Kirkpatrick Level Research Articles

Asynchronous training for ultrasound-guided peripheral IV placement among critical care nurses.

Teaching ultrasound (US) guidance for placement of peripheral intravenous (PIV) catheters requires significant time for synchronous didactic and hands-on training. The investigators assessed the feasibility of an asynchronous model for critical care nurses to learn the novel skill of US-guided PIV placement. Secondary outcomes included the percentage of successful attempts and number of sticks per attempt for anatomy versus US-guided approaches. The investigators built a self-contained training cart for learners to practice and record their performance. Training occurred asynchronously. The learners recorded data from PIV attempts. Participants completed pre- and post-training surveys. Data from this prospective observational cohort was analyzed for descriptive and comparative statistics, using Kirkpatrick's Model for evaluation of this educational intervention. During a 6 month period, 21 nurses completed the asynchronous training, with eight recording their PIV placements. 81.0% of the training occurred outside of a Monday to Friday 9AM-5PM period. There were 64 attempts by anatomy approach and 84 with US-guidance. The anatomic approach was successful in 35.9% of attempts with a mean of 1.5 sticks (SD 1.0, Range 1-5). The US-guided approach had a statistically significant greater rate of success (77.4%; p < 0.001) with a mean of 1.2 sticks (SD 1.2, range 1-2, p < 0.01). Participants reported increased confidence in US-guided PIV placement and enjoyment with this method of learning. Asynchronous learning model with cart-based instruction and practice is a feasible means for nurses to learn US-guided PIV placement. Significant outcomes were seen across Kirkpatrick levels I-IV for educational outcome assessment.

Next Generation Leaders Programme: A Multi-Methods Evaluation of a Leadership Development Programme for Biomedical Researchers.

Biomedical scientists have become de facto leaders for their research teams. Theories of expert leadership suggest that the specialist knowledge and credibility these researcher-leaders bring to their roles can lead to improved performance. Formal leadership development for biomedical researchers remains uncommon, and it is unclear whether existing leadership development programmes achieve improved individual and organisational outcomes. Our study evaluates the effectiveness of a single centre leadership development programme for biomedical researchers using a mixed-methods approach. 26 biomedical researchers participated in an 8 month single centre multidisciplinary leadership development programme. Participants completed prospective pre-test, retrospective then-test and traditional post-test self-assessments using the Primary Colours Questionnaire (PCQ) and Medical Leadership Competency Framework Self-Assessment Tool (MLCFQ). Pre-post pairs and then-post pairs were analysed for changes using Wilcoxon signed-rank tests and compared with a parallel mixed-methods evaluation organised by Kirkpatrick levels. There were significant increases in 3/7 domains and 1/5 tasks of leadership in the PCQ, in both pre-post and then-post paired assessments. There were statistically significant but small increases in 2/7 domains of the MLCFQ. The mixed-methods data showed positive outcomes at all Kirkpatrick levels.Participants said the programme was relevant, interesting and well-organised, with 63% reporting increased confidence and motivation. Participants had a significant change in behaviour, spending 1-2 hours per week on group projects, which were successfully implemented locally. 42% of participants expected these projects to continue beyond the programme. This study demonstrates a local leadership programme can have positive impact within a biomedical research centre despite time and financial constraints. We encourage future studies to utilise a mixed-methods approach to evaluating the impact of leadership development programmes.

Alternative Digital Credentials: UAE’s First Adopters’ Assessment and Evaluation Part (2)

Despite the wealth of research on full credentials assessments, standardized approaches are still scarce. This is even more threatening to the acceptance of higher education alternative digital credentials. To address this threat, validated and transparent assessments and evaluation processes are of paramount importance. This study is a continuum to our previous review on the pedagogical program analysis, design, development, and implementation. This paper reviews, assesses and evaluates the alternative digital credential offering case study. We review the development and administration of seven requirements and assessment tools used to evaluate students’ performance and use Kirkpatrick’s model to evaluate the effectiveness of the alternative credential offered. The predominantly clinical-based assessment tools and assessment decision criteria are reviewed in detail in this paper, allowing educators to leverage the outcome of this work. Results: The reviewed alternative digital credential case study in the human thorax and extremities from medical imaging has achieved Kirkpatrick level three, as evident in results, particularly from clinical assessments and clinical site viva-voce. When introducing a new competency-based assessment, professional standards can be used as a reference point to develop Behavioral Marker System rubrics. The Ebel method in calculating the cut score, which reflects expert judgment, should be considered when developing competency-based rubrics. Standardization of at least the top common technical and NTS is possible when researchers consider international collaboration by publishing comprehensive methodologies, frameworks, and results. This paper is unique as we are unaware of any publication on alternative digital credentials combining medical imaging and technical and non-technical skills within entrustable professional task assessment, verification, and program evaluation.

Do the benefits continue? Long term impacts of the Anatomy Education Research Institute (AERI) 2017

BackgroundThe Anatomy Education Research Institute (AERI) was held in Bloomington, Indiana in July of 2017. Previous research has shown that AERI was successful in meeting Kirkpatrick’s first two levels of evaluation via positive initial reactions and learning gains identified at the end of AERI. This manuscript demonstrates continued success in Kirkpatrick levels two and three via six-month and thirty-month follow-up surveys and nine-month follow-up focus groups and interviews.MethodsQuantitative analyses were completed using Microsoft Excel (2019) and SPSS version 26 while qualitative analyses were completed for both survey responses and focus groups/interviews using thematic analyses.ResultsResults demonstrate that the learning gains seen immediately post-AERI 2017 were sustained for all participants (accepted applicants and invited speakers). Qualitative results continued to demonstrate positive reactions to AERI 2017. Both quantitative and qualitative results demonstrated that the main obstacle to educational research for most participants is time, while collaboration, IRB, institutional roadblocks, and devaluing of educational research were also identified as obstacles.ConclusionsThe research presented here indicates positive outcomes to Kirkpatrick Levels 1, 2, & 3 of evaluation following AERI 2017. However, substantial obstacles still exist for researchers in medical education. The need for a sustained community of practice for educational researchers was suggested as a potential buffer against these obstacles and multiple options for providing that community are discussed.

Improving Diversity, Equity, and Inclusion Education in Hematology/Oncology Training

PURPOSE: Diversity, equity, and inclusion (DEI) are core principles in medical education and essential elements in eliminating health and workforce disparities. Over the past several years, institutional DEI initiatives have led to increases in the numbers of underrepresented trainees and faculty at Yale School of Medicine (YSM) and Yale Cancer Center (YCC). In 2021, the Yale Hematology/Oncology (HO) Fellowship Program created a DEI curriculum for Yale HO Fellows, designed by the HO Chief Fellows with guidance from Fellowship Program Leadership and the Vice Chair of DEI for YCC. The goals of the DEI curriculum were to foster a programmatic culture of inclusion and empower fellows to identify and respond to discrimination events in the workplace. METHODS: A baseline needs-based assessment was performed with online anonymized surveys. The six-question survey was designed to assess topic preferences and witnessed discrimination events; all HO fellows (n = 27) were emailed a link to the survey. Based on the needs assessment, a five part DEI curriculum was designed, which included 1) an interactive session with the Vice Chair of DEI, 2) a journal club with the Deputy Dean and Chief Diversity Officer at YSM, 3) an interactive session on advancing gender equity through allyship and awareness led by external consultants, 4) an interactive session on gender identity with two experts on LGBTQIA2S+ issues in medicine following a YCC Grand Rounds seminar, and 5) a Chief Fellow-led interactive session on upstander training. The DEI curriculum was mandatory for all fellows. Evaluations of the curriculum at its completion were collected via a separate online anonymous survey that included 11 questions about comfort level in addressing discrimination and harassment (Kirkpatrick level 2). Perceptions of DEI among HO fellows and Core Faculty were further gauged using annual trainee and faculty surveys distributed by the American Council of Graduate Medical Education (ACGME) in 2021 and 2022, and a separate survey designed and distributed by the Program Leadership to gauge perceptions of DEI among HO Core Faculty in 2021 and 2022. RESULTS: In total, 17 fellows (68%) responded to the pre-curriculum needs assessment survey. The majority of respondents witnessed (>75%) or experienced (>64%) some form of harassment during medical training. All respondents reported being under-equipped to navigate these scenarios. Inclusion of DEI into the fellowship curriculum was perceived as very important (mean 8.19/10, range 2-10). All fellows completed the five-part DEI curriculum. A total of 8 fellows (32%) responded to the post-curriculum survey; respondents reported an increase in comfort level navigating discrimination events (Figure 1). In ACGME trainee and faculty surveys prior to (2021) and following (2022) initiation of the DEI curriculum, compliance with DEI efforts increased above national means after initiation of the DEI curriculum (2021 mean scores, HO fellowship program vs national: faculty, 4.6 vs 4.4, fellows 4.2 vs 4.3; 2022: faculty 4.8 vs 4.5, fellows 4.6 vs 4.3). In surveys prior to and following the institution of the DEI, the percentages of HO Core Faculty who agreed that the HO Fellowship Program treats DEI as being core to its mission, on par with clinical excellence and investigative pursuits, increased from 71.4% to 80%. Those who agreed that DEI topics are formally or informally discussed as part of the educational experience of HO fellows increased from 28.5% to 50%. CONCLUSION: A DEI curriculum for HO fellows may lead to significant improvements in fellow upstander responses to discrimination in the workplace and may augment institutional perceptions of DEI among fellows and faculty. We plan to continue our fellow-led DEI curriculum in perpetuity as part of our fellowship program and institution's commitment to DEI efforts. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

18 EDUCATION AND TRAINING TO SUPPORT PHYSIOTHERAPISTS WORKING IN DEMENTIA CARE: A SCOPING REVIEW

Abstract Background Physical impairments associated with dementia include loss of mobility, diminished postural control and reduced muscle strength, which in turn can lead to an increase in falls, hip fractures and frailty. Physiotherapy can play a key role in many aspects of dementia care. Physiotherapists have reported carrying a high caseload of people with dementia. However, there is a paucity of evidence as to what constitutes effective dementia education and training for physiotherapists. The aim of this scoping review was to explore and map the evidence relating to education and training for physiotherapists, with a view to using these findings to inform the design and delivery of an educational program for physiotherapists. Methods This scoping review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. The protocol for this review was published in March 2021. This review included studies that examined dementia education and training for the wider healthcare team if physiotherapy was an included profession. All studies with a focus on any aspect of physiotherapy dementia education and training were included. Studies conducted in any setting, including acute, community care and residential or any educational setting were included. A chronological narrative synthesis of the data outlined how the results relate to the objectives of this study. Results A total of eleven papers were included. The principal learning outcomes evaluated were knowledge, confidence and attitudes. Immediate post intervention scores showed an improvement in all three outcomes. Most educational interventions reached Kirkpatrick level 2, which evaluates learning. A multi-modal approach, with active participation and direct patient involvement seems to enhance learning. Conclusion Allowing for the heterogeneity of intervention design and evaluation, some common components of educational interventions were identified that led to positive outcomes. This review highlights the need for more robust studies in this area. Further research is needed to develop bespoke dementia curricula specific to physiotherapy.

Introducing Flipped Classroom to Teach Basic Life-Support to First-Phase MBBS Students in a Medical College of West Bengal

Introduction: Basic life support (BLS) consists of a number of medical procedures provided to patients with life-threatening conditions of the body and there exists a significant lack of knowledge regarding the signs and risk factors associated with serious medical conditions among medical students. The present study was conducted to evaluate a module for teaching BLS to first MBBS students using the flipped classroom method. Methodology: The present study was conducted among first-phase MBBS students after taking institutional ethical clearance and informed consent of participants. Students of 2021–2022 were included in a WhatsApp group and YouTube videos were posted on the group where demonstrations of BLS were done and the importance of learning cardiopulmonary resuscitation was discussed. Students were then divided into groups of twenty and each group was asked to make a PowerPoint presentation which they had to present in live sessions and demonstrate the procedure. Students joined an online BLS Certification Course. Feedback was taken from students and faculty members and a program evaluation at Kirkpatrick's level 1 was done. Results: Two hundred students participated in the study. The mean ± standard deviation of marks obtained by students in the certification program was 87.67 ± 5.87 and posttest scores were significantly better as compared to pretest scores. Students and faculty members were satisfied with the program. Conclusions: The BLS module introduced in the Foundation Course using the flipped classroom at the beginning of the first phase of the MBBS course enabled the students to acquire the basic knowledge and skills required.

Creation of a novel course for the advanced emergency medicine ultrasound focused practice designation examination.

The American Board of Emergency Medicine recently established a new certification pathway in advanced emergency medicine ultrasound (AEMUS). Eligible applicants come from a wide range of experience but must pass the same examination to become certified. This study sought to evaluate a novel review course targeting a wide range of learners for a new examination. This was a cross-sectional study evaluating the outcomes of the American College of Emergency Physicians (ACEP) AEMUS review course. The program evaluation survey was designed to collect outcomes across multiple Kirkpatrick levels, including overall satisfaction, topic-specific satisfaction, topic-specific coverage, topic-specific confidence before and after the course, topic-specific perceived knowledge before and after the course, and changes in practice. Seventy-four of 79 participants (93.7%) completed the survey. Mean course satisfaction was 4.59/5.00 (95% CI 4.47-4.72). Confidence to pass examination components increased for the following topics: administration, advanced left ventricle (LV), education, head and neck, hepatobiliary, male genitourinary, musculoskeletal, nonobstetric gynecology, pediatrics, physics, procedures, research, right ventricle, and venous/arterial. Perceived knowledge increased for the following topics: administration, advanced LV, education, head and neck, male genitourinary, musculoskeletal, pediatrics, physics, procedures, renal/bladder, research, right ventricle, and venous/arterial. Fifty-three of 74 participants (71.6%) stated they would change their practice based on the course. Examples of changes in practice include increased use of ultrasound for advanced abdominal, musculoskeletal, pediatric, and procedural applications. Future work will determine the impact on longer-term outcomes and focused practice designation (FPD) examination pass rates. The ACEP AEMUS FPD review course demonstrated high levels of satisfaction, increased participant confidence, increased perceived knowledge, and several self-reported changes in participants' ultrasound practice.

Learning to Lead: 3 Models to Support Public Health Leadership Development

The current public health system is underresourced and understaffed, which has been exacerbated by the coronavirus pandemic. In addition, there has been a decline in the public health workforce at both state and local levels during the last decade. While workforce numbers dwindle, public health systems have to address increasingly complex challenges-such as climate change, chronic diseases, and health equity-challenges that require skilled, adaptive leaders. This article describes the importance of leadership development and how 3 public health training centers (PHTCs) are building leadership skills in the public health workforce. To address the need for public health leadership training, the PHTCs in the Health &amp; Human Services (HHS) Regions 4, 7, and 10 all offer public health leadership institutes (PHLIs). The 3 PHLIs discussed in this article vary in longevity (3-18 years), cohort length (8-12 months), and format (virtual, in-person, and hybrid); yet, all 3 emphasize adaptive leadership through a health equity lens and intentional opportunities to apply skills in practice. Each PHLI conducts extensive evaluation based on Kirkpatrick's levels of evaluation and collects common metrics collected by all PHTCs. Data from the PHLIs illustrate high levels of satisfaction with learning, presentation of data, identification of workplace actions, and improvement of subject matter understanding. Each PHLI also has numerous stories of impact. With public health leaders leaving the workforce and the complexities of practice increasing, leadership training is critical to the current workforce and succession planning. These PHTCs provide a significant, enduring resource toward the development of our nation's public health leaders, as well as meeting the unique needs of their regions' workforces.

774 Operative Experience Targets in General Surgery Training: A Systematic Review

Abstract Aim Operative experience targets are well established as a proxy measure for operative competence in surgical training across jurisdictions. The aim of this study was to examine the validity evidence of operative experience targets in surgical training as an assessment tool. Method A systematic review of the PubMed, EMBASE, Web of Science and Cochrane library databases was conducted in accordance with the PRISMA guidelines. The educational impact of included studies was evaluated using a modified Kirkpatrick model. Results Of 3,672 records identified on database searching, 11 papers were ultimately included in a narrative synthesis. Two studies reported a positive relationship between operative experience and self-reported confidence only (Kirkpatrick level 2a). Six studies documented improvements in assessed trainee performance associated with experience (Kirkpatrick level 2b). No study documented trainee behavioural change, or changes in organisational practice, related to experience targets (Kirkpatrick level 3 and 4a). No studies have identified an association between trainees reaching mandated experience targets and improved clinical outcomes. Conclusions Definitive evidence comparing either clinical or assessment outcomes for trainees who have reached pre-defined experience targets compared to those who have not is lacking. A number of studies have recorded competent trainee performance in key index procedures only after reaching experience thresholds greatly in excess of currently mandated targets in Ireland and the United Kingdom. This review supports the move away from these targets toward objective assessor-mediated measures of trainee competence.

SP1.2.8 Applying Kolb's Experiential Learning Theory Improves Medical Student Confidence in Reviewing Post-Operative Patients

Abstract Aims To see if a structured teaching programme designed according to Kolb's Experiential Learning Theory could be applied to improve medical student confidence in reviewing post-operative general surgery patients. Methods Post-final examination medical students at a UK university agreed to participate in the educational pilot in 2019 (n=18). The cohort were interviewed to evaluate any anxieties around undertaking FY1 surgical posts and responses were grouped thematically; reviewing the post-operative patient emerged as a dominant concern. Subsequently, a four-part teaching session was designed to move the learner through ‘Abstract Conceptualisation’ (Before the Bedside), ‘Active Experimentation’ (At the Bedside), ‘Concrete Experience’ (After the Bedside) and ‘Reflective Observation’ (Expert Example). Pre- and post-intervention interviews and Likert scale-based surveys were employed to evaluate impact (Kirkpatrick Level One). Results 18/18 (100%) participants reported feeling more confident reviewing the post-operative patient after the intervention. Learner feedback included “very little of the subject covered previously so helpful to get a structured approach”, “useful to discuss the history and examination before reviewing the patient” and “observing a consultant post-op review at the end really cemented what we were learning”. Conclusions A graded approach to developing confidence in assessing the post-operative patient, as proposed by Kolb's Experiential Learning Theory, seems to offer a useful teaching method and is valued by the learner. Ongoing expansion of this educational pilot will further evaluate its impact.

Supporting the learning experience of health‐related profession students during clinical placements with technology: A systematic review

AbstractHigh quality clinical education is a fundamental component of undergraduate health‐related professions programmes. Technological interventions offer potential to support and enhance student learning experiences during clinical placements, i.e. away from the university setting. This review aims to systematically explore, evaluate and summarise the range of technological strategies within the literature regarding support of the student learning experience during clinical placements. A systematic review was conducted using defined search terms, educational and medical subject headings (MeSH). Relevant databases were searched alongside hand searching of citations and grey literature. Experimental studies with technological strategies designed to support student learning during clinical placements were included. A modified version of Kirkpatrick's levels (Barr et al., Effective interprofessional education: Assumption, argument and evidence. Blackwell, 2005) was used to evaluate strategies. Twenty‐one papers met inclusion criteria. Heterogeneity existed in terms of strategies and their usage e.g. whether synchronous or asynchronous; targeting individual students or groups A wide range of technological strategies may be employed to support the student learning experience during placements. However, none were identified as being of high quality therefore further research is required to provide stronger evidence to support their use. Consideration should be given to the underlying purpose of the strategy as well as the potential barriers for implementation e.g. acceptability and connectivity. Students should be clearly informed of strategy purpose and requirements, with opportunities to practice prior to placements. Review findings may provide insight to assist educators to develop future support strategies for students on clinical placements during challenging circumstances such as the COVID‐19 pandemic. Context and implications Rationale for this study This systematic review aimed to establish and describe technological methods that are currently being used during clinical placements to support the learning experience of undergraduate students of health‐related professions. Why the new findings matter The findings indicate that a broad range of technological strategies may be utilised to support the student learning experience during placements, with numerous learner benefits including improved clinical knowledge, increased reflection upon practice, increased peer and staff support, and reduced sense of isolation during placements. Implications for educators Educators should clearly explain the strategy purpose and requirements of the student should be clearly explained, with opportunities provided for students prior to placements to practice its use. Balance is required in terms of (a) encouraging student engagement without over burdening the student and (b) moderator involvement to facilitate student engagement without stifling contributions. When selecting a technological support strategy, consideration should be given to (a) potential technological difficulties, such as accessing platforms and (b) acceptability of the strategy for use within a clinical context.

Case-based Virtual Seminars on Masticatory Muscle Disorders during the COVID-19 Pandemic.

Due to the significant influence of COVID-19 pandemic on dental education in the recent past, interactive educational strategies were explored to engage students. Case-based seminars (CBS) were proposed on masticatory muscle disorders (MMDs) for post-graduate dental students through integration of pathophysiology with its etiology, diagnosis, and management. Effectiveness of CBS was done at Kirkpatrick’s level 1 and level 2 hierarchy with a pre-test and a post-test. CBS enhanced learning outcomes of post-graduate students in understanding MMDs. Thus, this report could serve as a useful model for other dental schools in prosthodontic post-graduate curriculum.

Development and Evaluation of Unplugged Algorithmic Thinking Activities Training Program for In-Service Primary School Teachers

The aim of this study is to evaluate a professional development program applied to primary school teachers for unplugged algorithmic thinking activities and to improve it based on this evaluation. In this context, data were collected for the improvement of the program by consulting the opinions of the teachers. The professional development program was implemented in 3 different groups, respectively and improved in each group. Teachers' opinions were collected for each group in line with the Kirkpatrick Level 1 assessment approach. The reactions and likes of the teachers participating in the training courses towards the training program are included. In this way, it is aimed that the data obtained will guide the development of the training program. The measurement tool consists of 6 parts and includes closed-ended questions designed for the purposes of evaluating the educators, course components, implementation, physical environment, and teaching materials. The Kruskal-Wallis non-parametric test was used as an analysis method to determine whether there was a significant difference between the groups. In the study, the components in which significant differences emerged between the groups in the scores given by the participants were discovered, and the training program was improved after the first and second trainings in line with these findings.

Learning Through Listening: A Scoping Review of Podcast Use in Medical Education.

To improve understanding of podcast use in medical education by examining current research on descriptive attributes and educational outcomes, highlighting implications of the current evidence base for educational practices, and identifying research gaps to guide future investigation. The authors conducted a scoping review, searching PubMed and Embase databases in June-July 2020 for English-language studies of audio-only medical education podcast use in undergraduate, graduate, and continuing medical education. The authors excluded studies without original data or with nonphysician data that could not be separated from physician data. From included studies, the authors extracted data regarding descriptive outcomes (e.g., podcast use, content areas, structure) and educational outcomes (classified using Kirkpatrick's 4 levels of evaluation). Of 491 unique articles, 62 met inclusion criteria. Descriptive outcomes were reported in 44 studies. Analysis of these studies revealed podcast use has increased over time, podcasts are a top resource for resident education, and podcasts are being incorporated into formal medical curricula. Educational outcomes were reported in 38 studies. The 29 studies that assessed learner reaction and attitudes to podcasts (Kirkpatrick level 1) showed learners value podcasts for their portability, efficiency, and combined educational and entertainment value. The 10 studies that assessed knowledge retention (Kirkpatrick level 2) showed podcasts to be noninferior to traditional teaching methods. The 11 studies that assessed behavior change (Kirkpatrick level 3) showed improved documentation skills in medical students and self-reported practice change in residents and practicing physicians after listening to podcasts. None of the studies reported system change or patient outcomes (Kirkpatrick level 4). Future research should focus on the optimal structure of podcasts for learning, higher-level outcomes of podcasts, and the implementation of podcasts into formal curricula. Podcasts may prove to be essential tools for disseminating and implementing the most current, evidence-based practices.

Case-based, asynchronous sleep education outcomes among primary care nurse practitioner students.

Primary care nurse practitioners (NPs) receive little sleep education in graduate programs but are often first-line providers for patients presenting with sleep-related symptoms. A pre-/postevaluation study was conducted using asynchronous, case-based sleep education modules in a cohort of primary care NP students enrolled in a single academic institution's nursing master's degree program. Six virtual, case-based modules addressed adult sleep health and disorders, prioritized based on prevalence and primary care presentation. Kirkpatrick Training Evaluation Model guided outcome selection. Descriptive and paired comparative analyses were conducted. Participants were first-year NP students (n = 149; 88% female; 82% ≤ 35 years of age) in an adult primary care program that included psychiatric/mental health track. Participants reacted positively to course delivery methods and content. Insomnia was endorsed by 87% as most relevant to practice with healthy sleep (88%) and obstructive sleep apnea (50%) also frequently endorsed as practice relevant. Posttest knowledge scores significantly improved for all modules (P < .001). Self-rated confidence for future practice application was high. This novel asynchronous, virtual curriculum met Kirkpatrick levels 1 and 2 (positive reaction and knowledge transfer) in NP students who predicted an impact on their practice (Kirkpatrick level 3). Studies are needed to assess the benefits of increasing primary care NP knowledge in sleep medicine on quality of care and access to care (Kirkpatrick level 4). Future use of this novel sleep curriculum in other professional curricula, new-to-sleep clinical researchers, and practicing primary care providers may further potentiate care quality and sleep care access. Sawyer AM, Saconi B, Lyons MM, etal. Case-based, asynchronous sleep education outcomes among primary care nurse practitioner students. J Clin Sleep Med. 2022;18(10):2367-2376.

Systematic review and narrative synthesis of the impact of Appreciative Inquiry in healthcare

BackgroundAppreciative Inquiry is a motivational, organisational change intervention, which can be used to improve the quality and safety of healthcare. It encourages organisations to focus on the positive and investigate...

A Systematic Approach for the Interview of the Application to Psychiatry Specialty Training: The “I AM” Approach

AimsJob interviews are the platform for employers to identify suitable candidates for vacant posts, i.e. those who are able to demonstrate a certain set of competencies specified in the job description. In the recent psychiatry specialty training (ST) application process, candidates are required to propose a management plan for two complex scenarios. This interview can be stressful given the high-stakes nature of the outcome, i.e. the successful enrolment into a training programme of a preferred deanery. Candidates who are unable to have an organised approach to problem-solving will likely have an unfavourable result. To overcome this difficulty, a simplified “I AM” approach is being proposed to assist applicants to organise their thoughts during their ST application interview.MethodsThe “I AM” approach stands for “Issues, Assessments, and Management”, which is adapted from the “Handbook of Psychiatry: Surviving Consultation Viva Examination of Malaysian Conjoint Board”. The “Issues” are the problems identified in a scenario, “Assessments” are the investigation required to get a clearer picture of the problems, and “Management” is the action plan to solve the problems. This approach was piloted with five applicants of ST in psychiatry prior to their interview practices.ResultsFor a complex clinical case scenario, the “I AM” approach can be put into the matrix of 3 × 3 tables together with a biopsychosocial model to ensure the issues in different domains are explored thoroughly. Further sub-classification into necessary subheadings, including ideas, concerns, and expectations from different parties, can be included in the assessment matrix. Lastly, a management plan using a multidisciplinary team and collaborative decision-making model with the patient and family can be proposed. For a complex managerial scenario, the seven pillars of the National Health Service's clinical governance model involving different stakeholders can be incorporated into the “I AM” approach to explore problem-solving strategies from different angles. Positive reactions had been received from all five trainees (Kirkpatrick's Evaluation Model Level One).ConclusionThe “I AM” approach can be flexibly applied in different problem-solving scenarios and it works well with other models. The approach may be limited by inadequate information and a failure to prioritise. Further systematic evaluation of the effectiveness and generalisability of the “I AM” approach to other disciplines is required.

OpenMinds on Mental Health Literacy: A Reflective Journey of a Medical Student

AimsAs a medical student from a local university, the first author undertook a mental health education course, i.e. OpenMinds at the King's College University. The aim of the course is to improve literacy about key mental health issues that children and adolescents face and the stigma against mental illnesses. Upon completion of training, a medical student will be able to lead intervention workshops to share the mental health knowledge with local school audiences on these issues, promote early detection of mental illnesses among the audiences and their peers with the aim of improving health-seeking behaviour by providing information of where to access help to reduce the duration of untreated illness. This article is aimed to describe the personal reflective experience of a medical student and the lessons learnt.MethodsThe OpenMinds course was an eight-week workshop on important mental health topics such as depression, anxiety, coping strategies and psychosis. This was followed by a session on effective teaching detailing various techniques including maintaining children's concentration, increasing engagement by utilising different learning techniques, safeguarding and maintaining well-being during conversations about difficult and sensitive topics.ResultsAfter attending the OpenMinds educational workshop, the first author had delivered three workshops (one primary school and two secondary schools) as part of the bigger organising team from the other university. Overall, the verbal feedback from the local schools on the workshops was positive (Kirkpatrick's evaluation outcome level one). The challenge faced was virtual teaching due to the COVID-19 pandemic which meant not being able to read facial expressions or body language while delivering information. This limitation could be mitigated by having a trained teacher moderating the sessions on-site and making sure the workshops ran smoothly. Online lessons emphasised the use of technology which was proven to be useful as videos and other audiovisual aids had the ability to keep the children engaged and provide different sources of learning concurrently.ConclusionHaving participated in this course, the first author has learned teaching skills and a better way of communicating mental health issues to vulnerable audiences. Although face-to-face workshops are still not possible at the time of writing, the first author is keen to set up an OpenMinds branch at his university and be able to share with his fellow colleagues these skills in the future.

Quality Improvement Content in Physical Therapist Education: A Scoping Review.

The purpose of this study was to systematically review the literature regarding teaching quality improvement (QI) in physical therapist education based on the Institute of Medicine's 6-element definition of QI. Educational activities in QI methods in physical therapist professional education curricula, their developmental stage, and their level of evaluation were described. Keywords related to physical therapist students and QI educational activities were used to search studies indexed in PubMed, CINAHL, and ERIC published from 2004 through November 2020. This search yielded 118 studies. After applying inclusion and exclusion criteria, 13 studies were retained for full-text review, which was conducted independently by 2 reviewers. The University of Toronto framework was used to assess developmental stage, and Kirkpatrick's taxonomy was used to assess the evaluation level of 4 retained studies. The scope of QI educational activities in the 4 retained studies was limited to 3 of the 6 elements of QI: identifying opportunities for improvement, designing and testing interventions, and identifying errors and hazards in care. None of the studies included educational activities to teach understanding and measuring quality of care. Three of the 4 studies spanned the first 2 stages of the University of Toronto framework (exposure and immersion); 1 study was limited to exposure. None of the studies assessed competence in QI methods. Evaluation of QI education was limited to Kirkpatrick levels 1 (reaction) or 2 (learning). None of the studies evaluated activities at level 3 (transfer of new behaviors) or level 4 (results). Education in QI methods in professional physical therapist curricula may be limited in scope due to constraints in physical therapist education and the strategic objective of the profession to differentiate itself from other professions. Entry-level physical therapists might not be educated to fully participate in interprofessional teams that use QI methods to continuously improve the quality of patient-centered care.