Competency Domains Research Articles

Evaluation of artificial intelligence-generated drug therapy communication skill competencies in medical education.

This study compared three artificial intelligence (AI) platforms' potential to identify drug therapy communication competencies expected of a graduating medical doctor. We presented three AI platforms, namely, Poe Assistant©, ChatGPT© and Google Bard©, with structured queries to generate communication skill competencies and case scenarios appropriate for graduating medical doctors. These case scenarios comprised 15 prototypical medical conditions that required drug prescriptions. Two authors independently evaluated the AI-enhanced clinical encounters, which integrated a diverse range of information to create patient-centred care plans. Through a consensus-based approach using a checklist, the communication components generated for each scenario were assessed. The instructions and warnings provided for each case scenario were evaluated by referencing the British National Formulary. AI platforms demonstrated overlap in competency domains generated, albeit with variations in wording. The domains of knowledge (basic and clinical pharmacology, prescribing, communication and drug safety) were unanimously recognized by all platforms. A broad consensus among Poe Assistant© and ChatGPT© on drug therapy-related communication issues specific to each case scenario was evident. The consensus primarily encompassed salutation, generic drug prescribed, treatment goals and follow-up schedules. Differences were observed in patient instruction clarity, listed side effects, warnings and patient empowerment. Google Bard did not provide guidance on patient communication issues. AI platforms recognized competencies with variations in how these were stated. Poe Assistant© and ChatGPT© exhibited alignment of communication issues. However, significant discrepancies were observed in specific skill components, indicating the necessity of human intervention to critically evaluate AI-generated outputs.

Improving Self-Perceived Competencies of Second-Year Pharmacy Students Through an Introductory Medication Reconciliation Rotation

ObjectiveMedication reconciliation (MedRec) is an essential health care function that is particularly relevant to pharmacists’ expertise and a learning opportunity for pharmacy students. Our objective was to assess change across clinical competence, confidence, and communication skills after the completion of a MedRec rotation by second-year pharmacy students. MethodsA retrospective post-then-pre-survey including 29 questions was developed/delivered to students after the completion of required MedRec hours. The primary end point was the change in 3 domains via summed scores from individual questions. Cohen’s difference (d) was used to determine group effect size change. The secondary end points included individual question change, perceived patient impact, and subgroup analyses. ResultsOf 115 second-year pharmacy students, 81.7% (n = 94) participated in the study. Students self-reported increases on the Likert scale (0–10) of 2.49 ± 1.90 in clinical competency domain, 3.57 ± 2.13 in confidence domain , and 3.12 ± 2.15 in communication skills domain, representing statistically significant and large group effect changes across all 3. A total of 21 of the 22 individual questions had large group effect changes; 1 question (nursing communications) had a moderate group effect change. Student perception of MedRec impact on patient care (Likert scale 0–10) was positive: post-rotation score 7.39 ± 1.57. ConclusionTo the best of our knowledge, this is the first larger-scale study that examines student-evaluated outcomes of a MedRec-based rotation. Students self-reported high levels of post-rotation competency across all domains; students from ethnic minorities and with less work/MedRec experience increased their lower pre-rotation scores to statistically similar post-rotation scores, compared with non-minority and more experienced peers. Further study of the model and outcomes is advised.

Ensuring Accuracy: Making the Case for Inter-rater Reliability in Hospital Acquired Infection Surveillance

Background: Infection preventionists (Ips) have self-reported surveillance as the most time-consuming job task (1,2). APIC’s MegaSurvey 2020 reported that 60% of Ips consider themselves proficient or expert within this competency domain (2). Accurate coding of health care acquired infections is critical to identifying epidemiologically significant events, using data to improve practice, and compliance with state and federal mandated CMS reporting (3,4). Validated case study scenarios were distributed to infection preventionists to better understand how experience level and time spent performing surveillance affects interrater reliability (IRR) in applying the National Healthcare Safety Network (NHSN) surveillance definitions (5,6). Methods: Case study scenarios determined to have high item discrimination were added to an online test bank and distributed annually to Ips of varying experience levels and care settings as part of a mandatory training program (5). The test bank currently consists of forty-two validated questions. Each year, the participants receive approximately thirty questions, including twenty randomly selected from the test bank and ten beta scenarios under development. Only validated test bank scenarios are used to calculate the passing score of 85%. Participants are blinded to which questions are test bank scenarios versus beta scenarios. Additional information was gathered at the beginning of the test to determine CIC status, years of experience, and weekly hours spent doing surveillance. Data was analyzed for passing score on the first attempt for testing years 2019, 2021, 2022, and 2023. Results: Thirty-six Ips passed the IRR test on the first attempt (33%). Of those who passed on the first attempt, twenty-nine (81%) were certified and twenty-two (61%) reported at least nine hours a week performing surveillance. Of the seventy-three Ips (67%) who did not pass on the first attempt, thirty were certified (41%) and sixty (82%) reported performing surveillance for 8 hours or less per week. Conclusion: The first-time pass rate for certified and non-certified Ips was 33%, markedly lower than the self-reported proficiency rate of 60%. The majority of Ips who passed on the first attempt were certified and spent at least nine hours per week performing surveillance. certified and non-certified Ips who did not regularly perform surveillance as part of their weekly job tasks were less likely to pass the test on the first attempt. Given the first-time pass rate among all participants is below optimal, establishing inter-rater reliability systems and ongoing surveillance education for Ips is crucial to ensure accuracy of publicly reported data.

Designing Prefaculty Competencies for Diverse Learners Through a Modified Delphi Process

Faculty diversity in academic medicine may better prepare the next generation of equity-minded health care practitioners and leaders. Prefaculty development is an emerging concept to support trainees in achieving key knowledge, skills, and experiences to become successful faculty. To outline competencies, with corresponding milestones, to support the academic career development of learners, inclusive of racial, ethnic, sexual, and gender identities minoritized in medicine. Using a modified Delphi process, a national working group consisting of 13 members was established. The group used the published literature and listening sessions with diverse stakeholders to draft a set of competencies and milestones in July 2022. Diverse expert panelists reviewed the draft set over 2 rounds between September 2022 and January 2023. The group considered qualitative data to further refine the draft set between rounds. Consensus was reached when competencies and milestones were rated as agree or strongly agree on importance or appropriateness by 75% or greater of expert panelists after the second round. A final set of competencies and milestones was generated in February 2023. Data from round 1 were analyzed in October 2022 and data from round 2 were analyzed in January 2023. The development of prefaculty competencies with corresponding milestones by expert panel rankings and comments. The national working group consisted of 13 members who represented diversity across racial, ethnic, and gender identities and academic and career tracks. The working group developed an initial set of 36 competencies and corresponding milestones across 12 domains. After 2 rounds, consensus among 46 expert panelists generated a final list of 32 competencies with corresponding milestones across 11 domains. A total of 26 panelists (56.5%) were women, 11 (23.9%) were Black or African American, 17 (37.0%) were Latina/o/x/e, Hispanic, or of Spanish origin, and 10 (21.7%) were White. Competency domains were divided into 2 groups: foundational (academic career choice and professional identity, mentorship, networking, financial skills, diversity and inclusion, personal effectiveness and self-efficacy, and leadership) and focused (education, community engagement, research, and clinical medicine). Consensus for inclusion or elimination of items was greater than 90% between the 2 rounds. There was consensus among the working group and expert panelists regarding the importance and appropriateness of the competencies and milestones for diverse trainees to successfully obtain faculty positions. Institutions and national organizations can use these competencies as a framework to develop curricula that support diverse learners' career development toward academia.

Factors influencing intercultural competences of hospital workers for multicultural patients in South Korea.

This study aims to assess the intercultural competence of general hospital workers in South Korea by examining their understanding of cultural diversity in healthcare and to identify factors influencing their intercultural competence. A cross-institutional survey was conducted with 439 participants from four South Korean general hospitals, employing inferential statistics such as one-way Analysis of Variance, Mann-Whitney U, and Kruskal-Wallis test followed by post-hoc, and multiple linear regression analyses. While 85% (n = 362) of participants acknowledged the significance of multiculturalism in Korean society, only 11% (n = 49) felt competent in treating multicultural patients. Additionally, 72% (n = 315) experienced significant linguistic difficulties in medical communication. Multiple regression analysis identified advanced English competency, multicultural training experiences, and peer support with organizational awareness of multicultural importance as significant positive contributors to intercultural competence. Despite recognizing the importance of multiculturalism, general hospital workers face significant language barriers and low self-efficacy in providing care to multicultural patients. To address these challenges, hospitals should designate resident translators for culturally appropriate communication. Furthermore, a tri-tiered training approach is proposed to enhance the five domains of intercultural competence among general hospital workers in Korea, including overarching multicultural training, occupation-specific courses, and long-term managerial programs aimed at managing cultural diversity effectively in healthcare settings.

Interprofessional collaboration practices: Health worker’s perceptions in private hospital Surabaya

Background: The quality of services provided by hospitals is the responsibility of a group of multi-professional teams working with different professional backgrounds, resulting in inter-professional conflicts that cause losses. To produce quality services, building Interprofessional Collaboration (IPC) among health workers is very important. One of the challenges that prevents the implementation of IPC from working efficiently is the varying opinions of health workers regarding interprofessional collaboration activities. Objective: The goal of this study was to investigate the attitudes of health workers concerning the practice of IPC in hospitals. Method: This research was an observational study employing a cross-sectional strategy. Health workers' impressions of interprofessional cooperation practices were analysed using the Collaborative Practice Assessment Tool for health workers. Result: This study involved 105 health professional respondents. The findings of the questionnaire analysis indicated significant differences in the domain of Relationship among Team Members (p 0.027), Team Relationship with the Community (p 0.012), Leadership (p 0.009), and Mission, Goals, and Objectives (p 0.001). Conclusion: Based on research findings, there are differences in perceptions among health workers because each professional competency domain is different. Therefore, interprofessional education is necessary to illustrate the implementation of collaborative practices across various professions.

Investigating the Influence of Simulation-Based Instruction on Advancing Nursing Proficiency: A Rapid Review.

Nursing practice is continuously evolving, requiring nurses to update their knowledge and skills. A common approach in nursing education is simulation-based training. Although its effectiveness was studied in a sample of undergraduate students, evidence of its effectiveness in nursing continuing education is lacking. This review examined the effectiveness of simulation-based instruction in advancing nursing proficiency in lifelong or continuing learning. Searches of EMBASE, MEDLINE via PubMed, Web of Science, and Google Scholar were performed. Studies conducted between 2000 and 2023, focusing on postregistration or postlicensure nurses undergoing simulation-based training to improve their nursing proficiency, were considered for review. The quality of the studies was assessed using the transparency, accuracy, purpose, utility, propriety, accessibility, and specificity (TAPUPAS) criteria. Data were synthesized with narrative summaries. A total of 14 studies with a total sample size of 1,204 nurses met the eligibility criteria. Studies showed that simulation-based instruction in nursing continuing education improves knowledge and skills. Some studies showed disagreements on the effectiveness of simulation-based training on other factors. Embracing high-fidelity simulation in continuing education is crucial for advancing proficiency. Tailoring simulation scenarios to specific competency domains is recommended to address variations in outcomes. Policymakers are encouraged to integrate simulation into education policies and support ongoing research to refine best practices and align policies with evolving nursing needs. [J Contin Educ Nurs. 202x;5x(x):xx-xx.].

An Evaluation of the Sharing Dance Public School Program on Physical Literacy.

Introduction: Physical literacy (PL) is a multidimensional concept that includes the domains of movement competence, positive affect, social participation, and the confidence, motivation, and knowledge and understanding necessary for regular engagement in physical activity. The Sharing Dance Public School Program was created by Canada's National Ballet School specifically designed to promote PL through dance. The objective of this study was to evaluate the effectiveness of the program to improve PL in grade 4 to 6 children over the course of a school year. Methods: Children were initially recruited from two schools including an intervention and a control school. However, due to the COVID-19 pandemic, data collection was prematurely terminated which resulted in baseline and mid-point data from the intervention group only. As such, participants included 57 children (n = 28 females, Mage = 10.34 ± 0.85 years) that engaged in the dance program once per week for 50 minutes. Assessments of PL included a direct measure of movement competence (PLAYfun) and a self-report measure (survey) to assess the other domains of PL. Results: Significant improvements were found in movement competence. However, significant decreases were found for fun and enjoyment, confidence, and social participation. No changes were observed for knowledge and understanding or overall PL. Conclusions: Findings from the present study are encouraging as they provide initial evidence for the support of community-based PL programs, such as the Sharing Dance Public School Program, to help children develop their movement competence. Future research is needed to further evaluate the effectiveness of the Sharing Dance Public School Program over a school year, and when compared to a control group, as was initially intended.

A Comprehensive Framework for Middle Leaders’ Competencies in Promoting Teachers' Technology Acceptance in Education 4.0

The era of Education 4.0 presents new challenges and opportunities for school leaders to drive technology integration and acceptance among teachers. Middle leaders, situated between senior leadership and teaching staff, play a pivotal role in this process. However, existing competency models for educational leaders in Malaysia, such as SKKSM and KOMPAS, do not adequately address the specific competencies required by middle leaders to navigate the demands of Education 4.0 and promote technology acceptance. This article proposes a comprehensive conceptual framework for middle leaders' competencies, adapted from the School Leadership Competency Model for the era of Education 4.0 (SLCMEduc4.0). The framework encompasses nine key competency domains: emotional intelligence, leading for learning, digital dexterity, management and administration, entrepreneurial, communication and ethics, decision making and problem solving, collaboration, and critical thinking. By fostering these competencies, middle leaders can create a supportive environment that encourages teachers to embrace technology and effectively integrate it into their teaching practices. The article highlights the importance of developing middle leadership competencies to drive technology acceptance among teachers and ensure the successful implementation of Education 4.0 initiatives in Malaysian schools.

Development of a Novel Evidence-Based Practice-Specific Competency for Doctor of Physical Therapy Students in Clinical Education: A Modified Delphi Approach.

Evidence-based practice (EBP) results in high-quality care and decreases unwarranted variation in practice. Few performance criteria related to EBP are included in physical therapy clinical education (CE) performance measures, despite EBP requirements in Doctor of Physical Therapy education. The purpose of this study was to develop EBP-specific competencies that may be used for Doctor of Physical Therapy students for use throughout CE. Thirteen subject matter experts (SME) participated in this study. Subject matter experts were asked to rank each core EBP competency, from a previously described framework, using a 3-point Likert scale, which included "Not Essential," "Essential," and "Not Sure." A consensus of 70% or greater for the "Essential" rating advanced the competency to the final Delphi round, whereas a consensus of 70% or greater for the "Not Essential" rating was required for competency elimination. Subject matter experts voted to either "Accept" or "Modify" the competencies that had reached the inclusion consensus threshold. All competencies that reached consensus for inclusion after all 3 rounds were included in the final EBP Domain of Competence. Consensus was achieved in round one for 38% (n = 26) of items. In round 2, a consensus was achieved for 20% (n = 8) of items. Of the items remaining after rounds 1 and 2, 6 overarching competencies were identified, and all remaining items served as descriptions and specifications in the final EBP Domain of Competence. The 6 competencies developed from this study constitute the EBP Domain of Competence and may be used throughout CE to assess students' EBP competency in clinical practice.

The healthy, yet unhealthy choice: stereotypes about vegetarians and vegans in a meat-eating culture

Stereotypes about vegetarians and vegans influence behaviour toward these groups and the consumption of animal products. This affects the health and well-being of humans, other animals, and the environment. We studied these stereotypes in a meat-eating culture based on content analysis of open-ended responses in contrast to the more frequently used ad-hoc scales. We also compared the positivity and contents of stereotypes between men and women and between vegetarians/vegans and meat-eaters. We found that stereotypes about vegetarians are ambivalent, while stereotypes about vegans are more clearly negative, both to a greater extent among meat-eaters and among men. The open-ended responses were most frequently related to health, then to moral values, empathy, commitment, and unfavourable social traits. References to masculinity/femininity were not prominent in the spontaneous responses, and neither was the domain of competence. While meat-eaters mainly relate vegetarianism and veganism to health, vegetarians/vegans relate these choices to empathy and moral values. We discuss the implications of the findings for cross-cultural research and shaping public communications.

MANAGEMENT COMPETENCIES AND ORGANIZATIONAL EXCELLENCE OF PUBLIC SECONDARY SCHOOLS OF PANABO CITY DIVISION

The study explored the relationship between management competencies of school heads and organizational excellence. This claim was substantiated. However, this had never been explored specifically in the local setting. With this, the study determined the extent of management competencies of school heads and organizational in public secondary schools of Panabo City Division. Also, it investigated the association of the involved variables and the domains of management competencies of school heads that significantly influenced organizational excellence. With the use of probability sampling, 150 secondary teachers in the public schools were selected as the respondents. Utilizing the descriptive-correlational survey method, the data collated were analyzed through the use of Mean, Product-Moment correlation and Regression Analysis. Results revealed that there was an extensive management competencies of school heads and an extensive organizational excellence. Furthermore, there was a significant relationship between the two variables. Moreover, all domains of management competencies of school heads were found to have significantly influenced organizational excellence. Based on the findings, it was further suggested that higher officials in the Department of Education may identify means on how to help the school heads in strengthening their management competencies to ensure the attainment of organizational excellence. KEYWORDS: Management competencies, organizational excellence, descriptive correlation, Panabo City Division, Philippines

Architectures of Terror

International Relations theory, in spite of having undergone several epistemic iterations, continues to analyze urban warfare via outdated perspectives. This is exemplified in the state-centric analyses that dominate the literature on the history of Israel-Palestine. There is an overwhelming concentration on policy and belligerent behaviors and little to no consideration of anthropocentric perspectives. This results in a near-total exclusion of human suffering from discussions of the conflict and its impacts on everyday civilian life, which in turn heavily alters the socio-political foundations. The academic domains of critical theory and human geography have, however, made good progress in capturing the severity of these discourses, enabling a nuanced understanding of the manner in which conflict management takes place. This paper aims to unify these perspectives and in so doing, expand the grammar of realpolitik – identifying it as a competent domain of IR that primarily focuses on conflict and its modalities. Making use of diffractive reading and analysis, this paper showcases the impact of realpolitik from the perspective of those affected. The aim is to inject empathy into contemporary mainstream discussions that deal with complex geopolitical situations such as Israel-Palestine. To that end, post-structuralist perspectives from continental philosophy, human and critical geography and affect theory are employed. Additionally, the philosophy of realism is theorized to be the epistemic foundation of realpolitik, and is subsequently dissected. The paper concludes by arguing for interdisciplinary approaches into the existing subject matter of realpolitik, a re-evaluation of the epistemic foundations and reflections on practical novelties. Note that this paper in no way aims to suggest political solutions, legal interventions or strategic shifts, but rather interprets the methods of urban warfare used by the Israeli Defense Forces, which defies traditional operational logic.

Differences between resident self-assessments and faculty- assessments on Anesthesiology Milestones and associated factors: a cross-sectional study.

Accurate self-assessment is crucial for the professional development of physicians. There has been sparse data on the accuracy of self-assessments on Anesthesiology Milestones. The aim of this study was to investigate the differences between resident self-assessments and faculty-assessments on Anesthesiology Milestones and the associated factors. This was a cross-sectional study conducted in a general tertiary university-affiliated hospital. We included anesthesia residents who were enrolled in the standardized residency training program in postgraduate year two and three at the time of the Milestone evaluation. We requested evaluations of competencies from both the Clinical Competency Committee faculty and the anesthesia residents themselves, utilizing the Chinese version of Anesthesiology Milestones in January 2023 and January 2024. The primary outcome was the differences between self- and faculty-assessments, calculated by subtracting the faculty-rated score from the self-rated score on each subcompetency. A total of 46 and 42 residents were evaluated in year 2023 and 2024, respectively. The self-rated sum score was significantly higher than that rated by faculty [mean (standardized deviation): 120.39 (32.41) vs. 114.44 (23.71), P = 0.008 in paired t test] with an intraclass correlation coefficient of 0.55 [95% confidence interval (CI): 0.31 to 0.70]. The Bland-Altman plots revealed significant overestimation in patient care (bias 0.32, 95% CI: 0.05 to 0.60), practice-based learning and improvement (bias 0.45, 95% CI: 0.07 to 0.84), and professionalism (bias 0.37, 95% CI: 0.02 to 0.72). Ratings from residents with master's degrees (mean difference: -1.06, 95% CI: -1.80 to -0.32, P = 0.005) and doctorate degrees (mean difference: -1.14, 95% CI: -1.91 to -0.38, P = 0.003) were closer to the faculty-assessments than residents with bachelor's degrees. Compared with patient care, the differences between self- and faculty- rated scores were smaller in medical knowledge (mean difference: -0.18, 95% CI: -0.35 to -0.02, P = 0.031) and interpersonal and communication skills (mean difference: -0.41, 95% CI: -0.64 to -0.19, P < 0.001) in the generalized estimating equation logistic regression model. This study revealed that residents tended to overestimate themselves, emphasizing the need to improve the accuracy of Milestones self-assessment. The differences between self- and faculty-assessments were associated with residents' degrees and domains of competency.

Do biobanks need pharmacists? Support of pharmacy students to biobanking of human biological material for pharmaceutical research and development.

This study aimed to assess the biobank awareness among Polish pharmacy students and how it affects their support for biobank research. A survey among 366 pharmacy students enrolled at two Polish medical universities: the Poznań University of Medical Sciences and Medical University of Lublin was conducted. Although most pharmacy students felt positivity about biobanking and expressed the willingness to donate their biospecimens for biomedical research, their awareness on research biobanks was low. Their willingness to participate was driven by the desire to benefit society, help advance science and develop new therapies. While students supported donation for most types of research, biobanks run by medical universities were the highest trusted research institutions. The primary factors associated with student's willingness to participate were religiosity and place of study. Notably, nonreligious students and those studying in Poznan exhibited more favourable attitudes toward donating for research and expressed greater support for the establishment of research biobanks in Poland. Since biobank awareness among future pharmacists is inadequate incorporating biobank competency domains into education and training of pharmacists is required.

The Evolving Role of Aged Care Managers in Australia: A content analysis of aged care manager job descriptions

The Evolving Role of Aged Care Managers in Australia: A content analysis of aged care manager job descriptions

Future Translators’ Linguistic and Non-linguistic Competencies and Skills in The Age of Neural Machine Translation and Artificial Intelligence: A Content Analysis

Artificial Intelligence (AI) and machine learning (ML) are disrupting the way millions of people work. According to the Future of Jobs Report published by the World Economic Forum (WEF 2022), the Fourth Industrial Revolution will result in the disappearance of more than 75 million jobs by 2025. While this is considered bad news to many, the report also predicts the creation of 133 million jobs for the same reason. Among the at-risk jobs are translation and language services jobs which have witnessed a sharp drop in demand due to the adoption of AI and ML technologies in machine translation systems making them capable of producing translations that match the translations produced by expert human translators. Using content analysis method of online translation job advertisements in Saudi Arabia, this study sheds light on the current in-demand translator linguistic and non-linguistic competences and skills from the perspective of employers and matches those with the well-established translator competence models in literature. Through a content analysis of 213 online job advertisements, the study identifies five key competency domains: Language and Culture, Personal and Interpersonal, Service Provision, Technology, and Translation Knowledge. While language proficiency remains crucial, there is a growing emphasis on "soft skills," project management, technological adaptability, and ethical practice. The findings reveal a partial alignment with existing competency models but also highlight potential gaps, particularly regarding strategic planning and document analysis skills. The study underscores the need for translator education to adapt to the evolving demands of the industry, integrating traditional skills with emerging technologies and fostering a culture of lifelong learning. By bridging the gap between academic training and industry expectations, we can better equip future translators to navigate the complexities of the profession and thrive in the age of Neural Machine Translation and AI.

Comparing the effects of patient safety education using design thinking and case based learning on nursing students’ competence and professional socialization: A quasi-experimental design

BackgroundPatient safety issues should be constantly monitored and sensitively recognized. In nursing education, it is necessary to find effective teaching methods to increase students' competencies in patient safety. ObjectivesThis study aimed to compare the effectiveness of a new method, design thinking (DT), and a traditional method, case-based learning (CBL), in patient safety education. DesignThis study used a quasi-experimental, pre-post control group design. SettingsA 30-h training tutorial was developed for intervention groups, DT and CBL, while the control group received no treatment. ParticipantsIn this study were junior nursing students receiving baccalaureate nursing education with experiences of at least 480-h clinical practice. A total of 53 students (21 in the DT group, 19 in the CBL group, and 13 in the control group) were recruited. MethodsClinical reasoning competency, patient safety competency, and professional socialization were measured immediately after the end of the educational program using DT and CBL, 4 weeks later, and 8 weeks later. Effects of DT and CBL were analyzed using a generalized estimating equation. ResultsBoth DT and CBL were effective in clinical reasoning competency (χ2 = 15.432, p = 0.017) and knowledge domain of patient safety competency (χ2 = 42.824, p < 0.001), showing no significant difference between the two. CBL was more effective in professional socialization than DT. ConclusionsDT was as effective as CBL in clinical reasoning competency and knowledge domain of patient safety competency. In the healthcare field, where improving the patient experience is becoming increasingly important, DT is worth applying as an educational method to train nursing students who can take a creative and human-centered problem-solving approach. It is expected that educational curricula utilizing DT will be developed not only in the field of patient safety but also in various patient care areas.

Analyse systématique des évaluations de circuits multiples d’examen clinique objectif structuré (ECOS) : variables explicatives et corrélations inter-évaluateurs

IntroductionObjective Structured Clinical Examinations (OSCEs) assess professional performance in a simulated environment. Following their integration into the reform of the 2nd cycle of medical studies (R2C), this pedagogical modality was implemented in France. This study investigates the variability of students’ OSCE scores, as well as their inter-rater reproducibility. MethodsThis single-center retrospective study covered several sessions of evaluative OSCE circuits conducted between January 2022 and June 2023. Variables collected were: baseline situation family, competency domain, presence of a standardized participant for stations; gender and professional status for evaluators; scores (global, clinical and communication skills), number of previously completed OSCE circuits and faculty scores for students. ResultsThe variability of the overall score was explained mainly (79.7%, CI95% [77.4; 82.0]) by the station factor. The student factor and the circuit factor explained 7.5% [12.9; 20.2] and<0.01% [2.10-13; 2.10-9] respectively. The inter-rater intra-class correlation coefficient was 87.2% [86.4; 87.9] for the global score. Station characteristics (starting situation, domain) and evaluator characteristics (gender, status) were significantly associated with score variations. ConclusionThis first study on the variability of OSCE circuit scores in France shows good reproducibility with influence of station characteristics. In order to standardize circuits, variability linked to the domain competency should be considered as well.

A Smartphone App to Support Self-Management for People Living With Sjögren's Syndrome: Qualitative Co-Design Workshops.

Sjögren's syndrome (SS) is the second most common autoimmune rheumatic disease, and the range of symptoms includes fatigue, dryness, sleep disturbances, and pain. Smartphone apps may help deliver a variety of cognitive and behavioral techniques to support self-management in SS. However, app-based interventions must be carefully designed to promote engagement and motivate behavior change. We aimed to explore self-management approaches and challenges experienced by people living with SS and produce a corresponding set of design recommendations that inform the design of an engaging, motivating, and evidence-based self-management app for those living with SS. We conducted a series of 8 co-design workshops and an additional 3 interviews with participants who were unable to attend a workshop. These were audio recorded, transcribed, and initially thematically analyzed using an inductive approach. Then, the themes were mapped to the Self-Determination Theory domains of competency, autonomy, and relatedness. Participants experienced a considerable demand in the daily work required in self-managing their SS. The condition demanded unrelenting, fluctuating, and unpredictable mental, physical, and social efforts. Participants used a wide variety of techniques to self-manage their symptoms; however, their sense of competency was undermined by the complexity and interconnected nature of their symptoms and affected by interactions with others. The daily contexts in which this labor was occurring revealed ample opportunities to use digital health aids. The lived experience of participants showed that the constructs of competency, autonomy, and relatedness existed in a complex equilibrium with each other. Sometimes, they were disrupted by tensions, whereas on other occasions, they worked together harmoniously. An SS self-management app needs to recognize the complexity and overlap of symptoms and the complexities of managing the condition in daily life. Identifying techniques that target several symptoms simultaneously may prevent users from becoming overwhelmed. Including techniques that support assertiveness and communication with others about the condition, its symptoms, and users' limitations may support users in their interactions with others and improve engagement in symptom management strategies.For digital health aids (such as self-management apps) to provide meaningful support, they should be designed according to human needs such as competence, autonomy, and relatedness. However, the complexities among the 3 Self-Determination Theory constructs should be carefully considered, as they present both design difficulties and opportunities.