Virtual Sessions Research Articles

Patient experiences and outcomes in a virtual healing setting: A feasibility study.

How do participants with anxiety receiving distance healing using tuning forks, experience healing sessions? What outcomes do they spontaneously report? Modified grounded theory, using single interviews to learn about experiences with distant sound healing. Standardized open-ended, qualitative interviews of 30-minute length were conducted after the intervention and analyzed using an inductive and iterative process for identifying themes, categories, and patterns in qualitative data. Single-arm, pilot feasibility study of Biofield Tuning (BT) for anxiety during the COVID-19 pandemic delivered at a distance facilitated by Zoom (without video). A total of 15 participants were recruited to this study: 13 completed all quantitative aspects, and the 12 who completed the interviews are reported here. The 30-minute qualitative interviews were designed to understand the impact of virtual BT sessions on the participant's experience, anxiety, and within the larger context of their life. The Self-Assessment of Change measured subjective shifts pre and post treatment. The interviews were audio-recorded and transcribed using otter.ai. Two researchers read all the transcripts, identified key themes within the broader experience of sessions and outcomes categories, and came to consensus on key themes using a qualitative research analysis approach. Participants were surprised by the degree to which they felt sensations and heard tuning fork changes. They commented on the accuracy of the healers' perceptions and comprehension of their life experiences. Participants reported positive shifts in perceptions of themselves and their surroundings, both interpersonally and in response to triggers. The patients' own words provide insight into the lived experiences of healing, and guide future research.

Assessing the effectiveness of a learning collaborative to build capacity for community-based cancer survivorship navigation.

213 Background: Community-based patient navigation has emerged as a highly effective strategy to increase cancer screening and early diagnosis, particularly for underserved populations. This navigation typically ends at diagnosis, when patients transition to clinical care. However, clinical navigation offers limited assistance to connect survivors with a broad range of community resources and support services. Community-based survivorship navigators have the potential to bridge this gap. We implemented a virtual learning collaborative (VLC) to build community capacity to deliver breast cancer survivorship navigation. Our research assesses the impact of the VLC on participants' behaviors, self-efficacy, and barriers to navigation. Methods: We conducted an analysis of data from the Breast Cancer Survivorship Patient Navigator Virtual Learning Collaborative (VLC), a 14-week practice-based training for community health workers and patient navigators to address the needs of breast cancer survivors. Weekly 60-minute virtual learning sessions included a brief didactic, followed by participants’ presentation of de-identified client cases. A 27-item pre-post survey was used to assess changes in behaviors, self-efficacy, and barriers to navigation. Results: A total of 40 participants completed both the pre- and post-surveys. Participants were predominantly female (98%), White (55%) or Black (30%), and non-Hispanic (68%). The majority were affiliated with community-based organizations (50%), as well as health departments (19%), and hospitals/cancer centers (19%) serving urban (50%) and suburban (33%) communities. Survey results indicate an average increase of 24% in self-efficacy, with the greatest increase in ability to serve as a consultant to others on cancer survivorship (38%), link survivors to appropriate resources and services (32%), explain how clinical trials work (32%), and work with survivors to address their needs (32%). Reductions in barriers to navigation included limited knowledge of cancer and cancer treatment (33%) and awareness of survivorship resources and services (34%). We found no change in behaviors or other barriers to navigation. Conclusions: The results of this study indicate the effectiveness of the VLC to build community-based capacity to deliver breast cancer survivorship navigation through increased navigator self-efficacy. No changes in behaviors suggests that navigators provide survivorship support whether or not they have training, and points to a key opportunity to increase their knowledge of evidence-based information and resources. Results of this research provide evidence to support recognition of the critical role of community navigators and reimbursement to ensure high quality, consistent community-based care for cancer survivors.

A34Designing and implementing a National Simulation Faculty Development Programme for Wales (Sim FD Wales)

Simulation faculty should be trained and competent [1, 2]. A strategic objective of the Health Education and Improvement Wales (HEIW) Simulation team is to provide equitable access to a standardized simulation faculty development programme across Wales. A consultation process involving meetings, focussed discussions and webinars with key stakeholders, educators and clinicians from a range of professional backgrounds was carried out. The following priority areas were identified: development of a tiered programme supporting a competency-based approach to develop educational skills, knowledge and behaviours required to deliver high quality simulation-based education and training (SBET) in safe learning environments to promote interprofessional SBET and offer flexible and accessible faculty training opportunities. A tiered programme framework consisting of 3 standalone courses (essential, advanced and expert) comprising 4 blended learning modules each, was designed collaboratively and informed by the literature [2,3]. Following content mapping and creation by experts, the Essential Course was launched in October 2022. It entails 5 hours of self-directed e- learning followed by a 5-hour facilitated (virtually or face to face) session, fully funded by HEIW. Advanced Course content is under development, due to commence in March 2024. Thirty-eight participants completed the essential course between October 2022 and February 2023, Learners were asked to rate the usefulness of each e-learning module on a Likert scale, with 1 equating to ‘not at all’ and 5 to ‘very much’. The number of participants that evaluated each module and reported them ≥4 is as follows: ‘Introduction to simulation’ Evaluation of the essential course e-learning modules Response rate to the evaluation of the face-to-face sessions was 24/28 (86%) and 8/10 (80%) for the virtual session. All responders 32/32 (100%) rated the face to face and virtual sessions ≥4 regarding relevance and usefulness, with 31/32 (97%) agreeing that the learning objectives were met. Common themes identified as ‘most useful’ were the ability to practise running a scenario and opportunity to practise debriefing and gain feedback. The Essential Course of the Sim FD Wales Programme has been well received and evaluated so far. Uptake has been high, with demand outstripping places available. Further evaluation is required to determine the effectiveness and impact of each course and the programme as a whole. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

A104A virtual musculoskeletal case history simulation with service users for pre-registration physiotherapy students

Within health care provision many case history assessments are now performed online [1], with students expected to utilize a variety of virtual platforms in a safe, effective and professional manner. Aim: To approximate a real environment for students to practice virtual skills of case history assessment with service users. Objectives: Student development of: 1. Virtual communication skills (verbal, non-verbal, active listening, respect), 2. Clinical reasoning and interpretation, and 3. Reflective skills facilitated by debrief. Simulation preparation including revision of musculoskeletal assessment and familiarization with virtual ground rules linked to HCPC Guidance on Conduct and Ethics [2]. 42 students participated, split into groups of 14 for each virtual simulation session with a total of 5 service users briefed beforehand. Initial warm-up activities in breakout rooms were used to familiarize students with use of the online platform and to facilitate virtual communication skills. Groups of 4 students planned and undertook a virtual musculoskeletal case history with a service user. The Diamond structure for simulation debrief [3] was facilitated by Faculty staff involving the service users and peers; enabling further development of the students’ clinical reasoning and interpretation. Students reflected on their own performance using a simulation checklist as a resource, closing the loop by creating an action plan prior to their first practice placement. 25 students voluntarily completed an anonymous questionnaire linked to their virtual experiential learning activity. 75% strongly agreed and 21% agreed that the simulation was helpful in their development for placements (see Graph to show student response that virtual musculoskeletal simulation with service users was helpful in their development for placements Thematic analysis of good aspects of the activity identified 4 main themes: Benefits and realism of service user involvement compared to actors or peers Development of virtual communication and assessment skills Richness of involvement of service users in the debrief Usefulness of warm up activities using virtual technology Suggestions for improvement showed 2 main themes around increasing planning time and more opportunities for simulation with service users. Findings demonstrated the simulation aims and objectives were met with students positively reporting that the activity was helpful in their learning ahead of practice placements - enabling development of virtual communication, clinical reasoning/ interpretation and reflection through debrief. Approximation of a real environment for students to practice virtual case history assessment incorporating service users offers a rich educational example that aligns well with practice and sustainability in the current healthcare environment and is highly valued by students. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Continuous learning through platforms

The health crisis situation we have experienced caused by the SARS-CoV-2 virus has changed our daily life in numerous aspects, including those related to training (undergraduate, postgraduate, and continuing education, etc). Training activities, conferences, lectures, face-to-face workshops were suspended until the Health Situation was over. Alternatives to face-to-face training were needed to guarantee the continuity of these activities. Online training, teaching and evaluation emerged as a relatively fast, simple, operational and flexible solution.Universities and faculties promoted online teaching through virtual classes. The Spanish Society of Hospital Pharmacy supported this initiative by signing an agreement with the Board of Deans and Chancellors of Pharmacy to make it possible for undergraduate students to continue their studies and supervised practices in hospital pharmacy departments.Specialized training was affected. Pharmacy residency programs were significantly modified by hospital pharmacies to be able to provide the new clinical and research activities required, everyday, by the pandemic situation.Postgraduate and residency training were also negatively affected. Again, online activities made up for restrictions to face-to-face teaching and training. The Spanish Society of Hospital Pharmacy promoted continuing education and provided updated information on the SARS-CoV-2 virus through its website. Thus, numerous virtual sessions, lectures and webinars have been held, and high-quality material was offered to provide up-to-date knowledge, on the pharmacological management of patients with COVID-19.Online teaching and education has demonstrated to be an invaluable tool for hard times. During the lockdown, technology has kept us closer and has emerged as an ally. Many of us have found a new means of communication, information, and training. The Spanish Society of Hospital Pharmacy has substantially contributed to make it possible.

Sleep Quality, Sleep Efficiency, and Perceived Stress after Synchronous Virtual Mindfulness Meditation Sessions for Higher Education Students

This study<strong> </strong>examined the effects of virtual mindfulness meditation programming on sleep efficiency using wearable tracking devices, as well as effects on sleep quality and perceived stress in higher education students.<strong> </strong>A one-group, pretest-posttest design with convenience sampling and rolling recruitment over a six-month period resulted in twenty-five participants who completed the study and were included in data analysis. Paired t-tests were used to determine statistical significance for sleep efficiency measured using the Fitbit Inspire 2, Pittsburgh Sleep Quality Index (PSQI) global score, and Perceived Stress Scale (PSS) total scores. Significance was observed in positive outcomes for sleep quality (<em>p</em> = 0.010) and perceived stress (<em>p</em> = 0.032). Sleep efficiency resulted in no significant change (<em>p</em> = 0.063). The synchronous virtual program had a positive effect on the sleep quality and perceived stress; however, the use of wearables should be integrated with caution. Higher education students and professionals at higher education institutions may consider non-pharmacological approaches to treating stress and sleep.

Research and application of a teaching platform for combined spinal-epidural anesthesia based on virtual reality and haptic feedback technology

BackgroundIntraspinal anesthesia poses significant teaching challenges and inadequate teaching resources, which ultimately limit students’ opportunities for practice. To address this issue, we aimed to develop a virtual platform for combined spinal-epidural anesthesia that merges virtual reality technology with haptic feedback technology, while assessing its educational impact and learning outcomes.MethodsWe utilized MIMICS, 3Ds MAX, and UNITY 3D software to perform 3D reconstruction based on lumbar CT/MRI data from a standard male volunteer. The haptic coefficients were configured on each layer by 20 experienced anesthesiologists in accordance with the Geomagic Touch X force feedback device. A total of 20 anesthesiology interns completed 30 virtual puncture training sessions. Two experienced anesthetists evaluated the efficacy of the platform and the level of mastery achieved using the Global Rating Scale (GRS) and a Checklist score, respectively. Finally, a questionnaire survey was conducted to gather feedback on the virtual platform.ResultsAfter the 10th session, the puncture time stabilized at 2.4 min. As the number of sessions increased, the Global Rating Scale (GRS) score stabilized by the 8th session, and the Checklist scores tended to stabilize by the 10th session. Results from questionnaires indicated that over half of the anesthesiology interns (70%) believed that the platform, which exhibited strong repeatability, improved their anatomical recognition and provided a strong sense of breakthrough in identifying the ligamentum flavum. The majority of them (80%) expressed satisfaction with the virtual platform.ConclusionsThe platform effectively facilitated the acquisition of basic and accurate puncture skills on a virtual patient.

Grieving Children' Death in an Intensive Care Unit: Implementation of a Standardized Process.

Background: The grief that accompanies witnessing the death of a child puts health care professionals at risk of secondary trauma, burnout, and turnover when left unaddressed. Objective: Support staff well-being and promote resiliency. Methods: Descriptive implementation of a structured, peer-to-peer bereavement support program for intensive care unit (ICU) staff at a tertiary children's hospital. Results: Thirty-five virtual sessions were held over the period of one year.Through these sessions, participants shared perspectives and normalized reactions, and explored potential coping strategies. Post-session feedback surveys demonstrated the negative impact of a death on the personal or work life of ICU staff. Additionally, nearly all reported some level of burnout. Conclusions: The sessions were feasible and positively impacted staff coping and well-being. Barriers and facilitators to session attendance, as well as suggestions for improvement, were also explored. Implications for practice and future research are discussed. No clinical trial registration is applicable.

Has cross-level clinical coordination changed in the Catalan health system after the pandemic?

Abstract Background The COVID-19 pandemic triggered several changes in the organization of health services, such as the acceleration of the introduction of digital tools to improve cross-level clinical coordination and, therefore, the quality of care. The aim is to analyse changes in the experience, perception of cross-level clinical coordination and related factors of primary care (PC) and secondary care (SC) doctors in the Catalan health system between 2017 and 2022. Methods Comparison of two cross-sectional studies based on the online surveys COORDENA-CAT (2017) and COORDENA-TICs (2022) to PC and SC doctors. Sample 2017 n = 3308 (participation: 20.9%); 2022 n = 2277 (participation: 17.5%). Outcome variables: experience and perception of cross-level clinical coordination, and related factors, knowledge, and use of digital coordination mechanisms. Descriptive and multivariate analyses were performed to detect changes between years. Results Compared to 2017, there was a worse experience of clinical management coordination, particularly in cross-level care consistency and accessibility, and of the perception. Regarding related factors there was a worsening in some organizational factors (time available for coordination, institutional support), attitudinal factors (satisfaction with the job) and interactional factors (knowledge between doctors). The use of some coordination mechanisms such as electronic medical records and virtual consultations between PC and SC increased, while the use of virtual joint clinical sessions was limited. Conclusions Results show that after the pandemic there was a worsening in some items of the experience and in the perception of cross-level clinical coordination, despite the increased use of some digital coordination mechanisms. There is a need to explore in depth the factors associated with this worsening to identify and promote more effective strategies to improve cross-level clinical coordination in Catalonia. Key messages • Cross-level clinical coordination in Catalonia has worsened despite the increase in implementation and use of some digital coordination mechanisms. • It is necessary to explore in depth the factors related to this worsening to develop more effective strategies to improve cross-level clinical coordination.

A first intervention to support the mental health of transgender individuals in Eastern Europe

Abstract Background Transgender and gender-diverse (TGD) people in Romania experience high discrimination and related dysphoria, while gender-affirmation resources are scant. TGD Romanians report significant emotional distress and no access to competent mental health care. This pilot tested the feasibility, acceptability, and early efficacy of the first evidence-based mental health intervention implemented in Eastern Europe, using cognitive behavioral therapy within an identity-affirming framework. Methods Eligible TGD individuals (e.g., ≥ 18 years old, symptoms of past-90-day depression and/or anxiety) were recruited through community outreach. Participants completed a baseline (BL) assessment, were assigned to one of two trained psychologists, attended up to 16 1-hr virtual counseling sessions, and completed a 5-month follow-up assessment. Participants reported demographics, mental health (e.g., anxiety, depression), and identity-related psychosocial experiences (e.g., gender identity congruence). Analyses were conducted using paired sample t-tests and Wilcoxon rank sum tests to compare pre-post intervention scores. Results Of 24 participants enrolled (40% transgender female, 43% transgender male, 17% non-binary; M age=25.1, SD = 6.53), 22 were retained at follow-up. Significant reductions occurred from BL to follow-up in depression, anxiety, and psychological distress (p < 0.001), alcohol-related problems, gender identify rumination and difficulties with emotion regulation (p = 0.05). Satisfaction with the intervention was high. There were no changes in suicidal ideation, assertiveness, transgender congruence, gender identity acceptance, and emotion regulation. Conclusions This first intervention to support TGD Romanian's mental health shows promise and can be further studied in a randomized controlled trial. Its implementation across similar high-stigma, low-resource countries can provide critical mental health support in settings lacking such resources.

The Development of a Bereavement Support Group Curriculum for Bereaved Parents of Young Adult Children: Bridging the Gap.

Purpose: There is limited research addressing the bereavement needs of parents whose young adult (YA) children have died from cancer. Research within oncology about the impact of child loss has tended to focus on parents of pediatric aged children. We adapted a general bereavement support group curriculum used with adults to address the unique needs of bereaved parents of YAs. Methods: Using a quality improvement framework, 25 bereaved parents of YA children participated in one of three 6-session bereavement support group programs during 2020 and 2021. Due to the coronavirus disease 2019 (COVID-19) pandemic, the programs were offered virtually. The participants provided feedback and completed an evaluation. Results: Nineteen mothers and six fathers participated with 20 (80%) completing the evaluation. The median time since the death of their child was 6 months. The participants evaluated the program highly, reporting that they felt less isolated (4.25/5 on a 5-point Likert scale); that their concerns were similar to others (4.45/5); and the discussion topics were relevant (4.20/5). Other topics that were identified included the impact on the family of losing a YA child, and how other relationships change. Forty-five percent of participants expressed a preference for a hybrid delivery model, incorporating in-person and virtual sessions. The majority also wished to continue meeting monthly, given they had little contact with other bereaved parents of YAs. Conclusion: The general bereavement support group curriculum was readily adapted for use with bereaved parents of YA children who died from cancer. A hybrid delivery model was the preferred method for future groups.

Use of Human-Centered Design Methodology to Develop a Digital Toolkit to Optimize Heart Failure Guideline-Directed Medical Therapy.

Guideline-directed medical therapies (GDMTs) improve quality of life and health outcomes for patients with heart failure (HF). However, GDMT utilization is suboptimal among patients with HF. The aims of this study were to engage key stakeholders in semistructured, virtual human-centered design sessions to identify challenges in GDMT optimization posthospitalization and inform the development of a digital toolkit aimed at optimizing HF GDMTs. For the human-centered design sessions, we recruited (a) clinicians who care for patients with HF across 3 hospital systems, (b) patients with HF with reduced ejection fraction (ejection fraction ≤ 40%) discharged from the hospital within 30 days of enrollment, and (c) caregivers. All participants were 18 years or older, English speaking, with Internet access. A total of 10 clinicians (median age, 37 years [interquartile range, 35-41], 12 years [interquartile range, 10-14] of experience caring for patients with HF, 80% women, 50% White, 50% nurse practitioners) and three patients and one caregiver (median age 57 years [IQR: 53-60], 75% men, 50% Black, 75% married) were included. Five themes emerged from the clinician sessions on challenges to GDMT optimization (eg, barriers to patient buy-in). Six themes on challenges (eg, managing medications), 4 themes on motivators (eg, regaining independence), and 3 themes on facilitators (eg, social support) to HF management arose from the patient and caregiver sessions. The clinician, patient, and caregiver insights identified through human-centered design will inform a digital toolkit aimed at optimizing HF GDMTs, including a patient-facing smartphone application and clinician dashboard. This digital toolkit will be evaluated in a multicenter, clinical trial.

Healthcare professional and manager perceptions on drivers, benefits, and challenges of telemedicine: results from a cross-sectional survey in the Italian NHS

BackgroundThe Covid-19 pandemic provided new challenges and opportunities for patients and healthcare providers while accelerating the trend of digital healthcare transformation. This study explores the perspectives of healthcare professionals and managers on (i) drivers to the implementation of telemedicine services and (ii) perceived benefits and challenges related to the use of telemedicine across the Italian National Health Service.MethodsAn online cross-sectional survey was distributed to professionals working within 308 healthcare organisations in different Italian regions. Quantitative and qualitative data were collected through a self-administered questionnaire (June-September 2021). Responses were analysed using summary statistics and thematic analysis.ResultsKey factors driving the adoption of telemedicine have been grouped into (i) organisational drivers (reduce the virus spread-80%; enhance care quality and efficiency-61%), (ii) technological drivers (ease of use-82%; efficacy and reliability-64%; compliance with data governance regulations-64%) and (iii) regulatory drivers (regulations’ semplification-84%). Nearly all respondents perceive telemedicine as useful in improving patient care (96%). The main benefits reported by respondents are shorter waiting lists, reduced Emergency Department attendance, decreased patient and clinician travel, and more frequent patient-doctor interactions. However, only 7% of respondents believe that telemedicine services are more effective than traditional care and 66% of the healthcare professionals believe that telemedicine can’t completely substitute in-person visits due to challenges with physical examination and patient-doctor relationships. Other reported challenges include poor quality and interoperability of telemedicine platforms and scarce integration of telemedicine with traditional care services. Moreover, healthcare professionals believe that some groups of patients experience difficulties in accessing and using the technologies due to socio-cultural factors, technological and linguistic challenges and the absence of caregivers.ConclusionsRespondents believe that telemedicine can be useful to complement and augment traditional care. However, many challenges still need to be overcome to fully consider telemedicine a standard of care. Strategies that could help address these challenges include additional regulations on data governance and reimbursements, evidence-based guidelines for the use of telemedicine, greater integration of tools and processes, patient-centred training for clinicians, patient-facing material to assist patients in navigating virtual sessions, different language options, and greater involvement of caregivers in the care process.

Clinical and Psychosocial Predictors of Post-Event Processing in Adults Who Stutter.

Post-event processing, defined by self-critical rumination following a stressful communication event, is significantly associated with reduced quality of life. However, despite its relevance to the stuttering experience, to date, only a few studies have investigated post-event processing among adults who stutter, and no study has identified clinical and psychosocial predictors of post-event processing. The purpose of this study was to determine the contributions of clinical markers of stuttering and psychosocial variables to post-event processing. Adults who stutter (N = 96) participated in two virtual sessions. After completing the Trier Social Stress Test, a standardized social stress task in Session 1, participants completed measures of post-event processing, clinical markers of stuttering (i.e., the experience of stuttering, self- and observer-rated stuttering severity), and psychosocial characteristics (i.e., self-perceived performance, self-esteem, social anxiety, trait, and state self-compassion) in Session 2. Hierarchical linear regression models indicated that a more negative experience of stuttering, higher self-rated stuttering severity, and greater social anxiety predicted more post-event processing. Greater self-perceived performance and state self-compassion predicted less rumination. Observer-rated severity, self-esteem, and trait self-compassion were not significantly associated with post-event processing behavior. Findings reveal clinical and psychosocial variables to consider in the assessment and mitigation of post-event processing behavior in adults who stutter, and to bolster resiliency to social stress. https://doi.org/10.23641/asha.24223213.

THU005 Patient And Public Involvement In Virtual Simulation-based Education Informs And Enhances Clinicians’ Knowledge In Managing Polycystic Ovary Syndrome And Adrenal Conditions

Abstract Disclosure: C.S. Pan: None. E. Melson: None. T. Ogiliev: None. D. Zhou: None. S.Y. Ng: None. F. Rezai: None. Z. Olateju: None. E. Radcliffe: None. P. Balendran: None. A. Radcliffe: None. G.M. Lau: None. J. Sheikh: None. H. Kaur: None. C. Cooper: None. F. Abdelhameed: None. F. Pang: None. S. Bhatt: None. D. Shabbir: None. M. Davitadze: None. A. Prete: None. C.L. Ronchi: None. I. Bancos: None. V. Chortis: None. J.D. Newell-Price: None. H.L. Simpson: None. H. Gleeson: None. K. Manolopoulos: None. J. Chu: None. M.W. O'Reilly: None. W. Arlt: None. C. Gillett: None. P. Kempegowda: None. O. SIMBA team: None. Introduction: Simulation via Instant Messaging - Birmingham Advance (SIMBA) is an effective educational platform in increasing clinicians’ confidence in managing various endocrine conditions (Melson, 2020). However, it has lacked input from the patients living with these conditions. We hypothesize that engaging patients and members of the public can inform clinicians to better tailor management to suit the concerns and expectations of patients. Methods: Two virtual simulation sessions covering topics related to Polycystic Ovary Syndrome (PPI-PCOS) and Adrenal conditions (PPI-Adrenal) were organized for clinicians. Nine cases were simulated using anonymized real-life patient data. Members of the general public living with PCOS or Adrenal conditions were recruited from several support groups to undergo a workshop-style discussion to provide their opinions on how representative the cases were and how the management of the condition could be improved. At the end of the simulations, all clinicians and patients were invited to a panel discussion led by expert consultants over Zoom incorporating the summaries from the workshops. Pre- and post-simulation surveys were distributed to measure the change in clinicians’ confidence using Wilcoxon signed-rank test. Thematic analysis was used to identify gaps in knowledge and expectations between clinicians and patients with PCOS or Adrenal conditions. Results: Self-reported confidence by clinicians in the management of PCOS (n=25) and Adrenal conditions (n=23) increased post-simulation (PPI-PCOS simulated:+41.0%, p<0.001; non-simulated:+40.0%, p<0.001. PPI-Adrenal simulated:+22.5% (p=0.0001); non-simulated:+24.0% (p=0.0005)). 90% and 100% of patients agreed PPI-PCOS benefits patients to understand their condition better, and helps clinicians and patients understand each other’s perspectives respectively, whereas this is true for 80% of patients from PPI-Adrenal regarding both aspects. Recurring themes identified through thematic analysis included approach to handling complexities resulting in delayed diagnosis or management, the need for personalized care, lack of information provided to patients with regards to the progression of symptoms, complications or treatment received. Conclusion: PPI-PCOS and PPI-Adrenal were effective in increasing the knowledge and understanding of PCOS and Adrenal conditions for both members of the general public and healthcare professionals. They also helped narrow the gap in knowledge and expectations by exchanging perspectives through a common dialogue. Presentation: Thursday, June 15, 2023

Hybrid Train-The-Trainer course for the Fundamental Use of Surgical Energy certificates improves self-confidence in knowledge of surgical energy and develops teaching skills: a feasibility study.

Several well-trained expert instructors who completed the "Train-The-Trainer (TTT)" course are required to disseminate the safe use of surgical energy devices, which can be learned through the Fundamental Use of Surgical Energy (FUSE) program. This study aimed to explore whether the hybrid FUSE TTT course is feasible and effective, which can improve teaching skills of surgical energy. The hybrid TTT course, which was designed to train FUSE-certified personnel as instructors, comprised three virtual sessions spread over 5h in total and a 1-day in-person training, followed by a 100-min FUSE electrosurgery hands-on workshop in practice as an instructor. The participants reported on self-confidence regarding knowledge of various energy devices or adverse events before, immediately after, and 6months after the course. Participants and experienced FUSE instructors assessed the trainees' presentation skills at the beginning of the in-person training and after the hands-on workshop. The primary outcomes were the feasibility and completion rate of the entire course. Seventeen participants completed the entire couse; most (94%) were satisfied with the course. Self-confidence in knowledge about various contents improved significantly: the fundamentals of electrosurgery (post, p < 0.001; 6months, p = 0.01), mechanism and prevention of adverse events (post, p = 0.001; 6months, p = 0.04), monopolar instruments (post, p = 0.002; 6months, p = 0.01), bipolar instruments (post, p = 0.01; 6months, p = 0.06), and integration with other medical devices (post, p = 0.006; 6months, p = 0.02). The presentation skill index scores of self- and peer assessments improved after the in-person training (self-assessment [pre 44 vs. post 56, p < 0.001], peer assessment [pre 39 vs. post 68, p < 0.001]). The hybrid TTT course can provide FUSE-certified personnel with an improved self-confidence concerning knowledge of surgical energy and improve their presentation skills with midterm retention. This can help build trainees' self-confidence as instructors.

Effects of immersive virtual reality on sensory overload in a random sample of critically ill patients.

Sensory overload and sensory deprivation have both been associated with negative health outcomes in critically ill patients. While there is a lack of any clear treatment or prevention strategies, immersive virtual reality is a promising tool for addressing such problems, but which has not been repetitively tested in random samples. Therefore, this study aimed to determine how critically ill patients react to repeated sessions of immersive virtual reality. This exploratory study was conducted in the mixed medical-surgical intermediate care unit of the University Hospital of Bern (Inselspital). Participants (N = 45; 20 women, 25 men; age = 57.73 ± 15.92 years) received two immersive virtual reality sessions via a head-mounted display and noise-canceling headphones within 24 h during their stay in the unit. Each session lasted 30-min and showed a 360-degree nature landscape. Physiological data were collected as part of the participants' standard care, while environmental awareness, cybersickness, and general acceptance were assessed using a questionnaire designed by our team (1 = not at all, 10 = extremely). During both virtual reality sessions, there was a significant negative linear relationship found between the heart rate and stimulation duration [first session: r(43) = -0.78, p < 0.001; second session: r(38) = -0.81, p < 0.001] and between the blood pressure and stimulation duration [first session: r(39) = -0.78, p < 0.001; second session: r(30) = -0.78, p < 0.001]. The participants had a high comfort score [median (interquartile range {IQR}) = 8 (7, 10); mean = 8.06 ± 2.31], did not report being unwell [median (IQR) = 1 (1, 1); mean = 1.11 ± 0.62], and were not aware of their real-world surroundings [median (IQR) = 1 (1, 5); mean = 2.99 ± 3.22]. The subjectively reported decrease in environmental awareness as well as the decrease in the heart rate and blood pressure over time highlights the ability of immersive virtual reality to help critically ill patients overcome sensory overload and sensory deprivation. Immersive virtual reality can successfully and repetitively be provided to a randomly selected sample of critically ill patients over a prolonged duration.

Transnational Dialogues on Interdisciplinary Approaches for Advancing People-Centered Warning Systems

The United Nations Office for Disaster Risk Reduction and the World Meteorological Organization launched in 2022 the executive plan of the world program “Early Warning Systems for All” to be implemented from 2023 to 2027. This program champions an investment of USD 3.1 billion into the four pillars of warning systems and calls for multi-hazard and people-centered warning systems (PCWS). However, there is a scientific gap concerning interdisciplinary approaches to promoting them. Motivated by the call for action of “Early Warning Systems for All” and warning research gaps on the lack of interdisciplinarity, a workshop series “Interdisciplinary Approaches for Advancing People-Centered Warning Systems” was held in early 2023. This short article shares the preliminary findings and recommendations of this research, which involved a transnational virtual dialogue between one scientific organization in Brazil and one from the United States. The findings and recommendations discussed in three virtual sessions and one collective working paper were centered on three aspects: promoting interdisciplinary integration in research; the need to discuss the characteristics of a PCWS; and promoting problem- and solution-based programs with people to integrate them at all phases of the warning system.

Intervention to improve acute care nurses confidence and knowledge in hospital dementia care

ProblemAcute care nurses are the front line of hospital care for persons with dementia (PwD), yet many have inadequate dementia education and lack the confidence to appropriately manage PwD in the hospital setting. ImplementationTwo acute care units with high rates of PwD in a large tertiary-care hospital were provided an education intervention involving interactive case-based discussion of the challenges of inpatient dementia care. ResultsOut of 190 nurses, 171 completed a one-hour virtual educational session, 142 completed pre/post-session confidence surveys, and 123 completed pre/post-session knowledge tests. There was a statistically significant improvement in knowledge scores from 75.8% pre-session to 88.4% post-session (p < 0.001), and pre/post-session dementia care confidence increased from 3.49 to 4.44 ( + 27.22%; p < 0.001) ConclusionAn interactive virtual education intervention improves acute care nurses’ confidence and knowledge in managing PwD in the acute care setting and may improve hospital outcomes for this population.

S1760 GI Fellowship Applicants Experiences and Perceptions of Virtual Applicant-Fellow Sessions

S1760 GI Fellowship Applicants Experiences and Perceptions of Virtual Applicant-Fellow Sessions