scholarly journals A Structured Intervention for Medical Students Significantly Improves Awareness for Stigmatisation in Visible Chronic Skin Diseases: A Randomised Controlled Trial

Author(s):  
Rachel Sommer ◽  
Natascha-Alexandra Weinberger ◽  
Regina Von Spreckelsen ◽  
Ulrich Mrowietz ◽  
Maximilian C. Schielein ◽  
...  

People with skin diseases suffer from stigmatisation. The aim of this study was to develop and evaluate an intervention against stigmatisation of people affected for medical students. The new intervention was evaluated using a randomised controlled design. Effectiveness was assessed at three time points. Data from 127 participants were analysed. Regarding the outcome ‘social distance’, a significant difference between the measurement-points was observed for the intervention group (χ2(2) = 54.32, p < 0.001) which also showed a significant effect on the agreement to negative stereotypes (F(1.67, 118.67) = 23.83, p < 0.001, partial η² = 0.25). Regarding the outcome ‘agreement to disease-related misconceptions’, a significant difference between the measurement-points was observed for the intervention group (χ2(2) = 46.33, p < 0.001); similar results were found for the outcome ‘stigmatising behaviour’ (F(1.86, 131.89) = 6.16, p = 0.003, partial η² = 0.08). Results should encourage medical faculties to invest in such courses to prevent stigmatisation.

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Charlotte Loumann Krogh ◽  
Charlotte Ringsted ◽  
Charles B. Kromann ◽  
Maria Birkvad Rasmussen ◽  
Tobias Todsen ◽  
...  

Introduction. The aim of this study was to explore the learning effect of engaging trainees by assessing peer performance during simulation-based training.Methods. Eighty-four final year medical students participated in the study. The intervention involved trainees assessing peer performance during training. Outcome measures were in-training performance and performance, both of which were measured two weeks after the course. Trainees’ performances were videotaped and assessed by two expert raters using a checklist that included a global rating. Trainees’ satisfaction with the training was also evaluated.Results. The intervention group obtained a significantly higher overall in-training performance score than the control group: mean checklist score 20.87 (SD 2.51) versus 19.14 (SD 2.65)P=0.003and mean global rating 3.25 SD (0.99) versus 2.95 (SD 1.09)P=0.014. Postcourse performance did not show any significant difference between the two groups. Trainees who assessed peer performance were more satisfied with the training than those who did not: mean 6.36 (SD 1.00) versus 5.74 (SD 1.33)P=0.025.Conclusion. Engaging trainees in the assessment of peer performance had an immediate effect on in-training performance, but not on the learning outcome measured two weeks later. Trainees had a positive attitude towards the training format.


2019 ◽  
Vol 34 (1) ◽  
pp. 134-144
Author(s):  
Nicola White ◽  
Linda JM Oostendorp ◽  
Christopher Tomlinson ◽  
Sarah Yardley ◽  
Federico Ricciardi ◽  
...  

Background: Recognising dying is a key clinical skill for doctors, yet there is little training. Aim: To assess the effectiveness of an online training resource designed to enhance medical students’ ability to recognise dying. Design: Online multicentre double-blind randomised controlled trial (NCT03360812). The training resource for the intervention group was developed from a group of expert palliative care doctors’ weightings of various signs/symptoms to recognise dying. The control group received no training. Setting/participants: Participants were senior UK medical students. They reviewed 92 patient summaries and provided a probability of death within 72 hours (0% certain survival – 100% certain death) pre, post, and 2 weeks after the training. Primary outcome: (1) Mean Absolute Difference (MAD) score between participants’ and the experts’ scores, immediately post intervention. Secondary outcomes: (2) weight attributed to each factor, (3) learning effect and (4) level of expertise (Cochran–Weiss–Shanteau (CWS)). Results: Out of 168 participants, 135 completed the trial (80%); 66 received the intervention (49%). After using the training resource, the intervention group had better agreement with the experts in their survival estimates ( δMAD = −3.43, 95% CI −0.11 to −0.34, p = <0.001) and weighting of clinical factors. There was no learning effect of the MAD scores at the 2-week time point ( δMAD = 1.50, 95% CI −0.87 to 3.86, p = 0.21). At the 2-week time point, the intervention group was statistically more expert in their decision-making versus controls (intervention CWS = 146.04 (SD 140.21), control CWS = 110.75 (SD 104.05); p = 0.01). Conclusion: The online training resource proved effective in altering the decision-making of medical students to agree more with expert decision-making.


2005 ◽  
Vol 187 (4) ◽  
pp. 339-345 ◽  
Author(s):  
Zheng Li ◽  
David Arthur

BackgroundMuch of China lacks well-developed services for people with schizophrenia and their families, and most of the existing services focus on hospitals. There is a need for culturally sensitive family treatments offered by nurses.AimsTo conduct a longitudinal experimental study examining the effect of patient and family education in a sample of Chinese people with schizophrenia.MethodA randomised controlled trial was conducted in a large hospital with a sample of 101 patients with schizophrenia and their families. Data were collected at admission and at discharge, and then at 3 and 9 months after discharge. The intervention group received family education, and data on their knowledge about schizophrenia, symptoms, functioning, psychosocial behaviour, relapse and medication adherence were collected and compared with the control group.ResultsThere was a significant improvement in knowledge about schizophrenia in the experimental group and a significant difference in symptom scores and functioning at 9 months after discharge. Patients who were non-adherent to medication regimens were more likely to relapse.ConclusionsFamily education on schizophrenia by nurses in China was effective in improving knowledge and promoting improvement in patients' symptoms.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e042892
Author(s):  
Juan Pimentel ◽  
Anne Cockcroft ◽  
Neil Andersson

ObjectivesExplore the acceptability and feasibility of a randomised controlled trial (RCT) to assess game jams—participatory events to cocreate digital or board games in a time-constrained environment—in cultural safety training of medical students. The pilot tests methods and procedures and explores the validity and reliability of our research instrument.DesignTwo-arm parallel-group pilot RCT with a 1:1 allocation ratio.SettingFaculty of Medicine in Chia, Colombia.Participants79 final-year medical students completed the baseline questionnaire. 64 completed the assessment immediately after the intervention: 31 in the intervention group (20 female) and 33 in the control group (18 female). 35 completed the final assessment (18 control and 17 intervention) 4 months after the intervention.InterventionsThe intervention group joined a 5-hour game jam composed of a 1-hour lecture and a 4-hour session to create and to play educational games about cultural safety. The control group had a 1-hour conventional lesson, followed by a 4-hour study session of selected readings on cultural safety.Primary and secondary outcome measuresThe instrument, an online self-administered Likert-type questionnaire, assessed a self-reported cultural safety results chain based on a planned behaviour theory. Student recruitment, retention and perception of the activity determined acceptability. The methodological and logistical factors for a full-scale study determined feasibility.ResultsAfter the intervention, students randomised to that arm reported a slightly higher cultural safety score (26.9) than those in the control group (25.9) (difference −1, 95% CI −3.0 to 1.0). Students described game jam learning in favourable terms and considered cultural safety training relevant. The university authorised the conduct of the full-scale trial.ConclusionGame jam learning is feasible and acceptable for cultural safety training of Colombian medical students. Researchers and educators may find our results informative in the design of RCTs assessing educational interventions.Trial registration numberISRCTN14261595 (stage: pilot study results)


2021 ◽  
Author(s):  
Abdolrahim Asadollahi ◽  
Leila Ghahremani ◽  
Fatemeh Maghsoudi

Abstract Background: Retirement is a challenge for veterans during their life course. The aim of this study was to investigate the effect of educational intervention on the perception of aging and social adjustment during retirement. Methods: This quasi-experimental study was performed on 100 military retirees in Shiraz, Iran. Data collection tools included a demographic questionnaire, Perception of Aging, and Social Adjustment. The educational intervention used included six training sessions on the subject of mindfulness, physical and psychological changes of aging, health and self-care management, attitudes toward aging, and social and family relationships in old age. Data were collected at the beginning of the study and two months after the intervention and then analyzed using SPSS version 25. Results: The results showed no significant difference between the control and intervention groups in terms of demographic variables, perception of aging, and social adjustment before the educational intervention. However, the perception of aging significantly decreased, and social adjustment increased in the intervention group after the educational intervention. Improving the perception of aging and parents' perceived role can positively affect social adjustment. Multiple regression analysis indicated a predictive model for social adjustment in later life. Conclusions: With increased knowledge of the retirees on self-care, their perceptions of aging and their role in later life improved and predicte social adjustment.


2019 ◽  
Vol 10 (4) ◽  
pp. e37-e37 ◽  
Author(s):  
Marianne Hjorth Skorstengaard ◽  
Anders Bonde Jensen ◽  
Pernille Andreassen ◽  
Trine Brogaard ◽  
Elisabeth Brendstrup ◽  
...  

ObjectivesAdvance care planning (ACP) can be a way to meet patients’ end-of-life preferences and enhance awareness of end-of-life care. Thereby it may affect actual place of death (APOD) and decrease the rate of hospitalisations. The aim was to investigate if ACP among terminally ill patients with lung, heart and cancer diseases effects fulfilment of preferred place of death (PPOD), amount of time spent in hospital and APOD.MethodsThe study was designed as a randomised controlled trial. Patients were assessed using general and disease-specific criteria and randomised into groups: one received usual care and one received usual care plus ACP. The intervention consisted of a discussion between a healthcare professional, the patient and their relatives about preferences for end-of-life care. The discussion was documented in the hospital file.ResultsIn total, 205 patients were randomised, of which 111 died during follow-up. No significant differences in fulfilment of PPOD (35% vs 52%, p=0.221) or in amount of time spent in hospital among deceased patients (49% vs 23%, p=0.074) were found between groups. A significant difference in APOD was found favouring home death in the intervention group (17% vs 40%, p=0.013).ConclusionConcerning the primary outcome, fulfilment of PPOD, and the secondary outcome, time spent in hospital, no differences were found. A significant difference concerning APOD was found, as more patients in the intervention group died at home, compared with the usual care group.Trial registration numberNCT01944813.


2021 ◽  
Author(s):  
Takashi Kitagawa ◽  
Yuma Aoki ◽  
Hotaka Sugimoto ◽  
Natsumi Ozaki

Abstract Although there are increasing reports on the usefulness of sonopalpation with ultrasound imaging, many previous studies have reported interventions without a control group. This single-blind, parallel group randomised controlled trial aimed to determine whether educational instruction with sonopalpation for medical students has a superior effect on skill improvement than traditional instruction without ultrasonography. Twenty-nine medical students participated in the study and were randomised using block randomisation into an ultrasound imaging group (n = 15) and a control group (n = 14). Then, they underwent three training sessions focusing on the shoulder joint. Participants underwent a scoring assessment of their palpation skills at pre-intervention, post-intervention, and follow-up 3 months after training. The raters were blinded to the subjects’ group. The Friedman and Mann–Whitney U tests were used for data analysis. The intervention group showed a significant increase in scores at post-intervention and at the 3-month follow-up when compared with the pre-intervention group (p < 0.05); the effect sizes were large (0.849 and 0.849, respectively). A comparison of the scores at different time points after the intervention at the 3-month follow-up revealed that there was no significant difference between the groups. Education using ultrasound images may improve the sonopalpation skills of medical students.


2019 ◽  
Vol 217 (3) ◽  
pp. 477-483 ◽  
Author(s):  
Stefan Priebe ◽  
Agnes Chevalier ◽  
Thomas Hamborg ◽  
Eoin Golden ◽  
Michael King ◽  
...  

BackgroundBefriending by volunteers has the potential to reduce the frequent social isolation of patients with schizophrenia and thus improve health outcomes. However, trial-based evidence for its effectiveness is limited.AimsTo conduct a randomised controlled trial of befriending for patients with schizophrenia or related disorders.MethodPatients were randomised to a befriending programme for 1 year or to receive information about social activities only (trial registration: ISRCTN14021839). Outcomes were assessed masked to allocation at the end of the programme; at 12 months and at a 6-month follow-up. The primary outcome was daily time spent in activities (using the Time Use Survey (TUS)) with intention-to-treat analysis.ResultsA total of 124 patients were randomised (63 intervention, 61 active control) and 92 (74%) were followed up at 1 year. In the intervention group, 49 (78%) met a volunteer at least once and 31 (49%) had more than 12 meetings. At 1 year, mean TUS scores were more than three times higher in both groups with no significant difference between them (adjusted difference 8.9, 95% CI −40.7 to 58.5, P = 0.72). There were no significant differences in quality of life, symptoms or self-esteem. However, patients in the intervention group had significantly more social contacts than those in the control group at the end of the 12-month period. This difference held true at the follow-up 6 months later.ConclusionsAlthough no difference was found on the primary outcome, the findings suggest that befriending may have a lasting effect on increasing social contacts. It may be used more widely to reduce the social isolation of patients with schizophrenia.


2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711701
Author(s):  
Richard Kyle ◽  
Stephen Jones ◽  
Sandra Roycroft-Davis

BackgroundObesity is a global pandemic that threatens the health of the population and the sustainability of publicly funded health care. This randomised controlled trial addresses the gap in the literature surrounding unconscious persuasion and its use in weight loss and weight management. The Slimpod® tool is unlike any of those currently available on the market. Using breakthrough research in ‘nudge’ thinking, it is designed to retrain an adult’s habitual and emotional response to foodstuffs. This therapeutic model allows unconscious thought to be shaped into a manner more consistent with a healthy lifestyle. Candidates can then take control of their eating behaviours to induce a holistic state of wellbeing.AimTo assess the effectiveness of an audio unconscious-persuasion weight loss/weight management intervention (Slimpod®) compared with audio relaxation (control).MethodEighty-two overweight adults were randomised to intervention (n = 41) and control groups (n = 41). Weight was assessed at trial commencement, mid-trial (12 weeks), and trial end (24 weeks). Secondary outcomes were assessed using the Eating Self-Efficacy Scale (ESES), Exercise Confidence Scale (ECS), and Quality of Life Index Generic Version III (QLI-G3) at the start and end of the trial.ResultsReports found a statistically significant difference in mean weight loss between intervention group (1.7 kg at 12 weeks and 4.3 kg at 24 weeks) versus control (0.6 kg and 1.2 kg respectively) at P<0.001. ESES scores showed greater self-efficacy (P = 0.008) in intervention at 24 weeks. No significant differences in ESES negative affect sub-scale score or ECS were observed.ConclusionSlimpod® was effective at reducing weight and increasing eating self-efficacy in overweight adults.


2016 ◽  
Vol 20 (71) ◽  
pp. 1-96 ◽  
Author(s):  
Martin Tickle ◽  
Ciaran O’Neill ◽  
Michael Donaldson ◽  
Stephen Birch ◽  
Solveig Noble ◽  
...  

BackgroundDental caries is the most common disease of childhood. The NHS guidelines promote preventative care in dental practices, particularly for young children. However, the cost-effectiveness of this policy has not been established.ObjectiveTo measure the effects and costs of a composite fluoride intervention designed to prevent caries in young children attending dental services.DesignThe study was a two-arm, parallel-group, randomised controlled trial, with an allocation ratio of 1 : 1. Randomisation was by clinical trials unit, using randomised permuted blocks. Children/families were not blinded; however, outcome assessment was blinded to group assessment.SettingThe study took place in 22 NHS dental practices in Northern Ireland, UK.ParticipantsThe study participants were children aged 2–3 years, who were caries free at baseline.InterventionsThe intervention was composite in nature, comprising a varnish containing 22,600 parts per million (p.p.m.) fluoride, a toothbrush and a 50-ml tube of toothpaste containing 1450 p.p.m. fluoride; plus standardised, evidence-based prevention advice provided at 6-monthly intervals over 3 years. The control group received the prevention advice alone.Main outcome measuresThe primary outcome measure was conversion from caries-free to caries-active states. Secondary outcome measures were the number of decayed, missing or filled tooth surfaces in primary dentition (dmfs) in caries-active children, the number of episodes of pain, the number of extracted teeth and the costs of care. Adverse reactions (ARs) were recorded.ResultsA total of 1248 children (624 randomised to each group) were recruited and 1096 (549 in the intervention group and 547 in the control group) were included in the final analyses. A total of 87% of the intervention children and 85% of control children attended every 6-month visit (p = 0.77). In total, 187 (34%) children in the intervention group converted to caries active, compared with 213 (39%) in the control group [odds ratio (OR) 0.81, 95% confidence interval (CI) 0.64 to 1.04;p = 0.11]. The mean number of tooth surfaces affected by caries was 7.2 in the intervention group, compared with 9.6 in the control group (p = 0.007). There was no significant difference in the number of episodes of pain between groups (p = 0.81). However, 164 out of the total of 400 (41%) children who converted to caries active reported toothache, compared with 62 out of 696 (9%) caries-free children (OR 7.1 95% CI 5.1 to 9.9;p < 0.001). There was no statistically significant difference in the number of teeth extracted in caries-active children (p = 0.95). Ten children in the intervention group had ARs of a minor nature. The average direct dental care cost was £155.74 for the intervention group and £48.21 for the control group over 3 years (p < 0.05). The mean cost per carious surface avoided over the 3 years was estimated at £251.00.LimitationsThe usual limitations of a trial such as generalisability and understanding the underlying reasons for the outcomes apply. There is no mean willingness-to-pay threshold available to enable assessment of value for money.ConclusionsA statistically significant effect could not be demonstrated for the primary outcome. Once caries develop, pain is likely. There was a statistically significant difference in dmfs in caries-active children in favour of the intervention. Although adequately powered, the effect size of the intervention was small and of questionable clinical and economic benefit.Future workFuture work should assess the caries prevention effects of interventions to reduce sugar consumption at the population and individual levels. Interventions designed to arrest the disease once it is established need to be developed and tested in practice.Trial registrationCurrent Controlled Trials ISRCTN36180119 and EudraCT 2009-010725-39.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 71. See the NIHR Journals Library website for further project information.


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