Nurse Practitioner Education in India: Challenges,Opportunities, and Implications

Critical care nursing is a postgraduate residency program that was initiated by the Indian Nursing Council to address the critical care service requirements for the increasing number of patients across India due to the increasing burden of communicable and noncommunicable diseases among its population. This article describes the experiences and challenges of a leading nursing institution in India, the Manipal College of Nursing (Manipal), in initiating and implementing the program. Additionally, the authors discuss the need for starting a critical care nurse practitioner program in India and the introduction of critical care nursing in the country. The government of India and the Indian Nursing Council have made a prudent decision to start a postgraduate residency program in critical care to address the requirement of the Indian population. Despite the infancy stage of this program, its graduates provide hope for competent care to critically ill patients. It is the most cost-effective method for a resource-scarce country such as India to fulfill the requirements of critically ill patients. However, further nationwide uniform policies are essential for credentialing, privileging, and creating appropriate employment for the graduates of the program.     

Structured online training for university students to deliver peer-led addiction counselling for young drug abusers in China: Effect on improving knowledge,attitude, confidence,and skills

ObjectivesTo measure the effect of a structured online training programme on improving the knowledge, attitude, confidence, and skills of university students to deliver peer-led addiction counselling to young drug abusers.MethodsA structured training programme was designed for university students with a background in health-related disciplines. Pre- and post-training evaluations were conducted for 245 university students with health-related backgrounds who completed the training programme. The participants’ knowledge of and attitudes towards drug abuse and their confidence in delivering addiction counselling were evaluated and compared before and after the training. Counselling skills were assessed using a simulated standardised case.ResultsA paired test indicated that after attending the training programme, the participants’ knowledge of and attitudes towards drug abuse and their confidence in delivering addiction counselling were significantly improved. Most of the trained participants demonstrated satisfactory counselling skills.ConclusionParticipation in a one-day structured addiction training programme significantly improved students’ knowledge of and attitudes towards drug abuse and their confidence and skills to deliver addiction counselling.Practice implicationFuture research should elucidate the implementation of the counselling skills in terms of the counselling outcomes and successful referral. The clients’ health outcomes should be assessed to reflect the peer counsellors’ skills.     

Climate Change: Effects on the Older Adult

The effects of climate change include floods, hurricanes, heat waves, and fires; these natural disasters can result in respiratory, cardiovascular, and psychological harm in older adults, who experience the highest morbidity and mortality during heat waves. Advanced practice registered nurses (APRNs) need education on preparing, assessing, and treating older adults for climate-change disasters, especially heat waves. This article will help APRNs understand the effects of climate-change events on the vulnerable older adults and advocates for the need to integrate health effects of climate change into curricula, practicums, policy, and research agendas.     

Health-related information needs and preferences for information of individuals with cardiovascular disease from underserved populations: A systematic review

ObjectiveThis systematic review aimed to identify the information needs and preferences of individuals with CVD from underserved populations.MethodsFive databases were searched from data inception to February 2022. Pilot and case report studies, non-peer-reviewed literature, and studies published in a language other than English, Portuguese, or Spanish were excluded. Structured and thematic analysis of all included studies were performed. The Critical Appraisal Skills Program and the Downs and Black Checklist were used to assess the quality of the qualitative and quantitative studies, respectively.ResultsOf 35,698 initial records, 19 studies were included, most in observational design and classified as “fair” quality. Underserved populations – women, people living in rural areas, ethnic minority groups, older people, and those with low socioeconomic status – presented unique needs in four main groups, with some similarities across them: information about CVD, primary and secondary prevention of CVD, CVD management, and health care, policies and practices. Across the studies there was a lack of standardization on how individuals’ needs were assessed and reported.ConclusionUnderserved populations with CVD have unique information needs and preferences that should be address during their care.Practical implicationInformation from this study may assist health care professionals with the development of comprehensive strategies to improve their provision of care for specific CVD patient groups.     

Hands-On Training in a Digital World: A Novel Simulation-Based Virtual Training Program for Placement and Removal of the Subdermal Contraceptive Implant

ObjectiveThe COVID-19 pandemic necessitated a shift from traditional in-person instruction for learning new technical skills to virtual delivery of medical education training. The objectives of this study were to develop and evaluate a virtual simulation-based training program for Canadian health care professionals (HCPs) on the insertion, localization, and removal of the etonogestrel subdermal contraceptive implant.MethodsA scientific committee of Canadian family planning experts developed a 2-part virtual training program during the COVID-19 pandemic. Core educational content (part 1) was provided in an asynchronous, self-directed, online format. Part 2 consisted of synchronous, simulation-based training using web conferencing. The HCPs were provided with model arms and placebo applicators; the trainers demonstrated implant insertion and removal techniques, and trainees received individual feedback. All trainees were asked to complete an online evaluation upon completion of the program.ResultsBetween September 22, 2020, and December 31, 2021, 83 trainers conducted 565 virtual training sessions. A total of 3162 HCPs completed part 1 of the training program, of whom 2740 had completed part 2 by December 31, 2021. Participants reported high levels of satisfaction with virtual simulation-based training; 96.5% of respondents (1570/1627) agreed that the virtual format was effective. Additional training prior to inserting the implant in clinical practice was requested by 4.5% of respondents (75/1671).ConclusionVirtual simulation-based learning provides effective education and technique training for etonogestrel implant insertion and removal. Online training for implant use can be scaled, as needed, to reach professionals in remote or underserved locations. This virtual training approach may be appropriate for other technical or minor surgical procedures.     

Rethinking gross anatomy in a compressed time frame: Clinical symptoms,not case studies,as the basis for introductory instruction

The goal of this observational study was to develop effective approaches to introduce first year medical students to gross anatomy/embryology in a compressed time frame. Pedagogical reorganization of anatomy instruction in the regions of Lower Extremity and Head and Neck was based upon core clinical conditions taught in second‐year and USMLE Step 1 board review courses. These conditions were not presented as clinical problems, as many students had limited prior training in medical terminology, but focused upon clinical symptoms, allowing for direct correlation of structure and function. Instruction stressed vocabulary acquisition and was extended to prepare for laboratory dissections. Overall methodology was multimodal, including “flipped” and traditional lectures, study of prosections/radiographs and small group laboratory review sessions. Content was significantly reduced: knowledge of muscle actions and innervations was required, not muscle origins and insertions. Performance was evaluated by criterion‐based written examinations that included a set of questions (34) asked repetitively over an 8 year period (n = 606 students) and by regional practical exams. Mean scores in all areas were sustained or numerically improved, despite the compression of instruction duration. Analysis showed no significant differences based upon question format or instructional modality. Despite the high performance levels, students needing assistance in learning could be identified by score distributions. A survey of students indicated that these changes effectively decreased stress and facilitated review for the USMLE Step 1 Board examination. These results suggest that training in gross anatomy can be modified to a compressed duration by instruction in the context of clinical symptomatology.