scholarly journals An emergency care research course for healthcare career preparation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karen F. Miller ◽  
Rishub K. Das ◽  
Ciera D. Majors ◽  
Hadassah H. Paz ◽  
Ayana N. Robinson ◽  
...  
Keyword(s):  
University Students ◽  
Clinical Research ◽  
Emergency Care ◽  
Tertiary Care ◽  
Unmet Need ◽  
Independent Study ◽  
Course Evaluations ◽  
Biomedical Science ◽  
Research Experience ◽  
Care Research

Abstract Background University students have limited opportunities to gain healthcare clinical exposure within an academic curriculum. Furthermore, traditional pre-medical clinical experiences like shadowing lack active learning components. This may make it difficult for students to make an informed decision about pursuing biomedical professions. An academic university level research course with bedside experience provides students direct clinical participation in the healthcare setting. Methods Described is a research immersion course for senior university students (3rd to 5th year) interested in healthcare and reported study enrollment with final course evaluations. The setting was an adult, academic, urban, level 1 trauma center emergency department (ED) within a tertiary-care, 1000-bed, medical center. Our course, “Immersion in Emergency Care Research”, was offered as a university senior level class delivered consecutively over 16-weeks for students interested in healthcare careers. Faculty and staff from the Department of Emergency Medicine provided a classroom lecture program and extensive bedside, hands-on clinical research experience. Students enrolled patients in a survey study requiring informed consent, interviews, data abstraction and data entry. Additionally, they were required to write and present a mock emergency care research proposal inspired by their clinical experience. The course evaluations from students’ ordinal rankings and blinded text responses report possible career impact. Results Thirty-two students, completed the 16-week, 6–9 h per week, course from August to December in 1 of 4 years (2016 to 2019). Collectively, students enrolled 759 ED patients in the 4 survey studies and reported increased confidence in the clinical research process as each week progressed. Ranked evaluations were extremely positive, with many students describing how the course significantly impacted their career pathways and addressed an unmet need in biomedical education. Six students continued the research experience from the course through independent study using the survey data to develop 3 manuscripts for submission to peer-reviewed journals. Conclusions A bedside emergency care research course for students with pre-healthcare career aspirations can successfully provide early exposure to patients and emergency care, allow direct experience with clinical bedside research, research data collection, and may impact biomedical science career choices.

scholarly journals THU0528 NAILFOLD VIDEOCAPILLAROSCOPY REPORTING IN CLINICAL RESEARCH: INTERNATIONAL DELPHI BASED CONSENSUS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 503.1-504
Author(s):  
F. Ingegnoli ◽  
T. Schioppo ◽  
A. Herrick ◽  
A. Sulli ◽  
F. Bartoli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Research ◽  
Rheumatic Diseases ◽  
Unmet Need ◽  
Future Research ◽  
Invasive Technique ◽  
Delphi Consensus ◽  
Research Support ◽  
The Impact ◽  
Research Studies

Background:Nailfold capillaroscopy (NVC), a non-invasive technique to assess microcirculation, is increasingly being incorporated into rheumatology routine clinical practice. Currently, the degree of description of NVC methods varies amongst research studies, making interpretation and comparison between studies challenging. In this field, an unmet need is the standardization of items to be reported in research studies using NVC.Objectives:To perform a Delphi consensus on minimum reporting standards in methodology for clinical research, based on the items derived from a systematic review focused on this topic.Methods:The systematic review of the literature on NVC methodology relating to rheumatic diseases was performed according to PRISMA guidelines (PROSPERO CRD42018104660) to July 22nd2018 using MEDLINE, Embase, Scopus. Then, a three-step web-based Delphi consensus was performed in between members of the EULAR study group on microcirculation in rheumatic diseases and the Scleroderma Clinical Trials Consortium. Participants were asked to rate each item from 1 (not appropriate) to 9 (completely appropriate).Results:In total, 3491 references were retrieved in the initial search strategy, 2862 were excluded as duplicates or after title/abstract screening. 632 articles were retrieved for full paper review of which 319 fulfilled the inclusion criteria. Regarding patient preparation before the exam, data were scarce: 38% reported acclimatization, 5% to avoid caffeine and smoking, 3% to wash hands and 2% to avoid manicure. Concerning the device description: 90% reported type of instrument, 77% brand/model, 72% magnification, 46% oil use, 40% room temperature and 35% software for image analysis. As regards to examination details: 76% which fingers examined, 75% number of fingers examined, 15% operator experience, 13% reason for finger exclusion, 9% number of images, 8% quality check of the images and 3% time spent for the exam. Then, a three-round Delphi consensus on the selected items was completed by 80 participants internationally, from 31 countries located in Australia, Asia, Europe, North and South America. Some items reached the agreement at the second round (85 participants), and other items were suggested as important to consider in a future research agenda (e.g. temperature for acclimatization, the impact of smoking, allergies at the application of the oil to the nailbed, significance of pericapillary edema, methods of reporting hemorrhages, ramified and giant capillaries). The final agreement results are reported below:Conclusion:On the basis of the available literature the description of NVC methods was highly heterogeneous and individual published studies differed markedly. These practical suggestions developed using a Delphi process among international participants provide a guidance to improve and to standardize the NVC methodology in future clinical research studies.Disclosure of Interests:Francesca Ingegnoli: None declared, Tommaso Schioppo: None declared, Ariane Herrick: None declared, Alberto Sulli Grant/research support from: Laboratori Baldacci, Francesca Bartoli: None declared, Nicola Ughi: None declared, John Pauling: None declared, Maurizio Cutolo Grant/research support from: Bristol-Myers Squibb, Actelion, Celgene, Consultant of: Bristol-Myers Squibb, Speakers bureau: Sigma-Alpha, Vanessa Smith Grant/research support from: The affiliated company received grants from Research Foundation - Flanders (FWO), Belgian Fund for Scientific Research in Rheumatic diseases (FWRO), Boehringer Ingelheim Pharma GmbH & Co and Janssen-Cilag NV, Consultant of: Boehringer-Ingelheim Pharma GmbH & Co, Speakers bureau: Actelion Pharmaceuticals Ltd, Boehringer-Ingelheim Pharma GmbH & Co and UCB Biopharma Sprl

scholarly journals Acute care research competencies for clinical research professionals

2020 ◽  
Vol 4 (6) ◽  
pp. 485-492
Author(s):  
Stephanie Schuckman ◽  
Lynn Babcock ◽  
Cristina Spinner ◽  
Opeolu Adeoye ◽  
Dina Gomaa ◽  
...  
Keyword(s):  
Clinical Research ◽  
Acute Care ◽  
Performance Metrics ◽  
Task Force ◽  
Continuing Professional Development ◽  
Personal Characteristics ◽  
Care Research ◽  
Trial Competency ◽  
Conducting Research ◽  
Research Professionals

AbstractIntroduction:Acute care research (ACR) is uniquely challenged by the constraints of recruiting participants and conducting research procedures within minutes to hours of an unscheduled critical illness or injury. Existing competencies for clinical research professionals (CRPs) are gaining traction but may have gaps for the acute environment. We sought to expand existing CRP competencies to include the specialized skills needed for ACR settings.Methods:Qualitative data collected from job shadowing, clinical observations, and interviews were analyzed to assess the educational needs of the acute care clinical research workforce. We identified competencies necessary to succeed as an ACR-CRP, and then applied Bloom’s Taxonomy to develop characteristics into learning outcomes that frame both knowledge to be acquired and job performance metrics.Results:There were 28 special interest competencies for ACR-CRPs identified within the eight domains set by the Joint Task Force (JTF) of Clinical Trial Competency. While the eight domains were not prioritized by the JTF, in ACR an emphasis on Communication and Teamwork, Clinical Trials Operations, and Data Management and Informatics was observed. Within each domain, distinct proficiencies and unique personal characteristics essential for success were identified. The competencies suggest that a combination of competency-based training, behavioral-based hiring practices, and continuing professional development will be essential to ACR success.Conclusion:The competencies developed for ACR can serve as a training guide for CRPs to be prepared for the challenges of conducting research within this vulnerable population. Hiring, training, and supporting the development of this workforce are foundational to clinical research in this challenging setting.

Is Cancer Solvable? Towards Efficient and Ethical Biomedical Science

2019 ◽  
Vol 47 (3) ◽  
pp. 362-368 ◽  
Author(s):  
Jeff Shrager ◽  
Mark Shapiro ◽  
William Hoos
Keyword(s):  
Cancer Research ◽  
Clinical Research ◽  
Expert Knowledge ◽  
Information Gain ◽  
Biomedical Science ◽  
Global Information ◽  
Research Model ◽  
Model Combining ◽  
Treatment Analysis

Global Cumulative Treatment Analysis (GCTA) is a novel clinical research model combining expert knowledge, and treatment coordination based upon global information-gain, to treat every patient optimally while efficiently searching the vast space that is the realm of cancer research.

scholarly journals Social health insurance for the poor: lessons from a health insurance programme in Karnataka, India

2018 ◽  
Vol 3 (1) ◽  
pp. e000582 ◽  
Author(s):  
Neeraj Sood ◽  
Zachary Wagner
Keyword(s):  
Health Insurance ◽  
Financial Burden ◽  
Tertiary Care ◽  
Substantial Reduction ◽  
Unmet Need ◽  
Social Health Insurance ◽  
Well Being ◽  
Poverty Line ◽  
Social Health ◽  
The Poor

Life-saving technology used to treat catastrophic illnesses such as heart disease and cancer is often out of reach for the poor. As life expectancy increases in poor countries and the burden from chronic illnesses continues to rise, so will the unmet need for expensive tertiary care. Understanding how best to increase access to and reduce the financial burden of expensive tertiary care is a crucial task for the global health community in the coming decades. In 2010, Karnataka, a state in India, rolled out the Vajpayee Arogyashree scheme (VAS), a social health insurance scheme focused on increasing access to tertiary care for households below the poverty line. VAS was rolled out in a way that allowed for robust evaluation of its causal effects and several studies have examined various impacts of the scheme on poor households. In this analysis article, we summarise the key findings and assess how these findings can be used to inform other social health insurance schemes. First, the evidence suggests that VAS led to a substantial reduction in mortality driven by increased tertiary care utilisation as well as use of better quality facilities and earlier diagnosis. Second, VAS significantly reduced the financial burden of receiving tertiary care. Third, these benefits of social health insurance were achieved at a reasonable cost to society and taxpayers. Several unique features of VAS led to its success at improving health and financial well-being including effective outreach via health camps, targeting expensive conditions with high disease burden, easy enrolment process, cashless treatment, bundled payment for hospital services, participation of both public and private hospitals and prior authorisation to improve appropriateness of care.

scholarly journals Facilitating Emergency Care Research Networks: Integration into the Clinical Translational and Science Award (CTSA) Infrastructure

2009 ◽  
Vol 16 (10) ◽  
pp. 1005-1009 ◽  
Author(s):  
Judd E. Hollander ◽  
Glen N. Gaulton ◽  
D. Mark Courtney ◽  
Roger J. Lewis ◽  
Robert A. Lowe ◽  
...  
Keyword(s):  
Emergency Care ◽  
Research Networks ◽  
Care Research ◽  
Networks Integration

EXISTING EMERGENCY MANAGEMENT USED FOR VISARPA DISEASE

2020 ◽  
Vol 8 (9) ◽  
pp. 4478-4486
Author(s):  
Kendre Manchak ◽  
Jaybhaye Sulakshana
Keyword(s):  
Intensive Care ◽  
Emergency Management ◽  
Intensive Care Units ◽  
Emergency Care ◽  
Emergency Treatment ◽  
Review Article ◽  
Care Research

Emergency management in Visarpa is most challenging. The aim of this study is to review the existing Crit-ical care for Visarpa from basic Ayurveda classics as well as online. In this review article, after evaluation of emergency care from brihatrayai as well as laghutrai and available relevant 21 articles regarding Visarpa chikitsa, we discussed the need of development of Ayurveda diagnostic as well as intensive care units in present era. It is found that emergency treatment is not available to the satisfaction in Ayurveda literature. Therefore, possible strategy regarding emergency care research for this critical disease is provid-ed which is useful for Ayurveda researchers.

Collaborative Research: Once More Into the Breach

PEDIATRICS ◽  
1988 ◽  
Vol 82 (3) ◽  
pp. 510-511
Author(s):  
EVAN CHARNEY
Keyword(s):  
Clinical Practice ◽  
Clinical Research ◽  
Collaborative Research ◽  
Molecular Level ◽  
Organ System ◽  
Biomedical Science ◽  
Memorial Hospital ◽  
Narrow Focus ◽  
Higher Power ◽  
Practice Based Research

In this issue, Christoffel and associates1 described a new program of practice-based research involving community pediatricians and the Department of Pediatrics at Children's Memorial Hospital in Chicago. In one sense, all clinical research is practice based and has a long and honorable history in medicine. What has changed is that the gap between those who conduct research and those in clinical practice has widened. As the pathophysiology of diseases is better understood, the frontier of biomedical science has moved from the whole patient to the organ system, the cell, and, now, the molecular level. It is as if each generation of researchers has snapped a progressively higher power lens under the microscope, with a deeper but more narrow focus.

Mixed methods research: a design for emergency care research?

2010 ◽  
Vol 28 (8) ◽  
pp. 682-685 ◽  
Author(s):  
S. Cooper ◽  
J. Porter ◽  
R. Endacott
Keyword(s):  
Mixed Methods ◽  
Emergency Care ◽  
Mixed Methods Research ◽  
Care Research

Perceptions of emergency medicine and acute care among a cohort of non-emergency medicine health providers in Myanmar

2019 ◽  
Author(s):  
Corey B. Bills ◽  
Peter Acker ◽  
Tina McGovern ◽  
Rebecca Walker ◽  
Htoo Ohn ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Acute Care ◽  
Emergency Care ◽  
Healthcare Providers ◽  
Unmet Need ◽  
Health Providers ◽  
Care Providers ◽  
Convenience Sample ◽  
Care Services ◽  
Acute Care Services

Abstract Background Currently, Myanmar does not have a nationalized emergency care or emergency medical services (EMS) system. The provision of emergency medicine (EM) education to physicians without such training is essential to address this unmet need for high quality emergency care. We queried a group of healthcare providers in Myanmar about their experience, understanding and perceptions regarding the current and future needs for EM training in their country. Methods A 34-question survey was administered to a convenience sample of healthcare workers from two primary metropolitan areas in Myanmar to assess exposure to and understanding of emergency and pre-hospital care in the country. Results 236 of 290 (81% response rate) individuals attending one of two full-day symposia on emergency medicine completed the survey. The majority of respondents were female (n=138, 59%), physicians (n=171, 74%), and working in private practice (n=148, 64%). A majority of respondents (n=133, 57%) spent some to all of their clinical time providing acute and emergency care however 83.5% (n=192) of all surveyed reported little or no past training in emergency care; and those who have received prior emergency medicine training were more likely to care for emergencies (>2 weeks training; p=.052). 81% (n= 184) thought the development of emergency and acute care services should be a public health priority. Conclusions Although this subset of surveyed health practitioners commonly provides acute care, providers in Myanmar may not have adequate training in emergency medicine. Continued efforts to train Myanmar’s existing healthcare workforce in emergency and acute care should be emphasized.

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