Care Education Research Articles

More than a cluster of sawflies: understanding young children’s application of science skills in nature-based learning

ABSTRACT Background Despite playing an important role in early childhood education, the science teaching and learning that occurs in nature-based contexts such as forest school and nature kindergartens remains under-theorised. Utilising recent research to understand how science skills form an important part of children’s learning, this research is situated in the context of bush kinders, an Australian response to the European forest approach to early childhood education and care. There exist several teaching models to support how science skills can be taught to young children. Purpose This paper considers how young children’s play exhibits science skills and educators have opportunities to make children’s play-based learning meaningful in ‘bush kinder’. It is influenced by Piaget’s developmental work and its relationship to young children’s meaning making of science concepts can be enhanced by time spent in bush kinders. Design and method This study draws upon ethnography as its methodological approach and qualitative data that was collected as part of a longitudinal study between 2015 and 2023. Sample Fifteen Educators and 220 children from five bush kinders participated in this study. Results Using three vignettes as data, the interrogation and analysis of children’s learning of science skills whilst participating in nature play occurs here through the application of five inter-connected science skills. The analysis leads us to propose that bush kinders allow children to connect with nature and develop science skills. Conclusions The analysis of these data and their consideration of the skills is valuable in generating a broader narrative that provides deeper insight into the learning experience of science education in early childhood education and care in nature-based contexts.

Eucalyptol Attenuates Cerebral Ischemia/Reperfusion Injury in Mice

Background One of the leading causes of acute brain injury is cerebral ischemia/reperfusion (I/R) injury. It is an ailment that occurs when the brain does not receive enough oxygen-rich blood supply, which damages brain cells. Oxidative stress is recognized as a significant mechanism that causes I/R injury and is a critical focal point for therapy. Apoptosis and inflammation are all pathogenic processes underpinning I/R damage. Eucalyptol (EU), a plant-derived substance, protects neuronal damage. We postulate that EU inhibits apoptosis and oxidative stress after focal cerebral I/R damage in mice. Purpose Thus, the present work sought to examine the neurological protective benefits of EU in mice models of cerebral ischemia/reperfusion (CI/R) injury. Methods The measurement of neurological function, infarct volume, and the amount of water in the brain were evaluated subsequently. The brain tissue was examined to assess the activities of oxidative stress, inflammatory cytokines, and matrix metalloproteinases (MMP) levels, and histopathology was determined. Using enzyme-linked immunosorbent assay (ELISA), apoptotic marker expression was used to measure the levels of B-cell lymphoma 2 (Bcl-2), caspase-3, and Bcl-2 associated X-protein (Bax) proteins that exist as indicators of apoptosis. Results EU treatment malondialdehyde (MDA) levels decreased while glutathione (GSH), superoxide dismutase (SOD), A-TOC, and catalase (CAT) activity increased. Following EU therapy dramatically reduced cerebral dysfunction, which was supported by reduced histological damage in I/R injury. Furthermore, with lower levels of MMP-2 and 9, EU treatment could be a novel approach for preventing CI/R injury. EU-treated mice had a notable reduction in cleaved Bax, caspase-3, and increased Bcl-2 protein activities. EU therapy shields the brain against CI/R injury by inhibiting cell death. Conclusion According to the present study’s findings, EU is a promising neuroprotective agent that can be used to treat CI/R injury in mice. By focusing on these aspects, nurses can provide comprehensive care to patients involved in studies on the effects of EU on CI/R injury, promoting better outcomes through careful monitoring, supportive interventions, and education.

Tabletop Simulations in Medical Emergencies: A Scoping Review.

Tabletop simulations (TTS) are a novel educational modality used in health care education. The objective of this scoping review was to describe the use of TTS in medical emergencies, specifically settings, specialties, participants, formats, and outcomes.We included 70 studies (33 descriptive studies [47%], 33 cohort studies [47%], and 2 randomized controlled trials [3%]), of which 65 reported positive results regarding reaction and learning educational outcomes (reaction: n = 37, 53%; learning: n = 25, 36%; behavior: n = 7, 10%; result: n = 1, 1%). The scenario for most TTS was a disaster (n = 56; 80%). Most TTS involved participants from several professions (n = 45; 64%). A board game was used in 26 studies (37%).Most studies on TTS in medical emergencies involved participants from multiple professions addressing disaster scenarios and showed positive results pertaining to reaction or learning educational outcomes.

Differential roles of problematic media use by mothers and toddlers in the relation between parenting stress and toddlers’ socioemotional development

The increasing prevalence of digital media devices in families with young children has raised concerns over problematic media use. However, the link between toddlers’ problematic media use, their socioemotional development, and the influence of parental factors remains unclear. The current study examined the roles of problematic media use by both mothers and toddlers in the association between maternal parenting stress and toddlers’ socioemotional development. Participants comprised 215 mothers and 73 lead child care classroom teachers of toddlers aged 24–36 months enrolled in child care centers in South Korea. Mothers reported parenting stress and problematic media use by themselves and their toddlers, and child care teachers reported toddlers’ socioemotional development. The results from structural equation modeling analysis revealed that maternal parenting stress was related to toddlers’ socioemotional development both directly and indirectly through toddlers’ problematic media use, both alone and in conjunction with mothers’ problematic media use. Although maternal parenting stress was related to mothers’ problematic media use, mothers’ problematic media use was not directly related to toddlers’ socioemotional development. These findings underscore the importance of toddlers’ problematic media use in their socioemotional development and highlight the need for comprehensive approaches that address family dynamics, such as maternal parenting stress and problematic media use.

A Critical Look at Racism in the Clinical Learning Environment.

Academic medicine has long acknowledged the importance of diversity, equity, and inclusion (DEI) in the pursuit of health equity. Despite this recognition, the clinical learning environment (CLE) has struggled to foster an equitable and inclusive ecosystem that supports diverse learners and faculty.Efforts to dismantle racism in medicine represent an important approach to supporting diverse learners and faculty in the CLE, but they have fallen short of their intended impact. The reasons for this failure are complex and may include a limited understanding of the impact of racism and a misguided conviction that knowledge of harm suffered by minoritized groups is a sufficient driver of change.To advance understanding and increase motivation to dismantle racist systems within academic medicine, this paper posits 2 frameworks, Interest Convergence (IC) and Critical Whiteness Study (CWS). IC asserts that racial equity progresses only when it aligns with the interests of the majority, while CWS examines how Whiteness as a social construct upholds power and privilege, often to the detriment of White individuals themselves.Utilizing these frameworks, the authors detail how Whiteness negatively impacts the health of White people and impedes entry to medical school for low- and middle-income, first-generation White students. The authors illustrate how practices-such as patient- and family-centered care and competency-based medical education-which are intended to improve care and medical education for all, are fully aligned with and integral to DEI principles. The authors conclude that racism and upholding Whiteness cause harm to majority as well as minoritized peoples, while DEI principles provide the foundation for best practices in the CLE and improve outcomes for all.

The Effects of a Digital Multimedia Foot Ulcer Care Program on Health Beliefs and Self-Care Behaviors in People With Diabetic Foot Ulcer

Foot complications, common among diabetic patients, often lead to amputation and increased dependence on daily living assistance. Effective and sustained intervention programs are important challenges that nursing staff must address. This study was designed to explore the effectiveness of a digital multimedia foot ulcer care program on the foot health beliefs and self-care behaviors of diabetic patients. An experimental research design was adopted, with a total of 62 patients with type 2 diabetes in the plastic surgery ward of a regional hospital in southern Taiwan enrolled as participants. The participants were randomly assigned to either the experimental group (n = 31), which received a digital multimedia foot ulcer care program via mobile phones or tablets for eight weeks, or the control group (n = 31), which received conventional diabetic foot care education leaflets. The research instruments included a demographic questionnaire, the Diabetic Foot Ulcer Health Belief Scale, and the Diabetic Foot Care Behavior Scale. Data were collected at baseline, four weeks, and eight weeks, and were analyzed using SPSS 22.0. The study was completed with 30 participants in both groups. The experimental group showed significantly greater improvements in health beliefs at the fourth and eighth weeks post-assessment than the control group, with increases of 3.77 and 5.13, respectively (p = .03, p = .02). These improvements were statistically significant and exceeded baseline values significantly (p < .05). In terms of self-care behaviors, improvements in the experimental group exceeded those in the control group by 2.27 and 1.83, respectively, at four and eight weeks (p = .03, p = .05). Furthermore, the experimental group exhibited superior changes in scores compared to the control group. The digital multimedia foot ulcer care program implemented in this study significantly enhanced health beliefs and self-care behaviors in patients with diabetic foot ulcers. This program may be employed during hospitalization and post-discharge to improve foot ulcer care techniques and reduce diabetic foot ulcer deterioration.

The Effect of Stoma Care Teaching Based on the ARCS Motivation Model on Nursing Students' Learning Motivation, Self-Efficacy and Knowledge Levels

AimThis study aims to examine the effect of stoma care education based on the ARCS (Attention-Relationship-Confidence-Satisfaction) motivation model on nursing students' learning motivation, self-efficacy and knowledge levels. BackgroundNursing education is pivotal in ensuring that students gain the necessary knowledge and skills to provide quality care. Motivation and academic self-efficacy are key factors in student success. DesignThe study employed a randomized controlled pre-test-post-test experimental design. MethodsThis study, conducted between May and July 2024 at Atatürk University Faculty of Nursing, included 46 students attending the Fundamentals of Nursing course. Participants were divided into experimental and control groups, both receiving traditional stoma care training. The experimental group additionally received training based on the ARCS motivation model, designed to enhance attention, relevance, confidence and satisfaction. Data were collected using the "Introductory Information Form," "Motivation Scale for Instructional Material," the "Academic Self-Efficacy Scale," "Stoma Care Practice Knowledge Level Assessment Form." Pre-tests and post-tests covered motivation, knowledge and academic self-efficacy. ResultsStudents in the experimental group showed significant increases in post-test scores for "Attention," "Relevance," "Confidence," "Satisfaction," "Academic Self-Efficacy," and "Knowledge Test"(p<0.05). In the inter-group comparison, the post-test scores of the experimental group were significantly higher than those of the control group across all these dimensions (p<0.05). The most notable difference was observed in the "Knowledge Test" results (ES=4.786, p=0.001), where the experimental group outperformed the control group. ConclusionsAs a result, it was concluded that stoma care teaching based on the ARCS motivation model increased nursing students' nursing students' learning motivation, self-efficacy and knowledge levels.

“You write what you want and what you need”: incorporating reflective practice in the ELA classroom through caring pedagogy

ABSTRACT Caring pedagogy is critical in today’s classrooms, and supporting students’ emotional needs as well as educational needs is an integral part of the teaching profession. This qualitative case study examines how one 9th grade ELA teacher uses reflective practices to enact care for her students. Creating a specially designed 50-minute freewrite class, the participant centers students by welcoming their voices into the classroom. Notes from observations and semi-structured interviews are used to show how the participant’s reflections about her students’ journals and discussions drive instruction. Findings show that care-based instruction -giving students space to write about any topic, removing the potential barriers of correct spelling and grammar, and engaging in caring, collaborative discussion- encourages student investment in writing.

Evaluating diclofenac's risks in COVID-19: strategies for mitigating adverse outcomes.

The use of nonsteroidal anti-inflammatory drugs (NSAIDs), particularly diclofenac, during the COVID-19 pandemic has raised concerns due to its potential to worsen disease progression. This commentary evaluates key risks associated with diclofenac and highlights the critical role of pharmacists in mitigating adverse outcomes through careful medication management and patient education. Diclofenac poses unique risks due to its ability to generate reactive oxygen species (ROS), leading to oxidative stress and mitochondrial dysfunction. In COVID-19, a disease characterized by hyperinflammation, these effects may exacerbate systemic inflammation, contributing to severe outcomes. Moreover, diclofenac's known association with increased cardiovascular risks, such as myocardial infarction and stroke, is especially concerning in patients with COVID-19, who are predisposed to thrombotic complications. The drug's hepatotoxic potential adds another layer of concern, particularly in patients with pre-existing liver dysfunction or those at higher risk due to COVID-19-related liver involvement. Pharmacists play a pivotal role in addressing these risks by conducting thorough medication reviews and assessing patient-specific risk factors. They can guide clinicians and patients toward safer alternatives, such as ibuprofen or naproxen, which demonstrate a lower oxidative and cardiovascular burden. Patient education is equally critical; pharmacists should counsel individuals on potential adverse effects of diclofenac, such as cardiovascular symptoms, renal dysfunction, and liver complications, while advising on lifestyle modifications and adjunctive therapies to reduce NSAID dependence. Additionally, pharmacists contribute to pharmacovigilance by monitoring patients for adverse drug reactions and reporting safety concerns to improve NSAID usage guidelines during the pandemic. By adopting a personalized approach to NSAID therapy, pharmacists can minimize risks and enhance patient safety, ultimately improving outcomes in the management of COVID-19 and other inflammatory conditions. This underscores their indispensable role in optimizing care during complex clinical scenarios.

Characteristics of Student-Led Clinics in the Allied Health Professions: Protocol for a Scoping Review.

Student-led clinics can provide students from allied health professions with the opportunity to gain valuable placement experience as an integral component of their preregistration program, enabling them to develop their competencies, professional skills, and administrative and leadership skills. Student-led clinics have the capacity to help meet the demand for appropriate practice-based learning opportunities, as there is an expectation that all allied health professions students should have high-quality learning experiences, ensuring the future workforce is fit for purpose. An overview of existing student-led clinics will increase our understanding of key characteristics, assisting education providers who may be considering the development of their own clinics. This will include key factors to ensure that this model of practice-based learning meets the needs of service users, students, and education providers. This scoping review aims to increase our understanding of the characteristics of student-led clinics by answering the questions (1) what student-led clinics exist in the allied health professions, and (2) what are their characteristics? This scoping review has been developed in conjunction with Joanna Briggs Institute methodology. We will consider studies and publications that include student-led clinics as an integral part of the preregistration curriculum for allied health professions students as defined by the Health and Care Professions Council. An extensive search of electronic databases will be conducted, including PubMed, MEDLINE, and CINAHL, among others. Search strategies, including the identified keywords and index terms, will be modified for each included database used. Reference lists of all included evidence will be screened for additional relevant studies. Studies published in English with no date limitations will be included. Relevant sources will be imported into Covidence for screening conducted by 2 reviewers (SR and KB). Data extraction will be conducted by 2 reviewers using a piloted data extraction tool, and data will be charted and tabulated using the Template for Intervention Description and Replication (TIDieR) checklist. Data will be presented with a narrative summary and illustrated by graphs and figures. The scoping review will be reported in conjunction with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews) and the STORIES (Structured Approach to the Reporting In health care education of Evidence Synthesis) statement for health care education evidence synthesis. An initial limited search was conducted in February 2024. The study will be conducted in 2025. Publication of the results is expected in late 2025. This scoping review will provide key information regarding the characteristics of student-led clinics and will be of interest to preregistration education programs within the allied health professions who have an interest in exploring opportunities to address placement capacity issues. PRR1-10.2196/58084.

Patients' Ability to Self-Manage Their Surgical Wound to Prevent Wound Complications: A Cross-Sectional Study.

To provide insights into postdischarge patients' experiences and preferences regarding surgical wound care education at discharge in the Netherlands. Patient involvement in wound care practices postdischarge is beneficial for the prevention of surgical site infections and has become an essential component in reducing the burden on healthcare systems. Surgical wound care discharge education is crucial to achieve this. A cross-sectional survey was conducted using the 18-item Surgical Wounds And Patient Participation Questionnaire on patients who underwent surgery between January and May 2022. The survey was administered 2 weeks postoperatively. In total, 213 patients completed the survey. Most patients preferred verbal instructions about their surgical wound care (n = 146; 84.9%) at the time of discharge, with 52.3% indicating a preference for multiple forms of information. Approximately three-quarters of patients (n = 99; 76.7%) responded that they were able to successfully take care of their wounds at home and 16.3% indicated wound self-care inability. Our study highlighted patients' preferences for verbal instructions about their surgical wound care at the time of discharge. Notably, half of the patients expressed a desire for multiple forms of information. Furthermore, we identified gaps in the information provided to patients, indicating areas for improvement in discharge communication. The identified gaps in surgical wound care discharge education offer opportunities to enhance in-hospital education by aligning it more closely with patient preferences and providing education of topics often missed. This could ultimately improve their ability to self-manage their surgical wound at home. Future research should delve deeper into understanding the factors influencing patients' ability to self-manage their wounds. Despite the acknowledged importance of patient education on surgical wound care, there is limited literature regarding patients' experiences and preferences in this area. The findings of this study highlight patients' preferences for verbal instructions and reveal gaps in the information provided to patients about surgical wound care at the time of discharge. The identified gaps in information provided to surgical patients offer opportunities to enhance in-hospital education by healthcare professionals. We adhered to the STROBE guideline. No patient or public contribution.

Knowledge and attitudes of nurses toward caring of older people in primary health-care centers at South of Jordan

Purpose This study aims to assess the knowledge and attitudes of 420 nurses toward caring for older people in primary health-care centers in the southern region of Jordan. Design/methodology/approach Data collected through an electronic survey was analyzed using the Statistical Package for the Social Sciences (SPSS) version 23.0. Findings The findings revealed that 91.0% of nurses had limited knowledge, with only 7.1% demonstrating average knowledge and 1.9% showing good knowledge about older people care. Furthermore, 85.2% of participants held neutral attitudes toward aged care, while 12.4% had positive attitudes and 2.4% exhibited negative attitudes. A significant correlation was observed between knowledge and attitude scores (p-value = 0.000). Gender and marital status were found to influence attitudes, with significant statistical relationships (p-values: gender = 0.000, marital status = 0.004). These results emphasize the importance of improving nursing education in geriatric care and promoting positive attitudes toward caring for older people patients. Practical implications The study highlights the need for ongoing professional development to enhance patient outcomes and the quality of care for the older people population. Further longitudinal research and comparative analyses are recommended to deepen the understanding of knowledge and attitudes across various health-care settings. Originality/value The study revealed a significant correlation between nursing practitioners’ knowledge and attitudes toward geriatric care, with gender and marital status significantly influencing attitudes, while age did not. This underscores the need for further research.

Patient satisfaction with prescription opioid education in primary care

ObjectivesThis study explores patients' satisfaction with opioid education, identifies areas for improvement, and assesses differences between those more or less satisfied with their opioid education. MethodsA cross-sectional survey of adults with prescription opioid experience. Respondents reported opioid details, demographics, and pain coping. Satisfaction with education from prescribers and pharmacy staff on opioid usage, pain relief expectations, side effects, and tapering was assessed. Open-ended questions gathered suggestions for improvement. ResultsRespondents (n = 1605) seemed more satisfied with information on opioid usage (59–80 %) and expected pain relief (46–72 %) than on side effects (50–65 %) and tapering (29–50 %). Prescriber-provided education received higher satisfaction scores than pharmacy staff-provided education, though both were valued equally (∼ 70 %). Dissatisfied respondents tended to have higher education levels, lower pain coping scores, and often ineffective opioid experiences. Qualitative analysis of the 404 respondents who indicated a need for improvement emphasised the need for clearer information on side effects, addiction risks, and tapering, and more understandable formats. ConclusionsOpioid patient education should prioritise addressing side effects, addiction risks, and tapering at treatment initiation. The educational contributions of both prescribers and pharmacy staff are deemed important. Practice implicationsEngaging pharmacy staff, especially during repeat dispensing, can enhance patient education on opioids.

Teacher shortage in Croatia – a challenge for educational policy, initial teacher education and educational institutions

ABSTRACT The aim of this paper is to analyse teacher shortage in Croatia and ways in which educational policy reacts to teacher shortage in early childhood education and primary education. This paper presents descriptive study of current national shortage situation and a content analysis of national education policy documents. The data analyses reveal a significant shortage of early childhood education and care (ECEC) teachers. In the first phase of compulsory education there is no shortage of class teachers, while in the second phase of compulsory education exists a permanent shortage of all subject teacher profiles, predominantly from the STEM area. Key educational policy documents analysis reveals the lack of a national strategy for attracting teachers to the profession. Pending a systemic solution, preschool institutions and schools are forced to solicit and employ unqualified staff for teaching positions, whilst the consequences of employing non-professional staff remain uncertain.

Professional development opportunities and a newly built daycare center: incentives in ECEC teacher job advertisements in Finland

ABSTRACT Attracting and recruiting qualified, high-quality teachers is a global challenge. In Finland, the recruitment of Early Childhood Education and Care (ECEC) teachers has been particularly problematic, especially in the Helsinki metropolitan area. This paper investigates the incentives used in job advertisements to attract ECEC teachers in Finland and the differences in incentives between urban, semi-urban, and rural municipalities. The analysis of 322 ECEC teacher job advertisements revealed that the most frequently highlighted incentives were related to professional development opportunities and physical work environment. Urban municipalities featured more incentives compared to their semi-urban and rural counterparts, reflecting the observation that, unlike many other parts of the world, the teacher recruitment challenge in Finland is most acute in urban areas. This study contributes to the limited research on teacher recruitment and enhances the understanding of incentives used in recruitment beyond financial ones.

Effects of Interprofessional Education on Readiness for Interprofessional Learning in Rehabilitation Science Students From Professional Health Care Programs: Protocol for a Systematic Review.

The World Health Organization defines interprofessional education (IPE) as a process in which students from different health care programs work together to provide effective care while deepening their knowledge of each other's roles. Previous literature shows a strong argument for early exposure to IPE as a facilitator for high quality patient care. The goal of IPE is to improve interprofessional collaboration (IPC), the "gold standard" of care to enhance patients' quality of life, functional ability, and health status, especially for patients who require expertise from a variety of health care professionals. IPC has shown improvements in quality of life, functional ability, and health status. IPE can occur in the form of structured interventions or spontaneously in student placements. Literature has demonstrated that IPE facilitates skill, knowledge development, teamwork, communication skills, and mutual respect among health care professional students. This systematic review aims to examine IPE outcomes, including readiness for IPC, IPE perceptions, attitudes toward collaborative learning, student confidence, practice efficiency, and team dynamics after IPE interventions in rehabilitation science students. The study will be conducted as outlined by the Cochrane Handbook for Systematic Reviews and will be reported per the PRISMA (Preferred Reporting of Items for Systematic Reviews and Meta-Analyses) 2015 guidelines. Students have performed literature searches across the databases MEDLINE, Embase, CINAHL, ERIC, Web of Science, and AMED. Studies will be included if their IPE intervention included multiple prelicensure health care professional students in a health care or health care education setting. Based on timelines presented in the Institute of Medicine's report on the impacts of IPE, relevant studies from 2016 to the present will be included. The Risk of Bias 2 tool will be used to study sources of bias. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) working group's methods will be used to evaluate the quality of the evidence presented. The final 3 authors are assisting as supervisors, providing oversight and feedback as needed. Any deviations from this protocol will be reported in the final paper. The search strategy was finalized and searched across the databases by March 8, 2024. The systematic review was registered with PROSPERO on March 31, 2024. A total of 10,692 citations were retrieved for abstract and title screening, beginning in March 2024, and 756 were eligible for full-text screening in April 2024. Six articles were considered for inclusion and data extraction, which began in July 2024. Finalization of the extracted data and paper will occur in September 2024. This systematic review will provide a summary of the effects of IPE interventions in prelicensure rehabilitation science students. It will provide educators, health care providers, and students with valuable information for understanding the relevance of IPE. It will also shed light on research gaps and highlight areas for further study. PROSPERO CRD42024506081; https://tinyurl.com/3tf2h9er. PRR1-10.2196/60830.

12 Tips for Implementing Trauma-Informed Care Within Undergraduate Medical Education

Background Trauma-informed care (TIC) has received increasing attention in the literature; however, implementation remains challenging and varies by the target learner group. Undergraduate medical education (UME) requires a longitudinal and broad-based approach to prepare students entering all specialties to incorporate TIC principles into daily practice. Aims and Methods The Trauma-Informed Health Care Education and Research Committee (TIHCER) has released the first ever validated set of trauma-informed care competencies for undergraduate medical education, which serves as helpful framework for incorporation of TIC into UME curricula. A multi-specialty group of faculty clinical educators at the University of Michigan Medical School (UMMS) convened to articulate lessons learned from implementation of a longitudinal TIC curricula into the Doctoring clinical skills course. Results Educators involved in designing and implementing TIC will find practical tips rooted in both literature and experience for successfully designing and actualizing trauma-informed care curricula in a longitudinal fashion. Conclusions TIC can be successfully implemented and integrated longitudinally into UME. Efforts should include implementing the validated UME TIC competencies, strive to move on the continuum of TIC, and strategically partner with medical school leadership and institutional leadership to prioritize TIC efforts.

UK paediatric clinical trial protocols: A review of guidance for participant management and care in the event of premature termination.

Clinical trials provide an opportunity to identify new treatments and can offer patients access to treatments otherwise unavailable. However, approximately 10% of paediatric clinical trials discontinue before the trial has completed. If this premature termination is because the trial treatment(s) being investigated are identified to be ineffective or unsafe, it results in the abrupt discontinuation of the investigational medicinal product for participants. For some participants, there may not be other treatment options to pursue at the trial-end. Trials prematurely terminating can be a distressing experience for all involved and currently there is little published evidence about the guidance provided to healthcare professionals in the event of premature trial termination. The study protocol is the source of guidance for healthcare professionals delivering clinical research, detailing how to conduct all aspects of the trial. The aim was to quantify the proportion of clinical trial protocols that included premature trial termination and subsequently those that provided instructions related to participant management and care. In addition, to analyse the context in which premature termination was included and the detail of any instructions for participant management and care. The ClinicalTrials.gov database was searched by a single reviewer for UK interventional drug trials enrolling children with an available study protocol. Protocols were searched to assess if the risk of premature trial termination was identified, the context for premature termination being included, if information was provided to support the management and care of participants should this situation occur and the detail of those instructions. Data were summarised descriptively. Of 245 clinical trial protocols, 235 (95.9%) identified the possibility of premature trial termination, the majority within the context of the sponsor asserting their right to terminate the trial (82.7%, 115/235) and providing reasons why the trial could be stopped (65.5%, 91/235). Forty-two percent (98/235) provided guidance for participant management and care, most commonly to contact/inform the participant (45.9%, 45/98). Directions varied in the quantity and level of detail. This review of UK clinical trial protocol highlights that information surrounding premature termination is lacking, with only 42% providing guidance on the care of trial participants. While this ensures regulatory compliance, it fails to consider the challenge for healthcare professionals in managing participants on-going care or the duty of care owed to participants. Further research is required to understand if additional documents are being used in practice, and if these meet the needs of healthcare professionals in supporting research participants and families during premature trial termination.

Comparative Effectiveness of Health Communication Strategies in Nursing: A Mixed Methods Study of Internet, mHealth, and Social Media Versus Traditional Methods

Abstract Background Effective communication is vital in health care, especially for nursing students who are the future of health care delivery. In Iraq’s nursing education landscape, characterized by challenges such as resource constraints and infrastructural limitations, understanding communication modalities is crucial. Objective This mixed methods study conducted in 2 nursing colleges aims to explore and compare the effectiveness of health communication on the web, through mobile health (mHealth) applications, and via social media among nursing students in Iraq. The research addresses a gap in understanding communication modalities specific to Iraq and explores the perspectives, experiences, and challenges faced by nursing students. Methods Qualitative interviews were conducted with a purposive sample (n=30), and a structured survey was distributed to a larger sample (n=300) representing diverse educational programs. The study used a nuanced approach to gather insights into the preferences and usage patterns of nursing students regarding communication modalities. The study was conducted between January 12, 2023, and May 5, 2023. Results Qualitative findings highlighted nursing students’ reliance on the web for educational materials, the significant role of mHealth applications in clinical skill development, and the emergence of social media platforms as community-building tools. Quantitative results revealed high-frequency web use (276/300, 92%) for educational purposes, regular mHealth application usage (204/300, 68%) in clinical settings, and active engagement on social media platforms (240/300, 80%). Traditional methods such as face-to-face interactions (216/300, 72%) and practical experiences (255/300, 85%) were preferred for developing essential skills. Conclusions The study underscores nursing students’ preference for an integrated approach, recognizing the complementary strengths of traditional and digital methods. Challenges include concerns about information accuracy and ethical considerations in digital spaces. The findings emphasize the need for curriculum adjustments that seamlessly integrate diverse communication modalities to create a dynamic learning environment. Educators play a crucial role in shaping this integration, emphasizing the enduring value of face-to-face interactions and practical experiences while harnessing the benefits of digital resources. Clear guidelines on professional behavior online are essential. Overall, the study expands the understanding of communication modalities among nursing students in Iraq and provides valuable insights for health care education stakeholders globally.

Virtual Reality Simulation in Undergraduate Health Care Education Programs: Usability Study.

Virtual reality (VR) is increasingly being used in higher education for clinical skills training and role-playing among health care students. Using 360° videos in VR headsets, followed by peer debrief and group discussions, may strengthen students' social and emotional learning. This study aimed to explore student-perceived usability of VR simulation in three health care education programs in Norway. Students from one university participated in a VR simulation program. Of these, students in social education (n=74), nursing (n=45), and occupational therapy (n=27) completed a questionnaire asking about their perceptions of the usability of the VR simulation and the related learning activities. Differences between groups of students were examined with Pearson chi-square tests and with 1-way ANOVA. Qualitative content analysis was used to analyze data from open-ended questions. The nursing students were most satisfied with the usability of the VR simulation, while the occupational therapy students were least satisfied. The nursing students had more often prior experience from using VR technology (60%), while occupational therapy students less often had prior experience (37%). Nevertheless, high mean scores indicated that the students experienced the VR simulation and the related learning activities as very useful. The results also showed that by using realistic scenarios in VR simulation, health care students can be prepared for complex clinical situations in a safe environment. Also, group debriefing sessions are a vital part of the learning process that enhance active involvement with peers. VR simulation has promise and potential as a pedagogical tool in health care education, especially for training soft skills relevant for clinical practice, such as communication, decision-making, time management, and critical thinking.