Care Education Research Articles

Enhancing the Evaluation System of Training Hospitals for Neurosurgical Residency Training and Education in South Korea : Striving for Balanced Participation and Differentiation.

The Korean Neurosurgical Society, with its 62 years of history, has witnessed substantial growth in the field of neurosurgery, producing over 3,400 neurosurgeons, establishing 12 divisions and 9 regional branches, and advancing in clinical management, diagnostic methods and academic research. Despite these developments, the regulations governing neurosurgical training and evaluation methods for training hospitals have remained largely unchanged, necessitating comprehensive revisions in response to evolving medical environments. To provide balanced participation opportunities for neurosurgery residents, the Korean Neurosurgical Society formed the Training Status Investigation Standard Change Task Force (TF Team) under the Training Education Committee. This paper presents the TF Team's findings and proposals for revising training status investigation standards and evaluation criteria. Through the processes including a lot of team meetings, workshops, education programs, official communications with 12 division societies, benchmarking from other societies and analysis of encrypted data from the past 5 years for neurosurgical training hospitals, the TF Team created a revised training status investigation proposal, supplemented main surgery criteria. And we applied this revised proposal to the training status investigation data collected from training hospitals in 2022 for simulation. We reduced the score for main surgeries to 10 points, introduced core competency surgery standards, allocating 5 points each for brain core competency surgery and spine and peripheral core competency surgery, for a total of 10 points. We also adjusted the major surgery score to 13 points, expanding the total surgery index score to 33 points. We introduced additional definitions for main surgeries in the areas of spine, pediatrics, and functional surgery. The equipment score was reduced from 17 points to 9 points. We specified minimum requirements for resident allocation eligibility, and if a hospital meets all of these criteria, they become eligible to apply for resident allocation. We introduced a new bonus point system for hospitals performing mechanical thrombectomy or stenting and peripheral nerve. The proposed revisions aim to improve the training and education of neurosurgical residents and overall neurosurgical care in Korea by creating a balanced and differentiated evaluation system for training hospitals. Further monitoring, communication, and adjustments are crucial for successful implementation.

Maternal smoking during pregnancy and offspring risk of intellectual disability: a UK-based cohort study.

Observational studies have described associations of maternal smoking during pregnancy with intellectual disability (ID) in the exposed offspring. Whether these results reflect a causal effect or unmeasured confounding is still unclear. Using a UK-based prospectively collected birth cohort (the Avon Longitudinal Study of Parents and Children) of 13,479 children born between 1991 and 1992, we assessed the relationship between maternal smoking at 18 weeks' gestation and offspring risk of ID, ascertained through multiple sources of linked information including primary care diagnoses and education records. Using confounder-adjusted logistic regression, we performed observational analyses and a negative control analysis that compared maternal with partner smoking in pregnancy under the assumption that if a causal effect were to exist, maternal effect estimates would be of greater magnitude than estimates for partner smoking if the two exposures suffer from comparable biases. In observational analysis, we found an adjusted odds ratio for ID of 0.75 (95% CI = 0.49-1.13) for any maternal smoking and 0.97 (95% CI = 0.71-1.33) per 10-cigarette increase in number of cigarettes smoked per day. In negative control analysis, comparable effect estimates were found for any partner smoking (OR = 0.94; 95% CI = 0.63-1.40) and number of cigarettes smoked per day (OR = 0.94; 95% CI = 0.74-1.20). The results are not consistent with a causal effect of maternal smoking during pregnancy on offspring ID.

Understanding Successful Mentor-Mentee Relationships in New Faculty Scholars Program.

Mentorship is critical for the career development of health care professionals and educators. Facilitating successful mentorship is valuable in supporting future leaders and educators in family medicine. Since 1988, the Society of Teachers of Family Medicine's New Faculty Scholars (NFS) program has provided 1-year mentorship opportunities for new faculty. This qualitative study used group concept mapping to identify the characteristics of successful mentorship relationships within the NFS program. Eight New Faculty Scholars (five mentors, three mentees) from 2015 to 2021 participated in a virtual 90-minute group concept-mapping and pattern-matching session. Participants generated statements in response to a prompt about successful features of mentorship relationships. Participants categorized responses by similarity and rated each statement on a numerical scale from 1 to 5 (1 indicating lowest, 5 indicating highest) according to importance, current presence within the program, and feasibility. Statements generated by participants were grouped into seven common themes. Categories rated most important included interpersonal skills, mentor soft skills, and mentor preparation. Structured processes and goal setting, mentor soft skills, and mentor preparation were rated most feasible in terms of future improvement. Interpersonal skills, mentor soft skills, and mentor preparation were the most highly rated by participants, but also displayed the largest disparity when compared to ratings on current presence. Future efforts to improve interpersonal communication and mentor training can potentially lead to greater satisfaction with the NFS program. The most highly rated categories indicated the primary benefit of the relational components of mentorship.

Integrating Skincare into Medical Practice.

The integration of skincare into medical practice can enhance patient care. Understanding the anatomy and physiology of the skin is the foundation for effective skincare interventions. Genetic and inflammatory conditions play a significant role in aesthetic skin physiology. There are key active ingredients that are pivotal in addressing various skin concerns. Sunscreens provide crucial protection against UV radiation, while pigment control agents such as hydroquinone, kojic acid, and arbutin target the melanin pathway. Exfoliating agents and skin turnover enhancers such as retinoids and hydroxy acids promote skin renewal and rejuvenation. In addition, ingredients such as hyaluronic acid, ceramides, niacinamide, antioxidants, peptides, and botanicals contribute to improving skin quality. Adding skincare to medical practice requires careful product selection, patient education, and marketing strategies.

Individualized Cognitive Functional Therapy Compared with Conservative Treatment for Patients with Chronic Neck Pain-Study Protocol for a Single Blind Pragmatic Randomized Controlled Trial.

Chronic neck pain (CNP) is one of the most common musculoskeletal conditions, is considered the second leading cause of pain, and is among the leading causes of disability. Cognitive Functional Therapy (CFT) is a novel behavioral therapy for individualizing the management of spinal pain targeting the multidimensional aspect of musculoskeletal pain. This study outlines the protocol for an assessor-blind randomized controlled trial (RCT) designed to compare an individualized Cognitive Functional Therapy (CFT) intervention with usual care in terms of pain and disability. Aiming for a pragmatic intervention, the CFT group will receive 16 sessions based on patient's condition characteristics, and clinical presentation and progression. The control group will receive 16 sessions of standardized usual care (electrotherapy, massage, posture exercise, and educations). Both groups will have the same intervention duration. Patients will be randomly allocated into groups and will be assessed at baseline, at the 8th session, at the 16th session, and 3 months after randomization. Primary outcomes will be pain, disability, cervical range of motion, and neck muscle isometric strength. To our knowledge, this study will be the first RCT to compare the clinical effectiveness of CFT compared to UC for adults with CNP. The study results will provide information about the use of CFT in clinical practice.

A Novel Approach to Safe Patient Handling and Mobility Training in Physical Therapist Education

Background: Safe patient handling and mobility (SPHM) training is prevalent in health care education and practice. However, there is limited evidence of this training in physical therapist education programs. Purpose: To determine if a single training session with a mobile laboratory equipped with SPHM equipment increases the knowledge of SPHM principles and techniques and is valuable to students prior to their first clinical experience. Methods: Training included a 1-hour lecture on SPHM principles, research, and techniques, followed by two 50-minute SPHM practice stations. One session was conducted using a mobile laboratory. Students completed a pretest/posttest measuring knowledge of SPHM principles. Students completed a survey regarding the perception and placement of SPHM training within the curriculum. Results: A total of 129 students in a physical therapist education program were invited to participate; 59 from first-year cohorts and 70 from second- and third-year cohorts. Eighty-seven students volunteered to participate, including all 59 students from the first-year cohorts receiving training as the experimental group, and 28 from the other cohorts receiving no training as the control group. Seventy students met the criteria for survey data analysis; 42 experimental and 28 control. Of those who received training, 90.5% reported that SPHM training improved their confidence prior to their inpatient clinical experience; 85.5% in the control group would have felt more confident being placed in an inpatient facility if they received SPHM training, and 85.7% of the experimental group and 89.3% of controls agreed that SPHM training should be performed prior to the first clinical experience. A paired t test showed that first-year students reported a statistically significant increase in knowledge of SPHM principles (P < .001). Conclusions: Physical therapist education programs should consider SPHM training prior to students’ first clinical experience to increase student confidence in inpatient settings.

Oral health knowledge, attitudes, and practices of paediatric nurses caring for hospitalized children

ObjectivesNurses are well positioned to provide oral care to hospitalized children. This study explores pediatric hospital nurses’ knowledge, attitudes, practices and perceived barriers to providing oral care.MethodsUsing a descriptive cross-sectional design, previously validated surveys were adapted based on input from key stakeholders and administered to all nurses and staff providing patient care on inpatient units (N = 239) of a pediatric hospital.ResultsThe survey response rate was 40% (N = 96), providing a margin of error of 7.59% (95% C.I.). Most participants were unaware that caries is infectious (51%, n = 49) and caries-producing bacteria is transmissible (35%, n = 34). The majority (57%, n = 52) of participants did not recall oral care content within their formal education or oral care continuing education (88%, n = 81), despite high interest (87%, n = 80). Oral care was rated by most as a priority (85%, n = 81), yet the majority (74%, n = 69) believed it is under performed. More nurses with 6 or more years of experience placed a high or very high value on prioritizing oral health (p = 0.005). Furthermore, most nurses do not assess oral health on admission (63%, n = 60), routinely incorporate oral health into the care plan (45%, n = 43), or document oral care (60%, n = 56). Commonly reported barriers include lack of patient cooperation, medical status, and competing needs.Conclusions and outcomeDespite nurses valuing the importance of oral care and their willingness to learn, oral care practices are lacking, and barriers exist. Future investigation is required to further explore the findings related to barriers to care and lack of practice. These results and future findings will be used to guide institutional oral care policy and education.

Evaluation of A Business Management Program to Promote Child Care Educator Outcomes: A Randomized Controlled Trial

Evaluation of A Business Management Program to Promote Child Care Educator Outcomes: A Randomized Controlled Trial

Integrating root cause analysis in dental education for patient-centered and holistic care.

Integrating root cause analysis in dental education for patient-centered and holistic care.

The Relationship Between Premarital Reproductive Counselling and Husband Support with Increased Coverage Pure K1 Maternity Visit Coverage

Purpose: This study aims to evaluate the relationship between premarital reproductive counselling and husband support with increased coverage of pure K1 pregnancy visits at Puskesmas Ajangale in 2022. Research Design and Methodology: This study used a correlation study design with a retrospective cohort approach. Secondary data were taken from medical records and observation results, while primary data were obtained through questionnaires. The study population included first trimester pregnant women who had first contact with health workers at Ajangale Health Centre, and the sampling technique was total sampling. Findings and Discussion: The results of the analysis showed that premarital reproductive counselling and husband support had a significant correlation with increased coverage of pure K1 visits. Of the respondents who participated in premarital counselling, the majority made a pure K1 visit. Similarly, respondents who received good support from their husbands tended to be more compliant in conducting pure K1 visits. The P=0.002 value indicates a significant association between these variables. Implication: This study confirms the importance of integrating premarital reproductive counselling programmes in public health policies to increase the coverage of antenatal care visits. Husband support also needs to be improved through education and active involvement in antenatal care. The findings provide valuable insights for health practitioners and policy makers in an effort to improve maternal and child health.

Effects of intensive, targeted education by pharmacists on anticoagulant patients with atrial fibrillation: a multicenter randomized controlled trial from China.

Many people diagnosed with atrial fibrillation (AF) may lack awareness of AF and anticoagulants. The purpose of this study is to investigate the effects of intensive, targeted education by pharmacists on anticoagulant patients with AF. Three hundred seventy-six AF patients were randomly assigned to receive standard care or pharmacist education. Follow-up is scheduled after 1, 3, 6, and 12 months. Pharmacists provided intensive education on knowledge deficits revealed by the Jessa Atrial Fibrillation Knowledge Questionnaire (JAKQ) during each visit. Patients also completed two questionnaires to assess their medication adherence and satisfaction. Clinical outcomes were recorded during follow-up. 361 patients completed follow-up. Baseline scores on the JAKQ were similar in the education group (median: 31.3%) and the standard care group (median: 31.3%) (p = 0.911). Over time, the knowledge score of the education group increased significantly (1 month: 68.8%, 3 months: 81.3%; P <0.001), while there was no significant improvement in the standard care group (1 month: 37.5%, 3 months: 37.5%; P = 0.314). Adherence scores improved significantly over time in the education group (P < 0.001) but not in the standard care group (P =0.101). Compared with standard care, pharmacist education was associated with a significantly lower risk of bleeding (P=0.034). Given the knowledge deficiency of AF patients in China, standardized patient education should be a part of their daily care. Pharmacist-led education intervention can significantly improve the disease-related knowledge, medication adherence, and drug treatment satisfaction of AF patients while significantly reducing the risk of bleeding.

Higher education faculty beliefs in preparing the early learning and care workforce to work with dual language learners

ABSTRACT Dual language learners (DLLs) represent a large portion of children ages birth through five in the United States. California (CA) is one of the states with the largest DLL populations with about 59% of people in CA identifying as DLLs. While DLLs constitute a large portion of children in California, early learning and care (ELC) educators in California do not receive adequate preparation to work with this population. Institutions of higher education (IHE) are key in supporting the ELC workforce to obtain the skills necessary to work with DLL children. A mixed-method study was conducted to identify the beliefs faculty in California hold regarding preparing the ELC workforce to work with DLLs. One hundred and forty-one early childhood education/child development (ECE/CD) faculty throughout California participated in the study. Results indicated that most of the participants have positive attitudes toward embedding DLL content in ECE/CD courses, but some have reservations about offering DLL-specific courses and teaching courses in languages other than English. Implications for IHEs, policymakers, and research are provided.

The tip of the iceberg: Generalism in undergraduate medical education, a systems thinking analysis.

There is a shortage of generalist physicians globally impacting health equity and access to care. An important way in which medical schools can demonstrate social accountability is by graduating learners interested in careers in generalism. While generalism is endorsed as a matter of principle in medical education, how this translates into curricula is less clear. The aim of this study was to identify how generalism is understood and supported by family physician educational leaders in undergraduate medical education (UME) in Canada. We conducted a qualitative study, interviewing 38 family medicine leaders in UME across all 17 Canadian medical schools. We examined the data with template analysis, informed by the iceberg model of systems thinking. Four themes were identified: (1) Teaching and learning strategies in support of generalism-a consistent range existed across UME curricula; (2) Curriculum patterns-changes in leadership and curriculum reform created positive or negative feedback loops that promoted or hindered initiatives to support generalism; (3) Curriculum structures-organ-system-based curricula and availability of generalist faculty presented particular challenges to teaching generalist approaches; (4) Mental models and ways of knowing-the preponderance of biomedical frameworks of thinking in curricula unconsciously undermined generalist approaches to patient care. UME programmes promoted generalism through a range of teaching activities and strategies, but these efforts were countered by curriculum structures and mental models that perpetuate epistemic inequity between biomedical approaches to medical education and generalist models of care. Novel curricular frameworks are needed to align undergraduate programmes' commitment to social accountability with community-based need.

Canadian Post-licensure Education for Primary Care Nurses Addressing the Patient’s Medical Home Model and Canadian Competencies for Registered Nurses in Primary Care: An Environmental Scan

Canadian Post-licensure Education for Primary Care Nurses Addressing the Patient’s Medical Home Model and Canadian Competencies for Registered Nurses in Primary Care: An Environmental Scan

Self-Assessed Educational Needs of Chinese Pediatric Clinicians Regarding Pediatric Palliative Care: A Cross-Sectional Investigation

Background: An important first step in enhancing professional palliative care training is to investigate the educational needs of pediatric clinicians in this field. The aims of this research were to analyze the extent of end-of-life care experience of Chinese pediatric clinicians and identify the differing educational needs of physicians and nurses as well as associated impact factors. Methods: A cross-sectional descriptive survey via a structural questionnaire was used in this research. Results: In total, 187 clinicians, comprising 52 physicians and 135 nurses, participated in this study. The topics “pain management”, “symptom management”, and “discussing the prognosis with family members” were the most expressed educational needs among both physicians and nurses. Compared to nurses, physicians placed greater emphasis on the importance of “communication” and “pain and symptom management” (p &lt; 0.05). Clinicians with more extensive end-of-life care experience more strongly felt the importance of learning about pain management and communication regarding end-of-life care (p &lt; 0.05). Conclusions: Research showed that the education currently provided to pediatric clinicians does not meet their distinctive needs. Future palliative care education must be a continuing multi-level, interdisciplinary program and different education should be provided to physicians and nurses based on their respective needs.

Palliative care education in undergraduate medical and nursing programs in Colombia: a cross-sectional analysis

BackgroundThe number of people suffering from chronic diseases requiring palliative care (PC) is increasing rapidly. Therefore, PC teaching in undergraduate health science programs is necessary to improve primary PC based on international recommendations and available scientific evidence.MethodsA descriptive cross-sectional study was conducted. Active undergraduate medical and nursing programs that were approved by the Colombian Ministry of Education and integrated PC teaching into their curricula were included in the study. The total sample consisted of 48 programs: 31 nursing and 17 medical programs.ResultsPC competencies are distributed throughout the curriculum in 41.67% of programs, in elective courses in 31.25%, and in mandatory courses in 27.08% of the programs. The average PC teaching hours is 81 for nursing and 57.6 for medicine. PC clinical rotations are not offered in 75% of the programs. For undergraduate nursing programs, the most frequent competencies taught are the definition and history of PC and identifying common symptoms associated with advanced disease. In undergraduate medicine, the most common competencies are pharmacological and non-pharmacological pain management and identification of PC needs.ConclusionsPC teaching in undergraduate health science programs mainly addresses the conceptual and theoretical aspects of PC, which are part of the competencies present throughout the programs’ curricula. Low availability of PC clinical rotations was identified. Future studies should assess whether the low availability of clinical rotations in PC limits the ability of students to develop the practical competencies necessary to provide quality PC.Trial registrationNot applicable.

A Prospective Questionnaire-Based Study Evaluating Genetic Literacy and Impact of Brief Educational Intervention Among Breast Cancer Patients in a Low- to Middle-Income Country.

A significant proportion of breast cancer cases are hereditary and are potentially preventable. However, adoption of the preventive measures remains a significant challenge, particularly because of to lack of knowledge and awareness in low- to middle-income countries. This prospective study conducted at a high-volume tertiary care cancer center in North India to assess the knowledge, awareness, and attitudes of female breast cancer patients and impact of a brief educational intervention. The study involved three phases: pre-interventional assessment, educational intervention, and post-interventional assessment utilizing a structured questionnaire. The study involved 300 newly diagnosed breast cancer patients; 16.7% were familial. At the outset, 87.0% patients had low knowledge of risk factors, 90.3% about screening, and 32.7% about treatment. Awareness levels were low: 13.7% aware of familial risk and 2.7% of breast cancer genes. Affordability of genetic testing was low (15.2%), and interest in testing for self and family members was limited (32.0% and 26.3%). Following educational intervention, a significant positive percentage change was noticed in knowledge (risk factors: 12.8%, screening: 36.2%, treatment: 82%), awareness (familial risk: 66.7%, BRCA gene: 12.3%), and attitude (testing for self: 17.8%, family: 19.5%). This study highlights the significant knowledge gaps among breast cancer patients regarding genetics. The educational intervention led to notable improvements in knowledge, awareness, and attitudes, underscoring the importance of tailored patient education in breast cancer care.

Is ChatGPT ready for primetime? Performance of artificial intelligence on a simulated Canadian urology board exam.

Generative artificial intelligence (AI) has proven to be a powerful tool with increasing applications in clinical care and medical education. ChatGPT has performed adequately on many specialty certification and knowledge assessment exams. The objective of this study was to assess the performance of ChatGPT 4 on a multiple-choice exam meant to simulate the Canadian urology board exam. Graduating urology residents representing all Canadian training programs gather yearly for a mock exam that simulates their upcoming board-certifying exam. The exam consists of written multiple-choice questions (MCQs) and an oral objective structured clinical examination (OSCE). The 2022 exam was taken by 29 graduating residents and was administered to ChatGPT 4. ChatGPT 4 scored 46% on the MCQ exam, whereas the mean and median scores of graduating urology residents were 62.6%, and 62.7%, respectively. This would place ChatGPT's score 1.8 standard deviations from the median. The percentile rank of ChatGPT would be in the sixth percentile. ChatGPT scores on different topics of the exam were as follows: oncology 35%, andrology/benign prostatic hyperplasia 62%, physiology/anatomy 67%, incontinence/female urology 23%, infections 71%, urolithiasis 57%, and trauma/reconstruction 17%, with ChatGPT 4's oncology performance being significantly below that of postgraduate year 5 residents. ChatGPT 4 underperforms on an MCQ exam meant to simulate the Canadian board exam. Ongoing assessments of the capability of generative AI is needed as these models evolve and are trained on additional urology content.

Corrigendum to “Perinatal care and breastfeeding education during the COVID‐19 pandemic: Perspectives from Kenyan mothers and healthcare workers”

Corrigendum to “Perinatal care and breastfeeding education during the COVID‐19 pandemic: Perspectives from Kenyan mothers and healthcare workers”

Assessing nurses’ professional competency: a cross-sectional study in Palestine

BackgroundEvaluating nurses’ professional competence is critical for ensuring high-quality patient care. Therefore, this study aimed to evaluate the nurses’ professional competence level and to identify differences based on demographics in three West Bank hospitals.MethodsA cross-sectional design was used, and a convenient sample of 206 nurses participated in the study. The Nurse Professional Competence (NPC) Scale was used to assess the competency level. The investigator distributed the questionnaire and explained the aim of the research. Consent forms were signed before the data collection.ResultsThe average competency level was 79% (SD = 11.5), with 90% being professionally competent nurses. The average “nursing care” competency was 79% (SD = 12.98), and the competency level in providing value-based care was 80% (SD = 13.35). The average competency level in technical and medical care was 78% (SD = 13.45), whereas 79% (SD = 12.85) was the average competence level in “Care Pedagogics” and “Documentation and Administration “. The average competence level in the development and leadership subscale was 78% (SD = 12.22). Nurses who attended three to five workshops had a higher level of Nursing Care Competency, (H = 11.98, p = 0.003), and were more competent in value-based care (H = 9.29, p = 0.01); in pedagogical care and patient education (H = 15.16, P = 0.001); and in providing medical and technical care (H = 12.37, p = 0.002). Nurses attending more than five workshops were more competent in documentation and administration (H = 12.55, p = 0.002), and in development and leadership subscale ( H = 7.96, p = 0.20).ConclusionThe study revealed that participants lacked development and leadership skills. Engagement in workshops positively impacted the level of competencies among nurses. Notably, those attending more than five workshops exhibited greater competence in documentation, administration, development, and leadership in nursing care.ImplicationsThis study emphasized the role of continuing education in improving nurses’ competencies and highlighted the need to conduct the study at a wider aspect to involve more hospitals with various affiliations to help structure more sensitive professional development and adopt the competencies as an integral part of staff development.