Association of the time to first epinephrine administration and outcomes in out-of-hospital cardiac arrest: SOS-KANTO 2012 study

Objective

This study assessed the association between the timing of first epinephrine administration (EA) and the neurological outcomes following out-of-hospital cardiac arrests (OHCAs) with both initial shockable and non-shockable rhythms.

Improving HIV medical care engagement by attending to status disclosure and social support

ABSTRACT

Expeditious linkage and consistent engagement in medical care is important for people with HIV’s (PWH) health. One theory on fostering linkage and engagement involves HIV status disclosure to mobilize social support. To assess disclosure and social support’s association with linkage and engagement, we conducted a qualitative study sampling black and Latino men who have sex with men (MSM of color) in the U.S. Participants' narratives presented mixed results. For instance, several participants who reported delaying, inconsistent access, or detachment from care also reported disclosing for support purposes, yet sporadic engagement suggests that their disclosure or any subsequent social support have not assisted. The findings contribute to the literature that questions disclosure and social support’s influence on care engagement, especially when decontextualized from circumstances and intentions. Our findings suggest the mechanics of disclosure and social support require planned implementation if intending to affect outcomes, especially among MSM of color. From the findings, we explore steps that may bolster interventions seeking to anchor medical care engagement.     

胎盘前置剖宫产优质围术期护理对生产结局的影响

目的探究与分析胎盘前置剖宫产优质围术期护理措施的实施对胎儿生产结局的影响。方法选取本院自2016年5月—2019年5月收治的胎盘前置剖宫产患者68例,采取随机数字表法分为常规组与优化组,每组各34例,常规组给予基础的围术期护理措施,优化组在常规组的基础上建立并应用手术室信息平台优化护理人员技能,对比两组术中出血量、胎儿娩出时间、排气时间、住院时间、新生儿Apgar评分及护理满意度。结果优化组与常规组相比术中出血量少、胎儿娩出时间短、产妇排气时间短、住院时间短,组间差异具有统计学意义(P<0.05)。优化组与常规组相比新生儿1 min Apgar评分及5 min Apgar评分均较高,组间差异具有统计学意义(P<0.05)。优化组与常规组相比产妇对护理满意度较高,组间差异具有统计学意义(P<0.05)。结论在常规围术期护理的基础上建立并应用手术室信息平台优化护理人员技能应用于胎盘前置剖宫产中能够获得更好的围术期指标,缩短胎儿娩出的时间,新生儿Apgar评分较高,产妇对护理的满意度也较高。     

The role of online videos in teaching procedural skills to post-graduate medical learners: A systematic narrative review

Abstract

Objective: Online videos are commonly used in medical education. The aim of this review was to investigate the role of online instructional videos in teaching procedural skills to postgraduate medical learners.

Methods: This systematic narrative review was conducted according to the PRISMA guidelines. MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, ERIC and Google Scholar were searched. Full texts that applied to online videos, postgraduate medical learners and procedural skills were included without language restrictions. The methodological quality of the studies was evaluated using a validated tool. A thematic analysis of the studies was carried out using a general inductive approach.

Results: A total of 785 articles were retrieved and the full text was reviewed for 66 articles that met the inclusion and exclusion criteria of the study. Twenty papers that were relevant to the role of online videos in postgraduate medical education of procedural skills were used for this review. They were heterogenous in the outcomes collected and the evidence was of variable quality. There was strong evidence for the use of online videos for procedural skill knowledge acquisition and retention. Online videos were used for various purposes, such as supervision, assessment, postoperative debriefing, providing feedback, and promoting reflection.

Conclusion: Online videos are a valuable educational tool especially for procedural skill knowledge acquisition and retention. Future research needs to be carried out on the appropriate use of platforms in disseminating and using online videos, identifying the factors surrounding the learners, video characteristics, and data protection.     

Taking stock of what is known about faculty development in competency-based medical education: A scoping review paper

Abstract

Purpose: The primary objective was to inventory what is currently known about faculty development (FD) for competency-based medical educations (CBME) and identify gaps in the literature.

Methods: A scoping review methodology was employed. Inclusion criteria for article selection were established with two reviewers completing a full-text analysis. Quality checks were included, along with iterative consultation on data collection and consensus decision making via a grounded theory approach.

Results: The review identified 19 articles published between 2009 and 2018. Most articles (N?=?15) offered suggestions as to what should happen with FD in CBME, but few (N?=?4) adopted an experimental design. Six main themes were identified with three main features of FD noted across themes: (1) The importance of direct and timely feedback to faculty members on their teaching and assessment skills. (2) The role of establishing shared mental models for CBME curricula. (3) That FD is thought of longitudinally, not as a one-time bolus.

Conclusion: This work illustrates that there is limited, high quality research in FD for CBME. Future FD activities should consider employing a longitudinal and multi-modal program format that includes feedback for the faculty participants on their teaching and assessments skills, including the development of faculty coaching skills.     

Knowledge of PCOS in physicians-in-training: identifying gaps and educational opportunities

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive-aged women. A recent study found that many obstetrics and gynecology (ObGyn) practicing physicians are unaware of the Rotterdam criteria recommended for diagnosis. Our objective was to identify gaps in trainee knowledge of PCOS diagnostic criteria and management. An online survey was sent out to US ObGyn physicians-in-training in 2018. The primary outcomes were identification of at least one component of each Rotterdam criteria (Rot-3): (1) oligomenorrhea/amenorrhea, (2) clinical or biochemical hyperandrogenism, and (3) ovarian volume or antral follicle count, and identification of all five components (Rot-5). Secondary outcomes were identification of comorbidities and management of PCOS. Multivariable logistic regression was used controlling for gender, seniority (PGY) status, program type, completion of an REI rotation, and number of PCOS patients seen. 85.4% of 347 trainees completing the survey reported using Rotterdam criteria to diagnose PCOS. However, only 55% identified Rot-3 and less than 10% identified Rot-5. Seniority (PGY4 OR 2.2; 95% CI: 1.2–4.1; p?=?.01) and completion of REI rotation (OR 1.8 95% CI: 1.2, 1.8; p?=?.006) were associated with identifying Rot-3. Similar findings were noted with identifying Rot-5. Our study identified significant gaps in knowledge regarding PCOS, suggesting an urgent need for improving strategies for trainee education to increase patient satisfaction and provide comprehensive care.     

翻转教学与案例分析在《内科护理学》高职教学中的结合应用

目的：探讨翻转教学在高职《内科护理学》中与案例分析相结合的教学方法。方法：(1)调查研究 选取我校2014级高职高专两个大班(228人)的学生为研究对象,通过自制的问卷调查,了解《内科护理学》教学改革的必要性与改革方向,实施翻转教学的可行性和效果评价。(2)实验研究：实验组1大班(120人),对照组2大班(108人)。实验组选取《内科护理学》中循环系统疾病护理章节,进行翻转教学与案例分析相结合的教学方法,,对照组在同一章节仍用传统的教学方法。结果：(1)实验研究 实验组理论测试循环系统疾病得分值高于对照组,差异有统计学意义(p <0.05)。(2)调查研究 实验组护生认为翻转课堂与案例分析相结合的教学方法能促进知识的内化、提高课程的学习效果,培养自主学习的能力,缩短了理论实践与临床的距离。