Healthcare Training Research Articles

Gamification, Serious Games, and Simulation in Health Professions Education.

Health care educators may enhance learning with thoughtful incorporation of game elements. Gamification has shown success across various fields in medical education. It has demonstrated deeper engagement by leveraging both intrinsic and extrinsic motivational factors. While beneficial, gamification requires thoughtful implementation to increase active learning and avoid potential negative effects, such as unhealthy competition. Serious games integrate learning objectives directly within their framework, making the educational experience an intrinsic part of gameplay. These games are specifically designed to enhance knowledge and skills while promoting decision making, teamwork, and communication. The immersive nature of serious games requires players to actively engage and apply their knowledge to solve complex problems. Serious games and simulation represent transformative educational approaches that not only enhance learning and retention but also develop essential competencies crucial for health care professionals. These strategies, when combined with effective debriefing, provide a robust framework to enrich education and training in health care. [Pediatr Ann. 2024;53(11):e401-e407.].

Utilizing a university and state collaboration to advance student training and support public mental health care.

Utilizing a university and state collaboration to advance student training and support public mental health care.

From Simulation to Bedside: The Journey to Provide Equitable Patient Care.

Simulation-based education (SBE) has revolutionized health care training by enhancing skills and addressing systemic issues. This article explores how SBE can bridge the gap between recognizing health care disparities and implementing actionable steps to address them. The immersive nature of SBE, combined with structured debriefing, sets the foundation for a "brave space" that fosters critical discussions on crucial topics, such as health equity. SBE enables health care professionals to develop cultural humility, confront biases, and practice upstander skills. This approach not only addresses hidden curricula but also integrates equity into clinical practice through practical scenarios and community engagement. Despite the potential benefits, challenges such as unintentional harm and the need for thoughtful implementation persist. To maximize effectiveness, SBE initiatives must be aligned with organizational goals and include interdisciplinary team commitment. Ongoing research and robust evaluation are essential to measure SBE's impact on health equity and patient outcomes. [Pediatr Ann. 2024;53(11):e414-e419.].

Talking About Incarceration History: Engaging Patients and Healthcare Providers in Communication.

Incarcerated individuals in carceral facilities demonstrate an elevated prevalence of chronic disease conditions which are likely to persist post-release. Healthcare providers may not be trained on how exposure to incarceration may influence patient health outcomes and patient-provider communication. To examine the self-perceived preparedness of healthcare providers to interview patients regarding history of incarceration and the potential related health consequences. This cross-sectional study consisted of a web-based self-administered questionnaire distributed via email to a random sample of healthcare providers in the Department of Medicine at Brigham and Women's Hospital. In total, 400 healthcare providers were invited to participate; 114 respondents completed the survey, of which 26% were medical doctors (n=30), 41% were physician assistants (n=47), and 32% were nurse practitioners (n=37). Understanding healthcare provider training in caring for formerly incarcerated patients, current treatment practices and confidence caring for patients who have experienced incarceration, and implications for clinical care. Of 114 respondents, 73% reported that they currently care for formerly incarcerated patients. However, only 8% received specialized training for the care of formerly incarcerated patients. While most respondents did not ask their patients about prior history of incarceration (81%), when asked about comfortability in doing so, 60% reported low levels of comfort. Most providers (77%) reported high agreement that incarceration impacted health, with 54% reporting that it led to significant healthcare access barriers, but 64% reported low confidence levels in addressing the needs of formerly incarcerated patients. Healthcare workers recognized incarceration as a detrimental health exposure. However, providers reported low levels of confidence in understanding and addressing the unique needs of patients who experienced incarceration. Findings support the need for further training regarding how to address the needs of formerly incarcerated patients, which would support efforts towards achieving equitable healthcare.

Enhancing digital health competencies: insights from european human resources for health

Abstract Background Mixed-skills for digital health transformation are critical for human resources for health (HRH). This study aimed to inform the design of new training programmes that address soft, hard and digital health skills. Methods Using a mixed-methods design science approach, focus groups were conducted by invitation and with informed consent, online or in-person. A script was prepared with key questions for orientation and facilitation, addressing the topics of current situation, desired situation, desired skills, practical and organisational needs to implement continuous training in healthcare. The collected data were analysed using Nvivo. Results Focus groups (14) had 87 participants (Norway, Latvia, Belgium, Italy and Portugal): 26 healthcare professionals (nurses, midwives, nutritionists, pharmacists, assistants and doctors); 27 managers or directors of hospitals and care centres; 34 experts (digital health specialists, researchers, technical officers, members of professional societies and national authorities). Real needs were identified, with 2 direct sub-themes that were best related to each other (Pearson coefficient, p > 0.40 - cluster analysis): 1. ‘Current situation’: Cybersecurity (eg. privacy, law and ethics); Time (work time versus private time, p = 0.69); Type (informal versus formal training, p = 0.32); Programmes (graduation, continuing education and post-graduation levels). 2. ‘Desired situation: Desired skills (eg. digital - basic ICT, data analysis, soft - communication, emotional intelligence, and hard skills - medication administration, catheters, ECG, vital signs, telehealth - digital stethoscope); Learning design and objectives (eg. collective learning, simulations, location - peer-to-peer and hybrid); Emergency care and the link between primary and secondary levels of care were considered important. Conclusions These findings of convergence among HRH inform Program design process to support the training programs and course syllabus design. Key messages • The identified needs and priorities inform Program design further to support Digital Health Transformation training programs and course syllabus design. • Real needs points to Current and Desired situation, where HRH give important insights that need to be considered to engage people to perform training courses.

Abortion and Mental Health and Wellbeing: A Contemporary Review of the Literature.

This review discusses the importance of abortion care and access for mental wellbeing for people seeking abortion, abortion providers, and trainees. The recent Dobbs v. Jackson case has jeopardized the physical and mental health of millions. Much of the data regarding mental health impacts of abortion access comes from the Turnaway Study. This study supports that abortion does not cause negative mental health effects and being denied abortion is detrimental to mental health, physical health, and has negative socioeconomic impacts. Other recent studies support that the Dobbs decision continues to disproportionately harm historically marginalized groups. Additionally, there is more anxiety and depression reported in states with abortion restrictions. Many obstetrician gynecologists are moving away from restricted states and report moral distress due to restrictions. Many medical students are choosing not to apply to obstetrics and gynecology residency programs in states with abortion restrictions. Access to abortion care is important for mental and physical health, and socioeconomic well-being for people seeking abortion. Restrictive bans negatively affect people seeking abortion, as well as healthcare providers and trainees.

Exploring health-related quality of life in Portuguese Informal Caregivers

Abstract Background Caregiving can be associated with several adverse health impacts, such as in terms of mental health, health services use, or health-related quality of life (HRQoL). This study assessed HRQoL levels in Portuguese Informal Caregivers, and their relationship with caregiver psychosocial characteristics (e.g., perceived general and mental health; perceived level of support) and caregiving circumstances (e.g., caregiving duration, caregiving hours). Methods A cross-sectional study was conducted through an online survey directed to informal caregivers. HRQoL was measured using the Portuguese translation of the EQ-5D-5L. This instrument yields two values for HRQoL: a health profile (EQvalue) covering five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), and a visual analogue scale (EQvas). Bivariate analyses were performed and results with p-values below 0.05 were considered statistically significant. Results A total of 760 informal caregivers were surveyed (mean age 57 years (±9.9), 92.5% female, 41.5% at least university level, 44.4% works full or part-time). The mean total score for EQvalue (n = 733) was 0.8 (SD = 0.2). The mean total score for EQvas (n = 760) was 63.1 (SD = 21.5). The perceived general (p < 0.001) and mental (p < 0.001) health status, and the perceived access to healthcare (p < 0.001) were associated with EQvalue score. Also, EQvalue score was found to be directly correlated with the perceived level of support (r = 0.142; p < 0.001) and competence (r = 0,237; p < 0.001), and inversely correlated with the number of caregiving hours per day (r= -0,150; p = < 0,001) and the caregiving duration (r= -0,109; p = 0.008). Conclusions A significant relationship between caregiver HRQoL and several caregiver psychosocial variables was identified. Investing in and promoting the use of respite care services, as well as ensuring better access to healthcare for caregivers, appears important for improving caregivers’ HRQoL. Key messages • Improving caregivers’ access to healthcare and education or training programs (promoting a greater sense of competence) can be important in helping them maintain their quality of life. • Increasing the availability and promoting the use of respite care services by caregivers can be important in helping them maintain their quality of life.

Factors influencing antenatal care attendance in the eight contact era policy: a case of selected maternal health service facilities in Blantyre, Malawi

BackgroundMaternal mortality in sub-Saharan Africa and Malawi remains high. Effective antenatal care (ANC) services can reduce maternal morbidity and mortality. However, attendance to ANC clinics and the quality of services provided remain a challenge. Malawi adopted the 2016 WHO antenatal care model and there is a need to assess factors that influence antenatal care attendance. The main objective of this study was to assess factors influencing attendance in the era of the eight ANC contact policy in Blantyre.MethodsThis was an exploratory qualitative design in which 28 respondents participated using in-depth interviews and focus group discussions for the data collection process. The study sites included two healthcare facilities, namely Queen Elizabeth Central Hospital and Bangwe Health Centre, and a rural community (William Village Bangwe Rural) in Blantyre district. The 28 study participants included 11 ANC attendees, which comprised seven women in their final trimester and four postpartum women who attended ANC during their pregnancy, five midwives running the ANC clinics, and 12 non-users of ANC. The recordings were transcribed verbatim. The data were organized using Microsoft Excel and Microsoft word and analyzed using inductive content analysis.ResultsThe factors promoting ANC attendance in the context of the eight ANC contact policy include; motivation from health workers, family, and spouses and the women’s perceptions of ANC particularly the role it plays in preventing, detecting, and treating illness, but also preventing adverse pregnancy outcomes. On the other hand, the hindering factors to ANC attendance included lack of knowledge of the new ANC visit guidelines, financial constraints, quality of health services provided, attitude of healthcare workers, inadequate availability and training of healthcare workers, perceived poor quality of ANC services and personal beliefs.ConclusionIt is essential to provide comprehensive training to healthcare workers in the antenatal department regarding the new WHO ANC recommendations. This will help improve the quality of services at the antenatal clinics, including ensuring the availability of all necessary resources to encourage attendance. Additionally, promoting comprehensive spousal support, encouraging participation in activities, and adequately planning scheduled visits can help overcome financial barriers and further support antenatal attendance.

The interdisciplinary training academy for integrated substance/opioid use disorder prevention and health care: A qualitative look at a new remote field education model.

The opioid syndemic presents a critical need for effective interprofessional training in health care, especially in behavioral health disciplines. Addressing this need, the Interdisciplinary Training Academy for Integrated Substance/Opioid Use Disorder Prevention and Health care (ITA) was developed to provide adaptable educational experiences for emerging behavioral health professionals. This study, reflecting years 2020-2023, explored the experiences and perspectives of ITA fellows regarding interprofessional collaboration and opioid workforce development, focusing on how these elements are integrated. After conducting focus groups, we employed applied thematic analysis to qualitatively analyze the experiences of ITA fellows (11 women and six men; 41% Hispanic/Latino and 59% White; 14 Master of Social Work students and three psychology postdoctoral fellows). This method allowed for a detailed exploration of their perceptions and the nuances of their learning process within the context of opioid workforce development. The findings indicated that fellows' learning processes were adaptive, evolving over time to meet their changing needs. Initially, fellows faced challenges related to role clarity and process understanding. However, they reported significant professional growth as the program progressed, highlighting the effectiveness of the ITA's interprofessional approach in a remote learning setting. The study emphasizes the need for ongoing research to identify and overcome barriers to effective interprofessional collaboration. The results contribute insights into the role of remote field education in preparing future health care professionals to address complex health crises effectively. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Adding Life to Years: Comprehensive end-of-life care for all

This study builds upon our 2019 End-of-Life Care (EoLC) research, focusing on enhancing the quality and accessibility of EoLC in Hong Kong. With the introduction of the Advance Decision on Life-sustaining Treatment Bill, we identified the need for a more comprehensive approach to address the full spectrum of care needs beyond medical decisions. Our methodology leveraged insights from diverse stakeholders across various sectors and disciplines. The study revealed critical gaps in the system, service provision, and education related to EoLC. We propose six key recommendations: (1) develop a territory-wide standardised advance care planning (ACP) framework, (2) formulate an EoLC service strategy, (3) establish clear communication pathways to connect EoLC services, (4) promote public life and death education, (5) equip community professionals with ACP training, and (6) enhance university curriculum and on-the-job training in health and social care. These recommendations aim to create a cohesive EoLC ecosystem that respects individual preferences, optimises resource allocation, and addresses the challenges of an aging population. By implementing changes at system, service, and education levels, we envision EoLC in Hong Kong to be delivered in a person-centred, dignified, and coordinated manner, ensuring compassionate care at the final stage of life.

Unveiling the Burden of Nephrolithiasis in Low- and Lower-Middle Income Countries: A Review on Its Presentation, Risk Factors, Treatment Practices, and Future Directions

Background: Nephrolithiasis, or kidney stone disease, presents a significant global health burden, with global incidence rates and treatment practices varying widely. This study aims to discuss the epidemiology, risk factors, treatment modalities, and challenges for nephrolithiasis in the lower half of the World Bank rankings; that is, in low- and lower-middle-income countries. Methods: A comprehensive literature review was conducted using PubMed for each country on the list, focusing on studies published from January 2000 onwards and reporting data on prevalence, risk factors, treatment practices, and economic implications. Results: Nephrolithiasis represents a significant burden for healthcare systems, with noteworthy geographical variability in prevalence possibly dependent on socioeconomic status and gender. Risk factors include dietary habits, climate, pollution, and infectious diseases. Treatment practices in some regions still rely on open surgery due to limited access to advanced endourological techniques, while other regions demonstrate high proactivity in research. The burden is exacerbated by inadequate healthcare infrastructure and training. Conclusions: Addressing nephrolithiasis in challenging economic circumstances requires targeted interventions, including improved access to modern treatment methods, enhanced training for healthcare professionals, and better socioeconomic and environmental conditions. Future research should focus on region-specific strategies and the development of sustainable healthcare solutions.

Feasibility, Preference, and Impact of a Rapid Multiplexed Point-of-Care Digital Innovation (AideSmart!) to Expedite Screening of Sexually Transmitted Blood-Borne Infections in At-Risk Populations in Canada: Cross-Sectional Study.

With the need to expedite the detection of multiple sexually transmitted blood-borne infections (STBBIs), there is an increased demand for digital innovations and tests that improve the efficiency of point-of-care testing in outreach community settings. Multiplexed testing is being offered to at-risk populations by frontline health care professionals. With this in mind, we evaluated AideSmart! (for health aides or health care workers), an integrated app and platform solution that enables multiplexed STBBI screening at the point of care, for feasibility, preference, accuracy, and impact. With AideSmart!, we provided trained health care workers with the ability to perform rapid multiplexed tests; offer STBBI pre- or posttest counseling; maintain quality assurance of testing; facilitate linkages to care; and enhance health care provider-patient communication, data documentation, and patient engagement through the multiplexed STBBI screening and linkage process. We evaluated the performance of multiplexed tests. In a cross-sectional study conducted during the COVID-19 pandemic, we recruited at-risk populations in Canada from community-based organizations in Montreal, Quebec, and Saint John, New Brunswick, with unknown serostatus for HIV, hepatitis C virus (HCV), and syphilis. Following orientation and pretest counseling with AideSmart!, we performed multiplexed tests, simultaneously screening for HIV, HCV, and syphilis, using 2 rapid investigational multiplexed tests (Chembio for HIV and syphilis and MedMira for HIV, HCV, and syphilis) followed by confirmatory testing from local and national laboratories. Of the 401 participants, all (100%) accepted the AideSmart! multiplexed strategy: 59.4% (148/249) preferred multiplexed rapid tests over laboratory tests, and 56.6% (141/249) preferred receiving same-day test results. Rapid test results were obtained in 15 minutes (vs laboratory tests at 4-24 days). A total of 29 new infections (n=27, 93% HCV; n=1, 3% syphilis; and n=1, 3% HIV) were identified and treated within a week. Feasibility of the strategy (completion of testing and linkages to care) was at 76.1% (305/401). Health care professionals provided positive feedback and emphasized the importance of knowing one's negative or positive serostatus, especially during a pandemic. Multiplexed rapid tests' specificity (against laboratory reference standards) exceeded 98% (98.7%-100%) for all pathogens and devices. An electronic reader, used by the Chembio rapid test, enhanced sensitivity (HIV: 100%, 95% CI 79.4%-100%; syphilis: 86.8%, 95% CI 71.9%-95.6% [Chembio] vs HIV: 100%, 95% CI 78.2%-100%; HCV: 90.3%, 95% CI 80.1%-96.4%; and syphilis: 57.9%, 95% CI 40.8%-73.7% [MedMira]). The AideSmart! digital multiplexed rapid screening strategy for health care workers facilitated STBBI testing for multiple STBBIs and arranged for pre- or posttest counseling and rapid linkages with high feasibility and acceptability. Electronic readers enhanced the diagnostic performance of multiplexed biomarker tests. This study generated data in support of digital multiplexed strategies in digitally enabled settings for at-risk populations nationally and worldwide.

The impact of a professional development workshop on healthcare professionals' knowledge and readiness to use telehealth etiquette in virtual care.

Telehealth is a growing part of the healthcare field, and healthcare professionals and trainees require training not only on the clinical skills relevant to telehealth but also on professionalism skills or telehealth etiquette. As healthcare outcomes are influenced by the patient-provider relationship, training healthcare professionals on telehealth etiquette skills is imperative. Forty-eight healthcare professionals across different disciplines, work settings, and experience levels participated in a telehealth etiquette skills educational intervention workshop wherein their knowledge and readiness to use the skills (specific to technology, environment, confidentiality, and communication) were assessed before and after the workshop. Paired sample t-tests revealed that participating in the educational intervention resulted in statistically significant improvements in knowledge and perceived readiness to use telehealth etiquette skills pertinent to technology, environment, and communication. There were no associations between participants' personal factors and post-educational intervention changes. Study findings are significant and suggest that training healthcare professionals in telehealth etiquette have a positive impact. Since there is a known positive association between provider communication and patient satisfaction and a known association between patient satisfaction and healthcare outcomes, gaining telehealth etiquette skills is critical for promoting a positive patient-provider relationship via telehealth.

Gathering Validity Evidence for a Simulation-Based Test of Otoscopy Skills.

Otoscopy is a key clinical examination used by multiple healthcare providers but training and testing of otoscopy skills remain largely uninvestigated. Simulator-based assessment of otoscopy skills exists, but evidence on its validity is scarce. In this study, we explored automated assessment and performance metrics of an otoscopy simulator through collection of validity evidence according to Messick's framework. Novices and experienced otoscopists completed a test program on the Earsi otoscopy simulator. Automated assessment of diagnostic ability and performance were compared with manual ratings of technical skills. Reliability of assessment was evaluated using Generalizability theory. Linear mixed models and correlation analysis were used to compare automated and manual assessments. Finally, we used the contrasting groups method to define a pass/fail level for the automated score. A total of 12 novices and 12 experienced otoscopists completed the study. We found an overall G-coefficient of .69 for automated assessment. The experienced otoscopists achieved a significantly higher mean automated score than the novices (59.9% (95% CI [57.3%-62.6%]) vs. 44.6% (95% CI [41.9%-47.2%]), P < .001). For the manual assessment of technical skills, there was no significant difference, nor did the automated score correlate with the manually rated score (Pearson's r = .20, P = .601). We established a pass/fail standard for the simulator's automated score of 49.3%. We explored validity evidence supporting an otoscopy simulator's automated score, demonstrating that this score mainly reflects cognitive skills. Manual assessment therefore still seems necessary at this point and external video-recording is necessary for valid assessment. To improve the reliability, the test course should include more cases to achieve a higher G-coefficient and a higher pass/fail standard should be used.

The Power of Story Slams: A Mixed-Method Analysis of Narrative Medicine Connecting, Encouraging and Comforting Healthcare Trainees and Professionals

Background: Narratives convey information and emotion, evoke understanding, empathy, and connection. Healthcare professionals can use narratives to reduce burnout, benefiting them, patients, and colleagues. Story slams are narrative sharing events used for group reflection, providing an opportunity for participants and listeners to improve their well-being by processing complex emotions and identities. Story slams have traditionally been popular with creative writers and nonprofit organizations. Methods: Following a local event hosted by The Moth, the Temple University Lewis Katz School of Medicine (LKSOM) Narrative Medicine program hosted nine story slams over five years with 93 presenters including students and health systems staff. Through a mixed-method analysis, the authors examined the stories for thematic patterns and surveyed presenters to investigate how the experience had impacted markers such as job satisfaction, stress levels, and connection to patients. Eleven presenters were interviewed to provide additional information about the impact they experienced. Results: Patient-centered care, resilience, and the value of learning comprised over half of all themes presented. Following the event, many presenters experienced improved connections with patients, and everyone reported feeling neutral or increased satisfaction with their profession. The interviews conveyed participation, created a lasting impact, fostered a sense of community, and increased appreciation for diversity. Conclusions: Overall, story slams nourish humanity and promote diversity, enthusiasm, and encouragement. This study and others suggest that story slams are inexpensive and effective events that can help reduce burnout and provide academic medical centers with a way to restore and cultivate community among students, physicians, and staff.

Understanding stakeholder perspectives on Apgar score, cyanosis and identifying jaundice in ethnic minority neonates.

To explore neonatal assessments that include an element of evaluating skin colour in neonates of black, Asian and minority ethnicities, focusing on the Apgar score, presence of cyanosis and presence of jaundice. We employed focused ethnography involving diverse healthcare professionals (HCPs) and parents or caregivers with Black, Asian, or ethnic minority children born in the last five years. Zoom interviews were performed following a semi-structured interview guide. Ethnographic data analysis was conducted using NVivo software. There was a lack of consistency in how HCPs applied the Apgar scores, which also varied from textbook guidelines. The use of pink as a skin colour descriptor for ethnic minority neonates created a divide among both parents and HCPs. HCPs relied more heavily on other elements of the Apgar score or infant breathing and crying at birth to gauge infant wellness. When identifying cyanosis, HCPs depend on specific body locations for accurate assessment of oxygenation, but the limitations of visual assessment are acknowledged. For jaundice, most HCPs recognised the difficulty in identifying the colour yellow in infants with darker skin tones. HCPs focussed on yellowing of the sclera and gums and other well-being assessments to detect jaundice. Some interviewed parents noticed jaundice in their infants before HCPs but felt they were not listened to when raising concerns. HCPs acknowledged the need for additional training to effectively assess the health of ethnic minority infants. This study highlights disparities in neonatal health assessment from the perspectives of healthcare professionals and parents from diverse backgrounds. Varied practices in determining the Apgar score and recognising cyanosis and jaundice signal the need for standardised protocols, appropriate educational materials, and targeted training. Addressing these challenges is vital for equitable care, emphasising comprehensive training and bias mitigation efforts in maternal and neonatal healthcare.

Cybersecurity lessons from the Vastaamo psychotherapy data breach for psychiatrists and other mental healthcare providers.

The Vastaamo psychotherapy data breach in Finland is perhaps the largest cybersecurity incident in mental healthcare to date, resulting in significant patient harm. There are specific lessons for mental healthcare providers from an analysis of the incident. Case study of this specific electronic health record data breach, based on detailed media reporting. The issues raised include: the importance of governance of the cybersecurity of sensitive personal patient data, such as compliance with legislative requirements on privacy and data security; specific security measures such as de-identification of data, data protection via passwords, multi-factor authentication, firewalls and encryption; and timely and effective communication, and support of those who have been affected. The implications for mental healthcare providers, including psychiatrists and trainees, are that, within their capability, providers need to assess the efficacy and robustness of cybersecurity of electronic health record systems they use, and carefully consider the information that is recorded to minimise exposures such as in the Vastaamo breach.

A place to call our home: innovative rural physical therapy training in Canada

BackgroundTo promote rural practice and increase enrollment in the entry-level Master of Science Physical Therapy program at the University of Alberta, the Department of Physical Therapy developed a rural physical therapy satellite campus located in a farming region in central Alberta. A distributed learning format was used to connect the rural cohort to the main urban campus. Real time video conferencing was used to connect the two campuses for all lectures, seminars and clinical skills classes. This evaluation aimed to describe a unique rural training program for physical therapy students and its effectiveness in promoting work in rural communities after graduation.MethodsPhysical Therapy students in the first three years (2012–2015) of commencing the rural satellite program (n = 280) were surveyed, and six focus groups were held to capture student experiences, satisfaction and engagement. Data were collected on employment locations of the 2012–2019 graduates’ first physical therapy position and current employment.ResultsSurvey results suggested comparable levels of satisfaction and engagement for all physical therapy students regardless of campus. Focus group data revealed that students quickly accepted the distributed learning technological interface, enjoyed their local campuses, and felt connected to instructors and student colleagues. Compared to the overall physical therapy workforce, a higher percentage of physical therapists graduating from the rural campus reported working in rural centers for both their first and current jobs.ConclusionRegardless of campus, students were satisfied and equally engaged in the physical therapy program. Students who completed the physical therapy program in a rural setting tended to work rurally after graduation. A distributed learning model may be useful for other healthcare training programs to promote engagement in rural health.

A holistic approach to address female genital schistosomiasis in Ghana and Madagascar: the FGS Accelerated Scale Together Package

Women and girls who have been infected with the blood fluke Schistosoma haematobium can experience the chronic form of urogenital schistosomiasis, called female genital schistosomiasis (FGS). Some FGS symptoms resemble sexually transmitted infections. As a result, women and girls seeking treatment are often misdiagnosed and stigmatized. The FGS Accelerated Scale Together (FAST) Package project implemented a holistic approach to address FGS combining proven interventions in training, mass drug administration, diagnosis, and treatment as well as community awareness to address FGS in four selected districts in Ghana and Madagascar. The FAST Package was supported by an FGS National Committee who provided guidance on integration at the national level. Using an implementation research design, researchers worked closely with government counterparts in the programs for neglected tropical diseases in both countries. Baseline cross-sectional surveys and qualitative methodologies collected information on schistosomiasis and FGS awareness, experience with health seeking behaviors and knowledge of schistosomiasis prevention amongst community members and teachers. FAST Package interventions included healthcare provider training delivered in online and in person formats; development of an Educators’ booklet to support schistosomiasis/FGS awareness creation among teachers, healthcare providers and community members; suspected FGS case detection; and advocacy for the provision of praziquantel in the primary health care system. Endline results included a cross-sectional survey and qualitative methodologies amongst community members and teachers, including Photovoice for women of reproductive health age exposed to FGS. This paper presents a description of the FAST Package project, the value of its holistic approach, and selected results from both countries. It discusses the lessons learnt highlighting some of the challenges and opportunities for integration within the health system.

Psychological Safety Competency Training During the Clinical Internship From the Perspective of Health Care Trainee Mentors in 11 Pan-European Countries: Mixed Methods Observational Study.

In the field of research, psychological safety has been widely recognized as a contributing factor to improving the quality of care and patient safety. However, its consideration in the curricula and traineeship pathways of residents and health care students is scarce. This study aims to determine the extent to which health care trainees acquire psychological safety competencies during their internships in clinical settings and identify what measures can be taken to promote their learning. A mixed methods observational study based on a consensus conference and an open-ended survey among a sample of health care trainee mentors from health care institutions in a pan-European context was conducted. First, we administered an ad hoc questionnaire to assess the perceived degree of acquisition or implementation and significance of competencies (knowledge, attitudes, and skills) and institutional interventions in psychological safety. Second, we asked mentors to propose measures to foster among trainees those competencies that, in the first phase of the study, obtained an average acquisition score of <3.4 (scale of 1-5). A content analysis of the information collected was carried out, and the spontaneity of each category and theme was determined. In total, 173 mentors from 11 pan-European countries completed the first questionnaire (response rate: 173/256, 67.6%), of which 63 (36.4%) participated in the second consultation. The competencies with the lowest acquisition level were related to warning a professional that their behavior posed a risk to the patient, managing their possible bad reaction, and offering support to a colleague who becomes a second victim. The mentors' proposals for improvement of this competency gap referred to training in communication skills and patient safety, safety culture, work climate, individual attitudes, a reference person for trainees, formal incorporation into the curricula of health care degrees and specialization pathways, specific systems and mechanisms to give trainees a voice, institutional risk management, regulations, guidelines and standards, supervision, and resources to support trainees. In terms of teaching methodology, the mentors recommended innovative strategies, many of them based on technological tools or solutions, including videos, seminars, lectures, workshops, simulation learning or role-playing with or without professional actors, case studies, videos with practical demonstrations or model situations, panel discussions, clinical sessions for joint analysis of patient safety incidents, and debriefings to set and discuss lessons learned. This study sought to promote psychological safety competencies as a formal part of the training of future health care professionals, facilitating the translation of international guidelines into practice and clinical settings in the pan-European context.