scholarly journals Teaching the Technical Essentials of Direct Ophthalmoscopy Using a Portable Fundus Camera

2021 ◽  
Author(s):  
Weibo Feng ◽  
Yuxian Zou ◽  
Yonghao Li ◽  
Tao Shen ◽  
Ya Gao ◽  
...  
Keyword(s):  
Medical Students ◽  
Intervention Group ◽  
Training Session ◽  
Group Versus ◽  
Control Group ◽  
Accuracy Score ◽  
Fundus Camera ◽  
End Point ◽  
Accuracy Test ◽  
Direct Ophthalmoscopy

Abstract Aim: A portable fundus camera could allow the third person to observe the technique essentials of direct ophthalmoscopy from a real time screen. This study was designed to compare the proficiency of teaching direct ophthalmoscopy using a portable camera with conventional way in medical students. Methods: Medical students of fourth year were invited to participate the study. At baseline, the participants were taught fundoscopy with a conventional direct ophthalmoscope shortly. Then they were randomized to be taught the skill of fundoscopy either with a portable fundus camera or with a conventional direct ophthalmoscope as control for two days. Accuracy tests to match a subject’s fundus with one of the four photographs after examining an undilated eye using a direct ophthalmoscope were performed at baseline and end point. Accuracy test scores and self-reported confidence were compared between the two groups. Results: A total of 160 students participated the study, with 79 assigned to the intervention group, and 81 to the control group. All the students finished the study. At baseline, there was no difference in accuracy test score between the two groups. After two-day training session, the accuracy score improved in 26/79 (32.9%) students of intervention group versus 15/81 (18.5%) of the control group (p=0.037). At end point, a total of 39/79 (49.4%) students in the intervention groups versus 25/81 (30.9%) in the control group identified the correct fundus photograph (p=0.017). The confidence levels were significantly higher in the intervention group than the control group. Conclusions: Teaching direct ophthalmoscope using a portable fundus camera is associated with improved accuracy score and elevated confidence level in medical students when compared with conventional method.

scholarly journals Efficacy of implementing intermittent STOP THE BLEED® reviews on long term retention of hemorrhage control skills of first year medical students

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Enkhtsogt Sainbayar ◽  
Nathan Holt ◽  
Amber Jacobson ◽  
Shalini Bhatia ◽  
Christina Weaver
Keyword(s):  
Medical Students ◽  
Intervention Group ◽  
Training Session ◽  
Likert Scale ◽  
Control Group ◽  
First Year ◽  
Hemorrhage Control ◽  
Term Retention ◽  
Long Term Retention

Abstract Context Some medical schools integrate STOP THE BLEED® training into their curricula to teach students how to identify and stop life threatening bleeds; these classes that are taught as single day didactic and hands-on training sessions without posttraining reviews. To improve retention and confidence in hemorrhage control, additional review opportunities are necessary. Objectives To investigate whether intermittent STOP THE BLEED® reviews were effective for long term retention of hemorrhage control skills and improving perceived confidence. Methods First year osteopathic medical students were asked to complete an eight item survey (five Likert scale and three quiz format questions) before (pretraining) and after (posttraining) completing a STOP THE BLEED® training session. After the surveys were collected, students were randomly assigned to one of two study groups. Over a 12 week intervention period, each group watched a 4 min STOP THE BLEED® review video (intervention group) or a “distractor” video (control group) at 4 week intervals. After the 12 weeks, the students were asked to complete an 11 item survey. Results Scores on the posttraining survey were higher than the pretraining survey. The median score on the five Likert scale items was 23 points for the posttraining survey and 14 points for the pretraining survey. Two of the three knowledge based quiz format questions significantly improved from pretraining to posttraining (both p<0.001). On the 11 item postintervention survey, both groups performed similarly on the three quiz questions (all p>0.18), but the intervention group had much higher scores on the Likert scale items than the control group regarding their confidence in their ability to identify and control bleeding (intervention group median = 21.4 points vs. control group median = 16.8 points). Conclusions Intermittent review videos for STOP THE BLEED® training improved medical students’ confidence in their hemorrhage control skills, but the videos did not improve their ability to correctly answer quiz-format questions compared with the control group.

scholarly journals The Effectiveness of Bioskills Training for Simulated Open Lumbar Laminectomy

2017 ◽  
Vol 7 (8) ◽  
pp. 794-800 ◽  
Author(s):  
Barrett S. Boody ◽  
Brett D. Rosenthal ◽  
Tyler J. Jenkins ◽  
Alpesh A. Patel ◽  
Jason W. Savage ◽  
...  
Keyword(s):  
Medical Students ◽  
Clinical Education ◽  
Medical Center ◽  
Academic Medical Center ◽  
Intervention Group ◽  
Training Session ◽  
Senior Resident ◽  
Control Group ◽  
Junior Resident ◽  
Training Module

Study Design: Randomized, prospective study within an orthopedic surgery resident program at a large urban academic medical center. Objectives: To develop an inexpensive, user-friendly, and reproducible lumbar laminectomy bioskills training module and evaluation protocol that can be readily implemented into residency training programs to augment the clinical education of orthopedic and neurosurgical physicians-in-training. Methods: Twenty participants comprising senior medical students and orthopedic surgical residents. Participants were randomized to control (n = 9) or intervention (n = 11) groups controlling for level of experience (medical students, junior resident, or senior resident). The intervention group underwent a 40-minute bioskills training module, while the control group spent the same time with self-directed study. Pre- and posttest performance was self-reported by each participant (Physician Performance Diagnostic Inventory Scale [PPDIS]). Objective outcome scores were obtained from a blinded fellowship-trained attending orthopedic spine surgeon using Objective Structured Assessment of Technical Skills (OSATS) and Objective Decompression Score metrics. Results: When compared with the control group, the intervention group yielded a significant mean improvement in OSATS ( P = .022) and PPDIS ( P = .0001) scores. The Objective Decompression Scores improved in the intervention group with a trend toward significance ( P = .058). Conclusions: We conclude that a concise lumbar laminectomy bioskills training session can be a useful educational tool for to augment clinical education. Although no direct clinical correlation can be concluded from this study, the improvement in trainee’s technical and procedural skills suggests that Sawbones training modules can be an efficient and effective tool for teaching fundamental spine surgical skills outside of the operating room.

scholarly journals Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 463
Author(s):  
Mar Gomis-Pastor ◽  
Sonia Mirabet Perez ◽  
Eulalia Roig Minguell ◽  
Vicenç Brossa Loidi ◽  
Laura Lopez Lopez ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Patient Experience ◽  
Mobile Application ◽  
Standard Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Group Versus ◽  
Control Group ◽  
P Value ◽  
Adherence Score

Non-adherence after heart transplantation (HTx) is a significant problem. The main objective of this study was to evaluate if a mHealth strategy is more effective than standard care in improving adherence and patients’ experience in heart transplant recipients. Methods: This was a single-center, randomized controlled trial (RCT) in adult recipients >1.5 years post-HTx. Participants were randomized to standard care (control group) or to the mHeart Strategy (intervention group). For patients randomized to the mHeart strategy, multifaceted theory-based interventions were provided during the study period to optimize therapy management using the mHeart mobile application. Patient experience regarding their medication regimens were evaluated in a face-to-face interview. Medication adherence was assessed by performing self-reported questionnaires. A composite adherence score that included the SMAQ questionnaire, the coefficient of variation of drug levels and missing visits was also reported. Results: A total of 134 HTx recipients were randomized (intervention N = 71; control N = 63). Mean follow-up was 1.6 (SD 0.6) years. Improvement in adherence from baseline was significantly higher in the intervention group versus the control group according to the SMAQ questionnaire (85% vs. 46%, OR = 6.7 (2.9; 15.8), p-value < 0.001) and the composite score (51% vs. 23%, OR = 0.3 (0.1; 0.6), p-value = 0.001). Patients’ experiences with their drug therapy including knowledge of their medication timing intakes (p-value = 0.019) and the drug indications or uses that they remembered (p-value = 0.003) significantly improved in the intervention versus the control group. Conclusions: In our study, the mHealth-based strategy significantly improved adherence and patient beliefs regarding their medication regimens among the HTx population. The mHeart mobile application was used as a feasible tool for providing long-term, tailor-made interventions to HTx recipients to improve the goals assessed.

scholarly journals Perioperative Gabapentin Does Not Reduce Postoperative Delirium in Older Surgical Patients

2017 ◽  
Vol 127 (4) ◽  
pp. 633-644 ◽  
Author(s):  
Keyword(s):  
Postoperative Pain ◽  
Postoperative Delirium ◽  
Intervention Group ◽  
Group Versus ◽  
Length Of Hospital Stay ◽  
Treated Group ◽  
Assessment Method ◽  
Hospital Length Of Stay ◽  
Control Group ◽  
Opioid Use

Abstract Background Postoperative pain and opioid use are associated with postoperative delirium. We designed a single-center, randomized, placebo-controlled, parallel-arm, double-blinded trial to determine whether perioperative administration of gabapentin reduced postoperative delirium after noncardiac surgery. Methods Patients were randomly assigned to receive placebo (N = 347) or gabapentin 900 mg (N = 350) administered preoperatively and for the first 3 postoperative days. The primary outcome was postoperative delirium as measured by the Confusion Assessment Method. Secondary outcomes were postoperative pain, opioid use, and length of hospital stay. Results Data for 697 patients were included, with a mean ± SD age of 72 ± 6 yr. The overall incidence of postoperative delirium in any of the first 3 days was 22.4% (24.0% in the gabapentin and 20.8% in the placebo groups; the difference was 3.20%; 95% CI, 3.22% to 9.72%; P = 0.30). The incidence of delirium did not differ between the two groups when stratified by surgery type, anesthesia type, or preoperative risk status. Gabapentin was shown to be opioid sparing, with lower doses for the intervention group versus the control group. For example, the morphine equivalents for the gabapentin-treated group, median 6.7 mg (25th, 75th quartiles: 1.3, 20.0 mg), versus control group, median 6.7 mg (25th, 75th quartiles: 2.7, 24.8 mg), differed on the first postoperative day (P = 0.04). Conclusions Although postoperative opioid use was reduced, perioperative administration of gabapentin did not result in a reduction of postoperative delirium or hospital length of stay.

scholarly journals Development and evaluation of an online medication safety module for medical students at a rural teaching hospital: the Winchester District Memorial Hospital

2021 ◽  
Vol 10 (2) ◽  
pp. e001385
Author(s):  
Ali Elbeddini ◽  
Yasamin Tayefehchamani
Keyword(s):  
Online Learning ◽  
Medical Students ◽  
Medication Safety ◽  
Controlled Trial ◽  
Effective Means ◽  
Intervention Group ◽  
Control Group ◽  
Open Label ◽  
Online Module ◽  
Learning Module

ObjectiveTo design, implement and assess an online learning module for third-year and fourth-year medical students addressing medication safety.DesignThis study was a prospective, parallel, open-label, randomised controlled trial with two arms: (1) a control arm in which students were given five articles to read about medication safety, and (2) an intervention arm in which students were given access to an interactive web-based learning module on medication safety. Pretesting and post-testing were done online to evaluate change in medication safety knowledge.ResultsTen students completed the study in the intervention group (online module) and six students completed the study in the control group. The increase in score obtained on the post-test, relative to the pretest, was 15.4% in the group who completed the online module and 2.0% in the control group (difference=13.4%, 95% CI 0.5% to 26.2%, p=0.04).ConclusionStudents who completed an online educational tool about medication safety demonstrated a significantly greater increase in knowledge than those who completed a few readings. Online learning modules can be a convenient and effective means of teaching safe prescribing concepts to medical trainees.

Impact of a 12-month web and smartphone-based intervention initiated during spa therapy to improve long-term physical activity of patients with chronic diseases: randomized controlled trial. (Preprint)

2021 ◽  
Author(s):  
Florie FILLOL ◽  
Ludivine PARIS ◽  
Sébastien PASCAL ◽  
Aurélien MULLIEZ ◽  
Christian-François ROQUES ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Waist Circumference ◽  
Controlled Trial ◽  
Intervention Group ◽  
Group Versus ◽  
Control Group ◽  
Spa Therapy

BACKGROUND Lack of physical activity (PA) and sedentary behaviors are leading risk factors for non-communicable diseases (NCD). Web-based interventions are effective in increasing PA in older adults and in NCD patients. In many countries a course of spa therapy is commonly prescribed to NCD patients and represents an ideal context to initiating lifestyle changes. OBJECTIVE The main objective of this study was to evaluate in NCD patients the effectiveness of an intervention combining an individual face-to-face coaching during spa therapy and, when returning home, a web- and smartphone-based PA program including a connected wrist pedometer and a connected weighing scale, on the achievement of physical activity guidelines (PAG) 12 months after the end of spa therapy. METHODS This was a 12-month, prospective, parallel-group, randomized controlled trial. Patients were enrolled during spa therapy and randomized 1:1 to intervention or control group who received usual advices about PA. From the end of spa therapy, PA, weight, waist circumference, and quality of life of the participants in both groups, were assessed by phone every 2 months. Primary outcome was meeting PAG (PA≥600 METs) at 12 months after the end of spa therapy. Secondary outcomes were: meeting current PAG at 6 months of follow-up; sedentary time, weight and waist circumference, PA and quality of life, at 6 and 12 months. Objective use data of the web-and smartphone-based PA program were collected. Analytic methods include intention-to-treat and constrained longitudinal data analyses. RESULTS The study sample was 228 patients (female : 77.2% (176/228), mean age: 62.4 years (SD 6.7), retired: 53.9% (123/228), mean BMI = 28.2 kg.m-2 (SD 4.2)). No group differences were found for any baseline variable. At 12 months, the proportion of patients achieving PAG was significantly higher in intervention group versus control group (81% vs 67% respectively, OR = 2.34 (95% CI 1.02- 5.38; P=.045). No difference between intervention and control group was found neither in achieving PAG at 6 months nor for sedentary time, weight and waist circumference, at 6 and 12 months. Regarding quality of life, the physical component subscale score was significantly higher at 12 months in intervention group versus control group (mean difference: 4.1 (95% CI 1.9-6.3; P<.001). The mean duration use of the program was 7.1 months (SD 4.5). Attrition rate during the first 2 months of the program was 20.4% (23/113) whereas 39.8% (45/113) of the participants used the program for at least 10 months. CONCLUSIONS The results showed significantly more participants meeting PAG at one year in the intervention group compared to controls. A course of spa therapy offers the ideal time and setting to implement education in PA. Digital coaching seems to be more efficient than usual coaching for increasing the level of PA and decreasing sedentariness on the long term. CLINICALTRIAL ClinicalTrials.gov NCT02694796; https://clinicaltrials.gov/ct2/show/NCT02694796.

scholarly journals Immunization competence retention in medical students: a comparation between conventional lectures and lectures with simulations method

2016 ◽  
Vol 55 (6) ◽  
pp. 339 ◽  
Author(s):  
Hartono Gunadi ◽  
Rini Sekartini ◽  
Retno Asti Werdhani ◽  
Ardi Findyartini ◽  
Muhammad Arvianda Kevin Kurnia
Keyword(s):  
Experimental Study ◽  
Medical Students ◽  
Medical School ◽  
Intervention Group ◽  
Control Group ◽  
Vaccine Preventable Diseases ◽  
Before And After ◽  
Quasi Experimental

Background Immunization is recognized as one of the strategiesto reduce vaccine preventable diseases. Competency related toimmunization are consequently important for medical students andthe medical school needs to assure the competence acquisition.Objective To assess competence related to immunization andits retention following lectures with simulations compared tolectures only.Methods A quasi-experimental study was conducted to the 5th yearstudents of University of Indonesia Medical School during the ChildAdolescent Health Module in 2012-2013. The intervention grouphad lectures with simulations and the control group had lecturesonly. Immunization knowledge was assessed with a 30 multiplechoice question (MCA) items performed before and after themodule. Competence retention was assessed by MCQ (knowledge)and OSCE (skills) 2-6 months afterwards.Results Sixty eight subjects for each group with similarcharacteristics were analyzed. There was significant differenceafter module MCQ score between two groups. Competenceretention in 2-6 months after module completion was betterin intervention group, both for the knowledge (median MCQscore of 70.00 (range 37-93) vs. mean score of 58.01 (SD 12.22),respectively; P<0.001) and skill (OSCE mean scores of 75.21 (SD10.74) vs. 62.62 (SD 11.89), respectively; P < 0.001). Proportionof subjects in the intervention group who passed both the MCQand OSCE were also significantly greater.Conclusion Lectures with simulations are proved to bemore effective in improving medical students’ immunizationcompetence as well as its retention compared to lectures onlyapproach.

scholarly journals Implementation of a QTc-interval monitoring protocol by pharmacists to decrease cardiac risk in at-risk patients in an acute care inpatient psychiatric facility

2019 ◽  
Vol 9 (2) ◽  
pp. 82-87 ◽  
Author(s):  
Nicole M. Daniel ◽  
Kim Walsh ◽  
Henry Leach ◽  
Lauren Stummer
Keyword(s):  
At Risk ◽  
Acute Care ◽  
Medical Center ◽  
Intervention Group ◽  
Psychiatric Hospitals ◽  
Control Group ◽  
Qtc Interval ◽  
Psychiatric Facility ◽  
End Point ◽  
Monitoring Protocol

Abstract Introduction Many medications commonly prescribed in psychiatric hospitals can cause QTc-interval prolongation, increasing a patient's risk for torsades de pointes and sudden cardiac death. There is little guidance in the literature to determine when an electrocardiogram (ECG) and QTc-interval monitoring should be performed. The primary end point was improvement of the appropriateness of ECGs and QTc-interval monitoring of at-risk psychiatric inpatients at Barnabas Health Behavioral Health Center (BHBH) and Monmouth Medical Center (MMC) following implementation of a standardized monitoring protocol. The secondary end point was the number of pharmacist-specific interventions at site BHBH only. Methods Patients who met the inclusion criteria were assessed using a standardized QTc-prolongation assessment algorithm for ECG appropriateness. A retrospective analysis of a control group (no protocol) from January 1, 2016, to July 17, 2017, was compared with a prospective analysis of the intervention group (with protocol) from December 11, 2017, to March 11, 2018. Results At BHBH, appropriate ECG utilization increased 25.5% after implementation of a standardized protocol (P = .0172) and appropriate omission of ECG utilization improved by 26% (P &lt; .00001). At MMC, appropriate ECGs decreased by 5%, and appropriate ECG omissions increased by 28%, neither of which were statistically significant (P = 1.0 and P = .3142, respectively). There was an increase in overall pharmacist monitoring. Discussion The study demonstrated that pharmacist involvement in ECG and QTc-interval monitoring utilizing a uniform protocol may improve the appropriateness of ECG and QTc-interval monitoring in patients in an acute care inpatient psychiatric hospital.

The Effect of Lullaby Intervention on Anxiety and Prenatal Attachment in Women with High-Risk Pregnancy: A Randomized Controlled Study

2021 ◽  
pp. 1-9
Author(s):  
Nazlı Baltacı ◽  
Mürüvvet Başer
Keyword(s):  
High Risk ◽  
Intervention Group ◽  
Group Versus ◽  
Mean Difference ◽  
High Risk Pregnancy ◽  
Controlled Study ◽  
Control Group ◽  
Prenatal Attachment ◽  
Randomized Controlled ◽  
Risk Pregnancy

<b><i>Background:</i></b> Women with high-risk pregnancy experience anxiety and low mother-fetal attachment when faced with signs of danger and health problems. This study aimed to investigate the effects of lullaby intervention on anxiety and prenatal attachment in women with high-risk pregnancy. <b><i>Materials and Methods:</i></b> This randomized controlled trial was conducted in the perinatology clinic of a state maternity hospital in Turkey. Seventy-six women with high-risk pregnancy were included. The intervention group listened to lullabies for 20 min once a day, and accompanied by lullabies touched their abdomen and thought about their babies, but the control group did not. Data were collected using the Pregnant Information Form, the State Anxiety Inventory, and the Prenatal Attachment Inventory. <b><i>Results:</i></b> Baseline anxiety did not differ in the intervention versus control group (47.83 ± 10.74 vs. 44.10 ± 8.08, mean difference 3.73 [95% Cl –1.18 to 8.64], <i>p</i> = 0.13), but after the 2nd day lullaby intervention anxiety was lower in the intervention group versus control group (33.66 ± 9.32 vs. 43.06 ± 8.10, mean difference –9.40 [95% Cl –13.91 to –4.88], <i>p</i> &#x3c; 0.01). Baseline prenatal attachment did not differ in the intervention versus control group (56.03 ± 10.71 vs. 53.86 ± 9.98, mean difference 2.16 [95% Cl –3.18 to 7.51], <i>p</i> = 0.42), but after the 2nd day lullaby intervention prenatal attachment was higher in the intervention group versus control group (66.70 ± 7.60 vs. 54.36 ± 9.52, mean difference 12.33 [95% Cl 7.87 to 16.78], <i>p</i> &#x3c; 0.01). In the within-group analysis the intervention group had lower anxiety and better prenatal attachment (<i>p</i> &#x3c; 0.01), but not in the control group (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> Lullaby intervention can play an effective role in reducing anxiety and improving prenatal attachment. The use of this integrative, noninvasive, non-pharmacologic, time-efficient, and natural intervention is suggested in the care of pregnant women.

Reading comprehension gains in a differentiated reading intervention in Spanish based on the Simple View

2020 ◽  
pp. 026565902096798
Author(s):  
Gabriela Silva-Maceda ◽  
Blanca Flor Camarillo-Salazar
Keyword(s):  
Reading Comprehension ◽  
Listening Comprehension ◽  
Intervention Group ◽  
Group Versus ◽  
Control Group ◽  
Simple View ◽  
Comprehension Skill ◽  
School Year ◽  
Mixed Analysis ◽  
Post Test

This experimental study aimed to influence reading comprehension skills through the development of one or both components of the Simple View of Reading (decoding and listening comprehension), by using a differentiated instruction approach. Reading comprehension skill gains were compared in an intervention group versus a control, after the delivery of a program designed to target one or both of such components. Fifty-four children from two 1st grade classrooms in a public school in Mexico were screened for difficulties in decoding and listening comprehension at the end of the school year. At the beginning of 2nd grade, 27 students identified with difficulties were randomly assigned to either an intervention ( n = 14) or a control group ( n = 13). Students selected for the targeted intervention attended the sessions aimed at their specific needs: five students with poor decoding only received the Phonological and Orthographic Awareness sessions of the intervention (9 sessions); seven students with poor listening comprehension only attended the Oral Vocabulary sessions (5 sessions); two students with mixed difficulties attended the full program (14 sessions). A 2 × 2 mixed analysis of variance showed that the interaction between the Time and Group variables had a significant effect, i.e. students in the intervention group had significantly higher scores in the post-test evaluation with respect to their baseline and compared to the growth observed in the control group. Results are discussed concerning their implications for teaching practices and for the use of strategies that target reading specific difficulties in students using both oral and written language.

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