Mean Confidence Score Research Articles

Developing Awareness and Allies: Simulating Difficult Conversations about Microaggressions for Faculty and Students.

Discrimination and bias in clinical training often take the form of microaggressions, which, albeit unintentional, are detrimental to the learning environment and well-being of students. Although there are a few reports of medical schools training students to respond to microaggressions, none have included a complementery student-led faculty training module. The aim of this study was to develop and evaluate a case-based approach to improving student resilience and increasing faculty awareness of microaggressions in the clinical setting. We created four realistic cases of microaggressions and uncomfortable conversations, based on students' experiences on the wards, to implement training for incoming third-year students and their core faculty. Standardized patients were trained to effectively portray discriminatory faculty, residents, and patients. Institutional review board-approved surveys were administered and statistically analyzed to evaluate for efficacy. Students had greater mean confidence scores for responding to microaggressions immediately and at 6 months after the sessions (P < 0.05). Faculty showed improved mean confidence and understanding of the definition of a microaggression (P < 0.05). This approach had results similar to other studies, with the additional benefit of training faculty with the same scenarios. We believe that this method helped bridge the gap between students' notions of discrimination and faculty understanding of microaggressions.

Meta-Analyses of Glyphosate and Non-Hodgkin's Lymphoma: Expert Panel Conclusions and Recommendations

An expert panel was assembled to support a review of a series of recent publications using a modified Delphi format. These publications were scored based on a consideration of confidence in their methods, results, conclusions, and applicability to risk-based decision making. Mean confidence scores for the papers reviewed ranged from 53 to 74 (maximum score = 100), and key strengths and concerns were identified. This review highlights the need for transparency in meta-analyses.

Body Pose Estimation Integrated With Notational Analysis: A New Approach to Analyze Penalty Kicks Strategy in Elite Football.

Body orientation of football players has proven to be an informative resource related to successful penalty kicks. OpenPose is one of the most popular open-source pose estimation technologies. This study aims: (i) to verify whether OpenPose can detect relevant body orientation angles from video data of penalty kicks in elite football and (ii) to investigate the relationship between these body angles and observable behaviors analyzed via an observational system for penalty kick analysis in football (OSPAF) with the penalty taker and goalkeeper strategy. A total of 34 penalty videos, with standardized viewing angle, from the main European leagues (2017–2020) were analyzed. Relevant body orientation variables were selected for penalty kicks analysis and were extracted from video data through OpenPose technique. The OSPAF, previously validated by experts, was used. The mean confidence score of OpenPose measures was 0.80 ± 0.14. OpenPose Retest reliability values was 0.976 ± 0.03. Logistic regressions were performed to investigate the relationship between OpenPose investigated variables (penalty taker: shoulder, hips, and nonkicking foot orientation; goalkeeper: right and left foot, anticipation), observable behaviors (OSPAF variables), and the strategy (penalty taker: goalkeeper dependent or independent; goalkeeper: shooter dependent or independent) in penalty kicks. The selected body orientation angle (goalkeeper anticipation) measured through OpenPose correlated significantly with the goalkeeper strategy. The prediction model of the goalkeeper's strategy had its accuracy increased to 97% when the variable goalkeeper anticipation was included [ = 49.648, p < 0.001]. Lower degrees of goalkeeper anticipation, the goalkeeper tactical action (awaiting), and run up speed (slow) were associated with a kicker-dependent strategy. Regarding the penalty taker, the selected body angles measured through OpenPose did not associate significantly with the shooter strategy. Body orientation analysis by using OpenPose has shown sufficient reliability and provides practical applications for analyzing the strategies adopted by goalkeepers in penalty kicks in elite football.

Feasibility of Implementing a Food Skills Intervention

BackgroundFood skills are defined as meal planning, preparation, shopping, budgeting, resourcefulness, and label reading/consumer awareness. To date, food skills have not been tested in intervention-based studies. ObjectiveTo evaluate the feasibility of implementing a food skills intervention. DesignThis was an 8-week prospective food skills intervention. Study measures were completed through questionnaires provided before the start of the intervention and after the intervention was completed. For questionnaires, the web platform REDCap was used. Participants and settingThirty parents (aged 18 years or older) with at least one child (aged 2 to 12 years), attended weekly virtual intervention sessions via Zoom. The intervention took place from August to October 2020 with assessment measures collected within 2 months of the start and end date of the intervention. Participants were from the mid-Atlantic region of the United States InterventionA food skills intervention based on behavior modification strategies from the Social Cognitive Theory was implemented. Intervention goals included meal planning (six of seven dinner meals per week), meal plan implementation (at least four of six planned dinner meals), and always using a grocery list when shopping. Main outcome measuresFeasibility was evaluated based on parent attendance, number of self-monitoring booklets completed, adherence to goals, implementation fidelity, and qualitative responses to interviews. Change in food skills confidence and nutrition knowledge were also assessed. Statistical analysisDescriptive statistics and qualitative responses were used to describe feasibility. Paired t tests were used to evaluate change in food skills confidence and nutrition knowledge from baseline to 8 weeks. ResultsParents attended a mean of 7.6 ± 1.0 (out of eight) sessions and completed a mean of 6.2 ± 1.7 (out of seven) self-monitoring booklets. Parents planned a mean of 6.1 ± 1.5 dinners per week and implemented a mean of 4.7 ± 1.6 of the six planned dinners, achieving the intervention goals. Of the mean 1.2 ± 0.6 trips/week to the grocery store reported, grocery lists were used a mean of 1.1 ± 0.6 times. Mean food skills confidence score increased significantly from baseline to 8 weeks (baseline = 86.5 ± 18.0; 8 weeks = 101.4 ± 15.3; P < 0.001). Mean nutrition knowledge score also significantly increased (baseline = 64.1 ± 7.2; 8 weeks = 69.1 ± 6.6; P < 0.001). Parents reported on a scale of zero (“easy”) to 10 (“difficult”) a mean difficulty rating of 2.4 ± 2.4 for meal planning, a mean of 2.1 ± 2.1 for meal plan implementation, and a mean of 1.0 ± 1.7 for always using a grocery shopping list indicating acceptability of goals. ConclusionsFeasibility of a food skills intervention was demonstrated by high session attendance, high numbers of self-monitoring booklets turned in, high achievement of intervention goals, parent acceptability, and high ratings of implementation fidelity. There was an increase in food skill confidence and nutrition knowledge. Future research should examine the efficacy of changing food skill behaviors on dietary intake.

Assessing Vaccine Hesitancy Among Pediatric Healthcare Providers.

Vaccine compliance has fallen short of national and international targets, generating preventable disease outbreaks. While vaccine hesitancy in the general public is a factor in under-vaccination, vaccine hesitancy among healthcare providers remains an underrecognized obstacle to pediatric vaccine completion. The aim of this quality improvement study was to assess provider attitudes and practices regarding vaccine efficacy, safety, adverse effects, and recommendations. To assess for changes in their vaccine confidence, a convenience sample of three physicians and seven advanced practice registered nurses (APRNs) from a pediatric primary care clinic anonymously completed a self-administered survey, participated in an educational intervention, and then completed another survey. All eight providers denied personal vaccine hesitancy. However, one APRN did not fully vaccinate their child due to a medical exemption and another APRN reported concerns about influenza vaccine efficacy. While the mean confidence score for educating vaccine-hesitant parents increased from pre (8.75) to post intervention (9.13), the increase was not statistically significant. The pre-intervention survey affirmed the presence of parental vaccine hesitancy, but not provider vaccine hesitancy. Further study is needed to identify and address provider vaccine hesitancy to improve their vaccine confidence and, ultimately, pediatric vaccine completion.

Confidence and knowledge in emergency management among medical students across Colombia: A role for the WHO basic emergency care course.

Globally, medical students have demonstrated knowledge gaps in emergency care and acute stabilization. In Colombia, new graduates provide care for vulnerable populations. The World Health Organization (WHO) Basic Emergency Care (BEC) course trains frontline providers with limited resources in the management of acute illness and injury. While this course may serve medical students as adjunct to current curriculum, its utility in this learner group has not been investigated. This study performs a baseline assessment of knowledge and confidence in emergency management taught in the BEC amongst medical students in Colombia. A validated, cross-sectional survey assessing knowledge and confidence of emergency care congruent with BEC content was electronically administered to graduating medical students across Colombia. Knowledge was evaluated via 15 multiple choice questions and confidence via 13 questions using 100 mm visual analog scales. Mean knowledge and confidence scores were compared across demographics, geography and prior training using Chi-Squared or one-way ANOVA analyses. Data were gathered from 468 graduating medical students at 36 institutions. The mean knowledge score was 59.9% ± 23% (95% CI 57.8-62.0%); the mean confidence score was 59.6 mm ±16.7 mm (95% CI 58.1-61.2). Increasing knowledge and confidence scores were associated with prior completion of emergency management training courses (p<0.0001). Knowledge and confidence levels of emergency care management for graduating medical students across Colombia demonstrated room for additional, specialized training. Higher scores were seen in groups that had completed emergency care courses. Implementation of the BEC as an adjunct to current curriculum may serve a valuable addition.

The Effectiveness of Smartphones Video to Improve Skill Performance and Confidence of Student Nurses in Performing Hygiene Care

Self Confidence is a crucial component for students to achieve effective clinical performance. Lacking confidence may affect clinical skills performance which later can cause consequences in the safety of care delivered by the student nurses. This study proposes a method to use video on smartphones in teaching hygiene care nursing procedures. This study aimed to evaluate the effects of video of hygiene care on the skills and confidence of nursing students. The main contributions of video using smartphones have a great potential to provide clinical nursing education that is accessible, relevant, and supports patient safety. This study used a quasi-experimental, pre- test, and post-test design. Seventy-one students divide into thirty-six students in the control group and thirty-five students in the intervention group. The intervention group used a validated video on hygiene care on a smartphone, and the control group only used their nursing procedure book. Both groups were assessed for confidence level using the Confidence Scale and for the skill using Skill Performance Checklist as a pre-test. The same group of students were reassessed after a four-week intervention for post-test. Using descriptive analysis, independent t-test, and paired t-test. Pre-test confidence score, no significant difference in mean in both groups compared to a post-test confidence score. There is a substantial difference between the control and intervention groups. The mean confidence score between the pre-test and the post-test was significantly different (p &lt;0.001,95% CI of the mean difference (-10.038, -9.229). After the test, the total skill performance score improved from the total skill performance score before the test with a mean difference of -29.789. The mean Skill Performance Score before and after was significantly different (p &lt;0.001, 95% CI of the mean difference (-31.515, -28.063). The creation of video in the study serves as a roadmap for future research, particularly electronic learning in nursing education and other hospitals.

10 Introducing a Virtual Ward Round in Times of COVID-19

Many medical students feel unprepared for starting as FY1 doctors, and often report low confidence in taking responsibility for patients and working independently, and lack self-assurance in common FY1 skills, including assessing unwell patients and initiating management, task prioritization, referrals, documentation, ordering imaging and on-call shifts. These skills are developed during clinical placements; however, access to these opportunities during placements has diminished due to COVID-19 and concerns around patient safety. Simulation‐based teaching allows students to take responsibility and work within complex clinical environments without posing a risk to patients The aim of the study was to evaluate whether simulated mock ward rounds increase final-year medical students’ overall confidence and feeling of preparedness for starting as FY1 doctors.In total, 20 final-year medical students took part in the programme in two whole-day sessions. This was comprised of a simulated ward round of 10 patients. Students acted as FY1 doctors on the ward and carried out jobs, reviewed patients who deteriorated and had a number of tasks such as updating families, ordering radiology, initiating management and discharge summaries. Students’ confidence and preparedness was measured using pre- and post-course questionnaires. The questionnaires consisted of a 10‐point Likert scale for students to rate their confidence in key skills and overall preparedness for FY1 (1 = not at all confident, 10 = completely confident). These scores were matched and analysed using the Wilcoxon signed‐rank test. Additionally, there was blank spaces for feedback on the course which were analysed thematically.Pre- and post-course questionnaires demonstrated that students felt significantly more prepared for FY1 after the course (p &lt; 0.001). There was also a significant improvement in nine other domains deemed important for FY1 that students had reported low confidence in (see Figure 1). Qualitative data revealed that students appreciated the programme. They stated its superiority to other educational methods such as shadowing or didactic teaching sessions.Students mean confidence score in overall preparedness and key skills before and after the programme. P &lt; 0.001 for all domains.Simulated mock ward rounds can be used as an adjunct to clinical placements to increase medical students’ confidence about starting work, and to teach them valuable skills regularly utilized by FY1 doctors.

Effects of clinical practicum on nursing students' self-efficacy: Example of internal medicine wards.

To evaluate the effects of clinical practicum on nursing students' self-efficacy (perceptions of confidence and importance) in internal medicine wards and the factors affecting it. The single group pre-postdescriptive study was conducted with 134 final-year nursing students practicing in internal medicine wards. At the beginning of the practicum, the mean score of confidence and importance subscales were 3.72 ± 0.77 and 4.25 ± 0.57, respectively. At the end of the practicum, the mean score of confidence and importance subscales were 3.91 ± 0.70 and 4.81 ± 0.76, respectively. We found that there was a significant improvement in both subscales at the end of the practicum (p < 0.05). Clinical practicum positively affects students' self-efficacy in internal medicine wards.

Improving Patient Education for Atopic Dermatitis: A Randomized Controlled Trial of a Caregiver Handbook

To evaluate if an educational handbook could improve atopic dermatitis (AD) symptoms, caregiver confidence in AD management skills, and AD-related quality of life.In the study, researchers included children ages 1 month to 16 years with AD and their caregivers who had scheduled new or follow-up clinic appointments for the evaluation and management of AD at Boston Children’s Hospital. Inclusion criteria consisted of AD diagnosis confirmed by the health care provider during a clinic visit and an English-speaking caregiver.A randomized nonblinded controlled trial that was stratified to handbook and control arm. In the handbook arm, participants received a handbook in addition to standard AD care, versus only standard care in the control arm. Furthermore, each clinical program from which the participants was recruited was a separate randomization block. These clinical programs included allergy, dermatology, the Atopic Dermatitis Center (an interdisciplinary specialty clinic for AD), and primary care. All caregivers completed a self-reported questionnaire at baseline and a 3-month follow-up. After the baseline visit, the participants in the handbook arm were given a handbook and told to read it as a tool to help manage the child’s AD. The symptoms associated with AD were measured by using the Patient-Oriented Eczema Measure (POEM). POEM scores range from 0 (clear; no eczema) to 28 (severe eczema).A total of 245 patients from the ages of 3 months to 16 years were randomly assigned in this study. Of the total 245 randomly assigned patients, 175 caregivers completed questionnaires and were included in the repeated-measure analysis. There were 91 caregivers in the handbook arm and 84 in the control arm. The patients lost to follow-up were more likely to be African American or Hispanic (P < .14). The adjusted mean POEM score (±SD) decreased from 12.1 ± 9.9 to 7.7 ± 8.7 (difference: −4.4 [95% confidence interval (CI): −5.7 to −3.0]) in the handbook arm and 12 ± 10 to 8.6 ± 8.8 in the control arm (difference: −3.4 [95% CI: −4.8 to −2.0]; P = .343). Confidence scores (P = .093), infant quality of life (P = .944), child quality of life scores (P = .114), and family impact scores (P = .933) were not significant between time and study arm. The adjusted mean confidence score among new patients increased from 67 (95% CI: 60 to 74) to 83 (95% CI: 77 to 88) in the handbook arm, compared with 74 (95% CI: 65 to 82) to 75 (95% CI: 67 to 83) in the control arm (P = .012). Most of the caregivers found the handbook to be helpful.The use of the handbook did not significantly improve AD symptoms, when compared with standard care alone. Nonetheless, caregivers did find the handbook useful, and it may be especially useful to families managing a new diagnosis of AD.As health care providers, we often look for new and innovative ways to improve the care for our patients. Although, in this study, researchers did not find a significant difference in symptom or quality of life outcomes versus standard management, it is not to say another or modified tool would not have the desired impact. Consequently, the analysis of educational resources among various study populations and diseases should continue in an effort to improve overall management and health outcomes.

Nurses’ knowledge, practice and confidence about wound care based on the competency standards in 8 hospitals in Vietnam

Background: Wound Care (WC) plays a crucial role in patient care conducted by nurses. It directly affects treatment outcomes, especially when chronic or infected wounds remain a big challenge for WC specialists and requires huge medical recourses in wound care and treatment. Objectives: This research aimed to explore the actual situation of WC conducted by nurses to inform the development of a training program based on the Vietnam’s Basic Nursing Competency Standards (VNBNCS). Settings: Eight hospitals in Vietnam. Participants: 518 nurses directly performing WC. Design: Descriptive cross-sectional study. Methods: The study was implemented from June 2020 to October 2020, and the research indicators are nurses’ mean knowledge, practice, and confidence scores. The data collection tools included: 1) a self-administered questionnaire about nurses’ general characteristics (4 items) and WC knowledge (48 items), a WC evaluation checklist (16 items), and a self-administered questionnaire about their confidence in performing WC (12 items). Data were entered using EpiData 3.1 and analyzed with SPSS 16.0. A p&lt;0.05 was the level of significance. Results: The highest knowledge score of 1.67 ± 0.47 points was found in the item on clean WC. The highest practice score of 8.79 ± 1.20 points belonged to the item on in strict compliance with disinfection principles, compared to the lowest one of 7.58 ± 1.94 points found in the item on observing the patient’s post-WC reactions, such as pain and bleeding. Nurses who felt very confident in their bandage replacement skills formed 21.2% (110/518 nurses). Conclusion: Nurses had high mean knowledge and practice scores in all items, and nurses who were confident and highly confident in performing WC accounted for more than 50%. Keywords: nurse; wound; knowledge; practice; confidence.

Provider perspectives on communication and dismissal policies with HPV vaccine hesitant parents

Parental vaccine hesitancy is a growing concern. Less is known about provider or practice characteristics that encounter HPV-specific vaccine-hesitant parents, the providers’ confidence in responding to HPV vaccine concerns, and the attitudes and use of vaccine dismissal policies (i.e., removing patients from the practice). North Texas providers completed an online survey. Dependent variables assessed: (1) percentage of HPV vaccine-hesitant parents encountered in practice defined as substantive, or high (≥11%, or among more than one out of ten adolescent patient encounters) versus low (≤10%) levels; (2) confidence in responding to 11 HPV vaccine concerns; (3) attitudes and use of vaccine dismissal policies. Chi-square and Fisher’s exact tests were conducted. Among 156 providers, 29% reported high HPV vaccine hesitancy (≥11% of patient population). Overall, providers reported being “very confident” in addressing vaccine concerns (mean: 3.37 out of 4, SD: 0.57). Mean confidence scores were significantly higher for white (vs. non-white) providers and for pediatricians (vs. family practitioners). Providers were least confident in responding to parents’ religious/personal beliefs (69%). Some providers (25%) agreed with policies that dismissed vaccine-hesitant parents after repeated counseling attempts. More providers used dismissal policies for childhood (19%) than adolescent (10%) immunizations. Provider communication training should include parental religious/personal beliefs to effectively address HPV vaccine hesitancy. Other regions should examine their HPV-specific vaccine hesitancy levels to understand how the use of dismissal policies might vary between adolescent and childhood immunizations.

MP47-10 PEDIATRIC UROLOGISTS' ASSESSMENT AND MANAGEMENT OF PEDIATRIC PENILE CURVATURE

You have accessJournal of UrologyPediatric Urology III (MP47)1 Sep 2021MP47-10 PEDIATRIC UROLOGISTS' ASSESSMENT AND MANAGEMENT OF PEDIATRIC PENILE CURVATURE Mei Tuong, Anthony Herndon, Carlos Villanueva, Patricio Gargollo, Andrew Winkelman, and Nora Kern Mei TuongMei Tuong More articles by this author , Anthony Herndon Anthony Herndon More articles by this author , Carlos VillanuevaCarlos Villanueva More articles by this author , Patricio GargolloPatricio Gargollo More articles by this author , Andrew WinkelmanAndrew Winkelman More articles by this author , and Nora KernNora Kern More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002068.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Method for correction of pediatric penile curvature (PC) usually is dependent on degree of PC which is reliant on how degree is assessed. We sought to assess the confidence and accuracy of measuring PC and hence management using case-based examples. METHODS: An email survey was sent to 355 active members of the Societies of Pediatric Urology. The survey consisted of case scenarios and assessed the management technique and confidence in ability to measure PC. RESULTS: The response rate was 30% (108/355); 97% were fellowship trained. 75% worked in an academic institution, and 50% had greater than 20 years of experience. A Likert scale from 1-5 measured provider confidence on estimating PC; the mean confidence score was 3.6±0.8 (3-fairly confident; 4-very confident). In clinic, 89% of providers used eyeball estimates to assess PC; 5% used both eyeball and goniometer. In the operating room, 71% used eyeball estimates, 8% used goniometer, and 16% used both. If sole decision-maker, providers recommend surgical correction of PC over observation at median 30° (IQR 21-30°). At a median of 45°, there was a shift in corrective surgical preference from dorsal plication (DP) (IQR 30-54°) to ventral lengthening (VL) (IQR 34-60°). See Table 1. Providers underestimated PC degree for all cases. In case 1, only 24% of providers would correct a mean estimate of 23° PC; those who would correct had a higher mean PC estimate vs those who would not (28° vs 21°, p<0.001). Case 2 and 4 had similar estimations and correction methods. In case 2, those who chose VL had a higher mean PC estimate vs those who did not (43° vs 37°, p<0.01), but no estimate difference was seen for DP (p=0.52). In case 4 with lateral PC, those who chose DP had a higher mean PC estimate vs those who did not (41° vs 33°, p=0.049). Yet in case 3, there was no difference in PC estimate in providers who chose VL vs not (57° vs 53°, p=0.16). For all cases, there was no association between provider years in practice or confidence level on estimated PC degree. CONCLUSIONS: A uniform underestimation of PC exists despite provider reported confidence in the ability to measure PC. An increasing willingness to perform surgical correction was demonstrated with a shift towards VL for ventral curvature and less so for lateral curvature as PC worsens. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e826-e827 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mei Tuong More articles by this author Anthony Herndon More articles by this author Carlos Villanueva More articles by this author Patricio Gargollo More articles by this author Andrew Winkelman More articles by this author Nora Kern More articles by this author Expand All Advertisement Loading ...

Training Program for Ultrasound-Guided Intravenous Catheter Insertion.

Ultrasound guidance is now widely available in military treatment facilities and civilian hospitals alike, both in the USA and in forward-deployed military environments. Technical mastery of ultrasound-guided peripheral intravenous (USGPIV) catheter insertion can be easily achieved through a short training course. Mastery can be achieved even when trainees have a limited medical background before course attendance. An evidence-based practice project team sought to improve the knowledge, confidence, and skills in the placement of USGPIV catheters by clinicians at Naval Hospital Jacksonville. Completion of an USGPIV training program can equip healthcare providers with knowledge and confidence for placement of peripheral access necessary in critical situations such as those requiring medications or blood products. The project team conducted a literature review to evaluate the appropriateness of USGPIV training for the nurses and military medical technicians in this setting. The team developed and delivered a USGPIV training program based on adaptations from the literature. During the training period, knowledge and confidence scores were reported by each trainee to evaluate the perceptions of the quality of training. The number of attempted catheter placements and ultrasound utilization was recorded in the pre- and post-implementation periods to evaluate the project's effect on the delivery of patient care. Statistical analysis was conducted to evaluate project outcomes. In the pre-intervention period, none of the 252 intravenous catheters were placed with the USGPIV technique, compared to 50 of 267 in the post-intervention period. These results demonstrate an 18.7% increase in the USGPIV access approach by nursing staff. Mean knowledge scores significantly increased following the delivery of the training, 60% versus 80% in the pre- and post-training assessments, respectively (P < .001). Mean self-reported skill confidence scores also significantly improved (P < .001). Knowledge and self-reported confidence in USGPIV access improved for the trainees. Mean knowledge improved from 60% to 80%, while mean confidence scores increased from 2.74 to 3.79 for corpsman and from 3.0 to 3.88 for nurses. Utilization of the USGPIV technique increased by 18.7% in the post-intervention period. These results demonstrate that implementing this training program can improve knowledge, confidence, and use of ultrasound during the placement of PIV catheters.

The impact of the Dental Practicality Index on treatment planning.

Aim To compare the treatment planning decisions made by undergraduate and postgraduate dental students before and after training on the use of the Dental Practicality Index (DPI).Methodology One hundred and eight undergraduate and postgraduate dental students were randomly assigned to test (DPI) or control groups. The baseline knowledge was assessed in the first session; both groups were shown 15 clinical scenarios and asked to assign one of four treatment plan options (no treatment, simple treatment, complex treatment or extract). The most appropriate treatment plan had been agreed by a consensus panel of experienced dentists. The test group was then trained on the use of the DPI. In the second session, both groups were shown the same clinical scenarios again in a different order and asked to assign one of the four treatment plan options. Both groups completed the confidence questionnaire.Results Training with the DPI improved the test (DPI) group mean scores from 9.1 in the first session to 10.3 out of 15 in the second session, which was a statistically significant difference (p = 0.005) when compared to the control group mean scores of 8.9 in the first session to 9.2 out of 15 in the second session. The mean confidence score of the students was 6.5 out of 10. There was no correlation between self-reported confidence scores of the students and the treatment planning result scores.Conclusions The DPI aids in the systematic assessment and appropriate treatment planning of dental restorative problems by dental students.

Expanding a single‑lead mobile electrocardiographic device to multiple‑lead recordings improves diagnostic accuracy and confidence

BackgroundMobile electrocardiographic (mECG) devices that record ECG lead I have been used to detect atrial fibrillation. Other arrhythmias may not be readily diagnosed with one lead. Obtaining multi‑lead tracings from an mECG (MLmECG) to simulate a 12‑lead ECG may lead to more accurate diagnoses. MethodsWe developed a method to generate multi‑lead ECGs using a mECG device by attaching it with alligator clips connected to an insulated copper wire to adhesive electrodes on the patient's limbs and torso according to standard lead configurations. Different rhythm and conduction abnormalities from a sample of inpatients were collected. Arrhythmias were recorded in three ways (single lead, MLmECG, and standard 12‑lead) and grouped by category. Recordings were sent to cardiology fellows in the form of a multiple choice survey. Participants were asked for their diagnosis and confidence in their decision. ResultsSurvey response rate was 100%. Single‑lead, MLmECG, and 12‑lead yielded 48.2%, 81.6%, and 88.6% of agreement with the correct diagnosis, respectively (single‑lead vs. MLmECG or 12‑lead; p < 0.01). Overall mean confidence scores were 3.34, 4.35, and 4.53 out of 5, for single‑lead, MLmECG, and 12‑lead ECG, respectively (single‑lead vs. MLmECG or 12‑lead; p < 0.01, MLmECG vs. 12‑lead; p = 0.09). ConclusionThe diagnostic accuracy of MLmECGs were similar to that of a standard 12‑lead ECG. Fellows' confidence in their diagnosis were similar between MLmECG or 12‑lead ECG, and higher with both modalities compared to a single‑lead tracing. The ability to recreate, as fully as possible, a standard 12‑lead ECG is a reasonable goal for mobile technology.

A Feasibility Study to Direct System Level Change for Hospital Patients With Alcohol Use Disorder

The purpose of this feasibility study was to make system level change using motivational interviewing (MI), tailored discharge education, and electronic medical record (EMR) flow sheet intervention in patients with alcohol use disorder (AUD). Alcohol is known to be one of the most commonly misused addictive substances. It is a feasibility study with a descriptive exploratory design of an intervention with MI, tailored discharge education, and EMR flow sheet documentation. Participants were patients with AUD chosen over 3 months from two medical surgical floors. Instruments used were the readiness and confidence rulers (reliability/validity = .84 and .77, respectively). Analysis included descriptive statistics, estimation of effect size, and hypothesis generation. Of 14 participants, EMR flow sheet documentation was completed and the mean post readiness and confidence scores were 8.86 (1.167) and 8.07 (1.639), respectively. The pre/post confidence scores were statistically significant (p = .095) using the .10 significance level, indicating the intervention was effective in raising the confidence level for behavior change. High scores indicated patients were in contemplation and intending to change. Seven scores increased postintervention suggesting a future hypothesis that MI, tailored education, and EMR flow sheet documentation intervention is feasible for patients with AUD contemplating change in the near future.

Education in youth-friendly genetic counseling.

Genetic counselors have long recognized the challenges of working with adolescents and young adults (AYA) and their families. In 2010, a framework of Youth-friendly Genetic Counseling was developed by an expert reference group with the aim to improve both care for AYAs and the experience of health professionals delivering that care. Subsequently, an education workshop was developed aimed to upskill genetic health professionals in youth-friendly genetic counseling. The workshop was piloted with genetic counselors in Australia and New Zealand. A purpose designed, pre- and post-workshop survey and post-workshop focus group was utilized for evaluation. Mean confidence scores increased pre- and post-workshop. Participants also demonstrated increases in knowledge regarding: adolescent development; developmental theory; social factors impacting on health; the needs of young people; practice challenges; youth-friendly engagement, communication, consent and confidentiality; practice approaches; principles of adolescent healthcare; ethical issues; and available services and resources. Focus group data revealed several themes relating to practice challenges, learning gains, barriers, and enablers to clinical translation and workshop feedback. Results demonstrate utility of the workshop in up-skilling genetic health professionals in the provision of youth-friendly genetic counseling. Consideration of adaptation and sustainability, by embedding this theoretical and skills-based workshop as a module within genetic counseling education, is required to ensure practice competence and the best health outcomes for young people and their families.

Treating Withdrawal and Pain in Inpatients With Opioid Use Disorder: A Brief Educational Intervention for Internal Medicine Residents.

IntroductionDespite the effectiveness of opioid agonist therapy (OAT) for treating patients with opioid use disorder (OUD), insufficient education remains a barrier to prescribing. Internal medicine (IM) residents are optimally positioned to facilitate use of OAT, especially in the inpatient setting. We implemented an educational intervention aimed at increasing IM residents' knowledge and confidence regarding prescribing OAT to inpatients with OUD.MethodsWe created a 35-minute, case-based presentation highlighting the management of opioid withdrawal using OAT and treating pain in inpatients on maintenance OAT. It was presented to IM residents beginning their general medicine ward rotations from November 2019 through January 2020. We developed a survey to measure participants' knowledge (mean number of questions correct out of five) and confidence (mean Likert-scale score, 1 = Not at all confident, 5 = Extremely confident, on each of five items) regarding prescribing OAT in the inpatient setting. We compared knowledge and confidence before versus 1 month after the intervention using paired Student t tests, with p < .05 indicating significance.ResultsOf 103 unique residents completing ward rotations, 29 (28%) completed both the pre- and 1-month postsurveys and were included in the analysis. The mean number of knowledge questions correct increased from 3.1 pre- to 4.3 postintervention, and mean confidence scores increased from below 2 pre- to over 3 postintervention in four of five items (ps < .001).DiscussionA brief, generalizable, educational intervention significantly increased residents' knowledge of and confidence in prescribing OAT in inpatients with OUD.

Sterile Compounding Knowledge, Skills, and Confidence Among Graduating Doctor of Pharmacy Students

Objective. To determine whether the exposure to sterile compounding in the pharmacy curriculum produces Doctor of Pharmacy graduates who are both competent and confident in the area of sterile compounding, and to identify additional variables that may predict student performance.Methods. Participants were recruited from the fourth-year pharmacy class of 2018 at one university. The students were asked to complete a questionnaire assessing the following domains: demographics, confidence in compounding performance, prior experience, and theoretical knowledge. A written assessment was followed by a faculty-evaluated practicum in which the students were required to prepare two sterile products using a standardized rubric. Results were analyzed with a Student t test and linear regression to determine differences in performance based upon prior experience, confidence, and theoretical knowledge.Results. Overall, the 158 students performed well on the knowledge and skill examination, achieving an average total score of 89.8%. Of the 158 total participants, the 122 survey respondents had an overall mean confidence score of 2.9 on a four-point Likert scale, with 40.2% of students scoring in the confident or very confident range of the survey. In our analysis, we found that neither prior compounding experience or self-rated confidence were predictive of students' total score.Conclusion. The results of this study suggest that the inclusion of sterile compounding education and training in all four years of the pharmacy curriculum produces PharmD graduates who are competent, with varying levels of confidence in the area of sterile compounding.