Education Of Healthcare Professionals Research Articles

Protocol for leading health services innovation: a hybrid type 2 mixed method implementation trial for developing and assessing a codesigned graduate certificate program in health innovation

BackgroundA significant issue with innovative problem-solving in healthcare is an existing deficiency in continuing education for many healthcare professionals, which hinders the successful implementation of inventive solutions and progress in the field. Educators play a crucial role in guiding students to cultivate the knowledge and skills necessary to confront these challenges, including problem solving, collaboration, and the use of rapidly advancing technologies. It is vital to design educational programs that empower and motivate students to develop the proficiency and knowledge they need to be effective problem solvers, collaborators, and cultivators of innovative solutions. This project aims to assess the implementation and effectiveness of a codesigned postgraduate university program for a multidisciplinary health workforce.MethodsThe Leading Health Services Innovation Project is a hybrid type 2 mixed method implementation trial of a codesigned Graduate Certificate in Health Services Innovation. In collaboration with a large tertiary and quaternary health service, we developed a codesign process to guide the project, with time quarantined to create space for two-way learning between health sector partners and healthcare academics. Qualitative interviews and quantitative surveys for primary users will evaluate the implementation strategies. The reach, effectiveness, adoption implementation, and maintenance (RE-AIM) framework will guide the evaluation and maintenance of the program.ResultsIntegrating a codesign strategy complemented by a well-structured implementation and evaluation protocol that is a combination of implementation science theoretical frameworks (Knowledge to Action, Evidence-Based Co-design, RE-AIM) may lead to translational competence as a potential outcome.Anticipated outcomesThe application, resourcing and commitment to codesigned tertiary-level learning and qualification will demonstrate the achievement of a contemporary and comprehensive postgraduate university degree program in health innovation management.

An alcohol-related liver disease multi-stakeholder hub (ARMS-Hub) to enhance research activity in underserved communities in the UK

Background Alcohol use is the third leading risk factor of death and disability in the UK and costs the NHS £3.5 billion per year. Despite the high prevalence and healthcare burden of Alcohol-related Liver Disease (ArLD), there has been minimal research addressing prevention, morbidity and mortality. Reasons for this include stigma and lack of interest from public, charitable and commercial funding bodies. The objectives of this project were to identify and develop interdisciplinary partnerships, to explore stigma in ArLD, to develop a representative Patient and Public Involvement and Engagement (PPIE) group, to build research capacity, and to develop interdisciplinary research proposals targeting key research priorities. Methods ArLD networks were identified by members of the Project Steering Group. Health Care Professionals (HCPs) from different backgrounds were invited to join the ARMS-Hub. PPIE representatives were invited through charities and support groups. Research areas were identified, discussed, prioritised and ranked. Research questions were refined during an in-person symposium. A mentorship programme was created to encourage and facilitate networking and knowledge exchange for early career researchers. Results We established the ARMS-Hub with 31 HCPs and 40 PPIE members. There were five stakeholder meetings, which included PPIE representation. Three virtual and three in-person PPIE meetings took place. Topics relevant to stigma in ARLD identified during the meetings were education and awareness, language, and access. Priorities identified were the disconnect between mental health and liver services, education around the wider harms of alcohol, and education of HCPs regarding stigma. We established a mentorship network that regularly meets to support development of new research ideas. Conclusions Stigma is central to lack of research engagement from professionals and PPIE. The main priority identified relates to the disconnect between mental health and liver services. This collaborative study has allowed development of a research agenda to address this priority.

From the first European Climate Risk Assessment to action in policy and practice

Abstract The first European Climate Risk Assessment (EUCRA), produced by the European Environment Agency in March 2024, engaging nearly 100 authors across Europe, highlights health among the most at-risk sectors. According to the structured risk assessment that was conducted to support the transparent identification of priorities for policy action, more and urgent action is needed to reduce health risks from heat indoors and outdoors; from wildfires and outbreaks of vector- and water-borne diseases. The responsibility for managing risks lies both with the EU and Member States, and the policy readiness varies depending on the risk. The European Climate and Health Observatory, set up to better understand, anticipate and prevent climate risks to human health in Europe, in the most recent report ‘Responding to climate change impacts on human health in Europe: focus on floods, droughts and water quality’ provides in-depth analyses of some climate-related risks to health and presents examples of responses to them in both policy and practice. Both assessments emphasise that without fast and systemic action to increase societal resilience, the health impacts of the changing climate will worsen, affecting already disadvantaged or vulnerable groups the most. Health and health-determining sectors have the opportunity to address the health impacts of climate change by, among others, increasing the climate resilience of health systems; developing, updating and implementing national health adaptation plans; and supporting the education and training of public health and healthcare professionals on climate change threats. At the same time, addressing health impacts from climate extremes requires responses across sectors, actors and spatial scales.

Patients’ experiences of racism in German inpatient healthcare

Abstract Background Racism is recognised as a social determinant of health. An evolving concern in research and policymaking has been the impact of racism in the healthcare system, particularly regarding the quality of healthcare and barriers for healthcare. Little is known about patients’ experiences of racism in hospitals and rehabilitation facilities in Germany and their coping strategies in dealing with racism. Methods As part of a joint project on racism in healthcare (RiGeV) funded by the Federal Ministry of Education and Research, twenty qualitative interviews and two group discussions with patients and their next of kin about their experiences in hospitals and rehabilitation facilities were conducted and analysed using the documentary method. Ethical approval for this study was obtained from the Ethics Committee of Fulda University of Applied Sciences. Results Interviews with patients and their next of kin revealed that the most significant experiences of racism in hospitals are attributions of dramatisation and exaggeration of pain, embedded in a general perception of not being taken seriously and/or being ignored. Patients try to avoid such experiences that compromise their trust and sense of security, as well as the quality of treatment they receive. Healthcare for refugees is impacted by structural barriers (AsylBLg) which jeopardise the healing process and represent a considerable psychosocial burden. Conclusions Recommendations for policies and practice include a mission statement for non-discriminatory treatment and the sanctioning of racism within healthcare institutions. A complaints office should manage implementation and offer support for affected patients. The topic of racism must be addressed in the training and further education of doctors and healthcare professionals. Patient trust in a safe and high-quality form of healthcare should be strengthened by addressing their complaints. Health care for refugees has to be improved. Key messages • Racism in German inpatient healthcare represents a considerable psychosocial burden for patients and impairs the quality of treatment they receive. • Policies for reducing racism inpatient healthcare have to be implemented.

Leadership opportunities to mitigate challenges and barriers of precision health

Abstract Background Precision health, encompassing personalized and proactive health solutions, aims to address this gap by integrating genetic, behavioral, and environmental factors. However, challenges persist in its integration, necessitating new healthcare competencies, particularly in leadership, to expedite the transition. Our goal is to identify barriers and solutions for the implementation of precision health and build a core curriculum of leadership competencies to mitigate challenges and barriers for the implementation of precision health. Methods A systematic literature review of qualitative primary studies on barriers and facilitators to precision health implementation was conducted. Data extracted from included articles were analyzed thematically, adapting leadership competencies outlined in the CanMEDS Physician Competency Framework. This approach identified key leadership traits crucial for precision health implementation. Results 51 articles meeting inclusion criteria yielded 985 barriers and facilitators. Thematic analysis identified 9 primary leadership competencies essential for precision health implementation: application of quality improvement science (30%); fostering a culture of patient safety in data use (10%); advocacy for innovative data management (4%); resource allocation advocacy (9%); evidence-based cost management (4%); driving practice change (8%); prioritization and time management (11%); and optimization of healthcare workforce practices (14%). Discussion The synthesized leadership competencies provide a useful framework for addressing barriers and fostering precision health implementation among healthcare professionals. The high representation of competency related to quality improvement science is emblematic of how cultural elements specific to leadership and management in medicine could represent a strategic asset to foster the implementation of innovative solutions, like precision health, in healthcare. Key messages • Leadership skills are a crucial element in the curriculum of health professionals to support the implementation of precision health in clinical practice. • Incorporating elements of ‘quality improvement science’ in the healthcare professionals education emerged as essential to foster precision health implementation.

Understanding barriers and facilitators to lifestyle management in people with polycystic ovary syndrome: A mixed method systematic review.

Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting 10-13% of reproductive-aged women. Lifestyle management through diet and physical activity changes can improve reproductive, metabolic, and psychological comorbidities. The aim of this systematic review is to understand the barriers and facilitators to lifestyle changes from the perspective of people with PCOS and health care professionals (HCP) using the theoretical domains framework and capability, opportunity, motivation, and behavior model. Six databases were systematically searched for qualitative, quantitative, and mixed-methods studies to 22nd September 2022. Quantitative outcomes from quantitative and mixed-methods studies were narratively synthesized and all studies were thematically analyzed. Sixty-eight papers met the eligibility criteria. HCP education on lifestyle management in PCOS was viewed by all to be inadequate, impacting the quality of care and health outcomes. Lifestyle advice delivered by a multidisciplinary team, including dietitians, was identified as a key component for change. All agreed that there was a need for individualized and PCOS-specific lifestyle advice. Weight stigma was identified as negatively impacting both those in larger and smaller bodies with PCOS, reducing the quality of care and affecting self-perception and mental health. People with PCOS perceived that lifestyle management was overly focused on weight loss and fertility, independent of their own personal motivations and goals. Systemic changes, including increasing HCP education on lifestyle management and multidisciplinary collaboration, focusing on lifestyle advice that meets individual needs, and reducing the use of weight-centric care are necessary for long-term sustainable changes and improvements in health outcomes in people with PCOS.

Recovering Hope and a Sense of Agency Through Transformative Education for Internationally Educated Healthcare Professionals in Canada

This study examines the outcomes of transformative education in the program Fostering Canadian Integration for IEHPs: From Learning to Action, created to accompany internationally educated health professionals (IEHPs) in the difficult journey to find fair professional employment in Canada. It shows the importance of self-reflection, a learning community and a welcoming, participatory approach to learning that led to cognitive, emotional and conative transformation for participants. Increased self-awareness of their life journey and emotional patterns, together with critical understanding of their worldviews and new reality supported the participants in the recovery of hope and a sense of agency.

A Survey of Surrogates and Health Care Professionals Indicates Support of Cognitive Motor Dissociation-Assisted Prognostication.

Prognostication of patients with acute disorders of consciousness is imprecise but more accurate technology-supported predictions, such as cognitive motor dissociation (CMD), are emerging. CMD refers to the detection of willful brain activation following motor commands using functional magnetic resonance imaging or machine learning-supported analysis of the electroencephalogram in clinically unresponsive patients. CMD is associated with long-term recovery, but acceptance by surrogates and health care professionals is uncertain. The objective of this study was to determine receptiveness for CMD to inform goals of care (GoC) decisions and research participation among health care professionals and surrogates of behaviorally unresponsive patients. This was a two-center study of surrogates of and health care professionals caring for unconscious patients with severe neurological injury who were enrolled in two prospective US-based studies. Participants completed a 13-item survey to assess demographics, religiosity, minimal acceptable level of recovery, enthusiasm for research participation, and receptiveness for CMD to support GoC decisions. Completed surveys were obtained from 196 participants (133 health care professionals and 63 surrogates). Across all respondents, 93% indicated that they would want their loved one or the patient they cared for to participate in a research study that supports recovery of consciousness if CMD were detected, compared to 58% if CMD were not detected. Health care professionals were more likely than surrogates to change GoC with a positive (78% vs. 59%, p = 0.005) or negative (83% vs. 59%, p = 0.0002) CMD result. Participants who reported religion was the most important part of their life were least likely to change GoC with or without CMD. Participants who identified as Black (odds ratio [OR] 0.12, 95% confidence interval [CI] 0.04-0.36) or Hispanic/Latino (OR 0.39, 95% CI 0.2-0.75) and those for whom religion was the most important part of their life (OR 0.18, 95% CI 0.05-0.64) were more likely to accept a lower minimum level of recovery. Technology-supported prognostication and enthusiasm for clinical trial participation was supported across a diverse spectrum of health care professionals and surrogate decision-makers. Education for surrogates and health care professionals should accompany integration of technology-supported prognostication.

She said, “Really, you’re just going to have to suffer through it”: The lack of discussion of perimenopause between women and healthcare professionals

Perimenopausal symptoms adversely impacting women’s sexual health are often unacknowledged or even dismissed by healthcare professionals (HCP). Using semi-structured interviews with 23 women experiencing perimenopause, we aimed to understand how HCPs address women’s sexual health needs and concerns during this transition. Thematic data analysis was employed with the reduction of data into themes. Several major themes were identified concerning participants’ experiences with a HCP and sexual health, including insufficient sexual health information and preventative education; the lack of open discussion about sexual health; the need for enhanced support and treatment options; feeling dismissed by a healthcare professional; and sexual pleasure not addressed by healthcare professionals. Additionally, women expressed concerns regarding medical education and training in healthcare professionals on approaching sexual health conversations. There appears to be a need for more formal training, both within medical school and continuing medical education (CME), to address these important aspects of women’s sexual and reproductive health.

Development, dissemination and survey evaluation of layered education for healthcare professionals to support implementation of firearm injury and mortality prevention strategies in emergency care settings, New York, USA

BackgroundThere is consensus on the need and ability to address firearm injury risk in healthcare settings; however, the lack of education for healthcare professionals hinders the implementation of evidence-based firearm...

Investigating the capabilities of advanced large language models in generating patient instructions and patient educational material

ObjectivesLarge language models (LLMs) with advanced language generation capabilities have the potential to enhance patient interactions. This study evaluates the effectiveness of ChatGPT 4.0 and Gemini 1.0 Pro in providing...

Spinal muscular atrophy carrier screening program: awareness and attitude of healthcare professionals in Turkey.

Spinal Muscular Atrophy (SMA) is an autosomal recessive disease caused by variants in the SMN1 gene, leading to progressive muscle weakness. The carrier frequency of SMN1 gene variants, including variant and copy number variations, is estimated to be around 1 in 50 people, while the global prevalence of SMA is 1-3 per 10,000 live births. In response to the increasing carrier proportion, especially due to consanguineous marriages, Turkey launched the SMA Carrier Screening Program in 2021. Notably, recent SMA cases have been observed in the children of healthcare workers who did not undergo carrier screening, prompting us to evaluate their awareness of this program. After receiving ethics approval, 1,322 healthcare professionals completed a 15-item survey based on the SMA Carrier Screening Guidelines. Of these, 5.8% were unaware of SMA, and 26% lacked information about the national screening program. Awareness of the screening program was significantly lower among secondary and tertiary healthcare professionals compared to primary healthcare professionals (p < 0.0001) and among non-physician healthcare professionals compared to physicians (p < 0.0001). Additionally, a serious lack of knowledge was observed concerning the parts of the screening covering the pregnancy period. Although there is generally high awareness of the SMA Carrier Screening Program among healthcare professionals, significant knowledge gaps exist. These findings highlight the need for increased efforts to more effectively deliver screening programs and continue the education of healthcare professionals. Education and awareness campaigns can enhance program awareness and effectiveness, reach wider audiences, and contribute to preventive measures for the health of future generations.

Using Film to Explore Ideas with University Students Around Intergenerational Social Connection

ABSTRACT Intergenerational connection (IC) has been posited to mitigate the effects of social isolation and loneliness in older people. Using the film Manawaroa: Still Going Strong, we explored nursing and health sciences’ students’ views about IC, considering themes of loneliness and social connectedness among older people in Aotearoa New Zealand. Thirteen students participated in four online focus groups and data was analyzed using thematic analysis. Four themes included: 1) benefits of IC, 2) barriers to IC, and 3) ways to promote IC and 4) broader discourses affecting IC, which describes underlying discourses around who is considered “old” and who is responsible for IC. Participants concurred IC was beneficial for both older and younger generations. We identified the need for IC education for healthcare professionals to challenge societal prejudices they have absorbed and indicated the importance of promoting IC to also increase social cohesion.

Factors associated with acute kidney injury and outcomes in patients with malaria in a district hospital in Rwanda

Introduction: Acute kidney injury (AKI) remains one of the complications of severe malaria. Evidence on associated factors and outcomes for patients with complicated malaria and AKI is limited in Rwanda. Aim: To assess the factors associated with acute kidney injury and outcomes in patients with malaria in a district hospital in Rwanda. Method: A retrospective study design was applied. A census sampling strategy was used to select 122 files of patients admitted as severe malaria patients in 2016- 2017. A developed clinical audit form was used to collect data from patients’ files. Both descriptive and inferential statistics were used to analyze data. Results: Among the confirmed severe malaria files, 44% of participants were over 50 years and 52.5% were males. The majority, (91.5%) had community-based health insurance and 16.3% had acute kidney injury. The significant associated clinical factors were dehydration (p=.01), high-grade fever (p=.002), profuse sweating (p=.034), vomiting (p=.043), and diarrhea (p=.025). Of the 20 patients who developed AKI, 55% completely recovered, 15% died and 30% of cases were transferred to the highest facilities for hemodialysis. Conclusion: The existence of AKI among severe malaria patients was evident with some recovering and others dying. There is a need for educating healthcare professionals, mostly at district hospitals about the diagnosis and management of AKI as a result of complicated malaria. Keywords: Acute kidney injury; severe malaria; complications of malaria.

Attitudes towards Maternal Immunisation of Polish Mothers: A Cross-Sectional, Non-Representative Study.

Vaccination protects pregnant women against dangerous infectious diseases and contributes to disease prevention for the child until their vaccination schedule begins. Vaccination behaviour is related to attitudes concerning vaccine prevention. This cross-sectional, non-representative study was conducted among Polish mothers using a diagnostic survey. We used the Vaccination Attitudes Examination (VAX) Scale. The author's questionnaire included questions concerning experiences with adult and maternal vaccinations, as well as sociodemographic data. Among the 375 respondents, more than half (n = 208, 55.47%) received at least one vaccine during pregnancy. The majority of respondents had a university education (n = 356, 94.93%). There was no statistically significant difference in terms of receiving vaccines during pregnancy between respondents with and without a healthcare education (p = 0.230). A logistic regression model indicated that women who were vaccinated outside pregnancy for COVID-19 (OR 4.61, 2.60-8.22) and influenza (OR 7.14, 3.58-14.25) were statistically significantly more likely to be vaccinated during pregnancy. There were statistically significant differences between women who were vaccinated during pregnancy and those who did not receive maternal immunisation in three subscales of the VAX Scale: Mistrust of Vaccine Benefit, Concerns about Commercial Profiteering, and Preference for Natural Immunity (p < 0.001). The most frequently indicated reason for a woman's decision to be vaccinated was concern for the health and safety of the unborn child (n = 196, 94.23%). In contrast, women who were not vaccinated reported fear for the health and safety of the unborn child (n = 88, 52.69%). A key point may be to contribute to the vaccinology education of healthcare professionals, who play an important role in pregnant women's decision to be vaccinated. However, our results may be disrupted because the majority of the women in our study had a university education.

Women's experiences of vaginal examinations in labour: a literature review

Background/Aims Evidence for vaginal examinations to assess labour progress is inconclusive and indicates some negative psychological impacts for women. Understanding women's perceptions of vaginal examinations is essential to guide future clinical practice. This literature review aimed to explore women's experiences of vaginal examinations in labour. Methods A comprehensive review of four databases was carried out, searching for publications made between 2012 and 2023. Findings were synthesised using thematic analysis. Results Eight relevant papers were included. Four themes emerged: frequency of vaginal examinations, true, informed consent, emotional reactions and rapport building and humanisation. Conclusions Negative experiences were associated with overuse and lack of properly informed consent. Positive experiences linked to continuity in carer. Further research into alternative ways of assessing labour progression to minimise non-clinically indicated vaginal examinations may improve women's labour experience. Implications for practice There is a need for further education for healthcare professionals on ongoing informed consent, appropriate communication, the necessary frequency of vaginal examinations and avoiding desensitisation. Additional training should be well-established in hospitals to minimise exams when not clinically indicated.

Australian women’s experiences and perceptions of interconception care: a qualitative descriptive study

BackgroundInterconception, the time between pregnancies, is an opportunity to improve the health outcomes of women, infants and subsequent pregnancies. Interconception care involves the assessment of previous pregnancy outcomes, management of...

Developing empathy in healthcare professions students: protocol of a mixed-methods non-controlled longitudinal intervention study.

Despite the necessary focus on clinical skills and knowledge during the tertiary education of healthcare professionals, the literature highlights the importance of developing psycho-social competencies. Empathy, a cognitive-behavioral attribute linked to various benefits for patients and healthcare professionals, is one such competency. Pedagogical approaches to successfully develop empathy in tertiary healthcare students are available. However, these approaches are often integrated piecemeal throughout the tertiary education journey. Research on a more empathy-focused curriculum is scarce. This manuscript describes the design of a study that aims to examine the effects of a more empathy-focused curriculum on empathy in tertiary healthcare profession students in Singapore. Freshmen dentistry, medicine, nursing, and pharmacy students enrolled in a novel curriculum with a strong empathy focus will be recruited for the study and followed for the program's extent. Mixed-methods data collection at various time points will be conducted. Quantitative data will be collected on cognitive-behavioral empathy, intentions to provide empathic care, and engagement in courses of the curriculum. Qualitative data on perceptions of patient care and empathy in relation to relevant courses of the curriculum will be collected to provide context for quantitative findings. Ethics approval was granted by the Departmental Ethics Review Committee of the Saw Swee Hock School of Public Health, National University of Singapore (Ethics ID: SSHSPH-214).

Assessing healthcare professionals' knowledge of the therapeutic applications of marine products

This cross-sectional study examines the therapeutic applications of marine products in Algeria and their impact on human health. Based on a survey of healthcare professionals, using a questionnaire validated by experts in pharmacognosy and pharmacology, the study gathered 130 responses in four months, mainly from pharmacists. The results reveal a good knowledge of marine products among the majority of participants, but underline the need to reinforce expert training, improve education of healthcare professionals, raise public awareness, and put in place strict regulations to guarantee the quality and efficacy of these products in a therapeutic setting.

Frailty Assessment and Management: A Qualitative Study of the Educational and Training Experiences of Postgraduate Doctors

Abstract Background Understanding and addressing frailty, a complex syndrome commonly found in older adults, demands a deep understanding and proficiency across various health domains. Existing research indicates a disparity between medical education and the hands-on management of frailty in practice. There is a scarcity of research on the educational requirements of postgraduate doctors in caring for frail patients. Methods Qualitative semi-structured interviews were conducted with post-internship doctors working in an AMU, using transcripts to analyse themes. The focus was on frailty conceptualisation, educational training, and clinical experience. Results Several themes were noted, particularly the lack of focus and variation on frailty teaching in undergraduate curriculums. This, coupled with limited hands-on experience, an emphasis on acute care over chronic management, inadequate multidisciplinary training, and a need for more structured education on frailty assessment tools, underscores the need for ongoing education and support. Many interviewees shared their experiences of being well-equipped to handle acute medical emergencies, demonstrating the effectiveness of their current medical education. However, they also pointed out that this preparation did not adequately equip them for the ongoing, multidimensional care that frail patients require. Several interviewees stressed the role of continued education and support for healthcare professionals managing frailty, suggesting ongoing professional development opportunities could effectively bridge the gap between initial medical education and the evolving demands of clinical practice. The potential of mentorship from experienced geriatricians adds invaluable guidance for early career doctors. Conclusion This qualitative study underscores a significant gap between medical education and the practical management of frailty. Addressing this gap requires a multifaceted approach that integrates frailty-focused content into undergraduate curricula, provides hands-on experience, fosters multidisciplinary collaboration, and offers ongoing professional development. By enhancing frailty education and training, healthcare systems can improve the quality of care for this vulnerable population, leading to better patient outcomes and more efficient use of resources.