Participant Confidence Research Articles

South Asian Youth as Vaccine Agents of Change (SAY-VAC): evaluation of a public health programme to mobilise and empower South Asian youth to foster COVID-19 vaccine-related evidence-based dialogue in the Greater Toronto and Hamilton Area, Canada

ObjectivesThere have been substantial amounts of misinformation surrounding the importance, safety and effectiveness of the COVID-19 vaccine. The impacts of this misinformation may be augmented as they circulate among ethnic...

Gastroesophageal Balloon Tamponade Simulation Training with 3D Printed Model Improves Knowledge, Skill, and Confidence.

Gastroesophageal balloon tamponade (BT) tube placement is a life-saving procedure for refractory bleeding from gastroesophageal varices performed by gastroenterologists, intensivists, internists, and emergency medicine physicians. Despite a recognized need for procedural training, no standard curriculum or assessment tools exist. Given the infrequent performance of this procedure, the development of a representative and accessible simulation model would permit hands-on training to practice and maintain proficiency with BT tube placement. To assess BT tube placement performance before and after a novel simulation-based learning module in gastroenterology fellows and faculty. A 16-item knowledge questionnaire and 22-item procedural skill checklist utilizing a novel 3D printed esophagus model were developed to assess participant knowledge, procedural skills, and confidence prior to our simulation-based intervention and again 8-12weeks after. Performance metrics were compared pre- and post-intervention within groups and between participant groups. Fifteen gastroenterology fellows (of 15 eligible; 100%) and 14 gastroenterology faculty (of 29 eligible; 48%) completed training. Fellows demonstrated improvement in knowledge (55% to 79%, p < 0.001) and procedural skill (35% to 57%, p < 0.001) following training. Baseline faculty performance did not differ from fellows' performance and post-intervention showed similar improvement in knowledge (61% to 77%, p = 0.001) and procedural skill (40% to 49%, p = 0.147). Overall satisfaction with training was high in both groups post-intervention and faculty felt more confident teaching fellows. The presented learning module offers a unique, low stakes opportunity for learners to improve skills, gain knowledge, and build confidence in placing BT tubes using a realistic simulation model.

740 Improving the Management of Epistaxis in Clinical Practice

Abstract Aim Improving the standard of epistaxis management in Ayrshire &amp; Arran. Method A survey was distributed to doctors assessing their familiarity with epistaxis assessment and management. Working with the ENT department, a teaching programme was then developed aimed at improving skill in nasal packing, cautery and first aid, based on local guidelines. After the first session, all participants filled in a post-education questionnaire and results collated. Results The survey collected information throughout Ayrshire &amp; Arran, from 21 doctors across 10 different specialities, ranging from Foundation, Clinical Fellows, and Core Trainee's. Using a rating of one to five, least confident to most confident respectively. 95% of participants chose between one and three when asked about independently managing epistaxis, which significantly reduced to 0%. 52% of participants chose ‘least confident’ with familiarity of nasal packing and nasal cauterisation, reducing to 0%. In addition, 40% of doctors were unfamiliar with options for packing, which increased to 100%. Conclusions Epistaxis is one of the most common acute ENT presentations. 86% of cases will be initially managed by junior doctors using first aid management, packing, or cauterisation. This is not taught as standard in undergraduate or postgraduate education. Currently, there are no nationally accepted guidelines for its management, regardless of its high presentation, readmission, and mortality rate. There is an observable gap in epistaxis education, crucial when considering majority of its’ management will be handled by junior doctors. We have seen an increase in participants confidence and familiarity of the condition which merits running this teaching programme.

Optimizing pediatric asthma education using virtual platforms during the COVID-19 pandemic

BackgroundWe compared patient and caregiver knowledge and confidence for managing asthma, and participant experiences when comprehensive asthma education was delivered in person versus in the virtual setting.MethodsWe performed a multi-methods study using structured surveys and qualitative interviews to solicit feedback from patients and caregivers following participation in a comprehensive asthma education session between April 2018 and October 2021. We compared participant knowledge and confidence for managing asthma as well as user experience when the education was attended in-person or virtually. Quantitative responses were summarized descriptively, and qualitative feedback was analyzed for major themes.ResultsOf 100 caregivers/patients who completed post education satisfaction surveys and interviews, 52 attended in person and 48 virtually, with the mean age of patients being 6.7 years (range: 1.2–17.0). Participant reported gains in knowledge and confidence for asthma management were not different between groups and 65.2% preferred attending virtual asthma education. The majority of participants described virtual education as a safer modality that was more convenient and accessible.ConclusionsWe demonstrated the successful implementation of a novel, virtual asthma education program for patients and caregivers of children with asthma. Both virtual and in-person delivered asthma education were equally effective for improving perceived knowledge and confidence for asthma self-management and virtual education was considered safer, more convenient and accessible. Virtual asthma education offers an attractive and effective option for improving the reach of quality asthma education programs and may allow more children/patients to benefit.

Is Online Video-Based Education an Effective Method to Teach Basic Surgical Skills to Students and Surgical Trainees? A Systematic Review and Meta-analysis

BackgroundOnline education has been increasingly utilized over the past decades. The COVID-19 pandemic accelerated the transition of conventional face-to-face curricula to online platforms, with limited evidence for its teaching efficacy. This systematic review aims to assess the effectiveness of online video-based education compared with standard conventional education in teaching basic surgical skills to surgical trainees and students undergoing medical training.MethodsWe performed a literature search in Embase, Medline, Cochrane CENTRAL and Scopus from inception until February 2022. Studies included were randomised controlled trials (RCTs) and observational studies. We included randomised controlled trials only for meta-analysis. The primary outcome was surgical skill proficiency. The secondary outcomes were participant perception, confidence and satisfaction. Two authors independently assessed the search results for eligibility, extracted the data and assessed the risk of bias using the Cochrane Risk of Bias tool 2. Where appropriate, we performed random effects meta-analyses of the pooled study data to calculate a standardized mean difference.ResultsA total of 11 studies met the inclusion criteria totaling 715 participants; 603 were included in qualitative analysis and 380 in meta-analysis. All included studies were assessed as having a low risk of bias. The majority of studies found no significant difference between conventional and video-based education in teaching basic surgical skills, three studies found video-based education was superior and one study found conventional education was superior. There was no statistically significant difference in skill proficiency between the two groups (standardized mean difference of -0.02 (95% CI: -0.34, 0.30); p=0.90). Video-based education results in an equivalent improvement in confidence and satisfaction rates. Additional benefits of video-based education include convenience, accessibility and efficiency.ConclusionsBasic surgical skills can be taught as effectively through online video-based education as conventional teaching methods. Online education should be utilized as an adjunct to medical curricula beyond the COVID-19 era.

Bridging the divide on climate solutions: Development, implementation, and evaluation of an online workshop for climate volunteers

A critical component to addressing climate change is effective communication with the public and legislators about urgency for action. Health professionals have a vital role to play in climate advocacy. However, several key barriers to public advocacy have been identified, including limited communication skills to effectively advocate with others. We describe the development, implementation, and evaluation of a novel online workshop, whose goal is to teach volunteers to communicate more effectively on climate change with those holding differing views regarding potential solutions (e.g., role of government vs. private sector). The development phase included seeking input from multiple stakeholders about the workshop's focus and creating specific examples and prompts. The workshop was then pilot-tested, and refinements were made based on evaluations. Volunteers within a climate organization then took the workshop and evaluations were collected. Evaluations from 312 attendees were analyzed, including 14% in healthcare-related fields. On a 10-point scale (10 being highest), volunteers reporting a median score of 8 in their confidence level for setting a constructive tone in conversations with people holding differing views on climate solutions. Qualitative analysis of participants’ responses “Single most important learning?”, “What was most important to share?”, and “What would you like to see changed?” by two independent observers supported almost perfect agreement (kappa of 0.88) in themes that included Learning New Skills, Developing New Ways of Being, Format, and Additional Training/Suggested Enhancements. Our workshop increased participant confidence in having conversations on climate change solutions, an important part of climate advocacy.

Invertebrate research without ethical or regulatory oversight reduces public confidence and trust

Ethical and regulatory oversight of research animals is focused on vertebrates and rarely includes invertebrates. Our aim was to undertake the first study to describe differences in public confidence, trust, and expectations for the oversight of scientists using animals in research. Participants were presented with one of four treatments using a 2 by 2 design; terrestrial (T; mice and grasshoppers) vs. aquatic (A; zebrafish and sea stars) and vertebrates (V; mice and zebrafish) vs. invertebrates (I; grasshoppers and sea stars). A representative sample of census-matched Canadian participants (n = 959) stated their confidence in oversight, trust in scientists and expectation of oversight for invertebrates on a 7-point Likert scale. Participants’ open-ended text reasoning for confidence and expectations of oversight were subjected to thematic analysis. Participants believed invertebrates should receive some level of oversight but at two-thirds of that currently afforded to vertebrates. Four primary themes emerged to explain participant expectation: (1) value of life, (2) animal experience, (3) participant reflection, and (4) oversight system centered. Confidence in oversight was highest for TV (mean ± SE; 4.5 ± 0.08) and AV (4.4 ± 0.08), less for TI (3.8 ± 0.10), and least for AI (3.5 ± 0.08), indicating the absence of oversight decreased public confidence. Four themes emerged to explain participant confidence, centered on: (1) animals, (2) participant reflection, (3) oversight system, and (4) science. Trust in scientists was similar for TV (4.3 ± 0.07) and AV (4.2 ± 0.07), but higher for TV compared to TI (4.1 ± 0.07) and TV and AV compared to AI (4.0 ± 0.06); absence of oversight decreased public trust in scientists. These results, provide the first evidence that the public believe invertebrates should receive some level of oversight if used for scientific experiments. The gap that exists between current and public expectations for the oversight of invertebrates may threaten the social licence to conduct scientific research on these animals.

The School-Based Speech-Language Pathologist and Students With Concussion: An Examination of Evolving Knowledge and Confidence.

This study examines school-based speech-language pathologists' (SLPs') experience, knowledge, and confidence in supporting students as they return to the classroom following concussion, with a particular focus on knowledge of new management guidelines over the last decade. Participants were 74 school-based SLPs who completed an electronic survey about their knowledge and experiences serving students with concussion. We examined participants' accuracy and confidence across knowledge questions using Kruskal-Wallis tests. We also conducted linear regression to explore the relationships between training, work experiences, knowledge, and confidence. Nearly half of participants who are currently working with students with concussion reported having no clinical or training experiences related to concussion. Participants who had more concussion-related training or working experiences reported higher confidence. Participants were confident about general concussion knowledge but less confident about providing assessment and supporting students with concussion as they returned to school. Participants had the lowest confidence and accuracy for the most recent guidelines around rest and activity, as well as the differential impact of concussion on children as compared to adults. Many school-based SLPs have limited training around concussion management and are often not specifically consulted to work with students following concussion. Despite this, SLPs have good awareness of their knowledge about concussion, but show gaps in knowledge surrounding more recent evidence-based guidelines. Additional investigation is needed to determine better ways to move research into clinical practice and to increase the involvement of SLPs in school-based concussion teams. https://doi.org/10.23641/asha.20361969.

Compliance risks for crowdfunding. A neglected aspect of money laundering, terrorist financing and fraud

Purpose This study aims to highlight the risks and threats posed by crowdfunding. It also looks at the new European Union regulation on crowdfunding, which is intended to give participants confidence that there will be specific minimum regulatory standards to protect parties against mis-selling issues affecting some platforms. Design/methodology/approach This paper is based upon a thorough literature review. Findings Crowdfunding is an essential alternative for financing commercial and non-commercial projects. Although it is a fast-growing digital financial tool, it can also be considered extremely risky. It can be an ideal platform for money laundering and can facilitate the financing of terrorism and fraud. Originality/value Crowdfunding is still in its infancy, so the literature has not yet sufficiently addressed the compliance risks of crowdfunding. As a result, there is a significant research gap. Thus, this study aims to analyse and propose suggestions to mitigate the risks that all crowdfunding stakeholders may face when deciding to participate in a crowdfunding activity or when they want to set one up.

Preparing children's nurses for working with children and adolescents who self-harm: Evaluating the 'our care through our eyes' e-learning training package.

Rates of self-harm among children and adolescents have risen significantly over the past decade and clinical guidelines place children's nurses at the heart of their care. This article reports on the evaluation of 'Our Care Through Our Eyes', an online self-harm learning programme for children's nurses. A self-selected, convenience sample of registered children's nurses (n = 42) completed scales pre- and postlearning programme that captured their attitudes, beliefs, empathy, anxiety, and confidence. Mean change scores were assessed, and qualitative comments captured postintervention were thematically summarized. There were small improvements in participants' attitudes, empathy and confidence were reported. Anxiety scores increased in a small number of items. Qualitative comments confirmed the value of the online learning programme for improving children's nurses' knowledge and understanding of self-harm among CYP. Our findings demonstrate that children's nurses agree on the importance of mental health training in self harm, and this could be a catalyst for renewal of both pre- and postregistration education including support structures within the National Health Service. This study is the first to explore the feasibility of evaluating 'Our Care Through Our Eyes' delivered using e-leaning and could be used to inform further investigations.

Effectiveness of Using Augmented Reality for Training in the Medical Professions: Meta-analysis.

BackgroundAugmented reality (AR) is an interactive technology that uses persuasive digital data and real-world surroundings to expand the user's reality, wherein objects are produced by various computer applications. It constitutes a novel advancement in medical care, education, and training.ObjectiveThe aim of this work was to assess how effective AR is in training medical students when compared to other educational methods in terms of skills, knowledge, confidence, performance time, and satisfaction.MethodsWe performed a meta-analysis on the effectiveness of AR in medical training that was constructed by using the Cochrane methodology. A web-based literature search was performed by using the Cochrane Library, Web of Science, PubMed, and Embase databases to find studies that recorded the effect of AR in medical training up to April 2021. The quality of the selected studies was assessed by following the Cochrane criteria for risk of bias evaluations.ResultsIn total, 13 studies with a total of 654 participants were included in the meta-analysis. The findings showed that using AR in training can improve participants' performance time (I2=99.9%; P<.001), confidence (I2=97.7%; P=.02), and satisfaction (I2=99.8%; P=.006) more than what occurs under control conditions. Further, AR did not have any effect on the participants’ knowledge (I2=99.4%; P=.90) and skills (I2=97.5%; P=.10). The meta-regression plot shows that there has been an increase in the number of articles discussing AR over the years and that there is no publication bias in the studies used for the meta-analysis.ConclusionsThe findings of this work suggest that AR can effectively improve performance time, satisfaction, and confidence in medical training but is not very effective in areas such as knowledge and skill. Therefore, more AR technologies should be implemented in the field of medical training and education. However, to confirm these findings, more meticulous research with more participants is needed.

Shall AI moderators be made visible? Perception of accountability and trust in moderation systems on social media platforms

This study examines how visibility of a content moderator and ambiguity of moderated content influence perception of the moderation system in a social media environment. In the course of a two-day pre-registered experiment conducted in a realistic social media simulation, participants encountered moderated comments that were either unequivocally harsh or ambiguously worded, and the source of moderation was either unidentified, or attributed to other users or an automated system (AI). The results show that when comments were moderated by an AI versus other users, users perceived less accountability in the moderation system and had less trust in the moderation decision, especially for ambiguously worded harassments, as opposed to clear harassment cases. However, no differences emerged in the perceived moderation fairness, objectivity, and participants confidence in their understanding of the moderation process. Overall, our study demonstrates that users tend to question the moderation decision and system more when an AI moderator is visible, which highlights the complexity of effectively managing the visibility of automatic content moderation in the social media environment.

"Into the fire" approach to teaching endoscopic foreign body removal using a modular simulation curriculum.

As flexible endoscopy becomes an increasingly valuable minimally invasive approach to surgical challenges, an efficient and comprehensive training curriculum is needed to train surgeons in therapeutic endoscopy. We developed a modular curriculum utilizing a simulation-based, "into the fire" approach to endoscopic foreign body removal for practicing physicians with task performance pre- and post-testing. From 2020 to 2021, two sessions of our advanced flexible endoscopy course were taught by two expert surgical endoscopists using ex-vivo porcine models. The course focused on safe removal techniques for various foreign bodies as part of an overall endoscopy curriculum that uses hands-on simulation-based pre-testing, didactics, and mentored practice sessions, followed by post-course examination. Pre- and post-course assessments and surveys were used to evaluate knowledge, performance, and confidence of participants, and subsequently analyzed using the Wilcoxon-signed rank test. Of the 16 practicing physicians who participated in the course, 43.8% were certified in Fundamentals of Endoscopic Surgery, and 62.5% had completed > 200 prior upper endoscopies. Upon course completion, scoring on knowledge-based written examinations improved from 3.4 ± 1.9 to 5.8 ± 2.0 (p < 0.001). Technical facility of each participant demonstrated significant overall improvement with post-course score increased from 15.8 ± 2.5 to 23.6 ± 1.6 (p < 0.001), with skill refinement noted in technical subcategories of appropriate instrument use (p < 0.001), foreign body manipulation (p < 0.001), and successful foreign body removal (p < 0.001). Confidence surveys likewise demonstrated significant increase in confidence after completion of the curriculum 11.6 ± 3.4 to 23.0 ± 5.5 (p < 0.001). The "into the fire" approach to teaching endoscopic foreign body removal utilizing our simulation module provides an effective curriculum to improve knowledge, confidence, and overall technical performance. Our methodology utilizes hands-on, simulation-based pre-testing prior to instruction. This introduces clinical scenarios and technical challenges, while accounting for and tailoring to provider-specific variation in knowledge and experience, facilitating training efficiency.

Singapore Soundscape Site Selection Survey (S5): Identification of Characteristic Soundscapes of Singapore via Weighted k-Means Clustering

The ecological validity of soundscape studies usually rests on the choice of soundscapes that are representative of the perceptual space under investigation. For example, a soundscape pleasantness study might investigate locations with soundscapes ranging from “pleasant” to “annoying”. The choice of soundscapes is typically researcher led, but a participant-led process can reduce selection bias and improve result reliability. Hence, we propose a robust participant-led method to pinpoint characteristic soundscapes possessing arbitrary perceptual attributes. We validate our method by identifying Singaporean soundscapes spanning the perceptual quadrants generated from the “Pleasantness” and “Eventfulness” axes of the ISO 12913-2 circumplex model of soundscape perception, as perceived by local experts. From memory and experience, 67 participants first selected locations corresponding to each perceptual quadrant in each major planning region of Singapore. We then performed weighted k-means clustering on the selected locations, with weights for each location derived from previous frequencies and durations spent in each location by each participant. Weights hence acted as proxies for participant confidence. In total, 62 locations were thereby identified as suitable locations with characteristic soundscapes for further research utilizing the ISO 12913-2 perceptual quadrants. Audio–visual recordings and acoustic characterization of the soundscapes will be made in a future study.

A Statewide Collaboration to Deliver and Evaluate a Pediatric Critical Care Simulation Curriculum for Emergency Medical Services.

ObjectiveCare of the critically ill child is a rare but stressful event for emergency medical services (EMS) providers. Simulation training can improve resuscitation care and prehospital outcomes but limited access to experts, simulation equipment, and cost have limited adoption by EMS systems. Our objective was to form a statewide collaboration to develop, deliver, and evaluate a pediatric critical care simulation curriculum for EMS providers.MethodsWe describe a statewide collaboration between five academic centers to develop a simulation curriculum and deliver it to EMS providers. Cases were developed by the collaborating PEM faculty, reviewed by EMS regional directors, and based on previously published EMS curricula, a statewide needs assessment, and updated state EMS protocols. The simulation curriculum was comprised of 3 scenarios requiring recognition and acute management of critically ill infants and children. The curriculum was implemented through 5 separate education sessions, led by a faculty lead at each site, over a 6 month time period. We evaluated curriculum effectiveness with a prospective, interventional, single-arm educational study using pre-post assessment design to assess the impact on EMS provider knowledge and confidence. To assess the intervention effect on knowledge scores while accounting for nested data, we estimated a mixed effects generalized regression model with random effects for region and participant. We assessed for knowledge retention and self-reported practice change at 6 months post-curriculum. Qualitative analysis of participants' written responses immediately following the curriculum and at 6 month follow-up was performed using the framework method.ResultsOverall, 78 emergency medical technicians (EMTs) and 109 paramedics participated in the curriculum over five separate sessions. Most participants were male (69%) and paramedics (58%). One third had over 15 years of clinical experience. In the regression analysis, mean pediatric knowledge scores increased by 9.8% (95% CI: 7.2%, 12.4%). Most (93% [95% CI: 87.2%, 96.5%]) participants reported improved confidence caring for pediatric patients. Though follow-up responses were limited, participants who completed follow up surveys reported they had used skills acquired during the curriculum in clinical practice.ConclusionThrough statewide collaboration, we delivered a pediatric critical care simulation curriculum for EMS providers that impacted participant knowledge and confidence caring for pediatric patients. Follow-up data suggest that knowledge and skills obtained as part of the curriculum was translated into practice. This strategy could be used in future efforts to integrate simulation into EMS practice.

Financial Toxicity, Symptom Burden, Illness Perceptions, and Communication Confidence in Cancer Clinical Trial Participants.

Cancer clinical trial (CCT) participants are at risk for experiencing adverse associations from financial toxicity, but these remain understudied. From July 2015 to July 2017, we prospectively enrolled CCT participants referred for financial assistance and a group of patients matched by age, sex, cancer type, trial, and trial phase. We assessed financial burden of cancer care, cost concerns about CCTs, physical (Edmonton Symptom Assessment Scale [ESAS]) and psychologic (Patient Health Questionnaire-4 [PHQ-4]) symptoms, illness perceptions (Brief Illness Perception Questionnaire), and communication confidence (Perceived Efficacy in Patient-Physician Interactions). Adjusting for age, sex, race, performance status, marital status, income, insurance, and disease status, we examined associations of financial burden and cost concerns with patients' symptoms, illness perceptions, and communication confidence. Of 198 patients, 112 (56.6%) reported financial burden and 82 (41.4%) reported cost concerns. Higher ESAS-total (odds ratio [OR] = 1.03; 95% CI, 1.01 to 1.06; P = .001), PHQ-4 depression (OR = 1.58; 95% CI, 1.20 to 2.08; P < .001), PHQ-4 anxiety (OR = 1.26; 95% CI, 1.02 to 1.55; P = .025), and more negative illness perceptions (OR = 1.04; 95% CI, 1.00 to 1.07; P = .029) were associated with financial burden, but not communication confidence (OR = 0.98; 95% CI, 0.02 to 1.05; P = .587). Higher ESAS-total (OR = 1.03; 95% CI, 1.01 to 1.05; P = .004), PHQ-4 depression (OR = 1.36; 95% CI, 1.08 to 1.71; P = .03), PHQ-4 anxiety (OR = 1.26; 95% CI, 1.03 to 1.53; P = .018), more negative illness perceptions (OR = 1.06; 95% CI, 1.02 to 1.10; P = .001), and decreased communication confidence (OR = 0.93; 95% CI, 0.86 to 1.00; P = .029) were associated with cost concerns. In this study of CCT participants, greater symptom burden, more negative illness perceptions, and lower communication confidence were associated with financial toxicity, underscoring the importance of addressing these issues when seeking to alleviate adverse associations of financial toxicity.

“Transition to CAMHS SPR” – a Simulation Induction Course Provided for Newly Appointed Child and Adolescent Mental Health Service (CAMHS) Higher Trainees (HTs)

AimsThe transition between Core Psychiatry Training (CPT) and Psychiatry HTs is often anxiously anticipated by trainee psychiatrists, in view of the heightened responsibility and increased demand faced by trainees. The author wrote and delivered a one-day simulation induction course for newly appointed CAMHS HTs across London. The aim of this course was to improve participant's confidence, skills and knowledge in managing a range of conditions and challenging scenarios in children and young people (CYP) presenting to CAMHS. The course was also designed to improve HT's confidence in supporting junior colleagues and in managing conflict resolution. There was also an overarching aim of increasing human factor skills by focusing on these within the scenarios and debriefs.MethodsThe simulation training was delivered online and consisted of five scenarios commonly faced by CAMHS SPRs based in a variety of settings. Themes within the scenarios included eating disorders and deliberate self-harm, as well as managing risk, multiple demands, and the psychosocial factors contributing to mental illness. Professional actors, plants and virtual backgrounds were used to enhance fidelity of the scenarios. Platform orientation and an introduction to simulation were initially provided followed by “ice breaker” activities, which were used to promote psychological safety amongst participants. Each scenario lasted approximately 10 minutes. Following each scenario, participants were supported to engage in a debrief using the Maudsley Debrief model. Pre- and post-course evaluation questionnaires were given to participants to complete and comparative analysis was conducted.ResultsSeven participants completed both the pre- and post- course evaluation questionnaires. The mean sum score for course specific questions was 51.86 (SD = 9.56) pre course, and 68.00 (SD = 10.08) post course, showing a 31.12% increase in knowledge, skills, and confidence across the course specific domains.The mean sum score for the Human Factors Skills for Healthcare Instrument (HFSHI) was 76.67 (SD = 17.26) pre course, and 86.50 (SD = 16.54) post course, showing a 12.82% increase in human factors skills.ConclusionThis simulation course demonstrated it is an effective and innovative way to help with induction for HT, resulting in an increase in knowledge, skills and confidence in trainees transitioning from CPT to HT, both in terms of factors specific to managing CYP's care and in relation to broader human factor skills.

Propelling steady growth and high‐quality development through deeper reform and more comprehensive opening up: Outlook, policy simulations, and reform implementation—A summary of the Annual SUFE Macroeconomic Report (2021–2022)

AbstractChina's economy underwent a steady recovery in 2021. Investment grew steadily with structural improvement. Exports and imports surged while trade surplus expanded. On the other hand, although labor market conditions improved, income distribution worsened, contributing to sluggish growth in consumption, whereas the gap between consumer price index and producer price index widened, and the profits of enterprises of different sizes diverged, which may go beyond how they are correlated with the locations of the enterprises in the chain of production and trade. While proper liquidity was maintained with prudent monetary policy, risk spillover rose in the financial system, particularly for small and medium‐sized banks. Household and local government debts remained at relatively high levels, further dragging down growth in consumption and infrastructure investment. The “dual carbon” goals exerted downward pressure on near‐term growth in trading off their long‐term benefits. The economy also faced challenges in its external environment in the midst of the prolonged COVID‐19 pandemic aboard, trade protectionism, and the readjustment of the global value chain. Moreover, excessive supervision and inadequate implementation disturbed China's economy, resulting in declined market vitality and confidence of market participants. Based on the Institute for Advanced Research‐China Macroeconomic Model, the baseline real gross domestic product growth rate is projected to be 5.5% in 2022. Alternative scenario analyses and policy simulations are conducted, in addition to the benchmark forecast, to reflect the influences of various risks and possible favorable situations. The findings suggest that China should deepen reform and open up more comprehensively and initiatively, while special effort should be placed on providing accommodative policy and friendly public opinion environment, to facilitate steady growth and propel high‐quality development. A comprehensive macroeconomic governance framework with Chinese characteristics must be developed from systems thinking, to resolve the various issues, internal and external, cyclical and secular, structural and institutional, in an all‐inclusive and coherent manner.

Evaluating the Impact of a Simulation Based Training Course in Intellectual Disability Psychiatry and Autism Co-Delivered by Actors With Intellectual Disability

AimsInequalities in health outcomes, and avoidable deaths, in people with intellectual disability has highlighted the need for improved training and education in Intellectual Disability and Autism. Simulation training facilitated by actors with intellectual disability has been shown to improve connection with people with intellectual disability (Attoe et al 2017). The aim of this project was to develop a simulation-based training course, focused on topics in mental health, intellectual disability and autism, to improve participant confidence in clinical knowledge and skills, as well as support leadership and professionalism training. Here we evaluate the impact of the training on participants’ confidence, and the longer-term effect on attitudes and working practice after attendance.MethodsA novel simulation-based training course, directed at Specialty Trainees, was developed based on the Specialty Training in Learning Disability curriculum. The course was co-delivered by a person with intellectual disability. Participants who attended the simulation training completed general feedback, pre-course and post-course confidence questionnaires and attended a semi-structured group interview at 2 months. Questionnaire data weres analysed using descriptive and inferential statistics. Group interview data were analysed using open &amp; axial coding, and thematic analysis of content. The project was approved by East London NHS Foundation Trust Governance and Ethics Committee for Studies and Evaluations.ResultsEight psychiatrists participated in the training and completed the pre-course and post-course questionnaires. Independent t-test found significant increase in confidence for all scores from pre-course (M = 6.54, SE0.24) to post-course (M = 7.81, SE = 0.36), t= –2.93 p = 0.01. This included ratings of confidence in knowledge in areas such as mental health legislation, and improved confidence in skills such as communication with families of people with intellectual disability and difficult conversations with senior supervisors. In follow-up interviews we elucidated themes of the importance of supported, structured training opportunities with people with intellectual disability, and the value of connection with peers and supervisors.ConclusionSimulation based training in psychiatry, co-delivered with actors with intellectual disability, was reported to be an engaging and enjoyable form of learning. The evaluation suggests such training is effective in increasing trainee confidence in knowledge and skills at the time of training as well as resulting in a lasting change in attitudes after the training. We recommend such training be further developed and delivered at both postgraduate and undergraduate level.

Intensive care clincians' information acquisition during the first wave of the Covid 19 pandemic.

IntroductionThe global pandemic caused by novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has led to an unprecedented demand on critical care resources. The United Kingdom experienced its ‘first wave’ of Coronavirus–19 (Covid-19) disease in Spring 2020. Critical care units had to make major changes to their working practices in a short space of time and faced multiple challenges in doing so, including the challenge of caring for patients in multiple organ failure secondary to Covid-19 infection in the absence of an established evidence base of best practice. We undertook a qualitative investigation of the personal and professional challenges faced by critical care consultants in one Scottish health board in acquiring and evaluating information to guide clinical decision making during the first wave of the SARS-CoV-2 pandemic.MethodsCritical care consultants in NHS Lothian working in critical care from March to May 2020 were eligible to participate in the study. Participants were invited to take part in a one-to-one semi structured interview conducted using Microsoft Teams videoconferencing software. Reflexive thematic analysis was used as the method for data analysis using qualitative research methodology informed by a subtle realist position.ResultsAnalysis of the interview data generated the following themes: The Knowledge Gap; Trust in Information; and Implications for Practice. Illustrative quotes are presented in the text and thematic tables.DiscussionThis study explored the experiences of critical care consultant physicians in acquiring and evaluating information to guide clinical decision making during the first wave of the SARS CoV2 pandemic. This study revealed that clinicians were profoundly affected by the pandemic and the ways in which it changed how they could access information to guide clinical decision making. The paucity of reliable information on SARS-CoV-2 posed a significant threat to the clinical confidence of participants. Two strategies were adopted to ease mounting pressures – an organised approach to data collection and the establishment of a local community of collaborative decision-making. These findings contribute to the wider literature by describing health care professionals’ experiences in unprecedented times and could inform recommendations for future clinical practice. This could include governance around responsible information sharing in professional instant messaging groups, and medical journal guidelines on suspension of usual peer review and other quality assurance processes during pandemics.