Mixed Methods Research Study Research Articles

My back: co-designing municipal rehabilitation with and for individuals with long-lasting back problems: study protocol

BackgroundIn Denmark, the organization and content of rehabilitation for people with back problems vary by municipality. Furthermore, there is no systematic evaluation of the overall effect and quality of municipal rehabilitation efforts. Since individuals with long-lasting back problems often receive multiple interventions delivered by various professionals, departments, and sectors, a coordinated effort is essential within complex systems, like municipal organizations. Therefore, the Municipality of Svendborg, the University of Southern Denmark, and UCL University College aim to co-design an improved municipal rehabilitation program with and for individuals with back problems, within the existing municipal context. The new practices developed in the program seek to better support individuals to manage everyday life with back problems, develop effective rehabilitation practices, and decrease the associated municipal costs.MethodsMy Back is a mixed-method research study, utilizing a Plan-Do-Study-Act (PDSA) approach to ensure iterative development and continuous improvement of municipal rehabilitation practices. This study is structured into several work packages (WPs) that focus on identifying experiences (WP 1), mapping current practices (WP 2), summarizing relevant literature (WP 3), conducting co-design workshops (WP 4), and the development and implementation of new rehabilitation practices via PDSA cycles (WP 5). These WPs will inform the development and implementation of new rehabilitation practices, which will be evaluated for quality and effectiveness (WP 6), and system-level changes (WP 7), followed by dissemination of results (WP 8).DiscussionThrough a local co-design process involving individuals with back problems, municipal professionals, and leaders, we expect strong relevance and engagement, ensuring successful implementation. The new practices aim to better support people with back problems to manage everyday life through improved rehabilitation and interdisciplinary collaboration among municipal social and health professionals. A platform model for monitoring local rehabilitation will be introduced to evaluate workability and economic implications within the target population. The knowledge and results from this study can be disseminated and adapted to public contexts throughout Denmark and potentially other countries with similar municipal healthcare structures. Sharing best practices and lessons learned from the implementation process can inform rehabilitation practices in different international settings.

Alienation and/or anomie in pharmacists: a protocol for a narrative systematic review

IntroductionEpisodes of alienation and/or anomie in pharmacists have been reported in historical accounts since the 19th century. Alienation and anomie are distinct types of psychological or social ills where people...

Preparing Compassionate Nurses: Infusing School Mission and Values in Undergraduate Education.

In preparation for a curriculum revision, a cross-sectional, descriptive mixed-method research study sought to describe senior-level students' perspectives of Mercy and Jesuit faith-based tradition values integration in a pre-licensure BSN program. Integration of values was examined in both clinical settings and didactic classes. Students strongly articulated the importance of the school's values and mission to their future role as professional nurses. However, although value integration is occurring, greater attention to mission and values is needed in the clinical area.

Integration in Mixed Methods Research With an Exemplar Explanatory Sequential Study.

Integration-a hallmark of mixed methods research (MMR)-is crucial throughout the entire research process. Despite its importance, integration remains an elusive concept often inadequately addressed by researchers, with many publications focusing solely on the final stages of data analysis and interpretation. The authors aim to synthesize methodologic discussions of the mixed method research integration process and provide an illustration of integration across all phases of an exemplar explanatory sequential study. Integration in MMR includes four distinct dimensions encompassing philosophical assumptions and paradigms, methodological methods, and dissemination of integrated study findings. This paper presents our integrated study findings, illustrated by a research study conducted to investigate sleep health among women with breast cancer. Integration of quantitative and qualitative data analyses is demonstrated through consistently matching the guiding paradigm with design choice, meta-inferences, and visual joint displays. The connecting displays linking quantitative and qualitative data, compare sleep characteristics scores, and the relationship between anxiety and vasomotor symptoms. The results highlight the significance of visual tools in enhancing the analytic processes and providing a comprehensive understanding of complex clinical phenomena. Integrating across all stages of mixed method research studies presents many challenges. The proposed four-dimension model of integration contributes to understanding the unique value of fully integrated mixed methods results. The exemplary study findings confirm the value of integration in achieving a nuanced and comprehensive understanding of a significant clinical problem.

Validation Study of a Nursing Education and Competency Tool.

Distinguishing competency and education in clinical healthcare education is complex. The NYU Langone Health Nursing Education and Competency Algorithm (NE-CA) was developed as a tool for competency identification and sustainment. A mixed-methods design national research study was employed to evaluate the validity of the NE-CA. Findings of the study support the utilization of the NE-CA tool by expert clinical nurse educators, professional nurses, and organizations in structures and processes guiding competency in clinical education.

Navigating the food environment: Experiences of reduced calorie interventions to manage Type 2 Diabetes Mellitus.

Research into achieving Type 2 Diabetes Mellitus remission through weight loss efforts has grown steadily in the past decade. Most of this research has focused on the effectiveness of weight loss as a method to achieve remission, rather than considering individuals experiences of engaging with such change. This paper aims to review the qualitative research on individuals' experience of proposed dietary modifications with a weight loss focus. Six databases were searched for qualitative and mixed-methods research studies, and studies were subject to analysis following Thomas and Hardin's guidelines. The search yielded 2945 results, of which 47 were reviewed in full, and nine were included for analysis. Four analytical themes were identified; variability in support; choosing dietary change; re-negotiating the food relationship; and looking beyond weight loss. Providing tailored nutritional information that is comprehensible and culturally appropriate must be the premise of the interventions offered. Supporting patients to understand their relationship with food and identify meaningful goals beyond weight loss is an important starting point.

Advancing language learning: The impact and challenges of Computer-Assisted Language Learning (CALL)

Abstract. Computer-Assisted Language Learning (CALL) represents a transformative approach in modern education, integrating technology to enhance language acquisition effectively. This comprehensive review examines the various dimensions of CALL, focusing on its deployment through interactive software, online courses, mobile applications, and the accompanying challenges. Quantitative analyses reveal significant improvements in learner engagement and cognitive load management due to multimedia and interactive content. Moreover, the adaptability of CALL to cater to individual learning needs through personalized and adaptive learning systems demonstrates a superior proficiency acquisition rate. Despite these advancements, CALL implementation faces substantial barriers including technological limitations, the need for extensive teacher training, and concerns regarding data privacy and security. This article assesses the statistical impact of these elements on language learning outcomes and suggests strategies for overcoming the associated challenges. Through mixed-methods research and longitudinal studies, the effectiveness of CALL platforms is substantiated, highlighting their pivotal role in reshaping language education across diverse demographic and geographic spectrums.

Knowledge, attitudes and practices of the healthcare staff and students about disposal of unwanted medications: a systematic review

Abstract Introduction Improper disposal of medications poses a significant environmental risk on the ecosystems and human beings1. When medicines are discarded by flushing them down the toilet or throwing them in the household trash, their active components may leak into the water supply2. Aim This systematic review seeks to compile studies that examine healthcare professionals' and students' knowledge, attitudes, and practices (KAP) regarding medication disposal. It also aims to explore recommendations and barriers related to appropriate medication disposal. Methods A systematic review was conducted by adhering to guidelines outlined in Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 and the Joanna Briggs Institute. The primary outcome is to measure the levels of the healthcare staff and students' knowledge, as well as their attitudes, and practices about disposal of unwanted medications. Authors included qualitative, quantitative, and mixed-method primary research studies. Participants included pharmacists, doctors, nurses, and both undergraduate and postgraduate medical, pharmacy, and nursing students due to their significant involvement with medication and its disposal in healthcare settings. Data extraction was conducted by four of the researchers independently. The study details were categorised into three main domains i.e., knowledge, attitude, and practice using the KAP model. Other relevant information was also extracted, thematically, such as challenges and recommendations. Ethical approval was not required as this systematic review used previously published data. Results 37 studies from 18 countries (21 from Asia, 7 from the US, 5 from Africa, and 2 each from the EU and South America) met the inclusion criteria. 86.5% (n=32) investigated participants' knowledge of medication disposal. Although there is a good level of awareness about the environmental impacts, there are significant gaps in knowledge regarding correct disposal methods, available services, guidelines, and training. 30 studies explored participants' attitudes toward medication disposal. The results indicate a generally positive attitude towards the need for environmentally safe disposal practices. 35 studies evaluated participants' practices in relation to medication disposal. Although there was generally a positive attitude and some understanding of appropriate disposal methods, majority of the participants do not follow the practice guidelines, especially outside healthcare settings. This inconsistency may be due to numerous factors such as inadequate practical training, limited resources, or unclear guidelines. Discussion/ Conclusion Overall, it was found that while healthcare staff and students have fair knowledge and positive attitudes toward medicine disposal, their actual practices are lacking. One significant challenge identified is the limited awareness about proper disposal methods coupled with a lack of established services or guidelines in many regions. Even in cases where take-back programs are available, they often face issues with accessibility. To tackle these challenges, it is suggested by the studies that governmental bodies should establish and enforce clear policies on medication disposal while also expanding educational initiatives to increase understanding among healthcare professionals and students about appropriate disposal methods. Furthermore, improving access to take-back programs is crucial for ensuring safe medication disposal and minimising potential environmental and health hazards.

A study of the enablers and barriers to the collection of sociodemographic data by public health units in Ontario, Canada during the COVID-19 pandemic

BackgroundCollection and use of sociodemographic data (SDD), including race, ethnicity and income, are foundational to understanding health inequities. Ontario’s public health units collected SDD as part of COVID-19 case management and vaccination activities. This research aimed to identify enablers and barriers to collecting SDD during COVID-19 case management and vaccination.MethodsAs part of a larger mixed-method research study [1], qualitative methods were used to identify enablers and barriers to SDD collection during the COVID-19 pandemic. Purposive sampling was used to recruit participants from Ontario’s 34 public health units. Sixteen focus groups and eight interviews were conducted virtually using Zoom. Interview data were transcribed and analyzed using inductive and deductive qualitative description.ResultsSDD collection enablers included: legally mandating SDD collection and having dedicated data systems, technological and legal supports, senior management championing SDD collection, establishing rapport and trust between staff and clients, and gaining insight from the experiences from local communities and other jurisdictions. Identified barriers to SDD collection included: provincial data systems being perceived as lacking user-friendliness, SDD collection “was not a priority,” time and other constraints on building staff and client rapport, and perceived discomfort with asking and answering personal SDD questions.ConclusionA combination of provincial and local organizational strategies including supportive data systems, training, and frameworks for data collection and use, are needed to normalize and scale up SDD collection by local health units beyond the context of the COVID-19 pandemic.

Building patient safety culture by using interprofessional simulation with nursing, paramedic and emergency telecommunication students: A mixed-methods research study

AimThe aim of this study was to investigate student attitudes toward interprofessional education and collaborative practice and their perceptions of simulation design elements after participating in an interprofessional simulation educational activity. BackgroundPatient safety continues to be an international healthcare priority. However, critical incidents to patients continue to persist due to poor communication between professionals and poor teamwork. DesignA mixed methods design. MethodThe study sample consisted of Bachelor of Nursing (n=81), Paramedic (n=38) and Emergency Telecommunication (n=11) students randomized into interprofessional groups. Following the interprofessional learning experience, students completed two standardized self-reporting instruments, Students Perceptions of Interprofessional Clinical Education, National League for Nursing Simulation Design Scale and open-ended questions of their perceptions on teamwork and collaboration, communication skills, transfer of care and patient safety. ResultsStudents in each program reported high scores for attitudes toward the importance of teamwork and collaborative practice. There were significant differences in scores between programs for the ranking factors ‘Teamwork and Team-Based Practice’ (BN=4.74 SD 0.72, PM=4.66 SD 0.81, ET=4.95 SD 0.15 *; p = 0.00005) and ‘Roles & Responsibilities’ (BN=3.78 SD 1.12, PM=3.55 SD 0.92, ET=4.67 SD 0.85*; p= 0.012). Themes included: communication and collaboration in teamwork; roles, responsibilities and leadership; patient-centred care and safety; and emotional dynamics and professional growth. ConclusionAn interprofessional simulation is an effective strategy to practice teamwork and collaboration and communication skills during transfer of care. Ensuring earlier education of roles and responsibilities during transfer of care needs review as do strategies for structured handover communication tools.

An exploration of the Return to Practice experience of nursing students: An evaluative mixed methods research study

AimThis study was conducted to explore the experiences of nursing students on a Return to Practice course; including their confidence levels and intention to remain on the nursing register. BackgroundNurses and midwives whose registration with the NMC (Nursing & Midwifery Council) has lapsed may choose to undertake a Return to Practice course. This course enables those who have left the profession to update their skills and knowledge and to re-join the register. Currently, little information exists concerning the experience of returners as they prepare to re-enter the nursing workforce. DesignExploring the confidence levels and preparedness of Return to Practice nursing students and measuring the effectiveness of a Return to Practice course using an online questionnaire. MethodsMixed methods research design was used to address the evaluative research questions. An anonymous questionnaire was administered online to collect quantitative and qualitative data reflecting the experiences of the Return to Practice nursing students. ResultsReturn to Practice nursing students feel well prepared by their Return to Practice course and report a high level of confidence in returning to the clinical workforce. ConclusionsDespite their concerns around aspects of nursing, such as the highly pressured working environment, most Return to Practice students intend to continue as a nurse for the remainder of their careers and should therefore be supported with this route into the nursing profession.

A THEORETICAL MODEL OF STUDENT LEARNING IN AN ACADEMIC SERVICE-LEARNING COURSE: DIVERSITY AND CIVIC OUTCOMES

A qualitative-quantitative mixed-methods longitudinal research study was conducted to measure differences in civic and diversity outcomes in a cross-sectional sample of 138 undergraduate students. The quantitative results indicate that students improve their social justice attitudes, awareness of White racial privilege, racial-cultural-ethnic identity, and interests in multicultural work from the beginning of the semester. The qualitative findings replicate and extend the quantitative results. Career development and opportunities for growth were detected as unexpected themes that emerged from the data. The use of the mixed-methods approach provided an opportunity to conceptualize how students reformulate their diversity attitudes and acquire civic skills in an academic service-learning course. Implications for teaching and learning are discussed.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0799/a.php" alt="Hit counter" /></p>

Talk to Me: A social media campaign about clinical trials tailored to the needs of young adults with cancer.

67 Background: Among adolescents and young adults (AYAs; 15-39 years) with cancer, clinical trial enrollment (CTE) rates range from 3% to 14%. Patient-directed interventions to improve CTE are rare. Internet-based interventions, while feasible and acceptable to AYAs with cancer, often lack patient input and engagement that are critical to success. AYAs are digital natives and report that the internet and social media are the two most important sources of health-related information. We leveraged AYA engagement with social media and designed a mixed methods research study, "Talk to Me," to create targeted social media messages to increase awareness about CTE for AYAs with cancer. Methods: Our interdisciplinary study team includes clinicians, researchers, health educators, and AYA patient advocates. We conducted 5 focus groups among a demographically, clinically, and geographically diverse group of AYAs with cancer (n=35) to identify priority topics to 1) inform the development of social media message libraries to address informational gaps and dispel myths surrounding CTE and 2) guide implementation strategies of these messages. Design mock-ups and color palettes were co-designed and co-developed with focus group participants and patient advocates through iterative feedback. Results: Guided by qualitative findings, social media posts were categorized into "introduction", "knowledge dissemination", and "addressing social, cultural, emotional, and financial issues" related to CTE. Instagram was selected to host our messages as the demographics of users most closely matched that of our target audience. Hashtags were carefully chosen based on existing posts of related material on Instagram. Links to trusted sources for additional information were embedded in the post descriptions and housed in a linktr.ee bio-landing page. The campaign was officially launched on Instagram in April 2024. We posted 3 times a week in both English and Spanish and monitored metrics biweekly to assess engagement and reach. Over nearly 2 months, 42 messages were posted, 116 users followed the account, 656 accounts were reached, 108 accounts were engaged, and 432 visited our profile page. Engagement peaked in Week 2 with 238 accounts reached and in Week 6 with 119. Overall, there were 173 likes (English=128, Spanish=43). Conclusions: An interdisciplinary, patient-informed, iterative approach to developing a social media knowledge intervention demonstrates a robust, methodologic approach to developing acceptable information and messages for AYAs who may consider participating in clinical trials.

Feasibility, Acceptability, and Appropriate Use of Novel and Lesser-Used Medicines for Prevention and Treatment of Postpartum Hemorrhage: Evidence from Implementation Research.

Maternal mortality remains one of the primary global health challenges of the 21st century, despite major medical advances in the field. Although solutions are available, inequities determine where mothers die, with the majority of maternal deaths occurring in low- and middle-income countries (LMICs). More than one-third of maternal deaths are related to obstetric hemorrhage and most commonly postpartum hemorrhage (PPH). Effective, quality-assured uterotonics significantly reduce PPH-related morbidity and mortality. Updated World Health Organization (WHO) recommendations on uterotonics used for PPH prevention include the addition of heat-stable carbetocin (HSC) to the suite of prophylactic uterotonic agents as well as the use of tranexamic acid (TXA) for PPH treatment. Both medicines are promising interventions in obstetric care. However, the introduction of these medicines faces numerous challenges to end-user access, such as decentralized procurement, time-consuming policy updates, market access barriers, lack of demand for quality-assured products, and inadequate systematic training and information provision, impeding access in many LMICs. Assessing the feasibility and acceptability of implementing these medicines in different resource settings can help bridge the gap between research and development to policy and practice, in an effort to reduce the significant health inequities facing women accessing the public health sector for quality care during labor and delivery. In this Special Collection, we explore the findings from mixed-methods implementation research studies in nine LMICs which support the acceptability and feasibility of HSC and TXA administration by healthcare providers, generating evidence to help inform the introduction and scale-up of these new and lesser-utilized PPH medicines.

A clinical decision support tool for metabolic dysfunction-associated steatohepatitis in real-world clinical settings: a mixed-method implementation research study protocol.

Aim: A clinical decision support (CDS) tool for metabolic dysfunction-associated steatohepatitis (MASH) was developed to align health systems with clinical guidelines detailed in the MASH Clinical Care Pathway and improve patients' proactive self-management of their disease. The tool includes a provider-facing web-based application and a mobile application (app) for patients. This protocol outlines a pilot study that will systematically evaluate the implementation of the tool in real-world clinical practice settings. Materials & methods: This implementation research study will use a simultaneous mixed-methods design and is guided by the Consolidated Framework for Implementation Research. The CDS tool for MASH will be piloted for ≥3months at multiple US-based sites with eligible gastroenterologists and hepatologists (n=5-10 per site) and their patients (n=50-100 per site) with MASH or suspected MASH. Each pilot site may choose one or all focus areas within the tool (i.e., risk stratification, screening and referral, or patient care management), based on on-site capabilities. Prior to and at the end of the pilot period, providers and patients will complete quantitative surveys and partake in semi-structured interviews. Outcomes will include understanding the feasibility of implementing the tool in real-world clinical settings, its effectiveness in increasing patient screenings and risk stratification for MASH, its ability to improve provider and patient knowledge of MASH, barriers to adoption of the tool and the tool's capacity to enhance patient engagement and satisfaction with their care. Conclusion: Findings will inform the scalable implementation of the tool to ensure patients at risk for MASH are identified early, referred to specialty care when necessary and managed appropriately. Successful integration of the patient app can contribute to better health outcomes for patients by facilitating their active participation in the management of their condition.

English Learning Strategies and Proficiency Level: Grade 11 Students’ Perspective in the Post-Pandemic Era

Abstract — This mixed method research study sought to assess the English learning strategies vis-à-vis proficiency level of Grade 11 students of a public high school for S.Y. 2023-2024. This research made use of a survey questionnaire and interview guide in a form of open-ended questions in gathering the necessary data. There were 21 respondents who participated in the 1st part of the data gathering and 10 were selected to participate in the interview session for the 2nd part. Statistical tools for data analysis included weighted mean, percentage distribution, and frequency count. Results revealed that most respondents were on their appropriate age to be admitted in the grade level in accordance to the K-12 program and majority were females. In terms of English learning strategies, it was found out that respondents had an acceptable result to both cognitive and metacognitive and when taken as a whole garnering a weighted mean verbally interpreted as agree. Meanwhile, students’ level of English proficiency in terms of Synonyms, Antonyms, Single-Word Analogy, Double-Word Analogy, Identifying Errors, Correct Usage, and Reading Comprehension and when taken as a whole obtained a mean score verbally interpreted as did not meet expectation. The findings highlighted the dynamic and evolving nature of language acquisition, where strategies employed by learners play a crucial role in shaping their journey towards linguistic mastery. Thus, it is recommended that teachers must look on the other factors regardless of being internal or external that may influence students’ capacity in learning English.

The Utilisation of Islamic Integrated Science Comics to Teach Primary School Students about Reuse and Recycling

Despite implementing innovative instructional techniques, many students struggle to understand science topics. This mixed-method and action research study explored the effectiveness of Islamic integrated science comics in enhancing students' comprehension and performance on the topic of 'reuse and recycle,' a challenging area for most students. The study involved 50 Year 3 Bruneian primary school students and used quantitative and qualitative data collection methods. A Wilcoxon signed-rank test revealed significant improvements in students' post-test scores compared to their pre-test scores, demonstrating the intervention's success. Interviews with students further supported these findings, as they described the comic-based lessons as enjoyable and collaborative. The results suggest that integrating Islamic themes into science comics significantly improves students' understanding and application of scientific knowledge. This approach makes learning more engaging and aligns with students' cultural and religious contexts, thereby providing a more holistic educational experience. The study's findings have important implications for educators seeking to enhance science education in similar contexts.

Building Public Health Workforce Capacity: Longer-Term Effectiveness of a Capacity Building Intervention to Improve Community-Based Public Health Prevention Work

Objective: There is an urgent need to build capacity among existing and incoming public health workers to enhance community-based work focused on prevention and health promotion. Public Health Essentials (PHE), a cohort-based facilitated asynchronous online capacity building intervention, was designed to build public health workers’ strategic skills and professional confidence. Earlier research reported on the short-term learning outcomes of the intervention; here we report on results from a longer-term outcomes evaluation, including skill retention, skill application, and possible indicators of workforce retention and community health improvement.Methods: A sequential mixed-methods research study was used to assess and explore longer-term outcomes among a sample of PHE graduates working in community public health roles.Results: Some 46% of eligible PHE graduates (n=70) completed a skills survey at three timepoints: Pre-PHE, post-PHE, and 3-to-6 months post-PHE completion. Longitudinal analysis of responses showed statistically significant skill gains over baseline (Beginner → Proficient, p<0.005), despite a slight drop in self-perceived ability in the 3-6 months post-PHE completion. Qualitative interviews with respondents and focus groups with their supervisors suggest PHE completion benefits participants’ everyday work by developing strategic skills, and grounding their work in shared public health language, paradigms, and values. Broader reported benefits include the ability to apply new skills to community public health prevention projects and expressed motivation to continue to work in public health.Conclusions: Successful completion of PHE provides learners with durable skills applicable to public health work and may spur interest in continuing to work in the field of public health. The importance of developing and retaining a competent community-focused public health workforce cannot be overstated. Comprehensive facilitated, online asynchronous capacity building programs may be an effective tool.

Challenges, Barriers, and Facilitators in Telemedicine Implementation in India: A Scoping Review.

Telemedicine has revolutionized healthcare access by breaking geographical barriers and facilitating remote consultations. The eSanjeevani platform has been pivotal in India, especially during the COVID-19 pandemic. Despite its benefits, implementing telemedicine faces various challenges and barriers. This scoping review aims to identifythese challenges, barriers, and facilitators in the Indian context. This review follows the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. A comprehensive literature search was conducted using PubMed and Google Scholar to identify studies published between January 2019 and January 2024. Studies on telemedicine adoption, barriers, and facilitators in India were included. Data were extracted and synthesized from 26 quantitative, qualitative, and mixed-methods research studies. Individual-level challenges include limited digital literacy, particularly among older adults and those in rural areas, and health literacy issues. Barriers such as limited smartphone access, unreliable internet connectivity, and socio-cultural preferences for in-person consultations were identified. Facilitators at this level include family involvement, training programs, and community outreach. Provider-level challenges involve a lack of training and concerns about care quality, while barriers include insufficient infrastructure and medico-legal concerns. Facilitators include ongoing training, clear guidelines, and user-friendly telehealth systems. System-level challenges include integrating telemedicine into existing infrastructure and ensuring data security. Barriers include inadequate funding and resistance to change, while facilitators include policy support, investment in infrastructure, and collaborative efforts. Telemedicine holds great potential to enhance remote healthcare access in India, but its successful implementation requires addressing significant challenges and barriers. Strengthening digital infrastructure, enhancing digital literacy, standardizing protocols, and developing clear regulatory frameworks are essential. Collaborative efforts and tailored approaches that respect local cultures can further facilitate telemedicine adoption. Continuous research and public awareness campaigns are necessary to ensure telemedicine's sustainable and effective use in India.

Development and evaluation of scenario-based e-simulation for humanitarian health training: a mixed-methods action research study

ObjectivesThis study aimed to develop and evaluate a scenario-based e-simulation (SBES) to address the limited avilability of accessible and practical training for humanitarian public health responders. The objectives included SBES...