Lack Of Internet Access Research Articles

META ANALISIS: DAMPAK PANDEMI COVID-19 TERHADAP SISTEM PEMBELAJARAN

This study aims to analyze several related journals to the impact of the online learning at covid-19 pandemic. The method of this research used literature study or meta-analysis which aims to analyze variousrelated journals to the theme raised. The results of the analysis obtained show that learning during the Covid-19 pandemic has an impact on students, teachers and parents. The impact on students' learning are motivation is still low, students feel bored due to the closure of schools that are too long and the lack of infrastructure that supports online learning. The impact on teachers are, for senior teachers, they have to learn more in using technology because they are accustomed face-to-face learning, and the learning is not optimal because the implementation of online learning is not evenly distributed for all students and learning tends to be teacher centered. The impact on parents are additional expenses used to buy internet quotas to support online learning by their children, and parents must be able to share their time with their daily activities with the time to guide their children during online learning. Lack of internet access is also a barrier to online learning.

Internet Access in Rural Areas: Brake or Stimulus as Post-Covid-19 Opportunity?

The lack of internet access in most rural areas has become a challenge worldwide. The Covid-19 pandemic has highlighted trends such as teleworking and e-commerce, meaning an opportunity for the local economy of these areas, but with serious difficulties in carrying it out. This paper aims to detect this lack of internet in inland areas of the region of Valencia through local actors, in order to identify clear priorities and real needs through an explorative and replicable approach based on agglomerative hierarchical clustering (AHC). The main findings suggest that there are different patterns in the rural internet access related to adequate infrastructure and planned actions by local councils. In this way, a multitude of contextual elements have emerged that influence the importance of efficient access to the internet in rural areas. It is essential to know the real needs and demands of the population before implementing plans and programs that may not be relevant for the actors involved in territorial development.

Barriers and Facilitators Implementation of Evidence-Based Nursing practice in Hospitals: A Literature Review

The results of the literature review study clearly show: that attitudes and beliefs, knowledge about EBP, a capability to interpret faithful journals, nurses' demographic characteristics including the level of education, work experience, and age influenced the implementation of EBP. At the organizational level, the obstacles in implementing EBP consist of facilities and infrastructure, leadership, conflict, group dynamics, workplace, and organizational culture, lack of human resources, workload, lack of time, lack of internet access, the need for role models in the implementation of EBP. The results clearly showed that the implementation of evidence-based practice was a complex structure where the support of both individuals and organizations was very influential. It was necessary at the individual level to increase knowledge and skills in implementing EBP. However, workplace organizational management and strategic support integrated into the hospital's vision became the initial capital in implementing EBP

Internet non-use among Canadian Indigenous older adults: Aboriginal Peoples Survey (APS)

BackgroundOlder adults benefit considerably from Internet use, as it can improve their overall health and quality of life, for example through accessing healthcare services and reducing social isolation. The aim of this study is to assess the prevalence and characteristics of Indigenous older adults in Canada who do not use the Internet.MethodsThe Aboriginal Peoples Survey (APS) 2017 was used and analysis was restricted to those above 65 years of age. The main outcome variable was non-use of the internet in a typical month. Multivariable logistic regression was conducted to assess the relationship between each of the sociodemographic, socioeconomic, lifestyle and health factors and internet non-use.ResultsThe prevalence of Indigenous older adults who reported never using the Internet in a typical month was 33.6% with the highest prevalence reported by residents of the Canadian territories while the lowest prevalence was reported in British Columbia. After adjustment, results indicated that older age (OR = 4.02, 95% CI 3.54–4.57 comparing 80+ to 65–69 years of age), being a male (OR = 1.52, 95% CI 1.41–1.63), married (OR = 1.34, 95% CI 1.25–1.44), and living in rural areas (OR = 1.95, 95% CI 1.79–2.13) increased the odds of not using the Internet. First Nation individuals and those who have a strong sense of belonging to the Indigenous identity were more likely to not use the Internet compared to their counterparts. In addition, those who were less educated (OR = 8.74, 95% CI 7.03–1 0.87 comparing less than secondary education to Bachelor’s Degree and above), unemployed (OR = 1.41, 95% CI 1.26–1.57), smoked cigarettes, used marijuana and those with lower self-perceived mental health and unmet health needs were at increased odds of Internet non-use compared to their counterparts.ConclusionsFindings from this study show that a large proportion of the Indigenous older adults in Canada do not use the internet. It is necessary to address Indigenous communities’ lack of internet access and to create interventions that are consistent with Indigenous values, traditions, and goals.

Hard to reach: COVID-19 responses and the complexities of homelessness

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused more than 954 000 deaths worldwide to date,1WHOWorld Health Organization coronavirus disease COVID-19 dashboard.https://covid19.who.int/tableDate accessed: September 21, 2020Google Scholar but the burden of morbidity and mortality has fallen unevenly on particular countries and population groups. Worldwide, COVID-19 has been recognised as a potential public health problem among people experiencing homelessness and other vulnerable cohorts such as prisoners.2Del Brutto OH Mera RM Recalde BY Costa AF Social determinants of health and risk of SARS-CoV-2 infection in community-dwelling older adults living in a rural Latin American setting.J Community Health. 2020; (published online July 15.)https://dx.doi.org/10.1007/s10900-020-00887-9Crossref Scopus (0) Google Scholar, 3Naik SS Gowda GS Shivaprakash P et al.Homeless people with mental illness in India and COVID-19.Lancet Psychiatry. 2020; 7: e51-e52Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar, 4Oladimeji O Atiba BP Mbokazi JA Hyera FLM The homeless, inmates and refugees in Africa in the face of Covid-19 outbreak.Open Publ Health J. 2020; 13: 306-308Crossref Scopus (0) Google Scholar Broadly, reduced access to health care and basic sanitation, the potential for mobility between services and crowding within facilities, the greater sharing of resources between individuals, substance-seeking behaviours, economic need resulting in employment such as survival sex work,5Watson J Youth homelessness and survival sex: intimate relationships and gendered subjectivities. Routledge, London2017Crossref Google Scholar and underlying health conditions put such individuals theoretically more at risk of morbidity and mortality from COVID-19. There is growing evidence, however, of regional differences in the impact of COVID-19 on the socially vulnerable.6Karaye IM Horney JA The impact of social vulnerability on COVID-19 in the US: an analysis of spatially varying relationships.Am J Prev Med. 2020; 59: 317-325Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar, 7Maroko AR Nash D Pavilonis BT COVID-19 and inequity: a comparative spatial analysis of New York City and Chicago hot spots.J Urban Health. 2020; 97: 461-470Crossref PubMed Scopus (0) Google Scholar

Perioperative telemonitoring of older adults with cancer: Can we connect them all?

ObjectivesAlthough the increasing cancer incidence in older patients is widely recognised, older patients remain underrepresented in clinical cancer trials and eHealth studies. The aim of this research is to identify technological and patient-related barriers to inclusion of this population in a clinical eHealth study. Material and MethodsThis is a retrospective analysis of a prospective cohort study with older patients (≥ 65 years) undergoing cancer-related surgery, who were identified for a perioperative telemonitoring study. Reasons for ineligibility and refusal had been prospectively registered. Characteristics and postoperative outcomes were compared between participants and non-participants. ResultsBetween May 2018 and March 2020, 151 patients were assessed for eligibility, resulting in 65 participants and 86 non-participants. The main reason for ineligibility was lack of internet access at home (n = 16), while main reasons for refusal were perceived high mental burden (n = 46) and insufficient digital skills (n = 12). Compared with participants, non-participants were significantly older (mean age 75 vs. 73, p = 0.01); more often female (64% vs. 35%, p = 0.00), unmarried (42% vs. 8%, p = 0.01) living alone (38% vs. 19%, p = 0.02); had a higher ASA classification (43% vs. 19%, p = 0.00); often had polypharmacy (67% vs. 43%, p = 0.00); and were more often discharged to skilled nursing facilities (0% vs. 15%, p = 0.00). ConclusionOur results confirm the underrepresentation of older female patients with little support from a partner and higher comorbidity. We should be aware of technological and patient-related barriers to including older adults with cancer, in order to avoid further dividing patients with low and high digital health literacy.

Online Matriculation Program (OMaPro): Improving the Readiness of Prospective School Principals

School principals play an important role in developing high-performing schools. To meet the challenges of the 21st century, they need quality preparation and professional learning before their assignments. However, there are significant challenges to find out high quality people who are physically, mentally, and emotionally ready to join preparation training course. This study aims to examine the effect of the Online Matriculation Program (OMaPro) on the readiness of prospective school principals for Principal Preparation Training (PPT). A pretest-posttest quasi-experimental design was used in the study, in which a total of 189 prospective school principals participated in the pretest and posttest of the first PPT cohort. 129 prospective school principals participated in both the pretest and posttest, with 99 students taking OMaPro before training, and with 30 who had never followed a matriculation program before training serving as the control group. The results of the study show that OMaPro positively influenced the cognitive, behavioral and emotive-attitude readiness of the participants. Unfortunately, the program cannot run in rural areas because of the lack of internet access. The results should be helpful for prospective school principals to prepare themselves before training, and also for education authorities and policy makers in order to maximize the training results and manage the training programs.

E2M: An Efficient Emergency Management System

In an emergency situation, the required information is collected effectively by mobile devices. But, the low battery size of a mobile device with minimal computational sources is the bottlenecks. Hence the more power utilizing activities can be transferred to the cloud to minimize the load of the mobile devices. In fact, sometimes the lack of Internet access is an extremely difficult task to send mobile data from source to the target cloud. To overcome these problems, an Efficient Emergency Management System using NSGA-II optimization named as E2M has been proposed which works efficiently to manage the emergency situations. E2M is used to find the best mobile device which has higher rank and low Relative Network Load value by optimizing the accessible mobile devices in an emergency situation. The parameters such as precision, recall and F1-score values are used to measure the efficiency of E2M. The experimental results reveal that the E2M outperforms baseline algorithms.

EVALUATION OF EFFICIENCY OF ONLINE EDUCATION IN SPHERE OF PHYSICAL EDUCATION OF COLLEGE LEVEL STUDENTS DURING THE COVID-19 QUARANTINE IN UKRAINE

The unexpectedly rapid transition to online education in the 2nd semester of 2020 due to the COVID-19 outbreak became a challenge for the domestic educators in Physical Education. Despite the abundance of newest health-tracking and sports devices, apps, and online platforms and channels, appropriate sport facilities and equipment are still necessary due to safety restrictions and for conduction of good quality PE and sports classes. Ukrainian climate conditions do not allow a year-round outdoor training in the public premises. Lack of sports equipment in private apartments, insufficient supply of Ukrainian families with computers and telephones of the new generation, lack of Internet access in 35% of families, inability to use sports facilities even for teachers for shooting video lessons, etc. resulted in a drop in the success of university students of PE departments. The failure of half-a-year PE classes’ results on the state level was eloquently pronounced with the Ministry of Education official recommending assessment of students’ year PE results by the I-st semester grades. Thus, the need to analyze the efficiency of online-teaching experience in domestic physical education arose. The article analyses the pitfalls of the introduction of distance education in the field of physical education of students of Ukrainian universities according to the criteria of effectiveness proposed by A. Veremchuk (effectiveness, accessibility to all segments of the population, resource intensity, efficiency, democratic communication "teacher-student", and comprehensive software technologies) and recommendations for compensation of the mentioned problem.

Tele-Urology During COVID-19: Rapid Implementation of Remote Video Visits.

COVID-19 has brought unprecedented challenges to the delivery of urological care. Following rapid implementation of remote video visits at our tertiary academic medical center serving a large rural population we describe and assess our experience with planned video visits and ongoing scheduling efforts. Patients scheduled for video visits between April 14 and April 27, 2020 were included. Prospective and retrospective data were collected on patient and clinical characteristics as well as telemedicine outcomes. Multivariable logistic regression was performed to evaluate factors influencing video visit success. Concurrently scheduling data were collected from a separate cohort regarding patient access to technology and willingness to participate in video visits. A total of 209 patients were included with an overall video visit success rate of 67%. Of video visits that failed (69) reasons included no-show (35%), inability to connect to the telemedicine platform (23%) and lack of Internet access (10%). Nearly half of failed video visits (46.4%) were completed as phone visits. After adjustment for patient demographics commercial insurance was significantly associated with video visit success. In assessment of scheduling outcomes 179 patients were contacted to offer video visits. Of these patients 6.7% reported not having Internet access. Of those with Internet access 87% agreed to proceed with a video visit in lieu of visiting in person. Our experience indicates that rapid implementation of video telemedicine is feasible and highly accepted by patients. Efforts focused on standardized pre-visit patient education may further optimize successful telemedicine visits.

Potential for a web-based management information system to improve malaria control: An exploratory study in the Lahat District, South Sumatra Province, Indonesia.

BackgroundA web-based malaria reporting information system (MRIS) has the potential to improve malaria reporting and management. The aim of this study was to evaluate the existing manual paper-based MRIS and to provide a way to overcome the obstacles by developing a web-based MRIS in Indonesia.MethodsAn exploratory study was conducted in 2012 in Lahat District, South Sumatra Province of Indonesia. We evaluated the current reporting system and identified the potential benefits of using a web-based MRIS by in-depth interviews on selected key informants. Feasibility study was then conducted to develop a prototype system. A web-based MRIS was developed, integrated and synchronized, with suitability ranging from Primary Healthcare Centres (PHCs) to the Lahat District Health Office.ResultsThe paper-based reporting system was sub-optimal due to a lack of transportation, communication, and human capacity. We developed a web-based MRIS to replace the current one. Although the web-based system has the potential to improve the malaria reporting information system, there were some barriers to its implementation, including lack of skilled operators, computer availability and lack of internet access. Recommended ways to overcome the obstacles are by training operators, making the application in an offline mode and able to be operated by mobile phone text messaging for malaria reporting.ConclusionThe web-based MRIS has the potential to be implemented as an enhanced malaria reporting information system and investment in the system to support timely management responses is essential for malaria elimination. The developed application can be cloned to other areas that have similar characteristics and MRIS with a built-in web base to aid its application in the 5G future.

Caring for Miners During the Coronavirus Disease-2019 (COVID-19) Pandemic.

Caring for Miners During the Coronavirus Disease-2019 (COVID-19) Pandemic.

55-LB: Qualitative Results from Adults with Type 2 Diabetes Using the MyDay Smartphone App

Ecological momentary assessment (EMA) captures patients’ ongoing experiences in natural settings. In type 2 diabetes (T2D), EMA allows us to connect psychological experiences of illness with behavioral and biological processes. We implemented an EMA protocol to assess emotional distress, physical symptoms and diabetes self-care among predominantly ethnic minority and socioeconomically disadvantaged adults with T2D. We then collected qualitative data about patients’ experiences. We recruited 51 English-speaking adults receiving treatment for T2D (M(SD), age = 54.3(9.7), 61% Black and 39% Hispanic, 67% female, HbA1c = 8.6(2.4%)), from an urban academic medical center. Patients completed EMA surveys (3/day) via the MyDay smartphone app and used an electronic pill cap that tracked oral medication adherence over 2 weeks. No feedback was provided from the devices. Semi-structured individual interviews were conducted upon study completion. Patients were asked about their experiences and any differences in their diabetes self-care. Interviews were audio-recorded, transcribed, and analyzed for content. A vast majority (88%) would recommend the MyDay app to others. For 90%, it took less than a few days to feel comfortable with the app. About 69% said the app positively influenced their self-care, via more consistent medication-taking and/or blood-glucose monitoring. Some participants (41%) indicated that they encountered a challenge with app use (e.g., lack of internet access, difficulty recalling instructions) and a few (14%) said they felt overwhelmed by study participation. Results suggest that the app was well-received and considered acceptable by a diverse sample who used it over 2 weeks. For some, using the app may have improved self-care. Future research may explore barriers such as limited internet access or technological literacy. This work provides support for the acceptability of technologies for assessing patients’ experience with T2D self-management. Disclosure V.H. Jonas: None. S.R. Fishman: None. M. Sears: None. R. Fang: None. A.G. Asman: None. C.A. Solon: None. H. Mendez-Rodriguez: None. G. Crespo-Ramos: None. C.J. Hoogendoorn: None. S.A. Mulvaney: None. J.P. Crandall: Research Support; Self; Abbott. J.S. Gonzalez: None.

The use of information and communication technologies in Latin American dentists: a cross-sectional study from Ecuador

BackgroundThe use of information and communication technologies (ICTs) provide the tools for enabling fast and reliable real-time communications, as well as the transfer of information between dental professionals and their patients. However, little is known about the frequency and preference of ICTs among Latin-American dentists. Our study aims to fill this gap by assessing different aspects related to ICTs, mainly the frequency of use, perceptions, and barriers among Ecuadorian dentists.MethodsAn anonymous, cross-sectional survey-based study was conducted among 342 Ecuadorian dentists. The final questionnaire included 13 items related to the frequency of use, perceptions, and barriers of ICTs. Bivariate analysis was performed by using chi-squared testing to explore the association between the independent variables and the intended use of ICTs, as well as to characterize the perceptions and barriers related to ICTs.ResultsIn general, most participants reported the use of ICTs to communicate with colleagues (99.7%), and patients (96.2%), while only 63.5% reported using ICTs to obtain academic information in their daily practice. WhatsApp was rated as the most used ICT for communicating with colleagues and patients. A majority of participants considered that ICTs can be useful for facilitating continuing dental education (92.1%), searching new work opportunities (91.5%), promoting health (90.1%), working with colleagues and other health professionals (91.2%), promoting their professional services (90.6%), and for resolving clinical cases (87.7%). On the subject of barriers, privacy and security concerns about personal and/or patient information was the biggest concern among dentists (65%), followed by lack of time to learn how to use and/or use ICTs (48%), lack of mobile internet access (28.1%), and lack of internet access at work (24.9%).ConclusionIn our study, we found that Ecuadorian dentists had a high usage rate of ICTs, mainly for communicating with other colleagues and patients, while the academic use of technology remains a comparatively underused application. Most of the participants surveyed had a positive perception towards ICTs, while privacy and security concerns were identified as the main barrier. Older age was associated with a less favourable perception toward ICTs, as well as an increased likelihood of reporting barriers related to the use of technology.

Non-compliance with continuing professional development requirements: Perspectives of emergency medical care practitioners in a resource-poor setting

IntroductionIn 2002, the Health Professions Council of South Africa (HPCSA) made continuing professional development (CPD) a mandatory requirement for all registered healthcare practitioners. However, the latest (2017/2018) HPCSA report states that there is still a generally low level of compliance to CPD requirements by emergency medical care practitioners (EMCPs) nationwide.MethodsThis was a descriptive study that made use of a questionnaire survey administered to 261 EMCPs.ResultsOf the 261 questionnaires that were distributed, 247 were returned, giving a response rate of 94.6%. More than half (50.6%) of the EMCPs indicated that they lack knowledge on the HPCSA-recommended CPD requirements for EMCPs, and 54% stated that they do not have CPD portfolios. EMCPs listed the factors that hinder attendance of CPD activities: lack of information about the CPD activities (72.7%); cost of attending CPD events (70.6%); limited availability of CPD activities (70.6%); transportation problems (68.5%); timing of CPD activities (68.2%); difficulty in getting nominated to attend CPD activities (65.5%); and lack of personal funds (65.1%). Furthermore, EMCPs indicated that lack of internet access (45.5%) and poor knowledge of how to use the internet (15.2%) hinder them from accessing the internet for professional learning.ConclusionTo provide the best care to patients, healthcare professionals must commit to lifelong learning. Participating in CPD activities has been endorsed as a means for maintaining and updating professional competence. Identifying and alleviating barriers that limit engagement in CPD activities will ensure that EMCPs attain the required professional competence.

Stakeholder Perceptions of Internet-Delivered Cognitive Behavior Therapy as a Treatment Option for Alcohol Misuse: Qualitative Analysis.

BackgroundInternet-delivered cognitive behavior therapy (ICBT) has been found to be effective for treating alcohol misuse in research trials, but it is not available as part of routine care in Canada. Recent recommendations in the literature highlight the importance of integrating perspectives from both patient and health care stakeholders when ICBT is being implemented in routine practice settings.ObjectiveThis study aimed to gain an understanding of how ICBT is perceived as a treatment option for alcohol misuse by interviewing diverse stakeholders. Specifically, the objectives were to (1) learn about the perceived advantages and disadvantages of ICBT for alcohol misuse and (2) elicit recommendations to inform implementation efforts in routine practice.MethodsA total of 30 participants representing six stakeholder groups (ie, patients, family members, academic experts, frontline managers, service providers, and health care decision makers) participated in semistructured interviews. To be included in the study, stakeholders had to reside in Saskatchewan, Canada, and have personal or professional experience with alcohol misuse. Interviews were transcribed verbatim, anonymized, and analyzed using thematic analysis.ResultsStakeholders identified numerous advantages of ICBT for alcohol misuse (eg, accessibility, convenience, privacy, relevance to technology-based culture, and fit with stepped care) and several disadvantages (eg, lack of internet access and technological literacy, isolation, less accountability, and unfamiliarity with ICBT). Stakeholders also provided valuable insight into factors to consider when implementing ICBT for alcohol misuse in routine practice. In terms of intervention design, stakeholders recommended a 6- to 8-week guided program that uses Web-based advertising, point-of-sale marketing, and large-scale captive audiences to recruit participants. With regard to treatment content, stakeholders recommended that the program focus on harm reduction rather than abstinence; be evidence based; appeal to the diverse residents of Saskatchewan; and use language that is simple, encouraging, and nonjudgmental. Finally, in terms of population characteristics, stakeholders felt that several features of the alcohol misuse population, such as psychiatric comorbidity, readiness for change, and stigma, should be considered when developing an ICBT program for alcohol misuse.ConclusionsStakeholders’ insights will help maximize the acceptability, appropriateness, and adoption of ICBT for alcohol misuse and in turn contribute to implementation success. The methodology and findings from this study could be of benefit to others who are seeking to implement ICBT in routine practice.

The Trickle‐down Effect of Fintech Development: From the Perspective of Urbanization

AbstractThe emergence of a digital divide or a lack of internet access may hinder urbanization and adversely affect growth. However, fintech development can help to improve the accessibility and affordability of financial services, particularly for sections of the population formerly excluded from such services. Improved access is expected to stimulate the growth essential for promoting urbanization, possibly alleviating the negative impacts of a digital divide and creating a trickle‐down effect. This paper is among the first to investigate the effect of fintech development on urbanization, as indicated by labor transfer from agricultural to non‐agricultural sectors in China. It is found that: (i) the digital divide hindered, while fintech development contributed to urbanization; (ii) the positive effect of fintech development on urbanization affects individuals both with and without access to the internet, yielding the so‐called trickle‐down effect and thus helping to alleviate the negative consequences of a digital divide; and (iii) regarding transmission mechanisms, fintech development helps to generate additional jobs and raise income in non‐agricultural sectors, stimulating urbanization even for those without access to the internet.

Interactive Engagement in Rotational Motion via Flipped Classroom and 5E Instructional Model

This study determined the effectiveness of using a flipped classroom approach and the 5E instructional model in teaching the Physics topic, Rotational Motion. Using mixed methods, this study involved ten Grade 12 students under the Science, Technology, Engineering, and Math (STEM) track. Data showed that the implementation of the four-week study was successful. The students developed a sense of responsibility, participated in the discussion, and followed instructions as a result of the highly positive and highly interactive learning environment. They overcame the challenges that they faced during the learning process such as: the need for guidance / assistance in order to learn, difficulty in coping with the lesson, lack of internet access, incomplete homework, and lack of confidence in taking part in discussion. Most importantly, the students performed very well across a number of formative assessments. The study showed that the students’ positive attitude towards learning increased as evidenced by homework completion. In a flipped classroom environment, the students invest in their own learning.

Аналіз проблеми низької результативності дистанційної освіти у сфері фізичного виховання студентів ЗВО України під час карантину COVID-19

The abrupt transition to online education in 2020 was not successful in the field of physical education due to unsatisfactory conditions of private premises for specialized sports (such as swimming, etc.), ban for practical classes without the supervision of a specialist due to safety rules, lack of sports equipment in private apartments, lack of provision of Ukrainian families with computers and telephones of the new generation or in sufficient quantities, lack of Internet access in 35% of families, inability to use sports facilities even for teachers for shooting video lessons, and etc. The article analyzes the results of the introduction of online education in the field of physical education of students of universities of Ukraine on the example of Donbas State Pedagogical University in sports and pedagogical disciplines and offers recommendations for compensation of these problems: state planning and support (economically, legislatively, and at the level of educational services), organization of conferences for analysis of scientifically sound proportions of hybrid education for each of sports and pedagogical disciplines, development of curricula and media platforms with multimedia recordings, and formation of state standard databases of each discipline.

Veterinary student experiences in a community- and competency-based primary care rotation: A case study

Background: Over the past 10–20 years, health professions' education has increasingly utilized community-based models of distributive medical education (CBDME) and competency-based education (CBE) frameworks. Although programs combining CBDME and CBE have reported enhanced student education and professional development outcomes, health professions' educators have also noted challenges integrating these frameworks, including vague university expectations regarding student performance, issues balancing efficiency with student learning in the private practice environment, lack of private practitioner training in pedagogy, and limited university faculty involvement in community-based clinical training of students. Aims and Objectives: The current paper describes the efforts of one veterinary school to refine a 4-week community-based primary care clinical rotation. The 2-year project aimed (1) to incorporate tracked competencies, improve preceptor training, and enhance involvement of university faculty through online student learning (Year 1) and (2) to use focus groups to solicit students' feedback on the course (Year 2). Settings and Design: Descriptive and Case-study. Methods and Material: Focus group, semi-structured interview. Statistical Analysis Used: Content analysis method of qualitative data, open and axial coding. Results: Compared to other “hospital rotations”, students reported that the CBDVE-equine primary care course gave them more opportunity to voice their professional opinions, determine course(s) of treatment, and discuss concerns/questions regarding case management. CBE helped students distinguish between competencies they had completed themselves versus procedures they had only been able to observe. The technology meant to support competency tracking in the field presented significant challenges to the student learning experience, including lack of internet access in remote locations, concerns regarding use of technology and appearance of professionalism, and redundancy of competency documentation. Conclusions: Veterinary student perceptions towards CBE and CBDVE are positive. Incorporating technology to track clinical competencies and support student learning during distributed clinical training requires an iterative process of feedback and negotiation with stakeholders, including students, university faculty, and private practice partners. The project approach and study findings described will be of interest to health professions educators who participate in, or plan to use, competency- and/or community-based models of education.