Education Of Healthcare Professionals Research Articles

Evaluation of the knowledge of and attitudes towards pharmacovigilance among healthcare students in China: a cross-sectional study

BackgroundKnowledge of pharmacovigilance (PV) and adverse drug reactions (ADRs) are the core competencies that healthcare students should acquire during their studies. The objective of this study was to assess attitudes towards and knowledge of PV and ADRs among healthcare students in China.MethodsAn online, cross-sectional survey was conducted nationally among healthcare students in China from April through October 2023. Knowledge of PV and ADRs was assessed using a questionnaire based on current PV guidelines. We performed logistic regression analysis to determine the potential factors related to knowledge of and attitudes towards PV and ADRs.ResultsA total of 345 students were included in the analysis. Among the healthcare students who participated in the survey, 225 (65.22%) students correctly defined PV, while only 68 (19.71%) had a correct understanding of ADRs. Among all respondents included in the analysis, only 71 (20.58%) reported having taken a PV course. Pharmacy students were more likely to have taken PV courses at a university and to demonstrate superior knowledge compared to other healthcare students. The logistic regression model revealed that the significant predictors of a higher level of PV knowledge were being female (odds ratio [OR]: 1.76; 95% confidence interval (CI): 1.06–2.92; P value: 0.028) and having previously taken PV-related courses (OR: 2.00; 95% CI: 1.06–3.80; P value: 0.034).ConclusionsThis study revealed that healthcare students’ knowledge of PV and ADRs is unsatisfactory. However, there were a limited number of universities providing PV education. Given the vital role of healthcare professionals in identifying and reporting ADRs, our findings raise significant concerns. Hence, more efforts should be made to enhance PV education for future healthcare professionals.

Medical students', residents', and nurses's feedback to clinical educators in Taiwan: A qualitative study.

Feedback is a crucial element in learning. While studies in the field of healthcare professions education have highlighted the process of educators feeding back to learners, relatively little investigation exists on learners feeding back to educators in Asian cultures. Studies show that recipients of effective feedback develop educational skills and reflective practice, but the process of giving feedback seems to have been mainly studied through surveys and questionnaires. Such research offers little to no insights on feedback providers' and recipients' experiences of feedback. To fill the gap, in the context of multi-source feedback, we investigate medical students, residents, and nurses feedback giving to clinical educators (and their receiving of this) following a case presentation training course. We aim to understand the facilitators and inhibitors that encourage and/or prevent feedback provision alongside educators' uptake and reactions. We used semi-structured group interviews. Participants comprised five different categories of participants: year-4 medical students (n = 6); residents (n = 5); nurses (n = 4); junior clinical educators (n = 9); senior clinical educators (n = 3). We asked them about their experiences of providing feedback to educators and educators receiving of feedback on their teaching. Group interviews were conducted in the largest healthcare institution in Taiwan. Data were analysed using thematic Framework Analysis and managed in ATLAS.ti 8.0. We identified two major themes with respective sub-themes: (1) Factors affecting feedback giving (including desire for improvement, feedback content, process of feedback, feedback fears, feedback prevention and medical hierarchy); and (2) Educators' reactions to receiving feedback (including validity of feedback, face-saving and emotional reactions to receiving feedback). Feedback provision to educators on their teaching, and educators' receiving of this feedback in an Asian culture brings forth issues around medical hierarchy, in-person feedback and face-saving, which have important implications for effective and optimal delivery of feedback. Curricular developers should consider the context of feedback (e.g. anonymously online), facilitating students as active participants for the development of educational quality, and educators' mindful practice when engaging with student feedback.

COPD Self-Management: A Patient-Physician Perspective.

This article is co-authored by five patients living with chronic obstructive pulmonary disease (COPD), and a primary care physician who has over 30 years of clinical experience and is involved in educating healthcare professionals. The first section of this article is authored by the patients, who describe their experiences of living with COPD. The section that follows is authored by the physician, who discusses the management of COPD in the context of the patients' experiences.

Can on-line gait training improve clinical practice? Study protocol for feasibility randomised controlled trial of an on-line educational intervention to improve clinician’s gait-related decision-making in ambulant children and young people with cerebral palsy

BackgroundInstrumented gait analysis (IGA) is an assessment and research tool with proven impacts on clinical decision-making for the management of ambulant children and young people with cerebral palsy (CYPwCP) but is underused and variably understood by relevant clinicians. Clinicians’ difficulties in gaining expertise and confidence in using IGA are multifactorial and related to access for clinical decision-making, limited training opportunities and inability to translate this training into clinical practice.MethodsThe primary aim of this study is to test the feasibility of an educational intervention to advance clinicians’ application of gait analysis in CYPwCP, to inform a definitive trial. The secondary aim is to measure the effect that appropriate IGA training has on physiotherapists’ knowledge, skills, confidence and behaviours. This will be a two-arm feasibility randomised controlled trial with an experimental and control group. The 6-week on-line intervention uses a multicomponent approach grounded in behavioural change techniques. A repeated measures design will be adopted, whereby participants will complete outcome measures at baseline, immediately after the intervention and at 4 months. The primary outcome measures (trial feasibility-related outcomes) are recruitment and engagement. The secondary outcome measures (trial research-related outcomes) are knowledge, skills, confidence and practice change. Outcome measures will be collected via online questionnaires and during observed skill assessments. Analysis of data will use descriptive statistics, two-way mixed ANOVA model and qualitative content analysis.DiscussionThis study will determine feasibility of the definitive randomised control trial of educational intervention delivered to advance clinicians’ application of gait analysis in CYPwCP. This study offers the shift in emphasis from regarding IGA as a tool to a focus on clinicians’ requirements for access, training and a well-defined role to optimise utilisation of IGA. The impact of this should be better engagement with IGA and clinical practice change. This study will contribute to a body of educational research into clinical education of healthcare professionals and IGA training offering insight into high levels of evaluation evidence including clinical behaviour change.Trial registrationProtocol has been registered with the Open Science Framework (osf.io/nweq6) in June 2023.

UTILIZING DIGITAL COMPETENCES FOR THE DEVELOPMENT OF LEADERSHIP AND MANAGEMENT POTENTIAL IN HIGHER MEDICAL EDUCATION STUDENTS

Introduction. Building a robust healthcare system aimed at improving overall population health and a reliable electronic health system requires a corresponding level of proficiency in digital competences (DC) among future healthcare professionals. The relevance of this research lies in the understanding that the effective execution of medical and managerial responsibilities is impossible without an adequate level of DC, and mastering them must occur during the education of future healthcare professionals. The aim. To investigate the levels of proficiency in DC and the understanding of their importance among students enrolled in institutions of higher medical education (IHME) for the development of leadership and management potential during the educational process of future healthcare professionals. Materials and methods. A cross-sectional study was conducted among 265 students (1st-6th years) at Dnipro State Medical University. Bibliosemantic and sociological methods were used. Students were grouped by academic year: junior (1-2), middle (3-4), and senior (5-6). Results were analyzed using widely accepted statistical approaches and the integrated development environment Jupyter Notebook (https://jupyter.org/install). A significance level of p<0.05 was considered statistically significant for all hypotheses. Results. According to the obtained data all students, regardless of their academic year, understand the importance of studying digital competences. On average, the overall importance level for all DC was 6.99 (95% CI 6.72-7.26) on a ten-point scale. Proficiency in DC significantly (p=0.002) varied depending on the academic year, with seniors scoring higher than middle (in all aspects) and junior students (for most aspects). No significant differences were found between the proficiency levels of junior and middle students (p>0.05). Proficiency in general DC was significantly higher compared to special medical and cybersecurity DC, both within each group and for all respondents. More than 80% of respondents stated that mastering DC is important for performing managerial functions, with no differences between groups (p>0.05). Conclusions. Present-day healthcare professionals require a proper level of proficiency in DC. The study demonstrates that students' motivation to learn DC is more than sufficient, but proficiency in special medical and cybersecurity DC needs improvement. The majority of respondents consider mastering DC an integral element in the formation of health-oriented leadership and effective management in healthcare. Mastering of DC should occur systematically with active involvement of IHME in the process.

Status and perception of point-of-care ultrasound education in Korean medical schools: A national cross-sectional study.

As point-of-care ultrasound (POCUS) is increasingly being used in clinical settings, ultrasound education is expanding into student curricula. We aimed to determine the status and awareness of POCUS education in Korean medical schools using a nationwide cross-sectional survey. In October 2021, a survey questionnaire consisting of 20 questions was distributed via e-mail to professors in the emergency medicine (EM) departments of Korean medical schools. The questionnaire encompassed 19 multiple-choice questions covering demographics, current education, perceptions, and barriers, and the final question was an open-ended inquiry seeking suggestions for POCUS education. All EM departments of the 40 medical schools responded, of which only 13 (33%) reported providing POCUS education. The implementation of POCUS education primarily occurred in the third and fourth years, with less than 4 hours of dedicated training time. Five schools offered a hands-on education. Among schools offering ultrasound education, POCUS training for trauma cases is the most common. Eight schools had designated professors responsible for POCUS education and only 2 possessed educational ultrasound devices. Of the respondents, 64% expressed the belief that POCUS education for medical students is necessary, whereas 36%, including those with neutral opinions, did not anticipate its importance. The identified barriers to POCUS education included faculty shortages (83%), infrastructure limitations (76%), training time constraints (74%), and a limited awareness of POCUS (29%). POCUS education in Korean medical schools was limited to a minority of EM departments (33%). To successfully implement POCUS education in medical curricula, it is crucial to clarify learning objectives, enhance faculty recognition, and improve the infrastructure. These findings provide valuable insights for advancing ultrasound training in medical schools to ensure the provision of high-quality POCUS education for future healthcare professionals.

Abstract PO3-08-06: Challenges in Implementing Genetic Counseling and Genetic Testing for Breast Cancer: Insights from the First 1000 Families Assessed in a Public University Hospital in Argentina

Abstract Introduction: Integrating genetic testing into breast cancer patients care is crucial for personalized treatment recommendations, risk reduction strategies, and family members evaluation. However, Argentina faces several concerns in implementing these services. Objective: This study aims to explore the challenges encountered in implementing genetic testing for breast cancer, drawing insights from the assessment of the first 1000 patients at a public university hospital in Argentina. Methods: We conducted a retrospective analysis of patients who underwent genetic counseling in our institution from January 2015 to June 2023. We also analyzed patients who underwent surgery from June 2022 to May 2023. Results: 1032 patients were evaluated in our unit. 836 patients (81%) met the National Comprehensive Cancer Network (NCCN) criteria for genetic testing. Genetic testing was requested for 575 patients (68.7%) Only 44% of patients were able to access the test, with 60% receiving only the BRCA1/2 test (see Table 1 and 2 for details). In the analysis of breast cancer surgeries (n=246), 62% (n=154) met the NCCN criteria for genetic testing. However, only 56% of these patients underwent genetic counseling prior to their surgery and only 15 (9.86%) received their results before primary treatment. Discussion Unfortunately, only 9.8% of patients have the results of genetic testing prior to their primary treatment, indicating a critical need for timely referrals and mainstream genetic testing. To counteract, our university hospital's breast cancer unit has taken proactive measures since January 2015. Genetic counseling has been established as a standard of care for all patients, and a streamlined workflow has been implemented to optimize referrals. Trained professionals, including a genetic counselor, psycho-oncologist, and geneticist, have been integrated into core teams. Additionally, healthcare professional continued education has played a pivotal role in improving referrals. Additionally, we have introduced an easy workflow to optimize referrals to genetic counseling. Completion rate of requested genetic tests is concerning, with 56% of tests not being completed, and 60% of the completed tests limited to BRCA1/2. Improving access to genetic testing is imperative. Currently, comprehensive genetic testing is inaccessible to patients without medical coverage, and even those with coverage face difficulties in testing access. Moreover, patient education plays a vital role in promoting the importance of genetic testing and its impact on patient care and their families. In collaboration with the Argentinean Breast Pathology Society, we have developed two informative videos that reinforce knowledge provided by primary care physicians and breast surgeons. Conclusion, Our study is the first in Argentina to analyze the numerous challenges faced in conducting genetic testing for breast cancer in a public hospital. By addressing these challenges collectively, we can facilitate the effective integration of genetic counseling and testing into routine practice for breast cancer patients in Argentina. Table 1: Breast Cancer Genetic Counseling Unit Patients (2015-2023) Table 2: Breast Cancer Genetic Counseling Unit Patients studies (2015-2023) Citation Format: Dolores Mansilla, Diana Bequelman, Jorgelina Cavallero, Hernan Ursino, Berman Gaston, Ipiña Martin, Eduardo Armanasco, Andrea Aguilar, Valeria Caceres, Eugenia Azar. Challenges in Implementing Genetic Counseling and Genetic Testing for Breast Cancer: Insights from the First 1000 Families Assessed in a Public University Hospital in Argentina [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-08-06.

Technology-Mediated Learning in Higher Education Physiology Classes: The Use of MeGli App to Teach Glycemic Control

Glycemic control is a fundamental physiological concept in diabetes and obesity. Proper training of healthcare professionals in this content is essential for disease prevention and management. Active learning methods, including technology-mediated learning (TML), are important for effective education and student engagement. Given the complexity of physiology, educational technology can facilitate the visualization of its dynamic processes. Thus, we've developed the MeGli smartphone application as an educational tool to teach glycemic control and related conditions, aimed at undergraduate students in health and biological courses. Our hypothesis is that the use of MeGli in Physiology classes promotes student learning and satisfaction. MeGli ( https://t.ly/crEwT ) is a didactic simulator for glycemic metabolism, allowing users to observe postprandial and fasting events, interact with objects, and explore cellular processes. The aim of this study was to conduct and evaluate a TML class using the app and its impact on students' outcomes in Biological Sciences Physiology classes at University of Campinas (n = 23). We analyzed pretest-posttest knowledge questionnaires using the Wilcoxon matched-pairs signed rank test (p ≤ 0.05) due to non-normal data (Shapiro-Wilk normality test). Additionally, we applied a Likert scale opinion survey. Prior to the intervention, students provided informed consent, ensuring anonymous participation. The use of MeGli in a non-expository class, where students consulted the app in an active-learning process for answering and discussing questions, led to a significant improvement in their performance on the topic of glucose metabolism and diabetes (pretest mean 5,739± 0,3784 versus 8,652± 0,2142 on posttest; p < 0.0001). In terms of student feedback, opinion questionnaire results were overwhelmingly positive. All students agreed that the app was useful for learning and helped in their understanding of diabetes mechanisms. 87% understood the importance of healthy eating and physical exercise through the app. 91.3% reported a higher acquisition of knowledge due to the app's use and found the app-integrated class more stimulating and engaging. These findings strongly support the effectiveness of the MeGli application in facilitating physiology education, leading to a more motivating educational experience. Consequently, this study is significant in introducing an innovative tool that mediates active learning with technology, enhancing physiology teaching strategies and improving the education of future healthcare professionals. CNPq (441028/2020-9), FAPESP (2018/26080-4), CEPID (2013/07607-8). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Evaluation of treatment and long-term management of anaphylaxis in pediatric departments of Greece: a 2-year nationwide survey.

Anaphylaxis proportions of incidence are increasing globally. However, limited data are available regarding anaphylaxis in the pediatric population of Greece. The aim of the study was to evaluate management of anaphylaxis in Greek pediatric departments. We performed a questionnaire-based study of children aged less than 16 years presenting with anaphylaxis in 10 national pediatric hospitals over a period of 2 years. Management of anaphylaxis was assessed prior to and after an informative intervention. In all, 127 cases of anaphylaxis were identified. Epinephrine was administered in almost half of all cases (51.2%), predominantly through intramuscular route (88.5%), while the majority of anaphylaxis patients were treated with antihistamines (92.9%) and corticosteroids (70.1%). Epinephrine was more likely administered by physicians if the elicitor was a drug (P < 0.003). Regarding long-term management, an epinephrine auto-injector was prescribed in 66.9% of patients. Follow-up information was available for most of the patients (92.9%), the majority of whom (76.3%) were referred to an allergist. More than half of these patients (63.6%) had a documented allergy follow-up, which identified a causative allergen in 53.3% of cases. No statistically significant differences were recorded prior to and after the intervention regarding management of anaphylaxis. This nationwide study highlighted the necessity of further improvement in terms of anaphylaxis treatment and secondary prevention measures. This presupposes appropriate education and training of healthcare professionals, thus contributing to proper and comprehensive care of the pediatric population.

Implementation of Educational Opportunities for Social Determinants of Health in Health Professions Education: A Scoping Review

Objective Health professions programs have recently increased their efforts to educate health care professionals about the social determinants of health (SDH); however, there seems to be a disconnect between graduate medical education and its applicability to other peer health professions. The current scoping review aims to map the literature that explores the implementation of educational opportunities focused on SDH in health professions education programs. Data Sources PubMed, CINAHL, ERIC, Education Source, and the Health Policy Reference Center were searched to identify relevant articles. Study Selection To be included in our review, articles had to have been published in the last 5 years and describe how material related to SDH was implemented into a graduate health professions education program. Outcomes were analyzed by thematic categories by type of curricular delivery (didactic, clinical education, service-learning experience, or reflection), timing of the implementation in the program, methods of implementation, and assessment after implementation. Data Extraction Our search identified 2006 articles that were reviewed by study authors; 36 were included in our full-text review. Information extracted included the study design, type of graduate education, aims of the studies, description of technique, timing of implementation, type of curricular delivery, and outcomes. Data Synthesis The majority (23, 63.9%) of studies used an observational design and used 2 or more (27, 75.0%) types of curricular delivery presented to medical students. Didactic (19, 52.8%) and small-group discussion (14, 38.9%) methods were used most often. Assessments were mostly student reflections or self-report items. Overall, students reported increased knowledge and satisfaction with activities. Conclusions Results of our scoping review indicated that various education opportunities related to SDH exist in graduate health professions education but are likely insufficient. More studies are necessary to investigate the purposeful implementation of SDH and the best methods to assess student knowledge of SDH. Future research should also investigate how to objectively assess student learning of SDH.

Entrustable Professional Activites for Clinical Competence

Aim: In recent years Entrustable Professional Activities (EPAs) have developed as an essential framework for competency-based medical education (CBME) implementation, which has become an important component of contemporary medical education. The need to close the gap between healthcare professional education, healthcare delivery, and societal demands motivates the transition to CBME. While the competencies describe the attributes that medical professionals should possess, the EPAs describe the practical activities that learners are expected to perform in their medical education and future careers. The difficulty of translating abstract abilities into clinical practice in the real world encouraged the development of EPAs, which are specific activities or responsibilities that may be delegated to learners upon demonstrating competency. With the introduction of EPAs, medical education programs have discovered a more effective means of assessing competencies that aligns them with the professional tasks that students are expected to perform. This alignment promotes a meaningful connection between intended competencies and real-world practice, which ultimately improves the readiness of future medical professionals. Methods: The article was prepared by the traditional review method. Results: This article highlights the particular features of EPAs and the significance of competency-based assessments being grounded in actual clinical situations. EPAs enable learners to advance progressively, fostering preparedness as well as responsibility over time. It is discussed how the incorporation of technology into EPAs has the potential to improve both teaching and learning. The use of technological support and mobile applications can make EPAs more applicable and comprehensible to both faculty and students. Conclusions: The integration of CBME and EPAs is a promising strategy for addressing concerns about medical education’s effectiveness. By actively engaging in real-world tasks, EPAs facilitate the internalization of competencies by learners. By providing a structured, adaptable, and context-specific approach to competency assessment, EPAs enable learners to assume responsibilities progressively, thereby facilitating their path to becoming competent and confident healthcare professionals. By recognizing the complementary nature of EPAs and competences, medical education programs can develop thorough and efficient training techniques that bridge the gaps between theoretical knowledge and practical clinical abilities.

Patency, assessment, and management of central catheter occlusion in adult patients in the intensive care unit: a best practice implementation project.

Cannulation with a central venous catheter (CVC) is a common procedure used in critical care. One of the main complications is occlusion, which can lead to delayed treatment, prolonged hospital stay, and increased health care costs. The aim of this project was to promote evidence-based practice for nurses caring for patients with a CVC in a Spanish intensive care unit. The project also aimed to reduce CVC occlusion and ensure CVC patency. This project was guided by the JBI Model of Evidence-based Healthcare and the JBI Evidence Implementation Framework. Seven phases were followed using evidence-based auditing and feedback. The JBI Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) tools were used to support data collection, data analysis, and implementation planning. After project implementation, the following results were obtained. Criterion 1 (assessing the CVC, flushing, and aspirating) reached 100% compliance in both audits. Criterion 2 (occlusion documentation) showed a modest improvement, rising from 13.33% to 36.67%. Improvement for Criterion 3 (the need for a policy and protocol) was excellent, rising from 0% at baseline to 100% following implementation. Criterion 4 (rapid instillation of an appropriate thrombolytic agent if a CVC is occluded) remained at 0% compliance in both audits. Criterion 5 (continuing education for health care professionals) improved from 10% to 60%. Criterion 6 (flushing and locking before procedures) improved from 90% to 100%. The project objectives were largely met and resulted in a protocol, which has been shared with other departments within the hospital. The implementation of best clinical practice will be continued, including the use of thrombolytic agents. http://links.lww.com/IJEBH/A200.

Established and emerging theatre pharmacy services: a scoping review

Abstract Introduction Guidelines recommend that pharmacists contribute to perioperative patient care.[1,2] Expansion of perioperative pharmacy services was considered in Tallaght University Hospital following the appointment of a Critical Care &amp; Anaesthesia Chief II Pharmacist. Preliminary research indicated that activities at surgical pre-assessment clinics, in critical care and on inpatient wards are well-documented, while theatre pharmacy services appear comparatively under-developed. Pharmacists are well-placed to promote the safe and cost-effective use of medicines in this high-risk environment. An understanding of the evidence base could provide a foundation on which pharmacy departments seeking to expand their clinical services can build. Aim To determine the range, extent and nature of theatre pharmacy services internationally, and to describe any reported outcomes of these services. Methods This scoping review was conducted and reported as per the Joanna Briggs Institute methodology for scoping reviews and the PRISMA-ScR checklist. The review protocol was registered on Open Science Framework. A search was conducted across electronic (Ovid® MEDLINE, Embase, CINAHL and PsycInfo) and grey literature databases (Google Scholar, BASE, CADTH, and Google) without limitations on date of publication, study type or language (where English translation available). A manual search of the citation lists of all included publications supplemented the electronic search. One reviewer screened titles and abstracts and carried out data extraction, with a 10% sample screened by a second reviewer. Two reviewers evaluated full texts. Critical appraisal was performed using the Mixed Methods Appraisal Tool where appropriate. A narrative approach to evidence synthesis was employed. Extracted data about the type of pharmacy service(s) and associated outcomes were studied to inform development of key concepts through which results were presented. Results Ninety-two publications were included from 3924 results. Fifty-seven were primary research articles. Most publications were descriptive in nature. Over half of the included publications described services in the United States; the remainder were from Australia, several European countries, Egypt, Morocco, Japan, China and Taiwan. The majority of theatre pharmacy services involved medication management, i.e. procurement, spending, storage, formulary development and distribution of medicines. Clinical services incorporated provision of medicines information, protocol and guideline development, antimicrobial stewardship, education and training of healthcare professionals, engagement with health informatics and medication safety projects, practice-based research and intraoperative emergency support. Reported outcomes included financial savings, improved accountability of controlled substances, improved patient safety and staff satisfaction with the service. Many publications highlighted improved inter-departmental relationships between pharmacy and anaesthesiology. Of the 57 primary research articles, 48 lacked a clear research question and so did not satisfy the MMAT screening criteria. Of the nine assessed, adherence to quality criteria ranged from 40-100%. Conclusion Evidence for theatre pharmacy services is extensive and varied. Empirical research of high methodological quality is required to assess the outcomes of these services. Strengths of this review include the use of reporting guidelines and quality appraisal of the evidence. This review may have been limited by the exclusion of non-English language publications. This review collates practical guidance on the development of theatre pharmacy services and highlights facilitators of successful service establishment.

A scoping review of the questionnaires used for the assessment of the perception of undergraduate students of the learning environment in healthcare professions education programs.

The learning environment (LE) includes social interactions, organizational culture, structures, and physical and virtual spaces that influence the learning experiences of students. Despite numerous studies exploring the perception of healthcare professional students (HCPS) of their LE, the validity evidence of the utilized questionnaires remains unclear. This scoping review aimed to identify questionnaires used to examine the perception of undergraduate HCPS of their LE and to assess their validity evidence. Five key concepts were used: (1) higher education; (2) questionnaire; (3) LE; (4) perception; and (5) health professions (HP). PubMed, ERIC, ProQuest, and Cochrane databases were searched for studies developing or adapting questionnaires to examine LE. This review employed the APERA standards of validity evidence and Beckman et al. (J Gen Intern Med 20:1159-1164, 2005) interpretation of these standards according to 5 categories: content, internal structure, response process, relation to other variables, and consequences. Out of 41 questionnaires included in this review, the analysis revealed a predominant emphasis on content and internal structure categories. However, less than 10% of the included questionnaires provided information in relation to other variables, consequences, and response process categories. Most of the identified questionnaires received extensive coverage in the fields of medicine and nursing, followed by dentistry. This review identified diverse questionnaires utilized for examining the perception of students of their LE across different HPs. Given the limited validity evidence for existing questionnaires, future research should prioritize the development and validation of psychometric measures. This will ultimately ensure sound and evidence-based quality improvement measures of the LE in HP education programs.

Elder Abuse Prevention in Brazil, Norway and Slovakia: a Narrative Review

Abstract OBJECTIVES With the global population ageing, concerns about the incidence, prevalence and prevention of elder abuse have become increasingly pertinent. This study presents a narrative review of empirical research, investigating the elder abuse prevention implemented in public health policies in three selected countries. The narrative review aims to enrich academic critical discussion about the theme and provide insights for policymakers and professional practitioners working towards elder abuse prevention across different regions. METHODS Searches in the electronic database CINAHL, Medline, PsycINFO and Web of Science databases were performed to identify and synthesise studies reporting on research aimed at investigating elder abuse prevention. The studies that handle on all prevention levels, had to be published in a peer-reviewed journal, report on empirical research, and are available in full text in Portuguese, Slovak, English or Norwegian and published within a ten-year period (2012 to 2022) were included. A total of 981 studies were retrieved, of which 13 papers met the inclusion criteria for this narrative review. RESULTS The evidence indicated that proactive approach within primordial and primary prevention, interdisciplinary cooperation within primary and secondary prevention, and education for healthcare professionals within all forms of prevention were implemented to various extent as elder abuse prevention in Brazil, Norway and Slovakia. CONCLUSIONS There is a need to further enhance public awareness of elder abuse through campaigns and advocacy programs; additionally, the routine screening and assessments by healthcare providers for early detection and intervention in suspected abuse cases require improvement; and also, legal and health policy measures must be updated regularly. Elder abuse prevention should be a collective undertaking involving community leaders, healthcare providers, and governmental and non-governmental organisations.

Policies in Canada fail to address disparities in access to person-centred osteoarthritis care: a content analysis

BackgroundWomen are disproportionately impacted by osteoarthritis (OA) but less likely than men to access OA care, particularly racialized women. One way to reduce inequities is through policies that can influence healthcare services. We examined how OA-relevant policies in Canada address equitable, person-centred OA care for women.MethodsWe used content analysis to extract data from English-language OA-relevant documents referred to as policies or other synonymous terms published in 2000 or later identified by searching governmental and other web sites. We used summary statistics to describe policy characteristics, person-centred care using McCormack’s six-domain framework, and mention of OA prevalence, barriers and strategies to improve equitable access to OA care among women.ResultsWe included 14 policies developed from 2004 to 2021. None comprehensively addressed all person-centred care domains, and few addressed individual domains: enable self-management (50%), share decisions (43%), exchange information (29%), respond to emotions (14%), foster a healing relationship (0%) and manage uncertainty (0%). Even when mentioned, content offered little guidance for how to achieve person-centred OA care. Few policies acknowledged greater prevalence of OA among women (36%), older (29%) or Indigenous persons (29%) and those of lower socioeconomic status (14%); or barriers to OA care among those of lower socioeconomic status (50%), in rural areas (43%), of older age (37%) or ethno-cultural groups (21%), or women (21%). Four (29%) policies recommended strategies for improving access to OA care at the patient (self-management education material in different languages and tailored to cultural norms), clinician (healthcare professional education) and system level (evaluate OA service equity, engage lay health leaders in delivering self-management programs, and offer self-management programs in a variety of formats). Five (36%) policies recommended research on how to improve OA care for equity-seeking groups.ConclusionsCanadian OA-relevant policies lack guidance to overcome disparities in access to person-centred OA care for equity-seeking groups including women. This study identified several ways to strengthen policies. Ongoing research must identify the needs and preferences of equity-seeking persons with OA, and evaluate the impact of various models of service delivery, knowledge needed to influence OA-relevant policy.

The use of complementary and alternative medicine for functional gastrointestinal disorders among the saudi population

Background and objectiveComplementary and alternative medicine (CAM) is a common practice among patients, who experience functional gastrointestinal disorders (FGID). Among the Saudi population, less is known about CAM use for FGID. Therefore, this study aimed to determine the prevalence of CAM utilization for FGID amongst the Saudi population and determine the types of CAM used for treatment. MethodA cross-sectional study was carried out in Riyadh, Saudi Arabia during February 2023 through social media platforms using questionnaires adopted from the literature. There were three sections in the questionnaire including demographic information, questions to determine the prevalence of CAM use for FGID, the types of FGID, and the types of CAM utilization, and questions on the sources of information about CAM. Multivariable logistic regression was applied to find factors associated with CAM use. All statistical analyses were performed using SPSS version 26. ResultsA total of 828 people participated in this study. The overall prevalence of CAM use for FGID problems was 87.2 %. There were no significant differences in CAM use for FGID problems between men (87.5 %) and women (86.3 %) (P = 0.727). The most commonly used types of CAM for FGID were ginger (73.4 %), chamomile (66.6 %), mint (61.6 %), turmeric (59.0 %), anise (55.5 %), fennel (43.1 %), and Activia yogurt©️ (42.7 %). The most common FGID disorders for utilizing CAM were IBS (29.9 %), followed by constipation (29.8 %), dyspepsia (22.7 %), and bloating (17.0 %). In the multivariable regression, age, gender and employment status did not have an impact on the odds of using CAM. The subjects who had high school, university, and postgraduate education had significant odds ratios of CAM use (OR = 2.73; 95 % CI: 1.22–6.13), (OR = 4.18; 95 % CI: 2.03–8.58), and (OR = 20.85; 95 % CI: 5.51–78.80), respectively, compared to subjects who did not complete high school. Participants who had private insurance had a significant odds ratio (OR = 0.27; 95 % CI: 0.14–0.55) compared to governmental insurance. ConclusionThe use of CAM among the Saudi population is alarmingly high; however, the lack of standardized medical recommendations and treatment options may be the cause. Although there were no significant gender differences, participants with higher educational levels and private insurance coverage were more likely to use CAM for FGID. Patients suffering from FGID and limited access to medical advice and treatment options are vulnerable to being exposed to dubious and incredible information sources. Expanding access to preventative medical services, funding governmental medical websites to provide credible information, educating healthcare professionals about FGID, and conducting more research in safe and effective treatments for FGID is recommended.

Enhancing Cranio-Maxillofacial Fracture Care in Low- and Middle-Income Countries: A Systematic Review.

Background: Cranio-maxillofacial (CMF) injuries represent a significant challenge in low- and middle-income countries (LMICs), exacerbated by inadequate infrastructure, resources, and training. This systematic review aims to evaluate the current strategies and solutions proposed in the literature to improve CMF fracture care in LMICs, focusing on education, patient transfer, and off-label solutions. Methods: A comprehensive literature search was conducted using PubMed/Medline from January 2000 to June 2023. Studies were selected based on the Preferred Reporting Items for Systematic Review and Meta-analysis Statement (PRISMA). Solutions were categorized into three main areas: education (digital and on-site teaching, fellowships abroad), patient transfer to specialized clinics, and off-label/non-operative solutions. Results: Twenty-three articles were included in the review, revealing a consensus on the necessity for enhanced education and training for local surgeons as the cornerstone for sustainable improvements in CMF care in LMICs. Digital platforms and on-site teaching were identified as key methods for delivering educational content. Furthermore, patient transfer to specialized national clinics and innovative off-label techniques were discussed as immediate solutions to provide quality care despite resource constraints. Conclusions: Effective CMF fracture care in LMICs requires a multifaceted approach, prioritizing the education and training of local healthcare professionals, facilitated patient transfer to specialized centers, and the adoption of off-label solutions to leverage available resources. Collaborative efforts between international organizations, local healthcare providers, and educational institutions are essential to implement these solutions effectively and improve patient outcomes in LMICs.

Celiac Disease Review: Background and Emphasis on the Important Role of Health Education in the Prevention and Control of Symptom

Celiac disease is related to dietary gluten found in wheat, rye, and barley, CD is an immune-mediated enteropathy and it is one of the most prevalent lifelong food-related illnesses globally. In addition, CD is also thought to be a systemic ailment marked by a variety of gluten-related signs and symptoms as well as disease-specific antibodies. When gluten is consumed, it produces toxic gluten peptides that can trigger both innate and adaptive immune responses in people who are predisposed to them. The transglutaminase enzyme plays a role in the development of the situation by deaminating gluten to produce glutamic acid. Furthermore, the peptidase enzyme finds it difficult to break down the prolamin component of gluten, which is high in proline and glutamine. This leads to incomplete protein digestion and the creation of peptides that trigger the immunological response. Moreover, CD causes remarkable damage to the small intestinal mucosa in the jejunum, resulting in inflammation of the villi and villous atrophy, which hinders the absorption of nutrients. Combining small intestine mucosal histology under a gluten-containing diet with CD serology allows for the diagnosis of the condition. A stringent lifelong gluten-free diet is now the only effective treatment for CD; nevertheless, the diet is demanding, and avoiding gluten is challenging. Further research is needed to improve and develop the diagnosis and treatment of CD via healthcare professional education programs.

Definition and Assessment of Paediatric Breakthrough Pain: A Qualitative Interview Study.

Infants, children and young people with life-limiting or life-threatening conditions often experience acute, transient pain episodes known as breakthrough pain. There is currently no established way to assess breakthrough pain in paediatric palliative care. Anecdotal evidence suggests that it is frequently underdiagnosed and undertreated, resulting in reduced quality of life. The development of a standardised paediatric breakthrough pain assessment, based on healthcare professionals' insights, could improve patient outcomes. This study aimed to explore how healthcare professionals define and assess breakthrough pain in paediatric palliative care and their attitudes towards a validated paediatric breakthrough pain assessment. This was a descriptive qualitative interview study. Semi-structured interviews were conducted with 29 healthcare professionals working in paediatric palliative care across the UK. An inductive thematic analysis was conducted on the data. Five themes were generated: 'the elusive nature of breakthrough pain', 'breakthrough pain assessment', 'positive attitudes towards', 'reservations towards' and 'features to include in' a paediatric breakthrough pain assessment. The definition and assessment of breakthrough pain is inconsistent in paediatric palliative care. There is a clear need for a validated assessment questionnaire to improve assessment, diagnosis and management of breakthrough pain followed by increased healthcare professional education on the concept.