically significant improvement in medical knowledge test scores for questions aligned with content for both the PGY-1 and PGY-2 courses. The IMR program is an advance in the national effort to make training in integrative medicine available to physicians on a broad scale and is a success in terms of online education. Evaluation suggests that this program is feasible for implementation and acceptable to residents despite the many pressures of residency.

Navigating the Waters of Interprofessional Collaborative Education

The increasing emphasis on interprofessional practice to improve the quality and safety of health care delivery led the nursing faculty of a small liberal arts university to explore a unique collaborative educational initiative with School of Business Administration faculty. As the School of Nursing was developing a master's of science in nursing administration option, the School of Business Administration was creating an undergraduate health care administration concentration. Both disciplines were examined for common competencies, courses that could be shared were identified, and the initiative was launched. The response from students has been overwhelmingly positive. The ability to examine health care issues from both business and clinical perspectives has enriched the learning environment and broadened the views of students in both majors. Challenges faced and lessons learned are discussed. Recommendations for evaluating and strengthening the partnership are identified. Advice and encouragement are offered to others considering similar nonclinical collaborative opportunities.

Abstract 91: Nurses Activate Inpatient Stroke Alerts Faster than Physicians and are Equally Competent at Identifying Stroke Patients versus Stroke Mimics

Introduction: In-hospital “stroke alerts” are typically activated when a patient’s neurological status acutely deteriorates. Acute inpatient strokes represent an excellent potential opportunity for definitive treatment, but over triaging causing false alarms was a challenge at our institution, especially in the cardiology/CT surgery units, where many stroke mimic patients were being seen. Our stroke nurse, stroke coordinator, and stroke team physicians designed and implemented a formal collaborative educational initiative to improve quality and timeliness of stroke pager calls. Hypothesis: Non- neurological nurses educated to recognize stroke signs and symptoms who activate the stroke team will identify at least as great a proportion of true stroke patients as physicians. Methods: We retrospectively analyzed prospectively collected inpatient stroke team calls on 93 inpatients over one year’s time. The person (physician versus nurse) calling the stroke alert was identified via shared electronic medical record review. We compared the proportion of patients (via chi-square analysis) who after formal chart review had a true diagnosis of stroke (versus mimic). Neurological floor and neuro-ICU patients were excluded. Results: Nurses initiated 59/93 stroke team calls (63%) during the study period. Overall, 59% (37/59) of nurse- activated calls were for patients whom ultimately were determined to have had a true stroke as compared to 63% of physician-activated calls (20/34); p=0.71; 60% of stroke alerts came from the cardiology/CT surgery nursing units, and the accuracy of nurses on these units was 67% as compared to 53% for other non- neurological nursing units. (p=.323). Nurses activated the stroke team faster (median 2 hours [25 th , 75 th %ile 0.5hr, 6 hrs]) than physicians (median 4.9hrs [25 th , 75 th %ile 1.3, 21.3 hrs]), p=.0096 {Wilcoxon Rank Sum}. Conclusions: Non- neurological nurses educated on stroke recognition and stroke team activation are as accurate at identifying inpatient acute stroke patients as physicians, and do so more than twice as fast on average as physicians. Intensive, focused, collaborative education of nursing staff in high-risk for inpatient stroke units, who typically more frequently assess patients than physicians, may via rapid and accurate identification improve inpatient stroke outcomes.

Preparing Clinical Nurse Leaders in a Regional Australian Teaching Hospital

The need to develop nurses as managers and leaders is crucial to the retention of registered nurses at a time of work force shortages and an increasingly aging work force in most Western industrialized countries. This article describes a creative and collaborative educational initiative developed at a large regional teaching hospital in New South Wales, Australia, designed to address this need. Based on a competency assessment process designed around face-to-face education, resource materials, and individualized mentoring from nurse unit managers, the aim of this multifaceted educational program is to develop effective team leaders in the clinical setting as well as a new generation of nursing leaders.

Industry and Academia Forge Strong Links to Train Veterinary Pathologists

With continuing robust financial support of the biopharmaceutical industry, the Coalition for Veterinary Pathology Fellows has now established 13 new training positions for veterinary pathologists. This unique partnership between the American College of Veterinary Pathologists (ACVP) and Society of Toxicologic Pathology (STP) was established to provide a unified mechanism to solicit and allocate funding to train additional veterinary pathologists to fill critical positions in academia, government, and the private sector. Over the past 2 years, 51 applications have been submitted to the Coalition by North American training institutions for 13 newly funded training positions. Applications were evaluated by the Coalition Board of Governors and competitively awarded as follows. Appointed to anatomic pathology residencies are Drs. Torrie Crabbs, David Gardiner, and Sandeep Akare, funded by GlaxoSmithKline at the University of California at Davis, Colorado State University, and University of Illinois at Urbana-Champaign, respectively; Drs. Lyn Wancket, Robert Johnson, and Melissa Sanchez, funded by Pfizer at The Ohio State University, Purdue University, and University of Pennsylvania, respectively; Dr. Danielle Lewis Brown, funded by Sanofi-Aventis at North Carolina State University; and Dr. Jana Ritter, funded by Eli Lilly at Michigan State University. Appointed to postpathology residency PhD graduate positions are Drs. Alicia Olivier and Aaron Sargeant, funded by Bristol-Myers Squibb and Schering-Plough at Iowa State University and The Ohio State University, respectively. In addition, residents are currently being recruited for three other positions; two anatomic pathology residencies, funded by Amgen and Genentech at Washington State University and University of Guelph, respectively, and a clinical pathology residency funded by Merck at the University of Guelph. The Coalition has also received generous unrestricted grants from Bristol-Myers Squibb, Allergan, Experimental Pathology Labs, Integrated Lab Systems, Wyeth, The Leyden Group, and Burroughs Wellcome Fund to support important allied activities. Taken together, industry has provided more than $3M to support Coalition efforts. Solicitation of funds for additional training positions is underway for 2007. “Industry’s continued strong financial support and the intense competition amongst training institutions’ for these prized fellowships clearly demonstrates the value of, and need for, this type of collaborative educational initiative,” said Dr. Gary Cockerell, Director of the Coalition. Further information can be found on the ACVP/STP Coalition web site at 〈www.vetpathcoalition.org〉.

Industry and Academia Forge Strong Links to Train Veterinary Pathologists

With continuing robust financial support of the biopharmaceutical industry, the Coalition for Veterinary Pathology Fellows has now established 13 new training positions for veterinary pathologists. This unique partnership between the American College of Veterinary Pathologists (ACVP) and Society of Toxicologic Pathology (STP) was established to provide a unified mechanism to solicit and allocate funding to train additional veterinary pathologists to fill critical positions in academia, government, and the private sector. Over the past 2 years, 51 applications have been submitted to the Coalition by North American training institutions for 13 newly funded training positions. Applications were evaluated by the Coalition Board of Governors and competitively awarded as follows. Appointed to anatomic pathology residencies are Drs. Torrie Crabbs, David Gardiner, and Sandeep Akare, funded by GlaxoSmithKline at the University of California at Davis, Colorado State University, and University of Illinois at Urbana-Champaign, respectively; Drs. Lyn Wancket, Robert Johnson, and Melissa Sanchez, funded by Pfizer at The Ohio State University, Purdue University, and University of Pennsylvania, respectively; Dr. Danielle Lewis Brown, funded by Sanofi-Aventis at North Carolina State University; and Dr. Jana Ritter, funded by Eli Lilly at Michigan State University. Appointed to postpathology residency PhD graduate positions are Drs. Alicia Olivier and Aaron Sargeant, funded by Bristol-Myers Squibb and Schering-Plough at Iowa State University and The Ohio State University, respectively. In addition, residents are currently being recruited for three other positions; two anatomic pathology residencies, funded by Amgen and Genentech at Washington State University and University of Guelph, respectively, and a clinical pathology residency funded by Merck at the University of Guelph. The Coalition has also received generous unrestricted grants from Bristol-Myers Squibb, Allergan, Experimental Pathology Labs, Integrated Lab Systems, Wyeth, The Leyden Group, and Burroughs Wellcome Fund to support important allied activities. Taken together, industry has provided more than $3M to support Coalition efforts. Solicitation of funds for additional training positions is underway for 2007. “Industry’s continued strong financial support and the intense competition amongst training institutions’ for these prized fellowships clearly demonstrates the value of, and need for, this type of collaborative educational initiative,” said Dr. Gary Cockerell, Director of the Coalition. Further information can be found on the ACVP/STP Coalition web site at 〈www.vetpathcoalition.org〉.

Transferring Management Knowledge from the West to the Balkans: Dilemmas, Diversity, and the Need for Congruence

The paper presents and discusses the insights resulting from an evaluative study of a collaborative educational initiative which was essentially set up to enable the process of transferring Western management knowledge into the region of Serbia and Montenegro. Drawing on insights from the literature associated with this kind of international ventures, and utilising a critical framework for a value-centred evaluation of complex social arrangements, we have identified a number of closely interrelated tensions within the collaborative project. These tensions and concerns reflect the issues of pedagogy and participation, the problem of disconnection from local practice; signs of ideological invasion and linguistic imperialism; and problematic nature of western management knowledge and its de-contextualisation in these specific circumstances. Analysis and discussion have resulted in some practical and constructive recommendations for changes in the current conduct and process of the initiative. The key argument is to refocus attention from a mechanistic input-output mode of knowledge transfer towards acknowledging diversity, power asymmetries and inherent complexity in this type of social interventions, and facilitating collaborative learning and open dialogue among the involved actors.