Undertaking Procedure-Based Assessment is Feasible in Clinical Practice

INTRODUCTION With the development of a new curriculum, workplace based assessments such as procedure-based assessment (PBA) are becoming increasingly common within surgical training. However, there have been concerns about the impact of these assessments on clinical practice. This study assessed the time taken to complete PBA forms to determine whether it is feasible in clinical practice. MATERIALS AND METHODS PBAs for three colorectal procedures (anterior resection, right hemicolectomy and anal fistula) were undertaken by various trainers and trainees. A pilot study was performed to identify potential reasons for incomplete forms and procedural modifications subsequently applied in the main study. Times taken to complete the consenting and operative components of the forms were recorded. RESULTS Incomplete forms in the pilot were mainly attributable to time constraints. In the main study, all assessments were completed within 30 min. Assessment times increased with complexity of the procedure. Median times for completing the consenting and operative components in anterior resection were 13 min (range, 8–15 min) and 15 min (range, 10–18 min), respectively. CONCLUSIONS PBAs are feasible in clinical practice and are valued by trainees as a means of enabling focused feedback and targeted training. Commitment from trainers and trainees will be required but, with adequate planning, the assessment tool is effective with minimal impact on clinical practice.

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The Osteopathic Clinical Practice Assessment – a pilot study to develop a new workplace-based assessment tool

International Journal of Osteopathic Medicine ◽

10.1016/j.ijosm.2015.05.002 ◽

2015 ◽

Vol 18 (4) ◽

pp. 287-296

Author(s):

Brett Vaughan ◽

Keri Moore

Keyword(s):

Clinical Practice ◽

Pilot Study ◽

Assessment Tool ◽

Workplace Based Assessment ◽

Practice Assessment

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Impact of Interferons and Biological Drug Inhibitors of IL-2 and IL-6 on Small-Molecule Drug Metabolism Through the Cytochrome P450 System

Annals of Pharmacotherapy ◽

10.1177/10600280211022281 ◽

2021 ◽

pp. 106002802110222

Author(s):

C. Michael White ◽

Dakota J. Sicignano ◽

Kimberly Smith

Keyword(s):

Cytochrome P450 ◽

Clinical Practice ◽

Steady State ◽

Drug Metabolism ◽

Small Molecule ◽

Human Subjects ◽

Biological Drugs ◽

Minimal Impact ◽

Biological Drug ◽

The Impact

Objective: Assess the impact of interferons and interleukin (IL)-2 and IL-6 inhibitors on cytochrome P450 (CYP) drug metabolism in human subjects. Data Sources: PubMed search from 1980 to March 31, 2021, limited to human subjects and English language via search strategy: (biological drug names) [AND] (cytochrome [OR] CYP metabolism). Study Selection and Data Extraction: Narrative review of human studies assessing biological drugs in select classes that affect CYP drug metabolism. Data Synthesis: Exogenous interferons suppress CYP1A2 (theophylline, caffeine, antipyrone) clearance by 20% to 49% in patients; have minimal impact on CYP3A4 (midazolam and dapsone), CYP2C9 (tolbutamide), or CYP2C19 (mephenytoin) metabolism; and increase CYP2D6 (debrisoquine, dextromethorphan) metabolism. Biological IL-2 inhibitors (basiliximab, daclizumab) have no effect on metabolism via CYP1A2 (caffeine), CYP2C9 (s-warfarin), CYP2C19 (omeprazole), CYP2D6 (dextromethorphan), and CYP3A4 (midazolam, tacrolimus) but may enhance CYP3A4 (cyclosporin) metabolism over time. IL-6 inhibitors (sirukumab, tocilizumab, sarilumab) significantly enhance metabolism via CYP2C9 (s-warfarin), CYP2C19 (omeprazole), and CYP3A4 (simvastatin, midazolam) and reduce metabolism via CYP1A2 (caffeine). Relevance to Patient Care and Clinical Practice: Patients using interferons, IL-2, or IL-6 blocking drugs at steady state with CYP substrates could have altered drug metabolism and experience adverse events. With interferons and biological anti-inflammatory drugs, some isoenzymes will be inhibited, whereas others will be enhanced, and the magnitude of the effect can sometimes be significant. In clinical practice, clinicians may consider these metabolic changes as an additive effect to a patient’s entire disease and medication profile when determining risk/benefit of treatment. Conclusions: Interferon therapy or inflammatory suppression via IL-2 or IL-6 can alter steady-state concentrations of CYP-metabolized small-molecule drugs.

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PILOT STUDY ON CHILDRENâ€™S READING IN NAMIBIA: PITFALLS AND NEW STRATEGIES

Mousaion ◽

10.25159/0027-2639/1687 ◽

2016 ◽

Vol 32 (2) ◽

pp. 2-24 ◽

Cited By ~ 1

Author(s):

Andree-Jeanne TÃ¶temeyer ◽

Emmarentia Kirchner ◽

Susan Alexander

Keyword(s):

Pilot Study ◽

Data Collection ◽

Small Scale ◽

Main Study ◽

Pilot Studies ◽

Reading Levels ◽

Rural And Urban ◽

The Social ◽

The Impact ◽

New Strategies

The aim of this article is to report on a pilot study conducted in 2011 that preceded a main study undertaken in 2012, investigating the reading behaviour and preferences of Grade 6 Namibian students. The aims of the pilot study were to develop an easy to answer and reliable questionnaire; to enable emerging researchers to gain experience in data collection through small-scale sampling; and to test whether the instruments of data collection were covering the main aims of the study. The questionnaire was developed and tested three times on small groups before the pilot study. In all 226 students, both rural and urban, from three educational regions in Namibia were included in the pilot study. Vast differences in the studentsâ€™ language ability and socio-economic situation were observed. The data analysis showed that the researchers underestimated the impact of the social desirability factor and the reading levels of the respondents. The questionnaire had to be drastically redesigned. Six further versions of the questionnaire were developed and tested before implementation in the main study. Careful reporting and recording of the pilot process ensured that a successful main study was conducted in 2012. While pilot studies are not frequently fully documented and reported on, it is argued that valuable lessons can be learnt from this honest report.

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Developing and implementing a Radiotherapy Research Activity Assessment Tool (RAAT): a prospective feasibility study

Journal of Radiotherapy in Practice ◽

10.1017/s1460396916000121 ◽

2016 ◽

Vol 15 (3) ◽

pp. 223-231

Author(s):

Simon Goldsworthy ◽

Benjamin Roe ◽

Stuart McGrail ◽

Stephen McCormack ◽

Julie Walther

Keyword(s):

Cancer Research ◽

Clinical Practice ◽

Quality Function Deployment ◽

Assessment Tool ◽

Clinical Settings ◽

Research Activity ◽

Activity Assessment ◽

User Friendly ◽

The Impact

AbstractAimCancer research in the National Health Service has increased by 10·5% in 3 years since the formation of the National Cancer Research networks in 2000. The initial enthusiasm from clinical staffs to embark on a project has to be balanced against the implications of resources, costs and other developments. There is no standardised method to assess the impact of research projects on clinical practice. The aim of this project was to develop and implement a Radiotherapy Research Activity Assessment Tool (RAAT) to assess the feasibility of newly proposed projects within clinical settings.Methods and materialsA multi-step development method was used. The steps involved the principles of quality function deployment. The consecutive steps involved developing a user-friendly and replicable tool and would fit on one A4 page. The process involved multi-professionals and patients throughout the design process. The tool was preliminary tested on usability among eight stakeholders on a ten-point scale (1=poor; 10=very good). Percentage agreement was evaluated at 6 month post initial RAAT assessment scoring by the seven multi-disciplinary team (MDT) members.FindingsThe RAAT was developed in an e-form available in Microsoft Excel. The tool scored a mode of 6 for usability. Interrater reliability testing between the radiotherapy MDT resulted in 88% agreement. The RAAT seems to be feasible in clinical practice, and provide a framework to guide the decision-making process. The study calls for further testing of usability and review of long-term implications on all stakeholders.

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Nursing Students’ and Preceptors’ Experiences with Using an Assessment Tool for Feedback and Reflection in Supervision of Clinical Skills: A Qualitative Pilot Study

Nursing Research and Practice ◽

10.1155/2021/5551662 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Hilde Plathe ◽

Elisabeth Solheim ◽

Hilde Eide

Keyword(s):

Clinical Practice ◽

Pilot Study ◽

Nursing Students ◽

Undergraduate Students ◽

Assessment Tool ◽

Clinical Skills ◽

Qualitative Content Analysis ◽

Healthcare Services ◽

Community Health Services ◽

Personal Learning

Background. There is a need to improve students’ learning in clinical practice. Undergraduate students need guidance when it comes to transferring knowledge from the classroom to clinical practice in community health services. Competence Development of Practical Procedures (COPPs), a simulation assessment tool, was used to explore students’ and preceptors’ experiences with feedback and reflection during the supervision of clinical skills in real practice. Method. This was a pilot study with a qualitative exploratory and descriptive research design. Four students in their first year of a bachelor’s programme in nursing and four preceptors participated. Data were collected from eight clinical skills performance assessments, audio recordings of supervision, and open-ended questionnaires. Data were systematized, categorized, and analysed using qualitative content analysis. Findings. Participants’ experiences were divided into five categories: “learning environment, an atmosphere of respect, acceptance, and encouragement,” “students’ reflections on their own personal learning,” “students’ reflections on various care situations,” and “students’ and preceptors’ assessment and feedback.” Participants found COPPs easy to use and providing structure for assessment, feedback, and reflection during supervision. Concepts related to learning clinical skills became visible for both students and preceptors and helped students assess their performance of clinical skills. Through verbalization and reflection in supervision, participants established a consensus around what students knew and what they needed to learn. Conclusions. The students and preceptors experienced the tool as a supportive structure to enhance feedback and reflection for the learning of clinical skills in municipal healthcare services. COPPs filled a gap in practice by providing a language for students and preceptors to articulate their knowledge and increasing students’ awareness of what constitutes a good performance. The tool supported the coherence of concepts, enhanced clinical reasoning, and promoted deeper thinking and reflection, and the students gained insight into their own needs related to learning clinical skills.

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Translating Principles of Speech Science to Clinical Practice: Current and Future Trends in Craniofacial Disorders

Perspectives on Speech Science and Orofacial Disorders ◽

10.1044/ssod18.1.31 ◽

2008 ◽

Vol 18 (1) ◽

pp. 31-40 ◽

Cited By ~ 2

Author(s):

David J. Zajac

Keyword(s):

Clinical Practice ◽

Speech Intelligibility ◽

Current Practice ◽

Computer Assisted ◽

Behavioral Management ◽

Single Word ◽

Future Directions ◽

Speech Science ◽

The Impact ◽

Opinion Article

Abstract The purpose of this opinion article is to review the impact of the principles and technology of speech science on clinical practice in the area of craniofacial disorders. Current practice relative to (a) speech aerodynamic assessment, (b) computer-assisted single-word speech intelligibility testing, and (c) behavioral management of hypernasal resonance are reviewed. Future directions and/or refinement of each area are also identified. It is suggested that both challenging and rewarding times are in store for clinical researchers in craniofacial disorders.

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Do I Shoot Faster Because I Am Thinking about an Outgroup or a Threatening Outgroup?

Social Psychology ◽

10.1027/1864-9335/a000255 ◽

2016 ◽

Vol 47 (1) ◽

pp. 29-37 ◽

Cited By ~ 6

Author(s):

Jessica Mange ◽

Keren Sharvit ◽

Nicolas Margas ◽

Cécile Sénémeaud

Keyword(s):

Pilot Study ◽

Target Group ◽

Main Study ◽

Priming Effects ◽

Males And Females

Abstract. This research examines if aggressive responses through a shooter bias are systematically generated by priming outgroups or if a threat stereotypically associated with the primed outgroup is required. First, a pilot study identified outgroups stereotypically associated and not associated with threat. Afterwards, the main study included a manipulation of target group accessibility – ingroup versus nonthreatening outgroup versus threatening outgroup. Following exposure to primes of the group categories, the participants in all conditions played a shooter game in which the targets were males and females with ambiguous ethnicity and religion. Results demonstrated that while only priming of an outgroup stereotypically associated with threat elicits aggressive responses, priming of both nonthreatening and threatening outgroups leads to an increase in the ability to distinguish between stimuli compared to ingroup priming. These effects are discussed in terms of priming effects, dimensions of threat, and possible interpretations of this ability increase.

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