Two-hour Sessions Research Articles

The Effect of an Educational Intervention Based on Gratitude on the Stress and Mental Health of Mothers of Preterm Infants Hospitalized in a Neonatal Intensive Care Unit

Background and Objectives: One of the non-pharmacological interventions is gratitude, which has received less attention in the neonatal intensive care unit (NICU). The present study was conducted to investigate the effect of an educational intervention based on gratitude on the stress and mental health of mothers with preterm infants hospitalized in the NICU. Methods: A quasi-experimental controlled study was conducted on 50 mothers with infants hospitalized in the NICU of Shahrekord City, Iran, who were divided into two intervention and control groups. The intervention group was trained by the researcher in three two-hour sessions every week for two weeks. The results related to mothers’ general health and stress were analyzed by the parental stress questionnaire and Goldberg and Hiller’s general health questionnaire (GHQ-28) before and after the intervention by the paired t-test. Results: The mean stress score of mothers in the intervention group significantly reduced (P<0.001). Stress was reduced in the mothers of the control group who only received routine training, but this reduction was not statistically significant (P>0.05) (before training: 35.72 and after training: 34.08). In the intervention group, the mean score of mental health improved significantly two weeks after the gratitude-based training program (P<0.05) (before training: 26.56 and after training: 19.20). Conclusion: This is the first study on the effectiveness of gratitude on the health of Iranian mothers with preterm infants hospitalized in the NICU. Gratitude improves the stress level and increases the quality of mental health. The belief that gratitude will increase blessings is a crucial part of Iranian women’s religious beliefs and is a critical factor in the effectiveness of mind and body interventions.

Actor–partner effects of wellbeing, hope and self-esteem on depression in stroke survivor–caregiver dyads: A randomized controlled trial

Background Stroke is a disabling, long-term condition that challenges the mental and physical health of stroke-survivors concurrently with their primary family-caregivers (dyad). However, there has been a lack of emphasis on this dyadic need. Thus, this study aims to investigate the impacts of two interventions on hope, self-esteem and hedonic wellbeing on depression among the stroke-survivor–caregiver dyad. Methods This randomized-controlled-trial applied the actor–partner interdependence model to 100 randomly-selected dyads (N = 200) of stroke-survivors, mean (SD) age was 73.63(7.22) and family-caregivers, mean (SD) age was 62.49(14.44) years, recruited from Hong Kong hospitals and rehabilitation centres. The intervention was eight-weekly two-hour narrative therapy group sessions (n = 54 dyads), compared with the current model of psychoeducational group to each dyad as needed. Outcomes were collected via questionnaires and interviews, at four time-points: baseline (T1), during-intervention (T2) (1-month), immediately post-intervention (T3) (2-months) and follow-up (T4) (6-months). Results The results demonstrated that there are actor effects on stroke-survivors (β = −0.353, p < 0.05) and caregivers (β = −0.383, p < 0.05), where higher levels of hedonic wellbeing were associated with fewer depressive symptoms. Partner effects were observed as caregivers’ depressive symptoms were possessing a significant negative relationship with stroke survivors’ wellbeing (β = −0.387, p < 0.05). Those stroke survivors in the intervention group had a significantly higher level of self-esteem associated with lower levels of depression (β = −0.314, p < 0.05). Conclusions Improving hope, self-esteem and wellbeing through narrative therapy significantly mediates depressive symptoms, strengthening the dyadic support of stroke survivors and family caregivers.

A randomized controlled trial of a multi-modal palliative care intervention to promote advance care planning and psychological well-being among adults with advanced cancer: study protocol

BackgroundUp to half of adults with advanced cancer report anxiety or depression symptoms, which can cause avoidance of future planning. We present a study protocol for an innovative, remotely-delivered, acceptance-based, multi-modal palliative care intervention that addresses advance care planning (ACP) and unmet psychological needs commonly experienced by adults with metastatic cancer.MethodsA two-armed, prospective randomized controlled trial (RCT) randomizes 240 adults with Stage IV (and select Stage III) solid tumor cancer who report moderate to high anxiety or depression symptoms to either the multi-modal intervention or usual care. The intervention comprises five weekly two-hour group sessions (plus a booster session one month later) delivered via video conferencing, with online self-paced modules and check-ins completed between the group sessions. Intervention content is based on Acceptance and Commitment Therapy (ACT), an acceptance, mindfulness, and values-based model. Participants are recruited from a network of community cancer care clinics, with group sessions led by the network’s oncology clinical social workers. Participants are assessed at baseline, mid-intervention, post-intervention, and 2-month follow-up. The primary outcome is ACP completion; secondary outcomes include anxiety and depression symptoms, fear of dying, and sense of life meaning. Relationships between anxiety/depression symptoms and ACP will be evaluated cross-sectionally and longitudinally and theory-based putative mediators will be examined.DiscussionAmong adults with advanced cancer in community oncology settings, this RCT will provide evidence regarding the efficacy of the group ACT intervention on ACP and psychosocial outcomes as well as examine the relationship between ACP and anxiety/ depression symptoms. This trial aims to advance palliative care science and inform clinical practice.Trial RegistrationClinicaltrials.gov NCT04773639 on February 26, 2021.

Innovative forum theatre on dementia in a care home setting

With the ageing population in the UK, we have found a rising number of our patients are being diagnosed with dementia [1] and a significant proportion live in care homes. Education to care home staff to help support these residents has been inconsistent despite a need to continue to improve skills managing residents with dementia [2]. We developed an interactive training event, ‘Communication in Dementia’, based on the learning needs from a local care home. We opted to use Forum Theatre as a tool to deliver this training. Forum Theatre is where a challenging real-life scenario is dramatised by actors using a pre-written script in front of a group of participants. The group is then facilitated to reflect on what they have observed and explore solutions in a safe environment. This method has been applied successfully in teaching of healthcare professionals such as in nurse education, but its use in the care home setting is uncommon [3]. Despite offering and confirming places to twelve care workers for a two-hour in-person session, only four were able to attend the session on the day. We collected pre- and post-session qualitative and quantitative feedback from the care workers and a written ethnographic reflection of the session. Prior to this session, none of the care workers had experience of Forum Theatre. After the session, the feedback received was positive, particularly about the interactive element of the session, demonstrating how the use of Forum Theatre created an enjoyable and valuable learning experience and that all of the care workers felt more confident communicating with residents with dementia after the session. Thematic analysis of the care worker responses in the ethnographic data recorded demonstrated themes including building meaningful connections with residents and recognising burnout in care workers. We believe that the use of Forum Theatre to teach Communication in Dementia creates an insightful learning experience for care workers, promoting active involvement in the session. We were disappointed that so few care workers were relieved from duties to attend the session on the day. This may indicate the pressures that the workforce are experiencing. We hope that in sharing the learning from this event, we may promote the use of Forum Theatre in care homes as a means of developing care workers to enhance their skills and ultimately to improve the experience of residents with dementia in care homes. 1. Wittenberg R, Hu B, Barraza-Araiza L, Rehill A. Projections of older people with dementia and costs of dementia care in the United Kingdom, 2019–2040. London: London School of Economics. 2019 Nov. 2. Smith SJ, Parveen S, Sass C, Drury M, Oyebode JR, Surr CA. An audit of dementia education and training in UK health and social care: a comparison with national benchmark standards. BMC health services research. 2019;19(1):1–9. 3. Middlewick Y, Kettle TJ, Wilson JJ. Curtains up! Using forum theatre to rehearse the art of communication in healthcare education. Nurse education in practice. 2012;12(3):139–42.

As we live and breathe – the use of simulated education in the management of patients on continuous positive airway pressure (CPAP) with COVID-19 using both a high-fidelity manikin and a real person

Continuous Positive Airway Pressure (CPAP) was being used on patients within designated wards to help reduce pressures on the Intensive Care Unit [1] and the number of intubated patients. Those patients presenting with COVID-19 associated respiratory failure within 48 hours of diagnosis were placed on CPAP [2]. The aim was to reduce mortality from hypoxaemia and promote patient safety. Those eligible for CPAP showed deterioration in oxygenation on arterial gas sampling or were showing increased work of breathing including an unsustainably high respiratory rate [3]. The simulated education sessions were to upskill registered intermediate care nurses in the use of CPAP, our most advanced airway procedure outside of the intensive care unit, and support redeployed nurses rostered onto the COVID-19 wards from other non-COVID-19 clinical areas. The aim was to empower nurses to feel more confident in the management of patients requiring CPAP and for them to be able to troubleshoot common problems giving patients the best care and chance of survival. Methods included coordinating exposure for each nurse to a CPAP preloading session following Trust policy, proformas and competency, then ensuring clinicians attended a dedicated two-hour practical simulation-based session using a mixture of high-fidelity manikins and real persons as simulated patients. Scenarios were developed based on issues that had previously happened or could occur in clinical practice. This created both a progressive simulation or shorter sessions followed by a debriefing depending on the experience of the nurse and how they performed on the day. Staff were asked to complete a feedback form about how they found the session and then assessment was made in clinical practice with the signing off of the CPAP clinical competency Within two months the team delivered training to all nurses rostered onto the COVID-19 ward and 95% had the clinical competency signed off. The feedback following the debriefing sessions stated that they felt more confident in managing the CPAP machine and the patient. They felt that the educational processes now in place facilitated patient safety and improved the quality of care delivered. Simulation-based education with the CPAP machine improved not only theoretical but also practical knowledge to help staff feel more empowered and confident when in clinical practice. Using a real person for several of the scenarios instead of the manikins meant staff could experience and respond appropriately to situations as they developed. This not only improved realism but enabled more immersive experiences for all involved. 1. Vaschetto R, Barone-Adesi F, Racca F, Pissaia C, Maestrone C, Colombo D, Olivieri C, De Vita N, Santangelo E, Scotti L, Castello L. Outcomes of COVID-19 patients treated with continuous positive airway pressure outside the intensive care unit. ERJ Open Research. 2021;7(1). 2. Ashish A, Unsworth A, Martindale J, Sundar R, Kavuri K, Sedda L, Farrier M. CPAP management of COVID-19 respiratory failure: a first quantitative analysis from an inpatient service evaluation. BMJ open respiratory research. 2020;7(1):e000692. 3. Talbot-Ponsonby J, Shrestha A, Vijayasingam A, Breck S, Motazed R, Raste Y. Adaptation of a respiratory service to provide CPAP for patients with COVID-19 pneumonia, outside of a critical care setting, in a district general hospital. Future Healthcare Journal. 2021;8(2):302–306.

Investigating the Effect of Stress Management Counseling on the Sexual Function of Infertile Women

Background: Sexual dysfunction is one of the most common causes of family breakdown. In recent years, different approaches have been used to solve this problem. Due to the negative effects of sexual dysfunction in women and its complications. Objective: The present study was conducted to investigate the effect of stress management counseling on the sexual function of infertile women referred to Fatemieh Hospital in Hamadan. Methods: The present study was conducted as a randomized two-group clinical trial with two pretest and post-test stages on 104 eligible women referring to Fatemieh Hospital in Hamadan in 2017-2018. Intervention group subjects received 4 two-hour group counseling sessions with a cognitive- behavioral approach on sexual issues. Data were obtained using two questionnaires of demographic characteristics and the Female Sexual Function Index. To analyze the data, SPSS version 21 software and paired t-test, independent t-test, and analysis of covariance were used. The level of significance was considered to be less than 0.05. Results: The results of the present study showed that the mean scores in all areas of total sexual function did not differ significantly before the intervention in two groups. However, after stress management counseling, a significant increase was observed in all areas and general sexual function in the intervention group compared to the control group (P &lt;0.05). Conclusion: Stress management counseling in infertile women can play a positive and effective role in improving sexual function. Therefore, the effectiveness of this counseling in promoting sexual function can be confirmed with more confidence. Registeration No: The study was registered at the Iranian Registration Clinical Trials (IRCT201704149014N158) by I IRCT.

Collective feedback based on quizzes in online learning: a “double-edged sword” effect on attitude to courses, emotions, and academic behaviors

ABSTRACT The role of individual feedback in (online) learning has been widely studied by researchers, but collective feedback based on quizzes and its impact on various academic outcomes has been overlooked to date. The aim of the present study was to compare the effects of displaying individual or collective feedback during an online course on students’ attitudes (interest in the course), emotions (social comparison threat), and behaviors (engagement and academic performance). A two-hour online learning session was conducted among undergraduate students in psychology (N = 155) to examine the effects of collective or individual feedback using quizzes on academic outcomes. In a control condition, each student received individual feedback from the teacher privately on their own device indicating the correct/incorrect answers to each quiz question. In an experimental condition, collective feedback was given publicly to the whole online class by displaying the distribution of answers by response options to each quiz question via a videoconferencing system which shared the teacher’s computer screen. Results showed that students perceived a greater threat of social comparison, and demonstrated lower behavioral engagement and academic performance in the collective than in the individual feedback condition. The opposite effect was found on interest in the course, which was higher when collective feedback based on quizzes was displayed than when it was not. These findings suggest that collective feedback can be considered as a “double-edged sword” generating both positive and negative impacts depending on the type of academic outcomes taken into consideration. Highlights Collective feedback-based on quizzes is a “double-edged sword” in online learning. Collective feedback has a positive effect on students’ interest in the course. Collective feedback is threatening for students due to potentially unfavorable social comparisons. Collective feedback has negative effects on engagement and academic performance.

Cognitive rehabilitation in post-COVID-19 condition: A study protocol for a randomized controlled trial

BackgroundPost-COVID-19 condition is frequently comprised of persistent cognitive sequela, including deficits in attention and executive functions (EFs), which can act as a barrier for regaining pre-illness functional levels. Goal Management Training (GMT) is a cognitive rehabilitation (CR) intervention for improving attention and EFs that has received empirical support in studies of other patient groups. The present study aims to determine the efficacy of GMT for improving everyday attention and EFs in adults who experience persistent cognitive deficits after COVID-19. MethodsThis study protocol describes an open-label randomized controlled trial comparing the efficacy of GMT to a wait list control condition (WL), for improving persistent (> 2 months) cognitive sequela in post-COVID-19 condition. The study aims to recruit 240 participants aged 18 to 65 years with a history of SARS-CoV-2 infection and perceived attentional and EF difficulties in daily life. Participants will be block randomized (computer-algorithm) to either group-based GMT (n = 120) or WL (n = 120). GMT will be internet-delivered to groups of six participants in six two-hour sessions delivered once a week. The primary outcome will be the Metacognition Index of the Behavior Rating Inventory of Executive Function – Adult Version, a self-report measure assessing everyday EF difficulties, specifically metacognition, at six months post-treatment. Secondary outcomes include performance-based neurocognitive measures, and tertiary outcomes include rating scales of cognition, emotional health, quality of life, and fatigue. ConclusionStudy findings could contribute to providing an evidence-based treatment option for symptoms that are frequent and debilitating following a prevalent condition. Trial registration numberNCT05494424

A pre-post study investigating the effectiveness of functional neurological disorder (FND) training to increase healthcare staff’s knowledge, and confidence in FND management

Educational interventions aimed at improving healthcare professionals’ (HCPs) knowledge and confidence in managing complex conditions are widely recommended. However, there is limited evidence regarding the impacts of such interventions on HCP confidence and knowledge in relation to the management of Functional Neurological Disorder (FND). This investigation aimed to ascertain whether a two-hour FND training session, delivered online in group format, improved HCP confidence and knowledge in FND management, using a pre-post repeated measures design. Responses from 25 HCPs from community-based rehabilitation services at Whittington Health NHS Trust were included in the analysis. The findings indicated significant improvements in participant confidence and knowledge scores following training, suggesting the potential value of accessible low-cost training within the NHS. Future studies could adopt a randomised controlled trial design to reliably determine the effectiveness of delivering the training.

Old habits die hard? School guidance interventions and the persistence of inequalities

Social disparities in track choices are a well-known mechanism for the intergenerational reproduction of inequality. School guidance may help reducing such disparities by narrowing information gaps and by reducing the family influence on students’ decision making. We investigate the potential equalizing role of guidance programmes by analysing an intervention carried out in Italy, where students are tracked at age 14 and teacher recommendations are non-binding. The intervention took place in 2018 in the city of Turin and involved 40% of all eighth-grade students, shortly before their transition from comprehensive to tracked education. The students attended four two-hour sessions designed to provide them with information about the educational system and related job market opportunities, and to raise their awareness of their aptitudes and inclinations. We expected the programme to be of particular benefit to low socio-economic status (SES) and migrant students and thus to reduce social gaps in track choices. We adopted a mixed-method research design: with quantitative analyses based on a combination of propensity-score and differences-in-differences techniques, we compared the outcomes of comparable students from the 2017 and 2018 cohorts who were or were not exposed to the intervention in order to assess its impact on inequality; additionally, we use qualitative non-participatory observation to unveil the actual content and implementation of the programme and the behaviour of the key actors. We find that while the programme contributed to reducing indecision, it did not have any major effect on social inequalities in either intentions or choices. Results from the qualitative analysis help us shed light on the mechanisms at play behind this lack of effect. In particular, the heavy emphasis placed on current achievement records, dropout risks, and (short-term) labour-market outcomes may counteract the equalizing potential of the programme, by diverting low-SES kids away from academic tracks.

778 Portfolio for Core Surgical Training: International Doctors’ Experience

Abstract Introduction As the number of international medical graduates (IMG) applying for Core Surgical Training (CST) is growing, the understanding of the portfolio and application system is crucial to succeeding in this competitive application process. We conducted a webinar to grow the awareness of the system, especially amongst doctors still in the process of moving to the UK for surgical training. Method The webinar was part of an online teaching series for IMG doctors run by the SSID society. It was conducted in two separate two-hour sessions using a virtual conferencing tool in September and October 2021. Alongside, it was streamed on Facebook live to grow the reach. The advertising was done via flyers on social media and various WhatsApp groups. Each webinar was delivered by an IMG doctor in CST in the UK where they shared their personal experiences. Feedback was collected after each webinar using an online form generating tool and analysed on Excel. The certificate of attendance was distributed via E-mail. Results The webinar was viewed by 1200 on Facebook Live. Feedback was received from 66 attendees. 96.96% agreed that the webinar improved their understanding of the portfolio and 94.45% agreed they learned about ways to improve their portfolio. 89.39% agreed that they would change their practice after attending this webinar. Conclusions Simple online webinars can improve the understanding of the portfolio requirements for CST amongst IMG doctors. Subsequently, this could allow for early portfolio preparation opportunities, improve application self-assessment scores, and reduce the years needed to get a successful training number.

Impact of educational support on standards of medication administration regarding nursing medication errors in Intensive Care Units

ABSTRACT Medication errors may arise due to insufficient information on drug use. The purpose of this study was to determine the impact of educational support on standards of medication administration regarding nursing medication errors in Intensive Care Units (ICU). The study's participants included two groups of ICU nurses. Both groups were observed using a checklist, before and two weeks after training. Educational intervention in the form of two two-hour sessions was conducted for the intervention group, while control group received no intervention. No significant differences were found in both groups before intervention (P>0.05). However, the nurses’ medication errors significantly decreased in the intervention group compared to the control group (12.7 ± 1.5 vs. 22.7 ± 3.8; p <0.01). Therefore, education of standards can result in a significant reduction in medication errors among ICU nurses. Even for ICU nurses, post-medical education is important for continuing professional education.

Preliminary evidence of the efficacy of the Reducing Aggressive Driving (RAD) program

Introduction: Aggressive driving contributes to crashes, which often result in serious or fatal injuries. Efforts to reduce road trauma need to include strategies to reduce emotional and aggressive driving. Thus far, solutions have not comprehensively addressed the reasons why drivers become aggressive. This study provides preliminary evidence of the effectiveness of the Reduce Aggressive driving (RAD) program in improving driver behavior. The RAD is based on group discussion, feedback, and goal setting to encourage more positive responses to triggers for aggressive driving. The aim of this study was to evaluate the delivery of the RAD and its impact on driver anger and aggression. Method: A total of 94 drivers, ranging in age from 18 to 74 years (Mean = 38; SD = 15; 56% males) attended one two-hour online RAD session during which they identified triggers for their aggression and developed individual strategies to avoid aggressive driving. Most (87%) participants agreed that the RAD helped them generate realistic strategies to avoid aggressive driving. A subset of 67 participants provided self-reported anger and aggressive driving tendencies one month, and four months after the RAD. Results: When these were compared to baseline measures taken before participation in the RAD, decreases across all measures were observed. Thus, anger and aggressive driving significantly decreased one month after the RAD, and these decreases were maintained at the four month follow up; providing evidence of the effectiveness of the RAD in reducing these dangerous behaviors. Further research is needed to objectively measure changes in behavior to and support broader roll-out of the RAD program.

Effect of Mindfulness-Based Self-Care Education on the Quality of Female Nurses’ Life

Background and Objective: The stressful nature of nursing can affect the quality of nurses’ life. Mindfulness-based stress reduction can help improve the quality of their life. Therefore, the present study was conducted to investigate the effect of mindfulness-based self-care education on the quality of female nurses’ life working in Afshar Hospital, Yazd, Iran. Materials and Methods: This experimental study was conducted in 2020 on 60 female nurses working in Afshar Hospital (Yazd, Iran) randomly divided into experimental and control groups. For the experimental group, mindfulness-based self-care was taught in eight two-hour sessions. On the other hand, the control group did not receive any intervention. Data collection tools included a demographic questionnaire and the World Health Organization’s Quality of Life questionnaire. Data were analyzed using descriptive and inferential statistics with a significance level of 0.05 using the SPSS software (version 19). Results: The mean quality of life score before the intervention was not significantly different (P=0.11) between the control (69.58±13.00) and the experimental (64.58±11.41) group. After the intervention, the mean was 68.75±14.21 and 69.58±09.09 in the control and experimental group, respectively; however, the difference was not significant (P=0.78). Regarding the dimensions of the quality of life, there was a significant difference only in the psychological dimension (P=0.001). Conclusion: Mindfulness-based self-care education affects the psychological dimension of the nurses’ quality of life; therefore, it is suggested that programs of this kind be implemented for nurses in this field periodically to improve the quality of their life.

Assessing Changes in Anxiety, Empowerment, Stigma and Wellbeing in Participants Attending an Online-Based Recovery College in Quebec During the Covid-19 Pandemic: A Pre-Experimental Study.

Objectives: The present study aims to evaluate the effect of an online Recovery College (RC) program implemented in Quebec (Canada) during the COVID-19 pandemic. From October 2020 to June 2021, 27 training groups were conducted with a total of 362 attendees. Methods: Outcome was evaluated using a single group repeated measure design, assessing participants prior the training (T0), after the training (T1) and at follow up (T2). 107 learners of the Quebec RC program attended three two-hour sessions agreed to participate to the research. Results: Overall findings show at T1 a small but statistically significant reduction of anxiety and increase in empowerment, and below threshold reduction of stigmatizing attitudes and increase of wellbeing. Conversely, the medium-term changes at follow up were non-significant for all the outcome dimension except for anxiety. Conclusion: Findings suggest that the RC online program can be considered as a potential effective strategy to support self-regulation and empowerment of individuals and to reduce anxiety in the context of crisis for the general population.

The Effect of Blended Learning on Teaching Applied Biostatistics for Postgraduate Medical Students

Introduction: Unlike the face-to-face courses offered on campus, online courses are predominantly asynchronous, where students basically decide when they can attend online courses. There is also an intermediate method referred to as blended learning (BL) that combines the merits of both methods. This study investigates the effect of blended learning on attitude and learning applied Biostatistics.&#x0D; Methods: The students' comprehension levels and attitudes were measured for both groups. The face-to-face group is so designed as to include 16 weeks of two-hour sessions, one session weekly, in one semester. The blended-learning group is designed to receive in one semester 16 weeks of two-hour sessions, one session weekly, such that initially, the group receives four sessions of electronic educational content and then eight sessions of blended learning. The scores attitudes of students from either group were obtained after the final exam and via the university's course evaluation system. The final exam score of both groups based on the results of the student's Bachelor's degree was compared using ANCOVA in terms of either teaching methods.&#x0D; Results: The numbers (proportions) of the participants attending Environmental Health, Waste Management, and Elderly Health courses were 14 (35%), 13 (32.5%), and 13 (32.5%), respectively. The mean (SD) of the scores for the blended-learning group with 18 participants was 16.69 (2.45), which was significantly higher than the score of 14.49 (2.67) for the face-to-face learning group with 22 participants (P = 0.013). Comparisons were made after adjusting the average on the bachelor's degree of both groups.&#x0D; Conclusion: In addition to the improved score for the BL group, the attitudes differed. Therefore, this method is recommended for teaching Applied Biostatistics.

Effectiveness of educational intervention and cognitive rehearsal on perceived incivility among emergency nurses: a randomized controlled trial

BackgroundWitnessing or experiencing of incivility affected the nurses’ perception of the ethical climate and quality of their work life. The aim of this study was to investigate the effectiveness of educational intervention and cognitive rehearsal on perceived incivility among emergency nurses.MethodThis study was conducted as a randomized controlled parallel group clinical trial. Eighty emergency nurses participated in this study and were randomly assigned to intervention and control groups during December 2019—March 2020. Cognitive rehearsal program (include of definitions of incivility, ten common incivilities and appropriate practice methods for responding to each and role-plays) was delivered in five two-hour sessions over three weeks on different working days and shifts. The control group received only written information about what incivility is and how to deal with it before the implementation of intervention and one month after the completion of the training sessions, the demographic information form and the incivility scale were completed by the nurses.ResultsThe results showed that there was a significant effect on overall incivility, general incivility, and supervisor incivility between the intervention and control groups. However, these significant reductions were seen in control group who received only written education. There were no significant differences in nurse's incivility towards other nurses, physician incivility, and patient/visitor incivility between the two groups.ConclusionThe cognitive rehearsal program did not decrease perceived incivility among emergency department nurses in the short term.Trial registrationOur research was registered on clinicaltrials.gov. Registration number: IRCT20200714048104N1, first registration 16/07/2020.

Parent-child Relationship Outcomes of the Incredible Years Parents and Babies Program: A Pilot Randomized Controlled Trial.

BackgroundA warm, sensitive, and responsive relationship to a caregiver is essential for healthy child development.ObjectiveThis paper examines the effects of the Incredible Years Parents and Babies (IYPB) program on the parent-child relationship at post-intervention when offered as a universal parenting intervention to parents with newborn infants.MethodWe conducted a pragmatic, two-arm, parallel pilot randomized controlled trial; 112 families with newborns were randomized to IYPB intervention (76) or usual care (36). The IYPB program is a group intervention with eight two-hour sessions. In addition to parent-reported questionnaires, we collected a six-minute-long video at post-intervention from 97 families to assess the parent-child relationship, which was then coded with the Coding Interactive Behavior system.ResultsThere were no significant intervention effects on either the total score or any of the seven subscales at post-intervention when the children were around 5.5 months old. For parental sensitivity, results were significant at the 10% level, favoring the IYPB group. When examining the lowest-functioning mothers in moderator analyses, we also found no significant differences between the two groups.ConclusionIn line with parent-report outcomes, we did not find any statistically significant differences between the IYPB program and usual care on parent-child relationship when offered as a universal intervention for a relatively well-functioning group of parents with infants in a setting with a high standard of usual care. However, there was a positive trend for the total score, parental sensitivity and reciprocity with effect sizes in the range of .41-.51. It is possible that a larger sample would have resulted in significant differences for these outcomes.Trial registrationClinicalTrials.gov NCT01931917 (registration date August 27, 2013)

The impact of diversity, equity, and inclusion training in an independent community oncology practice.

11057 Background: Historically, Diversity, Equity, and Inclusion (DEI) efforts have largely been left out of private practice medical facilities – mainly present in large academic hospital centers. Virginia Oncology Associates (VOA), a member of The US Oncology Network, is an independent community oncology and hematology practice specializing in the diagnosis and treatment of cancer and blood disorders. VOA has approximately 600 total employees consisting of physicians and clinical and non-clinical staff. In August of 2020, VOA launched an initiative to foster a culture of inclusion with the creation of its Inclusion Council (IC). Sixteen employees’, both clinical (3 physicians) and non-clinical, were chosen to participate. The council reports to VOA’s joint policy board. Methods: The council partnered with an outside organization, Virginia’s Center for Inclusive Communities, to launch a practice-wide DEI training program focusing on unconscious bias and microaggression. The training was initially planned to be in person, but due to the constraints of the COVID pandemic, the training was performed using a virtual platform. The members of IC attended three two-hour sessions while other staff members and physicians were mandated to participate in at least one training session. After completion of the sessions, a survey was sent to all employees and physicians to measure the impact of DEI training. All employees were also given the opportunity to provide additional, anonymous, written feedback. Results: Table. A total of 169 employees responded. 72% of respondents agreed or strongly agreed that the program increased awareness of unconscious bias and microaggression, 67% felt that the program helps foster a culture of inclusion in the workplace, and 66% of respondents felt that the program met expectations. Conclusions: DEI efforts are vital in all aspects of health care delivery and oncology settings. DEI training met staff expectations and positively fostered a culture of inclusion by bringing attention to unconscious bias and microaggression in a community oncology practice.[Table: see text]

Catch Them Young! Changing Attitudes and Perspectives Towards Psychiatry by Using Patients as Educators Early in Medical Training

AimsThis teaching project aims to improve attitudes and perspectives towards psychiatry by using Patient as Educators (PaE) in a psychiatry teaching program early in medical training.MethodsFollowing the success of a small pilot study in 2020, the project was rolled out to the entire second year medical student body in 2021. Two-hour interactive sessions were delivered online to groups of approximately twelve students. Each session was introduced by a psychiatrist, followed by PaE discussion with questions and answers. The students completed a bespoke online survey at the beginning and the end of the session, looking at attitudes towards psychiatry. Comparative analysis of attitudes pre- and post-intervention was then undertaken. Qualitative data were examined through content analysis and quantitative methods were used to compare pre- and post- attitudes on the Likert scale.ResultsThe pre- and post-intervention questionnaires were completed by 373 and 305 students respectively. Both pre- and post-intervention attitudes were overwhelmingly positive. Post-intervention qualitative results demonstrate the session, especially the PaE, helped students to better understand the complexities of mental illness, the stigma faced and the potential efficacy of good treatment. There was a 25.7% increase in students’ perception of preparedness to see mentally unwell patients. The most significant findings were that the majority of students found having the PaE valuable in improving attitudes regarding the value of psychiatry (72.8% agreed/strongly agreed) and increasing interest in the speciality (84% agreed/strongly agreed).ConclusionEarly experience to clinical placements is an essential component in medical education. In Psychiatry, apart from gentle introduction into the specialty, it is essential that students are orientated into the world of mental health and its various challenges. This project has clearly demonstrated the effectiveness of early exposure of medical students to psychiatry as a specialty. It also demonstrates the effectiveness of using PaE in medical education. Further research would aim to examine whether effect on attitudes persist and correlate the effect on early exposure on recruitment to the speciality.