Online Logbooks Research Articles

Promoting transportation safety in adolescence: the drivingly randomized controlled trial

BackgroundThe impact of young drivers’ motor vehicle crashes (MVC) is substantial, with young drivers constituting only 14% of the US population, but contributing to 30% of all fatal and nonfatal injuries due to MVCs and 35% ($25 billion) of the all medical and lost productivity costs. The current best-practice policy approach, Graduated Driver Licensing (GDL) programs, are effective primarily by delaying licensure and restricting crash opportunity. There is a critical need for interventions that target families to complement GDL. Consequently, we will determine if a comprehensive parent-teen intervention, the Drivingly Program, reduces teens’ risk for a police-reported MVC in the first 12 months of licensure. Drivingly is based on strong preliminary data and targets multiple risk and protective factors by delivering intervention content to teens, and their parents, at the learner and early independent licensing phases.MethodsEligible participants are aged 16-17.33 years of age, have a learner’s permit in Pennsylvania, have practiced no more than 10 h, and have at least one parent/caregiver supervising. Participants are recruited from the general community and through the Children’s Hospital of Philadelphia’s Recruitment Enhancement Core. Teen-parent dyads are randomized 1:1 to Drivingly or usual practice control group. Drivingly participants receive access to an online curriculum which has 16 lessons for parents and 13 for teens and an online logbook; website usage is tracked. Parents receive two, brief, psychoeducational sessions with a trained health coach and teens receive an on-road driving intervention and feedback session after 4.5 months in the study and access to DriverZed, the AAA Foundation’s online hazard training program. Teens complete surveys at baseline, 3 months post-baseline, at licensure, 3months post-licensure, 6 months post-licensure, and 12 months post-licensure. Parents complete surveys at baseline, 3 months post-baseline, and at teen licensure. The primary end-point is police-reported MVCs within the first 12 months of licensure; crash data are provided by the Pennsylvania Department of Transportation.DiscussionMost evaluations of teen driver safety programs have significant methodological limitations including lack of random assignment, insufficient statistical power, and reliance on self-reported MVCs instead of police reports. Results will identify pragmatic and sustainable solutions for MVC prevention in adolescence.Trial RegistrationClinicalTrials.gov # NCT03639753.

Learning Model to Achieve Clinical Reasoning Competency Using Technology-Enhanced Learning in Neurology Clinical Rotation: An Exploratory Study

The COVID-19 pandemic has necessitated major adaptations in learning activities related to developing clinical reasoning competencies in neurology clerkship. The application of technology in this context is promising, but there are also several limitations. This study explores a learning model for achieving clinical reasoning competency using technology-enhanced learning in neurology clinical rotation. The study used a case-study design and was conducted at the Faculty of Medicine of YARSI University and its two teaching hospitals. Data were collected by document analysis, three focus group discussions with eight medical students and 20 postgraduate medical students, and five in-depth interviews with five neurologists. All the transcribed data were analysed with thematic analysis using the Steps for Coding and Theorization (SCAT) approach. Two themes were revealed—contributing factors and learning strategies—and six factors were found to influence the learning model: the quantity and quality of teacher interactions, students’ motivation and skills in learning and technology, the variety and number of patients in teaching hospitals, the quality and quantity of facilities and infrastructure for service and education at the teaching hospitals, the clinical rotation programme design, and learning adaptation during the pandemic. The following technology-enhanced learning strategies for developing clinical reasoning skills were identified: blended learning, online logbook, telemedicine, collaborative online learning between teaching hospitals, and learning videos. This learning model can be implemented in a limited resource setting. Importantly, the identified factors from the perspective of students, clinical teachers, and school of medicine/teaching hospital, as well as technical factors, should be considered for the implementation of this model.

Adolescent perspectives on participating in a feasibility trial investigating shoe inserts for patellofemoral pain

BackgroundPatellofemoral pain (PFP) affects one-quarter of adolescents, yet there are few evidence-informed recommendations to treat PFP in this population. HAPPi Kneecaps! is a randomised, controlled, participant- and assessor-blind, parallel-group feasibility trial of shoe inserts for adolescents with PFP. The aim of this qualitative study was to explore adolescents’ perspectives of participating in HAPPi Kneecaps!.MethodsAll 36 adolescents with PFP from the HAPPi Kneecaps! study were invited to participate in semi-structured interviews. We used a descriptive qualitative methodology underpinned by a relativist framework to investigate adolescents’ perspectives on participating in the trial. Inductive thematic analysis was used to examine patterns regarding how each adolescent experienced the HAPPi Kneecaps! study within their social, cultural, and historical contexts.Results14 out of 36 HAPPi Kneecaps! participants provided consent and participated in interviews (12 females; mean [SD] age 14.9 [2.4] years). Overall, most adolescents responded positively when discussing their experience, such as improvements in their knee pain and satisfaction with how the study was run. Major themes that were generated from the analysis and feedback were: (1) shoe inserts require little effort to use; (2) perceptions of the program were generally positive; (3) participation in the trial could be made easier; (4) warm weather matters; and (5) life happens.ConclusionAdolescents with PFP who participated in the HAPPi Kneecaps! study found that shoe inserts were easy to wear. Most adolescents experienced an improvement in their symptoms and enhanced participation in sport and exercise. Adolescents with PFP prefer an option for warmer climates (e.g. flip flops or sandals), access to online logbooks, and clinicians who are easily accessible.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000957190. Date registered: 8/07/2019.

English

BACKGROUND Medical and dental education is highly dependent on the development of students’ clinical skills in addition to their theoretical knowledge. The use of logbooks to monitor the clinical procedures performed by students provides a great advantage in the educational process. Because of the pandemic, utilisation of digital logbooks may prove to be more advantageous. This study aims to investigate the effective use of online progress records and as to whether they actually decrease the chance of error compared to the traditional paper-based logbooks. METHODS In this quasi-experimental study, 139 student logbooks were studied to compare online and paper-based clinical procedures. Logbook monitoring of undergraduate dental students reported by the students themselves vs. instructors was compared. Students filled mandatory individual paper-based logbooks, reporting the number of clinical procedures performed in that year. Additionally, they filled online log- sheets, and updated them regularly. Instructors proofread and signed the paper-based students’ logbooks. Instructors also separately submitted individual online forms recording each student’s clinical procedure performed in clinical sessions. A total of 556 logbook records was collected. The mean number of procedures recorded by the students and instructors (online and paper-based) were statistically compared. RESULTS The mean number of procedures recorded in student-reported online logbooks were significantly lower than that in all other logbooks. Paper-based and online instructorreported logbook data was identical to that of student reported paper-based logbooks. CONCLUSIONS Within the scope of the study, it was concluded that online tools are an asset and may be used as a substitute for paper-based monitoring of clinical activity for instructors. However, students’ compliance updating and uploading online forms is a factor, which is a matter of concern. KEY WORDS Undergraduate Dental Logbooks, Clinical Progress Records, Monitoring Methods, Monitoring Tools, Undergraduate Dental Monitoring, Undergraduate Clinical Procedures Records

Does a greater training load increase the risk of injury and illness in ultramarathon runners? : A prospective, descriptive, longitudinal design.

Ultramarathon running has become extremely popular over the years. Despite the numerous health benefits of running, there are also many negative effects of running, such as increased risk of musculoskeletal injury and illness. Monitoring of an athlete's training load has become extremely important in terms of injury prevention. Currently, the relationship between training loads and injury and illness incidence is uncertain. To determine if there are any associations between injury and illness incidences and training loads among ultramarathon runners in the 12 week period preceding an ultramarathon event and the four week period after the event. This prospective, descriptive, longitudinal study design was conducted in 119 runners who were training for the 2019 Two Oceans ultramarathon event. Data were collected once a week via an online logbook over 16 weeks. Training parameters measured included weekly average running distance, average duration, average frequency and average sessional RPE. Injury data included injury counts, the structure injured, the main anatomical location and the time-loss as a result of injury. Illness data included illness counts, the main illness-related symptoms and the time-loss as a result of illness. The overall injury incidence was five per 1000 training hours and the overall illness incidence was 16 per 1000 training days. There was a significant relationship between external training load and injury and illness incidence for those who ran less than 30 km per week. There was also a significant relationship between the ACWR (Acute Chronic Workload Ratio) and injury incidence when the ACWR was >1.5 and for illness incidence when the ACWR was <0.5. The use of both absolute and relative workloads in the monitoring of an athlete's training load with the aim of minimising injury and illness risk and maximising performance in ultramarathon runners is recommended.

Individual differences in processes of lifestyle changes among people with obesity: an acceptance and commitment therapy (ACT) intervention in a primary health care setting.

To explore what thoughts, feelings, and learning processes were involved in obese participants' lifestyle change during an acceptance and commitment therapy (ACT) lifestyle intervention delivered in primary health care. Previous studies have revealed that lifestyle interventions are effective at promoting initial weight loss, but reduced weight is often difficult to sustain because of the failure to maintain healthy lifestyle changes. Achieving and maintaining lifestyle changes requires to learn self-regulation skills. ACT-based lifestyle interventions combine many self-regulatory skill factors, and the results from previous studies are promising. Research on the individual learning processes of lifestyle change is still needed. This study investigated a subset of data from a larger web-based lifestyle intervention. This subset consisted of online logbooks written by 17 obese participants (n = 17, body mass index mean 41.26 kg/m2) during the six-week online module. The logbooks were analyzed via data-driven content analysis. Four groups were identified based on the participants being at different phases in their lifestyle changes: stuck with barriers, slowly forward, reflective and hardworking, and convincingly forward with the help of concrete goals. Differences between the groups were manifested in personal barriers, goal setting, training of mindfulness and acceptance, and achieving healthy actions. The ACT-based lifestyle intervention offered participants an opportunity to reflect on how their thoughts and feelings may hinder healthy lifestyle changes and provided tools for learning psychological flexibility.

Measure of dream recall frequency: Comparing retrospective and logbook evaluations

Dream recall frequency (DRF) is the main indicator for evaluating dream. In home-setting, DRF can be established using two major methods: the retrospective estimation (RE) and the logbook estimation (LE). No research to date has compared DRF obtained with these two methods on the same period and using an online logbook that does not allow rereading of previous reports. We aim at investigating on these two methods by evaluating their influence on the recall frequency of dream (DRF). In the present study, the protocol consisted of online questionnaires in order to prevent rereading: an initial RE, a LE for a 21-day period, and a final RE. Both RE were based on an open-ended question about DRF on the last 21 days. Thus, the score of DRF assessed with the LE and the post-logbook RE were established on the same period.In line with the literature, our results revealed that the score of DRF with the pre-logbook RE was significantly inferior to the score of DRF obtained with the LE. However, the score of DRF with post-logbook RE was not different to the score obtained with LE. Our preliminary results are discussed by suggesting that disparities existing between Pre-logbook RE and LE might be undermined by other factors than methods influence on DRF. We recommend that further methodological comparisons should cares about effects of period investigated and influence of rereading on memory.

Investigating relations of information seeking outcomes to the selection and use of information sources

ABSTRACTThis paper reports the findings of a study investigating the relationship between information seekers' selection and use of information sources and their perceptions of information seeking outcomes (i.e., successes and failures) in the context of information seeking barriers as well as contextual factors such as knowledge, emotions and social role. Fifty‐three participants performed four simulated information‐seeking tasks over a two‐day period and reported their experiences and findings in an online logbook. Semi‐structured interviews with 23 participants were also conducted in order to examine the issues that arose from the logbook. Data collected from the study were analyzed by applying both qualitative and quantitative methods. The findings suggest that use of impersonal sources provides a higher likelihood of successful outcomes in information seeking episodes compared to interpersonal sources. Meanwhile, interpersonal sources were found to be more effective in providing personalized information. Moreover, there were no significant associations among users' education, cognitive and emotional characteristics, and other contextual factors and successes and failures in information seeking. Lastly, constraints such as, lack of help from people, unreliable information, and time limitation seemed to influence information seeking outcomes and increase the chances of unsuccessful results.

Education in anesthesia: three years of online logbook implementation in an Italian school.

BackgroundThe progress of physicians through residency training in anesthesiology can be monitored using an online logbook. The aim of this investigation was to establish how residents record clinical activities in their computerized web-based logbooks during their first years of anesthesiology training.MethodsFor this retrospective observational trial, the ESSE 3© digital registry of the University of Modena and Reggio Emilia, Italy was used to record all anesthesia-related activities performed by three consecutive year-groups of residents (Groups A, B and C) between 2009 and 2012. The ratio of activities to sessions was chosen as a surrogate measure of compliance.ResultsA total of 41,348 actions were analyzed. The ratio of activities to sessions showed a statistically significant decline for all activities concerning the perioperative management of anesthesia, with a steady reduction from the first to the last year-group (Group A 23.7, Group B 14.1 and Group C 2.2; p = 0.003).ConclusionsAn online activities logbook is a useful tool for recording and assessing the clinical activities undertaken by each resident during residency training in anesthesiology.

Smartphones in orthopaedics

With the introduction of the European Working Time Directive, surgical trainees are facing limited training opportunities and doctors are required to maximise their training opportunities. Smartphone sales have been rapidly increasing over the last five years and can be used as a training tool for the orthopaedic trainee and surgeon. Common uses include applications (AO, eLogbook and PubMed), Ebooks, online Logbooks, Guidelines and surgical techniques. In addition, smartphones can be used to immediately complete work-based assessments, in the absence of computers, hopefully increasing completion rates and reliability. Some journals now provide podcasts and video tutorials which may be accessed on smartphones, which is useful for higher examinations. Smartphones can also be used in the clinical setting to take photographs of wounds. Smartphones are enjoying increased uptake and application in the workplace and we review their use for orthopaedic surgeons and trainees to allow them to make the most out of their training opportunities.

Diabetes NetPLAY: A physical activity website and linked email counselling randomized intervention for individuals with type 2 diabetes

Background -This pilot study evaluated the feasibility (recruitment, retention, adherence and satisfaction) and preliminary efficacy of a 12-week website and email-linked counselling intervention on physical activity behaviour change in individuals with type 2 diabetes.Methods -A total of 49 individuals with type 2 diabetes (59% female, average age 54.1 years) were randomized to the Diabetes NetPLAY intervention or control condition. The intervention condition received information grounded in the Social Cognitive Theory (SCT), personalized weekly emails, an on-line logbook and message board. Key outcomes included physical activity behaviour and related cognition changes. The control condition was provided links to the Canadian Diabetes Association's Clinical Practice Guidelines for Physical Activity and Canada's Guide to Physical Activity.Results -Intervention participants indicated high levels of satisfaction for this mode of delivery and study results demonstrated the feasibility of web-based mediums for the delivery of physical activity information in this population. The intervention group demonstrated a significant improvement in total vigorous and moderate minutes of physical activity (p = 0.05) compared to the control group over the 12-week study. Among the SCT variables, behavioural capacity, showed a significant increase (p < 0.001) among intervention participants.Conclusion -Web-based interventions for individuals with type 2 diabetes are feasible and show promise for improving positive physical activity outcomes.