Pre Course Research Articles

The doctor’s presence created a safe space - a mixed methods study of students’ learning outcomes from an elective course in palliative medicine

BackgroundCompetence in palliative medicine is required in clinical practice. Based on a literature review, we developed a two-week elective course in palliative medicine for 5th and 6th year medical students. We wanted to study learning outcomes from the course, especially related to knowledge, confidence, and reflections on the doctor’s role in palliative care.MethodsA multiple-choice questionnaire (MCQ) assessed knowledge in palliative care pre and post course. The Thanatophobia Scale (TS) and the Self-efficacy in Palliative Care Scale (SEPC) measured confidence in communication with patients close to death and in providing palliative care, respectively. Reflection notes were analysed using Systematic Text Condensation, a cross-case thematic analysis. Lave & Wenger’s theory about situated learning was used to support interpretations.ResultsFrom 2018 to 2022 we ran four courses for a total of 48 students. Test results improved over the course in all four groups. On average, MCQ scores increased by 22% (range 13–33), TS scores were reduced by 28% (24–32), and SEPC scores increased by 50% (42–64), reflecting increased confidence in dealing with seriously ill and dying patients and their relatives. The participants prepared reflection notes describing their main impressions and take-home messages from the course, focusing specifically on the role of the doctor. They described the doctor’s role linked to an overarching task of creating a sense of security for patients and relatives. Through the course, and especially through talking to patients and relatives and being part of the interprofessional team, the participants learned how this sense of security was built by gaining competence in the following domains: 1) Patient-centred communication about the disease, expected trajectory, and needs, establishing common ground and support; 2) Being the medical expert in symptom relief and decision-making, providing guidance and reassurance in difficult situations; 3) Professionalism rooted in a holistic and relational approach; and 4) Being a good team player, aware of their function and limitations.ConclusionsA two-week student-selected course in palliative medicine improved knowledge and skills and increased confidence in providing palliative care. The comprehensive understanding of the doctor’s role obtained in this course may also be relevant to other clinical specialties.Trial registrationNot applicable (no clinical trial).

Effects of undergraduate ultrasound education on cross-sectional image understanding and visual-spatial ability - a prospective study

Introduction/aimRadiological imaging is crucial in modern clinical practice and requires thorough and early training. An understanding of cross-sectional imaging is essential for effective interpretation of such imaging. This study examines the extent to which completing an undergraduate ultrasound course has positive effects on the development of visual-spatial ability, knowledge of anatomical spatial relationships, understanding of radiological cross-sectional images, and theoretical ultrasound competencies.Material and methodsThis prospective observational study was conducted at a medical school with 3rd year medical students as part of a voluntary extracurricular ultrasound course. The participants completed evaluations (7-level Likert response formats and dichotomous questions “yes/no”) and theoretical tests at two time points (T1 = pre course; T2 = post course) to measure their subjective and objective cross-sectional imaging skills competencies. A questionnaire on baseline values and previous experience identified potential influencing factors.ResultsA total of 141 participants were included in the study. Most participants had no previous general knowledge of ultrasound diagnostics (83%), had not yet performed a practical ultrasound examination (87%), and had not attended any courses on sonography (95%). Significant subjective and objective improvements in competencies were observed after the course, particularly in the subjective sub-area of “knowledge of anatomical spatial relationships” (p = 0.009). Similarly, participants showed improvements in the objective sub-areas of “theoretical ultrasound competencies” (p < 0.001), “radiological cross-section understanding and knowledge of anatomical spatial relationships in the abdomen” (p < 0.001), “visual-spatial ability in radiological cross-section images” (p < 0.001), and “visual-spatial ability” (p = 0.020).ConclusionUltrasound training courses can enhance the development of visual-spatial ability, knowledge of anatomical spatial relationships, radiological cross-sectional image understanding, and theoretical ultrasound competencies. Due to the reciprocal positive effects of the training, students should receive radiology training at an early stage of their studies to benefit as early as possible from the improved skills, particularly in the disciplines of anatomy and radiology.

Long-term effects of an undergraduate palliative care course: a prospective cohort study in El Salvador

BackgroundInternational organisations recommend the inclusion of palliative care undergraduate education as a way to meet increasing demand; the long-term effects, however, are unknown. Since 2013 the Dr José Matías Delgado...

P035 BSR Digital resources- Spotlights and Podcasts The Story So Far

Abstract Background/Aims The British Society for Rheumatology (BSR) has an eLearning site for members. Due to increasing demand for online learning triggered in part by the COVID pandemic, a decision was made to create a BSR digital learning board and produce a broader range of content. Methods The Digital Learning Board (DLB) was formed in February 2021 consisting of trainees, nurses, Consultant Rheumatologists and Allied Healthcare Professionals from all around the 4 nations. After consultation and discussion, a decision was made to produce two main new formats of resources in addition to the online webinar series that was already established. This included Spotlights where a variety of blended learning resources including webinars, podcasts, eLearning cases and links to relevant journal articles are collated on a topic. The Talking Rheumatology Spotlight podcast series was also developed and shared on streaming platforms such as Spotify, iTunes and the eLearning website. This includes overview podcasts on topics as well as bonus case based episodes. Resources for the wider community (not limited to members) include the podcasts and ‘How to’ resources created for doctors and nurses starting work in the specialty for the first time. Numbers of podcast downloads, views on the eLearning website and quantitative and qualitative feedback is collected via eLearning website. Results The DLB have produced 30 spotlights with the most popular topics being axial spondyloarthropathy, psoriatic arthritis and Sjogren’s. The average rating for this series is 4.5/5. Examples of feedback; “all areas of great interest and very educational”“I really enjoyed the course, the fact that BSR included several podcasts allowed me to complete the course while doing my exercise. Great course really useful for my clinical practice” 28 podcasts have also been produced so far. There have been 15,500 downloads with significant international interest particularly in the US, Europe and Oceania. The most popular episodes so far have been Polymyalgia rheumatica and Sjogren's syndrome. The how to resources for trainees resource has been viewed 3,897 times by 1502 unique users, and the how to for nurses resource has been viewed 3159 times by 1360 unique .Examples of feedback from nurses “I have now been in post for 6 months and have learnt so much with this resource”“Great introductory course to Rheumatology” Conclusion Work is underway to promote the resources, seek feedback and suggestions for further topics. Many face to face education programmes including the BSR’s own are running again but research (1) and behaviour suggest blended learning is here to stay and complements in person learning well. We are exploring this area further through the development of pre course learning for our face-to-face courses. Disclosure R. Benson: None. L. Coulson: Other; Louise works for the BSR as Digital Events Manager. W.J. Gregory: Honoraria; W.G. has received honoraria for speaker and advisory board from Abbive, Novartis, Pfizer and UCB.. J. Lemon: None. Y.L. Man: None. K. Maxey: Other; Kate works for the BSR as events and education officer. D. Pilbury: None. M. Serrano: Other; Marina works for the BSR as acting Head of Education. C. Wincup: None. P.A. Watson: Other; I am employed by the British Society for Rheumatology as Digital Learning Editor (2PA per week). S. Ellis: None. E. Chibueze Mbanasor: None. M. Malik: None. B. Lakshmana Murthy: None.

Emotional intelligence for translation and interpreting students

Inter and intra personal competencies have been recognized as important generic competencies included in the standards for translation and interpreting professions, issued by the national authorities worldwide These competencies actually comprise the so-called emotional intelligence skills. This is the reason why the authors of this paper, who have been teaching at the Translation and Interpreting Department from Skopje at the “Ss. Cyril and Methodius” University for more than a decade, have recognized the possibility to use language learning to enhance the awareness of the importance of emotional intelligence both for students’ professional and personal development. In addition, students also need positive emotions in the classroom because the future translators and interpreters have stressful experiences on a daily basis as the rate of development of the most relevant competencies for their future professions is continuously assessed by their teachers. This paper presents the results of the implementation of activities that affect emotional intelligence with the subject content activities of an academic course in Cultural Studies, thus fostering both subject and generic competencies relevant for translation and interpreting students We shall discuss the students’ results of the pre course and post course Leadership Toolkit: Emotional Intelligence questionnaire on their EI skills as well as the results from two relevant questionnaires prepared for the purpose of this paper research, on the effects of the emotional activities implemented at the translation and interpreting courses and answered anonymously by the fourth-year students who attended the Course in the summer semester 2023. In order to check the relevance of the implemented EI activities in the Cultural Studies we use the Six Seconds EI Model. / Keywords: emotional intelligence, translation and interpreting, pedagogical aspects, emotion, language

ELECTIVE COURSE DEVELOPMENT AND EVALUATION FOR THIRD-YEAR PHARMACY STUDENTS ON PHARMACY HEALTH COACHING IN INDONESIA

To describe our experiences in developing an elective course for third-year pharmacy students on pharmacy health coaching, as well as to evaluate its effects on students' attitudes, knowledge, and skills. The 3 Co-TEAM models consist of 18 hours of course modules. A multiple-choice and essay quiz was used to assess students' mastery of essential abilities pre and post elective courses. After the last teaching session, students' self-perceived attitude, knowledge, and skills were evaluated through a voluntary survey. Of the 60 students in the third year, only 7 students are willing to voluntarily take the elective course. The development of the curriculum resulted in a course of 3 modules, the duration of each course was 2 hours. Results showed that there was a significant improvement in knowledge overall mean score before and after the course (38.79, SD=7.11 and 81.21, SD=5.34, respectively, p&lt;0.05). The overall mean composite score in the student’s perceived attitudes, knowledge, and skills was increased by 48.35%, 96.43%, 51.91%, respectively; p&lt;0.05. This elective course has proven to be a successful way of educating pharmacy students. We advocate the incorporation of this style of education into the learning process to improve student's learning experiences while still supporting traditional healthcare learning.

A40The importance of human factors and the implementation of the ‘Social GRACES’ in simulation training: a 6-month review of foundation simulation training at Guys and St Thomas’ (GSTT) NHS Foundation Trust

Traditionally the focus of simulation has been centred on clinical management. More recently there has been a drive to enhance training on ‘human factors’ [1]. In simulation, human factors can be challenging to replicate, particularly with regards to how individuals interact within a system. At GSTT we introduced a concept known as ‘social GRACES’ into simulation training. Social GRACES, first described by John Burnham in 1992 [2], outline a framework to understand an individual’s personal and social identity. An abundance of research into the development of human factors skills exists in the literature. Our aim was to integrate social GRACES into our simulation programme as a novel approach to engage trainees with human factors. Between October 2022- April 2023, there were 23 full-day simulation training days. The course started with an introduction on human factors and the social GRACES. This was followed by a ‘lost at sea’ activity where trainees worked individually and in teams to prioritize the items they would take if lost at sea. This was followed by 4 clinical scenarios with debriefs related to clinical management, human factors and social GRACES. Pre and post course questionnaires were disseminated, and delegates were consented for data being used for quality improvement. Unique identifiers allowed for paired data analysis. 101 pre-course and 138 post-course feedback forms were received. To allow for paired analysis, only completion of both questionnaires was included, leaving 83 responses. There was a statistically significant increase in the percentage of responders who strongly agreed they felt confident in recognizing (7.2%-35.2%), assessing (15.7%-43.4%), managing (3.6%-20.5%) and escalating care (15.7%-35%), in acutely unwell patients. Additionally, confidence improved in understanding the impact of human factors in delivering care (9.6%-35%) and the performance of healthcare professionals (9.6%-39.8%). We explored confidence with regards to the practical implementation of human factors in healthcare ( 10 questions were devised to assess confidence relating to practical aspects of human factors in healthcare with regards to teamwork, communication, and leadership. Following paired data analysis, we found a statistically significant improvement in confidence in all areas investigated. The results demonstrate that the interplay between managing acute clinical scenarios &amp; human factors can effectively be taught through simulation and enhanced with an understanding of social GRACES. An increased understanding of human factors and simulation training was useful in improving 3 crucial skills; teamwork, communication and leadership, which are instrumental in improving clinician confidence and patient outcomes. Future direction should look to include awareness and implementation of human factors within mainstream simulation to effectively replicate real time clinical scenarios &amp; pressures. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

A107Mental Health Simulation for Foundation Doctors: Bridging the gap of placement variation

There is significant variation of foundation programme tracks across the United Kingdom, giving a range of clinical exposure to newly qualified doctors [1]. Common themes in tracks can be identified to include acute/emergency, community, general medicine, surgery and psychiatry components. In the deanery, many Foundation Trainees (FTs) on psychiatry will have up to 3 additional simulation days devoted to psychiatry themes and this is felt to be an especially effective way to supplement education on psychiatry consultation skills [2]. FTs who do not have psychiatry posts will not have the opportunity to attend this training. Typically, mandatory foundation simulation training focuses on human factors related to acute medical and surgical problems [3]. Our education department has developed a pilot programme to support simulation training on key mental health consultations to support well rounded training of FTs. Half day sessions have been delivered to small groups of FTs who do not have psychiatry posts. Faculty has included experienced simulation faculty and psychiatry doctors and the scenarios conducted in a small group format with professional actors playing patients for increased realism of scenarios. The participants rotated between 3 key scenarios covering essential themes of mental state examination, psychiatry team liaison, patient risk assessment and explaining mental health presentations. 2 sessions have been delivered for a total of 18 FTs. FTs showed insight to a number of challenges related to mental health presentations they had experienced outside of psychiatric settings and this formed the outline of the learning objectives for the session. The participants further reflected on discussions in their feedback from the session and portfolio. The sessions were well received, with improvement in confidence in managing these consultations demonstrated in pre and post course survey comparison from the majority of participants. Given the initial success of the session, the team is building a database of local faculty for continuity of the course and looking to secure relevant funding from HEE to provide further sessions for the FTs in the next academic year. This simulation pilot has shown promise to be a useful addition to supplement the education of FTs for mental health consultations applicable in all areas of their clinical practice. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Research on Blended Teaching of Computer Fundamentals in Art Universities under the Concept of Curriculum Ideology and Politics

Combining the characteristics of art majors and enhancing the ideological and political abilities of courses through aesthetic education, this paper proposes a mixed online and offline teaching mode for university computer basic courses. It also provides a detailed introduction to the effective integration of ideological and political education in the implementation process of computer basic teaching in art universities, as well as pre class preview, course organization, and post class review. It explores and practices the reform of mixed teaching for computer basic courses in art universities, it can effectively improve the quality of teaching.

MP25-10 IMPLEMENTING A NOVEL STRESS RESILIENCE TRAINING CURRICULUM AMONG UROLOGY TRAINEES: PROOF OF CONCEPT IN CURRICULUM DESIGN

You have accessJournal of UrologyCME1 Apr 2023MP25-10 IMPLEMENTING A NOVEL STRESS RESILIENCE TRAINING CURRICULUM AMONG UROLOGY TRAINEES: PROOF OF CONCEPT IN CURRICULUM DESIGN Angeline Johny, David Wittkower, William Whitworth, Carter Lebares, and Jennifer Taylor Angeline JohnyAngeline Johny More articles by this author , David WittkowerDavid Wittkower More articles by this author , William WhitworthWilliam Whitworth More articles by this author , Carter LebaresCarter Lebares More articles by this author , and Jennifer TaylorJennifer Taylor More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003253.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Burnout is a pervasive issue in healthcare, with urology trainees reporting burnout rates as high as 63.8%. Resilience training is a proven tool to prevent burnout and improve performance in high stress working environments, with demonstrated efficacy in surgical residency programs. Enhanced Stress Resilience Training (ESRT) is a mindfulness-based cognitive skills training developed and validated by Dr. Carter Lebares and the UCSF Center for Mindfulness in Surgery. ESRT offers tools to reframe thoughts and promote emotional regulation. The primary goal of this study is to assess feasibility and to introduce a curriculum to expand a pre-existing program focused on wellness and individual skill development. METHODS: Through consultation with Dr. Lebares, we customized course structure to include a didactics presentation and five ESRT sessions taught over Zoom by a certified ESRT instructor, a retired surgeon. We conducted the sessions in place of standard departmental conferences to mitigate personal time used for the training. Baseline descriptive pre and post course data was collected using validated surveys, including the Mental Health Continuum Short Form, Physician Wellbeing Index, and the Connor Davidson Resilience Index, with a subsequent focus group to gain qualitative data on overall course perception. Using two-sample t-tests, we compared differences between and pre and post course responses. RESULTS: There were 33 participants in the course, with 20 residents, 7 faculty, and 6 others (student/APP). Surveys were completed by 30 participants pre course and 15 participants post course, with 15 sets of paired data. There were no statistically significant differences in self-reported wellbeing or stress response after course participation; however, participants were significantly more likely to use meditation as a stress coping mechanism after the course (p=0.008). Qualitative descriptive results demonstrated a 15% increase in participants’ understanding of the impact mindfulness practices have on work performance. CONCLUSIONS: Our program successfully implemented ESRT via a novel remote delivery format. Although our analysis was limited by small sample size, our pilot study highlights feasibility in implementation. This curriculum also showed resident skill development in stress regulation through mindfulness practices. Next steps would include repeat delivery within the program to promote durability, and possible expansion beyond our single program. Source of Funding: Norton Rose Fulbright Educational Grant © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e346 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Angeline Johny More articles by this author David Wittkower More articles by this author William Whitworth More articles by this author Carter Lebares More articles by this author Jennifer Taylor More articles by this author Expand All Advertisement PDF downloadLoading ...

413 Addressing Healthcare Disparities in Patients Undergoing Cervical Spine Surgery

INTRODUCTION: Health disparities may be observed across pre and post-operative hospital courses amongst patients undergoing cervical spine surgery across racial minorities and their white counterparts. METHODS: Retrospective data analysis of the Thomas Jefferson University Center City Department of Neurosurgery undergoing cervical spine surgeries (based on select CPT codes) between January 1, 2018, and January 6, 2021, was conducted to evaluate healthcare disparities across the post-operative management of cervical myelopathy cases as part of a quality improvement initiative. Outcomes evaluated included: hospital length of stay, the 30-day hospital readmission rate, and discharge disposition (home vs non-home). Normality was assessed using Kolmogorov-Smirnov test. Readmission rates, length of stay (LOS) in days, and discharge disposition (DD) (home vs. non-home) were analyzed using the Student's T-test, ANOVA, and Mann-Whitney test. RESULTS: Two thousand twenty-five patients were identified that met inclusion criteria, of which 298 (15%) were readmitted within 30 days to the Emergency Department at Thomas Jefferson University Hospital. Of the 15% readmitted, 74% (223/298) were white, while 25% (75/298) were non-white. Non-white LOS was higher compared to the white population (5.7 days vs 4.3 days, p &lt; 0.0001. Non-white readmission rate was higher compared to the white population (22.3% vs 16%) p &lt; 0.001. Non-white DD was higher compared to the white population (61.9% vs 50%) p &lt; 0.001. CONCLUSIONS: Significant disparities exist in the post-operative management of patients with cervical myelopathy, particularly affecting the non-white population. Health disparities exist across multiple aspects of the discharge process for post-cervical spine surgery cases. Future investigations and interventions are required to address this quality gap.

Implementation of a novel ultrasound training programme for midwives in Malawi: A mixed methods evaluation using the RE-AIM framework.

Despite recommendation that all women receive an ultrasound in pregnancy prior to 24 weeks', this remains unavailable to many women in low-income countries where trained practitioners are scarce. Although many programmes have demonstrated efficacy, few have achieved longterm sustainability, with a lack of information about how best to implement such programmes. This mixed-methods study aimed to evaluate the implementation of a novel education package to teach ultrasound-naive midwives in Malawi basic obstetric ultrasound, assessing its impact in the context of the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. The study ran across six sites in Malawi between October 2020 and June 2021, encompassing three phases; pre-implementation, implementation and post-implementation. Twenty nine midwives underwent a bespoke education package with matched pre and post course surveys assessed their knowledge, attitudes and confidence and "hands on" assessments evaluating practical skills. Training evaluation forms and in-depth interviews explored their satisfaction with the package, with repeat assessment and remote image review evaluating maintenance of skills. 28/29 midwives completed the training, with significant increases in knowledge, confidence and practical skills. Adherence to the education package varied, however many changes to the proposed methodology were adaptive and appeared to facilitate the efficacy of the programme. Unfortunately, despite reporting approval regarding the training itself, satisfaction regarding supervision and follow up was mixed, reflecting the difficulties encountered with providing ongoing in-person and remote support. This programme was successful in improving trainees' knowledge, confidence and skill in performing basic obstetric ultrasound, largely on account of an adaptive approach to implementation. The maintenance of ongoing support was challenging, reflected by trainee dissatisfaction. By evaluating the success of this education package based on its implementation and not just its efficacy, we have generated new insights into the barriers to sustainable upscale, specifically those surrounding maintenance.

Pre and Peri-liver transplant clinical course and outcome of children diagnosed as biliary atresia in the context of accompanying cystic changes in biliary tree-A comparative study

Pre and Peri-liver transplant clinical course and outcome of children diagnosed as biliary atresia in the context of accompanying cystic changes in biliary tree-A comparative study

Effectiveness of accredited training courses by Nursing Colleges of Malaga during 2022

Today no one doubts the need for quality professional training to achieve individual professional progress in each profession. In Nursing, updating knowledge in considered essential in the science of care. One of the best indicators of the quality of the training offer in health professions is to achieve the accreditation of a responsible agency. Another indicator may be to demonstrate the effectiveness of such training. The objective of this work is precisely that, to evaluate the effectiveness of the accredited training of the Training Department of the College of Nursing of Malaga in the year 2022, by analyzing the scores of the pre and post course tests. With this objective, we designed a pretest-posttest study, in which participated all the students involved in the accredited training activities developed by our organization from January to December 2022 participated. During the study period, 11 courses were accredited, with a total of 246 attendees. These were mostly women (213 vs 33). The effectiveness of the training activity showed an increase in the scores of the previous and final tests of 1.79 points (p&lt;0.05). In this scenario, with a majority of accredited courses that were online or in the B Learning modality, a significant increase in final evaluations has been achieved. As a line for the future, we plan to study the effectiveness of the different didactic methodologies used in training activities.

Análise de um programa de identificação e intervenção da perda auditiva nos primeiros anos de vida na atenção primária

ABSTRACT Purpose: to analyze the implementation and effectiveness of a hearing loss identification and intervention program in the first years of life in primary care. Methods: an experimental study carried out in two Basic Health Units. Twenty-three Community Health Workers participated, trained through an online self-instructional course from the Ministry of Health. Subsequently, they followed the hearing and language of children from zero to two years old, referring them, if necessary, to audiological evaluation. For the analysis of pre and post online course knowledge, the Wilcoxon test was applied, and to compare the performance between the participants of the two Basic Health Units, the Mann Whitney test was used, adopting p&lt;0.05. Additionally, the qualitative perception of participating community workers, the referrals, and the result of the audiological evaluation were analyzed. Results: the online course was effective in improving the knowledge of the participants. A total of 102 children were monitored, 15 of them were referred for evaluation. From these, four underwent hearing screening and 11 underwent a complete hearing assessment, a case of conductive hearing loss being identified. Conclusion: the implementation of a program for the identification and intervention of hearing loss, in the first years of life, in primary care, permeated by community health workers, is feasible.

The effect of the Dar es Salaam neurosurgery training course on self-reported neurosurgical knowledge and confidence

IntroductionThe Muhimbili Orthopaedic Institute in collaboration with Weill Cornell Medicine organises an annual neurosurgery training course in Dar es Salaam, Tanzania. The course teaches theory and practical skills in neurotrauma, neurosurgery, and neurointensive care to attendees from across Tanzania and East Africa. This is the only neurosurgical course in Tanzania, where there are few neurosurgeons and limited access to neurosurgical care and equipment. Research questionTo investigate the change in self-reported knowledge and confidence in neurosurgical topics amongst the 2022 course attendees. Material and methodsCourse participants completed pre and post course questionnaires about their background and self-rated their knowledge and confidence in neurosurgical topics on a five point scale from one (poor) to five (excellent). Responses after the course were compared with those before the course. ResultsFour hundred and seventy participants registered for the course, of whom 395(84%) practiced in Tanzania. Experience ranged from students and newly qualified professionals to nurses with more than 10 years of experience and specialist doctors. Both doctors and nurses reported improved knowledge and confidence across all neurosurgical topics following the course. Topics with lower self-ratings prior to the course showed greater improvement. These included neurovascular, neuro-oncology, and minimally invasive spine surgery topics. Suggestions for improvement were mostly related to logistics and course delivery rather than content. Discussion and conclusionThe course reached a wide range of health care professionals in the region and improved neurosurgical knowledge, which should benefit patient care in this underserved region.

Abstracts Teaching Kitchen Research Conference Los Angeles, California October 18–19, 2022

Abstracts Teaching Kitchen Research Conference Los Angeles, California <i>October 18–19, 2022</i>

How can critical thinking be recognised and developed in students that are still developing tertiary-level English language proficiency?

As many international students attending Western universities do not have English as their first language, they can experience difficulty sharing their wealth of ideas. As critical thinking and academic writing are often mutually dependent, this study sought to explore how international students express their ideas and how this can be further supported in the classroom. Using educational design research, 20 tertiary foundation students received 12 weeks instruction in critical thinking and academic writing and their output assessed pre and post course. The study established that students could demonstrate critical thinking on entry to the program and, with focused instruction, were able to further enhance their skills. However, findings also illustrate that the students did not possess the same ability to construct advanced written representation of their ideas. This study suggests that consideration be given to alternate methods of assessment and instruction that recognise international students’ existing critical thinking skills base.

Impacts of Prosthetic Innovation in Ecuador Study Abroad Course.

Biomedical engineering (BME) students typically have a schedule filled with specific course requirements, leaving little room for spending a semester studying abroad. We established a new short-term BME study abroad course, partnering with a non-profit healthcare organization that provides high-quality prosthetic care to underserved populations. This innovative study abroad course was met with great student demand. The impact of this short-term study abroad course is increased by developing year-long BME senior capstone design projects based on the needs identified throughout the experience in Ecuador. Shortly after the conclusion of spring semester, students and two BME faculty/staff traveled to Ecuador. During the work week, the students participated in small teams in patient evaluations, castings, fabrication of prosthetics, device fittings, rapid prototyping-testing iterations, and post-prosthesis gait training with physical therapy. Weekends included guided cultural activities. Each student maintained a journal that reflected observations and insights from these experiences. Upon return to the US, students that registered for an additional course credit created video reflection presentations and wrote project proposal reports based on the needs identified in Ecuador. The project proposal reports were used to develop a BME senior capstone design project. Pre and post course self-assessment surveys showed significant increases in five ABET learning outcomes, three BME learning outcomes, and four course-specific learning outcomes. Students who took the two-credit course reported significant increases in four more learning outcomes than students who took the one-credit course. Many students described the experience as inspiring and life-changing, and the program continues to run each summer.

Abstract 12970: Predictors of Stroke and Mortality in Children Who Undergo Ventricular Assist Device Placement: An Evaluation of Pre And Post-Operative Risk Factors Linked From the Advanced Cardiac Therapies Improving Outcomes Network (action) and Pediatric Cardiac Critical Care Consortium (pc4) Registries

Introduction: Ventricular assist devices (VAD) have improved outcomes in children with advanced heart failure. However, despite improvements in adverse event rates, mortality and early post-VAD stroke remain important consequences. We sought to determine pre and post-operative factors that increase the risk of these outcomes utilizing data linked from the ACTION and PC4 registries. Methods: ACTION and PC4 registries are audited, comprehensive, encounter-based registries of patient course and outcomes for pediatric heart failure and pediatric cardiac critical care respectively. Data from patients who underwent initial VAD placement in each registry from 8/2014-7/2020 were linked using indirect patient identifiers. Patient demographics, heart disease, pre and post-operative ICU courses and outcomes were compiled. Appropriate descriptive and univariate statistics assessed association of patient factors with hospital mortality and stroke. Multivariable logistic regression sought independent associations with these outcomes. Results: 248 ACTION subjects were linked to a matching patient in PC4 with 98% match concordance. Median age was 7.7 years (1.5-15.5), weight 21.3kg (9.1-58) and 56% male. The cohort had 66% LVAD, 23% Single ventricle VAD and 10% BiVAD. Of the devices, 52 (21%) were Berlin EXCOR, 95 (38%) intracorporeal continuous flow, and 30 (12%) temporary continuous flow. The primary diagnosis was congenital heart disease in 35% of patients. Overall, 32 patients (13%) had a stroke and 45 patients (18%) died prior to discharge. Multivariable analysis found risk factors for mortality included only congenital heart disease (OR=3.78 [95%CI: 1.16-12.29], p=0.027), INTERMACS profile 1 (OR=6.51 [95%CI: 1.08-39.26], p=0.041), post-operative hepatic dysfunction (OR=37.35 [95%CI: 4.39-317.76], p&lt;0.01) and stroke (OR=5.33 [95%CI: 1.4-20.31], p=0.014). For stroke, no significant independent predictors were identified. Conclusion: Critical care therapies are not independently associated with post-VAD hospital death or stroke. Post-operative liver injury and stroke were associated with mortality.