Continuing Education Opportunities Research Articles

Cultural Competence: Where Are We as Athletic Training Educators?

Context Cultural competence is the ability of health care professionals to investigate and incorporate the cultural needs of patients into care and clinical decisions. Research shows that athletic training students and certified athletic trainers possess moderate to high levels of cultural competence yet struggle exhibiting culturally competent behaviors. Therefore, an exploration of athletic training educator cultural competence and preparedness to teach cultural competence concepts is warranted. Objective The study sought to assess the cultural competence of athletic training educators and how prepared, comfortable, and confident they feel teaching cultural competence and related concepts. Design Cross-sectional survey. Setting Online. Patients or Other Participants Ninety professional-level athletic training educators (60 women, 30 men). Data Collection and Analysis Cultural competence scores were collected using a previously validated survey tool. The remaining survey items collected information about participants' self-reported cultural competence teaching efficacy. All responses were collected through Qualtrics and analyzed using SPSS version 25. Frequency counts and percentages were determined. Measures of central tendencies were calculated for continuous variables. A paired-samples t test was used to determine if cultural competence knowledge and exhibition of culturally competent behaviors differed significantly. Results Athletic training educators identified mostly as white women (n = 59/90, 65.56%) and had high levels of self-reported cultural competence (5.33/7.00 ± 0.66). However, half of respondents (50.56%, n = 45/89) believed they do not possess adequate knowledge of cultural competence concepts, and a majority of respondents were not taught cultural competence concepts during professional education (78.89%, n = 71/90) nor during athletic training-specific continuing education opportunities (54.44%, n = 49/90). Conclusion(s) Further investigation regarding athletic training educator cultural competence education is warranted. Additionally, barriers to recruitment and retention of underrepresented athletic training faculty should be explored to increase diversity within athletic training programs. Finally, an athletic training-specific cultural competence assessment may more accurately measure cultural competence in this population.

Developing Tomorrow's Library Leaders

Developing Tomorrow's Library Leaders Brian E. C. Schottlaender (bio) One of the hallmarks of the professions is the commitment to, if not the requirement for, continuing education. This is as true of librarianship as it is of medicine, the law, or teaching. In fact, the American Library Association is on record as saying that: Education and Continuous Learning is one of five key action areas adopted by the American Library Association to fulfill its mission of promoting the highest quality library and information services for all people . . . For librarians, continuous learning is critical to renewing the expertise and skills needed to teach and assist members of the public in the new information age.1 Continuing education encompasses a spectrum of possible activities, including workshops, credit-granting classes, professional development programs, leadership development programs, and training—or (shudder) "trainings." Any of these can be certificated, or not; and, increasingly, many take place online, in whole or in part. While professional and leadership development are often considered interchangeable, they are actually different—at least in their focus and intent. Professional development is learning intended to help one earn or maintain professional credentials, while leadership development is the acquisition of skills and knowledge to expand one's capacity and capability for performing in leadership roles within organizations.2 In what follows, I will consider the latter. One of the first post-master of library science (MLS) development efforts of the modern era was launched in 1968 by the Council on Library Resources (CLR): the CLR Fellows program. While one can debate the point, I consider it to have been professional development, not leadership development. The following description, extracted from the College & Research Libraries News announcement of the eighth cohort in 1976, supports this view: "Each fellow will spend three months or more pursuing a self-developed study project, aimed at improving his or her competence in the substantive, administrative, or technical aspects of librarianship."3 This language is much like that used to describe what is arguably the program's follow-on nearly four decades later, the Postdoctoral Fellowship Program that CLIR4 began in 2004: "Fellows work on projects that forge and strengthen connections among collections, educational technologies, and current research."5 The program lists leadership [End Page 227] first among its core goals, followed by awareness, changing roles, relevant resources, and young scholars.6 Nevertheless, its focus strikes me as one of professional development, rather than leadership development. In 1982, Robert Hayes, dean of the Graduate School of Library and Information Science at the University of California, Los Angeles (UCLA), launched the longest-standing leadership development program in librarianship, Senior Fellows. Following my retirement from UC San Diego in 2017, I was appointed director of that program. I shall describe it in greater detail following this brief overview of cognate programs. In the mid-1990s, CLR and Emory University in Atlanta, Georgia, helped launch the Digital Leadership Institute, which rapidly matured in 1999 into the Frye Leadership Institute. Named for the former chancellor of Emory—Billy E. Frye—and cohosted by Emory, CLIR, and EDUCAUSE, the mission of the Frye Institute was to "provide continuing education opportunities for individuals who currently hold, or will one day assume, positions that make them responsible for transforming the management of scholarly information in the higher education community."7 The two-week, annual, Emory-based program continued as such through the first decade of the 2000s, until it evolved again and emerged in 2012 as the Leading Change Institute (LCI). As its name indicates, the latter's remit is more narrowly focused on change leadership and is specifically "designed for leaders in higher education, including CIOs, librarians, information technology professionals, and administrators, who are interested in working collaboratively to promote and initiate change on critical issues affecting the academy."8 With that evolution, the institute also moved to Washington, D.C., and reduced its on-site component from two weeks to one. Launched in 1999, the Harvard Leadership Institute for Academic Librarians is a collaboration between the Association of College and Research Libraries (ACRL) and the Harvard Graduate School of Education. This weeklong on-site offering is intended to help "college-level librarians and...

An Empirical Study of the Influence of Continuing Education on Youth Entrepreneurship in Taiwan

Despite the importance of lifelong education and its reported benefits for graduates entering the workforce, few empirical studies have evaluated the relationship between continuing education on entrepreneurship. In order to address this research gap, this study conducted secondary data analysis from the 2015 Adult Education Survey in Taiwan (AEST 2015) conducted by the Taiwan Ministry of Education. The purpose of this study was to determine the proportion of youth engaged in entrepreneurship (as measured by self-employment) and evaluate the relationship between continuing education and youth entrepreneurship. A sample from Taiwan was purposefully selected due to cultural factors which balance Eastern and Western approaches to education, allowing for better generalizability to a variety of populations. Data from a total of 2,696 valid participants was utilized. The results are as follows: a) the rate of youth entrepreneurship in Taiwan is moderate, at 8%; b) participation in continuing education demonstrated no significant relationship on youth entrepreneurship; c) entrepreneurial youth tend not to participate in continuing education, citing reasons including “lack of time” and “lack of necessary courses” at a frequency higher than non-entrepreneurial youth; and d) in terms of opportunities for future participation in continuing education, entrepreneurial youth placed less emphasis on the importance of transportation costs and tuition fees as compared to non-entrepreneurial youths. The results of this study suggest that continuing education courses are not currently meeting the needs of young entrepreneurs. Conclusions and suggestions are provided in terms of the evaluation of youth self-employment and continuing education opportunities for the promotion of entrepreneurship.

An Empirical Study of the Influence of Continuing Education on Youth Entrepreneurship in Taiwan

Despite the importance of lifelong education and its reported benefits for graduates entering the workforce, few empirical studies have evaluated the relationship between continuing education on entrepreneurship. In order to address this research gap, this study conducted secondary data analysis from the 2015 Adult Education Survey in Taiwan (AEST 2015) conducted by the Taiwan Ministry of Education. The purpose of this study was to determine the proportion of youth engaged in entrepreneurship (as measured by self-employment) and evaluate the relationship between continuing education and youth entrepreneurship. A sample from Taiwan was purposefully selected due to cultural factors which balance Eastern and Western approaches to education, allowing for better generalizability to a variety of populations. Data from a total of 2,696 valid participants was utilized. The results are as follows: a) the rate of youth entrepreneurship in Taiwan is moderate, at 8%; b) participation in continuing education demonstrated no significant relationship on youth entrepreneurship; c) entrepreneurial youth tend not to participate in continuing education, citing reasons including “lack of time” and “lack of necessary courses” at a frequency higher than non-entrepreneurial youth; and d) in terms of opportunities for future participation in continuing education, entrepreneurial youth placed less emphasis on the importance of transportation costs and tuition fees as compared to non-entrepreneurial youths. The results of this study suggest that continuing education courses are not currently meeting the needs of young entrepreneurs. Conclusions and suggestions are provided in terms of the evaluation of youth self-employment and continuing education opportunities for the promotion of entrepreneurship.

Factors associated with job satisfaction among graduate nursing faculties in Nepal

BackgroundJob satisfaction among nursing faculty is critical to improving quality of nursing education, producing future nurses who will contribute directly to the health of patients at a local and national level. This study explores factors associated with job satisfaction among graduate nursing faculties in different universities of Nepal.MethodsA cross-sectional study was conducted among nursing faculty with at least one year of teaching in their respective institutions. A 36-items job satisfaction questionnaire with 6-point Likert type responses was administered online. The questionnaire was pre-tested with 30 faculties pooled from multiple institutions. Link to the final survey was sent via e-mail to 327 nursing faculties working in 39 nursing colleges. Respondents were contacted by phone as a follow up to the email to politely remind them about the survey. Data analysis was carried out with SAS University Edition software. Chi-Square test and t-test were used for simple descriptive analysis. A multivariate binary logistic regression model was used to identify the significant factors associated with nursing faculties’ job satisfaction. Adjusted odds ratio was calculated and significance was considered at p ≤ 0.05 with 95% confidence interval.ResultsThe response rate was 54.4%. After retrospective cleaning of data, usable response rate was 52.3% (n = 171). The average age of the nursing faculties was 36.8 ± 7.0 years. Based on the overall job satisfaction score, 36.8% nursing faculties were satisfied with their current job. The coefficient for Cronbach’s alpha was 0.895 suggesting very good reliability of the overall measure. The significant factors associated with job satisfaction were the involvement of the faculties in decision making process related to the department (OR = 4.83) and adequate access to reference materials (OR = 2.90).ConclusionsThis study suggests that nursing faculties have positive attitude towards their job but are dissatisfied with the benefits offered to them and the operating condition of their institutions. Expanding the teaching learning resources, such as reference books, subscription to journals, and continuing education opportunities for nursing faculties through participation in professional meetings would be helpful in improving the quality of nursing education in Nepal.

The Validation of the Military and Veteran Family Cultural Competency Model (MVF-CCM)

There is increasing use of cultural competency models to guide health care interactions with military community members, including families, however, at this time there is no validated model. This study confirms the accuracy of the Military and Veteran Family Cultural Competency Model (MVF-CCM). Using a systems theory-informed qualitative approach, focus groups and interviews were conducted. Data were analyzed using a step-wise process to integrate changes. Feedback was provided to both the model and framework to expand on content and increase clarity. The MVF-CCM is an evidence-informed resource to support the development of cultural competent health care curriculum, continuing education opportunities, and clinical practice.

Making the future makers

Purpose The purpose of this paper is to identify and explore curriculum related to makerspaces and making within library and information science graduate programs and continuing education opportunities available to librarians. These findings are compared against prior assessments of makerspace-related educational offerings, as well as contrasted with recent practitioner survey results indicating the number of library practitioners involved in makerspace work and their needs. Design/methodology/approach This paper employs content analysis to assess makerspace topics within American Library Association (ALA)-accredited library and information science Masters programs’ course catalogs and in continuing education opportunities for librarians. Findings This work identified a total of eight courses from seven ALA-accredited Masters of Library Science programs relating to makerspace and making topics. A series of past and current makerspace-related continuing education opportunities were noted, with a variety of durations and structures, all offered in online format. As compared to prior research, these findings describe a notable increase in training and curriculum relating to library makerspaces. Research limitations/implications A limitation of this work is the difficulty in assessing frequency of course offerings, details regarding special topics courses and the potential continuing education materials that may have been removed from the internet since their offering. Originality/value Although significant research efforts have focused on makerspaces, little work has directly assessed the ongoing impact of the makerspace trend on library and information science graduate programs and continuing education opportunities.

Extending medical librarians' competencies to enhance collection organisation.

Like many health library associations, the Medical Library Association (MLA) developed competencies guiding lifelong learning and competence for medical librarians. Medical librarians should be able to develop skills in identified areas. One MLA indicator of organising resources defines expert skill as the ability to develop classification and metadata schemes for unique collections. This manuscript reviews available curricula for selected library programmes in the United States and Canada, along with professional development and informal opportunities for skill development to identify how medical librarians, who are not experts in cataloging or metadata and not employed as cataloging or metadata librarians, can progress in competency. The authors reviewed library school and continuing education programming around metadata, along with answers from a pre-existing informal poll regarding cataloging and metadata roles in health sciences libraries. Data were collected and examined using descriptive statistics. Gaps and opportunities for education around organising resources are discussed, including library school courses, formal continuing education opportunities and informal learning (e.g. peer support networks, on-the-job learning). Education in organising resources should be created throughout the educational journey of librarianship. Continuing educational opportunities in organising resources should be created by professional organisations that expect competency in this area.

A Survey of Clinicians With Specialization in Childhood Apraxia of Speech.

Purpose Little is known about how clinicians develop expertise in childhood apraxia of speech (CAS), a rare speech disorder with heterogeneous presentation. The purpose of this survey study was to examine the beliefs and practices of clinicians specializing in CAS. Method Speech-language pathologists who self-identify as having expertise in CAS (n = 165) completed an online survey regarding influences on clinical practice and beliefs about CAS. Practice patterns and perspectives regarding CAS were analyzed for respondents who self-identify as having expertise in CAS, across 4 experience bands (1-5, 6-10, 11-15, and 15+ years). Results A majority of the respondents to this survey provide treatment to preschool-age children with CAS. Respondents report features used in differential diagnosis aligned with the American Speech-Language-Hearing Association's (2007) technical report, with inconsistency as a key feature. Results suggest that continuing education courses are highly influential in the perceived development of expertise and perspectives regarding CAS. Respondents expressed uncertainty about comorbidity of CAS with other communication disorders. Overall, beliefs and practices are relatively uniform across levels of clinical experience. Conclusions Practices and perspectives of clinicians who self-identify as having expertise with CAS are influenced by factors noted in previous literature. Results of this survey highlight the need for research on the development of expertise in the clinical management of CAS, updated consensus statements that reflect advances in current research, clarification regarding comorbidity of CAS with other communication disorders, and evaluation of continuing education opportunities. Supplemental Material https://doi.org/10.23641/asha.9755459.

Continuing Education for Haitian Nurses: Evidence from Qualitative and Quantitative Inquiry.

Background:There is increasing evidence that to improve nursing practice, nurses must embrace lifelong learning. Research indicates that engagement in lifelong learning positively affects the quality of nursing care, improves patient outcomes, and increases nurses’ job satisfaction. Both lack of standardized initial education and nurses’ limited opportunities for lifelong learning are challenges in Haiti. It is crucial to ensure adequate continuing education in order to support the professional growth and development of Haiti’s existing nursing workforce.Objectives:The objectives of this study were to: 1) assess the continuing education nursing needs and desires of practicing Haitian nurses and 2) contribute to the body of knowledge about nursing in Haiti to help inform practice and policy.Methods:A multimodal needs assessment approach was used, with semi-structured focus groups and written surveys. The results were analyzed, and common themes were identified.Findings:The results were analyzed from 100 surveys and four focus groups (n = 33). Overwhelmingly, Haitian nurses desire continuing nursing education. Major themes include: recognition that continuing education is necessary to provide high quality patient care, continuing education saves lives, and more consistent and standardized initial nursing education is needed. Barriers to participation in continuing education opportunities were also identified.Conclusions:This study was one of the first formal studies that addressed continuing education needs of Haitian nurses. By identifying the barriers to important resources, we hope to continue to collaborate with our Haitian nursing colleagues to build curriculum and improve education programs. We also hope that this research will ensure that Haitian nurses voices are heard and will serve to foster change within the Haitian nursing education system. These results were shared with our nurse colleagues in Haiti.

Disseminating and implementing a lifestyle-based healthy weight program for mothers in a national organization: a study protocol for a cluster randomized trial

BackgroundExcessive weight gain among young adult women age 18–45 years is an alarming and overlooked trend that must be addressed to reverse the epidemics of obesity and chronic disease. During this vulnerable period, women tend to gain disproportionally large amounts of weight compared to men and to other life periods. Healthy Eating and Active Living Taught at Home (HEALTH) is a lifestyle modification intervention developed in partnership with Parents as Teachers (PAT), a national home visiting, community-based organization with significant reach in this population. HEALTH prevented weight gain, promoted sustained weight loss, and reduced waist circumference. PAT provides parent–child education and services free of charge to nearly 170,000 families through up to 25 free home visits per year until the child enters kindergarten.MethodsThis study extends effectiveness findings with a pragmatic cluster randomized controlled trial to evaluate dissemination and implementation (D&I) of HEALTH across three levels (mother, parent educator, PAT site). The trial will evaluate the effect of HEALTH and the HEALTH training curriculum (implementation strategy) on weight among mothers with overweight and obesity across the USA (N = 252 HEALTH; N = 252 usual care). Parent educators from 28 existing PAT sites (14 HEALTH, 14 usual care) will receive the HEALTH training curriculum through PAT National Center, using PAT’s existing training infrastructure, as a continuing education opportunity. An extensive evaluation, guided by RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance), will determine implementation outcomes (acceptability, adoption, appropriateness, feasibility, fidelity, and adaptation) at the parent educator level. The Conceptual Framework for Implementation Research will characterize determinants that influence HEALTH D&I at three levels: mother, parent educator, and PAT site to enhance external validity (reach and maintenance).DiscussionEmbedding intervention content within existing delivery channels can help expand the reach of evidence-based interventions. Interventions, which have been adapted, can still be effective even if the effect is reduced and can still achieve population impact by reaching a broader set of the population. The current study will build on this to test not only the effectiveness of HEALTH in real-world PAT implementation nationwide, but also elements critical to D&I, implementation outcomes, and the context for implementation.Trial registrationhttps://ClinicalTrials.gov, NCT03758638. Registered 29 November 2018

De Souza interprofessional practice cancer competency framework

As the demand in cancer care continues to increase, health systems require a workforce of highly educated specialists and generalists to provide continuity of care across settings. Led by de Souza Institute in Canada, an interdisciplinary working group was formed to develop a competency framework with relevance across regulated health professionals involved in cancer care. The working group was presented with results from a scoping review of national and international guidelines, standards, and competencies in oncology, as well as data from needs assessments on continuing education opportunities and oncology topics most relevant to clinicians. Fifty-one professionals from, e.g., family medicine, pharmacy, social work, psychology, occupational therapy, and nursing participated in seven focus groups. An additional 32 nurses participated in a nursing-specific needs assessment survey. Using modified Delphi technique, working group members conducted three iterative rounds to review data and built consensus on competency items in relation to three levels of expertise, from early learner/novice practitioner, advancing practitioner, to expert practitioner. A final consensus was reached for the selection of competencies that reflect optimal cancer care mapped into three levels of expertise, as well as knowledge, skills, and attitudes expected of each level. Examples for the competency for early learner/novice practitioner include the following: Have awareness of common ethical issues in cancer care (knowledge); demonstrate ability to discuss, educate, and counsel patients and their support persons(s) regarding preferences (skills); and appreciate the impact of culture, the sensitivity, and diversity of attitudes in relation to cancer (attitude). Expert practitioner examples include: recognition of need for, and ability to advocate for challenges involving equity and access in order to improve health outcomes (skill) and awareness of workplace complexities, such as provider roles, team functioning, and organizational environments affecting patient-practitioner relationships (attitude). The de Souza Interprofessional practice cancer competency framework provides a set of shared competencies and a novice to expert pathway for clinicians across disciplines and supports a more standardized learning and comprehensive approach in organizing professional development towards a coordinated, high quality, and person-centered care.

Graduate training in psychotherapy: The importance of ongoing clinical activity for the training faculty

AbstractBackgroundPsychotherapy training is designed to help graduate students develop confidence and competence in their clinical skills.ApproachThe present manuscript explores three dimensions of an Aristotelian doctrine of knowledge as related to skill in psychotherapy.FindingsFirst, a psychotherapist should be knowledgeable about the background information pertaining to psychological theories and current research in the field. Typically, background information is covered in graduate courses and updated through continuing education opportunities for the licensed psychologists. Second, psychotherapists develop competence in technical skills used in psychotherapy sessions. For graduate students, competence in technical skills can be developed through the direct provision of clinical services in supervised placements. For faculty members, technical skills can be maintained through their involvement in ongoing clinical activities. Third, psychotherapy instructors need expertise in practical wisdom to guide clinical judgment and ethical reasoning skills. Expertise develops through years of practice.ConclusionsGraduate students are expected to develop background knowledge and basic competence in clinical skills. Furthermore, faculty members who teach graduate courses on psychological assessment, psychiatric diagnosis and psychological treatments can be expected to attain a level of expertise. Psychotherapy training is improved when faculty instructors have ongoing clinical experience and practical wisdom. The present manuscript confronts the problem and proposes several possible solutions.

Clinical Decision Making in Speech-Language Intervention for Toddlers With Autism and Other Social Communication Delays

Purpose This study investigated current speech-language intervention practices with young children with social communication delays including autism and the educational experiences that shape these practices. Method A 25-item web-based survey was completed by 264 speech-language pathologists who worked with children under the age of 3 years. Results A majority of respondents reported targeting a variety of areas of social communication across daily activities, regularly utilizing the parent as the primary agent, and often providing in-home services; however, a minority of respondents reported only using materials available in families' homes. Previous clinical experiences and continuing education were reported to most influence clinical decision making. Results indicated the incorporation of many aspects of evidence-based naturalistic interventions into practice and the use of continuing education opportunities to expand clinical knowledge. Conclusion Although speech-language pathologists reported promising directions toward recommended best practices, further research and training are needed to optimize services provided to young children and their families.

Translation of Standardized Patient Encounter Performance and Reflection to Clinical Practice

Context Standardized patient (SP) encounters have been incorporated into many healthcare education programs, including professional athletic training programs, yet there is little exploration about the use of SP encounters in postprofessional programs and continuing education opportunities. Objective To explore athletic trainers' translation of skills and reflections in clinical practice after an SP encounter and debriefing session. Design Qualitative action research. Setting One-on-one interview. Patients or Other Participants Fifteen learners from the same postprofessional athletic training degree program (males = 3, females = 12; age = 25 ± 5 years; certified experience = 3 ± 3 years) without previous SP experience participated in this study. All learners had to be employed full or part-time in a clinical setting. Main Outcome Measure(s) Sixty days after an SP encounter related to patient-centered care during an orthopedic evaluation and subsequent debriefing session, participants completed an online, audio-only interview after a 10-question, semistructured interview protocol. A 3-person primary coding team identified domains and categories using the consensual qualitative research tradition. Results Three main domains emerged from the study: (1) limitations of a novice SP experience, (2) practice transformation, and (3) promoting self-reflection. Participants reported that the initial SP encounter in their postprofessional education was a new experience through which they were able to implement new skills learned in their previous courses. Translation of newly learned ideas or ways of thinking to clinical practice varied among clinicians and their job settings. Collaborative thinking and self-reflection were key components. Participants were able to identify with their classmates' struggles and triumphs and to take away new learning experiences. Conclusions SP encounters are a useful instructional and assessment technique for athletic trainers in a postprofessional athletic training degree program to promote self-reflection and to translate newly learned skills to their clinical practice, while nerves and anxiety influenced the learners' ability to suspend reality.

Bringing SBIRT into the Community: An Evaluation of a Continuing Education Training for Social Workers

Continuing education (CE) is critical to effective social work practice. There are limited reports of evaluations of CE training in general and Screening, Brief Intervention, and Referral to Treatment (SBIRT) in particular. One school of social work offered 3 annual, 1-day CE opportunities focusing on different aspects of SBIRT for practicing social workers. Data on participants’ knowledge, attitude, skills, self-efficacy, and behavioral intent were collected using pretest and posttest. This article presents the findings from the evaluation of the SBIRT CE program.

Confidence and performance of health workers in cardiovascular risk factor management in rural Botswana: a cross-sectional study

Abstract Background Social and demographic changes in Botswana are resulting in an increased prevalence of cardiovascular disease (CVD). Providers, mostly nurses, in this setting have limited training in managing CVD risk and few opportunities for continued medical education. We aimed to evaluate providers' perceived confidence in managing CVD risk factors and describe management of patients with hypertension at public-sector clinics in a rural district of Botswana. Methods In this cross-sectional study, we invited public-sector health-care providers in 11 ambulatory clinics in the Kweneng East district of Botswana to complete an anonymous questionnaire survey. We used descriptive statistics to evaluate providers' confidence in managing CVD risk (a Likert scale from 1 [low confidence] to 5 [high confidence]). We used t tests to compare confidence levels between groups of providers and specific risk factors. Additionally, we interviewed patients and did chart reviews to assess how CVD risk factors were managed in 275 hypertensive patients at seven of the 11 sites surveyed. Uncontrolled hypertension was defined as ≥140/90 mm Hg (or ≥130/80 mm Hg in patients with diabetes) for an average of two blood pressure readings and CVD risk was defined using WHO guidelines. Findings Of 88 health care providers invited to participate, 44 registered nurses (80%), four family nurse practitioners (7%), and seven doctors (13%) completed the survey. Providers reported feeling significantly more comfortable managing hypertension than they did diabetes (3·73 vs 3·15; p Interpretation Public sector health-care providers in rural Botswana have low confidence in managing CVD risk factors. Although reported confidence was higher for management of hypertension than for diabetes, there were significant lapses in management of both diseases. CVD and diabetes account for 22% of all adult deaths in Botswana and it is imperative that training in management of these diseases is improved. To address low provider confidence and gaps in guideline-driven CVD prevention, we plan to implement an integrative training programme for health workers in the Kweneng East district of Botswana. Funding Hospital Medicine, Beth Israel Deaconess Medical Center.

Utilization of vasopressin before and after protocol implementation in a surgical intensive care unit

IntroductionVasopressin is recommended for management of septic shock refractory to fluid challenge and norepinephrine. Controversy exists over when to add vasopressin to norepinephrine treatment. Due to the rising cost of vasopressin and the lack of mortality benefit, the surgical intensive care unit (SICU) at Vanderbilt University Medical Center implemented a protocol for vasopressin use with the purpose of decreasing utilization and cost.ObjectiveThe purpose of this study was to characterize vasopressin utilization and evaluate adherence to this protocol.MethodsThrough a retrospective, observational analysis, adult patients admitted to the SICU who received vasopressin during the 11 months before and after protocol implementation in August 2015 were identified. The primary outcome was vasopressin usage per patient. Secondary outcomes included norepinephrine use, vasopressin cost, and protocol adherence.ResultsDuring the pre‐ and post‐protocol periods, 144 of 1788 admitted patients (8%) and 119 of 1845 admitted patients (6%) received vasopressin, respectively. The total duration of vasopressin infusion during hospitalization was similar before and after protocol implementation (20 vs 18 hours, P = 0.526), but vasopressin was both added and discontinued when norepinephrine was infusing at a higher rate (added at 12 vs 18 mcg/min, P < 0.001; discontinued at 0.5 vs 6.0 mcg/min, P < 0.001). Norepinephrine was infused for a longer duration post protocol implementation (31 vs 57 hours, P < 0.001). After implementation, a protocol violation occurred in 59 patients (50%); however, 59% of these were related to vasopressin initiation in the operating room. Thirty‐two patients (27%) experienced a SICU‐related violation, with the most common type being discontinuation of norepinephrine prior to vasopressin.ConclusionImplementation of a vasopressin utilization protocol in a SICU resulted in more selective usage of vasopressin and a similar duration of infusion when it was utilized. Protocol adherence was nearly 75%, exposing some opportunities for continued education and improvement.

US e-learning course adaptation to the Ukrainian context: lessons learned and way forward

BackgroundAccess to continuing education opportunities is limited for Ukrainian healthcare workers, and the need is acute in order to support healthcare reform efforts currently underway in Ukraine. Online learning is a cost-effective mechanism for continuing education since healthcare workers can remain on the job during training. It also provides a means of keeping health professionals up to date on their knowledge and skills in rapidly changing and increasingly complex healthcare environments.MethodsThis paper describes the process of adapting an existing e-learning course from a US institution to the Ukrainian setting. Course participants’ feedback was used to evaluate the effectiveness of the adapted version that was piloted twice in 2016–2017 with 53 participants in total, 46 of whom completed the course and contributed to the evaluation.ResultsThis was the first fully online course on Leadership and Management in Health (LMiH) to be offered in Ukraine. Several lessons were learned during course adaptation when multiple aspects of the Ukrainian environment were taken into account including 1) linguistic accessibility, 2) access to the Internet, 3) computer literacy, and 4) novelty of online learning. Based on these findings, course material was first adapted by translating it from English to Ukrainian with the emphasis on cultural adjustment of idioms and real life examples. Then, using the first pilot results and participants suggestions, videotaped interviews with local healthcare management experts were added in order to further enhance cultural suitability as well as relevance and applicability of the course concepts. The last but not least lesson learned consisted in the fact that enhancing, transitioning, and sustaining online learning to new contexts required engagement of key stakeholders, national level support, and technical assistance through implementation and beyond yet turned out to be both cost-effective and sustainable investment of limited resources. Formative evaluation confirmed that the adaptation efforts resulted in a course relevant and acceptable to healthcare professionals in Ukraine.ConclusionTransition of the course to local ownership was accomplished in partnership with the Ukrainian Family Medicine Training Center in the Bogomolets National Medical University in Kyiv: LMiH is now certified for continuing medical education credit and offered twice a year by this institution. Lessons learned from this experience provide a roadmap for rapidly increasing access to new knowledge and skills for healthcare workers by adapting existing online resources to local needs; they are used to facilitate rapid expansion of other continuing education offerings in Ukraine: additional online courses from the University of Washington (UW) are planned for adaptation.

ІННОВАЦІЙНІ ТЕХНОЛОГІЇ В ПРОФЕСІЙНІЙ ОСВІТІ: СУЧАСНІ ТЕНДЕНЦІЇ ТА ПРАКТИКА ВПРОВАДЖЕННЯ

Мета роботи – висвітлити досвід застосування дистанційної форми навчання, яка працює на відкритій і найбільш популярній у світі платформі – Moodle, для підвищення якості підготовки висококваліфікованих фахівців-провізорів у Дніпропетровській медичній академії.
 Основна частина. У статті розглянуто досвід впровадження новітніх інноваційних технологій навчання, які використовуються викладачами на кафедрі загальної та клінічної фармації при підготовці фахівця-провізора. Показано особливості дистанційної системи навчання, її переваги. Оцінка ефективності використаних інноваційних технологій проводиться протягом усього терміну навчання конкретної дисципліни, шляхом тестування та постійного контролю і перевірки опанування теоретичного матеріалу та практичних навичок перед початком кожного практичного чи лабораторного заняття. Показана ефективність використання дистанційної системи навчання як позааудиторної форми організації самостійної роботи студентів.
 Висновки. Інноваційні технології навчання сприяють розвитку пізнавальних і когнітивних здібностей студентів, а саме – вміння вирішувати поставлені завдання, займатися збором, аналізом і синтезом даних, витягувати з них інформацію, самостійно мислити, володіти комунікативними навичками. Освітні технології відкривають нові горизонти викладання, навчання й оцінки здобутих знань, дозволяють втілювати інноваційні, ефективні моделі адміністрування та управління. Здійснювати постійний моніторинг оволодіння професійними компетенціями, що дозволяє за короткий строк відкоректувати та індивідуалізувати процес навчання. Дистанційні системи навчання надають можливості безперервного навчання, забезпечуючи великому колу людей можливість отримання як післявузівської, так і додаткової освіти.