Education Time Out and Debrief: Structured Implementation of Perioperative Resident Technical Education Discussion

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心脏介入药物涂层球囊临床使用合理性评价及干预研究

目的对某三级医院心脏介入药物涂层球囊的临床使用情况进行分析，评价其临床使用合理性。方法参考HB-HTA评价维度，从安全性、有效性、经济性3个方面制定评价指标体系，通过与药物洗脱支架进行对比，评价药物涂层球囊临床使用合理性，并将评价结果应用于管理决策。结果该药物涂层球囊临床使用有效性与药物洗脱支架基本一致，经济性具有一定优势，但在安全性方面有71.1％的病例存在未按说明书使用情况。制定改进措施并实施后，药物涂层球囊未按说明书使用病例比例由69%降为0%，同时患者人均药物涂层球囊费用由23 203.1元降至20 350.0元。结论医院开展医用耗材临床合理使用管理工作时，可参考HB-HTA模式，建立临床使用合理性评价指标体系，并进行定期评价，为管理决策提供依据，以提升医院耗材管理水平。     

Diseñando una encuesta para residentes de formación sanitaria especializada sobre la satisfacción con la docencia. Experiencia en la Comunidad Autónoma del País Vasco (2009-2018)

In Spain, the evaluation of internal resident's satisfaction with the training they receive is legally mandatory for autonomous regions. Beyond this obligation, the evaluation of training leads to its improvement. However, an effective evaluation procedure requires a series of steps that should not be overlooked. Throughout the text, we will give a series of clues that will help those responsible for training, at different levels, to start up a procedure of this type. We will talk about technical requirements for the construction of an effective questionnaire, the most appropriate way to apply the survey in the field of training residents, the importance of statistically validating the questionnaire in order to obtain usable conclusions, and the dissemination of results, from the review of the process itself. Finally, as an example, we will bring up the survey of residents of specialized health training in the Autonomous Community of the Basque Country from 2009 to 2018.     

Behavior Change Following Implementation of Home‐Based Life‐Saving Skills in Liberia,West Africa

Introduction: Home‐Based Life‐Saving Skills (HBLSS) has been fully integrated into Liberia's long‐term plan to decrease maternal and newborn mortality and morbidity, coordinated through the Ministry of Health and Social Welfare. The objective of this article is to disseminate evaluation data from project monitoring and documentation on translation of knowledge and skills obtained through HBLSS into behavior change at the community level. Methods: One year after completion of HBLSS training, complication audits were conducted with 434 postpartum women in 1 rural county in Liberia. Results: Sixty‐two percent (n = 269) of the women were attended during birth by an HBLSS‐trained traditional midwife or family member, while 38% (n = 165) were attended by a traditional midwife or family member who did not receive HBLSS training. Home‐Based Life‐Saving Skills–trained birth attendants performed significantly more first actions (life‐saving actions taught to be performed after every birth) than the attendants not HBLSS trained. Fourteen percent of our sample (n = 62) reported too much bleeding following the birth. Of these women, approximately half (n = 29) were attended by an HBLSS‐trained traditional midwife or family member. There was a significant difference in secondary actions (those actions taught to be performed when a woman experiences too much bleeding following childbirth) that were reported to have been performed by HBLSS‐trained attendants (mean 5.26, standard deviation [SD] 1.88) and untrained attendants (mean 2.73, SD 1.97; P < .0001). Discussion: Our findings suggest that HBLSS knowledge is being transferred into behavior change and used at the community level by traditional midwives and family members.     

Pilot for Learning Interprofessional Physical Assessment Skills

A 6-week pilot study of graduate nursing students and School of Medicine students integrated into the same learning laboratory with the same testing and passing standards in a physical assessment course showed no negative impact on learning outcomes when compared with a concurrently run traditional course. Focus group comments revealed a positive attitude toward continued interprofessional experiences and the development of mutual respect between students, despite some disruptive impact on their personal lives. Scoring on the Readiness for Interprofessional Learning survey had a ceiling effect. A full integration of both school cohorts is planned.     

Visual-perceptual-kinesthetic inputs on influencing writing performances in children with handwriting difficulties

This study investigated the role of visual-perceptual input in writing Chinese characters among senior school-aged children who had handwriting difficulties (CHD). The participants were 27 CHD (9–11 years old) and 61 normally developed control. There were three writing conditions: copying, and dictations with or without visual feedback. The motor-free subtests of the Developmental Test of Visual Perception (DTVP-2) were conducted. The CHD group showed significantly slower mean speeds of character production and less legibility of produced characters than the control group in all writing conditions (ps < 0.001). There were significant deteriorations in legibility from copying to dictation without visual feedback. Nevertheless, the Group by Condition interaction effect was not statistically significant. Only position in space of DTVP-2 was significantly correlated with the legibility among CHD (r = −0.62, p = 0.001). Poor legibility seems to be related to the less-intact spatial representation of the characters in working memory, which can be rectified by viewing the characters during writing. Visual feedback regarding one's own actions in writing can also improve legibility of characters among these children.