Education Of Healthcare Professionals Research Articles

BUILDING SUSTAINABILITY IN PUBLIC HEALTH ALZHEIMER’S DISEASE PROGRAMS

Abstract While public health experts cannot yet say how to prevent Alzheimer’s disease and related dementias (ADRD), public health has a role in slowing ADRD through the implementation of risk reduction strategies, early diagnosis, and better education and training of front-line health care professionals. Efforts to enhance the sustainability of programs, with changes to systems, environments, and policies enhances uptake and increases the lifespan of these interventions, as well as facilitates continuity and integration of efforts across jurisdictions. This approach includes multiple partners from a wide-range of sectors. This presentation will describe public health approach to ADRD including increasing awareness and action on dementia risk reduction, early detection, and coordination with aging services including supporting dementia caregivers. We will discuss innovative approaches of achieving sustainability, including identifying approaches that seek to reach entire populations for widespread and sustained impact utilizing examples from BOLD Programs to develop widespread public health infrastructure.

Cannabis vaporisation: Understanding products, devices and risks.

Vaporisation is a common method of cannabis administration. Inconsistent terminology and jargon regarding vaporisation has led to confusion. The increasing public interest and access to cannabis, combined with possible safety concerns associated with certain cannabis vaping products, warrants improved consumer and public and health care professional knowledge. To improve this knowledge, we conducted a review of the common terminology, regulatory status, products and device types related to cannabis vaporisation. Cannabis vaporisation devices can be separated into nine types. While vaporisation reduces respiratory risks associated with cannabis combustion, not all vaping products and device types carry the same level of safety. Metered dose inhalers and dried product vaporisers present the lowest safety risk due to a lower risk of toxin exposure and the use of lowertetrahydrocannabinol potency products. As both vaping and cannabis use increase in popularity, focusing on accurate health education will help facilitate health promotion to encourage lower risk use. The current lack of understanding on risk differences between types of cannabis vaporisation is a missed opportunity for harm reduction. Increased opportunities for public health and health care professional education on different cannabis vaporisation devices and associated risks are warranted. Improvements to health warning labelling may also be beneficial. Not all cannabis vaporisation devices and products carry the same level of risk. A better understanding of risk differentiation is needed among consumers and health professionals. Continued research, policy development and health education can lead to safer cannabis vaporisation.

Assessment and early warning signs of deterioration in hospitalized patients

Efficient assessment methods and early warning systems are crucial to prevent events like arrest, unexpected transfers to the intensive care unit (ICU) or even death. This in-depth review delves into the aspects of evaluating and handling early warning indicators of deterioration among patients admitted to hospitals. The primary emphasis lies in identifying any signs of decline by observing and tracking indicators, like heart rate, blood pressure, respiratory rate, body temperature and oxygen saturation. Standardized assessments like the modified early warning score (MEWS) play a role in assessing the seriousness of a patient’s condition while rapid response teams (RRTs) provide interdisciplinary interventions. Personalized care plans, customized medication management and the inclusion of support highlight an approach. Continuously reevaluating patients and providing education for healthcare professionals underscores the nature of patient care. Despite advancements in technology that enable real time monitoring challenges such as alarm fatigue and the need for consistent staff training persist. This review concludes that a comprehensive strategy combining expertise standardized assessments and technological support is vital for managing early warning signs of deterioration to ultimately enhance patient outcomes in hospital environments.

Exploring Interprofessional Education and Collaboration in the Midst of COVID-19

The COVID-19 pandemic and the inequities it uncovered highlighted the need for a rapid and coordinated response among different disciplines in medical settings. Interprofessional collaboration and education is necessary to provide culturally competent emergent care. However, there is still scarce evidence demonstrating the use of interprofessional education in emergent care settings. This paper explores the training and education of health care professionals in a primarily minority serving hospital located in New York City during the first phase of COVID-19. Guided by the appreciative inquiry framework, two focus groups were conducted with administrators and health care workers who provided care to COVID-19 patients in an emergent care setting. It was found that a positive work environment that emphasizes knowledge sharing, collaboration, communication, and continuous on-the-job training facilitates culturally competent care. The implementation of interprofessional education and collaboration has the potential to transform clinical practice and improve health outcomes for under-resourced communities.

Twelve tips for implementing trigger or content warnings in healthcare professions education

Trigger warnings are statements offering prior notification of sensitive content, allowing recipients to prepare for and avoid ensuing distress. Students are increasingly reporting expectations for warnings in classrooms and learning contexts. Discussions regarding use of warnings have clear relevance to healthcare education, which regularly explores sensitive content. Their use has been positioned as a measure for inclusive education and as a means to enhance trauma awareness and empathy. Expectations for warnings need to be considered in the context of preparedness for professional practice. This Twelve Tips paper explores the evidence in relation to warnings and its applicability to social learning contexts. These tips highlight considerations and strategies for the use of warnings in the context of healthcare education, balancing issues of inclusivity, learner and educator wellbeing, and professional preparedness. These discussions are situated within the context of current classroom-based healthcare education.

Lived experience narratives in health professional education: educators’ perspectives of a co-designed, online mental health education resource

IntroductionMeaningful involvement of people with lived experience is an invaluable approach to education that facilitates the development of knowledge, skills and attitudes for collaborative, compassionate and person-centred healthcare practice. The purpose of this evaluation was to gain health professional educators’ perspectives of an online learning resource that presents the lived experiences of people who have been consumers of the Australian mental health system.MethodsA cross sectional study design was used to survey educators who had registered to use the online education resource. Data were collected using an online survey and follow-up interviews. Two lived experience researchers were involved in the research. Quantitative survey data were analysed descriptively, and qualitative data were analysed thematically.FindingsThe Listening to Voices online education resource is being used in a range of settings. Educators perceived the content facilitated achievement of learning outcomes related to understanding the experiences of people with mental health issues. The free, online, and flexible design of the resource promoted access and helped overcome barriers to including lived experience experts in education. The powerful impact of the resource and importance of creating safe learning environments when using the resource were highlighted. Suggestions for future developments were provided.ConclusionInvolving people with lived experience in education of healthcare students and professionals can assist in developing skills for collaborative, compassionate, and person-centred care. Implementation of co-design principles and the use of creative pedagogical approaches can contribute to the development of impactful educational resources that foreground lived experience. Making these resources flexible and freely available online improves their utility.

Positioning humility within healthcare delivery - From doctors’ and nurses’ perspectives

ObjectiveExplore the roles of humility in healthcare delivery from perspectives of active doctors and nurses. BackgroundAlthough the concept of humility has gained attention in the healthcare and health professions education fields, previous literature has primarily been anecdotal reflections or conceptual explorations, leaving a gap of empirical approaches to what humility “looks like” in healthcare. MethodsThree hundred and five active U.S.-based doctors and nurses completed a survey containing close- and open-ended questions examining their experiences with and perceptions of humility in the clinical care setting. ResultsThe findings from this study echo previous literature touting the value of humility in regard to patient care, but also spotlight the connections between humility and status, how humility acts as a leveling mechanism, and humility's roles regarding facilitating collaborative, team-based care. We also find evidence of the effects of intellectual humility, as well as the tenets of the professional humility concept. ConclusionAccording to doctors and nurses, humility is essential to high quality team-based, patient-centered care, but there is an explicit connection between humility and status – specifically related to the occupational status embedded within healthcare delivery. Future research should investigate not only how humility may facilitate interprofessionalism, but also the roles and impact of humility regarding uncertainty, and the processes related to feedback and decision making.

Embedding cultural competency and cultural humility in undergraduate pharmacist initial education and training: a qualitative exploration of pharmacy student perspectives.

Emphasis has been placed upon embedding equity, diversity and inclusion within the initial education and training of healthcare professionals, like pharmacists. Yet, there remains limited understanding of how best to integrate cultural competency and cultural humility into undergraduate pharmacy student training. This qualitative study explored the views of pharmacy students to understand perspectives on, and identify recommendations for, embedding cultural competency and cultural humility within pharmacy education and training. Undergraduate pharmacy students from one UK-based School of Pharmacy were invited to participate in an in-person, semi-structured interview to discuss cultural competency in the pharmacy curriculum. Interviews were conducted between November 2022 and February 2023 and were audio-recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes. QSR NVivo (Version 12) facilitated data management. Ethical approval was obtained from the Newcastle University Ethics Committee. Twelve undergraduate pharmacist students, across all years of undergraduate training, were interviewed. Three themes were developed from the data, centring on: (1) recognising and reflecting on cultural competency and cultural humility; (2) gaining exposure and growing in confidence; and (3) thinking forward as a culturally competent pharmacist of the future. These findings offer actionable recommendations to align with the updated Initial Education and Training standards from the United Kingdom (UK) pharmacy regulator, the General Pharmaceutical Council; specifically, how and when cultural competency teaching should be embedded within the undergraduate pharmacy curriculum. Future research should further explore teaching content, learning environments, and methods of assessing cultural competency.

Developing a framework and digital toolkit for healthcare professional students and educators to support Technology-Enabled Practice Education (TEPE)

Practice education is a core component of speech and language therapy education. COVID-19 led to the abrupt disruption of student placements and the rapid adoption of technology-supported solutions to ensure the continuity of clinical learning, including telepractice and simulation-based learning. Technology brings many opportunities. For example, simulation-based learning allows students to engage with rare clinical presentations or practise skills before meeting clients. However, the sudden shift to technology solutions meant that many practice educators and students were learning through trial and error as they engaged with the technology. Furthermore, telepractice requires additional skill learning and competency development for both students and educators. This study aimed to evaluate the experience of students and educators involved in practice education during the pandemic and identify how technology-enabled practice education can be effectively supported in the future. Using a six-step co-design approach, we considered the extant literature and evaluated the benefits and challenges of using technology-enabled practice education during the pandemic. Through an iterative co-design process, we synthesised the learning to develop a framework to support technology-enabled practice education and an online toolkit resource to support students engaging with technology-enabled practice education.

Urgent need for planetary health education for healthcare professionals and students in India.

The current climate crisis has had a significant negative impact on human health across the globe including India. Climate change is leading to global heating, rising sea levels and more severe extreme weather events such as floods, cyclones and droughts. These events have direct and indirect detrimental impacts on human health such as increased risk of water-related illnesses, vector-borne diseases, malnutrition due to food insecurity and pollution-related poor health. These effects are disproportionately borne by vulnerable communities, primarily low socioeconomic groups, women, children, and the elderly. Health professionals need to be upskilled to anticipate, diagnose and manage climate-related health issues and respond to environmental emergencies. The emerging transdisciplinary field of planetary health is based on the principle of protecting the planet to protect the health of humans. The authors argue that it is an ethical imperative to include planetary health education in the curricula of medical and other health professions in a way that would help ensure both climate resilience and social justice.

Impact of Antimicrobial Stewardship on Reducing Antimicrobial Resistance.

Antimicrobial resistance has become a serious global issue, posing a significant threat to public health and healthcare professionals. Since the advent of penicillin, many antibiotics have lost their effectiveness in combating microbes simply due to inappropriate, irrational, unnecessary, and unrestricted use. The ineffectiveness of an increasing number of antibiotics necessitates the utilization of more potentantimicrobial agents for combatting uncomplicated infections. In response to the escalating prevalence of multidrug-resistant pathogens and the imperative to curtail the demand for novel antibiotics, the Antimicrobial Stewardship Program was conceived and implemented. This initiative is characterized by a lead physician, ideally possessing expertise in infectious diseases, alongside a pharmacist serving as a secondary leader and a microbiologist with defined responsibilities to achieve several objectives. These objectives include reducing indiscriminate usage of antimicrobial agents, promoting selective antimicrobial utilization based on culture results, de-escalating therapy from broad-spectrum to targeted antimicrobial agents, and transitioning from parenteral to oral administration when feasible. These objectives are pursued through a combination of pre-prescription and post-prescription strategies. While the Antimicrobial Stewardship Program is widely established in developed nations, a pressing need exists for its more comprehensive implementation in less developed regions.This review aims to examine the strategies used in antimicrobial stewardship programs to evaluate their effectiveness in preventing the development of multidrug-resistant organisms (MDROs) based on existing research studies.Under the Antimicrobial Stewardship Program, education of healthcare professionals and continuous disposal of information about antimicrobial resistance have helped to restrict the emergence of multidrug-resistant organisms.

User experience and analytics inform the development of an innovative telehealth curriculum: ROAD MAP (Recovery-Oriented Approach to Dementia through Meaningful Activity Participation)

Objective:To user-test a recovery-oriented, clinician-facilitated, web-based, self-management intervention accessible via mobile device: ROAD MAP. The initial programme theory underlying this research is that supporting the experiences of CHIME (connectedness, hope and optimism, identity, meaning in life and empowerment), in persons living with dementia (PLWD) will have health-promoting benefits for the PLWD.Method:The intervention will be delivered to 20 dyads of community-dwelling PLWDs and their carers via a five-week, online, recovery-based curriculum. Five convenience-sampled occupational therapists (OT) will be trained online in a 10-hour training programme to deliver the intervention. All data collection instruments are informed by realist evaluation (RE) methodology and enquire into initial programme theories (IPTs) used to develop the curriculum and the ROAD MAP digital tool. Data collection, between January and March 2023, will occur during both the OT training and the five-week pilot study. The OT facilitators will provide qualitative feedback on the ROAD MAP technology. Data will be collected via pre-post self-completion forms, semi-structured interviews, a focus group, and weekly guided reflective journal. PLWD’s self-reported, user experience will be live polled within the weekly one-hour long sessions of the pilot. Their digital usage analytics will be generated by the MyGuide platform on which the ROAD MAP intervention is built. These data will be manually screened for IPT relevance and used to test emerging programme theories.Results:All data will be collected by end of March 2023 and analysed by end of May 2023. NVivo will be used to generate refined programme theories according to RE methodology. This will provide evidence of plausible, causal context-mechanism-outcome configurations which may optimize the refined version of the ROAD MAP digital intervention, curriculum and facilitator training methods.Conclusion:This study will increase knowledge of a methodology for developing useable and acceptable recovery-oriented telehealth tools for PLWD. This intervention could directly enhance the education of health care professionals and improve the equitable delivery of dementia services.

Genomics education for advance practice nurses: Staying cutting edge.

As we celebrate the 20th anniversary of sequencing of the human genome and the rapid integration of genetics in health care, we pause to reflect on the status of genomic competency in nursing. The literature provides evidence that nurses do not feel prepared or confident in genomics. Genomic education for nurses and other health care professionals can support access and equity in the integration of genomics into practice. Resources are provided to support genomic education and clinical support.

What is the current global health participation and future interest of healthcare students and National Health Service (NHS) staff? A cross-sectional research study of healthcare students and NHS staff in England

ObjectivesThis research aimed to understand the prior and current global health participation, current availability of and future interest in participating in global health activities healthcare students and National Health Service...

P197: Delirium in nursing homes (DeliA) - an interdisciplinary health services research project

Background:Delirium is a potential emergency with serious consequences. Little attention has been paid to residents of nursing homes, although they are at extreme risk for developing delirium. Health Care Professionals (HCPs) such as nurses and general practitioners are assumed to know little about delirium in nursing homes.Objectives:The German project DeliA (delirium in nursing homes) comprises three sub- studies and two reviews. The sub-studies have the following objectives: (1) to determine the prevalence of delirium and its sub-types in German nursing homes; (2) to describe and assess the quality of delirium care practices (prevention, diagnosis, therapy) of HCPs in nursing homes; and (3) to develop a Technology Enhanced Learning (TEL) to increase the delirium- specific knowledge of HCPs in nursing homes. The reviews aim to (a) summarize the prevalence of delirium reported in international studies and (b) to find out how, why and under what context education for HCPs in nursing homes works.Methods:A systematic review of the reported prevalence of delirium in nursing homes will be conducted (a). The prevalence study (1) will assess delirium and its proposed associated factors in at least 50 nursing homes using validated measurements. Medication schedules of participating residents will be analyzed to determine potential for delirium. To describe current practice, process-oriented semi-structured guided interviews will be conducted with 30 representatives of the (nursing home) medical service and the nursing service of nursing homes (2). As a theoretical basis for the TEL, a realist review will be conducted to understand the active ingredients of educational interventions and to develop an initial program theory (b). The curriculum for the proposed TEL will be developed based on a synthesis of existing curricula and evaluated by Delphi experts for relevance, comprehensiveness, and content. A final feasibility study will assess the potential increase in knowledge about delirium among HCPs (n = 50) in nursing homes (3).Expected Results:It is expected that the project and the dissemination of its findings will raise awareness among HCPs and the public about delirium in nursing homes. The developed TEL and its underlying program theory will be further tested.

Current status of heart failure management in Vietnam

Heart failure is a growing public health issue with high mortality and hospitalization rates. Comprehensive management programs are needed to improve outcomes and reduce costs. In Vietnam, there are gaps in guideline-directed medical therapy, lack of a multidisciplinary approach, inadequate patient education, and poor continuity from inpatient to outpatient care. However, management programs are evolving with 29 hospitals having established programs. Initial results show improved use of medications, reduced hospitalizations and mortality, and better quality of life in some programs. Challenges remain around resources, costs, patient diversity, and lack of standardization. Standardization initiatives like EuroHeart are working to define common data sets and care standards internationally. Effective programs require optimized hospital treatment, comprehensive discharge planning, structured follow up, and patient selfmanagement support. Further government support, healthcare professional training, public education, research, and regional collaborations are needed to advance heart failure care in Vietnam.

Bariatric surgery stigma from the perspective of patients: A scoping review.

To explore the experiences and consequences of bariatric surgery stigma from the perspective of bariatric surgery patients and to identify knowledge gaps in the literature. A scoping review. Studies published between December 2002 and January 2022 were identified from the following databases: PubMed, Web of Science, PsycINFO and MEDLINE. We screened 3092 records and included 28 studies. Findings were grouped thematically using the health stigma discrimination framework. Patients experienced several types of stigmas, including perceived, experienced, anticipated and internalized stigma, related to undergoing bariatric surgery. Patients were confronted with negative comments and judgement from others when they disclosed their decision to have surgery or when they revealed that they had undergone surgery. These experiences led to conflicts in the decision-making process, such as delaying the choice for surgery, seeking surgery abroad or opting out. Patients who internalized stigma often reported feelings of shame and embarrassment for choosing surgery and felt the need for secrecy or selective disclosure. Stigma experiences were influenced by gender and differed between different subgroups of patients. The stigma surrounding bariatric surgery has detrimental consequences for eligible individuals and bariatric surgery patients. However, the evidence from patients' perspective remains limited. More research into patient's experiences is needed to improve patient care and further educate healthcare professionals. In addition, to better understand the nature and implications of bariatric surgery stigma, future research should be founded on stigma theories and distinguish between the different types of stigmas. This scoping review contributes to a better understanding of the implications the stigma surrounding bariatric surgery has for bariatric surgery patients before and after surgery. The knowledge generated by this review can inform improvements in the education and management of people living with obesity and bariatric surgery patients. The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews checklist. No Patient or Public Contribution. A protocol was not registered for this scoping review.

Improving care for patients who experience miscarriage in emergency departments: a practice innovation.

Vaginal bleeding during pregnancy is a common patient presentation in emergency departments (EDs), and in some cases this will occur due to miscarriage. However, there are several barriers to effective and sensitive communication with patients experiencing a miscarriage. Women presenting to EDs who are experiencing a miscarriage are more likely to be psychosocially vulnerable and less satisfied with their care compared with those seeking care in the outpatient setting. There is a gap in nursing and advanced practice provider preparation regarding techniques for breaking bad news to patients in the ED setting. At one high-volume, urban ED in the US, an education programme for staff regarding best practice in breaking bad news to patients experiencing a miscarriage was developed based on an established protocol. The intention was to increase the confidence levels of nurses and other healthcare professionals in breaking bad news to these patients. After the education programme, many participants self-reported increased confidence in breaking bad news and comfort in managing patients' emotions. The results can be used to inform education for healthcare professionals who deliver bad news in the ED and other departments.

Disparities in alcohol- and substance-related hospitalizations and deaths across sexual orientations in Canada: a longitudinal study

ObjectivesWe aim to quantify disparities in substance-related acute events (i.e. hospitalizations and deaths for substances, including alcohol, cannabis, opioids, narcotics, and/or illicit drugs) across sexual orientations based on health administrative data. Study designThis was a longitudinal analysis from six waves of the Canadian Community Health Survey (2009–2014) linked to hospitalization/mortality data in Ontario, Canada. MethodsThe study sample consisted of survey respondents aged ≥15 (weighted n = 15,406,000) who provided a valid response to the question about sexual orientation. The primary outcome was substance-related acute events, including hospitalizations and deaths due to alcohol, cannabis, opioids, narcotics, and/or illicit drugs. Disparities in substance-related acute events across sexual orientation and gender were examined using flexible parametric survival analysis. ResultsBisexual women had hazard ratios of 2.46 (95% confidence interval: 1.46–4.15) for any substance-related acute event and 2.67 (95% confidence interval: 1.42–5.00) for non-alcohol substance acute events compared to heterosexual women. Lesbian women did not exhibit significant differences in acute event risk compared to heterosexual women. Gay and bisexual men demonstrated elevated but not statistically significant risks compared to heterosexual men. ConclusionsBisexual women face higher risks of substance-related acute events, potentially due to self-medication of unique stressors brought on by discrimination and isolation. Enhanced education and training for healthcare professionals are essential to increase awareness and sensitivity toward the heightened substance use risk among lesbian, gay, and bisexual individuals. Targeted interventions aimed at reducing substance use problems among bisexual individuals warrant increased funding and research.

Social Determinants of Health: A Multilingual Standardized Patient Case to Practice Interpreter Use in a Telehealth Visit.

The growing diversity of the United States population and strong evidence of disparities in health care make it critically important to educate health care professionals to effectively address issues of culture. To that end, we developed a simulation for teaching interpreter use in a telehealth setting. Our contribution of non-English language preference (NELP) patient cases in Spanish, Tagalog, French, and Igbo advances existing literature by combining the skills of interpreter use and telehealth while widening the array of cultures represented. Simulations were implemented for two cohorts of 60 first-year medical students. In the pilot, nine groups of six to seven students and one faculty met via Zoom with an NELP patient complaining of fatigue, weakness, and cough. When students determined the need for an interpreter, faculty admitted one to the meeting, and the telehealth visit continued. Postsession activities included debriefing and writing a progress note. Course evaluation comments from the first cohort and a postencounter survey of the second cohort were positive. They revealed that students learned to speak slower, in shorter phrases, and directly to the patient. Learners completed note documentation according to a rubric. This low-stakes activity provides faculty with a resource for introducing cultural competence into the curriculum. The original Spanish version of the case has been translated into three additional languages, providing a diverse representation of the NELP population. Important points for communicating through an interpreter are practiced in a telehealth setting with a fatigue case.