Interdisciplinary Health Professionals Research Articles

Let's Chalk About It: Introducing the TinyTalks Curriculum, a Paradigm for Short, Virtual Chalk Talks.

In busy clinical environments, educational opportunities must be designed to accommodate learner-specific needs. Many adult learners prefer short, relevant, technology-enhanced learning. As such, electronic learning (e-learning) experiences have become a prominent part of medical education. Yet, there remain challenges to e-learning experiences in the current educational landscape. To address these challenges, the authors developed the TinyTalks paradigm, which serves as the educational foundation for the TinyTalks curriculum.The TinyTalks paradigm was developed using the existing e-learning literature and foundational principles of adult learning and related theories. The TinyTalks paradigm includes 3 ground rules: (1) all TinyTalks videos must identify a category (approach to, explanation of, or application of) to clarify the focus of the topic, (2) all TinyTalks videos must be less than 7 minutes with all material presented on one virtual chalkboard screen, and (3) all TinyTalks videos must use the hook, frame, and delivery model, which guides the creation of the video. The resulting TinyTalks curriculum is an online repository of short, chalk talk-style educational videos, developed by interdisciplinary health professionals and targeted to the level of trainees, that is available to be used flexibly by learners for just-in-time learning, flipped classroom sessions, and/or self-study.The authors used Kern's 6-step approach to curriculum development as the conceptual framework for the development and implementation of the TinyTalks curriculum at Mass General for Children (June 2021-January 2023). While developing and implementing the curriculum, the authors focused on topic selection, stakeholder recruitment, establishing a process flow, and creating a virtual home.The authors believe the TinyTalks paradigm outlines an effective educational strategy that accommodates the unique needs of both learners and teachers in the medical education setting. The next steps are to scale the TinyTalks curriculum up by expanding the content library and to evaluate its efficacy.

Priorities, barriers, and facilitators for nutrition-related care for autistic children: a qualitative study comparing interdisciplinary health professional and parent perspectives.

Children with autism spectrum disorder often face nutrition-related challenges, such as food selectivity, gastrointestinal issues, overweight and obesity, and inadequate nutrient intake. However, the role of routine nutrition-related screening or care by interdisciplinary health professionals is not well understood. This study aimed to compare the beliefs of health professionals with those of parents of autistic children regarding high-priority nutrition-related challenges, barriers and facilitators to care, and desired education and resources related to nutrition for autistic children. Interdisciplinary health professionals (n = 25) (i.e., pediatricians, occupational therapists, speech-language pathologists, board certified behavior analysts, registered dietitians) and parents of autistic children (n = 22). The study used semi-structured phone interviews, which were recorded, transcribed, verified, and double-coded using the Framework Method. Thematic analysis of transcripts revealed that while health professionals and parents of autistic children shared some perspectives on nutrition-related challenges and care, they also had distinct viewpoints. Parents emphasized the importance of addressing food selectivity, behavioral eating challenges, sensory issues, and sleep disturbances affecting appetite. Both groups acknowledged the need for tailored support, access to an interdisciplinary care team, and reasonable expectations. Some health professionals perceived parents as lacking motivation or the ability to make changes. In contrast, many parents felt that health professionals lacked the knowledge and motivation to take nutrition or growth concerns seriously. Health professionals acknowledged that their lack of knowledge or capacity to provide nutrition education or referrals was a common barrier to care, particularly given limited community resources. Health professionals who serve autistic children are motivated to address nutrition-related challenges but lack resources related to nutrition. To promote better health outcomes for autistic children, professionals should identify and support parent motivations around nutrition-related care. Both groups expressed interest in accessing autism-specific resources for education, referral, and screening guidance. Future research could explore the development of healthcare training models that improve the competency of health professionals in providing nutrition care and referral for autistic children.

Art is Patient: A Museum-Based Experience to Teach Trauma-Sensitive Engagement in Health Care.

Psychological trauma is ubiquitous, an often hidden yet influential factor in care across clinical specialties. Interdisciplinary health professions education is mobilizing to address the importance of trauma-sensitive care. Given their attention to complex human realities, the health humanities are well-poised to shape healthcare learners' responses to trauma. Indeed, many such arts and humanities curricula propose narrative exercises to strengthen empathy, self-reflection, and sensitive communication. Trauma, however, is often unwordable, fragmentary, and physically encoded, incompatible with storying methods. This article presents a recent innovation, the Art is Patient seminar series, which focuses on aesthetic exercises to help learners access and share non-verbal, embodied, and relational responses to art. Based in an art museum context, it provides successive experiences of approaching, witnessing, and engaging with visual art as an analogue to developing trauma-sensitive relationships. Reflections on the process locate the seminar vis-à-vis health humanities practices, aesthetics, and trauma-informed approaches.

Collective Vision: Promoting Leadership, Partnership, and Opportunities to Improve Health in Greater Hazelwood

Greater Hazelwood, a neighborhood located in Pittsburgh, Pennsylvania, saw a decline in residents, businesses, and services at the decline of the steel industry. Residents, philanthropic organizations, advocates, health centers, schools, universities, and community-based organizations continue to collaborate to revitalize the Greater Hazelwood neighborhood. Duquesne University Center for Integrative Health was engaged by a place-based grantmaking strategy in Greater Hazelwood to explore the creation of a collaborative partnership between universities, federally qualified health centers (FQHCs), schools, residents, and community-based organizations to improve access to comprehensive and quality healthcare in Greater Hazelwood. This collaborative designed health and wellness programs based on community-identified health priorities to improve health outcomes. These programs provide opportunities to for multi-sector partners and interdisciplinary health professionals to meet residents where they are, decrease disease disparity, and promote health equity.

Impact of an Online Program of Bubble Continuous Positive Airway Pressure Education in a Resource-Constrained Setting.

Respiratory distress is a leading cause of preterm infant mortality in sub-Saharan Africa. Bubble continuous positive airway pressure (CPAP) is emerging as a potentially safe, cost-effective way of delivering noninvasive respiratory support in low-income and middle-income countries. However, without healthcare providers who are knowledgeable and skilled in the use of this technology, suboptimal neonatal care and related health disparities are likely to persist. We hypothesized that an Internet-based, blended curriculum on bubble CPAP for bedside providers in low-resource mother-baby units (MBUs) could be developed and implemented and lead to improvements in clinical knowledge, reasoning, and learner confidence in bubble CPAP. Clinical educators from Israel, Ghana, and the United States used the analysis, design, development, implementation, and evaluation (ADDIE) design framework to create an online curriculum for two MBUs in Kumasi, in the Ashanti Region of Ghana. Participants completed pre and post curriculum knowledge tests and completed surveys on their perspectives. Fifty-four interdisciplinary health professionals from the MBUs participated in the curriculum. Median knowledge test scores improved from 64% (interquartile range [IQR] = 50-72%) to 81% (IQR = 71-89%) after participation in the curriculum (P < 0.001). Learners reported high levels of confidence with bubble CPAP after participating in the curriculum and evaluated the curricular components highly. An online curriculum was successfully implemented and led to changes in healthcare worker knowledge in bubble CPAP. This may be an effective way to deliver education to healthcare professionals in resource-constrained countries and warrants further study.

Team-based primary care reforms and older adults: a descriptive assessment of sociodemographic trends and prescribing endpoints in two Canadian provinces

BackgroundTeam-based primary care reforms aim to improve care coordination by involving multiple interdisciplinary health professionals in patient care. Team-based primary care may support improved medication management for older adults with polypharmacy and multiple points of contact with the healthcare system. However, little is known about this association. This study compares sociodemographic and prescribing trends among older adults in team-based vs. traditional primary care models in Ontario and Quebec.MethodsWe constructed two provincial cohorts using population-level health administrative data from 2006–2018. Our primary exposure was enrollment in a team-based model of care. Key endpoints included adverse drug events (ADEs), potentially inappropriate prescriptions (PIPs), and polypharmacy. We plotted prescribing trends across the observation period (stratified by model of care) in each province. We used standardized mean differences to compare characteristics of older adults and providers, as well as prescribing endpoints.ResultsFormal patient/physician enrollment increased in both provinces since the time of policy implementation; team-based enrollment among older adults was higher in Quebec (47%) than Ontario (33%) by the end of our observation period. The distribution of sociodemographic characteristics was reasonably comparable between team-based and non-team-based patients in both provinces, aside from a persistently higher share of rural patients in team-based care. Most PIPs assessed either declined or remained relatively steady over time, regardless of model of care and province. Several PIPs were more common among team-based patients than non-team-based patients, particularly in Quebec. We did not detect notable trends in ADEs or polypharmacy in either province.ConclusionsOur findings offer encouraging evidence that many PIPs are declining over time in this population, regardless of patients’ enrollment in team-based care. Rates of decline appear similar across models of care, suggesting these models may not meaningfully influence prescribing endpoints. Additional efforts are needed to understand the impact of team-based care among older adults and improve primary care prescribing practices.

"ai4health" - Development and Conception of a Learning Programme in Higher and Continuing Education on the Fundamentals, Applications and Perspectives of AI in Healthcare.

AI applications play an increasingly important role in all areas of healthcare. Therefore, a basic understanding of AI technology for health professionals seems necessary. However, to date there is no learning programme in Germany that includes technological basics, applications, and perspectives of AI in healthcare for interdisciplinary health professions. The ai4health project investigates which basic knowledge and competences health professionals need to acquire for an informed handling of AI applications in healthcare, and what the appropriate didactic approach is. Through the qualitative research by interviews and a workshop, six relevant areas of competences were identified. The two most important areas are ELSA and relevant AI applications. Explainability was also highlighted as an important point. The implementation of the topics in a blended learning course for interdisciplinary health professionals and educators in the healthcare sector is now planned.

The impact of therapy dogs on the social and emotional wellbeing of students: a systematic review

ABSTRACT Objective This systematic review examined the impacts of therapy dogs on the social and emotional wellbeing of K-12 students. Procedure Five electronic databases (PsycINFO, Informit A+ Education, PubMed, Web of Science and ProQuest Dissertations & Theses Global) were searched to find English language, grey literature and peer-reviewed articles up to November 2020. Results A narrative synthesis of 23 articles indicated that therapy dogs may enhance students’ mood and positive emotionality, social and communication skills, confidence and their relationship with teachers. Inconsistently, other studies reported that therapy dogs may not enhance the social and emotional wellbeing of students. Conclusion The current research is characterised by methodological limitations and an over-reliance on the perceptions of students and teachers. To enhance the quality and reliability of the evidence, future researchers are encouraged to adopt more rigorous methodologies with larger sample sizes and control procedures. It is also recommended that the perceptions of school leaders, other educational personnel and interdisciplinary health professionals are incorporated into future studies. This may contribute to a greater level of consensus in the educational sector about the impacts of therapy dogs on the social and emotional wellbeing of K-12 students.

Parenting stress: psychological condition of parents with children with cirrhosis of the liver

Cirrhosis of the liver is common in someone who has had liver damage for years, but it can also occur in children. The daily life of children with cirrhosis of the liver, both physical and psychosocial will be disrupted, so that the child becomes more dependent on their parents. However, often parents are not ready to accept the child's condition. This study was to describe the psychological condition of parents who care children with cirrhosis of the liver. This study used electronic data base as a method by reviewing some articles published since 2007 to 2017. The results showed that the doctor's initial diagnosis of their child with liver cirrhosis was an initial problem that caused uncomfortable feelings in parents, such as shock, resistance, sadness, confusion, and anger. Parents feel responsible for their child's illness, which causes feelings of guilt and despair. The uncertainty of the child's condition or the potential that will happen to their child in the future is the biggest stressor for parents. The stress level will increase during transplant preparation and transplantation. In conditions of increase stress levels, not seldom create tension in the relationship between father and mother. Parents who have children with cirrhosis of the liver faced more complex challenges than parents who have healthy children. They must prepare themselves for the doctor's diagnosis, progression of disease, need for treatment at an uncertain time, transplantation and also potential cure. In these conditions, having a good quality relationship between husband and wife is important to deal with the impact of problems with children with liver cirrhosis. In addition, parents need to seek social support from interdisciplinary health professionals for dealing with each stage of the stressor.

An Investigation on the Perceptions of Practicing Interdisciplinary Health Professionals on Rapid Cycle Deliberate Practice Simulation.

Rapid cycle deliberate practice (RCDP) is a relatively new method for delivering simulation for a structured algorithm-based clinical content. We sought to understand how a group of practicing emergency medicine healthcare professionals would perceive RCDP as a learning method. This was a qualitative study of participants' reactions to RCDP simulation during an orientation process to a new freestanding emergency department using grounded theory. Focus groups were held after simulation sessions to investigate the participants reactions to RCDP as well as the experience of multiple professions participating. Two investigators independently coded the focus group transcripts to detect themes and developed a list of codes, which were then confirmed by consensus. Data were organized into themes with contributing codes. Thirty-one individuals participated in the focus groups including physicians, nurse practitioners, nurses, respiratory therapists, and patient care technicians. Four themes were detected: the procedural components of RCDP, the behavioral response to RCDP, learning through RCDP, and RCDP as interprofessional experience. The participants view of emotions and interruptions and pauses had discrepant interpretation. Participants received RCDP simulation positively. Initial negative reactions to the interruptions and pauses of RCDP dissipated as the simulation progressed. Ultimately, learners agreed that RCDP was extremely effective as compared with traditional simulation for medical resuscitation training because of the authenticity of the multidisciplinary aspect. This suggests that RCDP may be an effective tool for continuing education of practicing healthcare professionals.

More Information Continuity Through Health Networks? Barriers to Implementation and Use of Health IT.

Wound networks, as a voluntary structure formed by interdisciplinary health professionals, have the capacity to improve the continuity of care. Health IT systems (HIT) might be able to support these networks ensuring the information continuity in this process but electronic networking usually fails. The aim of this qualitative study is to examine the barriers why the networks do not take this step and possible approaches on how to overcome them. Based on interviews with 11 managers of wound networks 13 barriers could be detected which can be assigned to the main categories personal, financial, technical and legal barriers. It becomes clear that networks as voluntary bottom-up movements cannot increase the information continuity and hence also not the continuity of care on their own. This requires an overall concept. However, according to health experts, this must be drawn up, financed and above all coordinated by policy makers. In addition, these experts postulate structural guidelines for a cooperation in networks as well as nationally binding processes and standards in wound care. These guidelines and processes should then be mapped in a mandatory central HIT.

Neurology clinicians' views on palliative care communication: "How do you frame this?"

The communication process of preparing patients and families facing progressive neurodegenerative diseases for future illness has not been empirically elucidated; the goal of this qualitative study was to explore neurology interdisciplinary health professionals' communication experiences, including current approaches, facilitators, and challenges. Three focus groups were conducted with 22 clinicians representing a range of health professions from several multidisciplinary neurology outpatient clinics at a large academic medical center. A thematic analysis approach was used to develop a coding structure and identify overarching themes. Neurology clinicians highlighted that in their practice, (1) conversations are triggered by acute events and practical needs; (2) conversations occur routinely but are rarely documented; (3) loss of patient capacity and resultant surrogate decision-making can be ethically fraught, especially in times of family conflict; (4) prognostic uncertainty, unfamiliarity with disease trajectories, and patient or surrogate avoidance pose communication challenges; and (5) generalist- and specialty-level palliative care roles should be better defined. There is a need for a systematic, structured approach to communication that can be applied early in the disease trajectory and considered when developing integrated neuro-palliative care programs.

Foreword: The Moment of Discovery: How Do You Know When You Hit a Question That's Pure Gold?

Foreword: The Moment of Discovery: How Do You Know When You Hit a Question That's Pure Gold?

Drug-Related Problems and Associated Factors among Patients Admitted with Chronic Kidney Disease at Jimma University Medical Center, Jimma Zone, Jimma, Southwest Ethiopia: A Hospital-Based Prospective Observational Study.

Background There is an alarming rise of chronic kidney disease prevalence globally associated with significant morbidity and mortality necessitating special attention as one of the major growing public health problems. Medication-related problems are common in hospitalized patients including chronic kidney disease and may lead to increase hospital stay and health care cost and augment the risk of morbidity and mortality. Objective To determine prevalence of medication-related problems and associated factors among chronic kidney disease patients admitted to Jimma University Medical Center from April to September 2018. Methods A hospital-based prospective observational study was conducted among 103 chronic kidney disease patients admitted to Jimma University Medical Center from April to September 2018. Data regarding patient characteristics, medications, diagnosis, length of hospitalization, and laboratory results were collected through review of patients' medical charts. Data were analyzed by using Statistical Package for the Social Sciences (SPSS) version 21.0. Univariate and multivariate logistic regression was utilized to assess the associations between dependent and independent variables. Statistical significance was considered at p value <0.05. Results Out of 103 chronic kidney disease patients, 81 (78.6%) of patients had MDRs, on average 1.94 ± 0.873 per patient. The rate of overall MRPs was 30.95 per 100 medication orders. The most common MRPs among CKD patients were need additional drug therapy (62 (31%)), nonadherence (40 (20%)), and dose too low (36 (18%)). The most common cause of need additional drug therapy (52 (26%)) was untreated medical conditions; nonadherence (19 (9.5%)) was mostly due to that the patient/caregiver forgets to take/give the medication, and dose too low (29 (14.5%)) was mostly due to that the dose is too low to produce the desired response. Polypharmacy (AOR = 4.695, 95% CI: 1.370–16.091), number of comorbidities (AOR = 3.616, 95% CI: 1.015–1.8741), and stage of CKD (AOR = 3.941, 95% CI: 1.221–12.715) were independent predictors for MRPs. Conclusions We have demonstrated that medication-related problems are high among chronic kidney disease patients. Marital statuses, stage of CKD, polypharmacy, and comorbidity were independent predictors for MRPs. Interdisciplinary health professionals should work to decrease the high prevalence of MRPs among chronic kidney disease patients.

Health Professionals Perceived Concerns and Challenges in Providing Palliative and End-of-Life Care: A Qualitative Analysis.

The Institute of Medicine identifies that quality palliative/end-of-life (EOL) care should be provided to patients with serious, life-limiting illnesses and their families by competently prepared health professionals. This study assessed perceived concerns of health professionals pertaining to the delivery of palliative/EOL care in the hospital setting. The specific aim was to determine thematic concerns in the delivery of palliative/EOL care which emerged from respondents' impressions of a memorable palliative/EOL patient experience. Interdisciplinary health professionals at a large academic health system in the Midwest were surveyed to reflect upon a memorable palliative/EOL life care patient situation (positive or negative). A Thematic Analysis approach was used to code qualitative responses to 4 open-ended questions and then extract themes and subthemes from the coded data. Concerns identified by participants (N = 425) emerged around 7 themes including communication (97%), decision-making/care planning (75%), education needs (60%), EOL care (48%), ethics (24%), satisfaction with care (9%), and spiritual/cultural sensitivity (6%). Challenges exist in the delivery of quality palliative/EOL care in the hospital setting which may be addressed through educational initiatives that focus on recognition of cultural influences on care preferences, improving communication between patients/families and providers, education about the differences between palliative and EOL care, and increased competency of health providers in having EOL/goals-of-care discussions. Health professionals must recognize the benefit of collaborative palliative care in order to meet patient and family needs holistically and comprehensively.

When science meets Google: Reflections on research and evidence in the age of science deniers.

Noni is a former Dean of Medicine at Dalhousie University. Her two current major areas of interest are 1) Vaccines, including vaccine safety, hesitancy, demand, pain mitigation, education and policy especially through her work with the World Health Organization as a member of Strategic Advisory Group of Experts on Immunization and 2) MicroResearch, building capacity in community-focused research in developing countries and now also in Canada to help interdisciplinary health professionals find local solutions for community health problems that fit the context, culture and resources. Noni has long been internationally recognized as an advocate for children and youth health and as a leader in pediatric infectious disease and global health.

Improving primary care for persons with spinal cord injury: Development of a toolkit to guide care

ObjectiveTo identify a set of essential components for primary care for patients with spinal cord injury (SCI) for inclusion in a point-of-practice toolkit for primary care practitioners (PCP) and identification of the essential elements of SCI care that are required in primary care and those that should be the focus of specialist care.DesignModified Delphi consensus process; survey methodology.SettingPrimary care.ParticipantsThree family physicians, six specialist physicians, and five inter-disciplinary health professionals completed surveys.Outcome MeasuresImportance of care elements for inclusion in the toolkit (9-point scale: 1 = lowest level of importance, 9 = greatest level of importance) and identification of most responsible physician (family physician, specialist) for completing key categories of care. Open-ended comments were solicited.ResultsThere was consensus between the respondent groups on the level of importance of various care elements. Mean importance scores were highest for autonomic dysreflexia, pain, and skin care and lowest for preventive care, social issues, and vital signs. Although, there was agreement across all respondents that family physicians should assume responsibility for assessing mental health, there was variability in who should be responsible for other care categories. Comments were related to the need for shared care approaches and capacity building and lack of knowledge and specialized equipment as barriers to optimal care.ConclusionThis study identified important components of SCI care to be included in a point-of-practice toolkit to facilitate primary care for persons with SCI.

Management training in global health education: a Health Innovation Fellowship training program to bring healthcare to low-income communities in Central America

ABSTRACTBackground: Interprofessional education is increasingly recognized as essential for health education worldwide. Although effective management, innovation, and entrepreneurship are necessary to improve health systems, business schools have been underrepresented in global health education. Central America needs more health professionals trained in health management and innovation to respond to health disparities, especially in rural communities.Objective: This paper explores the impact of the Health Innovation Fellowship (HIF), a new training program for practicing health professionals offered jointly by the Central American Healthcare Initiative and INCAE Business School, Costa Rica. Launched in 2014, HIF’s goal is to create a network of highly trained interdisciplinary health professionals in competencies to improve health of Central American communities through better health management.Methods: The program’s fellows carried out innovative healthcare projects in their local regions. The first three annual cohorts (total of 43 fellows) represented all health-related professions and sectors (private, public, and civil society) from six Central American countries. All fellows attended four 1-week, on-site modular training sessions, received ongoing mentorship, and stayed connected through formal and informal networks and webinars through which they exchange knowledge and support each other. CAHI stakeholders supported HIF financially.Results: Impact evaluation of the three-year pilot training program is positive: fellows improved their health management skills and more than 50% of the projects found either financial or political support for their implementation.Conclusions: HIF’s strengths include that both program leaders and trainees come from the Global South, and that HIF offers a platform to collaborate with partners in the Global North. By focusing on promoting innovation and management at a top business school in the region, HIF constitutes a novel capacity-building effort within global health education. HIF is a capacity-building effort that can be scaled up in the region and other low- and middle-income countries.

Global Application of the Assessment of Communication Skills of Paediatric Endocrinology Fellows in the Management of Differences in Sex Development Using the ESPE E-Learning.Org Portal

Background: Information sharing in chronic conditions such as disorders of/differences in sex development (DSD) is essential for a comprehensive understanding by parents and patients. We report on a qualitative analysis of communication skills of fellows undergoing training in paediatric endocrinology. Guidelines are created for the assessment of communication between health professionals and individuals with DSD and their parents. Methods: Paediatric endocrinology fellows worldwide were invited to study two interactive online cases (www.espe-elearning.org) and to describe a best practice communication with (i) the parents of a newborn with congenital adrenal hyperplasia and (ii) a young woman with 46,XY gonadal dysgenesis. The replies were analysed regarding completeness, quality, and evidence of empathy. Guidelines for structured assessment of responses were developed by 22 senior paediatric endocrinologists worldwide who assessed 10 selected replies. Consensus of assessors was established and the evaluation guidelines were created. Results: The replies of the fellows showed considerable variation in completeness, quality of wording, and evidence of empathy. Many relevant aspects of competent clinical communication were not mentioned; 15% (case 1) and 17% (case 2) of the replies were considered poor/insufficient. There was also marked variation between 17 senior experts in the application of the guidelines to assess communication skills. The guidelines were then adjusted to a 3-level assessment with empathy as a separate key item to better reflect the qualitative differences in the replies and for simplicity of use by evaluators. Conclusions: E-learning can play an important role in assessing communication skills. A practical tool is provided to assess how information is shared with patients with DSD and their families and should be refined by all stakeholders, notably interdisciplinary health professionals and patient representatives.

A novel interdisciplinary health professions education program at King Saud University: strategy and structure (Phase I)

A novel interdisciplinary health professions education program at King Saud University: strategy and structure (Phase I)