Likert-type Response Scale Research Articles

Development of a signs and symptoms outcome measure for caregivers of patients with methylmalonic acidemia and propionic acidemia (MMAPAQ)

Background and objectiveMethylmalonic acidemia (MMA) and propionic acidemia (PA) are rare inborn errors of metabolism with shared signs and symptoms that are associated with significant morbidity and mortality. No disease-specific clinical outcomes assessment instruments for MMA and/or PA currently exist to capture the patient perspective in clinical trials. Because patients with these conditions are generally young and have cognitive impairments, an observer-reported outcome (ObsRO) instrument is crucial. We report results from qualitative research supporting development of the Methylmalonic Acidemia and Propionic Acidemia Questionnaire (MMAPAQ), a signs and symptoms ObsRO measure for caregivers of patients with MMA and/or PA. MethodsConcept elicitation (CE) interviews were conducted with 35 participants across 2 studies who were aged ≥18 years and caregivers of patients with a confirmed diagnosis of MMA or PA, and an additional 5 patients aged ≥6 years with MMA or PA in Study 1, to identify core signs/symptoms for inclusion in the MMAPAQ. All interviews were conducted in English. Study 2 included cognitive interviews (CI) with caregivers and clinical experts to further assess content validity. CE and a conceptual framework review were also conducted with clinical experts to further support findings. ResultsA consistent set of signs/symptoms of MMA and PA were reported by eligible caregivers interviewed in study 1 (n = 21) and study 2 (n = 14), representing 11 patients with MMA and 20 with PA. Based on concepts reported in study 1, a draft instrument was constructed and compared with the Pediatric Quality of Life Inventory™ (PedsQL™) and Family Impact module, demonstrating face validity for measuring key signs/symptoms important to patients and caregivers. The PedsQL™ and Family Impact modules were preferred to assess patient and caregiver impacts. Two waves of CE and CIs were conducted in study 2, with wave 1 resulting in removal of 7 items and other revisions to improve clarity, and wave 2 resulting in modification of examples used for 2 items. The final instrument consisted of the following 7 items assessed over the past 7 days using a Likert-type response scale ranging from “never” to “very often”: uncontrollable or involuntary movements, dehydration, rapid breathing at rest, appearing lethargic, appearing disinterested in eating, refusing to eat, and vomiting. ConclusionsThis study establishes the content validity of the MMAPAQ as the first ObsRO questionnaire for measuring core signs and symptoms of MMA and PA in clinical trials and community research. Scoring and psychometric measurement properties of the MMAPAQ will be established in future studies. The PedsQL™ was found to have face validity in measuring concepts that affect the MMA and PA patient populations and should also be considered for use in clinical trials in MMA and PA.

Sexual support and education for adults with mild intellectual disabilities: a Delphi study on multiple perspectives.

Providing appropriate sexual support and education for adults with mild intellectual disabilities (IDs) is a source of considerable debate, resulting in diverse, non-funded and potentially adverse practices. This study aims to identify a consensus among experts regarding what conditions are conducive to successful sexual support and education for adults with mild IDs. A Delphi study was conducted with 13 experts, including experts-by-experience, relatives, support staff, psychologists and sexologists. Qualitative data on the conditions for sexual support and education were gathered in the first round and thematically analysed. In the following three quantitative rounds, consensus was achieved using Likert-type response scales and participants' feedback. Round 1 resulted in 82 conditions on six themes: 'the necessary attitude', 'requirements', 'approach to delivering sexual support and education', 'appropriate providers', 'settings and timing' and 'effective collaboration with the network'. In the following three quantitative rounds, the experts reached consensus on 68 conditions distributed across the six themes. The six themes highlight conducive conditions for successful sexual support and education for adults with mild IDs, emphasising the significance of a safe and supportive environment, comprehensive educational programmes, and the promotion of autonomy and protection. The consensus-based findings have distinct implications for practice and future research.

Behavioral Determinants of Business Continuity in Public Drinking Water Utilities (PDAM) in East Nusa Tenggara of Indonesia

The research pointed out the escalating challenges faced by the Indonesian Public Drinking Water Utilities (PDAMs) in ensuring water access, emphasizing the need for sustainable practices. The primary research problems are deliberately around understanding how CSR practices, corporate culture, and leadership styles impact business continuity in the context of water management utilities. The objective is to explore the relationships between CSR, corporate culture, leadership styles, and business continuity in PDAMs. The data were collected through structured self-administered questionnaires distributed to 100 employees of PDAM in East Nusa Tenggara of Indonesia, assessing their perceptions of CSR practices, corporate culture, leadership styles, and business continuity. The Likert-type scale responses were analyzed, revealing significant associations between these variables. Findings indicate that CSR initiatives positively contribute to business continuity, aligning with the leader's vision of community impact. The unique corporate culture, rooted in strong spiritual values, fosters a distinct work atmosphere and influences community habits. Additionally, a distinctive leadership style, treating employees as family, positively impacts employee attitude and business sustainability. While providing valuable insights, the study acknowledges limitations in generalizability and recommends further research for a comprehensive understanding of these dynamics.

Assessing the reaction to and efficacy of the Screener drug discovery and development board game as a pedagogical tool in postgraduate courses.

Screener, a board game supplemented with online resources, was introduced and distributed by the Brazilian Society of Pharmacology and Experimental Therapeutics to postgraduate programs as an instructional tool for the process of drug discovery and development (DDD). In this study, we provided a comprehensive analysis of five critical aspects for evaluating the quality of educational games, namely: 1) description of the intervention; 2) underlying pedagogical theory; 3) identification of local educational gaps; 4) impact on diverse stakeholders; and 5) elucidation of iterative quality enhancement processes. We also present qualitative and quantitative assessments of the effectiveness of this game in 11 postgraduate courses. We employed the MEEGA+ online survey, comprising thirty-three close-ended unipolar items with 5-point Likert-type response scales, to assess student perceptions of the quality and utility of Screener. Based on 115 responses, the results indicated a highly positive outlook among students. In addition, we performed a preliminary evaluation of learning outcomes in two courses involving 28 students. Pre- and post-quizzes were applied, each consisting of 20 True/False questions directly aligned with the game's content. The analysis revealed significant improvement in students' performance following engagement with the game, with scores rising from 8.4 to 13.3 (P<0.0001, paired t-test) and 9.7 to 12.7 (P<0.0001, paired t-test). These findings underscore the utility of Screener as an enjoyable and effective tool for facilitating a positive learning experience in the DDD process. Notably, the game can also reduce the educational disparities across different regions of our continental country.

Cardiac POCUS: Another Tool in the Armory.

This study assessed the educational impact of hybrid cardiac Point of Care Ultrasonography (POCUS) training in a community-based academic setting. Internal Medicine and Medicine/Pediatrics residents across all post-graduate years (PGY) at a midwestern medical school under-took a structured hybrid (online and hands-on teaching) model of POCUS training. Anonymous surveys with Likert-type scale responses were administered before and after the curriculum. Questions were categorized into domains to assess the residents' interest in learning POCUS, their understanding of fundamental cardiac ultrasound (US) concepts, and their confidence in its application. The authors used Fisher's Exact and t-test, and estimated odds ratios to gauge the impact of the training to achieve net scores above 0 on each domain. A total of 27 and 26 residents completed the pre-and post-training surveys, respectively. Experience with previous cardiac US use showed a positive skew. The training resulted in a significant increase in both, the understanding of the principles, and the residents' confidence in its application. These findings were most significant amongst PGY 2 and 3 residents. Post-training mean scores were similar across all domains for subgroups of PGY level and previous ultrasound experience. Residents displayed greater understanding of the fundamental cardiac ultrasound concepts with improved confidence levels after implementing a structured hybrid teaching model for POCUS. Future studies with objective assessment tools are needed to gauge the clinical impact of POCUS and its adoption rate in clinical practice to guide a recommendation for its incorporation into the residency curriculum.

Sleep-Disordered Breathing and Its Association with Nocturnal Enuresis at the Primary Schools in Saudi Arabia: A Cross-Sectional Study

The correlation between nocturnal enuresis (NE) and sleep-disordered breathing (SDB) was reported. We aim to determine whether there is an association between NE and SDB in children and to assess the prevalence of SDB and NE in primary school children aged 6–12 years in Saudi Arabia. A cross-sectional observational study was conducted among the caregivers of children aged 6–12 years in all Saudi Arabia regions. The data were gathered through a self-administered online questionnaire. It included demographic information, weight and height, and associated comorbidities, in addition to the weekly frequencies of snoring symptoms and of enuresis, as well as of unrefreshing sleep using Likert-type response scales. Counts and percentages, the mean ± standard deviation, chi-square test, independent samples t-test, and regression analysis were used in the statistical analysis using R v 3.6.3. The questionnaire was completed by 686 respondents. Most respondents did not report any comorbidities in their children (77.1%). Asthma and adenotonsillar hypertrophy were reported in 16.2% and 15.6% of children, respectively. Unrefreshing sleep, mouth breathing at night, snoring, chronic nasal obstruction, and difficulty breathing while asleep were reported once or twice per week in 38%, 34%, 28%, 18%, and 18% of children, respectively. The prevalence of NE was 22.3%, with about 36.6% of children having NE two or more times per week. Significantly, NE was reported in 26.6% of children who slept before 10 PM compared to 19% of children who slept after 10 PM; in 28.6% of children who snored or loudly snored (57.1%) three times or more per week; and in 51.2% and 27.5% of children with difficulty breathing while asleep and who breathed through their mouth at night for one or two nights per week, respectively. A multivariable regression analysis showed that male gender (OR = 1.52, p = 0.010), obesity (OR = 1.24, p = 0.028), early sleeping time (OR = 1.40, p = 0.048), loud snoring for three or more nights per week (OR = 1.54, p = 0.001), difficulty breathing for one or two nights per week (OR = 1.85, p = 0.010), and mouth breathing at night for one or two nights per week (OR = 1.55, p = 0.049) were associated with higher odds of NE. Our study revealed that 22.3% of primary school children reported suffering from NE. SDB is a common problem among children with NE. The exact mechanism that links SDB to the increase in the risk of NE is unknown. Male gender, obesity, early sleeping time, loud snoring, difficulty breathing, and mouth breathing at night are potential independent risk factors of NE in school-age children.

Explorando la opinión de los especialistas españoles acerca de la utilidad de la radiómica en el área oncológica

AimTo describe the knowledge and opinion of health professionals regarding the usefulness of radiomics in oncology. MethodsA 12-question questionnaire (multiple-choice responses, Likert-type scale, and open response) was developed and sent to professionals related to diagnosis/treatment of oncological diseases (Oncology, Radiodiagnosis, Nuclear Medicine, Radiation Oncology, Hematology-Oncology, Radiophysics and Pathology). Participants were classified into two groups according to their level of training: attending physicians and residents. Results114 professionals completed the survey (54% residents, mostly from Nuclear Medicine and Radiodiagnostic specialties). Attending physicians obtained a better performance in the area pf knowledge compared to residents. Both groups of respondents agreed regarding the usefulness of radiomics to help make more accurate diagnoses and promoting the work of medical teams and the most frequent disadvantages were related to the lack of systematization in the acquisition of images and extraction of parameters, the need for the training of professionals and concern about the replacement of human work by technological tools. ConclusionsRadiomics is a novel field and the most general aspects are known by health professionals. The professionals surveyed were optimistic about the benefits provided by radiomics and other types of tools. The main problem detected was the lack of systematization in its implementation. The replacement of professionals and job loss is a concern, albeit less prevalent, and may respond to a generational phenomenon.

Pedagogy of death within the framework of health education: The need and why teachers and students should be trained in primary education

The objective of the present study is to analyze the perceptions of in-service teachers about Pedagogy of Death within the framework of Health Education (HE), with respect to the training received and their teaching experience. A quantitative method was utilized, with the design of an ad hoc questionnaire with a Likert-type response scale and dichotomous questions. The results showed that while the teachers were aware of the need to educationally address death and health, they lacked or did not have initial or continuous training for doing so, and had not thought about it as a normalized aspect throughout their teaching career. We believe it is necessary to offer more training on Pedagogy of Death in the area of HE at universities and continuous education centers, so that it can ultimately be implemented in Primary Education classrooms.

Exploring the opinion of Spanish medical specialists about the usefulness of radiomics in oncology

AimTo describe the knowledge and opinion of health professionals regarding the usefulness of radiomics in oncology. MethodsA 12-question questionnaire (multiple-choice responses, Likert-type scale, and open response) was developed and sent to professionals related to diagnosis/treatment of oncological diseases (Oncology, Radiodiagnosis, Nuclear Medicine, Radiation Oncology, Hematology-Oncology, Radiophysics and Pathology). Participants were classified into two groups according to their level of training: attending physicians and residents. Results114 professionals completed the survey (54% residents, mostly from Nuclear Medicine and Radiodiagnostic specialties). Attending physicians obtained a better performance in the area pf knowledge compared to residents. Both groups of respondents agreed regarding the usefulness of radiomics to help make more accurate diagnoses and promoting the work of medical teams and the most frequent disadvantages were related to the lack of systematization in the acquisition of images and extraction of parameters, the need for the training of professionals and concern about the replacement of human work by technological tools. ConclusionsRadiomics is a novel field and the most general aspects are known by health professionals. The professionals surveyed were optimistic about the benefits provided by radiomics and other types of tools. The main problem detected was the lack of systematization in its implementation. The replacement of professionals and job loss is a concern, albeit less prevalent, and may respond to a generational phenomenon.

Prevalence of Anxiety amongst Interns while Performing Treatments in Dental Colleges of Navi Mumbai: A Cross-sectional Survey

Introduction: Anxiety is one of the most commonly experienced disorders across gender and all ages. Dental anxiety seen in patients prior to or during treatment is a well-researched topic. However, anxiety experienced by interns while treating patients in the dental college is a lesser explored side of the same coin. Aim: To evaluate and understand the prevalence of anxiety experienced by dental interns while performing treatments in a college clinical set-up and studies the various factors precipitating anxiety. Materials and Methods: This cross-sectional survey was conducted using Google forms, amongst interns of five dental colleges in Navi Mumbai region from July 2021 to October 2021. A sample size of 350 was derived by convenient sampling method. The parameters assessed via questionnaire through a Likert-type response scale included various factors precipitating anxiety amongst interns such as performing invasive dental treatments, lack of in-depth knowledge of procedures, age, attitude and medical conditions of patients, encountering complications while treating patients, presence of supervision and working with anxious peers. Chi-square test was performed to analyse collected data, extract results and draw a conclusion. Results: Out of 350 participants, 332 showed symptoms of anxiety while treating patients in clinics. No significant gender predilection was noted for anxiety (p=0.544). Factors precipitating anxiety included performing invasive dental treatments (p=0.0004), lack of in-depth knowledge of certain procedures (p=0.020), patient’s attitude (p=0.017), treating patients with certain medical conditions (p=0.035) as well as encountering complications while treating patients (p=0.022). A significant number of participants thought that anxiety leads to more procedural errors (p=0.010). The need to incorporate anxiety management in the dental curriculum was observed (p=0.023). Conclusion: The results of this study showed prevalence of anxiety amongst dental students and highlighted the need to incorporate anxiety management programs in the curriculum. Preparing interns to cope with anxiety resulting from treating patients seems to be of importance for their future clinical practice.

An item response theory analysis of two frequently used measures of identity development.

Identity development-exploring options and making commitments-is an important process related to human functioning across the lifespan. An accurate understanding of identity development processes requires precise measures, but commonly used questionnaires have not been subject to intensive psychometric analyses. We investigated the psychometric properties of two such measures, the Utrecht Management of Identity Commitments Scale and the Dimensions of Identity Development Scale. Previous analyses have treated the response scales as interval rather than ordinal, which may not be reasonable given the measures' Likert-type response scales. Accordingly, we evaluated their measurement precision by conducting multidimensional item response theory analyses of data from six studies of secondary and postsecondary students in The Netherlands and the United States (total N = 4,844; 36.00% boys/men, 63.07% girls/women; 0.02% nonbinary or missing gender data; 62.39% completed the measure in Dutch, 37.61% in English; 52.66% postsecondary school; 47.34% secondary school; racial, ethnic, and nationality information varied across studies). Graded response models showed that a limited range of the latent attributes was precisely measured, and the quality of items varied considerably. The measures functioned mostly similarly between gender groups, but there was substantial differential item functioning based on school level and language of the measure. We originally sought to create shortened versions, but the shortened versions provided no improvement over the low quality of the longer versions. Our analyses suggest that reflection on what these identity processes entail is needed, to develop new items that address different manifestations of the attributes under consideration. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Human resource management, internal communication and remote work of servers in a public entity

Given the need to seek mechanisms to strengthen and improve the quality of educational services in the region, this study aimed to determine the influence of human resource management and internal communication in remote work on the servers of a public entity. . The study was basic with a quantitative approach of non-experimental design, correlational-causal level. The study population was made up of 120 members of a public entity in Peru, the sampling was simple random probabilistic type, being made up of 102 participants, the technique used was the survey, for data collection a virtual questionnaire was used as an instrument made up of 46 questions structured with alternatives in Likert-type scale responses, whose reliability was determined by Cronbach's Alpha coefficient ( 0.943 ), and was validated by expert judgment. After obtaining the data, the statistical analysis was carried out using the SPSS Statistics version software. The results indicated a level of significance of 000 &lt; 00.5, and the Wald statistic 18,076 concluding that the management of means humans Y the communication internal they have a positive influence on the remote work variable of the servers in a public entity.

1010-P: Diabetes Distress in Younger vs. Older Emerging Adults: Confirmation of Content Validity of the Problem Areas in Diabetes—Emerging Adult Survey (PAID-EA)

The developmental stage of emerging adulthood covers a wide age span (ages 18-30 years) with potential for differing emotional burdens for those living with type 1 diabetes (T1D) . To further confirm the content validity of the PAID-EA and to investigate differences between younger and older emerging adults, item responses on the newly developed, previously validated PAID-EA survey were examined by age group. Emerging adults (N=287) with T1D completed online measures of diabetes distress, depressive symptomology, and the PAID-EA. The PAID-EA has 25 items and uses a 5 point Likert-type response scale with options ranging from agree to disagree. The sample was split into 2 age groups: younger emerging adults (ages 18-24, N=143) and older emerging adults (ages 25-30, N=122) . Self-reported HbA1c was significantly worse in younger vs. older emerging adults (7.4% vs. 6.8%, p&amp;lt;.001) . Other demographic variables and total scores on measures were similar between age groups. Only 3 items on the PAID-EA differed by age group with younger emerging adults endorsing more diabetes distress: (1) Item 6: “I worry about being able to socialize because of how alcohol affects my blood sugar” (p=.03) , (2) Item 7: “I worry that a new romantic partner will see my diabetes devices or supplies” (p=.04) , (3) Item 25: I feel like I am trying my hardest to take care of diabetes, but it never works” (p=.02) . Experimentation with alcohol and intimacy with new partners may be experienced differently for younger compared with older emerging adults. Intense feelings of burnout and failure may also differ; this finding requires further exploration. Though emerging adulthood spans more than a decade, perceptions of the emotional burden of living with T1D appear consistent for the younger and older age groups, confirming the content validity of the PAID-EA throughout emerging adulthood. Disclosure K.Wentzell: None. R.J.Vitale: None. L.M.Laffel: Advisory Panel; Medtronic, Roche Diabetes Care, Consultant; Boehringer Ingelheim International GmbH, Dexcom, Inc., Dompé, Insulet Corporation, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk, Provention Bio, Inc. Funding Joslin DRC: P30DK036836 NIH: T32DK007260, T32DK007529

Medical Ward Round Teaching: A Mixed Methods Study to Explore the Perspective of Junior Doctors

Aim: To evaluate the educational value of the ward round in medicine and allied wards for junior doctors and identify the barriers to effective learning during a round. Methodology: This mixed-method study was conducted over six months in the medicine and allied units of Ayub Teaching Hospital, Abbottabad. A semi-structured online questionnaire consisting of five and six point Likert-type scale responses was administered to 172 house officers and junior residents and data recorded through Google Forms. Data was analyzed by SPSS version 25.0 for descriptive statistics. The quantitative part was triangulated for validation with seven in-depth interviews from purposively selected participants which were thematically analyzed after assigning codes, categories and subthemes. Results: The response rate was 76.7%. The most important skill acquired during ward round was development of an approach towards patients 60(45.5%). This was followed by learning presentation skills 56(42.4%) and patient management 52(39.3%). Majority of the participants identified bed-side overcrowding 90(68.1%) to be the greatest barrier in learning during a round. Content analysis of the qualitative part suggested that an improvement in learning could be achieved by reducing the number of participants, introducing structured checklists and removing distractions for a consultant. Conclusion: Ward round is perceived to be an important tool for learning in medical education by junior doctors, but its full potential is not being utilized. Improvements can be made by changes made in the ward environment and structuring rounds by leading physicians. Keywords: Medical education, teaching rounds, physicians, learning

Medición del clima laboral: una propuesta de evaluación para el psicólogo profesional en el área industrial-organizacional

&nbsp;The purpose of this paper is to build and review the psychometric properties of the Brief Work Climate Scale (EBCL), therefore, an instrument comprised of 15 items in its initial version was designed, which had a Likert-type response scale with 5 alternatives, of which only 13 items had content-based validity evidence due to an Aiken’s V greater than .80, with probability of statistical significance (p &lt; .05). The final version was applied to two sample groups (n1 = 121; n2 = 126) of employees at the operational level of two companies related to the grocery sales sector in Metropolitan Lima. In the first sample, the exploratory factorial analysis was reviewed with a Pearson correlation matrix, demonstrating the existence of two well-defined models (two oblique factor model and one-dimensional model), the first factor explained 55.4% of the accumulated variance and the second 49.1%. Confirmatory factor analysis was performed with the second sample group, in such a way that the two models mentioned above and a bifactor model were compared, identifying that the goodness-of-fit indices were not satisfactory to confirm any predominant model; however, there is adequate reliability in the reaction-effect dimension of the worker (α = .91, ω = .90) and company factors (α = .82, ω = .86); as well as for the one-dimensional model (α = .92, ω = .94). The results show that the EBCL Scale has adequate evidence of psychometric properties.

Perspectives of Hospitalists in an Academic Health System

The primary outcome of this study is to assess the perspectives of Hospitalists on their workload and their perceived effects on patient care. The secondary outcomes are to evaluate the satisfaction of the Hospitalists with their compensation, quality of life, scholarship activity and promotion in their department and the support received to achieve this. We developed a 49-question questionnaire. The questionnaire was based on (a) Oldenburg Burnout Inventory and (b) topics specific to census, compensation, academic support with desire for promotion, and the effects of workload on patient care and teaching. All questions were formatted with a 4-point Likert-type response scale. The questionnaires were distributed electronically using an online survey platform to all 32 of the Hospitalists at our institution. Each institution needs to do a self-assessment based on clinician feedback: Hospitalists workload, burn-out and satisfaction to reduce the high turnover rates and brevity of this role. From this study in this academic institution, the perspectives of Hospitalists revealed a high level of burn out (exhaustion and disengagement) and high assigned patient censuses that negatively impact their ability to deliver optimal patient care. Most Hospitalists reported lack of mentorship and inadequate time allocated for scholarly activity. The majority reported not having their input on decisions made by the administration that directly affect them. Most were unsatisfied with their compensation and the lack of PTO (paid time off). The majority would like to be promoted in this academic institution but feel unsupported to achieve this goal.

Evaluation of Student Satisfaction with Ubiquitous-Based Tests in Women's Health Nursing Course.

Learning evaluation using ubiquitous-based tests may be essential during a public health crisis, such as the COVID-19 pandemic, during which theoretical classes and clinical practice are conducted online. However, students may not be as familiar with ubiquitous-based tests as they are with paper-based tests. This survey study aimed to evaluate students’ satisfaction with ubiquitous-based tests and compare the evaluation results of a paper-based test with that of a ubiquitous-based test in nursing education. For the midterm exam of the Women’s Health Nursing course, a paper-based test was conducted, while a ubiquitous-based test using a tablet computer was used for the final exam. The Ubiquitous-Based Test Usefulness and Satisfaction tool, which has a five-point Likert-type response scale, was employed to evaluate the post-test usefulness and satisfaction scores of the ubiquitous-based test. The mean score of the ubiquitous-based test usefulness was 4.01 ± 0.67. There was a significant difference in satisfaction levels between the ubiquitous-based and the paper-based test (t = −3.36, p = 0.001). Specifically, the evaluation scores were not affected by different evaluation methods. Study participants deemed the ubiquitous-based test highly useful and satisfactory, suggesting that such tests may be a future-oriented evaluation method, potentially replacing paper-based tests.

Abstract 12830: Cardiac POCUS: Another Tool in the Armory

Introduction: Cardiac Point-Of-Care-Ultrasound (POCUS) is a valuable bedside tool that has been shown to provide better-quality patient care. Few studies have examined residents’ interest and the educational impact of a hybrid Cardiac POCUS training model in a community-based academic setting. Material and Methods: Internal Medicine and Medicine/Pediatrics residents across all post-graduate years (PGY) undertook a structured hybrid (online and hands-on teaching) model of POCUS training. Anonymous surveys with Likert-type scale responses were conducted before and after the curriculum. Questions were categorized into domains to assess the residents’ interest in learning POCUS, their understanding of fundamental cardiac ultrasound (US) concepts, and their confidence in its application. Direct comparisons were made using Fisher’s exact and t-test as appropriate. Odds ratios were estimated to further gauge the impact of the training. Results: A total of 27 and 26 residents completed the pre-and post-training anonymous surveys, respectively. A median of 1 previous cardiac US was reported, with the distribution showing a positive skew. Responses inquiring about residents’ interest in learning POCUS were similar post-training compared to the pre-training survey (OR 3.66 [CI 0.86 - 15.59], p = 0.07), a finding consistent amongst sub-groups female gender, and PGY levels 2 &amp; 3. The training did reveal a significant increase in both, the understanding of cardiac POCUS principles (OR 8.25 [CI 1.61 - 42.28], p = 0.005), and the residents’ confidence in its application (OR 13.53 [CI 1.58 - 116.04, p=0.005]. The mean score on confidence level, though higher post-training, was not significant amongst PGY 1 residents. Conclusions: Understanding fundamental cardiac ultrasound concepts and the confidence level in its application were significantly greater amongst residents after implementing a structured hybrid teaching model for Cardiac POCUS. This may be most impactful if designed for PGY levels 2 &amp; 3. Future studies with a comprehensive teaching curriculum and more objective assessment tools are needed to gauge its clinical impact, its adoption rate in clinical practice, and a recommendation for incorporation into the residency curriculum.

362 Acceptability of a Novel Smartphone Application as a Patient Engagement Tool in the Emergency Department

The experience of care is a primary tenant of healthcare value. Growing evidence indicates that patients who are more engaged have better experiences and health outcomes. Engaging patients in the emergency department (ED) setting is challenging, often leading to dissatisfaction. We developed navigatER®, a mobile application (app) designed by frontline providers to help engage, inform, and educate patients as care is being delivered. The goals of this quality improvement project were to evaluate patient and provider perceptions of the utility, ease of use, efficacy, acceptability, and impact on care delivery of the navigatER app. For this small pilot project, we enrolled a convenience sample of adult patients (≥ 18) treated in our Level 1, tertiary care ED over a 6 week period. Included were willing English-speakers with smartphones and a chest or abdominal complaint. Following consent, participants were instructed on how to download the app. Dual factor authentication was used to confirm identity and link the app to the participant’s medical record. Participants received care notifications and corresponding educational material in real-time and were queried on satisfaction throughout care delivery. Upon disposition, a 6 question QI survey utilizing a Likert-type response scale ranging from 1-5 (1 = Strongly Disagree through 5 = Strongly Agree), was delivered via the app evaluating participant impressions of navigatER. Endorsing the two strongest categories (agree or strongly agree) was considered an affirmative response. ED providers were queried in a post-shift assessment following encounters with patients who used navigatER. Providers were not intentionally informed as to which patients were using the app. 146 participants were enrolled with 110 (75%) responding to a care related survey question and 29 (20%) completing the disposition survey. Survey respondents were 58% female with a mean age 45 years (range 20-77). Of the disposition survey respondents 76% agreed or strongly agreed that navigatER was useful in communicating diagnostic tests, 69% affirmed that the app kept them updated, 66% endorsed it as being helpful, 76% supported the app’s ease of use, 76% endorsed the educational material as being helpful, and 72% reported liking the app overall. All 16 of the providers queried had a neutral or favorable impression of the app’s usefulness as a communication tool and none felt that it was disruptive or increased workload. In this small pilot the majority of participants found this early stage version of the navigatER app to be useful, effective, easy to use, and acceptable when used during care delivery in the ED setting. No providers indicated that the app was disruptive to the care environment. The app holds promise as a useful tool for engaging ED patients. Participant feedback will be used to improve the app’s utility and usability prior to wider adoption. Future studies will evaluate the impact of navigatER on publicly reported patient experience metrics such as the Net Promoter Score to validate the role of this digital tool.

Validation and Polish Adaptation of the Authorized Bratman Orthorexia Self-Test (ABOST): Comparison of Dichotomous and Continuous Likert-Type Response Scales.

PurposeAlthough research on orthorexia nervosa (ON) has developed in recent years, there exists a continuous need to develop valid tools to assess ON risk, according to strict diagnostic criteria. The present study aims to conduct Polish adaptation and validation of the Authorized Bratman Orthorexia Self-Test (ABOST), through a comparison of dichotomous and continuous Likert response scales.Participants and MethodsThis cross-sectional study involved 472 people with mean age of 27 years (ranging between 18 and 78 years, M = 26.88, SD = 10.40). The survey included demographic questions and measures of orthorexia (the ABOST and ORTO-15), eating disorders (EAT-26), body mass index (BMI), obsessive–compulsive disorder (OCI-R), anxiety (GAD-7), and depression (PHQ-9). The following statistical tests were performed to explore the psychometric properties of the ABOST: descriptive statistics, Student’s t-test, Pearson’s correlation, Cronbach’s α reliability, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA).ResultsThe ABOST using a five-point Likert scale for responses demonstrated good psychometric properties. The CFA goodness-of-fit indices confirmed the one-factor solution. Positive correlations were found between the ABOST and the ORTO-15, EAT-26, OCI-R, GAD-7, and PHQ-9. Women scored higher in the ABOST than men, while BMI was unrelated to the ABOST.ConclusionThe ABOST using the Likert scale provides a reliable and valid instrument to assess ON risk, as indicated by the face, structural, and convergent validity results. However, more research in various countries is needed, in order to verify the results of this study.