Maximizing your Patient Education Skills (MPES): A multi-site evaluation of an innovative patient education skills training course for oncology health care professionals

Objective

To evaluate the acceptability and relevance of the Maximizing your Patient Education Skills (MPES) course and to determine whether it significantly improved knowledge regarding patient education (PE) theory, self-assessed PE competencies, and PE skills using case based vignettes.

Methods

1-Group, multi-site, pre-post-intervention. Participants completed a pre-assessment (T1), participated in the 4-h MPES course, and then a 3-month post-assessment (T2). A focus group was conducted with sub-set of participants.

Results

98 (75%) of participants completed both time points. Participants were highly satisfied with MPES and found it to be relevant. Results showed that MPES had a significant impact on all of our outcome measures.

Conclusion

Findings from this study show that oncology HCPs knowledge of patient education theory, self-assessed competencies and skills can improve after participating in a brief problem-focused and interactive workshop.

Practice implications

Given the evidence that well-planned education and support can contribute to a number of positive health outcomes and the evidence that HCPs may lack the skills to teach and support patients and their families effectively, these results suggest that MPES course may be of value to oncology professionals. Efforts to further develop this course include exploring alternative funding models and using different learning platforms.     

CAI at the Ohio State University College of Medicine (1973)

The organization and activities related to The Ohio State University College of Medicine CAI efforts are presented in this paper. Typical production methodolgy is discussed as it relates to the various developmental and continuing applications of CAI. Ongoing CAI projects in medical, nursing and allied health curricula, the use of CAI in independent study, and the use of CAI in continuing health professional education are discussed.The central organization and staffing has resulted in a viable system through the sharing of project personnel, materials and programs. Therefore, it has been possible to distribute and lower the cost of using CAI, through increased system efficiency and utilization, and eliminating duplication of efforts.     

Development of a tool to assess the impact of a brief counseling curriculum: Validation of the Attitudes to Psychological Interventions and Counseling in Primary Care (APIC-PC) survey

Objective

To develop and validate an instrument to assess knowledge and attitudes regarding the use of psychological interventions in primary care.

Methods

A 13-item questionnaire was developed based on literature review and expert panel discussion. Exploratory and confirmatory factor analyses were carried out to test the construct validity of the subscales. Item-scale correlations were used to test the construct validity of the items. Internal reliability was tested by Cronbach's alpha. Responsiveness of the instrument was evaluated by using independent t-test of pre and post program scores.

Results

Exploratory factor analysis extracted four factors: skills and knowledge, confidence to provide counseling, willingness to provide counseling, and curriculum needs. Confirmatory factor analysis demonstrated excellent goodness-of-fit. Item scale correlations confirmed convergent and discriminant validity. Good responsiveness was shown on independent t-test of the pre and post responses.

Conclusions

The Attitudes to Psychological Interventions and Counseling in Primary Care (APIC-PC) survey is a valid and responsive instrument for assessing knowledge and attitudes regarding psychological approaches in patient management (mental health care).

Practice implications

Psycho-social counseling skills training is increasingly being recognised as a valuable component of undergraduate primary care medical education. The APIC-PC is a useful tool for evaluating the impact of such programs.     

Effects of dietary caloric density on feeding behavior in Mongolian gerbils (Meriones unguiculatus)

Total daily energy intake, water intake, body weight, and meal patterns were studied in Mongolian gerbils as a function of dietary caloric density. On diets ranging in caloric density from 2.25 kcal/g to 6.09 kcal/g, gerbils consumed an average of 40 kcal per 100 g of body weight per day. In comparison to gerbils fed ground Purina Laboratory Chow (4.2 kcal/g), gerbils presented with diets diluted with nonutritive cellulose increased food intake in proportion to the percentage of cellulose added. Gerbils given diets in which the caloric density was increased by the addition of fat, decreased food intake as a direct function of the added fat. Water intake was increased on the calorically diluted diets, and decreased on the concentrated diets. Body weight did not vary as a function of dietary conditions. On a standard pelleted diet (Noyes), gerbils ate approximately 18 meals a day. Average meal size was 0.4 g. When presented with calorically diluted pellets, gerbils maintained daily energy intake by increasing both meal frequency and meal size. There were no differences in food intake, meal frequency or meal size between the light and dark portions of the 24-hr cycle.     

Effects of cognitive style and maintenance strategies on breast self-examination (BSE) practice by African American women

A convenience sample of 159 African American women, 18–45 years old, was trained to perform breast self-examination (BSE) and was categorized according to the participants' cognitive style (monitors/blunters). Participants were then randomly assigned to one of four groups differing in BSE maintenance strategy (self-management, positive reinforcement, both, or neither). Self-reported monthly compliance with BSE was subsequently assessed during a 9-month period. A significant interaction between maintenance strategies and cognitive style was found. For blunters, the highest compliance rates and the highest competency scores occurred in the group with no maintenance strategy, whereas for monitors, the highest compliance rates and competency scores were found in the groups receiving positive reinforcement and/or self-management strategies. Additional results indicate that high levels of BSE competency were achieved across conditions and that competency improved over time.This paper was supported in part by National Cancer Institute Grant 5 RO3CA48388-02 and in part by Biomedical Research Support Grant PHS RR-05665-22 (Penn), University of California, San Diego.     

Activation and Deactivation of the Polymerization of Ethylene over rac‐EtInd2ZrCl2 and (nBuCp)2ZrCl2 on an Activating Silica Support

A study is carried out in order to better understand the kinetic behavior of two different metallocene precursors supported on an activating silica support, and, in particular, to attempt to reduce the significance of catalyst deactivation through the use of different alkylating agents. It is observed that it is difficult to prevent the deactivation of the rac‐EtInd₂ZrCl₂ sites on the activating support, and, furthermore, the deactivation is accompanied by the disa­ppearance of sites producing the highest‐molecular‐weight polymer. On the contrary, with the (nBuCp)₂ZrCl₂ precursor, it is possible to manipulate the addition of either tri‐isobutylaluminum (TIBA) or triethylaluminum (TEA) to significantly reduce the deactivation of the catalyst on the activating supports. Finally, the molecular‐weight distribution seems to depend much more on the intrinsic properties of the active sites than on how the active sites are treated.

     

Impact of two types of Internet-based information on medical students’ performance in an Objective Structured Clinical Exam (OSCE)

Objectives

Internet-based information has potential to impact physician–patient relationships. This study examined medical students’ interpretation and response to such information presented during an objective clinical examination.

Method

Ninety-three medical students who had received training for a patient centered response to inquiries about alternative treatments completed a comprehensive examination in their third year. In 1 of 12 objective structured clinical exams, a SP presented Internet-based information on l-theanine – an amino acid available as a supplement. In Condition A, materials were from commercial websites; in Condition B, materials were from the PubMed website.

Results

Analyses revealed no significant differences between Conditions in student performance or patient (SP) satisfaction. Students in Condition A rated the information less compelling than students in Condition B (z = −1.78, p = .037), and attributed less of the treatment's action to real vs. placebo effects (z = −1.61, p = .053).

Conclusions

Students trained in a patient centered response to inquiries about alternative treatment perceived the credibility of the two types of Internet-based information differently but were able to respond to the patient without jeopardizing patient satisfaction. Approach to information was superficial. Training in information evaluation may be warranted.     

Influence of recovery mode (passive vs. active) on time spent at maximal oxygen uptake during an intermittent session in young and endurance-trained athletes

The aim of this study was to analyze the effects of recovery mode (active/passive) on time spent at high percentage of maximal oxygen uptake i.e. above 90% of and above 95% of during a single short intermittent session. Eight endurance-trained male adolescents (15.9 ± 1.4 years) performed three field tests until exhaustion: a graded test to determine their (57.4 ± 6.1 ml min⁻¹ kg⁻¹), and maximal aerobic velocity (MAV; 17.9 ± 0.4 km h⁻¹), and in a random order, two intermittent exercises consisting of repeated 30 s runs at 105% of MAV alternated with 30 s passive (IE_P) or active recovery (IE_A, 50% of MAV). Time to exhaustion (t _lim) was significantly longer for IE_P than for IE_A (2145 ± 829 vs. 1072 ± 388 s, P < 0.01). No difference was found in and between IE_P (548 ± 499–316 ± 360 s) and IE_A (746 ± 417–459 ± 332 s). However, when expressed as a percentage of t _lim, and were significantly longer (P < 0.001 and P < 0.05, respectively) during IE_A (67.7 ± 19%–42.1 ± 27%) than during IE_P (24.2 ± 19%–13.8 ± 15%). Our results demonstrated no influence of recovery mode on absolute or mean values despite significantly longer t _lim values for IE_P than for IE_A. In conclusion, passive recovery allows a longer running time (t _lim) for a similar time spent at a high percentage of      

Pronounced effect of hapten binding on thermal stability of an anti-(4-hydroxy-3-nitrophenyl)acetyl antibody possessing a glycine residue at position 95 of the heavy chain

Immune response to T-cell-dependent antigens is highly dynamic; several B-cell clones responsible for antibody production appear alternately during immunization. It was previously shown that at least two-types of antibodies are secreted after immunization with (4-hydroxy-3-nitrophenyl)acetyl (NP); one has Tyr and another has Gly at position 95 of the heavy chain (referred to as Tyr95- and Gly95-type). The former appeared at an early stage, while the latter appeared at a late stage, i.e., after secondary immunization, although Fv domains of these antibodies were encoded by same genes of variable heavy and light chains. We examined whether any biophysical properties of antigen-combing sites relate to this shift in B-cell clones by preparing single-chain Fv (scFv). Thermodynamic and kinetic parameters of the interaction of scFv with various haptens are in accordance with those of intact antibodies, indicating that scFvs are appropriate models for the study on structure and function of antibodies. Next, we measured thermal stability of scFvs using differential scanning calorimetry and found that the apparent melting temperature of free Tyr95-type was 64–66 °C,while that of Gly95-type was 47–48 °C, indicating that the latter was highly unstable. However, Gly95-type greatly gained thermal stability because of hapten binding. We discussed the relationship between thermal stability resulted by hapten binding and dynamism of antibody response during immunization.