Undergraduate Education Curriculum Research Articles

Perinatal mental health in medical school curricula: a national scoping survey of British universities and student psychiatry societies.

With increasing recognition of the prevalence and impact of perinatal mental health (PMH) disorders comes a responsibility to ensure that tomorrow's doctors can support families during the perinatal period. Online surveys seeking information about the inclusion of PMH education in undergraduate curricula were sent to psychiatry curriculum leads and student psychiatry societies from each university medical school in the UK between April and September 2021. Responses were received from 32/35 (91.4%) medical schools. Two-thirds reported specific inclusion of PMH content in the core curriculum, typically integrated into general adult psychiatry or obstetric teaching. Students at the remaining schools were all likely to be examined on the topic or see perinatal cases during at least one clinical attachment. PMH education offers an opportunity for collaboration between psychiatry and other disciplines. Future work looking at educational case examples with objective outcomes would be valuable.

Teaching Reform of Undergraduate Courses in Colleges and Universities Based on Machine Learning and Improved SVM Algorithm

In order to deeply understand the current situation, problems, and satisfaction of undergraduate education courses in Contemporary Colleges and universities, and further improve the teaching level of professional courses, first, this paper makes an in-depth investigation on the teaching status and satisfaction of undergraduate education majors in two colleges and universities. The results show that the teaching and satisfaction of undergraduate education majors are at a medium level (m = 2.27). On this basis, combined with the existing problems, combined with the SVM parameter optimization algorithm of improved machine learning and particle swarm optimization algorithm, this paper puts forward the optimization strategy of undergraduate education curriculum teaching reform.

World Federation of Athletic Training and Therapy World Congress 2022 Peer-Reviewed Track Abstracts, May 5–7, 2022, Winnipeg, Manitoba, Canada

Context: Recent research has highlighted changes in neurocognitive and central nervous system function among some of the most common injuries, particularly in those with chronic ankle instability (CAI). Functional performance tests (FPT) like the side-hop test (SHT) are often used to assess physical performance, however, minimally stress a patient's neurocognitive function. On the contrary, dual-tasking is often used to assess the interplay between physical and neurocognitive performance, however, these traditional laboratory tasks are minimally challenging on higher-level athletes. Modifying and adding a reactive component to an already proven FPT may provide clinicians with increased insight into neurocognitive performance. Therefore, the purpose of this study was two-fold, to validate a choice-reaction hop test (CRHT) by assessing differences in timing versus the SHT, and to determine the CRHT's test-retest reliability. We hypothesized that the CRHT would take longer to complete than the SHT and it would demonstrate good test-retest reliability.Methods: Fourteen physically active (>90 minutes of physical activity/week) participants (5 female/9 male, 24.5±3.6 years old, 174.2±9.3 cm, 74.4±16.3 kg) with a range of ankle injury history completed the study. Participants were initially screened and completed injury history questionnaires followed by two hop tests in a randomized order. For the SHT, participants performed 20 hops on a single limb medially and laterally over a 30-cm distance as quickly as possible. For the CRHT participants similarly hopped on an instrumented mat 20 times on a single limb medially and laterally over a 30-cm distance, however, participants had to react to one of two squares on each side randomly indicated by flashing lights on a computer screen. Participants completed 3 trials of each hop test in a counterbalanced order. Participants returned one-week later to repeat the CRHT. To validate the CRHTs neurocognitive component, a paired t-test between the SHT and the CRHT was conducted. To assess the test-retest reliability of the CRHT, an ICC using a 2-way, random effects model for consistency of average measures was computed between day 1 and 2.Results: Participants took significantly longer to complete the CRHT (22.1±3.8s) compared to the traditional SHT (10.4±2.0s, p<0.001). The CRHT demonstrated good-excellent test-retest reliability across testing days (r=0.873, p<0.001).Conclusions: Compared to the SHT, the CRHT took significantly longer to complete indicating its ability to stress neurocognitive function during an FPT. The CRHT also demonstrated adequate test-retest reliability, which may allow it to be a useful measure in serial evaluations such as during rehabilitation benchmarking. The CRHT may be an effective FPT to assess combined physical and neurocognitive function to assist clinicians in evidence-based decision making. Future research needs to assess differences in the CRHT in those with CAI versus healthy control participants to further validate its clinical utility.Context: The biopsychosocial model (BPS) has allowed healthcare professionals like Athletic Therapists/Trainers to holistically examine patients, through the integration of biological, psychological, and social factors, addressing the complexity of pain and disability during musculoskeletal injury. Despite clinician's knowledge on the importance of the BPS model, especially in chronic pain, a biomedical approach to overall Athletic Training and Therapy education and clinical practice still exists.Objective: to establish what Graduate Certified Athletic Therapists perceptions are on the importance of the Biopsychosocial Model in overall patient management within clinical practice? Secondly, examining what are Graduate Certified Athletic Therapists views on the Biopsychosocial Model in their undergraduate educational curriculum in Athletic Therapy?Study Design: Cross-sectional study using an online survey was implemented.Patients or Other Participants: 133 Athletic Therapists/Trainers completed the survey (completion rate = 89%).Main Outcome Measure(s): Participants completed demographic, Biopsychosocial Model in Practice and Biopsychosocial Model in College/University Curriculum questions. The 14-item survey used a combination of multiple choice and Likert scale questions. Descriptive statistics characterised the participants; reliability/internal consistency was assessed using Cronbach's α, Chi Squared tests explored the relationships between BPS model and patient care and education. Spearman's Correlation assessed the relationships between Athletic Therapists/Trainers perceptions of BPS and patient care. Mann Whitney U identified the differences between BPS, sex, and education.Results: There was a very strong positive correlation between implementation and the importance of the BPS model in patient management (r= 0.729, n=133, p<0.000). A positive correlation was found between confidence levels and implementation of the BPS model in patient management (r= 0.364, n=133, p<0.000). A weaker but positive correlation was found between confidence levels and effectiveness in incorporating the BPS model on patient outcomes (r= 0.264, n=133, p<0.002). Descriptive statistics showed 82.7% of participants viewed BPS as very important, 71.4% reported very strong implementation with patients, while 56.4% of participants were very confident in their knowledge of the BPS model. A significant difference was found in the understanding of BPS model based on third level education in Athletic Therapists/Trainers and the transferrable skills of the BPS in clinical practice, U = 1208.000, z= -4.425, p = 0.00, r = 0.383. Descriptive statistics showed 61.7% of participants viewed having inadequate transferable skills of the BPS model to a clinical setting, where 27.8% of participants agreed that knowledge of the BPS model was important to ATs and that their educational curriculum was adequate. The survey was assessed for reliability, Cronbach's α score of 0.729.Conclusion: Graduate Athletic Therapists positively view the importance of Biopsychosocial model in patient management, which will enhance clinical practice and patient outcome measures. However, the transferability of BPS from educational curriculum into clinical practice could be further enhanced and developed. Shifting educational curriculum from biomedical focus to a Biopsychosocial model is needed across all Athletic Therapy/ Training programs.Context: All Canadian based members of the Canadian Athletic Therapists Association (CATA) are required to be members of a regional association (RA). The CATA Board of Directors presented a bylaw change eliminating this requirement. This announcement was unexpected by many members, resulting in varied opinions. The Bylaw change has many implications, such as the role of the CATA and RA, membership fee changes, and questioning the value of memberships. The purpose of this research was to explore these issues, and gauge membership opinions of the value of the CATA and RAs.Methods: An online-based survey was targeted to members of the CATA through RAs in Canada, social media, and snowball sampling. Reminders were sent through the same channels, and the survey was open for 1 month. The survey consisted of 50 questions including demographic data detailing membership status, RA affiliation, and membership length. We included questions about membership value and knowledge about association work. Data were tabulated and analysed for national and regional trends and differences. Primary analysis suggested examining Ontario members' opinions as a unique group.Results: Of 682 who started, 61% (N=416) participants completed the survey, and incomplete surveys were deleted. Certified participants were as follows: ATABC (36), AATA (44), SATA (1), MATA (40), OATA (204), CTSQ (69), APATA (6). Provisional[ly] certified, retired, and associate members (N=5) were counted in the certified groups. The remaining participants were certification candidates (3.8%). Over half (57%) of ATs felt the CATA provided 70-100% of national advocacy for the profession. Less than half (44%) of the membership felt the RA provided 70-100% local advocacy, but that value increased to 57% when the OATA group was removed. Just under half (48%) of members credit the RA 70-100%, on advocating for regulation, but 24% were unsure. Removing the OATA group resulted RA regulation advocacy increasing to 63%. Eighty-three percent (83%) of OATA members value the CATA, but only 45% of other RA members share this value. Thirteen percent (13%) of OATA members value their RA, while this percent rises to 74% for other RA members.Conclusion: In general, there is value associated with CATA and RA membership, but there is a strong divide between members of the OATA and other RA members. Regulation, an important issue for many members, is inconsistently viewed by members across the RAs. Most believe regulation is the responsibility of the RA. The dissatisfaction of OATA members skews the opinions of the national membership. . This survey was completed with the goal of understanding membership knowledge and values to better inform all members of the CATA and RAs. The information obtained is of value beyond the bylaw change. A membership survey asking similar questions should be completed every five years.Context: Recent estimates from Alberta, Canada suggests that one in four high school students will have sustained at least one sport-related concussion by the time they graduate and annual prevalence is one in nine. Sustaining a concussion likely increases an adolescent's risk of subsequent injury, yet few studies have quantified this risk across different populations. This study aimed to examine the prevalence of sustaining any subsequent injury and specifically a recurrent concussion following sport-related concussion in the same season among male and female youth ice hockey players ages 11-17 years.Methods: These data are from a 5-year prospective cohort study including youth ice hockey players (n=4420) from British Columbia and Alberta (2013-2014 to 2017-18). We used validated injury surveillance methodology that included a preseason demographic and medical questionnaire, baseline evaluation of symptoms, cognitive function, and balance using the Sport Concussion Assessment Tool (v.3 or v.5), weekly hockey participation hours, and a standardized injury report form validated by a study clinician. All ice hockey injuries requiring medical attention, the inability to complete a session, or time loss from hockey were identified. All players with a suspected concussion were referred to a sport medicine physician and concussion diagnosis was based on the most current International Consensus Statement on Concussion in Sport. We identified participants with a suspected hockey-related concussion that returned to sport within the ice hockey season and reported 1) the estimated prevalence [95% confidence intervals (CI) adjusting for cluster by team] of players with a subsequent injury (including concussion) or recurrent concussion in the same season, and 2) the median (range) number of days to subsequent injury. Prevalence ratios (PR) to assess differences between males and females were estimated using robust Poisson regression adjusted for clustering by team.Results: Of the 384 males and 64 females concussed in this sample, 72 males (18.8%, 95%CI: 15.1%-30.0%) and 7 females (10.9%, 95%CI: 0.4%-23.2%) sustained a subsequent injury before the end of their season. The median (range) days to subsequent injury was 101 (11-181) for males and 75 (7-123) for females. In total, 50 males (13.0%, 95%CI: 9.9%-17.1%) and 4 females (6.3%, 95%CI: 1.7-22.6%) sustained a recurrent concussion, specifically. The median (range) days to recurrent concussion was 96 (11-164) for males and 39 (12-75) for females. Males and females did not differ in the risk of sustaining a subsequent injury (PR=0.58, 95%CI: 0.21-1.60) or recurrent concussion (PR: 0.48, 95%CI: 0.13-1.76).Conclusions: An estimated 1 in 5 male and 1 in 10 female hockey players sustained a subsequent injury within the same season following a sport-related concussion. While no significant differences were identified between males and females, results should be interpreted with caution due to the low number of females in this sample.Context: Neuropsychological assessments are routinely used in the evaluation of concussion. . Ideally, every athlete would have a baseline neuropsychological assessment for comparison in the event of a concussion, however many factors make it challenging to have these assessments on each athlete. Further, the datasets currently available do not stratify by concussion history which is known to cause changes in neuropsychological performance. The purpose of this study is to provide a large normative dataset as a reference for interscholastic athletes, stratified by concussion history.Methods: 36,360 interscholastic athletes (males n= 21,696, females n= 14,664) between the ages of 10-18 years old participated in preseason baseline concussion testing which included Immediate Post-concussion Assessment and Cognitive Test (ImPACT). ImPACT testing was conducted in groups prior to the start of sport participation by an ATC trained in ImPACT test administration. Outcome data obtained for Verbal (VEM) and Visual (VIM) Memory, Visual Motor Speed (VMS), Reaction Time (RT) and Impulse Control (IC) was stratified by number of previous concussions.Results: Descriptive data are as follows; VEM (84.25 ± 10.263), VIM (73.69 ± 13.115), VMS (35.31 ± 7.102), RT (0.65 ± 0.101) and IC (6.31 ± 4.465). . A one-way ANOVA compared the IMPACT outcomes based upon the number of reported concussions. A significant difference was noted for VIM (F(9,36351) = 1.91, p<0.05), VMS (F(9,36352) = 13.73, p<0.05), RT (F(9,36352) = 7.39, p<0.05), and IC (F(9,36352) = 8.73,p<0.05). No significant differences were found for VEM based upon number of concussions. . Post-hoc testing revealed significant differences between athletes who sustained 0, 1, 2, and 3 concussions. No differences were noted for number of concussions greater than 3.Conclusions: The outcomes support the use of stratified norms for concussion history in interscholastic athletes. Further, healthcare professionals should use caution when comparing post-injury data to standard normative data as concussion history is not taken into account and may impact the outcome. Future research should evaluate ImPACT data in athletes who have sustained more than 3 concussions. The current dataset, while robust, was limited to mostly athletes who had sustained 3 or fewer concussions.Context: Concussions in interscholastic athletes pose a challenge for athletic trainers as the brain of adolescents is growing and developing, which can make the diagnosis and management of those injuries increasingly difficult for healthcare providers. While having a baseline measure for each athlete is recommended, the time and resources required to administer baseline tests for all athletes is not always feasible. Therefore, having access to a large baseline dataset will provide healthcare professionals a reference point to compare when individuals sustain a concussion. . The purpose of this study is to provide ImPACT normative data as a reference for athletes of different ages and genders.Methods: More than 36,000 interscholastic athletes (males n= 21,696, females n= 14,664) between the ages of 10-18 years old participated in pre-season baseline concussion testing. Traditional computer based Immediate Post-concussion Assessment and Cognitive Test (ImPACT), was utilized as a measure of neuropsychological assessment. Athletes were tested in a group environment prior to the start of sport participation. All testing was supervised by an Athletic Trainer trained in ImPACT test administration. Outcome data obtained for Verbal (VEM) and Visual (VIM) Memory, Visual Motor Speed (VMS), Reaction Time (RT) and Impulse Control (IC) was stratified by age and gender.Results: Outcomes for all participants are as follows; VEM (84.25 ± 10.26), VIM (73.69 ± 13.12), VMS (35.31 ± 7.10), RT (0.65 ± 0.10) and IC (6.31 ± 4.47). A one-way ANOVA was used to determine difference in outcomes based upon age. Significant differences were found for: VEM (P(8,36307) = 82.77, p<0.05), VIM (P(8,44177) = 71.00, p<0.05), VMS (P(8,44178) = 776.66, p<0.05) RT (P(8,44178) = 360.26, p<0.05), and IC (P(8,44178) = 68.99, p<0.05). Tukey's HSD was used to determine the nature of the differences between ages, multiple significant differences were noted between each age for each outcome. An independent t-test found significant differences between gender for; VEM (t(44245) = 23.79, p<0.05), VMS (t(44246) = 20.83, p<0.05), RT (t(44246) = 7.33, p<0.05), IC (t(44246) = 13.33, P<0.05).Conclusions: While standard ImPACT baseline norms do stratify by age, gender stratifications are not currently published. It is important that healthcare professionals use the appropriate stratifications to compare post-concussion data in interscholastic athletes, as there are differences between gender and between age groups.Context: Alterations in scapular position and motion (scapular dyskinesis [SD]) are a prevalent clinical finding in symptomatic and healthy individuals that increases the risk of shoulder pain and pathology. Given the multi-directional muscle fibres of the trapezius, differences in excitation within a region likely influence scapular position and motion. The purpose of the study was to examine muscle excitation in the three regions of the trapezius in those with and without SD during shoulder flexion to determine if differences in the mean location of excitation (i.e. barycentre) exist.Methods: Fifty-six healthy right-handed participants were assessed for SD using the SD test: 28 had normal scapular motion (CON: 15 Female, 27±9 years) and 28 had dyskinesis (DYS: 22 Female, 24±7 years). Participants completed five repetitions of weighted shoulder flexion. Kinematics of the upper extremity were collected to determine glenohumeral angle, while high-density surface electromyography of the upper [UT], middle [MT], and lower [LT] trapezius was collected using 3, 32-electrode grids. Barycentre within 30-degree ranges (30°-60°, 60°-90°, 90°-120°) was extracted during elevation [UP] and lowering [DOWN] phases for each grid. A two-way ANOVA was conducted for each grid in each range, resulting in six ANOVAs to examine the interaction of group and angle.Results: Barycentre location is expressed as a percentage of grid position from 0% (most cranial) to 100% (most caudal). A significant interaction was found for LT-UP (p = .025, η2p = .079). Barycentre was located more cranially in DYS at each range, with differences of 4.6% (CON=35.2±6.6%, DYS=30.6±7.9%, p = .022) for 30°-60°, 5.0% (CON=35.1±6.7%, DYS=30.1±8.2%, p = .015) for 60°-90°, and 5.8% (CON=35.7±7.3%, DYS=29.9±8.4%, p = .008) for 90°-120°. Simple main effect of angle was significant for DYS (p = .042, η2p = .132) but not CON. A significant interaction was found for LT-DOWN, (p = .041, η2p = .073). Barycentre was located more cranially in DYS at 120°-90° and 90°-60°, with differences of 5.9% (CON=36.3±6.9%, DYS=30.4±8.5%, p = .006) and 4.5% (CON=36.1±6.2%, DYS=31.6±7.9%, p = .021), respectively. Simple main effect of angle was significant for CON (p = .030, η2p = .157) and DYS (p < .001, η2p = .404). No significant interactions were found for UT or MT during UP or DOWN phases.Conclusion: Mean location of excitation in the LT was more cranial in DYS at various angles of shoulder flexion compared to CON, which may contribute to alterations in scapular kinematics observed in individuals with SD. Future research is needed to determine if selective excitation of sub-regions of the trapezius is associated with deviations in scapular kinematics, and whether the location of excitation within a muscle can be altered, both acutely and chronically, by targeted rehabilitation strategies to improve scapular kinematics and reduce the risk of shoulder pathology.Context: Shoulder conditions are among the most common reason for visiting primary point of care services such as family physicians and allied health professionals (i.e. athletic therapists, physiotherapists), resulting in an overwhelming high demand for services. The current system, however, is plagued with variations in patient care, inappropriate or unnecessary treatment, inaccurate diagnoses, and greater use of healthcare resources. For instance, there is a lack of consistency and awareness with respect to appropriate imaging criteria by ordering physicians. This results in a high volume of magnetic resonance imaging (MRI) that continues to be ordered at the primary care level when not indicated. . Standardized clinical decision-making tools improve patient access and quality of care. Standardized care pathways provide guidance on best practice and aim to decrease variance in practice across the continuum of care, while reducing unnecessary wait times and healthcare expenditures.Methods: Development of the tool underwent: 1) completion of a rapid review; 2) selection of experts, and 3) implementation of a modified Delphi voting process.Results: The rapid review initially yielded 6,451 articles after duplicates were removed. After title, abstract, and full-text review, 88 articles provided evidence and generated 271 voting statements. Fifty-five experts were selected to participate in three rounds of Delphi voting. Experts were chosen to represent different health disciplines and geographical locations across Alberta. Rounds 1 and 2 voting occurred via email using Research Electronic Data Capture (REDCap) survey distribution tools; Round 3 voting occurred “face-to-face” using the video-conferencing web-based platform, Zoom Video Communications (version 5.1.0). Consensus was reached for a standardized primary care decision-making tool for the following shoulder conditions: rotator cuff disease, biceps pathology, superior labral tear, instability, adhesive capsulitis, and osteoarthritis of the glenohumeral and acromioclavicular joints.Conclusion: This tool is intended to provide a province-wide standardized approach for managing shoulder conditions in primary care. This tool consists of a clinical examination algorithm for assessing, diagnosis, and managing shoulder pain; recommendations for history-taking and identification of red flags or additional concerns; recommendations for physical examination and neurological screening; and stepwise approaches for clinical decision-making. Development of this tool was an Alberta Health Services' Bone and Joint Health Strategic Clinical Network (BJH SCN) initiative of the Musculoskeletal Transformation (MSK-T) Program. The MSK-T Program is a province-wide initiative aimed to improve quality of care; standardize MSK care across Alberta; and support innovating models that shift the burden of care and dollars from downstream management (i.e. surgery) towards prevention, early detection, and appropriate community management. This initiative is also supported by the Alberta Bone and Joint Health Institute.Context: The Canada Games (summer and winter) have been held since 1967. Injury and health surveillance systems are important for understanding the burden, causes, and potential prevention opportunities of injuries and illnesses during major sporting events. This study aimed to examine sport-related injury and illness rates during the 2019 Canada Games and determine potential improvements for future injury surveillance.Methods: This is a retrospective cohort study using data extracted from registration information and incident reports by medical staff from the 2019 winter Canada Games. All medical reports were independently coded by two researchers with sports medicine backgrounds, based on the Orchard Sports Injury and Illness Classification System (OSIICS) and the International Olympic Committee (IOC) consensus statement on methods for recording and reporting of epidemiological data on injury and illness in sport. Conflicts were discussed with the research team. All registered athletes (ages 12-30) were included in this analysis. Injury incidence proportions (IP) per 100 registered athletes with 95% confidence intervals (CI) were calculated for male and female by sport based on injuries classified as index injuries directly or non-directly related to sport during the Canada Games. The incidence proportion of all illnesses are also reported.Results: In total, 2,346 unique athletes (1,110 males, 1,235 females, 1 non-disclosed) participated in 2019. There were 2,249 medical incident reports, of which 562 were identified as index injuries either directly or non-directly related to sport during the games [IP: 23.9 injuries (95% CI 22.0-26.0) per 100 athletes] and 97 illnesses [IP: 4.1 illnesses (95% CI 3.4-5.0) per 100 athletes]. The sporting events with the highest incidence of injuries included, men's and women's freestyle skiing [IP: 62.8 injuries (95% CI 41.4-91.4) per 100 athletes and IP: 56.0 injuries (95% CI 30.6-94.0) per 100 athletes respectively], men's boxing [IP: 46.3 injuries (95% CI 27.0-72.4) per 100 athletes], women's snowboarding [IP: 44.1 injuries (95% CI 24.7-72.8) per 100 athletes], women's biathlon [IP: 40.5 injuries (95% CI 22.7-66.9) per 100 athletes] and men's gymnastics [IP: 36.1 injuries (95% CI 23.6-52.9) per 100 athletes]. Despite standardized coding procedures, many of the medical reports lacked sufficient detail, resulting in many cases requiring discussion prior to coding (e.g. 23% of injury pathology type cases, 40% of OSIICS injury diagnoses).Conclusion: Approximately 1 in 5 athletes sustained at least one injury requiring medical attention during the 2019 Canada Games. The IOC consensus statement on methods for recording and reporting of epidemiological data provides sport organizers with guidelines and best practices on how to collect and report injury rates, but these strategies have yet to be implemented. Implementing more standardized reporting can improve the reliability of monitoring injury and illness burden and inform prevention strategies at future Canada Games.Context: The Children Focused Injury Risk Screening Tool (ChildFIRST) was developed to identify children who present poor movement competence and may have increased risk of lower limb injury. The correlation of movement competence and physical activity levels has been widely studied; however, the correlation between physical activity levels and a tool that evaluates movement competence and injury risk has not been explored. The purpose was to evaluate the correlation between the ChildFIRST scores and physical activity levels in 8–12-year-old children.Methods: We conducted a cross-sectional study to evaluate apparently healthy, injury free, 8-12-year-old children. After conducting a power analysis, we used convenience sampling to recruit participants from local schools and sport academies. We evaluated movement competence using the ChildFIRST which is a valid and reliable tool that consists of ten movement skills (i.e., bodyweight squat, vertical jump, horizontal jump, walking lunge, running, leaping, single-leg hop, single-leg sideways hop and hold, two to one hop and hold, and 90-degree hop and hold) each with four evaluation criteria for a total score of 40 points. Demographic data, self-reported physical activity, and ChildFIRST scores analyzed in this study were collected as part of the continued validation ChildFIRST study using 3-dimensional motion analysis. We computed a Pearson correlation coefficient (r) with 95% confidence intervals (CI) and an alpha level of 0.05 to study the correlation between the ChildFIRST and physical activity levels. We determined the physical activity levels by adding the number of physical activity sessions (excluding physical education classes) and sport practices per week.Results: Seventeen (17) children completed the tests (82.35% male, years = 10.46 ±1.33, BMI = 17.13 ±1.58). The children participated in 4.53 ±1.59 physical activity sessions and 2.88 ±1.87 sports practices for a total of 7.41 ±2.47 sessions per week. These sessions lasted less than 30 minutes for 12.50% of the participants, between 30 and 60 minutes for 56.25% of the participants, and more that 60 minutes for 31.25% of the participants. The mean of ChildFIRST scores was 30.18 ±4.96, and the correlation between physical activity and ChildFIRST scores was positive (r = 0.49; 95%CI [0.02, 0.79]) and significant (p = 0.044).Conclusion: Consistent with the literature, there is a moderate positive correlation between ChildFIRST scores and physical activity levels. Including an injury prevention approach to movement competence assessment is congruous to promoting safe physical activity. Focusing on the development of movement skills should continue to be advocated by practitioners working with pediatric populations. Improved movement competence may lead to increased motivation and confidence that may lead to increased physical activity levels. The ChildFIRST can provide information to assist stakeholders in designing individualized movement-based interventions associated with long term physical activity levels.Context: Special Operations Forces (SOF) combat Soldiers endure various occupational exposures including blunt and blast head trauma. These exposures may result in occupational injuries, which may negatively affect human performance. Vision contributes to human performance, and existing data support two premises: 1) concussions adversely affect vision, and 2) visual deficits are associated with increased head impact frequency and severity, and decreased impact anticipation. These premises affect athletes and Sol

Development of a list of core clinical topics suitable for a shared primary care curriculum for medical undergraduates in Malaysia: A Delphi study

ABSTRACT In the last few decades, primary care medicine (PCM) is increasingly recognised as a cornerstone of an efficient and effective healthcare system. However, the PCM discipline is now facing challenges such as a shortage of doctors. One of the possible reasons could be the lack of comprehensive PCM curricular components in the undergraduate medical programmes. This study aimed to develop a list of core clinical topics suitable to be used as a shared PCM curriculum for undergraduate education in Malaysia. A Delphi survey that consisted of three iterative rounds with feedback was used in this research. The participants included PCM experts involved in the undergraduate level of PCM teaching. These experts were selected based on the criteria developed by two senior academicians in PCM medical education. The final developed list contained 34 core clinical topics that should be incorporated into the undergraduate PCM curriculum. The findings will be useful in establishing the policies and guidelines of PCM education for undergraduates in various medical schools. This study may also promote the field of PCM and encourage more doctors to take up the speciality. Lastly, it provides essential information to address the knowledge gap in PCM education among undergraduate medical students in Malaysia.

A qualitative study on the perspectives and needs of oncology nurses about recognition and management of suicide risk in cancer patients.

To determine the perspectives and needs of the oncology nurses in recognising and managing the risk of suicide in cancer patients. Cancer patients are one of the groups with a high risk of suicide. The perspectives and needs of oncology nurses regarding their recognition and management of suicide risk in such patients need to be clarified. This qualitative descriptive study used a sample of 33 oncology nurses that were sampled by maximum variation sampling from different oncology units and hospitals. Data were collected with in-depth interviews via a semi-structured interview form and analysed with content analysis. The COREQ guideline was followed for the reporting of the study. Three main themes and eight subthemes were identified, namely 'An uncertain atmosphere: sensing the risk of suicide but not seeing the picture' (Subthemes: Inability to identify suicide risk, Unclear responsibilities and Distress as a result of uncertainty), 'Efforts to give meaning to and compensate losses of patients' (Subthemes: Attributions to cancer-related losses of patients and Interventions to alleviate distress related to loss) and 'Hindrances beyond the nurse' (Subthemes: Stigma towards psychosocial problems and getting help, Disagreement with the Physician and A lack of institutional culture on suicide prevention). Our study revealed that oncology nurses have insufficient knowledge and skills and unclear roles in recognising and managing suicide risk. In addition, nurses have difficulty in helping patients due to the insufficient support of team members, stigmas of patients and their relatives towards getting help, patient workloads, and inadequate institutional support in risk management. Training programmes aiming to increase nurses' awareness, knowledge and skills should be developed and embedded into current in-service education programmes and undergraduate education curricula as part of professional improvement. The results of the study can contribute to planning the content and scope of suicide prevention training peculiar to oncology nursing.

Positioning Design Science as an Educational Tool for Innovation and Problem Solving

This study discusses design science from a teaching and learning perspective. Predominantly targeted to information systems research, design science notwithstanding can also contribute as a pedagogical tool, which promotes innovation and problem solving in a variety of domains. However, the related literature still lacks experiences and best practices on how to position design science as an educational tool. We fill this gap by exploring the purpose and meaning of design science in higher education, with a focus on undergraduate courses. We elaborate on a process that helps educators integrating this innovative tool into their course designs. The process has been instantiated in various undergraduate courses in different domains. Based on these course instantiations, we propose a stronger position of design science education in undergraduate curricula.

Attitudes and practices of tobacco cessation counseling among Saudi dental professionals: A nationwide cross-sectional survey.

Dental professionals can play a pivotal role in educating the public about the harmful effects of smoking and encouraging them to quit the habit. This study assesses the attitudes and practices of tobacco cessation counseling (TCC) among dental professionals in Saudi Arabia. This questionnaire-based cross-sectional study targeted dentists and dental interns working in government and private sectors in Saudi Arabia. We conducted a descriptive analysis by using SPSS Statistics, version 25.0. A total of 895 respondents (314 interns and 581 dentists) participated in this survey. Although the majority of respondents (93%) reported that they always ask patients about tobacco habits, only 59% reported recording tobacco habits in patients' files, and only 55% of the respondents reported explaining to patients the harmful effects of tobacco. Around 91% of the participants believe that a dental clinic is an appropriate place for TCC, and 22% believe that TCC has a negative impact on dental practice. Smoking status, work setting, and the number of years since graduation were found to be significantly associated with the respondents' attitudes and practices. Lack of training, time limitations, and lack of confidence were barriers for TCC. Dental professionals in Saudi Arabia demonstrated relatively positive attitudes but weak practices of TCC. Continuous education and motivation are needed to improve dentists' confidence, attitudes, and willingness for TCC. Integration of tobacco control education in undergraduate curricula is recommended.

EFFECTIVENESS OF PEDIATRIC PALLIATIVE CARE EDUCATION PROGRAM IN STRENGTHENING NURSING STUDENTS’ PALLIATIVE CARE PRACTICES AND ATTITUDES TOWARD CARE OF THE DYING

Objective: The present study used a quasi-experimental design to determine the effectiveness of palliative care education program in strengthening nursing students’ palliative care practices and attitudes toward care of the dying. 
 Methods: The study involved 39 nursing student of 4th year, including 17 students in the experimental group and 22 in the control group. A pediatric palliative care education program was applied to the intervention group through interactive learning methods. The data was evaluated using multidimensional variance analysis, the Bonferroni modified t measure, and regression analysis.
 Results: A significant difference was found among the experimental and the control group for total mean scores of the all scale. A high level, positive, and highly significant relationship was found between the education program and all scale.
 Conclusion: The results of the study indicated that the pediatric palliative care education program was an effective method that could be used in educating nursing students. The study provides effective results for including pediatric palliative care nursing course to the nursing undergraduate education curriculum.

Factors Affecting Interpersonal Competence of Nursing Students: Focused on Self-Assertiveness and Empathy

Purpose: Interpersonal competence, a key competence for patient-centered care by nurses, should be understood. Therefore, factors influencing the interpersonal competence of nursing students should be identified to explore and enhance their interpersonal relationships during the undergraduate educational curriculum for nursing educators. In this study factors influencing interpersonal competence, especially on self-assertiveness and empathy in nursing students were identified and analysed.Methods: A cross-sectional study design was used for the study in two Korean nursing colleges with similar baccalaureate nursing curricula. A total of 251 nursing students from freshman to senior year completed a questionnaire to measure related factors that were assumed to influence nursing students’ interpersonal competence. Data were collected from October 11~31, 2016. Study variables included self-assertiveness, empathy, interpersonal competence, and socio-demographic status. Multiple regression analysis was used for data analysis.Results: Nursing students’ interpersonal competence was explained by personality (β=.22), self-assertiveness (β=.16) and empathy (β=.38). The explanatory power of these predictors was 26.8% (p<.001).Conclusions: Nursing students’ interpersonal competence during the undergraduate nursing years can be enhanced by educational strategies that improve their interpersonal relationship as patient-centered care providers. Simultaneously, the attitude of the nurse educator is also important for nursing students who are to be treated as valuable learners and to improve students' empathy and self-assertiveness ability.

The State of the Perioperative Nursing Specialty Workforce:: A Concern for Executive Nurse Leaders

Executive nurse leaders with operational responsibilities over perioperative departments are faced with challenges in recruitment, retention, and educational preparedness in perioperative nurses. Establishing academic partnerships with hospital facilities and incorporating perioperative nursing education in undergraduate curricula is a successful approach to addressing recruitment and retention challenges. This article provides an overview based on the literature of the current state of the perioperative nursing workforce and offers recommendations for executive nurse leaders from health care facilities and academic institution to establish programs to address perioperative nurse workforce shortages. Executive nurse leaders with operational responsibilities over perioperative departments are faced with challenges in recruitment, retention, and educational preparedness in perioperative nurses. Establishing academic partnerships with hospital facilities and incorporating perioperative nursing education in undergraduate curricula is a successful approach to addressing recruitment and retention challenges. This article provides an overview based on the literature of the current state of the perioperative nursing workforce and offers recommendations for executive nurse leaders from health care facilities and academic institution to establish programs to address perioperative nurse workforce shortages. Rebecca Vortman, DNP, RN, CNOR, is clinical assistant professor in the Department of Population Health Nursing Science at the College of Nursing, University of Illinois Chicago, in Springfield, Illinois. She can be reached at [email protected] . Sara McPherson, PhD, RN, is clinical assistant professor in the Department of Biobehavioral Nursing Science at the College of Nursing, University of Illinois Chicago.

Exploring pharmacy ethics in developing countries: a scoping review.

Background Healthcare ethics have been profoundly influenced by principles of bioethics that emerged post-World War II in the Declaration of Geneva 1948. 'Beneficence' (to do good), 'Non-Maleficence' (to do no harm), 'Justice' (fairness and justice in access) and 'Respect for Autonomy' (respect for patient individuality, including decision making, privacy, and right to refuse), have become foundational principles of contemporary medical codes of ethics. These principles are well reflected in most professional pharmacy code of ethics globally. This domain remains relatively unexplored in most developing countries and the majority of what has been published in this area relates to western cultures. There have been no attempts to pool findings from a similar scope of research emanating in developing countries. Aim of the review This study aims to explore the scope of pharmacy ethics in the literature pertaining to developing countries. Methods An extensive search of three relevant (Scopus, CINAHL, IPA) databases was conducted from Jan 2000 to Feb 2020, in order to identify relevant studies conducted in or focussed on ethics in pharmacy in developing countries. A separate Google Scholar search was carried out in an effort to locate supplementary articles, hand-searched articles were also included to achieve an exhaustive investigation of all current relevant studies. Results The full text of 20 relevant articles that met inclusion criteria were critically analysed and qualitatively categorised into three emerging themes; Ethical challenges in pharmacy practice, Approaches used in teaching pharmacy ethics, and Code of ethics analysis and implementation. Conclusions: Findings of this literature review illuminated a gap in pharmacy ethics literacy in developing countries and variances in pharmacists' ethical attitudes in handling ethical dilemmas, as well as a lack of familiarity with ethical principles and codes of ethics. Pharmacists' lack of respect for patients' autonomy and pharmacists being prone to financial pressure were found to have a significant impact on pharmacy practice in most of developing countries. However, attempts are being made to rectify this gap by efforts to incorporate ethical and professional education in undergraduate curricula, and by studies in which new codes of ethics are being implemented.

Simulation-Based Medical Education in Undergraduate Curriculum: Will a Home-Developed Model Suffice?

A medical student needs to understand the integral theory of continence, clinically elicit urethral hypermobility and understand the surgical principles of repair. A skill development model was designed for the final year curriculum of medical students to explain the basic knowledge of integral theory of continence along with surgical repair of urinary incontinence. The primary objective of the study was to assess the efficacy of simulation-based teaching (SBT) using a home-developed model as compared to video-based teaching (VBT). The secondary objective was to elicit the feedback of students who underwent SBT. One hundred fifty-nine medical students participated in the study. Simulation-based teaching (SBT) (n= 81) was compared with video-based teaching (VBT) (n= 78). Pretest and posttest results were used to assess learning. Feedback was obtained to improve the existing teaching method. In the VBT group, the posttest values of lowest score, 25th percentile, 75th percentile, and maximum scores were 9, 10, 12, and 15, respectively. In the SBT group, the posttest values of lowest score, 25th percentile, 75th percentile and maximum scores were 11, 12, 14, and 15, respectively. The students were able to comprehend the anatomical landmarks and integral theory of urinary continence better in SBT group. The surgical technique demonstration and hands-on training done on the pelvic model improved their comprehension. A home-developed model is an effective and economic tool in training medical students. This prototype model of education can be employed as a teaching tool in other surgical disciplines as well.

Two-year analysis of dermatological out-of-hours consultations at Frankfurt University Hospital.

In recent years, emergency consultations have become more common in all medical disciplines. In Germany, dermatological out-of-hours consultations are handled by emergency practices, emergency departments and tertiary care providers. Little information is available on the reasons for these dermatological consultations. The aim of this study was to analyze patient characteristics, diagnoses and admission rates resulting from these consultations. We conducted a retrospective study covering two years of out-of-hours consultations at a dermatological tertiary referral center. A total of 3635 patients presented at the referral center. The most frequent outpatient diagnoses were acute urticaria (13.8%) and bacterial infections (12.3%). 83% of the outpatient diagnoses required the most advanced competence level according to the new German curriculum for undergraduate education of medical students. 405 (11.01%) patients did not require dermatological treatment, and 430 patients (13.6%) were admitted to hospital. Most admissions were due to bacterial infections and herpes zoster. Advanced age, pain and fever were associated with a relatively high risk of admission. Admission rates at the dermatological tertiary referral center were substantially lower than at interdisciplinary emergency departments. A few diagnoses accounted for more than half of all consultations. These diagnoses are well represented within the new German curriculum.

Understandable Unified Description about Diffraction and Scattering of X‐Ray and Visible Light Beams from Soft Matters in Terms of Educational Aspects

In attempt to pursue easy understanding about 1) wide angle X‐ray diffraction (WAXD), 2) small angle X‐ray scattering (SAXS) and 3) small angle light scattering (SALS) under polarization, teaching methods in this manuscript are focused on the concept that quantitative analysis above three phenomena are developed from a unified fundamental equation EE* (E: scattering amplitude, E*: the conjugate complex). The graduate students studying material science can understand the approach based on mathematical knowledge within undergraduate educational curriculum. This approach refers to two important points associated with the different developments. The first is the different wave lengths between X‐ray and visible light associated with different photon energy. When an incident X‐ray beam is entered in the polymer material, electrons in atoms behave as free electrons because of high photon energy. On the other hand, when visible light with low photon energy is entered, electrons of atom cause vibration on bottom of the potential box. These different electron behaviors emphasize to provide the different scattering modes of X‐ray and visible light. The second is the commentary about branching point about the mathematical treatments concerning X‐ray diffraction and scattering amplitude in spite of a unified equation represented by Equation (II‐1). This is explained in terms of focusing element scales. The diffraction and scattering in most of the textbooks have been written individually by different authors and then the descriptions have been never focused on the branching point.

Biomedical engineering undergraduate education: A Canadian perspective

Background With an aging population and increasing demand on health care systems, biomedical engineering as an undergraduate program fits a growing societal need. As such, many Canadian universities have implemented biomedical engineering undergraduate programs. This provides a unique opportunity for core engineering faculty, engineering education researchers, and curriculum specialists to implement proven educational theories in the core curriculum of these programs to ensure exemplary and competent Canadian-trained biomedical engineering graduates. Purpose This paper discusses the need for biomedical engineering as a core undergraduate program in Canada, the historical context of educational theories as related to biomedical undergraduate engineering education, a framework for the implementation of proven strategies, and learner-centric methods that benefit the learner, mentor, and society as a whole. Scope/method: The historical context of curriculum theories related to biomedical engineering undergraduate education, evaluation of the intrinsic and extrinsic curriculum theories in current biomedical engineering undergraduate education, educating progressive learners and development of future biomedical engineering undergraduate education curriculum, is explored. Conclusion The integration of educational theories in the development of a biomedical engineering undergraduate engineering education is essential to ensure learners are provided with opportunities to experience cutting edge, quality engineering education. Empirical evidence demonstrates the successful implementation of applied methodologies such as model-electing activities, problem-based learning, and the flipped classroom. Providing biomedical engineering faculty with professional development opportunities around the successfully implementation of these tools aimed at culturally diverse, globalized 21st-century learners, can be catalytic in shifting to a new paradigm for engineering education in Canada and globally.

Cross-sectional survey of the undergraduate rheumatology curriculum in European medical schools: a EULAR School of Rheumatology initiative

ObjectivesTo survey the undergraduate rheumatic and musculoskeletal diseases (RMDs) curriculum content in a sample of medical schools across Europe.MethodsThe undergraduate musculoskeletal diseases and disability curriculum of University of Nottingham, UK,...

Construction of nursing undergraduate education curriculum modules based on competency

Objective To construct nursing education curriculum modules to evaluate the competency for nursing undergraduate students. Methods Convenient sampling method was performed from September to December 2014 to select 7 experts from 1 medical university in Tianjin and 2 medical universities in Beijing to attend the conference. Nursing undergraduate education curriculum modules were constructed through the live discussion and distribution of expert opinion questionnaire within the competency comprehensive evaluation index system for nursing graduates. Results The active coefficient of experts was 100%; the coefficient authority (Cr) was 0.95; and the coordination coefficient (W) was 0.37 (P<0.001) . 12 knowledge modules and 5 curriculum modules were constructed. Conclusions The 5 constructed curriculum modules of this study can provide references for curriculum revision based on competency. Key words: Students, nursing; Education, medical, undergraduate; Curriculum

Resources for Educating, Training, and Mentoring Nurses and Unregulated Nursing Care Providers in Palliative Care: A Review and Expert Consultation.

Nurses and nursing care providers provide the most direct care to patients at end of life. Yet, evidence indicates that many feel ill-prepared for the complexity of palliative care. To review the resources required to ensure adequate education, training, and mentorship for nurses and nursing care providers who care for Canadians experiencing life-limiting illness and their families. This is a systematic search and narrative review in the Canadian context. Six previous reviews and 26 primary studies were identified. Studies focusing on regulated nurses indicated that even amid variability in content, delivery methods, and duration, palliative education improves nurses' knowledge, confidence, attitudes, and communication abilities, and decreases nurses' stress. Results from palliative education in undergraduate curriculum were less definitive. However, studies on palliative simulation in undergraduate education suggest that it improves knowledge and confidence. Studies focusing on educating nursing care providers, either alone or in collaboration with regulated nurses, indicated positive outcomes in knowledge, confidence, communication, identification of clients who are dying, abilities to interact with patients and families, and a better understanding of their own contributions to care. Curricular resources in Canada have been developed. However, there is no dedicated and funded capacity-building strategy. Resources exist to support palliative education for nurses and nursing care providers. Furthermore, the evidence suggests good outcomes from this education. However, there is no dedicated strategy for implementing those resources. Furthermore, there is little evidence of the critical role of knowledge translation in preparing nurses and nursing care providers for evidence-informed palliative practice.

Environmental Education in the Curriculum: A Space for the Formation of Environmental Educators

This article aims to discuss the implementation of Environmental Education in undergraduate curricula from the Brazilian legal framework (Constitution 88, National Environmental Education Policy, National Curricular Guidelines for Environmental Education, National Curricular Guidelines). Space for formation of environmental educators was provided, and it was inferred in the role of leadership in cultural and social change, which should be assumed by higher education institutions in the process of technological development. Besides the preparation of students and provision of information that can lead to a critical appropriation of knowledge, attitudes and values: political, social and historical, in terms of a sustainable and fair society.

SURVEY OF DENTAL STUDENTS’ ATTITUDE REGARDING ORIENTAL MEDICINE/COMPLEMENTARY AND ALTERNATIVE MEDICINE: COMPARISON BETWEEN TWO JAPANESE DENTAL SCHOOLS

Background:The present study aimed to examine the impact of “curricula for undergraduate education in oriental medicine (OM)/complementary and alternative medicine (CAM)” on student awareness of OM. A questionnaire survey was conducted involving the Nagasaki University School of Dentistry (NUSD), a university that implements education in OM as part of its undergraduate curriculum, and Tokyo Dental College (TDC), which does not teach OM.Materials and methods:The third- and fifth-year students of both NUSD and TDC underwent the anonymous questionnaire survey, which included questions regarding their knowledge of OM and CAM, interests in these subjects, and their opinions on the necessity of teaching OM in the undergraduate dental education, and the results were collected for analysis.Results:Whereas 33% of 5th year NUSD students had knowledge of OM/CAM was 33%, only 10% of 5th year TDC students reported knowledge on the subject. 69% of 5th year NUSD students interested in OM/CAM, while 5th year TDC students who interest them were only 45%. Although 77% of 5th year NUSD students were in favor of OM education implemented in the Faculty of Dentistry, the percentages of TDC students of that were smaller (46% in 3rd year and 48% in 5th year). Whereas 26% of 5th year TDC students did not recognize the necessity of oriental medicine education, only one 5th year NUSD student (2%) did not so.Conclusion:Introduction of education in OM in the undergraduate dental education program helps students to increase their interests in dental clinical applications.