Live Videoconferencing Research Articles

Can dermatologists reach their full potential in teledermatology? A validation study of diagnostic performanceof skin diseases in live video conferencingteledermatology.

The diagnostic accuracy rate of live videoconferencing (LVC) teledermatology, by board-certified dermatologists compared to non-dermatologists has not yet been fully investigated. The aim of this study was to compare the diagnostic accuracy of board-certified dermatologists, dermatology specialty trainees, and board-certified internists in LVC teledermatology. We examined the diagnostic accuracy of clinicians from different specialties in diagnosing the same group of patients. The clinicians were isolated from each other during the diagnosis process. We enrolled 18 volunteer physicians (six board-certified dermatologists, six dermatology specialty trainees, and six board-certified internists) who reviewed the skin conditions of 18 patients via LVC teledermatology. The diagnostic accuracy of the participating physicians was evaluated using the final diagnosis as the reference standard. The diagnostic accuracy averages were compared according to the physicians' specialties and disease categories. The mean ± standard deviation diagnostic accuracy of the most detailed level diagnosis was 83.3% ± 3.5% (range, 77.8%-89.0%) for board-certified dermatologists, 53.7 ± 20.7% (range 27.8%-77.8%) for dermatology specialty trainees, and 27.8 ± 5.0% (range, 22.2%-33.3%) for board-certified internists. Board-certified dermatologists showed significantly higher diagnostic accuracy, not only against board-certified internists (p < 0.0001) but also against dermatology specialty trainees (p < 0.05). Disease categories with high accuracy rates (≥80%) only by board-certified dermatologists were inflammatory papulosquamous dermatoses (87.5%), compared to 58.3%, and 20.8% for dermatology specialty trainees and board-certified internists respectively). For inflammatory erythemas and other reactive inflammatory dermatoses the accuracy rates for board-certified dermatologists, dermatology specialty trainees, and board-certified internists were 83.3%, 33.3%, 8.3% respectively; for melanoma insitu neoplasms, 83.3%, 50.0%, 66.7% respectively), and for genetic disorders of keratinization 83.3%, 33.3%, and 0% respectively). Our findings showed that board-certified dermatologists may have high diagnostic accuracy with practical safety and effectiveness in LVC teledermatology.

Teledermatology: Simulating Hybrid Workflows for Telemedicine Education.

Given the importance of telemedicine in improving healthcare access for underserved patients, professional students need experience using virtual clinical workflows. We developed an educational workshop with (1) readings, (2) a knowledge assessment test, (3) dermatology and teledermatology lectures, (5) a telemedicine simulation with a standardized patient, and (6) a debriefing session. The simulation included a "hybrid" workflow with live videoconferencing and store-and-forward image review. We measured student performance using three American Association of Medical Colleges (AAMC) Telemedicine Competencies for medical education. Ninety-eight medical and physician assistant students completed this workshop between 2021 and 2022, and 80% were entrustable or approaching entrustment in each competency. Some students struggled with data collection and technology use. Our results suggest that this workshop offers a practical and generalizable way to teach about multiple virtual workflows and strengthen students' telemedicine competencies.

Teledermatology in practice: Report of Mayo Clinic experience.

Delivery of dermatologic care through telemedicine was accelerated by the COVID-19 pandemic. We sought to analyze the teledermatology experience across Mayo Clinic's health care system to identify strengths and limitations of teledermatology. Electronic health records of dermatology televisits were reviewed from multiple U.S. Mayo Clinic sites from January 2020 through January 2021. A total of 13,181 dermatology televisits were conducted in 6468 unique patients. Patients were primarily female (60.2%), and mean age of all patients was 34.1 years. Synchronous / live video conferencing visits were the most common (40.0%) telecare modality. Synchronous / live audio conferencing and asynchronous / store-and-forward visits comprised 33.0% and 27.0% of appointments. In total, 3944 televisits (29.9%) were successfully concluded via a single appointment. An in-person appointment was needed for 1693 patients (26.2%) after their initial televisit. For patients with a single televisit, synchronous / live video conferencing was the most common virtual modality (58.0% vs 32.2% of patients with multiple visits, p < 0.001). Patients needing in-person follow-up visits were slightly older than those who did not (mean [SD], 38.8 [22.3] vs 35.0 [23.6] years; p < 0.001) but without any sex-based difference. Around one-third of patients needed an in-person follow-up visit after their initial asynchronous / store-and-forward visit which was higher when compared with synchronous / live audio and video conferencing. Single dermatology televisits effectively managed nearly one-third of patients who did not require in-person follow-up. An initial synchronous / live video conferencing was more likely to yield a single clinical encounter, whereas asynchronous / store-and-forward visits required more in-person follow-up. Future studies are required that focus on dermatology-specific cost, diagnoses, access, quality of care, and outcomes.

STUDENTS GAIN APPRECIATION FOR PATIENT-CENTERED AND TEAM-BASED CARE PARTICIPATING IN A GERIATRIC CASE COMPETITION

Abstract Health science students must attain interprofessional teamwork and collaboration competencies to provide effective, patient-centered care to older adults requiring complex care. However, students typically learn in disciplinary silos and lack engaging opportunities for interprofessional teamwork. To provide students with an interprofessional learning activity the Geriatric Workforce Enhancement Programs (GWEP) at Saint Louis University and the University of Minnesota implemented a Geriatric Case Competition. We present the students’ experience with the 2022 competition. Students assigned to interprofessional teams with a coach had one month to prepare a 20-25 minute presentation of a comprehensive care plan using a simulated complex geriatric patient case. Judges scored team presentations using a rubric of core competencies for interprofessional collaborative practice. Each GWEP held local competitions with winning teams presenting at the inter-GWEP competition held via live videoconferencing. Top scoring teams received prizes. Students completed an eight-item satisfaction survey using a 5 point likert scale (5=poor to 1=excellent). Answers to open ended questions were analyzed qualitatively to find themes about their experience. 132 students joined the competition and 54 completed an evaluation survey (response rate 41%). Students rated their experience as good to excellent with mean ratings on 8 questions ranging from 1.5-2.2 (N=54). Themes included: the importance of patient centered care and the power of multiple perspectives/expertise. Students offered improvements related to student, coach, and judge expectations. In summary, the competition provided a very positive learning activity that helped students value the importance of patient centered care and interprofessional collaboration for older people.

Telehealth use and work stress among Chinese health care providers during the COVID-19 pandemic

Telehealth services in China rapidly expanded during the COVID-19 pandemic. The work stress of health care providers (HCPs) associated with providing telehealth care services in China has been less studied. Our study describes the telehealth services provided by hospitals in China and examines the relationships between telehealth use and work stress of HCPs in China during the COVID-19 pandemic. With a survey research design, HCPs aged 18 or older in China were electronically recruited from October 19 to November 10, 2021 (n=1,073). After preprocessing, data from 1,036 HCPs were used for further analyses, which included descriptive statistics and multiple linear regression models. Results showed that 64.29% of Chinese hospitals reported virtual physician-to-physician consultations, and 59.94% of Chinese HCPs conducted online physician consultations. Lower levels of HCP work stress was associated with live video conferencing (p=0.04), online physician consultations (p=0.00), and higher levels of team collaboration (p=0.00) and team trust (p=0.00). Work stress was also positively correlated with COVID-19 stress (p=0.00), working hours (p=0.00), and the interaction between live video conferencing and COVID-19 stress (p=0.04). HCPs’ work stress decreased by using live video conferencing and online patient care. However, the positive effects of live video conferencing may decrease with the increase in COVID-19 stress for HCPs. Our findings encourage efforts to develop extensive coverage of telehealth service systems in China to promote HCPs’ virtual communication and collaboration to relieve HCPs’ work stress and support their well-being.

Pet owners prefer face-to-face consultations, with many being open to considering virtual consultations with veterinarians.

To explore pet owners' use of information and communication technologies (ICTs) during virtual veterinarian-client-patient consultations and to examine pet owners' attitudes toward virtual consultations. 714 pet owners. In an anonymous online survey distributed using snowball sampling, all participants were asked about utilization of ICTs, preferred method of interaction (face-to-face and 5 ICTs), opinion on virtual communication, and demographics. Sentiment toward virtual veterinarian consultations was measured for participants who had experienced a "virtual only" or "combination virtual and face-to-face" consultation in the previous 6 months using the Net Promoter Score. For these participants, multivariable logistic regression was used to explore factors associated with recommending virtual consultations. 92% (583/632) of participants resided in Ontario, Canada. Most (85.6% [611/714]) participants had experience using the telephone for veterinary care, while only 5.2% (37/714) had used live videoconferencing. Participants ranked face-to-face interactions as most preferred (P < .001), followed by telephone and then live videoconferencing. Participants were significantly (P < .001) less confident communicating during virtual consultations, particularly for building rapport. For participants experiencing a virtual consultation in the previous 6 months (n = 348), the overall Net Promoter Score was neutral at -1.43. Participants were divided about recommending virtual consultations, with 33.3% (116/348) being promoters and 34.8% (121/348) being detractors. Age of participant and comfort using videoconferencing were positively associated (P < .05) with recommending virtual consultations. Although participating pet owners significantly preferred face-to-face consultations with veterinarians, many appear willing to consider virtual consultations. Further exploration of pet owners' preferences and concerns around virtual care, including communication, is needed.

Virtual global health through longitudinal case-based rounds.

The COVID-19 pandemic rapidly transferred medical education curricula to online platforms. Due to travel bans, students were cut off from traditional global health experiences. This project was developed to confront the travel restrictions, time restraints and cost barriers associated with global health during the pandemic. Now, with fewer travel restrictions, this programme continues to offer learning opportunities: it could be extended to practice medical language proficiency in non-English speaking countries, compliment in-person experiences and increase the sustainability of global health programs. We provided American and Tanzanian students with a longitudinal, global health experience through an interactive, online collaboration. The cohort engaged in bi-weekly meetings using live video conferencing. During the 3-hour calls, students presented and discussed de-identified patient-cases representative of cases seen in outpatient primary care clinics at their home institutions. Additionally, follow-up reports from previous cases were presented to incorporate an element of longitudinal care. Six medical students from an urban hospital in the United States (USA) and physician-assistant students from a rural Tanzanian hospital were led by an attending physician in their respective countries. The pilot program's efficacy was assessed through anonymously reviewed qualitative surveys at its initiation in December 2021, midpoint, and conclusion in April 2022. Student testimonies from the US cohort were acquired before and after the study using a Likert scale to determine student growth, global health interest and clinical skill acquisition. Although analysis was limited by the cohort's size, students indicated an increase in self-reported global health experiences, knowledge of health care limitations and benefits in resource-limited countries, primary care patient presentations proficiency and a decrease in student burnout. We have demonstrated the ability to deploy a virtual global health experience for medical students. This program is unique in its bi-directionality: students and attending physicians from two continents directly communicated and discussed cases, as opposed to traditional lecture-based global health courses. Along with the increased exposure to primary care cases, students expressed a sense of community and mentorship in these cohorts, as upper-class students provided points of guidance to students in their first and second years of training. To increase student interaction between countries and sense of community during the 6-month course, we implemented a brief introduction into each class called ‘About Me.’ Each week, two students would present a 5-minute talk describing their personal goals, hobbies and background to the group. Students experienced cultural variations in medical practice, as they were introduced to country-specific pathologies and guided through each country's approach to providing a diagnosis and treatment plans. Occasionally, there would be differences and innovations that justified additional discussion. At the end of classes, we allowed time for a student to briefly present a topic of their choosing discussed during the previous week. This program also lends itself to annual continuation, as students strengthen their bond with their international counterparts and naturally progress from inexperienced mentees to experienced mentors in the context of global health. The authors meet conditions 1, 2, 3 and 4. All authors have given final approval of the paper.

CHALLENGES IN THE IMPLEMENTATION OF ONLINE LEARNING IN HIGHER EDUCATION IN KENYA

The covid 19 pandemic caused a disruption in the education system in Kenya and the whole world, instutions had to get a way of continuing with the learning process without involving the learners physically, online learning which had not been explored in the previous years was now the only option remaining for the universities in Kenya and around the world. The paper analyzes how online learning was implemented and what were the challenges and achievements of the online learning. And the way in which students adapted to the new method of instruction. Universities adopted the online learning using online learning platforms such as zoom meeting, Microsoft teams, WhatsApp groups and other platforms which enabled the online interactions between the learners and the teachers, the online learning to a large extent was successful as students were able to attend classes, make presentations and sit exams online leading to a smooth process of learning. Students and teachers experienced various challenges in using the online platforms as this was a very new idea, some students and learners lacked a stable network to carry out the online classes, this made the students and teachers to at times miss classes. Lack of a reliable source of electricity also affected the online classes as the electricity would go off without prior notice, truance on the part of student where some skipped classes out of their own wish. The challenges not withstanding online learning has achieved more in the learning process as the interaction between the teacher and learner has been improved through the use of live classes and video conferencing, this has led to universities adopting full online courses especially those that do not require practical training. However, improvements are to be introduced in the online learning such as providing recorded lessons for every lesson attended. Virtual libraries to be improved to include all materials needed for the course being studied. It has therefore been proven that online learning is a as equally effective as the face-to-face learning.

Transformation of Eye Care Through Innovations.

Transformation of Eye Care Through Innovations.

Shaping the future of teledermatology: a literature review of patient and provider satisfaction with synchronous teledermatology during the COVID-19 pandemic.

SummaryFollowing the onset of the COVID‐19 pandemic, widespread adoption of synchronous teledermatology (e.g., live videoconferencing) has increased patient and provider familiarity. To our knowledge, no teledermatology reviews have exclusively characterized patient and provider satisfaction with synchronous models of teledermatology. This study determines the quantitative evaluation of patient and provider satisfaction through a literature review of synchronous teledermatology studies conducted during the COVID‐19 pandemic. A review of the literature was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines within the PubMed database. Search terms included, but were not limited to, teledermatology, patient satisfaction, and provider satisfaction. Studies were evaluated for quality of evidence based on guidelines described by the Oxford Center for Evidence‐based Medicine. Fifteen studies satisfied the inclusion criteria which described the satisfaction of 7871 patients and 146 providers with synchronous teledermatology during the COVID‐19 pandemic. Patients and providers were overall satisfied with access measures, the patient‐ provider relationship and the ability of synchronous teledermatology to meet patient needs. Limitations of the virtual physical exam and image or video quality were two consistent limiting factors in patient and provider experience, respectively. Patients and providers perceive that synchronous teledermatology meets the needs of the patient. Patients perceived satisfactory patient‐provider relationship through synchronous teledermatology. Practices can identify best applications and educate patients on expectations of the virtual examination in order to enhance utilization and sustainability of synchronous teledermatology beyond the pandemic.

Forced Online and Distance Learning (ODL) During COVID-19 Pandemic: Revealing Students’ Perceptions and Experiences

: The emergence of COVID-19 pandemic has forced educational institutions to change and adapt to ODL. This is to avoid disruption to students’ education and study plans. However, the forced actions resulted in mixed reactions from students and educators. Both parties were not ready and anticipated difficulties in executing forced ODL. Problems faced include internet connectivity, inadequate learning devices and lack of skills during the implementation of full ODL. This study was conducted to assess perceptions and experiences (i.e. challenges, advantages and disadvantages) of ODL among Diploma in Pharmacy students. Data were obtained through a cross-sectional survey through online questionnaires. Questionnaires which consisted of demographic, perspectives and experiences towards ODL were distributed using WhatsApp and email. A total of 262 respondents (209 females and 53 males) completed the questionnaires. Majority of the students (94.3%) chose to study at home and used both mobile phones (92.4%) and laptops (96.2%) for ODL. Most students preferred ODL because of convenience (83.6%) whilst reduced concentration (80.9%) and poor internet connection (76.3%) were among the challenges encountered. Most frequently used digital platforms include UFUTURE (98.9%), Microsoft Teams (94.3%) and Google Classroom (89.7%). Likewise, live video conferencing (72.1%), pre-recorded videos (67.2%) and videos from online sources (59.5%) were among the most used type of delivery modes by lecturers. Our findings may help to strengthen the understanding of current ODL implementation and teaching processes. Results from this study will assist in improving various aspects of ODL to increase its effectiveness and efficiency for students’ learning.

Virtual Tai Chi program for patients with irritable bowel syndrome with constipation: Proof-of-concept feasibility trial.

Satisfaction with current treatment options for irritable bowel syndrome with constipation (IBS-C) is low, with many patients turning to complementary treatments. Tai Chi is a mind-body medicine practice with proven efficacy in other functional disorders. As a proof-of-concept, we tested the feasibility and preliminary clinical outcomes associated with a Tai Chi program designed for IBS-C. A total of 27 IBS-C patients participated in a single-arm trial of 8 sessions of Tai Chi delivered weekly over 7 weeks via live videoconferencing in group format. Clinical improvement was assessed via change in IBS Symptom Severity Score (IBS-SSS) from baseline to 4 weeks posttreatment (week 11) with secondary outcomes exploring symptom ratings, IBS-related quality of life (IBS-QOL), GI-specific anxiety, abdominal distention, and psychological factors. Despite substantial dropout (n=7; 26%), the treatment protocol had moderate to excellent feasibility for other criteria. Treatment satisfaction was excellent. Exit interviews confirmed high satisfaction with the program among completers, but a high burden of data collection was noted. One participant experienced an adverse event (mild, exacerbation of sciatica). There was a significant improvement in intra-individual IBS-SSS between baseline and posttreatment (average change -66.5, 95% CI -118.6 to -14.3, p=0.01). Secondary outcomes were notable for improvements in other IBS symptom scoring measures, IBS-QOL, measured abdominal diameter, and leg strength. Our data provide preliminary evidence of the feasibility of a Tai Chi intervention for IBS-C, show promise for improving outcomes, and identify more streamlined data collection as an area for further program improvement.

Teaching Teledermatology: A Simulation Pilot for Health Professional Students.

We developed a teledermatology simulation to give medical and physician assistant students practice with live videoconferencing and store-and-forward workflows. The simulation included (1) pre-session reading; (2) a brief teledermatology didactic; (3) a simulated encounter with a standardized patient; and (4) faculty-led debriefs. The faculty observed students during the simulation and distributed a post-session learner satisfaction survey. Although students had mixed feelings about the simulation, 88% said the workshop met or exceeded expectations.

Virtual Support and Intimate Partner Violence Services: A Scoping Review

PurposeThis article reports on a scoping review that maps the empirical research on virtual intimate partner violence (IPV) interventions.MethodFollowing the Joanna Briggs Institute’s nine-step scoping review methodology, 25 studies were selected.ResultsThe majority of the studies (72%) were published in the United States, and included quantitative (56%), mixed methods (24%), and qualitative study designs (20%). The most frequent focus of the virtual interventions to support survivors of IPV included safety (52%), with other interventions focusing mainly on treatment (36%), and education and prevention (12%). Forms of interventions included interactive, internet-based (72%), smartphone apps (16%), live videoconferencing (8%), and an asynchronous chatroom (4%). Barriers and strengths of virtual IPV interventions are identified.DiscussionFrom this analysis, emerging models in virtual IPV intervention are identified, as well as next steps necessary in virtual IPV practice and research. The article concludes with implications for social work practice and research.

Parent peer coaching program: A cascading intervention for parents of children with autism in Mongolia.

Parents of children with autism are known to experience severe hardships related to raising their children. These hardships are exacerbated in low-resource settings internationally where there is very little resource for children and their families, including professionals who provide evidence-based treatment. Mongolia was chosen as an example of such low-resource settings in this single-case research, and four parent mentors and five parent peers and their children with autism participated and completed the study. A local parent group, the Autism Association of Mongolia, was actively involved in this study and helped with recruitment, development, adaptation, and implementation of the intervention to increase acceptability and feasibility. In addition, a local bilingual research assistant was also utilized as the purpose of this study was to build capacity of diverse stakeholders of children with autism in Mongolia. The research assistant was trained and coached by the research team on both content (communication teaching strategies and behavior management) and delivery (coaching adults), who then provided coaching to parent mentors via live videoconferencing in Mongolian. Parent mentors then similarly provided coaching to parent peers after observing the interactions with their children with autism. The findings suggest that parents can effectively deliver high-fidelity coaching to disseminate evidence-based treatment in low-resource settings when given proper training and coaching. Further examination on scalability and sustainment of effects is suggested.

Strategies for implementation of virtual home visitation in the United States

Utilising telepractice videoconferencing technology to offer home visitation services has the potential to provide access and parenting support through a high-tech and high-touch service delivery option. Families can receive evidence-based, family support intervention from their home via videoconferencing technology, removing the need for the provider to be physically in the home. While the expansion of telehealth and telepractice services for families is essential for meeting the needs of both parents and their children, well-documented engagement barriers to digital health/computer-mediated interventions exist across treatment modalities and technology platforms. Semi-structured interviews with 15 providers were conducted and analysed to identify engagement strategies utilised to sustain families in a home visitation model offered through live videoconferencing technology on a telehealth platform. Analysis revealed four themes that were deemed essential for successfully attracting and maintaining families in a telepractice-based home visitation programme: (a) engagement strategies to encourage families to participate; (b) clinical skills used within sessions; (c) articulation of benefits to the family; and (d) exploration of rationale for ending services. This study was able to identify strategies for engagement and sustained involvement of families in telehealth-based home visitation. Findings include evidence that providers should be able to move between telehealth and on-ground service provision with relative ease.

OUTCOME MEASURES: EP.325 Remote testing: is it worth the effort? Feasibility in the clinical and research setting

The COVID 19 pandemic required clinicians to be agile and innovative to continue to provide necessary clinical care, as well as limit data loss in ongoing clinical trials. Our project prospectively investigated the feasibility of remote patient testing using common neuromuscular outcomes. Between April 2020 and April 2021 our neuromuscular physical therapy (PT) team assessed over 70 patients with neuromuscular diseases such as spinal muscular atrophy, Duchenne muscular dystrophy, and subtypes of limb girdle muscular dystrophies (ages 4 months-73 years) via live video-conferencing.

A Technology-Enabled Adaptation of Face-to-Face Caregiver-Mediated JASPER Intervention: Preliminary Examination of Video Conferenced Caregiver Coaching.

Family-centered practices that involve direct participation of caregivers as part of intervention is critical to effective early intervention. However, regularly scheduled, in person service delivery is not always possible in remote communities, prompting a need for adaptations to the delivery of services, such as the use of live video conferencing to coach caregivers in strategies to promote their children's development. In this study, caregivers and their children ages 2-9 with autism who were living in rural and remote Canadian communities were included. A concurrent multiple baseline design across participants was applied to examine the effects of live video conference caregiver coaching on children's time jointly engaged with caregivers and caregivers' intervention strategy implementation. Results indicated that all children demonstrated greater time jointly engaged and caregivers demonstrated greater use of strategies in comparison to baseline. The results of this study offer preliminary evidence of the effectiveness of real time video conference coaching for caregivers engaging their children with ASD in play.

A Live Video Program to Prevent Chronic Pain and Disability in At-Risk Adults With Acute Orthopedic Injuries (Toolkit for Optimal Recovery): Protocol for a Multisite Feasibility Study.

BackgroundDespite the pivotal role of psychosocial factors in pain and disability after orthopedic injury, there are no evidence-based preventive interventions targeting psychosocial factors in patients with acute orthopedic injuries. We developed the first mind-body intervention focused on optimizing recovery and improving pain and disability in patients with acute orthopedic injuries who exhibit high levels of catastrophic thinking about pain and/or pain anxiety (Toolkit for Optimal Recovery [TOR] after orthopedic injury). In a pilot single-site randomized controlled trial (RCT), the TOR met a priori set benchmarks for feasibility, acceptability, and satisfaction. The next step in developing TOR is to conduct a multisite feasibility RCT to set the stage for a scientifically rigorous hybrid efficacy-effectiveness trial.ObjectiveThe objective of this study is to conduct a rigorous multisite feasibility RCT of TOR to determine whether the intervention and study methodology meet a priori set benchmarks necessary for the successful implementation of a future multisite hybrid efficacy-effectiveness trial. In this paper, we describe the study design, manualized treatments, and specific strategies used to conduct this multisite feasibility RCT investigation.MethodsThis study will be conducted at 3 geographically diverse level 1 trauma centers, anonymized as sites A, B, and C. We will conduct a multisite feasibility RCT of TOR versus the minimally enhanced usual care (MEUC) control (60 patients per site; 30 per arm) targeting a priori set feasibility benchmarks. Adult patients with acute orthopedic injuries who endorse high pain catastrophizing or pain anxiety will be recruited approximately 1-2 months after injury or surgery (baseline). Participants randomized to the TOR will receive a 4-session mind-body treatment delivered via a secure live video by trained clinical psychologists. Participants randomized to the MEUC will receive an educational booklet. Primary outcomes include feasibility of recruitment, appropriateness, feasibility of data collection, acceptability of TOR (adherence to sessions), and treatment satisfaction across all sites. We will also collect data on secondary implementation outcomes, as well as pain severity, physical and emotional function, coping skills, and adverse events. Outcomes will be assessed at baseline, posttreatment, and at the 3-month follow-up.ResultsEnrollment for the RCT is estimated to begin in June 2021. The target date of completion of the feasibility RCT is April 2024. The institutional review board approval has been obtained (January 2020).ConclusionsThis investigation examines the multisite feasibility of TOR administered via live videoconferencing in adult patients with acute orthopedic injuries. If feasible, the next step is a multisite, hybrid efficacy-effectiveness trial of TOR versus MEUC. Preventive psychosocial interventions can provide a new way to improve patient and provider satisfaction and decrease suffering and health care costs among patients with orthopedic injuries who are at risk for chronic pain and disability.International Registered Report Identifier (IRRID)PRR1-10.2196/28155

The use of information and communication technology in continuing education in tuberculosis

ABSTRACT Introduction: The use of information and communication technologies (ICT) tools has been impacting health care. Distance learning has been used for the continuing improvement of healthcare workers (HCWs). In this systematic review, we evaluated the use of ICT in tuberculosis (TB) continuing education. Methods: We searched Medline and Embase for cross-sectional studies that included HCWs or students, and that reported participants’ learning level. Results: Four studies proved eligible. Three used online educational tools, and another one used CDroms and live video conferencing. All studies evaluated participants’ learning level through online pre- and post-tests. The quality of the studies was high. Conclusions: There is a paucity of studies evaluating distance learning in TB training. Continuing education of students and HCWs is essential for TB control. Accomplishing this is critical in increasing the skills and the numbers of qualified HCWs capable of meeting the health care needs of the population.