Pre-post Intervention Study Research Articles

Implementing the ask-advice-connect method in a university hospital

Abstract Funding Acknowledgements Type of funding sources: None. Background Smoking cessation reduces the relative risk of morbidity and mortality.(1, 2) Healthcare professionals (HPs) can play a substantial role in smoking cessation counselling (SCC) but in practice often skip this task.(3, 4) A quick and effective method for HPs to assist is the Ask-Advise-Connect method in which the physician asks about smoking, advises to quit and offers to connect the patient to an external SCC program.(5) Purpose To evaluate an intervention aimed to implement the Ask-Advise-Connect (AAC) method in a University hospital. Methods This mixed methods pre-post interventional study was performed at the Cardiology department of a University hospital and consisted of 1) semi-structured interviews with 10 HPs to assess their attitudes towards AAC, 2) a blended intervention aimed to implement AAC, and 3) quantitative assessment of patient smoking registration and HP connection rates to external SCC which were collected from the Electronic Medical Record. In total, 48,321 patient consultations and 67 HPs were included. The blended intervention consisted of face-to-face and online AAC psychoeducation for HPs followed-up with motivational messages over a period of 6 weeks. Results Before the intervention, HPs assessed smoking status in 74.0% of patients and connected 9.3% of identified smokers with external SCC. The blended intervention did not increase these percentages at post-test (respectively 73.2%, p=0.20; and 10.9%, p>0,05). Nonetheless, the vast majority of HPs feel it is important to discuss patient smoking, and view it as their duty to do so. Main barriers to AAC reported by HPs were forgetfulness and time pressure. Conclusion This study shows that this AAC intervention does not increase Asking after smoking status or Connection of patients to SCC. However, HPs hold positive attitudes towards AAC. A better understanding of the mechanisms required for changing HPs practice behavior is needed.

Reducing Laboratory Turnaround Time in Patients With Acute Stroke and the Lack of Impact on Time to Reperfusion Therapy.

Timely reperfusion improves the recovery of patients with acute ischemic stroke. Laboratory results are crucial to guide treatment decisions in patients when abnormal laboratory tests are suspected. To implement a new laboratory workflow for acute stroke patients and compare laboratory turnaround time (TAT) preimplementation and postimplementation. We conducted a retrospective pre-post intervention study of patients with suspected acute stroke during the 4-month periods before and after the implementation of a new laboratory workflow process. The improvement process included relocating the specimen registration site, laboratory notification before specimen arrival, a color-coding system on tubes, timing at all processes, and eliminating the smear review if platelets were normal. TATs of the laboratory and door-to-clinical intervention times before and after the improvement process were compared. Postintervention, median specimen transportation time decreased from 11 (interquartile range [IQR], 8.4-16.4) to 9 minutes (IQR, 6.3-12.8), P < .001. The intralaboratory and total TATs of complete blood cell count, coagulation tests, and creatinine significantly decreased (P < .001 for all). Blood drawn-to-laboratory reported time decreased from 43 (IQR, 36.0-51.5) to 33 minutes (IQR, 29.2-35.8, P < .001). However, door-to-needle time for thrombolysis and door-to-puncture time and door-to-recanalization time for mechanical thrombectomy were not statistically different (P = .11, .69, and .50, respectively). The new laboratory workflow significantly decreased transportation time, TAT of individual tests, and the blood drawn-to-laboratory reported time. However, the time to treatment of acute ischemic stroke patients was not different between preimplementation and postimplementation.

Rehabilitation for atraumatic shoulder instability in circus arts performers: delivery via telehealth.

The Watson Instability Program (WIP1) is current best evidence for conservative management of atraumatic shoulder instability, but it is unknown if this program can be effectively delivered via tele-consultation. The purpose of this longitudinal pre-post intervention study was to determine the effects of the WIP1 on patient-reported outcome measures, scapular position, shoulder strength, and handstand stability in student circus performers with atraumatic shoulder instability when delivered via tele-consultation. Student circus performers aged between 15 and 35 years from the National Institute of Circus Arts were recruited. A 12-week shoulder exercise program was delivered via tele-consultation during the Melbourne, Australia COVID-19 (coronavirus disease 2019) lockdown. The primary outcome measures were the Western Ontario Shoulder Instability Index score and the Melbourne Instability Shoulder Scale score. Secondary outcomes measures included the Orebro Musculoskeletal Pain Questionnaire, the Tampa Scale for Kinesiophobia, and physical assessment measures including strength via handheld dynamometry, scapular position using an inclinometer, and handstand stability via center-of-pressure fluctuation. Patient-reported outcomes were collected at baseline and 6-week, 12-week, 6-month, and 9-month time points, and physical outcomes were measured at baseline and 9-month time points. A repeated-measures mixed model (with effect sizes [ESs] and 95% confidence intervals [CIs]) was used to analyze patient-reported outcomes, handstand data, strength, and scapular measures. Significance was set at P < .05. Twenty-three student circus arts performers completed the study. Significant improvements were found in both Western Ontario Shoulder Instability Index scores (effect size [ES], 0.79 [95% CI, 0.31-1.33] at 6 weeks; ES, 1.08 [95% CI, 0.55-1.6] at 12 weeks; ES, 1.17 [95% CI, 0.62-1.78] at 6 months; and ES, 1.31 [95% CI, 0.74-1.95] at 9 months; P < .001) and Melbourne Instability Shoulder Scale scores (ES, 0.70 [95% CI, 0.22-1.22] at 6 weeks; ES, 0.83 [95% CI, 0.34-1.37] at 3 months; ES, 0.98 [95% CI, 0.46-1.54] at 6 months; and ES, 0.98 [95% CI, 0.43-1.50] at 9 months; P < .001), as well as Orebro Musculoskeletal Pain Questionnaire scores at all follow-up time points. The Tampa Scale for Kinesiophobia scores reached significance at 6 weeks and 12 weeks. Following rehabilitation, we found statistically significant increases in shoulder strength in all positions tested and increased scapular upward rotation measured at end-of-range abduction, as well as during loaded external rotation. The affected arm showed greater instability than the unaffected arm with a significant intervention effect on the affected arm showing a greater consistent anterior-posterior movement pattern. In a group of circus performers with atraumatic shoulder instability, treatment with the WIP1 via telehealth resulted in clinically and statistically significant improvements in shoulder symptoms and function.

Clinical Impact of the Capacity-Motivation-Opportunity Pharmacist-Led Intervention in People Living with HIV in Spain, 2019-2020.

BackgroundPeople living with HIV (PLWH) have significantly enhanced their life expectancy. Consequently, age-associated comorbidities and related health conditions are increasingly found in PLWH complicating their clinical management.ObjectiveTo determine the effect of the capacity-motivation-opportunity (CMO) structured pharmaceutical care intervention for improving clinical health-care results frequently associated to PLWH.MethodsMulticenter, prospective, pre-post intervention study evaluating the CMO pharmacist-led program in adult PLWH was conducted between September 2019 and September 2020 with six months of follow-up. The primary objective of this study was to determine differences in clinical outcomes (total cholesterol, triglycerides, HDL, blood pressure and glycosylated hemoglobin) and variation in the patient’s activation measure before and after the intervention.ResultsA total of 61 patients were included, 72% were men with a median age of 53 years. After the implementation of the pharmacist-driven program, the percentage of patients with high levels of total cholesterol decreased significantly (18% to 4.9%; p < 0.001). Similarly, the prevalence of patients with high levels of triglycerides, HDL or with hypertension was significantly lower post intervention (13.1% to 6.6%, p < 0.001; 47.5% to 6.6%, p = 0.019 and 24% to 4%, p = 0.009, respectively). The number of patients who achieved the highest activation level increased from 69% to 77.6% (p < 0.001).ConclusionThe CMO program resulted in significantly better health outcomes during the six months following the pharmacist-led intervention as well as improved activation in PLWH.

The impact of additional allied health staffing on rehabilitation outcomes at discharge from a sub-acute geriatric evaluation and management unit: A quasi-experimental, pre-post intervention study

Objective The purpose of this study was to examine the impact of increasing allied health staffing levels on patient and health service outcomes across 1) all Geriatric Evaluation and Management patients, and 2) Geriatric Evaluation and Management patients discharged to home in the community. Design Quasi-experimental, pre-post intervention study. Setting Two sub-acute hospital units in an Australian, tertiary health service. Subjects Data related to patients admitted to the study units, who were classified as Geriatric Evaluation and Management patients. Interventions Comparison of therapy time across two units with a differential in staffing allocation over a six-month trial period. Main measures Primary outcomes: length of stay, readmission rate, and improvement on the Functional Independence Measure. Secondary outcomes: total cost of admission per patient and number of allied health sessions. Results Data were analysed for 214 patients (mean age = 79.9, standard deviation (SD) = 9.4 years, mean Functional Independence Measure (FIM = 64.9, SD = 21.2) admitted to the intervention unit, and 199 patients (mean age = 81.3, SD = 8.5, mean FIM = 64.2, SD = 24.0) admitted to the control unit. The overall difference in staffing allocation between the control and intervention units for the trial period was 21%. There was no statistically significant difference between units in subacute length of stay (Adj Coef = -0.10 days, 95%CI = -0.39 to 0.19), rate of readmission (OR = 1.0, 95%CI = 0.5 to 2.0) or change in function (Coef = 1.42 FIM change score, 95%CI = -2.4 to 5.3). Conclusions Increasing allied health staffing allocation to a unit over six-months did not impact change in function or length of stay for patients admitted for Geriatric Evaluation and Management.

Tailored order set in the electronic health record decreases postoperative opioid prescriptions

BackgroundAdherence to opioid prescribing protocols after operations remains challenging despite published guidelines. Integration of these guidelines with the electronic health record could potentially improve their adoption. We hypothesize that implementing an electronic health record order set containing prepopulated tablet quantities tailored to surgical procedures based on published guidelines will decrease postoperative opioid prescription. MethodsWe conducted a 12-month prepost intervention study on adult patients who underwent appendectomy, cholecystectomy, inguinal or umbilical hernia repair, thyroidectomy, or parathyroidectomy at a single institution. An electronic health record order set was developed with prepopulated opioid tablet quantities reflecting the upper limit of published recommendations. The primary endpoint was change in morphine milligram equivalent prescribed postintervention and was analyzed using linear regression adjusting for age, race, procedure, and prescriber training level. Secondary endpoints were emergency department visits for pain-related issues and opioid refill rates. ResultsWe identified 524 patients (mean age = 53, 51% male) in our baseline cohort and 433 patients (mean age = 52, 58% male) in our postintervention group. The mean morphine milligram equivalent prescribed was 62.6 and 50.4 for the preintervention and postintervention cohorts, respectively (P = .049). Thyroidectomies and parathyroidectomies achieved the largest decrease after intervention, which decreased to 42.6 morphine milligram equivalent from 79.7 morphine milligram equivalent preintervention (P < .001). Refill rate was 1.6% postintervention compared to 3.1% preintervention (P = .20), and emergency department visit for pain control rate was 0.2% post intervention and 2.5% preintervention (P = .005). ConclusionAn electronic health record tailored order set based on prescription guidelines is a safe, effective, and scalable intervention for decreasing opioid prescriptions after operations.

Effect of orange almond potato cookies supplementation on the nutritional status of underweight preschool-aged children during COVID-19 pandemic.

Most undernourished preschool-aged children have low hemoglobin and albumin levels, which leads to a higher risk of infections, including COVID-19. This study was designed to determine whether potato almond orange cookies increase weight, hemoglobin, and albumin) in undernourished preschool-aged children during the COVID-19 pandemic. A pre-post intervention study was conducted with 30 subjects during 8 weeks in which hemoglobin and albumin levels were recorded at the beginning and end. Education on balanced nutrition was provided to mothers using leaflets, flipcharts, and videos. The results showed increases in weight (0.4 kg), height (1.98 cm), hemoglobin level (0.1 g/dL), and albumin level (0.1 g/dL) accompanied by a significant increase in weight, height, and the Z-score index for weight for age, whereas those for Hb and albumin levels were not. Energy, carbohydrate, fat, vitamin C, vitamin E, and iron intake increased significantly. Further, there was a significant difference in mothers’ knowledge of balanced nutrition and COVID-19 at the end of the study. Thus, high levels of cookie consumption increased the weight of underweight preschool-aged children. Future studies may wish to consider examining the issue using stunted, wasted, and anemic preschool-aged children as the research subjects.

A pharmacist-led educational intervention to improve nebulization-related knowledge and practices of nursing staff: a pre–post interventional study from Pakistan

A pharmacist-led educational intervention to improve nebulization-related knowledge and practices of nursing staff: a pre–post interventional study from Pakistan

Effects of a Competency-Based Education Program for Inpatient Psychiatric Nurses: A Pre-Post Intervention Study

Purpose: This study aimed to develop a competency-based educational program for strengthening the competency of psychiatric nurses and evaluate its effects.Methods: The study used a quasi-experimental design. Participants included 64 psychiatric nurses in South Korea: 33 nurses (32 females, 1 male) in the experimental group and 31 nurses (26 females, 5 males) in the control group. A competency-based education program for psychiatric nurses was developed through a literature review and discussion with 12 experts. The program addressed eight topics and provided 24 hours of education over 4 days, for 6 hours each day. The collected data via questionnaires were analyzed statistically.Results: The education program enhanced overall clinical nursing competence and strengthened professional self-growth competence. The management and teaching competencies of both the experimental and the control groups also increased significantly.Conclusion: The findings of this study presented an educational program to strengthen the clinical competency of psychiatric nurses and it was proven that the education had a capacity-building effect.

Student pharmacist opioid risk consultations: a pre-post educational intervention study.

The primary aim was to assess third year student pharmacists' communication skills about opioid risks and safety before and after an educational intervention. This assessment was utilized to identify gaps that skills training programmes need to address for students and pharmacists. Seventy-one students in 2018 (pre-intervention/baseline) and 133 students in 2019 (post-intervention) were videotaped during consultation with standardized patients receiving opioid medications for low back pain. The consults were quantitatively coded for what topics students discussed, terms used, eye contact and filler words. Coding of video-recording had high inter-rater reliability (kappa = 0.90). A significant increase was seen in the post-intervention phase compared with baseline data in the number of students who mentioned the term opioid and initiated conversations about opioid risks. The majority of student pharmacists discussed common opioid side effects and performed teach-back with patients. In both of the phases, students used more filler words when discussing dependence, addiction or overdose risk when compared with the rest of the consult. At baseline, students in the expressed discomfort and desired additional training and resources for communicating about opioids, and students in the post-intervention phase reported increased confidence. This educational intervention demonstrated improved opioid risk communication skills among student pharmacists. This study warrants national evaluation of student pharmacist preparedness and provision of structured education and training as necessary to help empower student pharmacists as opioid risk and safety educators.

A Novel Blended Learning Module in Family Medicine: An Interventional Study at the Faculty of Medicine, Suez Canal University, Ismailia, Egypt

Blended learning (BL) has been reported as an effective method for teaching family medicine to undergraduates in high-income countries; however, studies of its effectiveness are limited in low- and middle-income countries. This study aimed to assess the effectiveness of an innovative BL module in family medicine including knowledge, skills and attitudes (KSA), and e-learning experiences. The grades of the fourth-year medical students at the Faculty of Medicine, Suez Canal University were correlated with the above items. A pre–post interventional study was conducted on a convenience sample of 117 fourth-year students in the educational year 2017–2018. Their KSA were assessed using valid and reliable questionnaires before and after the intervention was implemented. The intervention combined the traditional training in primary healthcare settings with the newly designed asynchronous e-learning module on the Moodle platform. The prepared website consisted of e-sections and an e-forum which was validated by expert staff. A questionnaire about students’ e-learning experiences was used to assess students’ satisfaction. The students’ final fourth-year marks for the family medicine module were correlated with their KSA and e-learning satisfaction. The overall means of students’ KSA were statistically significantly improved post-implementation. The posttest students’ skills were positively correlated with their marks in family medicine (rs = 0.308, p = 0.001). Students valued the e-resources and their relevance to the face-to-face activities. They were satisfied with their e-learning experiences (54.7%). Their e-learning satisfaction was positively correlated with the improvement in their knowledge (rs = 0.20, p = 0.031). BL had positive effects on students’ KSA and their satisfaction with the family medicine module. Combined asynchronous and synchronous e-learning in the COVID-19 era was applied in this study.

The effect of Patient\u2019s Own Medication use on patient\u2019s self-reported medication knowledge during hospitalisation: a pre-post intervention study

BackgroundImproving patient’s medication knowledge and consequently medication use is essential for optimal treatment outcomes. As patient knowledge about medication is currently suboptimal, interventions to optimise medication knowledge are necessary. Implementation of Patient’s Own Medication (POM) in which patients bring their outpatient medication to the hospital, and nurses administer these during admission, may increase medication knowledge. The aim of this study is to explore the impact of POM use on self-reported medication knowledge of hospitalised patients compared to standard care. Patient’s sense of medication safety, attitude to the provision of information, and to inpatient medication use were studied in both standard care and during POM use too.MethodIn this nationwide intervention study perceived medication knowledge was assessed with a questionnaire pre and post implementing POM use. The questionnaire assessed perceived medication knowledge at admission and discharge, medication safety during hospitalisation, the provision of information during hospitalisation and at discharge, and inpatient medication use during hospitalisation. Patients’ answers were categorised into positive and negative/neutral. The proportion of patients with adequate medication knowledge, in the standard care and POM use group at hospital admission and discharge, were calculated and compared with adjustment for potential confounders.ResultsAmong the 731 patients (393 received standard care and 338 POM) who completed the questionnaire (80.2%), POM use seemed to be positively associated with self-reported knowledge on how to use medication at discharge (adjusted OR: 3.22 [95% CI 2.01–5.16]). However, for the other two knowledge related statements POM use was not associated. Medication knowledge at admission was the most important variable associated with perceived medication knowledge at discharge. The majority perceived POM use to be safer (52.9% of standard care patients versus 74.0% POM users; P < 0.01), POM users knew better which medicines they still used during hospitalisation (85.8% versus 92.3% resp.; P = 0.01), and most patients preferred POM use regardless of having experienced it (68.2% versus 82.2% resp.; P < 0.01).ConclusionPOM use positively affects patient’s medication knowledge about how to use medication and patients’ perception of medication safety. With POM use more patients have a positive attitude towards the provision of information. The majority of patients prefer POM use. In conclusion, POM use seems a valuable intervention and requires further investigation.

Stand Up for Indigenous Health: A Simulation to Educate Residents About the Social Determinants of Health Faced by Indigenous Peoples in Canada.

In Canada, Indigenous peoples face significant health disparities. To improve health outcomes of and provide culturally safe care to Indigenous patients, medical learners must receive training on the social determinants of health (SDOH) driving these health inequities. The authors developed Stand Up for Indigenous Health (SU4IH), an immersive 2-hour simulation where participants navigate a series of scenarios as an Indigenous person. The objective of this pilot study was to assess whether SU4IH promotes intercultural empathy and enhances medical learners' knowledge of Indigenous SDOH. The authors partnered with 4 Indigenous communities in Ontario, Canada, from urban, rural, and remote settings to develop the scenarios for SU4IH between June 2015 and March 2016. During each SU4IH simulation, learners experience 14 scenarios using the Stand Up for Health mobile app, which automatically calculates each individual's financial balance and stress levels as the simulation unfolds. The authors conducted a pre-post intervention study of SU4IH in January 2019 with family medicine residents recruited from 2 training sites in Ontario (n = 29). Residents completed pre- and postsurveys assessing change in empathy toward Indigenous patients (primary outcome), knowledge of Indigenous SDOH (secondary outcome), and motivation to engage with Indigenous patients in a culturally safe manner (secondary outcome). Residents' empathy scores significantly increased after participating in SU4IH (P < .001), as did residents' knowledge of Indigenous SDOH (P < .001) and motivation to engage with Indigenous patients in a culturally safe manner (P = .031). The authors are working to expand their capacity to implement this learning tool across Canada, which has involved relationship building with medical learners and faculty outside of Ontario who will need to partner with Indigenous communities in their region to develop region-specific scenarios. SU4IH is also being redesigned for small-group and virtual formats to facilitate its expansion.

The role of primary physician training in improving regional standardized management of diabetes: a pre-post intervention study

BackgroundHierarchical diagnosis and treatment has been gradually implemented throughout the China. Primary physicians are the main force in primary-level medical and health services, which means that standardized training of primary-level doctors is indispensable.ObjectivesEvaluation of the effect of primary physician training on standardized management of diabetes, and comparison of the effects of different training models.MethodThe study selected 24 community health service centers from 4 cities in Liaoning Province, and consisted of two groups: primary physicians (n = 2083) who received training; and patients with diabetes (n = 585) in community health service centers. Short-term training effects on primary physicians were assessed through diabetes knowledge tests at baseline and at the end of training; the long-term effects of training on patients with diabetes were assessed by questionnaires at baseline and 1 year after training. The differences in training effects between different training models were compared. Complication screening results were also assessed.ResultsAfter training, the primary physicians’ knowledge of diabetes diagnosis and treatment improved (p < 0.05). The complication screening rate of local diabetes patients increased from 22.2% before training to 27.7% 1 year after training (p = 0.033). There were significant differences in the training effect between different training models (p = 0.038). The short-term intensive training group demonstrated the greatest training effect, primary physicians under this training model are more likely to conduct standardized screenings for patients (OR = 1.806, 95%CI 1.008–3.233), and the complication screening rate was the highest (37.6%).ConclusionThis study shows that training of primary physicians is an effective way to improve the standardized management of diabetes, by improving the ability of primary physicians to manage diabetes in a standardized manner, so that patients in primary hospitals receive more comprehensive diagnosis and treatment services. Compared with scattered training throughout the year, short-term intensive training was found to be more effective.

Influences on Non-Pharmacological Pain Management Decision-Making

PURPOSE: People with persistent pain may choose non-pharmacological pain management modalities for a variety of reasons, including cultural practices, financial resources, education and overall dissatisfaction with traditional methods of pain management. This IRB-approved qualitative study investigated perceptions regarding various complementary or alternative pain management options to increase understanding of decision-making for adults receiving opioids for persistent pain. Methods: A qualitative descriptive study was conducted to investigate data from adults (N=5) enrolled in a pre-post intervention study testing the receptivity and effects of non-pharmacological telehealth consultations for adults receiving opioids for persistent pain.

The Benefits of a Therapeutic Exercise and Educational Intervention Program on Central Sensitization Symptoms and Pain-Related Fear Avoidance in Breast Cancer Survivors

BackgroundCentral sensitization symptoms and pain-related fear avoidance are two common problems in breast cancer survivors. Non-pharmacologic interventions such as therapeutic exercise and patient education can be effective in this population. AimsThis study aimed to: (1) analyze the benefits of a therapeutic exercise and educational program on central sensitization symptoms and pain-related fear avoidance in breast cancer survivors, and (2) explore the association between pain-related fear avoidance and central sensitization symptoms. DesignA single group pre–post intervention study was conducted. MethodsPatients were recruited from the service of Medical Oncology of the University Clinical Hospital Virgen de la Victoria, in Málaga (Spain). The intervention consisted of a therapeutic exercise and educational program that lasted 12 weeks, twice a week, for 1 hour. Two instruments were used: the Spanish version of the Central Sensitization Inventory and the Spanish Fear Avoidance Components Scale. ResultsA total of 82 breast cancer survivors participated in the study. Pre–post change on Central Sensitization Inventory was statistically significant (p = .007). There was a trend towards a significant difference for the Spanish Fear Avoidance Components Scale (p = .062). There was a statistically significant correlation between pain-related fear avoidance and central sensitization symptoms (r = 0.536, p < .001). ConclusionsThe current study has provided preliminary evidence on the benefits of this intervention in pain-related fear avoidance and central sensitization symptoms in breast cancer survivors. The Spanish version of the Central Sensitization Inventory and the Spanish Fear Avoidance Components Scale demonstrated responsiveness to change.

Evaluation of T-piece resuscitator in the delivery room management of pre-term neonates with respiratory distress syndrome in resource-limited settings: A pre-post intervention study.

The aim of our study was to evaluate the impact of the T-piece resuscitator in the delivery room management of pre-term neonates in a resource-limited setting. We compared the incidence rates of delivery room intubation, surfactant replacement therapy, pulmonary air leak syndrome, and pre-term very low birth weight infant mortality, before and after T-piece use. Bi-monthly neonatal resuscitation training sessions were conducted for healthcare providers during the study period. We emphasized hands-on experience with the T-piece resuscitator and delivery room early respiratory care practices during the post-intervention epoch. Our pre- and post-intervention data recorded statistically significant decline in delivery room intubations, a 32% decrease in surfactant replacement therapy, and a 57% decrease in air leaks in pre-term neonates. However, the use of T-piece resuscitator did not have a statistically significant effect on pre-term very low birth weight infant mortality.

Applying a Modern Pedagogy to Emergency Residency Ultrasound Education.

BackgroundModern technology has revolutionized pedagogy in medicine. With the availability of high-quality resources in the palm of our hands, the flipped classroom model has gained widespread support. Additionally, devices such as “clickers” allow for the ability to interact much more directly with lecture participants.ObjectiveWe aimed to investigate the impact of a modern refresh to our emergency point of care ultrasound (POCUS) curriculum on resident exam performance and satisfaction.MethodsIn 2021, we conducted a single-site pre-post interventional study with Emergency residents as eligible participants. The interventions included two modifications to the POCUS curriculum. First, residents prepared and delivered mini-lectures in lieu of formal didactic sessions. Second, weekly image review was reimplemented with more active participation. Our primary outcome was end-of-rotation exam performance and our secondary outcome was learner satisfaction.ResultsDuring the study period, 19 residents participated in the curriculum. Exam scores were similar, 90.84% +/- 2.27% and 89.34% +/- 3.43% (p = 0.105) for pre and post-intervention scores respectively. Satisfaction surveys were completed by 12 of the 19 participants. On a scale of 1-5, average satisfaction was fair (3.9 to 4.1) regarding the mini-lecture intervention and high (4.3 to 4.6) for the active weekly image review modification.ConclusionsThe POCUS curriculum refresh was well-received by emergency medicine residents. However, there was no clear competency benefit when compared to the traditional approach. The modified active weekly review was particularly well-received amongst our residents and maybe a strong model for emergency POCUS programs across the country.

Scaling up innovative interventions for family caregivers: Evaluation of the Reitman Centre CARERS program for supporting dementia family caregivers: a pre-post intervention study.

Scaling up innovative interventions for family caregivers: Evaluation of the Reitman Centre CARERS program for supporting dementia family caregivers: a pre-post intervention study.

Outcomes of an intervention program for family physicians on well-child care for children under 5 years in Suez Canal region, Egypt

BackgroundFamily physicians play a critical role in providing well-child care (WCC) in Egypt to children under five. Family physicians’ knowledge, attitudes, and practices (KAP) on WCC must be appropriately developed to optimize health status and developmental potential in children. The study aimed to evaluate the effect of an innovative, 6-month educational training program on the KAP of family physicians toward WCC. This pre-post interventional study was conducted from September 2014 to March 2016 on a convenience (Suez Canal University) sampling of 39 family physicians who were under training in the Family Medicine Department at the Faculty of Medicine Suez Canal University. After 6 months of implementing the training program, KAP toward WCC was assessed by a 79-item questionnaire at baseline.ResultsThe overall mean percentage of participants’ KAP scores was statistically and significantly increased from 23.68% ± 13.68%, 67.15% ± 6.75%, and 40.98% ± 12.24% to 88.46% ± 8.09%, 88.62% ± 5.17%, and 71.79% ± 14.63%, respectively (p < 0.001). Recognizing the appropriate anticipatory guidance for the use of car seats made up the epitome of what was lacking in posttest knowledge (53.8%). Tendency of performing red reflex testing especially reduced refinement in posttest attitudes (53.8%). The least improved post-intervention practices were anticipatory guidance (7.7%), examination for developmental hip dysplasia (28.2%), and caries (43.6%), eliciting parents’ concerns for hearing and speech (38.5%) and vision screening (38.5%).ConclusionsThe educational program had positive effects on family physicians’ KAP toward well-child care for children under five. Further interventions are needed for improving the family physicians’ practices of sensory screening, assessment of hip dysplasia, oral health, and anticipatory guidance.