Multimodal Education Program Research Articles

Evaluating the impact of a multimodal perinatal education program on birth preparedness, mental health, and birth outcomes among rural primiparous women: a retrospective cohort study

BackgroundPerinatal education programs play a crucial role in enhancing maternal knowledge and practices related to childbirth, particularly among rural populations. This study aims to assess the impact of a holistic perinatal education program on birth preparedness, mental health, and birth outcomes among rural primiparous women.MethodsA retrospective cohort design was employed, utilizing patient records from Third Affiliated Hospital of Xinxiang Medical University between January 2021 and December 2022. A total of 149 rural primiparous women, aged 18–49 years with a rural household registration, were identified and categorized into two groups: the Intervention Group (n = 77), exposed to the perinatal education program, and the Control Group (n = 72), not exposed. The program encompassed physical workshops, a digital learning platform, and personalized counseling sessions. Outcome measures included Birth Preparedness and Complication Readiness (BPCR) scores, mental health metrics (BDI-II for depression and STAI-S for anxiety), and birth outcomes.ResultsThe Intervention Group demonstrated significant improvements in BPCR knowledge scores (P < 0.001) and practice scores (P = 0.047) post-intervention. A reduction in depressive (P = 0.021) and anxiety symptoms (P = 0.017) was also observed in the Intervention Group over time. There were significant differences in the mode of delivery and reasons for cesarean deliveries between the groups, with a higher rate of vaginal births (P = 0.035) and fewer maternal indications for cesareans (P = 0.021) in the Intervention Group compared to the Control Group.ConclusionThe holistic perinatal education program shows a positive impact on birth preparedness, mental health, and birth outcomes among rural primiparous women. Such programs could be crucial in empowering women in rural settings, enhancing their preparedness for childbirth, and improving maternal mental health.

Results of a Digital Multimodal Motivational and Educational Program as Follow-Up Care for Former Cardiac Rehabilitation Patients: Randomized Controlled Trial.

Digital interventions are promising additions for both usual care and rehabilitation. Evidence and studies for the latter, however, are still rare. The aim of the study was to examine the app/web-based patient education program called "mebix" (previously called "Vision 2 - Gesundes Herz") regarding its effectiveness in relation to the parameters of disease-specific quality of life (HeartQoL), cardiovascular risk profile (Cardiovascular Risk Management [CARRISMA]), and prognostic estimation of early retirement (Screening instrument work and occupation [SIBAR]) in 190 participants from a cardiological rehabilitation clinic. To evaluate mebix, 354 patients from the Roderbirken Clinic of the German Pension Insurance Rhineland (Germany) with a coronary heart diesase were recruited and randomized either to the intervention group (using mebix postrehabiliation for up to 12 months) or the control group (receiving standard care). The data collection took place at the end of inpatient rehabilitation (t0), as well as 6 months (t1) and 12 months (t2) after the end of rehabilitation. Analyses of variance are used to assess the overall significance of difference in outcome parameters between groups and over time. The primary endpoint of disease-related quality of life shows a significant improvement of 7.35 points over the course of the intervention that is also more pronounced in the intervention group. Similarly, the 10-year risk of cardiovascular death and myocardial infarction showed significant improvements in the cardiovascular risk profile over time and between groups, indicating better results in the intervention group (ie, a reduction of -1.59 and -5.03, respectively). Positive effects on secondary outcomes like body weight, blood pressure, and number of smokers only showed time effects, indicating no difference between the groups. In addition, the SIBAR was significantly lower/better at the end of the observation period than at the beginning of the observation for both groups. Overall, the digital training program represents an effective follow-up offer after rehabilitation that could be incorporated into standard care to further improve disease-related quality of life and cardiovascular risk profiles.

ENHANCING KNOWLEDGE AND AWARENESS FOR MEASLES AND RUBELLA ELIMINATION TO PREVENT CONGENITAL RUBELLA SYNDROME IN KULON PROGO AND GUNUNGKIDUL REGENCIES

Introduction: Measles-Rubella (MR) Vaccination coverage is important in eliminating Congenital Rubella Syndrome (CRS). In 2023, Kulon Progo and Gunungkidul Regencies recorded 98.59% and 97.63%, respectively. We conducted campaign activities, introduced the Measles-Rubella (MR) vaccine, and implemented educational efforts crucial for controlling measles, rubella and CRS. A collaborative educational program was organized to improve the quality of promotive and preventive education provided to health workers and elementary teachers. Aims: To enhance the knowledge of health workers and elementary teachers regarding measles, rubella, CRS and elimination strategies in Kulon Progo and Gunungkidul Regency. Methods: This study employed a quasi-experimental, non-randomized design with no control group. The participants were selected from all primary health care centers and selected elementary schools in Kulon Progo and Gunungkidul Regency. Before and after a multi-modal educational program, knowledge of participants was measured using questionnaire and analyzed using Wilcoxon signed-rank test. Results: We included 72 health workers and 8 elementary teachers in Kulon Progo and Gunungkidul Regency. The results indicated an increase in knowledge among health workers regarding these topics. However, elementary teachers did not demonstrate statistically significant improvements in knowledge level, likely due to the small number of participants and a general lack of knowledge about these subjects among teachers. Conclusion: Multi-modal intervention enhanced the knowledge of health workers and elementary teachers about measles, rubella, CRS, elimination strategies of these diseases in two regencies of the Special Region of Yogyakarta. Therefore, it is essential that public health authorities should prioritize continuous and accessible education programs for them

Catheter-associated urinary tract infection prevention: Implementation of a multimodal and evidence-based education program.

Catheter-associated urinary tract infection prevention: Implementation of a multimodal and evidence-based education program.

Implementation of Point-of-Care Ultrasound Training Into Nurse Practitioner Student Education: A Cohort Study

Point-of-care ultrasound (POCUS) has become ubiquitous in clinical practice and the standard of care in the augmentation of physical examination and procedures for providers in both inpatient and outpatient settings. Nurse practitioners are core members of the health care team, with many already using POCUS in their practice. Despite this, there is a lack of consensus about integrating POCUS into graduate education. This study evaluated the implementation of a multimodal POCUS education program for adult-gerontology acute care nurse practitioner students and found that after this intervention participants self-reported increased comfort, confidence, and understanding with POCUS.

A study to evaluate the effectiveness of multimodal educational program on knowledge of school children regarding environmental sanitation at selected areas of Belagavi district

A study to evaluate the effectiveness of multimodal educational program on knowledge of school children regarding environmental sanitation at selected areas of Belagavi district

School-Based Sleep Education Program for Children: A Cluster Randomized Controlled Trial

Insufficient sleep contributes negatively to child developmental processes and neurocognitive abilities, which argues the need for implementing interventions to promote sleep health in children. In this study, we evaluated the effectiveness of a multimodal and multilevel school-based sleep education program in primary school children using a cluster randomized controlled design. Twelve schools were randomly assigned to either the sleep education or nonactive control groups. The sleep education group included a town hall seminar, small class teaching, leaflets, brochures, and a painting competition for children. Parents and teachers were invited to participate in a one-off sleep health workshop. Parental/caregiver-reported questionnaires were collected at baseline and 1-month follow-up. A total of 3769 children were included in the final analysis. There were no significant improvements observed in the sleep-wake patterns, daytime functioning, and insomnia symptoms between the two groups at follow-up, whereas the intervention group had significantly improved parental sleep knowledge than the controls (paternal: adjusted mean difference: 0.95 [95% confidence interval (CI): 0.18 to 1.71]; maternal: adjusted mean difference: 0.87 [95% CI: 0.17 to 1.57]). In addition, children receiving the intervention had a lower persistence rate of excessive beverage intake (adjusted odds ratio: 0.49 [95% CI: 0.33 to 0.73]), and experienced greater reductions in conduct problems (adjusted mean difference: 0.12 [95% CI: 0.01 to 0.24]) compared with the controls at 1-month of follow-up. Moreover, a marginally significant reduction for emotional problems in the intervention group was also observed (adjusted mean difference: 0.16 [95% CI: −0.00 to 0.32]). These findings demonstrated that school-based sleep education was effective in enhancing parental sleep knowledge and improving behavioral outcomes in children, but not sufficient in altering the children’s sleep-wake patterns and sleep problems.

Implementation of a standardized multimodal pain regimen significantly reduces postoperative inpatient opioid utilization in patients undergoing bariatric surgery.

Routine opioid use in surgical patients has received attention given the opioid epidemic and a renewed focus on the dangers and drawbacks of opioids in the postoperative setting. Little is known about opioid use in bariatric surgery, especially in the inpatient setting. We hypothesize that a standardized opioid-sparing protocol reduces postoperative inpatient opioid use in bariatric surgery patients. A retrospective cohort study was conducted of bariatric surgery patients at a single institution. From March to September 2019, a standardized intraoperative and postoperative opioid-sparing protocol was designed and implemented along with an educational program for patients regarding safe pain management. Inpatient opioid utilization in patients undergoing surgery in the preintervention phase between April and March 2019 was compared to patients from a postintervention phase of October 2019 to December 2020. Opioid utilization was measured in morphine milliequivalents (MME). A total of 359 patients were included; 192 preintervention and 167 postintervention. Patients were similar demographically. For all patients, mean age was 44.1years, mean BMI 49.2kg/m2, and 80% were female. Laparoscopic sleeve gastrectomy was performed in 48%, laparoscopic gastric bypass in 34%, robotic sleeve gastrectomy in 17%, and robotic gastric bypass in 1%. In the postintervention phase inpatient opioid utilization was significantly lower [median 134.8 [79.0-240.8] MME preintervention vs. 61.5 [35.5-150.0] MME postintervention (p < 0.001)]. MME prescribed at discharge decreased from a median of 300 MME preintervention to 75 MME postintervention (p < 0.001). In the postintervention phase, 16% of patients did not receive an opioid prescription at discharge compared to 0% preintervention (p < 0.001). When examining by procedure, statistically significant reductions in opioid utilization were seen for each operation. Implementation of a standardized intraoperative and postoperative multimodal pain regimen and educational program significantly reduces inpatient opioid utilization in patients undergoing bariatric surgery.

A multimodal interprofessional education program including case-based problem solving focused on pain management increases student’s knowledge and interprofessional skills

ABSTRACT Interprofessional education (IPE) activities are recommended to reflect current and future practice. The opioid epidemic is one of the most significant current health challenges; recently declared a United States public health crisis. Thus, an IPE program centered on interprofessional roles in pain management during the opioid crisis was developed at the Eugene Applebaum College of Pharmacy and Health Sciences. Professional students from pharmacy, physical therapy, occupational therapy, physician assistant, and nurse anesthesia programs were included. The program included a lecture about each profession, small group case-based problem-solving sessions (group activity), and a panel discussion led by representative pain management experts from each profession. We conducted a retrospective review of data from 251 professional students attending the IPE program, and assessed students’ knowledge of each profession and their respective roles in pain management. We evaluated interprofessional skills using the Interprofessional Collaborative Competency Attainment Survey and gathered qualitative student feedback. Participants gained knowledge about other professions. Each represented profession had improvements in five constructs related to interprofessional skills. Students found the most value from the group activity, which encouraged interaction among professions. Overall, the program design was effective in enhancing student knowledge and attitudes regarding collaborative interprofessional team skills.

Evolution of a Bidirectional Pediatric Critical Care Educational Partnership in a Resource-Limited Setting.

Introduction: Children in resource-limited settings are disproportionately affected by common childhood illnesses, resulting in high rates of mortality. A major barrier to improving child health in such regions is limited pediatric-specific training, particularly in the care of children with critical illness. While global health rotations for trainees from North America and Europe have become commonplace, residency and fellowship programs struggle to ensure that these rotations are mutually beneficial and do not place an undue burden on host countries. We created a bidirectional, multimodal educational program between trainees in Manila, Philippines, and Baltimore, Maryland, United States, to improve the longitudinal educational experience for all participants.Program Components: Based on stakeholder input and a needs assessment, we established a global health training program in which pediatricians from the Philippines traveled to the United States for observerships, and pediatric residents from a tertiary care center in Baltimore traveled to Manila. Additionally, we created and implemented a contextualized simulation-based shock curriculum for pediatric trainees in Manila that can be disseminated locally. This bidirectional program was adapted to include telemedicine and regularly scheduled “virtual rounds” and educational case conferences during the COVID-19 pandemic. Providers from the two institutions have collaborated on educational and clinical research projects, offering opportunities for resource sharing, bidirectional professional development, and institutional improvements.Conclusion: Although creating a mutually beneficial global health partnership requires careful planning and investment over time, establishment of a successful bidirectional educational and professional development program in a limited-resource setting is feasible and benefits learners in both countries.

Exploring Perceptions of Education for Central Venous Catheter Care at Home.

Pediatric oncology patients with an external central venous catheter (CVC) in situ can be discharged from the hospital. Caregivers are expected to learn how to care for the CVC prior to discharge while also dealing with their child's new cancer diagnosis. This study aimed to evaluate the perceptions of a CVC education program received by caregivers to identify opportunities for improvement. A qualitative study was conducted in 3 stages, using an evidence-based co-design approach, involving caregivers and one adolescent patient discharged from the British Columbia Children's Hospital Oncology/Hematology/BMT inpatient unit. Stage I involved semi-structured interviews to gain feedback on the existing CVC education program. In Stage II, educational resources were updated or developed and implemented. For Stage III, the revised CVC education program was evaluated through a focus group and semi-structured interviews. Interview transcripts were analyzed using QSR NVivo®. The original CVC education program was overall well received. Repeated instruction and support provided by nurses was reported to have increased confidence with performing CVC skills. Participants appreciated the multimodal approach to meet learning needs and expressed interest in additional visual aids. Inconsistencies in nurses’ practice and offers of “tips and tricks” were identified to be challenging for caregivers while learning a new skill. Videos depicting CVC care were developed to provide an additional visual tool, decreased inconsistencies in care, and support to caregivers at home. Caring for a CVC at home is challenging and overwhelming for caregivers. A standardized multimodal education program is required to support caregivers at home.

Improving Geropsychology Competencies of Veterans Affairs Psychologists.

Older adults are more likely to seek mental health care through integrated care settings such as primary care. Currently, there exists a significant shortage of mental health providers trained in geropsychology and integrated care competencies. To address this need within the Veterans Health Administration, a national workforce development program was extended to include psychologists, which is called the Geriatric Scholars Program-Psychology Track (GSP-P). The GSP-P has two overarching educational program aims: (1) to improve geropsychology competencies of practicing VA psychologists, particularly those working within integrated settings (e.g., primary care) and (2) enrich psychologists' abilities to enact change in their clinical settings. Ninety-eight VA clinicians participated in the GSP-P, which includes a multi-day in-person course, from 2014 to 2018. Participants completed measures assessing confidence and self-reported knowledge in geropsychology and integrated care competencies pre-course and 3-months post-completion. Two-weeks post-course participants responded to open-ended survey questions regarding their perceptions of the course and potential applications of learning. Significant improvements in confidence in and knowledge of geropsychology and integrated care competencies emerged from pre-course to 3-months post-completion. Qualitative findings demonstrated that participants valued the face-to-face, integrated multimodal educational program. Findings provided insights regarding clinicians' planned application of the knowledge acquired, such as modifying treatments for older patients. Specialized workforce programs such as the GSP-P have a significant, positive impact on the care of older Veterans.

Development, implementation, and assessment of a comprehensive, integrated, and multimodal interprofessional education (CIM-IPE) program

Abstract Objective The 2016 ACPE Standard 11 mandates the inclusion of interprofessional education (IPE) in pharmacy programs. However, challenges exist in the standardized design, delivery, and assessment of an IPE curriculum. We developed and implemented a c omprehensive, vertically and horizontally i ntegrated, m ultimodal IPE curriculum (CIM-IPE) and assessed for student, program, and institutional outcomes. Methods We established an IPE collaboration, created an institutional infrastructure, and operationalized the curriculum incorporating pharmacy, nursing, and medical students using a five-pronged approach built around 1) a didactic component, 2) high fidelity simulation with manikins with content-emphasis, 3) hospital simulation with manikins with process emphasis, 4) interprofessional case conferences, and 5) a Hotspotting IPE-elective. The 2016 Interprofessional Education Collaborative competencies and ACPE Standard 11 were used to assess outcomes, classifying developmental stages as initial, developing, developed, and proficient. Results In seven IPE events distributed across the P1 through P3 years of the CNUCOP Pharmacy curriculum, a high total number of pharmacy, nursing and medical school participants (N = 1799) were repeatedly engaged. Overall assessment data show a high success rate of the integrated CIM-IPE program with mean performance scores of 98 (SD = 13, N = 117) and 95 (SD = 5, N = 67) for the interprofessional case conferences, 100 (SD = 2, N = 117), 95 (SD = 4, N = 67), and 95 (SD = 5, N = 67) for the three simulation based IPE events. Conclusion Our curricular and assessment strategies for CIM-IPE outline a stepwise development and implementation blueprint for an inclusive and comprehensive IPE program that is readily transferable to other colleges and schools of pharmacy and other health care professional programs.

Evaluation of nurses’ experiences of a post education program promoting recognition and response to patient deterioration: Phase 2, clinical coach support in practice

Front-line nurses providing around the clock care are pivotal to the identification, recognition, and response to patient deterioration. However, there is growing evidence that patient deterioration indicators are poorly managed and not escalated to rapid response teams (RRTs), contributing to adverse outcomes. Access to effective educational programs has been cited as vital in optimising nurses' recognition and response to deteriorating patients. Several studies evaluated educational programs, but have not explored nurses’ experiences of engaging in patient deterioration events post attendance.Participants in a multimodal education program (DeTER) were invited to attend a series of focus groups three months post workshop as phase two of an overall study. A convenience sample of 22 acute care nurses was recruited. A qualitative descriptive design incorporating focus groups and thematic analysis was used to evaluate participants’ experiences of engaging with the RRT during patient deterioration events and whether clinical coach support in practice influenced their recognition and response. Four themes were identified within the data, categorised as enhanced confidence, effective communication, supportive culture, and early response.The importance of an educational model using multimodal strategies, underpinned by coach support and guidance post workshop, was clearly demonstrated to optimise nurses’ management of patient deterioration events.

Evaluation of pharmacist-led strategy to reduce outpatient fluoroquinolone prescribing from the emergency department

ObjectiveThe purpose of this study was to evaluate the effectiveness of a pharmacist-led initiative to reduce outpatient fluoroquinolone prescribing in the emergency department (ED). DesignEight common indications for fluoroquinolone prescribing were selected for intervention. The intervention consisted of a multimodal prescriber education program providing empirical recommendations for antibacterial agents on the basis of guidelines, the local ED antibiogram, and clinical trials. The electronic medical record was reviewed to identify all prescriptions for moxifloxacin, ciprofloxacin, and levofloxacin oral tablets written at the time of discharge by ED providers. Setting and participantsThis study was conducted in a 62-bed emergency department at an academic community medical center with approximately 90,000 ED visits per year. Adult patients who were prescribed an oral fluoroquinolone at discharge from the ED were included. Outcome measuresThe primary outcome of the study was fluoroquinolone days of therapy (DOT) prescribed per 100 ED visits. ResultsIn the preintervention group, the primary outcome of fluoroquinolone DOT per 100 ED visits was 18.4, 17.8, 16.5, 19.8, and 16.8 for the months of December 2017 through April 2018, respectively. The fluoroquinolone DOT per 100 ED visits in the postintervention group was 8.7, 7.9, 8.0, 6.3, and 6.0 for the months of December 2018 through April 2019, respectively. The fluoroquinolone DOT per 100 ED visits was found to be significantly shorter in the postintervention group with P = 0.009. ConclusionThe results of this study reveal that pharmacist-led interventions, focused on multimodal provider education, were effective at reducing ED discharge prescriptions for fluoroquinolones.

Multimodal Education Program to Improve Nurses' Knowledge and Confidence on Delirium Recognition in a Surgical-Trauma Intermediate-Care Setting.

High incidence of delirium in hospitalized patients has been reported in the United States and is significantly associated with increased morbidity and mortality. The lack of knowledge and confidence in performing delirium assessment (KCDA) has led to significant underrecognition of delirium by nurses regardless of evidence-based education intervention. The purpose of this study was to determine the effectiveness of a multimodal educational program (MEP) to enhance nurses' KCDA. A MEP including an online didactic with a video-simulation and 1:1 bedside coaching with delirium screening (DS) was conducted in the surgical intermediate-care unit of an academic medical center. A quasi-experimental pre- and post-test design was used. Of 23 nurses, the majority were <41 years old (73.9%) and had at least a bachelor of science in nursing degree (78.3%) with <6 years of experience (60.9%). The overall KCDA scores and the performance of DS improved significantly after the MEP (p < .001). A positive correlation was noted between the changes of the KCDA scores (p = .009). The MEP demonstrated improvement in nurses' KCDA. The MEP should focus on an individualized learning approach with a targeted patient population, using current delirium screening tools. Educational programs are recommended in either an orientation or continuing education program on nursing units. This is also recommended for use in other academic centers that encompass similar clinical settings and could possibly be considered for use in other disease processes.

GERI-VET: A PROGRAM FOR OLDER VETERANS SEEN IN THE EMERGENCY ROOM

Older adults made over 21 million Emergency Room (ER) visits accounting for nearly 46% of all ER hospital admissions in 2015. The ER setting provides not only a unique opportunity to assess patients’ health, functional status and social issues, but also provide recommendations to help coordinate care. Geriatric ER assessments have been associated with reduced avoidable hospitalizations, functional decline, and institutionalization. However, few ER clinicians including physicians, nurses and technicians have received adequate training to perform geriatric screenings and implement timely referrals. In 2014 American College of Emergency physicians and American Geriatric Society published guidelines for care. Based on these guidelines A” Geri-Vet Bootcamp” Program was developed and piloted at the Northeast Ohio VAMC. This program included: simulation emphasizing standardized screenings, and the use of decision support aides for management and referrals for older adults seen in the ER. Following this multi-modal education program, 91% clinicians reported greater ability to apply knowledge learned, 82% clinicians were able to more accurately identify geriatric syndromes, and 86% were able to identify additional resources. Of the patients screened over one year, 73% of patients were identified as being at high risk for falls, 32% had high family caregiver burden, 15% had moderate to severe dementia, and 14% had positive delirium screens. Those veterans screened by Geri Vet trained Staff received significantly more referrals than usual care staff, home care 28.7% vs.15.6%, geriatric clinic 20.5% vs. 11.7% and caregiver support 5.0% vs. 1.3%. Data show hospital admissions have decreased 5-7%. Education and dissemination continues

A Multi-faceted Educational Approach for Pain Metric Recording Prior to Knee and Hip Arthroplasty: Effects on Documentation by an Acute Pain Service.

BackgroundDespite the increased use of electronic medical records (EMRs) in past years, the recording of clinically useful baseline pain information may still be lacking. An educational effort targeted at the acute pain service and reinforced by electronic prompting may be an effective way to promote electronic documentation of relevant pain metrics. The objective of this study was to assess whether an educational effort with electronic prompting in the EMR promotes the documentation of baseline pain scores and preoperative opioid use by an acute pain service (APS).MethodsA total of 98 patients were included in this study: 49 in the study group and 49 in the control group. The study group consisted of patients who underwent knee and hip arthroplasties after the institution of a multimodal analgesia educational program that also incorporated an electronic prompt to promote behavior change. Primary outcomes were the frequency of documentation of baseline pain scores and preoperative opioid use.ResultsAfter the implementation of the education initiative, 67% of the patients had baseline pain scores recorded in the preoperative APS documentation, compared to 20% in the control group (p = 0.0001). Preoperative opioid use was recorded in 24% of APS documentation within the control group, but this increased to 73% after the educational intervention (p = 0.0001). Documentation of resting pain scores on the day of surgery also increased from 59% to 87% (p = 0.0014).ConclusionsThe introduction of a multi-dimensional educational effort focused on baseline pain metric recording within the context of an analgesic change of practice increased assessment of both baseline pain and preoperative opioid use by APS. These results can be applied to other settings in which a focused change of practice is required and an electronic medical record already utilized.

Advance Care Planning Conversations: Measuring Registered Nurses' Self-Efficacy Before and After an Educational Intervention (QI701)

•Describe advance care planning from the perspective of the registered nurse.•Articulate changes in registered nurse advance care planning self-efficacy following evidence-based training. Advance care planning (ACP) improves patient outcomes at the end-of-life. Effective ACP requires specialized knowledge and communication skills lacking in traditional nursing education and by nurses practicing in our local community. Substantial gaps in the literature exist in understanding nurses’ ACP self-efficacy and the effects of innovative teaching approaches on this outcome. The purpose of this quality improvement project was to evaluate changes in registered nurses’ (RNs) ACP self-efficacy after participating in a multimodal evidence-based educational program designed to improve ACP conversations. This project was a comparative study using a non-experimental Before-After design with an equivalent control group. Participants completed a demographic survey and the Advance Care Planning Self-Efficacy (ACP-SE) scale before and after a program combining lecture, video-taped demonstration using a simulated patient scenario, and role-play activities. Analyses were conducted using descriptive statistics and Wilcoxon Signed Rank test. Bivariate correlations between a global single-item measure of ACP-SE and the mean score of the items on the ACP-SE scale were examined using Spearman Rho correlation coefficient to assess the validity of the ACP-SE scale, originally developed for physicians, in this sample of RNs (N=45). Findings demonstrated a statistically significant improvement in ACP-SE scores following the program, z=-3.65, p<.000, with a medium effect size (r=.39). The median score on the ACP-SE scale increased from pre-activity (Md=65) to post-activity (Md=74). There were strong, positive significant correlations between the global single-item and mean score of ACP-SE pre-activity, rs=.73, and post-activity, rs=.78, supporting the validity of the ACP-SE scale in this sample of RNs. Findings demonstrated that a multimodal educational program improved nurses’ self-efficacy in conducting ACP. As nurses are uniquely positioned to facilitate ACP, additional research is needed to determine if increased ACP-SE improves patient and family outcomes and decreases healthcare costs.

Developing a program to increase geropsychology competencies of Veterans Health Administration (VHA) psychologists

ABSTRACT There is an alarming supply and demand gap for geropsychology expertise within the United States. Health policy experts called for increasing geriatric mental health competencies for all mental health providers, including within Veterans Health Administration (VHA), to address this problematic gap. The VHA Geriatrics Scholar Program (GSP) Psychology Track was developed because there were no commercially available trainings in geropsychology for licensed psychologists. Developing the GSP Psychology Track was based on an evidence-based educational model for the VHA primary care workforce; and included a stepwise curriculum design, pilot implementation, and program evaluation. The educational program was pilot tested with eight VHA psychologists. Evaluation results demonstrated feasibility of implementing an innovative integrated multimodal educational program in geropsychology. Furthermore, this program was associated with reports of increased confidence in geropsychology competencies and self-reported implementation of geropsychology knowledge, indicating the potential for this educational model to improve mental health care for older Veterans.