Pain medicine fellow neuromodulation surgical skill assessment tool: a pilot

2019 ◽  
Vol 45 (1) ◽  
pp. 38-43
Author(s):  
Thomas P Pittelkow ◽  
Jonathan M Hagedorn ◽  
Markus A Bendel ◽  
Jason S Eldrige ◽  
Matthew J Pingree ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Skill Training ◽  
Pilot Project ◽  
Skill Assessment ◽  
Pain Medicine ◽  
Cross Sectional Survey ◽  
Surgical Performance ◽  
Cross Sectional ◽  
Surgical Skill Assessment ◽  
Primary Specialty

ObjectiveSpinal cord stimulation (SCS) is an evidence-based therapy for the treatment of refractory pain. Current American College of Graduate Medical Education requirements for pain medicine fellowship graduation include observation of five neuromodulation cases. Matriculating fellows have varying degrees of technical skill, training, and experience. The purpose of this study was to use an innovative skill-based assessment tool using the validated Zwisch scale to evaluate fellow surgical performance during SCS cases.DesignCross-sectional surveySettingMayo Clinic, Rochester, Minnesota.SubjectsConsultant faculty (10) in the Division of Pain Medicine and pain medicine fellows (5).MethodsA list of faculty-driven neuromodulation surgical objectives was formed and a rubric was created that focused on technical approach, imaging, epidural access and wound closure. Consultants who perform surgical cases were instructed to use the Zwisch scale as a guide to evaluate fellow surgical performance during a neuromodulation case. Faculty and fellows were surveyed before and after implementation of the tool to determine their satisfaction with use of the skill assessment tool.ResultsThe consultants reported they were more satisfied, consistent, and efficient with feedback provided to the trainee on every aspect of neuromodulation surgical cases. The improvement was most significant during the fellows’ intraoperative skill assessment. The fellows indicated increased satisfaction, improved communication, and increased efficiency of feedback when the tool was utilized. The fellows reported greater intraoperative skill assessment and consistency of feedback provided.ConclusionsThe diverse nature of primary specialty backgrounds observed in pain medicine fellowship training offers a unique opportunity to assess and improve fellow skill and surgical competence in the field of neuromodulation. Both faculty and fellows reported improved satisfaction, consistency and efficiency with feedback provided. Importantly, this pilot project observed that implementation of a skill assessment tool was beneficial for both the faculty and fellow as the feedback received was viewed as strongly beneficial to the educational experience.

Ethics knowledge of recent paediatric residency graduates: the role of residency ethics curricula

2016 ◽  
Vol 42 (12) ◽  
pp. 809-814 ◽  
Author(s):  
Jennifer C Kesselheim ◽  
Julie Najita ◽  
Debra Morley ◽  
Elizabeth Bair ◽  
Steven Joffe
Keyword(s):  
Decision Making ◽  
Knowledge Score ◽  
Educational Interventions ◽  
Cross Sectional Survey ◽  
Passage Rate ◽  
Cross Sectional ◽  
Formal Curriculum ◽  
Incorrect Decision ◽  
Primary Specialty ◽  
Residency Programme

ObjectiveTo evaluate the relationship between recently trained paediatricians' ethics knowledge and exposure to a formal ethics or professionalism curriculum during residency.MethodsWe conducted a cross-sectional survey of recently trained paediatricians which included a validated 23-item instrument called the Test of Residents' Ethics Knowledge for Pediatrics. The sample included paediatricians who completed medical school in 2006–2008, whose primary specialty was paediatrics or a paediatric subspecialty, and who completed paediatric residency training in 2010–2011. This sample was stratified based on residency programme variables: presence of a formal curriculum in ethics or professionalism, programme size and American Board of Pediatrics certifying exam passage rate. Paediatricians were randomly selected from each stratum for survey participation.ResultsAmong the 370 responding paediatricians (55%), the mean knowledge score was 17.3 (SD 2.2) out of a possible 23. Presence of a formal curriculum in ethics and/or professionalism was not significantly associated with knowledge. Knowledge was lowest on items about parental requests for a child to undergo genetic testing (2 items, 44% and 85% incorrect), preserving patient confidentiality over email (55% incorrect), decision-making regarding life-sustaining technologies (61% incorrect), and decision-making principles such as assent and parental permission (2 items, 47% and 49% incorrect).ConclusionsThis study highlights several areas in which paediatricians' knowledge may be low and that are amenable to targeted educational interventions. These findings should prompt discussion and research among ethicists and educators about how ethics and professionalism curricula can more consistently influence paediatricians' knowledge.

Measuring Patterns of Surgeon Confidence Using a Novel Assessment Tool

2016 ◽  
Vol 82 (1) ◽  
pp. 28-35
Author(s):  
Timothy M. Farrell ◽  
Iman Ghaderi ◽  
Lindsee E. Mcphail ◽  
Amy R. Alger ◽  
Michael O. Meyers ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Clinical Scenarios ◽  
Academic Settings ◽  
Few Data ◽  
Transition Into Practice ◽  
Experience Curves ◽  
Reliable Scale ◽  
Confidence Scale

Confidence should increase during surgical training and practice. However, few data exist regarding confidence of surgeons across this continuum. Confidence may develop differently in clinical and personal domains, or may erode as specialization or age restricts practice. A reliable scale of confidence is needed to track this competency. A novel survey was distributed to surgeons in private and academic settings. One hundred and thirty-four respondents completed this cross-sectional survey. Surgeons reported anticipated reactions to clinical scenarios within three patient care domains (acute inpatient, nonacute inpatient, and outpatient) and in personal spheres. Confidence scores were plotted against years of experience. Curves of best fit were generated and trends assessed. A subgroup completed a second survey after four years to assess the survey's reliability over time. During residency, there is steep improvement in confidence reported by surgeons in all clinical domains, with further increase for inpatient domains during transition into practice. Confidence in personal spheres also increases quickly during residency and thereafter. The surgeon confidence scale captures the expected acquisition of confidence during early surgical experience, and will have value in following trends in surgeon confidence as training and practice patterns change.

scholarly journals A household food inventory for North American Chinese

2001 ◽  
Vol 4 (2) ◽  
pp. 241-247 ◽  
Author(s):  
Jessie A Satia ◽  
Ruth E Patterson ◽  
Alan R Kristal ◽  
T Gregory Hislop ◽  
Michele Pineda
Keyword(s):  
Assessment Tool ◽  
Dietary Behaviour ◽  
High Fat ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Chinese Populations ◽  
Reduced Fat ◽  
Household Food Inventory ◽  
Behaviour Changes ◽  
Behaviour Score

AbstractObjectiveTo determine whether a short set of questions about foods in the household can provide information about the fat-related dietary behaviour of individual household members in less-acculturated Chinese populations.DesignCross-sectional survey.ParticipantsThe study population included 244 adult females of Chinese ethnicity in Seattle, WA, and Vancouver, BC, Canada.SettingBilingual interviewers collected information on the presence of 14 high-fat foods and seven reduced-fat foods in the household. Respondents were also asked about the consumption of foods and behaviour reflective of adoption of Western dietary practices, fat-related dietary behaviour, changes in consumption of high-fat foods since immigration, and sociodemographic characteristics.ResultsAlthough this was a less-acculturated sample, many households had Western foods such as butter (58%), lunchmeats (36%), snack chips (43%), and 1% or skim milk (48%). Households with respondents who were younger, married, employed outside the home, and lived with young children had significantly more high-fat foods, while high education and longer percentage of life in North America were significantly associated with having more reduced-fat foods (P ≤ = 0.05). Participants living in households with more high-fat foods had higher-fat dietary behaviour than those with fewer high-fat foods (fat-related dietary behaviour score, 1.54 versus 1.28; P < 0.001). Women in households with more reduced-fat foods had a significantly decreased consumption of high-fat foods since immigration compared with those in households with fewer reduced-fat foods (P < 0.001). Western dietary acculturation was higher among women in households both with more high-fat foods and more reduced-fat food counterparts (P ≤ 0.05).ConclusionsOur inventory of household foods was strongly associated with current dietary behaviour, changes in food consumption, and westernization of dietary patterns. This simple, practical measure may be a useful alternative dietary assessment tool in less-acculturated Chinese populations.

scholarly journals Emergency nurse’s perceptions of hospital facility support and disaster preparedness

2020 ◽  
Vol 9 (4) ◽  
pp. 347
Author(s):  
Dewa Gede Sanjaya Putra ◽  
Kuswantoro Rusca Putra ◽  
Noorhamdani AS
Keyword(s):  
Disaster Preparedness ◽  
Assessment Tool ◽  
Health Workers ◽  
Health Sector ◽  
Rank Test ◽  
P Value ◽  
Evaluation Tool ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hospital Facility

Disasters cause material losses, morbidity, and deaths. Support for the role of hospitals and health workers, especially nurses, is needed to reduce the number of victims in each disaster. Using a cross-sectional survey design, this study aims to analyze the relationship between nurse’s perceptions of hospital facility support and disaster preparedness. One hundred sixty seven respondents were selected using proportional random sampling. Disaster preparedness evaluation tool (DPET) was used to assess the participants’ readiness, and the Health Sector Self-Assessment Tool for Disaster Risk Reduction was used to assess nurse’s perceptions of hospital facility support. The final results of the analysis using the Spearman Rank test showed a significant correlation between hospital infrastructure support and emergency nurse’s preparedness in disaster preparedness with a p-value (0.00). The higher the nurse’s perceptions of hospital facility support, the higher their preparedness in disaster management is. Strengthening guidelines of disaster planning in hospitals, especially regarding the ability of hospitals to overcome the impacts of disasters, will provide optimal support for emergency nurses during a disaster crisis.

scholarly journals Hypertension and beyond in Indian clinical practice study: a nationwide survey assessing knowledge, attitude and practices of physicians

2021 ◽  
Vol 8 (11) ◽  
pp. 1701
Author(s):  
Uday Jadhav ◽  
Arun Purohit
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Assessment Tool ◽  
Heart Association ◽  
Fixed Dose ◽  
Long Term Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hypertensive Patients

Background: Hypertension is the leading cause for the ever-increasing burden of mortality due to stroke and cardiovascular diseases (CVD). Treatments are complicated due to comorbidities and can lead to patient noncompliance. Patients with low existing cardiovascular risk are prone to have higher lifetime cardiovascular risk, which timely assessment necessary.Methods: A digital cross-sectional survey questionnaire about knowledge, attitude and practice habits regarding cardiovascular risk assessment was administered to 400 physicians and cardiologists across India. The questionnaire assessed various topics such as practice of hypertension diagnosis and treatment based on guidelines, cardiovascular risk calculators, occurrence of comorbidities and patient awareness on cardiovascular risk prevention.Results: Out of the 400 physicians, 398 completed the survey. About 52% physicians considered presence of multiple risk factors as vital for having cardiovascular risk. American college of cardiology/American heart association (ACC/AHA) calculator was preferred by 51.6% study participants. Cardiovascular risk estimation was vital for treatment-related decision-making according to 71% participants, while only 7.7% participants calculated cardiovascular risk in >90% of their patients. Approximately 44% survey participants calculated cardiovascular risk in hypertensive patients with 2 additional risk factors, while 5.6% calculated it in >70% hypertensive patients without comorbidities. About 46.6% participants reported that 30%-50% of their patients were on fixed-dose combinations of two antihypertensive medications.Conclusions: Findings from the study indicate predisposition of medical professionals towards having a risk assessment tool designed for the Indian population to timely assess and forestall long-term effects of cardiovascular risk in hypertensive patients. 

scholarly journals Quality of Pre-Service Midwifery Education in Public and Private Midwifery Schools in Afghanistan: A Cross Sectional Survey

2021 ◽  
Author(s):  
Partamin Manalai ◽  
Sheena Currie ◽  
Massoma Jafari ◽  
Nasratullah Ansari ◽  
Hannah Tappis ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Assessment Tool ◽  
Rapid Assessment ◽  
Newborn Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public And Private ◽  
Midwifery Education ◽  
Quality Aspects

Abstract Background Midwives are the key skilled birth attendants in Afghanistan. Rapid assessment of public and private midwifery education schools was conducted in 2017 to examine compliance with national educational standards. Aim was to assess midwifery education to inform Afghanistan Nurses and Midwives Council and other stakeholders priorities for improving quality of midwifery education. Methods A cross-sectional assessment was conducted from September 12–December 17, 2017, using a modified Midwifery Education Rapid Assessment Tool to assess education quality aspects related to infrastructure, management, teachers, preceptors, clinical practice sites, curriculum and students in 29 midwifery schools. A purposive sample of six Institute of Health Sciences schools, seven Community Midwifery Education schools and 16 private midwifery schools was used. Participants were midwifery school staff, students and clinical preceptors. Results Libraries were available in 28/29 (97%) schools, active skills labs in 20/29 (69%), childbirth simulators in 17/29 (59%) and newborn resuscitation models in 28/29 (97%). School managers were midwives in 21/29 (72%) schools. Median numbers of students per teacher and students per preceptor were 8 (range 2–50) and 6 (range 2–20). There were insufficient numbers of teachers practicing midwifery (132/163; 81%), trained in teaching skills (113/163; 69%) and trained in emergency obstetric and newborn care (88/163; 54%). There was an average of 13 students at clinical sites in each shift. Students managed an average of 15 births independently during their training, while 40 births are required. Twenty-four percent (7/29) of schools used the national 2015 curriculum alone or combined with an older one. Ninety-one percent (633/697) of students reported access to clinical sites and skills labs. Students mentioned, however, insufficient clinical practice, lack of education materials, transport facilities and disrespect from school teachers, preceptors and clinical site providers as challenges. Conclusions Positive findings included availability of required infrastructure, amenities, approved curricula in 7 of the 29 midwifery schools, appropriate clinical sites and students’ commitment to work as midwives upon graduation. Gaps identified were use of different often outdated curricula, inadequate clinical practice, underqualified teachers and preceptors and failure to graduate all students with sufficient skills such as independently having supported 40 births.

scholarly journals Evaluating equity in healthcare: pilot implementation of a self-assessment tool

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Chiarenza ◽  
D Domenig ◽  
S Cattacin
Keyword(s):  
Quality Of Care ◽  
Assessment Tool ◽  
Healthcare Providers ◽  
The Self ◽  
Vulnerable Groups ◽  
Service Users ◽  
Cross Sectional Survey ◽  
Self Assessment ◽  
Cross Sectional

Abstract Background Several sets of standards aiming at improving access and quality of care for service users have been published in recent years. Certain standards focused on improving healthcare providers’ responsiveness to specific target groups. The general goal of this research was to improve organisations’ awareness of equity standards that are not focused on specific groups, but on all contributing factors that put vulnerable groups at risk of exclusion. The specific objective was to evaluate the degree of compliance with a set of equity standards in 52 health care organisations from 16 countries. Methods A self-assessment tool (SAT) was developed to allow healthcare organisations to measure their capacity to provide equitable care for service users. The SAT indicates the main areas that should be addressed: equity in policy; equitable access and utilisation; equitable quality of care; equity in participation; promoting equity. A cross-sectional survey addressing participants from pilot-organisations was used for data collection, concerning both the self-reported compliance score with the standards, as well as the additional information provided to support the score assigned. Data were analysed quantitatively as well as qualitatively. Results The findings confirm that healthcare providers do invest in improving equity in the access and delivery of services to vulnerable groups. However, many health organisations have inadequate strategies to address inequities and are insufficiently engaged in improving equity in participation and promoting equity outside the organisation. Conclusions The participating organisations reported a significant impact from use of the self-assessment tool: some received the support from regional/national authorities to continue working on improving equity in healthcare; others linked the equity standards to existing performance-measurement strategies; others invested in new frameworks to improve service users engagement. Key messages The implementation of the SAT contributes to a self-reflective process, involving health professionals and managers, in which gaps and potential improvements are identified. Pilot organisations utilised the SAT as part of a process of increasing their awareness of equity issues and changing their organisational culture.

Assessment of professional bereavement: The development and validation of the Professional Bereavement Scale

2021 ◽  
pp. 1-11
Author(s):  
Chuqian Chen ◽  
Amy Yin Man Chow
Keyword(s):  
Factor Analysis ◽  
Assessment Tool ◽  
Mainland China ◽  
Global Perspective ◽  
Measurement Tool ◽  
Global Changes ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Five Factors ◽  
Specific Assessment

Abstract Objectives To develop and validate Professional Bereavement Scale (PBS), a specific measurement tool for professional bereavement experiences. Methods An online cross-sectional survey collected data from 563 physicians and nurses from urban hospitals in Mainland China. Item consistency analysis, component factor analysis, exploratory factor analysis, and confirmatory factor analysis were run to develop and validate the scale. Correlational analysis was conducted to evaluate the psychometric property of the scale. Results Two subscales of the PBS were developed: the 17-item Short-term Bereavement Reactions Subscale (PBS–SBR) and the 15-item Accumulated Global Changes Subscale (PBS–AGC). Four factors, namely, frustration and trauma, guilt, grief, and being moved, are involved in PBS–SBR. Five factors are involved in PBS–AGC, which are new insights, more acceptance of limitations, more death-related anxiety, less influenced by patient deaths, and better coping with patient deaths. Both subscales have good content validity, construct validity, and criterion validity, as well as satisfactory internal consistency and split-half reliability. Significance of results PBS is a specific assessment tool for professional bereavement which is clearly defined, comprehensive, rigorously tested, and generalizable to different professional caregivers from various departments. Unveiled constructs illustrate that professional bereavement experiences contain a professional dimension in addition to a personal dimension both in an event-specific and a global perspective, which distinguishes them from familial bereavement experiences.

Practised sedation in mechanically ventilated patients: A survey of nurses’ perceptions

2020 ◽  
Vol 40 (2) ◽  
pp. 105-112
Author(s):  
Vivian Nystrøm ◽  
Brita Fosser Olsen ◽  
Idunn Brekke
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Continuous Infusion ◽  
Assessment Tool ◽  
Scoring Systems ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mechanically Ventilated ◽  
Nurses Perceptions ◽  
Light Sedation

Recent clinical practice guidelines recommend analgosedation in intensive care unit patients, where the patients' pain first is relieved, followed by sedatives only on indication. The aims of the present study was to examine sedation practice today, to evaluate the degree to which there is a difference in sedation practice between units, and to investigate the associations between nurses' demographic characteristics and their perception of sedation practice. A cross sectional survey was conducted to the nurses in three intensive care units in Norway. The results indicated that light sedation was implemented in the three intensive care unit studied. Continuous infusion of propofol and dexmedetomidine were used most frequently, and continuous infusion of midazolam was used occasionally. However, the sedation practices varied significantly between the units. Subjective scoring systems, physician's prescriptions, and prescription follow-up were reported to be most frequently used as guidelines and directives, and Richmond Agitation–Sedation Scale was reported to be the most frequently used sedation assessment tool.

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