Group Workshops Research Articles

Using the Ophelia (Optimising Health Literacy and Access to Health Services) process as a practical tool for health promotion program delivery in various Philippine communities.

The Ophelia (Optimising Health Literacy and Access to Health Services) process can be used as a practical tool for effective health promotion program delivery because of its multi-sector and pragmatic approach to designing health interventions. An initial case study showed how its first phase was successfully adapted in a pilot community in Leyte, Philippines. In this study, the three phases of the Ophelia process were implemented in Leyte, along with additional communities in Mindoro and Surigao. After conducting needs assessment and community profiling in phase 1, the results were transformed into vignettes, hypothetical personas representing the health needs of the community. These were used in phase 2, which involved focus group discussions and workshops to cocreate intervention ideas with government organisations, practitioners, and community representatives. A rapid realist review was conducted in phase 3 to check for the feasibility of interventions. Through this, the top evidence-based health interventions for each life stage were listed and presented for prioritisation. Program implementation and impact evaluation plans were created for the top health intervention prior to implementation. The Ophelia process ensured that health promotion interventions addressed community needs and were designed using community resources and the wisdom of health practitioners that have been immersed in the local health system. SO WHAT?: The study demonstrated the usefulness of vignettes in presenting data to lay people and how the rapid realist review approach is a practical tool for policy-makers to ensure that program plans designed by the communities and health practitioners are evidence-based without sacrificing the timeliness of implementation.

Evaluasi Kompetensi terhadap Peningkatan Komitmen dan Kinerja ASN

Purpose: Provide knowledge and skills to employees to be able to analyze and evaluate increased commitment and performance based on employee competency management at the Kupang City Government Secretariat.. Methodology: This PkM implementation method uses lecture and training techniques, which are generally known as focus group discussions (FGD) and workshops. Activity partners are determined by purposive sampling technique (deliberately) based on the organizational structure of the Kupang City Government which is at the Echelon II level (Department/Agency), which consists of 28 SKPD (Badan/Department). Based on this, the participants are determined by quota sampling technique, namely, the PkM activity participants are the direct leaders of the organization with the rank/position/class of Echelon II, the Heads of Service, and Heads of the Agency. Thus the participants who took part in this PkM activity were 28 participants. Results: The results of PkM activities were evaluated using a SWOT analysis tool, where participants were asked to formulate organizational conditions based on the internal environment (strengths and weaknesses) and the external environment (opportunities and threats) based on the knowledge management presented by the resource persons. Then, a solution strategy concept was developed based on the SWOT matrix. Contribution: This training can increase the knowledge and skills of employees in analyzing and evaluating employee commitment and performance from the aspect of motivation using the SWOT analysis method.

Medication Reconciliation: Paperwork Saves Lives

Patients often transition health care settings, such as from hospital to SNF and SNF to hospital or home. When an older adult is admitted to a new health care setting (e.g., hospital or nursing facility) or transferring within a hospital setting, it is imperative that clinicians review prior medication lists along with new orders and plans for care and reconcile any discrepancies. Research has demonstrated that inaccurate communication of medical information at transitions of care is responsible for as many as 50% of all medication errors and up to 20% of adverse drug events in the hospital setting. This is especially true for older adults on psychiatric medications which may be altered for formulary reasons or treatment of acute delirium.This session will describe the importance of accurate medication reconciliation especially during transitions of care. We will describe our interventions to improve medication reconciliation as well as demonstrate the educational program we designed as an instructional method via PowerPoint to educate health care providers to perform an accurate medication reconciliation. We implemented the program in multiple grand rounds settings with students, trainees, and attending physicians. Our educational program was successful in improving learners' knowledge in every question we tested. We will include small workshop groups to demonstrate the importance of proper medication reconciliation and for participants to practice implementing the knowledge gained. Our session will show the important of accurate medication reconciliation as well as provide the tools for attendees to impart the knowledge and skills in their institutions to improve accurate medication reconciliation for better communication and transitions of care.Please note: A version of this presentation was presented at the Annual meeting of AMDA (Society for Post-acute and Long-term Care) in 2021 and research about the educational module was published in: Lester PE, Sahansra S, Shen M, Becker M, Islam S. Medication Reconciliation: An Educational Module. MedEdPORTAL. 2019 Nov 1;15:10852. doi: 10.15766/mep_2374-8265.10852. PMID: 31934615; PMCID: PMC6952281. The proposed presentation for AAGP will be unique because of its focus on geriatric psychiatry patients including medication reconciliation issues related to antipsychotics and the challenges faced by frequent transfers to/from medicine and psychiatry for older adults who are in the hospital setting.

Effects of charcoal ban on value chains and livelihoods in Kenyan coast – Stakeholders’ perceptions

Charcoal production in Africa has been seen by experts and authorities as a driver of forest degradation and deforestation; hence, governments are implementing measures to address this problem, including banning of charcoal production and trade. The effectiveness of these policies is uncertain, and stakeholders’ reactions to, and perceptions of, the regulations are unknown. This study analyzed impacts, perceptions, and feedback reactions among stakeholders after the charcoal ban was introduced in Kenya in February 2018. The conceptual framework refers to the theories on sustainability transitions, and data was collected through key informant interviews, focus group discussions (FGDs), individual interviews, workshops, and surveys among value chain actors, organizations, and government agencies in Kwale, Taita Taveta and Mombasa counties in Kenya. Several economic, behavioral, attitudinal, and institutional consequences of the ban were identified. The policy showed characteristics of a negative feedback loop, meaning the policy may not succeed in reaching its purpose because of adverse side effects. Possible “policy mix” approaches and advancement of alternative charcoal sources such as briquettes could in the long-term, promote sustainable development of the Kenyan charcoal sector hence supporting the policy implementation.

Design and evaluation of a multi-sensory representation of scientific data

IntroductionModern sciences and Astrophysics in particular study objects and phenomena not visible in physical terms, that is they cannot be investigated with the eyes or analogous optical systems. Nevertheless, they make intensive use of visual representations, showing data in a figurative way, using lights, shadows, colors, and shapes familiar to the user and aesthetically pleasant. Besides being inaccessible for Blind and Visually Impaired (BVI) users, such figurative visual representation can lead to misunderstandings about the real nature of the represented object, physically invisible, particularly if the representation code is not declared. In this work we argue that multi-sensory representations clearly arbitrary, i.e., that do not aim to imitate reality, are a valid choice for an effective learning and understanding of astronomical science and for an effective meaning-making process for all. The presence of a cognitively challenging code of representation can make the fruition more conscious and attentive, leading to a deeper understanding of the represented reality, also mirroring the search for relevant information proper of basic research. In an equity perspective, multi-sensory representations also create an effective common ground for inclusion among people with diverse abilities, skills, and learning styles, in the framework of Universal Design for Learning.MethodsIn order to investigate our hypothesis we designed two mono-sensory representation (one only haptic and the other only acoustic) and tested them in individual and group workshops with both sighted and BVI users. We then used our results to guide the design of a multi-sensory representation of non-visible astronomical data including visual, acoustic, and haptic stimuli. We tested this representation as well, in order to refine and propose it to the public.ResultsThe result is the exhibit “Sense the Universe,” to be used for outreach and education. “Sense the Universe” was part of a museum exhibition attended both by sighted and BVI users, where we collected feedback about the final outcome of our work.DiscussionOur findings suggest the validity of multi-sensory representations for a truly and effective engagement in scientific learning, both in terms of intelligibility and persistence of scientific contents and of a more equal access to scientific culture.

Development of a tailored intervention targeting sedentary behavior and physical activity in people with stroke and diabetes: A qualitative study using a co-creation framework.

Type 2 diabetes and sedentary behavior pose serious health risks in stroke survivors. Using a co-creation framework, this study aimed to develop an intervention in collaboration with stroke survivors with type 2 diabetes, relatives, and cross-sectoral health care professionals to reduce sedentary behavior and increase physical activity. This qualitative explorative study used a co-creation framework consisting of a workshop and focus group interviews with stroke survivors with type 2 diabetes (n = 3), relative (n = 1), and health care professionals (n = 10) to develop the intervention. A content analysis was used to analyze data. The developed "Everyday Life is Rehabilitation" (ELiR) intervention consisted of a tailored 12-week home-based behavior change intervention with two consultations of action planning, goal setting, motivational interviewing, and fatigue management including education on sedentary behavior, physical activity, and fatigue. The intervention has a minimalistic setup using a double-page paper "Everyday Life is Rehabilitation" (ELiR) instrument making it implementable and tangible. In this study, a theoretical framework was used to develop a tailored 12-week home-based behavior change intervention. Strategies to reduce sedentary behavior and increase physical activity through activities of daily living along with fatigue management in stroke survivors with type 2 diabetes were identified.

Teachability of lower cervical spine injury classifications

ObjectivesTo compare the teachability of the Allen–Ferguson, Harris, Argenson, AOSpine, Subaxial Cervical Spine Injury Classification (SLIC), Subaxial Cervical Spine Injury Classification (CSISS) and to identify the classification that a group of residents and junior neurosurgeons find easiest to learn. MethodsWe used data from 64 consecutive patients. Answers of nine residents and junior neurosurgeons and four experienced surgeons in two assessment procedures were used. Six raters (workshop group) participated in special seminars between assessments. Three other raters formed the control group. Experienced surgeon's answers were used for comparison. Teachability was measured as the median value of the difference (ΔK) in the interrater agreement on the same patients by the same pairs of subjects. ResultsMedian Δ K for the Allen–Ferguson, Harris, Argenson and AOSpine classifications were: (1) 0.01, 0.02, 0.29, and 0.39 for the workshop group; (2). 0.09, −0.03, 0.06 and 0.04 for the control group, respectively. Between numerical scales, median ΔK was higher for SLIC but did not exceed 0.16. Interrater consistency with expert's opinion was increased in the workshop group for Allen–Ferguson, Argenson and AOSpine and did not differ in either group for SLIC and CSISS. ConclusionThe AOSpine classification was the most teachable. Among numeric scales, SLIC demonstrated better results. The successful application of these classifications by residents and junior neurosurgeons was possible after a short educational course. The use of these scales in educational cycles at the stage of residency can significantly simplify the communication between specialists, especially at the stage of patient admission.

A pragmatic trial evaluating the effectiveness of web versus live training in functional behavior assessment and interventions among special educators

AbstractThis study adopted a pragmatic trial with randomization to investigate the relative effectiveness of web versus live training on special educators' competence and perceived skills in functional behavior assessments (FBA) and behavior interventions. Pragmatic trials seek to determine the effectiveness of an intervention in a real‐world setting to ensure better application and generalizability in routine practice conditions. The live training group received an in‐person workshop delivered in a lecture format via powerpoint slides. The web training group received asynchronous online instruction via a secure website. The same training content was delivered to both groups. Participants were randomly assigned across both instructional modalities and completed two pre‐ and post‐test measures. Results indicated that participants (N = 104) in both groups showed a significant increase in theoretical competence of FBA and behavior interventions post training. Only participants in the live workshop group reported a significant increase in perceived skill scores. When comparing outcomes across groups, the live training group gained significantly more theoretical competence in FBA and behavior interventions than that in the web training group. These results shed light on the practical implications of online platforms for professional development among in‐service teachers in behavior management for schools with children having disabilities and challenging behavior.

Development of Academic Atmosphere in Women's Small Enterprises in North Sumatra

This community service aims to develop the academic atmosphere of women entrepreneurs to have entrepreneurial competencies in overcoming challenges and developing their enterprises to become upgraded SMEs. This service was conducted in Medan City and Deli Serdang Regency with a total of 31 women’s small enterprises. This activity was carried out using qualitative descriptive methods from 5 tools, namely documents, focus group discussions (FGDs), interviews, observations, and workshops. The results of FGDs showed that women entrepreneurs needed to collaborate with universities to make affordable and quality products. The results of interviews and observations showed that they ran the enterprises because they wanted to get more income, dared to take calculated risks, had the competence, were able to take advantage of opportunities, and were able to face changes in society. These women entrepreneurs were also given training in the form of workshops to develop the academic atmosphere and increase competence in managing entrepreneurship by creating entrepreneurial journeys, namely the understanding of being successful entrepreneurs. Therefore, they can contribute to large companies.

Mycotoxin communications: Managing messages for different audiences

Mycotoxins, such as aflatoxins, fumonisins, trichothecenes, and zearalenone, are increasing in visibility as a public health threat through both acute and chronic exposure in food. USAID through its Feed the Future program has sponsored research in Nepal on mycotoxin contamination and the correlated high levels of stunting in children under age five. Communicating about mycotoxins is a complicated matter, as is communicating about any potentially serious economic or health threat that may be difficult to control. Two nominal group workshops in Nepal focused on identifying problems from multiple perspectives and developing potential communication strategies to mitigate the problem and potential concerns about it. Target audiences were identified along with their interests and effective channels to communicate with and within them. The first audience to work with is the government, as it must understand and value the problem and help generate confidence in potential regulatory and mitigation processes. Producers, educators and health professionals are the next audiences to address as they are the most closely involved with the problem. Consumer engagement is last, with a communication goal of sharing information to heighten awareness and minimize unwarranted public concern.

Diminished ovarian reserve is a risk factor for preeclampsia and placental malperfusion lesions

To assess obstetric outcomes and placental findings in pregnancies attained by invitro fertilization (IVF) in patients with diminished ovarian reserve (DOR). Retrospective cohort study. University-affiliated tertiary hospital. DOR, defined as an antral follicle count (AFC) of 6 or less (DOR group), compared with patients with no DOR and an antral count above 6 (control group). Live singleton births after IVF between 2009 and2017. Primary outcomes were placental findings, including anatomic, inflammatory, vascular malperfusion, and villous maturation lesions, as categorized according to the Amsterdam Placental Workshop Group Consensus. Secondary outcomes included obstetric and perinatal outcomes. A total of 110 deliveries of patients with DOR were compared with 772 controls. Maternal age was higher in the DOR group than in the control group (36.3 ± 4.4 years vs. 35.3 ± 4.1 years, P=.02). Patients with DOR were more likely to have a diagnosis of endometriosis (P=.02) and less likely to have a diagnosis of male factor (P<.001), ovulation disorder (P<.001), or tubal factor (P=.04), or a transfer of a blastocyte (P=.007). After adjustment for confounders, pregnancies in the DOR group were notable for a significantly higher rate of preeclampsia (8.1% vs. 2.7%, adjusted odds ratio: 3.05, 95% confidence interval: 1.33-6.97). On placental examination, DOR was associated with a higher rate of fetal vasculopathy (P=.01) and multiple fetal vascular malperfusion lesions (P=.03), and a lower rate of circummarginate insertion (P=.01) and intervillous thrombosis (P=.02). DOR, specifically defined as an AFC of 6 or less, is associated with a higher incidence of preeclampsia and multiple placental fetal vascular lesions.

Clinical Outcomes Following the Implementation of a Novel One-Year Training Program in Emergency Medicine in Karachi, Pakistan.

Most Emergency Departments (EDs) in low- and middle-income countries (LMICs), particularly in Pakistan, are staffed by physicians not formally trained in Emergency Medicine (EM). As of January 2022, there were only 13 residency training programs in EM throughout all of Pakistan. Therefore, an intermediate solution-a one-year training program in EM-was developed to build capacity. To determine the impact of a novel training program in EM on clinical metrics and outcomes. The first cohort of a novel, one-year training program-the Certification Program in Emergency Medicine (CPEM)-completed the program in June 2019. The program consisted of two arms: CPEM-Clinical (CPEM-C), which included physicians from the Indus Hospital and Health Network (IHHN) ED; and CPEM-Didactic (CPEM-D), which included physicians from EDs across Karachi. Both groups participated in weekly conferences, such as didactics, small group discussions, workshops, and journal clubs. CPEM-C learners also received clinical mentorship from local and international faculty. Mortality, length of stay (LOS), and time-to-evaluation, as well as metrics in four key areas-patients at risk for cardiovascular disease/acute coronary syndrome, sepsis, respiratory illness, and intra-abdominal trauma-were assessed before and after the initial cohort at IHHN and compared with other groups in IHHN. More than 125,000 patients were seen from July to December 2017 (pre-CPEM) and July to December 2019 (post-CPEM). Overall, there were significant improvements in all clinical metrics and outcomes, with the exception of LOS and time-to-evaluation, and a trend toward improved mortality. In comparing CPEM graduates to other groups in IHHN ED, most metrics and outcomes significantly improved or trended toward improvement, including mortality. Implementation of a medium-duration, intensive EM training program can help improve patient care and the development of EM as a new specialty in lower-resource settings.

Assessment of Diabetic Foot Prevention by Nurses

Diabetic foot is a severe complication of diabetes, with serious consequences such as amputations and high mortality rates as well as elevated economic costs. To evaluate whether or not nursing staff follow the recommendations of national and international organizations regarding diabetic foot prevention, a cross-sectional and observational descriptive study was carried out using an ad hoc self-administered questionnaire validated by seven experts, with a Cronbach's alpha of 0.731. Of the total 164 participants, 157 met the inclusion criteria. Findings showed that 96.58% asked their patients to remove their footwear, 78.34% performed thorough examinations, and 80.25% assessed the risk of developing diabetic foot. Participants educated their patients in self-care and evaluated skills related to diabetic foot control either frequently (84.07%) or very frequently (62.42%), and only 19.11% of them carried out group activity workshops. Significant statistical differences were found in the performance of activities in the groups by participant age intervals, whether working in primary health care or a hospital, having specific training, and the participant's DM patient ratio. We obtained high percentages of compliance in the assessed activities in comparison to other studies. Nevertheless, we believe it is necessary to encourage screening in specialized care, skills testing, and the implementation of educational group activities and workshops.

Why workshops work: Examining the efficacy of training trainers to train goats.

Experimental procedures involving farm animals are often associated with stress due to restraining. Stress can be reduced through use of positive reinforcement training, which then serves as refinement according to the 3Rs principles. Trainer skills, however, may influence the feasibility and success of animal training. The potential influence of trainer skills as well as the education of animal trainers are rarely described in literature but are necessary information for the implementation of positive reinforcement training as a refinement measure. To investigate the effect of educational programmes on animal trainers, we compared the training success of two groups of participants in training goats to elicit a behaviour that would allow simulated venipuncture. One group was educated in a two-day workshop while the other was provided with specific literature for self-instructed learning. Training success was evaluated using an assessment protocol developed for this study. A greater training success in the WORKSHOP GROUP, reflected by objective and subjective measures, was clearly supported statistically. In addition, 73 versus only 13% of the participants of the WORKSHOP GROUP and the self-instructed BOOK GROUP, respectively, stated that they could completely implement the knowledge gained in the course of this study. Our results indicate that more intensively educated trainers can train animals more successfully. In conclusion, if animal training is implemented as refinement, animal caretakers should receive instruction for positive reinforcement training.

Genomics education for medical specialists: case-based specialty workshops and blended learning

Aim: To develop and evaluate genomics education programs for health professionals to expedite the translation of genomics into healthcare. Methods: Our co-design team of genetic specialists, expert medical specialist peers, and genomics educators developed two continuing genomics education programs for health professionals: stand-alone, specialty-specific workshops and a generic blended learning course, combining online learning with workshops. Both programs referenced adult learning theories; workshops included case-based learning and expert peer-led discussion. Longitudinal surveys evaluated changes in confidence and understanding of genomic testing processes and clinical practice. Results: We delivered eleven specialty workshops (414 attendees) and a blended learning course comprising four self-directed online modules (61 users) and workshops (71 attendees) for mixed-specialty groups with adult, pediatric, or oncology cases. Surveys (214 workshops; 63 blended) showed that both programs significantly increased confidence and understanding of genomic testing processes. Blended learning participants showed additional gains in confidence after attending a workshop following online learning. Workshop discussions with experts were valued, particularly regarding interpreting and applying results. At follow-up, gains in confidence and understanding were maintained for both programs and 81% of respondents had performed a new genomics activity in clinical practice. Conclusion: Scalable education is needed. Our results suggest that specialty-specific genomics education may not be required to meet the needs of multiple specialties across a health system. Online learning can meet foundational learning needs but may not be sufficient to apply learning to practice. Blended learning offers flexible, continuing education pathways for dispersed national audiences as genomics becomes increasingly used across varied specialties.

Risk communication on COVID-19 with the dialogue among the public: Sketching out the figures of the persons concerned

The purpose of this study is to gain knowledge on the state of risk communication regarding COVID-19 to promote detailed policies from a long-term perspective by clarifying through dialogue the opinions of related parties and minorities who are often buried in statistics. The research method was online group workshops and analysis of dialogue transcripts.Between April 2020 and February 2021, dialogues were held on overall general themes (general public type) and individual specific themes (related party type), and general and thematic issues related to COVID-19 were categorized to form a sketch of the overall. Furthermore, the method of dialogue was organized as "Sketch Dialogue" and generalized.

Identidade negra/quilombola: diálogos intergeracionais de autoafirmação em uma comunidade do sertão nordestino

ABSTRACT This work registers a research carried out with quilombola children, preadolescents and elderly people presenting the following topic: the construction processes of black and quilombola identities and self-affirmation. The research aimed to identify racial- and cultural-defined factors of these individuals’ identities; presenting the relations between racial identity and quilombola identity, in order to comprehend how such social constructions are related to each other and how they are managed by individuals from different generations. The research was conducted at the quilombola community Serra das Viúvas (Alagoas). A qualitative research was carried out with group workshops inspired by focal groups. A group of two elderly people and 37 children and preadolescents participated in the research. The results show generational factors involved in racial self-affirmation, as well as in being a quilombola, factors which were presented differently by young and elder participants.

Feasibility of RESTORE: An online Acceptance and Commitment Therapy intervention to improve palliative care staff wellbeing

Background: Acceptance and Commitment Therapy is a form of Cognitive Behavioural Therapy which uses behavioural psychology, values, acceptance and mindfulness techniques to improve mental health and wellbeing. Acceptance and Commitment Therapy is efficacious in treating stress, anxiety and depression in a broad range of settings including occupational contexts where emotional labour is high. This approach could help palliative care staff to manage work-related stress and promote wellbeing. Aim: To develop, and feasibility test, an online Acceptance and Commitment Therapy intervention to improve wellbeing of palliative care staff. Design: A single-arm feasibility trial of an 8-week Acceptance and Commitment Therapy based intervention for staff, consisting of three online facilitated group workshops and five online individual self-directed learning modules. Data was collected via online questionnaire at four time-points and online focus groups at follow-up. Setting/participants: Participants were recruited from Marie Curie hospice and nursing services in Scotland. Results: Twenty five staff commenced and 23 completed the intervention (93%). Fifteen participated in focus groups. Twelve (48%) completed questionnaires at follow-up. Participants found the intervention enjoyable, informative and beneficial. There was preliminary evidence for improvements in psychological flexibility (Cohen’s d = 0.7) and mental wellbeing (Cohen’s d = 0.49) between baseline and follow-up, but minimal change in perceived stress, burnout or compassion satisfaction. Conclusion: Online Acceptance and Commitment Therapy for wellbeing is acceptable to palliative care staff and feasible to implement using Microsoft Teams in a palliative care setting. Incorporating ways to promote long-term maintenance of behaviour changes, and strategies to optimise data collection at follow-up are key considerations for future intervention refinement and evaluation.

"I see salt everywhere": A qualitative examination of the utility of arts-based participatory workshops to study noncommunicable diseases in Tanzania and Malawi.

The burden of noncommunicable diseases (NCDs) including hypertension, diabetes, and cancer, is rising in Sub-Saharan African countries like Tanzania and Malawi. This increase reflects complex interactions between diverse social, environmental, biological, and political factors. To intervene successfully, new approaches are therefore needed to understand how local knowledges and attitudes towards common NCDs influence health behaviours. This study compares the utility of using a novel arts-based participatory method and more traditional focus groups to generate new understandings of local knowledges, attitudes, and behaviours towards NCDs and their risk factors. Single-gender arts-based participatory workshops and focus group discussions were conducted with local communities in Tanzania and Malawi. Thematic analysis compared workshop and focus group transcripts for depth of content and researcher-participant hierarchies. In addition, semiotic analysis examined the contribution of photographs of workshop activities to understanding participants' experiences and beliefs about NCD risk factors. The arts-based participatory workshops produced in-depth, vivid, emotive narratives of participants' beliefs about NCDs and their impact (e.g., "… it spreads all over your body and kills you-snake's poison is similar to diabetes poison"), while the focus groups provided more basic accounts (e.g., "diabetes is a fast killer"). The workshops also empowered participants to navigate activities with autonomy, revealing their almost overwhelmingly negative beliefs about NCDs. However, enabling participants to direct the focus of workshop activities led to challenges, including the perpetuation of stigma (e.g., comparing smells associated with diabetes symptoms with sewage). Semiotic analysis of workshop photographs provided little additional insight beyond that gained from the transcripts. Arts-based participatory workshops are promising as a novel method to inform development of culturally relevant approaches to NCD prevention in Tanzania and Malawi. Future research should incorporate more structured opportunities for participant reflection during the workshops to minimise harm from any emerging stigma.

A "patient as educator" intervention: Reducing stigmatizing attitudes toward mental illness among medical students.

This pre-post quasi-experimental pilot study aimed to assess the degree of stigma toward mental illness and whether a single, direct-contact "patient as educator" intervention with people with mental illness can reduce the degree of stigma among medical students. All second-year medical students from the University of Valencia were invited to voluntarily complete the Community Attitudes Toward the Mentally Ill (CAMI), Reported and Intended Behavior Scale (RIBS), and Mental Health Knowledge Scale (MAKS) questionnaires before and after participating in the formal medical psychology course. A "patient as educator" workshop with expert patients was organized in the middle of the semester. A total of 127 students completed the survey; 20 students participated in the workshop (workshop group), and the remaining 107 students only took the formal educational course, forming the control group. At baseline, the groups were demographically matched and did not differ in the components of stigma or knowledge of mental illness. After the intervention, a greater reduction in the CAMI subscales of authoritarianism and social restriction was observed in the workshop group than in the control group. In the workshop group, scores for the benevolence subscale of the CAMI decreased more among women than men. In the control group, scores for the authoritarianism and benevolence subscales of the CAMI increased and decreased significantly more, respectively, in women than men. No significant changes were observed in scores for the RIBS at post-intervention in either group. The results of this pilot study suggest that a brief, direct-contact intervention in addition to formal medical education may further help reduce stigmatizing attitudes during the first years of medical school.