Large Group Discussions Research Articles

EFFECTS OF ADVANCE CARE PLANNING TRAINING ON STUDENTS’ KNOWLEDGE, COMFORT, AND CONFIDENCE

Abstract Students report feeling unprepared to engage in advance care planning (ACP). Methods A 2-hour, interprofessional workshop was held in-person in April 2018 and 2019, and virtually in 2021 and 2022 for students from medicine, nursing, physician assistant, speech pathology, counseling psychology, biomedical sciences, communication, and sociology (N=223). The workshop aimed to educate students about ACP, foster exploration of personal preferences for end-of-life care, and empower them to initiate ACP conversations with others. It incorporated highly engaging activities including personal reflection, drawing, writing, video clips, case presentations, as well as small and large group discussions. A Qualtrics survey, using a retrospective post- then pre- questionnaire design, elicited feedback 1-day post-workshop. Results Regardless of delivery format, respondents rated the workshop highly (97% excellent or good) and liked interacting with peers from other disciplines in small group discussions best. Paired-samples t-tests revealed statistically significant differences following the workshop in four of five areas (p< 0.001) i.e., increased understanding of advance directives, comfort completing their own advance directive, comfort talking with their family and/or personal doctor, and confidence in starting an ACP conversation with others. No significant change was detected in students’ comfort exchanging ACP ideas in a team discussion (p=0.19). Discussion A workshop can increase students’ self-reported knowledge, comfort, and confidence with ACP, as applied to themselves and/or family. However, results suggest working in an interprofessional healthcare team requires additional training and experience. These findings can help guide ACP curricula in health professions education.

Enhancing Class Culture: Assessing and Improving the Impact of the "Thriving Together" Workshop for Dalhousie Medical Students.

Introduction Collaboration and collegiality in medical school benefit students' experiences and contribute to improved patient care. Learning environments have the potential to foster competition and discourage collaboration. Thriving Together was created to address class dynamics and culture early in medical training. Objective The objective of the study is to thoroughly evaluate the Thriving Together Workshop. Methods The Thriving Together workshop, led by upper-year students, comprises a presentation on class culture, anonymous polling, and small-group case-based exercises. It concludes with a large-group discussion. Pre- and post-workshop survey results were collected via Opinio software. A basic statistical and thematic analysis was conducted to identify response themes. Results The post-workshop survey response rate was 29 out of 41 attendees (70.7%) in 2022 and 20 out of 55 attendees (36.4%) in 2023. Forty-eight (96.6%) respondents would recommend the workshop to next year's medical cohort, and 44 (89.8%) were interested in a follow-up workshop. Qualitative comments were positive, with feedback focused on attendance, group randomization, and the need for formal resources and post-workshop follow-up. Conclusion The Thriving Together workshop has a positive impact on class culture as evidenced by voluntary attendanceand positive survey responses. Strategies to improve attendance will be implemented for upcoming sessions and will focus on refining the workshop to encourage inter-group interactions.In addition, formal resources will be provided to those interested. These adjustments aim to sustain the positive impact of the Thriving Together initiative on medical school culture.

Physicians’ attitudes toward gastroprotective strategies for nonsteroidal anti-inflammatory drug prescription

Introduction There is a paucity of information regarding providers’ attitudes toward gastric-protective strategies with concurrent use of nonsteroidal anti-inflammatory drugs (NSAIDs). We aimed to assess gastric-protective strategies used upon prescribing NSAIDs and providers’ awareness of societal guidelines for preventing NSAID-induced gastric complications. Methods A standardized 10-item questionnaire was sent to all orthopedic providers in North Carolina and South Carolina. The survey design and refinement were based on a literature review, item generation, and small and large focus group discussions. Results Forty-two orthopedists responded to the survey (response rate 16%). The most frequently used NSAIDs were meloxicam (79%), naproxen (69%), and ibuprofen (64%). NSAIDs were most commonly prescribed on an as-needed basis (52%), followed by <3 months (43%). The most common indications were degenerative arthritis (95%) and herniated disk (45%). Gastrointestinal adverse effects of NSAIDs were managed by discontinuing NSAID therapy (73%) or switching to a cyclooxygenase-2 (COX-2) inhibitor (40%). A small proportion were managed by referring to another physician (36%). Some clinicians prescribed gastric prophylaxis for patients at high risk for NSAID-induced gastric complications (24%). The academic setting was significantly associated with gastric prophylaxis and frequent assessment for NSAID-induced gastric adverse events. Providers with >20 years of experience showed similar trends. In low-risk patients, compliance with gastroprotective prophylaxis prescription was low (5%). Most providers were unaware of the societal guidelines for NSAID-induced gastric complications or the preventive strategies. Conclusion Prescription of gastric-protective medications with concurrent NSAID therapy is relatively low among orthopedists. Academic setting and higher years of experience showed a significant trend toward more gastric-protective medication prescription, COX-2 inhibitor use, and frequent assessments for gastric adverse events when prescribing NSAID therapy. Provider education on the latest societal guidelines and computer-based alerts can increase compliance and assessment for NSAID-induced gastric complications and preventive strategies.

Reducing mental health stigma in academia: Assessing the acceptability of a first-person narrative program.

Academics are more likely to experience mental health difficulties like depression and anxiety. However, stigma remains a key barrier to help-seeking, and limited data exists on stigma reduction for academics. This study examines the acceptability of a first-person narrative-based antistigma program conducted by Dragonfly Mental Health at a large public university. This intervention used a multitiered approach that leverages education and contact strategies to reduce stigma among graduate students, postdoctoral fellows, staff, and faculty. Personal stories of six local faculty with lived experience of mental health struggles were shown in a short film during three separate departmental retreats, followed by moderated large and small group discussions. This study presents descriptive survey data from academics (N = 149) who attended one of these three programs. A thematic content analysis was conducted on open-ended responses from 86 participants. Overall, the Dragonfly Mental Health program was well-received: 95% of participants found the film beneficial, and over 92% felt the film and discussions reduced stigma. Qualitative analysis highlighted several themes on participants' experiences. Participants appreciated the open, honest disclosures of faculty members in the film but reported that the vague disclosures perpetuated stigma. Participants liked the normalization of mental illness but desired more representation from the mental health spectrum. Participants expressed frustration over an academic work culture that is defined by overwork and burnout. These findings suggest that sharing faculty stories is a powerful mechanism to build connectedness among academics, promote open communication, and foster change in academic culture around mental health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Impact of Online Cooperative Learning on Scientific Reasoning Skills and Motivation

During the COVID-19 pandemic, all universities across Turkey transitioned to remote education as an urgent measure. Despite indications that the pandemic has subsided, online teaching practices continue to prevail in higher education. Accordingly, the purpose of this study, conducted under extraordinary circumstances of the pandemic, is to examine the impact of online cooperative learning on the scientific reasoning skills and motivation of pre-service science teachers. A total of 54 students participated in the study, with 28 from the experimental group and 26 from the control group, following a non-equivalent control group design. The experimental group received instruction using the online cooperative learning, while the control group participated in large group discussions in an online environment in the context of a science teaching methods course. Data for the research were collected through pre-test and post-test administrations of the Lawson’s Classroom Test of Scientific Reasoning (LCTSR) and the Motivated Strategies for Learning Questionnaire (MSLQ). According to the results, compared to whole-class discussions, online cooperative learning increased pre-service science teachers’ scientific reasoning skills and motivation. In conclusion, online cooperative learning is considered an effective method for enhancing the pre-service science teachers’ education, contributing to the further improvement of online teaching, which has become even more widespread due to the impact of the COVID-19 pandemic.

Impact of a psychoeducational intervention on willingness to seek help for depression among African American young adults.

Despite the success of psychoeducational interventions at improving willingness to seek professional help for mental illness, limited research explores the effect of culturally tailored psychoeducational interventions on African American (AA) college students. The objective of this study was to determine if exposure to a culturally relevant psychoeducational intervention impacted AA young adult attitudes, subjective norms, perceived behavioral control, depression stigma, disclosure and willingness to seek help for depression. We conducted a one-group pre- and post-test intervention study of AA college students (N = 75). The 2.5-h intervention featured presentations, large-group discussions, videos, and active learning exercises and was guided by applying a cultural adaptation framework to an existing psychoeducational intervention. The self-administered surveys were created using the Theory of Planned Behavior as a guide. Data were analyzed using paired t-tests. A total of 70 participants completed both pre- and post-test surveys. Overall, willingness, attitude, and disclosure significantly increased after the intervention (p < .001). Additionally, depression stigma significantly decreased after the intervention, indicating fewer stigmatizing beliefs about depression (p < .001). Willingness to seek help for depression among AA college students can be improved through culturally relevant and interactive psychoeducational interventions. These interventions can also improve negative attitudes and perceived behavioral control toward seeking help and decrease stigmatizing beliefs. More research is needed to explore the longitudinal impact of culturally relevant psychoeducational interventions and how they may affect actual help-seeking behavior among AA college students.

“A problem shared is a problem solved:” integrating human-centered design and implementation science to optimize lay counselor supervision in Western Kenya

Implementation science and human-centered design (HCD) offer useful frameworks and methods for considering and designing for individuals' needs and preferences when implementing new interventions or technologies in global health. When used in tandem, the two approaches may blend creative and partnered research methods with a focus on the factors necessary to design, implement, and sustain interventions. However, research is needed that describes the process of blending these two approaches and explores the experiences of community partners. This study builds from a stepped-wedge cluster-randomized trial in Western Kenya, wherein teachers and community health volunteers have been trained to provide trauma-focused cognitive behavioral therapy (TF-CBT). Mobile phones emerged as a tool to supervise lay counselors from afar; however, their use was characterized by unique challenges. Informed by human-centered design and implementation science, we first engaged lay counselors (n = 24) and supervisors (n = 3) in individual semi-structured interviews then hosted an in-person participatory workshop to “co-design” solutions to optimize the use of mobile phone supervision. Lay counselors participated in focus group discussions regarding their experiences in the workshop. Focus group transcripts were analyzed using thematic analysis. We describe our approach as well as focus group discussion results. Counselors felt the workshop was a valuable experience to learn new strategies from their colleagues, and they enjoyed the “collaborative spirit” that emerged as they worked together. Counselors felt that varying small and large group discussions fostered participation by creating opportunities for more people to engage and share their thoughts. Counselors suggested the approach be improved by providing more tangible materials (e.g., hand-outs) and more closely following a schedule of activities. It is important to also center stakeholders’ experiences as partners in the research process. Though counselors largely expressed positive sentiments, they also shared valuable suggestions for how to improve participatory research practices in the future.

Promoting diversity, equity and inclusion awareness in clinical documentation through postgraduate year one training

Background and purposeAs healthcare providers increasingly focus on emerging issues of diversity, equity and inclusion (DEI) in patient care, less is known about the training in postgraduate year one (PGY1) pharmacy residency on DEI clinical documentation considerations. This pilot project explored whether training, discussion and self-reflection within a peer review activity promoted DEI self-awareness in clinical documentation through a centralized curriculum of a multisite PGY1. Educational activity and settingBuilding upon an established peer review of clinical documentation activity, PGY1 pharmacy residents practicing in ambulatory care settings received training on DEI considerations and completed small and large group discussions, a post-activity mixed methods survey with self-reflection prompts, and a three-month follow-up survey. FindingsTwenty-two residents participated in the peer review of clinical documentation activity, DEI training and discussions. Twelve residents completed the post-activity survey with reflection prompts; 6 (50%) reported similar previous DEI training prior to residency. After the DEI training and discussions, 12 (100%) agreed or strongly agreed that their awareness of DEI documentation considerations increased; 10 (83%) would document their submitted notes differently, while one resident was unsure and one would not make changes. Twelve residents completed the follow-up survey three months following the activity. Themes from the free-text responses on key learnings collected post-activity and three-month post (respectively) included: 1) new knowledge, increased self-awareness, and intended action and 2) increased self-awareness and changes in note-making convention. SummaryIntegrating DEI training, discussion, and self-reflection prompts into a peer review clinical documentation activity increased self-awareness and knowledge of DEI considerations and promoted intended changes in patient care documentation for pharmacy residents. Regardless of previous training, residents reported continued self-awareness and changes in documentation conventions continued three months later.

Research ethics and artificial intelligence for global health: perspectives from the global forum on bioethics in research

BackgroundThe ethical governance of Artificial Intelligence (AI) in health care and public health continues to be an urgent issue for attention in policy, research, and practice. In this paper we report on central themes related to challenges and strategies for promoting ethics in research involving AI in global health, arising from the Global Forum on Bioethics in Research (GFBR), held in Cape Town, South Africa in November 2022.MethodsThe GFBR is an annual meeting organized by the World Health Organization and supported by the Wellcome Trust, the US National Institutes of Health, the UK Medical Research Council (MRC) and the South African MRC. The forum aims to bring together ethicists, researchers, policymakers, research ethics committee members and other actors to engage with challenges and opportunities specifically related to research ethics. In 2022 the focus of the GFBR was “Ethics of AI in Global Health Research”. The forum consisted of 6 case study presentations, 16 governance presentations, and a series of small group and large group discussions. A total of 87 participants attended the forum from 31 countries around the world, representing disciplines of bioethics, AI, health policy, health professional practice, research funding, and bioinformatics. In this paper, we highlight central insights arising from GFBR 2022.ResultsWe describe the significance of four thematic insights arising from the forum: (1) Appropriateness of building AI, (2) Transferability of AI systems, (3) Accountability for AI decision-making and outcomes, and (4) Individual consent. We then describe eight recommendations for governance leaders to enhance the ethical governance of AI in global health research, addressing issues such as AI impact assessments, environmental values, and fair partnerships.ConclusionsThe 2022 Global Forum on Bioethics in Research illustrated several innovations in ethical governance of AI for global health research, as well as several areas in need of urgent attention internationally. This summary is intended to inform international and domestic efforts to strengthen research ethics and support the evolution of governance leadership to meet the demands of AI in global health research.

Obesity and Aging: Optimizing Health at the Intersection of Ageism and Weight Bias

Obesity is a chronic and complex disease that can negatively impact health, functioning and quality of life. In the past decade, obesity's largest prevalence growth occurred in older adults, particularly among racial and ethnic minorities. By the year 2030, an estimated 50% of the population over 65 is likely to be living with obesity. Until recently, little attention has been given to obesity as a chronic disease, and those living with obesity have encountered challenges accessing high quality medical care. Despite growing evidence for bariatric and obesity medicine, these treatments remain inaccessible for most patients, especially for older adults. Obesity research focused on older adults has been very limited and ideal weight standards for older adults are more controversial, especially in later life where frailty and sarcopenia may develop. As concerns about the public health effects of obesity have risen in the U.S., so too have negative and stigmatized views of individuals with obesity. Weight stigma has serious negative emotional and physical health consequences including low self-esteem, negative body image, engagement in disordered eating patterns, reduced physical activity and may promote weight gain. Older adults with obesity may encounter the double stigma of both ageism and weight bias, which are two of the most socially acceptable forms of bias and discrimination in the U.S. This interactive session will focus on three areas related to obesity and older adults. Through case examples, small and large group discussions, the presenters will: i) explore potential weight bias amongst participants and discuss strategies to mitigate this bias in working with older adults; ii) discuss complex connections between obesity and frailty syndrome in older adults, and the risks associated with weight loss in later life; iii) introduce evidence-based assessment and treatment recommendations for older adults interested in obesity treatment. This session will focus on the role of psychiatrists and other mental health clinicians in the care of older patients with co-morbid obesity and mental health disorders. Also, presenters will discuss the importance of increasing awareness, advocacy, and practical strategies to combat the impact of weight bias and ageism in healthcare settings. Ultimately, the goal is to raise awareness of this complex problem and provide clinically helpful information to improve care for older patients with obesity. This symposium is sponsored by the AAGP's IDEA committee.

Population health in primary care.

Population health in the United States continues to lag behind other wealthy nations. Primary care has the promise of enhancing population health; however, the implementation of a population health approach within primary care deserves further consideration. Clinicians and staff from a national sample of 10 innovative primary care practices participated in a working conference to reflect upon population health approaches in primary care. A series of small- and large-group discussions were recorded, transcribed, and coded through an immersion/crystallization approach. Two prominent themes emerged: (1) Transitioning to a population health focus generally develops through stages, with early implementation focusing on risk stratification and later, more advanced stages focusing on community health; and (2) Several inherent barriers confront implementation of a population health approach, including tensions with patient-centered care, and limitations of health information technology. A broader conceptualization of population health in terms of community health could more effectively allow partnerships among primary care, large health care systems, public health organizations, patients, and other partners in the community.

Young Women's Perspectives on Being Screened for Hereditary Breast and Ovarian Cancer Risk During Routine Primary Care

PurposeThe U.S. Preventive Services Task Force recommends screening women to identify individuals eligible for genetic counseling based on a priori hereditary breast and ovarian cancer syndrome (HBOC) risk (i.e., risk assessment). However, risk assessment has not been widely integrated into primary care. This qualitative study explored young women's views on implementing routine HBOC risk assessment with a focus on equity and patient-centeredness. MethodsWe conducted group discussions with young women (aged 21–40 years) receiving care in an integrated health care system. Discussion groups occurred in two phases and used a modified deliberative approach that included a didactic component and prioritized developing consensus. Twenty women participated in one of three initial small group discussions (phase one). All 20 were invited to participate in a subsequent large group discussion (phase two), and 15 of them attended. FindingsKey themes and recommendations were as follows. Risk assessment should be accessible, contextualized, and destigmatized to encourage participation and reduce anxiety, particularly for women who do not know their family history. Providers conducting risk assessments must be equipped to address women's informational needs, relieve emotionality, and plan next steps after positive screens. Finally, to minimize differential screening uptake, health care systems must prioritize equity in program design and contribute to external educational and outreach efforts. ConclusionYoung women see pragmatic opportunities for health systems to optimize HBOC screening implementation.

How to facilitate NHS professionals to recognise and use skills gained from global health engagement when back in the UK workforce? A participatory action research project to design, pilot and evaluate a series of online leadership workshops

ObjectivesLeadership knowledge and skills are known to be developed by health professionals during global health experiences overseas. However, volunteers struggle to recognise and use these new skills on return to...

Anti-racism curricula in undergraduate medical education: A scoping review

Purpose Medical educators have increasingly focused on the systemic effects of racism on health inequities in the United States (U.S.) and globally. There is a call for educators to teach students how to actively promote an anti-racist culture in healthcare. This scoping review assesses the existing undergraduate medical education (UME) literature of anti-racism curricula, implementation, and assessment. Methods The Ovid, Embase, ERIC, Web of Science, and MedEdPORTAL databases were queried on 7 April 2023. Keywords included anti-racism, medical education, and assessment. Inclusion criteria consisted of any UME anti-racism publication. Non-English articles with no UME anti-racism curriculum were excluded. Two independent reviewers screened the abstracts, followed by full-text appraisal. Data was extracted using a predetermined framework based on Kirkpatrick’s educational outcomes model, Miller’s pyramid for assessing clinical competence, and Sotto-Santiago’s theoretical framework for anti-racism curricula. Study characteristics and anti-racism curriculum components (instructional design, assessment, outcomes) were collected and synthesized. Results In total, 1064 articles were screened. Of these, 20 met the inclusion criteria, with 90% (n = 18) published in the past five years. Learners ranged from first-year to fourth-year medical students. Study designs included pre- and post-test evaluations (n = 10; 50%), post-test evaluations only (n = 7; 35%), and qualitative assessments (n = 3; 15%). Educational interventions included lectures (n = 10, 50%), multimedia (n = 6, 30%), small-group case discussions (n = 15, 75%), large-group discussions (n = 5, 25%), and reflections (n = 5, 25%). Evaluation tools for these curricula included surveys (n = 18; 90%), focus groups (n = 4; 20%), and direct observations (n = 1; 5%). Conclusions Our scoping review highlights the growing attention to anti-racism in UME curricula. We identified a gap in published assessments of behavior change in applying knowledge and skills to anti-racist action in UME training. We also provide considerations for developing UME anti-racism curricula. These include explicitly naming and defining anti-racism as well as incorporating longitudinal learning opportunities and assessments.

International judicial symposium on family court reform: Final report

AbstractOn May 30, 2023, the Association of Family and Conciliation Courts (AFCC) and the National Council of Juvenile and Family Court Judges (NCJFCJ) co‐sponsored an international symposium to explore the subject of family court reform. Twenty‐eight judges representing eight countries and including numerous North American states and provinces met in Los Angeles, California, to identify the most pressing challenges facing family courts and to document promising approaches to improve practice and outcomes in family court cases. They focused on domestic relations cases, as opposed to child welfare and juvenile justice matters. Prior to the symposium, participants responded to a survey about family court reform efforts in each participant's jurisdiction. Judicial officers attending the symposium represented diverse legal systems with some common and many different practices and challenges. After a day filled with small and large group discussions, participants identified key takeaways and made recommendations emanating from the day's discussions.

Developing a best-practice agenda for music therapy research to support informal carers of terminally ill patients pre- and post-death bereavement: a world café approach

BackgroundInformal carers of terminally ill patients play a vital role in providing palliative care at home, which impacts on their pre- and post-death bereavement experience and presents an up to 50% greater risk for mental-health problems. However, developing and implementing effective bereavement support remains challenging. There is a need to build the evidence base for music therapy as a potentially promising bereavement support for this vulnerable population. This study aimed to co-design an international best practice agenda for research into music therapy for informal carers of patients pre- and post-death bereavement.MethodsOnline half day workshop using a World Café approach; an innovative method for harnessing group intelligence within a group of international expert stakeholders (music therapy clinicians and academics with experience of music therapy with informal carers at end-of-life). Demographics, experience, key priorities and methodological challenges were gathered during a pre-workshop survey to inform workshop discussions. The online workshop involved four rounds of rotating, 25-minute, small group parallel discussions using Padlet. One final large group discussion involved a consensus building activity. All data were analysed thematically to identify patterns to inform priorities and recommendations.ResultsTwenty-two consented and completed the pre-event survey (response rate 44%), from countries representing 10 different time zones. Sixteen participated in the workshop and developed the following best practice agenda. The effectiveness of music therapy in supporting informal carers across the bereavement continuum should be prioritised. This should be done using a mixed methods design to draw on the strengths of different methodological approaches to building the evidence base. It should involve service users throughout and should use a core outcome set to guide the choice of clinically important bereavement outcome measures in efficacy/effectiveness research.ConclusionsFindings should inform future pre- and post-death bereavement support research for informal caregivers of terminally ill patients. This is an important step in building the evidence base for commissioners and service providers on how to incorporate more innovative approaches in palliative care bereavement services.

International Federation for Emergency Medicine New and Emerging Leaders Course: A Pilot Program

Background: The International Federation for Emergency Medicine (IFEM) recognizes that early career Emergency Medicine (EM) leaders need additional skills leading healthcare teams. Especially in environments where EM is a new specialty, newly graduated specialists may take positions of authority with little direct training for the responsibilities. IFEM developed a New and Emerging Leaders course to address these needs and to build an ongoing community of practice for EM leaders to gather additional support and camaraderie. In early 2023, IFEM member organizations were asked to encourage senior EM trainees and Emergency Doctors (i.e. consultants, attendings, specialists) in their first 10 years after completing EM specialty training to apply for the program. Methods The pilot course was delivered March-May 2023 consisting of one three-hour virtual meeting of the cohort each month. Each session started with a presentation from a current EM leader discussing their own leadership journey and lessons learned. Delegates participated in a question and answer and discussion session with the leader. The remainder of each session was facilitated by a professional development expert to focus on elements of the IFEM curriculum utilizing didactics, large group discussions and small-group breakouts as well as individual independent activities. Learning objectives included development of understanding and application of the following topics: • Team leadership • Developing high-performing teams • Mentorship and growth mindset • Basic skills for delivering education and developing training programs for junior staff • Personal leadership style development • Negotiation skills • Strategic reviews and an agile response • Global awareness and benchmarking The pilot course was offered on a conference platform housing login links, speaker biographies, course agendas, resource materials, course recordings and delegate chat opportunities. All delegates were requested to complete feedback surveys after each session. Findings Interest in the program was brisk. 139 applications were received with 97 applications meeting delegate requirements. There were 14 applications from High-Income Countries, 10 from Upper-Middle Income Countries, 63 from Lower-Middle Income Countries, and 52 from Low-Income Countries. Of the 97 invited, 26 completed payment and attended the course. 15/26 participants completed the post-course survey. 53% (n=8) were in their first 5 years of EM specialist work, 27% (n=4) 5-10 years post-training, 13% (n=2) were senior Emergency Medicine trainees. One EM administrator and leader trained in another specialty also participated. 80% (n=12) registered from a Low-Income Country and 20% (n=3) from Middle Income Countries. Participants ranked their satisfaction with the session as Very Good or Excellent (87%). Feedback on the course conference platform was mixed. Qualitative feedback supported the small groups, interactivity, and asynchronous activities. Interpretation Overall, the pilot was extremely successful. A large waiting-list of future attendees confirmed interest in continuing the course. Five additional cohorts are planned through December 2024. The nature of an international program necessitates that timing will be inconvenient for some no matter when a course is produced. In this case, a portion of the pilot fell during Ramadan and was timed to fall after Iftar in the UAE. IFEM received feedback from those in Oceania that the time was too late for participation. Future cohorts will be delivered to suit various time zones. Additional feedback identified opportunities to partner with regional societies of EM to ensure representation and additional sponsorship. Future cohorts will utilize simpler web resources to minimize issues with navigation and will develop WhatsApp or other similar groups for ongoing discussion. Future activities will develop additional topical trainings for graduates.

The Impact of Racism on Health: A Health Equity Training on Structural Racism for Military Residents and Fellows.

Recognizing the need for more opportunities to learn about health equity within military graduate medical education (GME), we developed a resident-led curriculum to introduce these concepts from a military cultural competency lens. The Impact of Racism on Health module focuses on structural racism and health disparities. This 60-minute module was presented to ear, nose, and throat (ENT) and pediatrics residents and fellows. It includes a case presentation of an adolescent with an asthma exacerbation, a large-group discussion about social determinants of health and structural racism, and a small-group discussion/debrief conceptualizing the case. Thirty pediatrics residents and 15 ENT residents participated in this activity with a 46% and 60% pretest response rate, respectively. A two-sample Mann-Whitney U test showed statistically significant improvement (p = .005) in knowledge related to structural racism between the pretest (M = 0.5, SD = 0.3) and posttest (M = 0.7, SD = 0.1) knowledge assessments with a small effect size (r = 0.4; Z = 2.8). We demonstrated that interactive teaching methods can be used to educate military GME trainees on the impact of structural racism on health outcomes for military health care beneficiaries. Understanding the role of structural racism in the context of military health care using curricula that highlight military-specific health disparities is essential to understanding the role of the military physician in systemically addressing health disparities.

The Integrated Care Programme for the Prevention and Management of Chronic Disease: implementing a population health approach in Ireland.

The Integrated Model of Care for the Prevention &amp; Management of Chronic Disease (MoC) provides a population health approach to the prevention &amp; management of chronic disease (CD). This model is currently being rolled out across Ireland at scale. This workshop aims to explore the Irish experience of implementing integrated care as part of a population health approach to the prevention and management of CD.&#x0D; Our current, hospital-centric method of delivering health services is not sustainable, nor is it patient-centred. The MoC takes a generic, multi-morbidity approach to the prevention and management of four major CDs: type 2 diabetes; asthma; COPD; cardiovascular disease. It aims to shift care to the left by enabling GP-led primary care and empowering patients to self-manage their CDs.&#x0D; Aim: To describe our real-world experience of implementing at scale a MoC that places an emphasis on the delivery of a person-centred, equitable health service as we work to improve population health in Ireland&#x0D; Objectives:&#x0D; 1. To describe our MoC, and the evidence underpinning it, which is currently being implemented across Ireland &#x0D; 2. To discuss our successes&#x0D; 3. To discuss our challenges and potential solutions&#x0D; 4. To describe importance of involving patients as partners in care &#x0D; 5. To discuss the future of integrated care in Ireland&#x0D; We anticipate that this workshop will appeal to a broad international audience and range of integrated care professionals (from primary care, community care to acute care, public health physicians, commissioners and health service managers) – as well as to patients themselves. It may be particularly relevant to those working in CD care.&#x0D; &#x0D; A.Presentations &amp; Speakers (7 mins per presentation: 50% of workshop)&#x0D; 1.Overview of the Integrated Model of Care for the Prevention &amp; Management of CD (Dr. Sarah O'Brien) &#x0D; 2.Ensuring a population health approach to the delivery of care: delivering direct GP access to diagnostics as part of the Integrated MoC (Dr. Maria O'Brien) &#x0D; 3.The first report from the Structured CD Management Programme in General Practice (Dr. Orlaith O'Reilly) &#x0D; 4.Staff recruitment, retention and development: how to support the workforce in delivering integrated care (Maireád Gleeson)&#x0D; 5.Involving patients in care: identifying and implementing PROMs as part of the MoC (Dr. Ellen Cosgrave)&#x0D; 6.Building on the model: the development of an integrated virtual case management service for multimorbid patients with CD (Margaret Curran)&#x0D; B.Interactive discussion (50% of workshop): How can we ensure a population health approach to the prevention &amp; management of CD to ensure no one gets left behind? (All)&#x0D; 23 min small group work using post-its and flip charts, 20 min feedback and large group discussion&#x0D; C.Sum up of learning and closing remarks (5 min)&#x0D; •We are implementing an integrated MOC that takes a population health approach to the prevention and management of chronic disease&#x0D; •This model is already demonstrating evidence of positive impact&#x0D; •We must now build on this model, using data to support population profiling, stratification and the identification of unmet need, to deliver an integrated health service that is responsive to population need&#x0D;

Workshop (Clinical/Best Practice Implementation) ID 1972517

Background/Objectives Teams with diverse perspectives and experiences have been increasingly recognized for their ability to identify key issues and utilize creativity and problem solving to plan and implement research and clinical initiatives that lead to greater impact. Yet, often we are unsure how to best engage individuals with differing expertise, such as those with lived experience, clinicians, healthcare administrators, engineers, researchers, funders and policy experts. After completing this workshop, participants will be able to: 1) Understand the principles and value of meaningfully engaging with a diverse team when conducting research or clinical projects, 2) Identify strategies that can facilitate the meaningful engagement of individuals with differing expertise, and 3) Create a plan of engagement for a research study or clinical initiative. Methods/Overview A combination of lecture-based and case-based learning will be used to explain the guiding principles and best-practices for meaningful engagement and to discuss relevant resources, such as the North American Spinal Cord Injury (SCI) Consortium’s SCI Resource Advocacy Course and the Integrated Knowledge Translation Guiding Principles. Participants will be asked to apply these principles and practices to one of their own research or clinical initiatives through small group discussion. The Canadian Activity-Based Therapy (ABT) Community of Practice, which brings together diverse groups to address priorities for ABT research and clinical care, will be used as a case example during large group discussion. Results Not applicable. Conclusions Through this workshop, participants will gain knowledge and strategies that can be applied to facilitate meaningful engagement in research and clinical initiatives.