Significant Improvement In Understanding Research Articles

Implementing a formal curriculum on surgical ethics and palliative care for otolaryngology residents

ObjectiveResidents are faced with ethical issues every day but most residency curriculums do not routinely include formal ethics skills training. In order to address this, a comprehensive curriculum on ethics and surgical palliative care was implemented for otolaryngology residents. MethodsAn 8-h ethics didactics curriculum was designed in collaboration with our institution's Institute of Ethics. Varied strategies were used to cover basic principles and practical skills. Anonymous assessments were completed by learners at 3 points during the curriculum on a 5-point scale. ResultsNine residents were surveyed. Prior to the curriculum, a large majority of residents (85 %) expressed little to no familiarity with basic ethical principles. There was statistically significant improvement in understanding of and familiarity with bioethics topics, including the four principles of bioethics (Δ = 2.4, p = 0.004). There was also statistically significant improvement in comfort with the implementation of ethical decision making and palliative care skills, including with difficult conversations with patients (Δ = 1.3, p = 0.03). Participation in sessions was excellent with positive qualitative feedback. ConclusionAn interactive curriculum in ethics and palliative care can be engaging and practical for busy surgical residents, with measurable improvement in comfort with challenging cases and ethical, patient-centered care.

ROOTS AND WINGS - CULTURAL AWARENESS AND PERSONAL DEVELOPMENT PROGRAM FOR CHILDREN

In the current context, cultural education plays an essential role in the integral development of children, especially in rural communities where access to cultural resources may be limited. This article examines the "Roots and Wings" program, an innovative project designed to enrich the cultural education of rural children through direct and experiential activities. Through storytelling and folklore workshops, cultural preservation projects, local art and history sessions, children's festivals and partnerships with schools, the program aims to strengthen children's ties with the cultural heritage of their community. The study uses mixed methods, including participatory observations and questionnaires, to assess the impact of the program on children's knowledge, appreciation and application of cultural values in everyday life. Preliminary results suggest a significant improvement in understanding and appreciation of local culture, as well as an increase in confidence in one's own creative and social skills. The article argues that such programs can serve as valuable models for integrating culture into the educational curriculum, having the potential to transform children's perspective on cultural heritage and positively influence their behavior.

Improving argumentation by teaching philosophy of science with critical questions in Chinese senior high school

ABSTRACT This study examines the use of critical questions (CQs) as an ‘explicit’ pedagogical method in the nature of science to teach Chinese high school students topics of philosophy of science (POS). The study results, evaluated through deductive thematic and qualitative comparative analyses using Toulmin’s argumentation patterns and a critical integrative argumentation model, revealed that students who participated in the POS course showed significant improvement in understanding and application of argumentation by asking CQs as suggested by instructors. This finding strongly supports the use of CQs for rebuttals in argumentation based on crisp qualitative comparative analysis. The study results have broad implications for how CQs can promote engagement in high school argumentation. The study conclusions highlight the limitations of oral questioning in classroom argumentation. Finally, the study discusses how POS can improve students’ classroom argumentation.

Peningkatan kualitas pengajaran di era digital melalui pelatihan pengembangan video pembelajaran interaktif

Effective teaching in the digital era poses a major challenge in education, especially in elementary schools. This study highlights the importance of interactive learning media in enhancing teaching quality. Utilizing methods of presentation, discussion, and mentoring, this training targeted 50 elementary school teachers at SDN 39 and SDN 08 Sungai Kakap. The main focus was on creating educational videos using Microsoft PowerPoint, a software commonly used by teachers. The training content included the definition of educational videos, steps in video creation, tips for making engaging videos, and using PowerPoint for educational purposes. Pre-tests and post-tests were conducted to measure participants' understanding before and after the training. Results showed a significant improvement in understanding and skills in creating educational videos, with average pre-test scores rising from 54 to 93 in post-tests. Participants realized that PowerPoint is not only for presentations but also an effective tool for creating engaging and efficient educational videos. This research affirms that technology-based interactive learning, such as PowerPoint educational videos, enhances teachers' enthusiasm and student engagement, and supports teaching effectiveness in elementary schools. The main conclusion is that educational technology training like this is crucial for enhancing teachers' creativity and the quality of learning in the digital era.

1855. Understanding Cytomegalovirus (CMV) Symptom Management, Quality of Life, and Care Coordination in Transplant Recipients Through Patient and Care Partner (CP) Experiences

Abstract Background Transplant recipients with CMV infection have a high risk of complications and mortality. This study aimed to better understand patient and CP knowledge of post-transplant CMV and identify how it can be improved. Methods The study included 2 research phases (Fig 1). We report results from Phase 2 (September 2022–March 2023), which included an educational webinar with a pre- and post-webinar assessment comprising 4 questions on the risk, symptoms, treatment, and complications of CMV; participants (pts) self-reported their confidence rating pre- and post-webinar. Transplant recipients and CPs also completed a quantitative survey on CMV management and patient/CP burden. Pts were recruited via the PatientsLikeMe (PLM) website, email, or social media. Results The webinar was completed by 33 pts. There was a total of 86 and 121 correct responses to the 4 pre- and post-survey questions, respectively, indicating a significant improvement in understanding of CMV post-webinar as compared with before (p< 0.05; t-test statistic). Almost half (n=16 [48%]) of pts reported feeling “not at all confident” in recognizing CMV symptoms post-transplant pre-webinar; post-webinar, this was 0 pts. Twenty-eight transplant recipients (27 solid organ transplant; 1 hematopoietic cell transplant) and 1 CP completed the quantitative survey. Half of recipients received a CMV diagnosis post-transplant and 16/28 reported having no awareness of their or their donor’s CMV status prior to transplant. Most (27/28) recipients reported a positive experience with their care team post-transplant. Half of recipients set goals with their care team or were provided resources to track them post-transplant. Recipients reported CMV medication changes and challenges with treatment (Table 1). Patients primarily contacted their surgeon about CMV and sought information on the internet. Conclusion Although transplant recipients reported positive experiences with their healthcare team, the post-transplant care journey could be improved by better educating patients about CMV and CMV management. Aggregate-level learnings from the study with be shared on the PLM platform to reinforce the value of participation in research. Funding: Collaborative research study; primary funding from Takeda Pharmaceuticals U.S.A., Inc. Disclosures Deepshikha Singh, MPH, PatientsLikeMe: Employee|PatientsLikeMe: Ownership Interest Mary C. Burke, MHA, PatientsLikeMe: Employee|PatientsLikeMe: Ownership Interest Subhara Raveendran, PhD, Ascendis Pharma: Employee|PatientsLikeMe: Ownership Interest Erlyn Rachelle Macarayan, PhD, PatientsLikeMe: Employee|PatientsLikeMe: Ownership Interest Maisha Razzaque, MS, PatientsLikeMe: Employee|PatientsLikeMe: Ownership Interest Genovefa Papanicolaou, MD, Allovir: Advisor/Consultant|Amplyx: Advisor/Consultant|Astellas: Advisor/Consultant|Cidara: Advisor/Consultant|CSL Behring: Advisor/Consultant|DSMC: Advisor/Consultant|Merck: Advisor/Consultant|Merck: Grant/Research Support|Merck: institutional research support for clinical trials|MSD: Advisor/Consultant|Octapharma: Advisor/Consultant|Partners Rx: Advisor/Consultant|Shire/Takeda: institutional research support for clinical trials|Symbio: Advisor/Consultant|Symbio: Advisor/Consultant|Takeda: Advisor/Consultant|Vera Pharma: Advisor/Consultant Macey L. Levan, PhD, Takeda Pharmaceuticals: Advisor/Consultant Maggie McCue, MS, RD, Takeda Pharmaceuticals U.S.A., Inc.: Employee Megan Gower, PharmD, Takeda Pharmaceuticals U.S.A., Inc.: Employee|Takeda Pharmaceuticals U.S.A., Inc.: Ownership Interest Daniele K. Gelone, PharmD, Abbott Laboratories: Ownership Interest|Ionis Pharmaceuticals: Ownership Interest|Johnson & Johnson: Ownership Interest|NovoNordisk: Ownership Interest|Pfizer: Ownership Interest|Regenxbio: Ownership Interest|Takeda Pharmaceuticals U.S.A., Inc.: Employee|Takeda Pharmaceuticals U.S.A., Inc.: Ownership Interest|Vertex Pharmaceuticals: Ownership Interest

HPB P14 Setting the Foundation: Empowering Junior Doctors in Complex Specialties through Induction Excellence

Abstract Background The newly qualified junior doctors in the UK face challenges due to limited experience and unfamiliarity with their rotations. We aim to share the experience of establishing a Hepatobiliary and Pancreatic (HPB) surgery specific induction program at University Hospitals of Leicester NHS Trust and assess its impact on doctors' knowledge and experience. Methods A booklet was distributed to new junior doctors and a two-hour structured teaching session was also conducted, with pre- and post-session assessments using multiple-choice questions and a feedback survey. The survey measured understanding of HPB anatomy, interventions, and satisfaction with the teaching methodology. Results Prior to the teaching session, levels 4 and 5 understanding of HPB anatomy were reported by 18.1% of participants. After the teaching session, there was a significant improvement in understanding, with levels 4 and 5 reported by 95% of participants, and only 5% reporting level 3. Similar improvements were observed in other tested categories. Factual knowledge also improved, with a 38% increase in correct responses on basic HPB and surgical knowledge questions. Participants found the session helpful and well-structured, with 60% strongly agreeing and an additional 30% agreeing. The delivery method was deemed appropriate by the majority. Conclusions Specialty-specific induction programs are crucial for providing support and ensuring the development of competent doctors. Efforts should be made to create supportive working environments for junior doctors to alleviate stress and improve their well-being.

Fostering interdisciplinary working within global surgery at an undergraduate level: A hackathon based approach

ObjectiveTo investigate the effectiveness of a virtual hackathon in fostering interdisciplinary working amongst undergraduate students in global surgery. MethodologyIn this study, we developed a 3 day event consisting of guest lectures, a documentary screening and a hackathon supported by academics and experts in the field, to provide students with the opportunity to learn more about and work in interdisciplinary teams within global surgery. Students had the option to attend just the lectures or both the lectures and hackathon. Quantitative and qualitative results were collected through a pre and post session survey. ResultsA total of 21 responses were received for the hackathon and 26 responses for the general event (response rate for event = 26 %, response rate for hackathon = 24.7 %). There was a significant improvement in understanding of interdisciplinary working in global surgery between the pre and post-session survey, with an increase in median from 3 (IQR = 2–3.5, n = 21) to 4 (IQR = 4–5, n = 21) (p < 0.05). Respondents noted that the benefits of a hackathon were that it was very engaging, and brought in diversity of thought and expertise. The drawbacks to the hackathon were that it was fast-paced, required prior knowledge and the virtual platform it was hosted on. ConclusionOur study demonstrates that hackathons are an effective, inclusive and equitable way for students to engage in and learn about interdisciplinary working. It is important that as institutions recognise and develop global surgery courses, these courses reflect the interdisciplinary nature of the field.

A pilot evaluation of a training programme on understanding and responding to sexual behaviours in children and young people

ABSTRACT Practitioners who work with children and young people such as educators, psychologists, and social workers, are required to understand and respond to various sexual behaviours in children and young people. However, there is a dearth of training programmes dealing with sexual development. To reduce over- and under-reporting of risk, which can have serious adverse outcomes, it is essential to educate practitioners in understanding and responding appropriately to sexual behaviours. This study evaluated Traffic Lights® professional development training programme – a one-day programme offered across Queensland, Australia, with the goal of educating practitioners and promoting safe and respectful sexual health among children and young people. Thirty postgraduate psychology students working with/interested in working with children and young people received Traffic Lights® training, and accuracy of understanding and responding to sexual behaviours presented in scenarios was assessed pre- and post-training. Participant responses were scored using criteria developed by a local sexual health organisation’s research specialists. Findings revealed no significant improvement in understanding and responding to sexual behaviours in children and young people. Implications of this study include recommendations for small-scale evaluations with sexual health experts and follow-up research, which is critical given the need for evidence-based practice in this area.

Evaluasi Efektivitas Penggunaan Teknologi Pembelajaran Interaktif dalam Mata Pelajaran Matematika di Sekolah Dasar

The aim of this study was to evaluate the effectiveness of using interactive learning technology to enhance students' understanding in mathematics at SDN Genteng 1 elementary school. Employing a quantitative approach and an experimental research design, two groups of students (30 students per group) were involved in this study: an experimental group receiving instruction with interactive technology, and a control group receiving conventional instruction. Data were collected through pre-tests and post-tests as well as observation of student interaction with the interactive technology during the learning period. The results indicated that students in the experimental group experienced a significant improvement in understanding compared to the control group. The average post-test scores for the experimental group showed a greater increase compared to the control group. Thus, the use of interactive learning technology proved to be effective in enhancing students' understanding in mathematics at the elementary school level. This finding underscores the importance of integrating technology in education to create engaging and effective learning environments. Therefore, it is recommended that instructional approaches integrating interactive technology continue to be developed and implemented in teaching practices. Further steps are necessary to deepen understanding of how interactive technology can be effectively integrated into education and to identify the best strategies for optimizing its benefits for student learning outcomes. This abstract provides a comprehensive overview of the research findings and their implications for educational practice.

Building Capacity for Implementation Science in Precision Health and Society: Development of a Course for Professional and Graduate Students in Pharmacy.

Training in the field of implementation science is critical for future pharmacists and pharmaceutical scientists to successfully implement precision health interventions in pharmacy practice. We developed an elective course for second- and third-year students at the UNC Eshelman School of Pharmacy to develop foundational knowledge in implementation science with a focus on precision health implementation. The eight-week course used a flipped classroom format featuring lecture videos, suggested readings, quizzes, guest lectures from experts, case studies, and a group project. We evaluated course quality through class participation, a pre- and post-test on course content, and a mixed-methods survey completed by the students. Overall engagement in in the course was high and students demonstrated significant improvement in understanding of implementation science and precision health. Strengths of the course as identified by students were the use of expert guest speakers, pre-class lectures, and case study exercises, while the ordering of content and improved connection between content and guest lectures were identified as areas for improvement. In conclusion, the elective course was well-received and meets a critical need in the field of pharmacy to build implementation science capacity. Future work is needed to expand and refine education for the implementation of precision health for pharmacy professionals.

Using Pensieve: Guiding and Evaluating a Learning Session on Reflections.

The objectives of this study were to guide students on reflective essay writing, evaluate their understanding and explore the immediate impact of a well-designed session on learning of students. A 1.5-hour learning session was designed following Gagne's nine events of instruction and conducted on final year MBBS students to guide them on reflective practice and its significance. The session was evaluated by a self-designed, structured questionnaire given as a pre-test and post-test. Of 158 students, self-scoring of reflective essay, by hand raising method, revealed that nearly 60% students were critical reflectors, 30% were reflectors and 10% were non-reflectors. Five out of nine questions showed a significant effect (p <0.001) in two-tailed t-test. This learning session led to a significant improvement in understanding of students regarding role of reflective practice in modifying their future behaviour, and its role in making them a better professional. Key Words: Learning, Reflections, Satisfaction, Feedback, Written, Educational assessment, Medical students.

Criminal and financial penalties for clinicians in the ACT Mental Health Act weigh more heavily on senior doctors.

We sought to assess the attitudes of ACT public psychiatry doctors towards the financial and criminal penalties in the ACT Mental Health Act 2015. Baseline attitude was surveyed with an 11-item 5-point Likert scale. Education was then provided about the offences outlined in the Act and the associated penalties. The same initial survey was then repeated. Primary outcomes were changes in attitude pre- and post- information, and secondarily data was explored for differences related to gender and seniority. Forty-nine percent of 89 eligible public mental health system doctors responded. The majority of the survey respondents were female (59%). Provision of information resulted in a significant improvement in understanding of liabilities (2.80 (SD 1.14) versus 3.58 (SD 0.93), t(39) = 4.06, p < 0.001). Gender had no significant impact on scores. Senior staff were less legally secure and less satisfied with the Mental Health Act pre-information being provided. With regards to notification penalties, with education, junior staff became more secure and seniors less so. Information provision improves understanding of the penalties under the Mental Health Act 2015. Having a senior role predicts lower satisfaction with the penalties in the Act.

3 Peer-Produced Induction Material for Foundation Year One Doctors in Plastic Surgery – A Quality Improvement Project

Abstract Introduction Induction programmes are recommended for all junior doctors starting new posts and are mandatory for foundation year one doctors (FY1s). Constraints on time and staff mean these guidelines are not always met. This project aimed to improve the efficiency, effectiveness, and timeliness of care by designing and distributing peer-produced induction material to FY1s starting placements in plastic surgery. Method A quality-improvement methodology was utilised. Online questionnaires assessed FY1 experiences in several domains using five-point Likert scales and free-text answers. This information was used to design induction material. Material was distributed to incoming FY1 cohorts, the questionnaire was repeated, and material updated and redistributed. Results Three quality improvement cycles were performed over a one-year period. Four FY1s were surveyed pre-intervention, and four post-intervention. Post-intervention, there was a statistically significant improvement in understanding of responsibilities (+2.2, p &amp;lt; 0.01) and departmental structure (+2.0, p = 0.018). FY1s felt confident in starting (4.75±0.5), prepared for on-calls (4.75±0.5), and satisfaction was high (4.75±0.5) Conclusions Peer-produced induction material for FY1s can improve understanding of responsibilities and structure within a plastic surgery department. This will increase confidence of new starters and facilitate smooth transition of staff, enabling the provision of high-quality care by enhancing its efficiency, effectiveness, and timeliness.

Integrated Group Study with Lecture in Teaching Sensory and Motor Pathways in Cross‐sectional Anatomy

IntroductionFirst year dental students are trained to interpret clinical presentations of injuries on brainstem or spinal cord. Therefore, it is necessary for them to understand the three major sensory and motor pathways (dorsal column/medial lemniscal system, anterolateral system, corticospinal tracts) that go through brainstem and spinal cord, including their functions and cross‐sectional anatomy.AimThe present lesson was designed for first year students at Boston University School of Dental Medicine to learn the three sensory and motor pathways by using cross‐sectional figures of brainstem and spinal cord, and help students to apply the knowledge in clinical cases.MethodsThree sessions with the same contents were held on two days. Two sessions were held on the first day containing 30 students in total, and the last session was held on the fifth day containing 20 students. The lesson started with a pre‐quiz, and then students worked in groups of 4 to 5 people to order cross‐sectional figures of brainstem and spinal cord. Then, the instructor gave a lecture to explain the answer, followed by a brief review on sensory and motor pathways. In the second group activity, students were asked to label the three pathways on the cross‐sectional figures. In the third group activity, students were given the location of a lesion on brainstem, and then were asked to discuss the potential clinical presentations. Instructor explained the answers after each activity. At the end, students took a post‐quiz. Both pre‐quiz and post‐quiz had a full score of 5, containing 2 questions on clinical cases, 1 question on pathway, 2 questions on cross‐section anatomy. All questions were multiple choice. The levels of difficulty in two quizzes are similar.ResultsThe average scores from pre‐quiz and post‐quiz were compared by conducting a t‐test. Students showed significantly improvement in the post‐quiz as compared to pre‐quiz (pre: 1.50+/−1.07; post: 3.12+/−1.05; p&lt;0.00001). Both pre and post scores of students attending on the fifth day were significantly higher as compared to the pre and post scores of students on the first day (pre: day1=1.20; day5=1.95; p=0.01; post: day1=2.76; day5=3.65; p=0.003). A t‐test was conducted to compare group differences of the improvements (first day vs. fifth day). Improvements of students were defined as the differences between post and pre‐quiz scores, and the improvements were not significantly different based on the day of the session (p=0.69).ConclusionStudents showed significant improvement in understanding cross‐sectional anatomy of three major sensory and motor pathways after group study integrating with lectures. In addition, the effectiveness of this teaching methods was not affected by the baseline scores of students.

PD23-05 INTERACTIVE VIRTUAL REALITY (iVR) AS AN EDUCATIONAL AND PREOPERATIVE PLANNING TOOL FOR LIVING DONOR NEPHRECTOMIES: A CASE-CONTROLLED STUDY

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology II (PD23)1 Apr 2020PD23-05 INTERACTIVE VIRTUAL REALITY (iVR) AS AN EDUCATIONAL AND PREOPERATIVE PLANNING TOOL FOR LIVING DONOR NEPHRECTOMIES: A CASE-CONTROLLED STUDY Lillian Xie*, Francis Jefferson, Rajiv Karani, Luke Limfueco, Egor Parkhomenko, Mitchell O'Leary, Shoaib Safiullah, John Sung, Roshan Patel, Hirohito Ichii, Donald Dafoe, and Jaime Landman Lillian Xie*Lillian Xie* More articles by this author , Francis JeffersonFrancis Jefferson More articles by this author , Rajiv KaraniRajiv Karani More articles by this author , Luke LimfuecoLuke Limfueco More articles by this author , Egor ParkhomenkoEgor Parkhomenko More articles by this author , Mitchell O'LearyMitchell O'Leary More articles by this author , Shoaib SafiullahShoaib Safiullah More articles by this author , John SungJohn Sung More articles by this author , Roshan PatelRoshan Patel More articles by this author , Hirohito IchiiHirohito Ichii More articles by this author , Donald DafoeDonald Dafoe More articles by this author , and Jaime LandmanJaime Landman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000873.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Computed tomography (CT) requires surgeons to translate more than 2000 images into a mental understanding of the renal anatomy prior to laparoscopic donor nephrectomy (LDN). In contrast, interactive virtual reality (iVR) provides a three-dimensional (3D) “hands-on” experience with the donor’s renal anatomy. Herein, we present a retrospective, case-controlled study to determine if iVR renal models viewed prior to LDN positively impacted surgery. METHODS: Twenty patients undergoing LDN were prospectively recruited. Their CT images were transformed into 3D models and uploaded to an iVR platform. The iVR platform allowed participants to rotate and deconstruct the renal anatomy utilizing a headset and hand-held devices. Surgeons answered questionnaires that assessed their understanding of renal anatomy after viewing CT alone and then after viewing CT+iVR. Patients assessed their anatomical understanding and anxiety level before and after iVR. Surgical outcomes for the iVR cohort included operative time, estimated blood loss, and postoperative complications; these data were compared to a retrospectively-matched, non-iVR cohort of LDN patients based on age, gender, BMI, ASA score, and surgeon from 2013 to 2018. RESULTS: Surgeons altered their surgical plans in 18 out of 20 LDNs (90%) after viewing iVR models due to a significant improvement in understanding of the vascular anatomy (p < 0.001); they also noted increased confidence in the final surgical plan (p < 0.001) (Table 1). Postoperatively, surgeons reported that iVR correlated better with patient anatomy than did CT alone (p < 0.001). Patients reported a better understanding of their anatomy (4.9/5) and decreased anxiety about their surgery (4.5/5) after viewing iVR. When compared to a non-iVR retrospective cohort, the iVR cohort had a mean 24% reduction in operative time (190 ± 57 min vs. 252 ± 67 min, p < 0.001). CONCLUSIONS: Preoperative viewing of CT-derived iVR models altered the operative approach, decreased operative time, and improved the surgeon’s confidence and understanding of the renal anatomy. As a patient education tool, viewing the iVR model reduced patients’ preoperative anxiety. Source of Funding: n/a © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e465-e466 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lillian Xie* More articles by this author Francis Jefferson More articles by this author Rajiv Karani More articles by this author Luke Limfueco More articles by this author Egor Parkhomenko More articles by this author Mitchell O'Leary More articles by this author Shoaib Safiullah More articles by this author John Sung More articles by this author Roshan Patel More articles by this author Hirohito Ichii More articles by this author Donald Dafoe More articles by this author Jaime Landman More articles by this author Expand All Advertisement PDF downloadLoading ...

A Shared Decision-Making Model for Management of Small Renal Masses: Optimizing the Patient Experience

Background: The finding of a small renal mass (SRM) on radiological imaging and the potential of a cancer diagnosis is anxiety provoking in most patients. The decision-making process often occurs in the absence of any framework regarding the nature and treatment outcomes. This project aimed to educate patients newly diagnosed with a SRM, implement a shared decision-making (SDM) model, and assess the educational attainment and effect on a SDM intervention. Methods: This project assessed the educational attainment and its effect on a SDM intervention using a pre-and post- intervention survey, an educational video [Urology Care Foundation, “What is a renal mass?], and a structured provider discussion. The survey incorporated eight knowledge questions and two questions which addressed anxiety related to diagnosis and confidence in decision-making. Results: Fifty surveys were completed. The post intervention score showed a significant increase in patient knowledge. Wilcoxon signed rank test (P = &lt;0.001; 2.0; CI 95% (1.54–2.46)). Thirty-nine demonstrated improvement in knowledge with a mean of 2.0, 9 were unchanged and 2 decreased. Approximately 42% of patients reported a decrease in anxiety rating by a mean of 40%. When confidence in decision-making improved, it improved by a mean of 45%. Conclusions: A significant improvement in understanding of SRMs was demonstrated. This model showed improved knowledge, alleviation of anxiety and improved confidence and denotes the feasibility of implementing a SDM model in newly diagnosed patients. Results should encourage providers who aspire to incorporate a SDM as a Best Practice.

Effect of an educational intervention on knowledge and perception of individuals at risk for stroke in Tabuk, Saudi Arabia.

Objectives:To assess the effect of an educational program on the knowledge and perception of stroke in individuals at risk.Methods:This quasi experiment study, conducted in Health Education Clinics at King Salman Armed Forces Hospital, was designed to assess the knowledge of people who were at risk for stroke, before and after delivering educational content. This content comprised 4-minute face-to-face explanation by a trained educator, 99-second video clip and a short hand-out. The assessment was performed by administering a structured questionnaire.Results:A total of 313 people participated in this study. Before the intervention, 63.6% understood stroke to be due to a disturbance in blood flow resulting in loss of brain function. After delivery of the educational content, the percentage raised to 97.1%. Thirty-Four and Eight percent (109) of participants stated they knew stroke symptoms, and 55.96% knew 2 to 4 symptoms prior to intervention. Our educational content raised these percentages to 98.4% and 79.8% respectively. Good knowledge of stroke symptoms and risk factors was associated with younger age and higher level of education.Conclusion:Educational content by means of one-to-one interaction with trained educators, video clips and handouts results in significant improvement in understanding of stroke symptoms and risk factors among at-risk participants.

Documentation of medical marijuana use in cancer patients.

Medical marijuana is often used as adjuvant therapy in cancer patients for symptom management, although limited evidence-based studies evaluating its efficacy or safety exist. Similar to over-the-counter medications, supplements, or herbal products, documentation of medical marijuana is important to monitor efficacy, potential adverse effects, or interactions. The objective of this quality improvement study was to improve the consistency of medical marijuana documentation in cancer patients by assessing current practices; educating healthcare team members about the importance of documentation and newly established documentation process; and evaluating the new documentation process. This three-part quality improvement study was approved by the Institutional Review Board. In part I, a voluntary survey was sent via email to Cancer Center healthcare personnel to assess the current documentation process of medical marijuana. In part II, a best practice process for documenting medical marijuana in the electronic medical record was established. Medical marijuana was to be listed as a historical medication in the medication list. In-person and electronic education sessions were offered to Cancer Center clinical staff. The education emphasized the importance of documenting medical marijuana use and provided a detailed process for electronic medical record documentation. A pre- and post-test to assess understanding was also included. Part III was a retrospective chart review to evaluate documentation practices of certified medical marijuana users in the Cancer Center. Patients included in the study were greater than 18 years old and certified for medical marijuana use on or after 1 January 2018. Department of Corrections patients were excluded. Descriptive statistics were used for data analysis. The survey results in part I demonstrated a lack of consistency in the documentation of medical marijuana in the Cancer Center. The pre- and post-test scores measured in part II showed a significant improvement in understanding after education was provided. The average pre-test score was a 61 and post-test score was 88, indicating an average increase of 27 points. A larger increase in test scores was observed in those attending the in-person education than the online sessions (p < 0.002). The results of the retrospective chart review in part III revealed 56 patients who met inclusion criteria, but only 39 patients were alive and evaluated at the time of the retrospective chart review. Of the 39 patients, 22 never completed the patient registration process and therefore, would never have been able to obtain medical marijuana. Seven patients had medical marijuana properly documented in their medication list and 10 patients were missing documentation in the medication list, showing room for improvement in documentation practices. This quality improvement study led to the implementation of medical marijuana documentation in the medication list. Education increased healthcare team members understanding of medical marijuana utilization and the importance of documentation.

The role of digital stories and civic actions on student-teachers’ understanding about social sustainability in urban settings

The present study aims to explore student-teachers’ (STs’) progress in understanding social urban sustainability and how it is affected through the development of digital stories and engagement in civic actions. Participants were 44 STs enrolled in a Department of Primary Education located in Northern Greece. Although participants were aware of the principles of sustainable development and education for sustainability, none of them had familiarity with social or urban sustainability. Three individual digital concept maps constructed before, intermediate and after the end of the course served as data sources. Both quantitative (significance testing, effect sizes, and confidence intervals) and qualitative (categories development) methods of analysis were implemented. Results indicate a sound improvement of STs’ understanding even in the intermediate concept maps with the most significant proposition gains associated with the society pillar. Moreover, despite the significant improvement in understanding of all main pillars of sustainability, this improvement was unbalanced because a minority of subcategories constituted the majority of STs’ propositions in all settings, indicating a strong and constructive combination between theory and praxis for the advancement of STs’ learning.

A new strategy in neurocritical care nurse continuing stroke education: A hybrid simulation pilot study.

IntroductionHigh-fidelity simulation is frequently utilized in medical education. Its use in the neurosciences is limited by the inherent limitations of the manikin to simulate neurological changes. We report here the use of a hybrid simulation – a combination of lecture and high-fidelity manikin – in the education of neurosciences nurses, involved in care of neurocritical care patients.MethodsNeurosciences nurses from at the University of Missouri, Columbia, MO, USA, which is an academic, tertiary-care medical center participated in the simulation during Spring of 2016. The simulation involved a patient presenting with acute intracerebral hemorrhage (ICH) who neurologically deteriorated to brain death. Pre- and post-simulation questionnaires were administered using a questionnaire with five-point Liker scale.ResultsSeventy-two responses were returned. The majority had 0–5 years of nursing experience with 83.8% having prior critical care experience. Pre-simulation, the majority of nurses (85.7%) agreed or strongly agreed with managing patients with ICH. When the responses of “agree” were compared to “strongly agree”, a significant improvement (p<0.001) in all responses except confidence in speaking with other healthcare providers was found.ConclusionNurses reported significant improvement in understanding and managing patients with acute ICH and neurological deterioration after participating in a neurocritical care hybrid simulation. This study shows the benefit of using hybrid simulation in the education of neurocritical care nurses.