Training interventions for healthcare providers offering group-based patient education. A scoping review

ObjectivesTo provide overview of research on training interventions for healthcare providers aimed at promoting competencies in delivering group-based patient education.MethodsA systematic literature search identified relevant studies. Data was extracted on training details, study design, outcomes and experiences. Results were summarized and qualitative data analyzed using content analysis.ResultsTwenty-seven studies exploring various training interventions were included. Ten studies used qualitative methods, eight quantitative and nine mixed methods. Use of a comparison group, validated instruments and follow-up measures was rare. Healthcare providers’ reactions to training were mostly positive. Several studies indicated positive short-term effects on self-efficacy and knowledge. Results on observed skills and patient outcomes were inconclusive. Results on healthcare providers’ experience of delivery of group-based patient education following training were categorized into 1) Benefits of training interventions, 2) Barriers to implementation and 3) Delivery support.ConclusionsFurther evaluation of training for healthcare providers delivering group-based patient education is needed before conclusions on training efficacy can be drawn. The results indicate an expanding research field still in maturation.Practice implicationsEfficacy studies evaluating theoretically grounded training with clear attention on group facilitation and follow-up support are needed. Inclusion of validated instruments and long-term outcomes is encouraged.     

Ophthalmology Services at Student-Run Free Clinics: A National Survey

ImportanceStudent-run free clinics (SRFCs) primarily service the uninsured and are a unique way for medical students to gain hands-on exposure to ophthalmology. The free clinic model takes many different forms- some with episodic and longitudinal models-- and this is mirrored in corresponding eye services.ObjectiveTo describe SRFC ophthalmology services nationwide.DesignThis was a telephone survey study administered from June through July of 2018.SettingThis study surveyed medical school SRFC clinics across the United States.ParticipantsSurvey request was sent to 19 SRFCs previously identified as having ophthalmology services via internet search. Fourteen SRFCs (73%) participated; participants were either student clinic leaders or medical directors. One respondent no longer had a distinct eye clinic so was excluded from relevant results.Main Outcome and MeasureCharacteristics of ophthalmology SRFCs including participants, frequency of sessions, common diagnoses treated, and challenges encountered were assessed through this survey.ResultsOn average, each SRFC provided 5.15 hours per month of ophthalmology services. The mean number of medical students involved per session was 8.7. Lack of infrastructure to ensure adequate patient follow-up and faculty recruiting were cited as the main challenges in providing ophthalmology services. Most SRFC leaders indicated exposure to ophthalmology and practice with the exam as the main experiences that students sought and achieved. The most common conditions treated were refractive error (92.3%) and diabetic retinopathy (69.2%).ConclusionThere are a small number of SRFCs that have ophthalmology services, and they share common features in terms of participants, staffing, and, barriers to sustainability. Ophthalmology services at SRFCs offer a unique venue for medical students to gain exposure to an under-represented field in medical school curricula. The growth of this critical venue for medical student training could be enhanced by recruitment strategies aimed at ophthalmology faculty with a strong interest in service and teaching.     

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.     

Communication,collaboration and contagion: “Virtualisation” of anatomy during COVID‐19

COVID‐19 has generated a global need for technologies that enable communication, collaboration, education and scientific discourse whilst maintaining physical distance. University closures due to COVID‐19 and physical distancing measures disrupt academic activities that previously occurred face‐to‐face. Restrictions placed on universities due to COVID‐19 have precluded most conventional forms of education, assessment, research and scientific discourse. Anatomists now require valid, robust and easy‐to‐use communication tools to facilitate remote teaching, learning and research. Recent advances in communication, video conferencing and digital technologies may facilitate continuity of teaching and research activities. Examples include highly‐interactive video conferencing technology, collaborative tools, social media and networking platforms. In this narrative review, we examine the utility of these technologies in supporting effective communication and professional activities of anatomists during COVID‐19 and after.     

Employability in Academe for Athletic Trainers With the Doctor of Athletic Training Degree

ContextThe doctor of athletic training (DAT) degree has recently been introduced into academe. Limited literature exists regarding how individuals with this degree can become part of an athletic training faculty.ObjectiveTo identify department chairs'' perceptions of the DAT degree and determine whether they viewed the degree as viable when hiring new faculty within a postbaccalaureate professional athletic training program.DesignCross-sectional study.SettingOnline survey instrument.Patients or Other ParticipantsA total of 376 department chairs who had oversight of Commission on Accreditation of Athletic Training Education athletic training programs were invited to participate. Of these, 190 individuals (50.5%) accessed the survey, and 151 of the 190 department chairs (79.5%) completed all parts of the survey.Main Outcome Measure(s)A web-based survey instrument consisted of several demographic questions and 4-point Likert-scale items related to perceptions of the DAT degree. Independent variables were degree qualifications, advanced degree requirements, institutional control, student enrollment, current faculty with a clinical doctorate, and institutional degree-granting classification. The dependent variables were the department chairs'' responses to the survey items.ResultsMore than 80% of department chairs were moderately or extremely familiar with the concept of an advanced practice doctoral degree, and 64% believed it would be extremely to moderately beneficial to hire someone with this degree in the athletic training program. Furthermore, 67% of department chairs were very likely or likely to hire someone with a DAT degree and expected they would do so in the next 5 years. Characteristics associated with higher perception scores were lower institutional student enrollment, having more current faculty with an advanced practice doctoral degree, and a lower institutional degree-granting classification.ConclusionsDepartment chairs recognized the DAT degree as a viable degree qualification for teaching in professional athletic training programs. Future researchers should examine the need for athletic trainers with the DAT degree in clinical practice settings.     

Thank you for letting me be your physician

I believe this article emphasizes how emotionally valuable receiving patients' trust is to the practicing physician. It also gives new insight into understanding the emotional loss a physician may experience when leaving private practice, even if they remain active in medicine. Finally, for those entering medicine, it explains the profound personal satisfaction they can experience from long term trusting relationships with patients.     

A case study about the use of the prospective strategy in the scenarization of a pedagogical workshop

IntroductionPedagogical workshop planning is challenging especially when we aim to promote a reflective practice of the tutees. This practice has been widely discussed in the literature without a real consensus. Some authors reported oral exercises or anecdotes, other described writings or even storytelling. The aim of the authors was to describe the different steps performed by the tutors and to assess the tutees’ satisfaction.Material and methodsThis was a pilot study dealing with the use of the prospective strategy principles in order to plan a pedagogical workshop. Included participants were early academic teacher trainees.ResultsThe authors illustrated how they planned a pedagogical workshop using the prospective strategy and highlighted the satisfaction of the tutees.ConclusionProspective strategy is mainly used in economic field in order to change the future of the companies by acting on different intervening factors. Associating prospective strategy to pedagogical principles hasn’t been reported in the medical literature and seems to be available in order to induce reflective practice.