scholarly journals Increased competency of dietitian nutritionists’ physical examination skill after a simulation-based education in the United States

2020 ◽  
Vol 17 ◽  
pp. 40
Author(s):  
Elizabeth L. MacQuillan ◽  
Jennifer Ford ◽  
Kristin Baird
Keyword(s):  
Clinical Skill ◽  
Training Session ◽  
The United States ◽  
Registered Dietitian ◽  
Video Recordings ◽  
Physical Examination Skill ◽  
Simulation Based ◽  
Before And After ◽  
Examination Skill ◽  
Registered Dietitian Nutritionists

Purpose: This study aimed to translate simulation-based dietitian nutritionist education to clinical competency attainment in a group of practicing Registered Dietitian Nutritionists (RDNs). Using a standardized instrument to measure performance on the newly-required clinical skill, Nutrition Focused Physical Exam (NFPE), competence was measured both before and after a simulation-based education (SBE) session. Methods: Total 18 practicing RDNs were recruited by their employer Spectrum Health system. Following a pre-brief session, participants completed an initial 10-minute encounter, performing NFPE on a standardized patient (SP). Next, participants completed a 90-minute SBE training session on skills within NFPE, including hands-on practice and role play, followed by a post-training SP encounter. Video recordings of the SP encounters were scored to assess competence on seven skill areas within the NFPE. Scores were for initial competence and change in competence.. Results: Initial competence rates ranged from 0- 44% of participants across the seven skills assessed. The only competency where participants scored in the “meets expectations” range initially was “approach to the patient(. When raw competence scores were assessed for change from pre- to post-SBE training, a paired t-test indicated significant increased in all seven competency areas following the simulation-based training (P< .001). Conclusion: This study showed the effectiveness of a SBE training for increased competence scores of practicing dietitian nutritionist on a defined clinical skill.

scholarly journals Malnutrition definitions in clinical practice: To be E43 or not to be?

2019 ◽  
Vol 49 (1) ◽  
pp. 74-79 ◽  
Author(s):  
Wendy Phillips ◽  
Jennifer Doley ◽  
Kelli Boi
Keyword(s):  
United States ◽  
Extended Period ◽  
International Classification Of Diseases ◽  
The United States ◽  
Nutrition Status ◽  
Registered Dietitian ◽  
Classification Of Diseases ◽  
Registered Dietitian Nutritionists ◽  
Medical Record Documentation

Malnutrition is a disease that imposes a significant healthcare cost burden in the United States, especially when left undiagnosed and untreated for an extended period of time. This article discusses traditional malnutrition diagnostic criteria for adults and why registered dietitian nutritionists and physicians should no longer use these criteria to determine nutrition status. It concludes with the malnutrition clinical characteristics currently accepted in the United States and globally, with implications for practice. Clinical documentation specialists and medical coders can use this information to better interpret medical record documentation and assign the correct International Classification of Diseases, 10th Revision, Clinical Modification codes to the coding abstract.

Enhancing paediatric resuscitation team performance: targeted simulation-based team leader training

2020 ◽  
Vol 7 (1) ◽  
pp. 44-46
Author(s):  
Ashley Keilman ◽  
Jennifer Reid ◽  
Anita Thomas ◽  
Neil Uspal ◽  
Kimberly Stone ◽  
...  
Keyword(s):  
Training Session ◽  
Team Leadership ◽  
Team Leader ◽  
Communication Performance ◽  
Specific Process ◽  
Simulation Based ◽  
Before And After ◽  
Summary Statement ◽  
Process Metrics ◽  
Leader Training

Effective team leadership is linked to improved resuscitation outcomes. Previous studies have focused primarily on trainee performance and simulation-based outcomes. We hypothesised that a targeted simulation-based educational intervention for experienced physicians focusing on specific process and communication goals would result in improved performance during actual resuscitations. We conducted an observational pilot study evaluating specific process metrics during clinical resuscitations before and after a 1-hour training intervention for paediatric emergency medicine (PEM) supervising physicians using rapid cycle deliberate practice simulation-based training. Videos of clinical resuscitations from before and after the intervention were retrospectively reviewed to assess time to patient transfer to emergency department stretcher, time to primary assessment and time to team leader summary statement. Between March and July 2018, 21/38 of PEM supervising physicians participated in a training session. After the intervention period, clinical resuscitation teams showed significant improvements in targeted process metrics: transfer of patient within 1 min (79% vs 100%, p=0.03), assessment completed within 3 min (28% vs 75%, p=0.01) and summary statement within 5 min (50% to 85%, p=0.03). Brief, focused simulation-based team leader training can improve the teamwork and communication performance of experienced clinicians during clinical resuscitations.

scholarly journals Perspectives of Registered Dietitian Nutritionists on Adoption of Telehealth for Nutrition Care during the COVID-19 Pandemic

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 235
Author(s):  
Cory Brunton ◽  
Mary Beth Arensberg ◽  
Susan Drawert ◽  
Christina Badaracco ◽  
Wendy Everett ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Healthcare Professionals ◽  
The United States ◽  
Quality Improvement Initiative ◽  
Registered Dietitian ◽  
Care Needs ◽  
Nutrition Care ◽  
Nutrition Programs ◽  
Risk Patients ◽  
Registered Dietitian Nutritionists

Widespread transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has resulted in a global coronavirus disease 2019 (COVID-19) pandemic that is straining medical resources worldwide. In the United States (US), hospitals and clinics are challenged to accommodate surging patient populations and care needs while preventing further infection spread. Under such conditions, meeting with patients via telehealth technology is a practical way to help maintain meaningful contact while mitigating SARS-CoV-2 transmission. The application of telehealth to nutrition care can, in turn, contribute to better outcomes and lower burdens on healthcare resources. To identify trends in telehealth nutrition care before and during the pandemic, we emailed a 20-question, qualitative, structured survey to approximately 200 registered dietitian nutritionists (RDNs) from hospitals and clinics that have participated in the Malnutrition Quality Improvement Initiative (MQii). RDN respondents reported increased use of telehealth-based care for nutritionally at-risk patients during the pandemic. They suggested that use of such telehealth nutrition programs supported positive patient outcomes, and some of their sites planned to continue the telehealth-based nutrition visits in post-pandemic care. Nutrition care by telehealth technology has the potential to improve care provided by practicing RDNs, such as by reducing no-show rates and increasing retention as well as improving health outcomes for patients. Therefore, we call on healthcare professionals and legislative leaders to implement policy and funding changes that will support improved access to nutrition care via telehealth.

scholarly journals Toledo Naloxone Outreach Program: Patient and Health Care Professional Student Education

2021 ◽  
Vol 4 (1) ◽  
pp. 53-59
Author(s):  
Alex Petrak ◽  
Luke Zona ◽  
Jeni Ten Eyck ◽  
Manish Karamchandani ◽  
Tanvir Singh
Keyword(s):  
Health Care ◽  
Health Care Professional ◽  
Family Members ◽  
Training Session ◽  
The United States ◽  
Outreach Program ◽  
Student Survey ◽  
Train The Trainer ◽  
Before And After ◽  
Professional Student

Background: In 2016, Ohio was home to 2 of the top 10 cities with opioid overdoses in the United States. Dayton ranked first, and Toledo held the tenth slot. In response to the opioid epidemic, the Toledo Naloxone Outreach Program (TNOP) was developed to provide naloxone to underserved patients at a student-run free clinic.Methods: The TNOP takes place weekly at 2 locations in the greater Toledo area. Patients are asked to fill out an anonymous survey and given a brief training session by a health care professional student. Patients are then sent home with a free naloxone kit. Additionally, health care professional students were surveyed on their confidence of acquiring a substance use history and knowledge of local services for patients and family members of those experiencing addiction during the "train the trainer" event. The health care professional student survey utilized a 1-5 Likert scale and was analyzed using paired student t tests.Results: Survey results from patients indicate that a majority had not received nalox one prior to the training, indicating the service was expanding access to an otherwise underserved population. Results from the survey administered before and after health care professional student training sessions reflect a significant increase in confidence eliciting a substance abuse history and providing patients and/or family members with addiction resources in the community.Conclusion: The TNOP has provided the community of Toledo with 2 additional outreach locations for receiving free naloxone kits with proper education. Currently, TNOP is in the process of expanding the outreach program to additional student-run free clinics in Ohio.

scholarly journals Effects of Using an Abdominal Simulator to Develop Palpatory Competencies in 3rd Year Medical Students.

2021 ◽  
Author(s):  
Robert M. Hamm ◽  
David M. Kelley ◽  
Jose A Medina ◽  
Noreen S. Syed ◽  
Geraint A. Harris ◽  
...  
Keyword(s):  
Medical Students ◽  
Training Session ◽  
Simulator Training ◽  
Initial Questionnaire ◽  
Before And After ◽  
Examination Skill ◽  
Manual Pressure ◽  
Extended Practice ◽  
Abdominal Examination ◽  
The Impact

Abstract Background. US medical students seldom practice enough on patients to master the palpation skills of the physical examination of the abdomen. We evaluated the impact of extended practice with an abdominal simulator which provides concurrent and summative feedback on the appropriate depth of palpation and coverage of relevant areas. Methods. All third-year medical students were given the opportunity to study with the AbSim simulator during the family medicine rotation. The competence of those who studied with the simulator was measured by its sensors, before and after a training session that included visual feedback regarding the depth and coverage of the student’s manual pressure. Additionally, they reported their confidence in their abdominal examination skill at the beginning and end of the rotation. Results. 119 (86.9%) of 137 students filled out the initial questionnaire, and 73 (61.3%) studied the tutorial. Pre-training competence was predictable by gender, but not by month of third year nor by previous surgery or internal medicine rotations. There was little relation between students’ confidence in their abdominal examination skills and their measured competence. The simulator training had a highly significant effect, improving overall competence (4 measures, all p’s < 0.001). Conclusions. A tutorial using an abdominal simulator increased medical students’ competency examining the abdomen, both the depth of palpation and the thoroughness of coverage. Interpretation of changes in confidence are uncertain, because confidence was unrelated to objectively measured competence, although low initial confidence did influence student choice to study with the abdominal simulator.

Reliability of the Conversational Interaction Coding Form When Applied to Natural Conversation of Individuals With Aphasia

2010 ◽  
Vol 20 (4) ◽  
pp. 125-135 ◽  
Author(s):  
Ashley Pozzolo Coote ◽  
Jane Pimentel
Keyword(s):  
Best Practice ◽  
Interobserver Reliability ◽  
Training Session ◽  
Clinical Tool ◽  
Group Setting ◽  
Conversational Interaction ◽  
Video Recordings ◽  
Aphasia Therapy ◽  
Natural Conversation ◽  
Point To Point

Purpose: Development of valid and reliable outcome tools to document social approaches to aphasia therapy and to determine best practice is imperative. The aim of this study is to determine whether the Conversational Interaction Coding Form (CICF; Pimentel & Algeo, 2009) can be applied reliably to the natural conversation of individuals with aphasia in a group setting. Method: Eleven graduate students participated in this study. During a 90-minute training session, participants reviewed and practiced coding with the CICF. Then participants independently completed the CICF using video recordings of individuals with non-fluent and fluent aphasia participating in an aphasia group. Interobserver reliability was computed using matrices representative of the point-to-point agreement or disagreement between each participant's coding and the authors' coding for each measure. Interobserver reliability was defined as 80% or better agreement for each measure. Results: On the whole, the CICF was not applied reliably to the natural conversation of individuals with aphasia in a group setting. Conclusion: In an extensive review of the turns that had high disagreement across participants, the poor reliability was attributed to inadequate rules and definitions and inexperienced coders. Further research is needed to improve the reliability of this potentially useful clinical tool.

Effects of Time and Perceptual Orientation on Actors' and Observers' Attributions

1984 ◽  
Vol 58 (1) ◽  
pp. 23-30
Author(s):  
Donald S. Martin ◽  
Ming-Shiunn Huang
Keyword(s):  
Video Recording ◽  
Control Group ◽  
Control Groups ◽  
Video Recordings ◽  
Before And After ◽  
Perceptual Orientation ◽  
Initial Difference ◽  
Variety Show ◽  
And Control ◽  
Unrelated Variety

The actor/observer effect was examined by Storms in a 1973 study which manipulated perceptual orientation using video recordings. Storms' study was complex and some of his results equivocal. The present study attempted to recreate the perceptual reorientation effect using a simplified experimental design and an initial difference between actors and observers which was the reverse of the original effect. Female undergraduates performed a motor co-ordination task as actors while watched by observers. Each person made attributions for the actor's behaviour before and after watching a video recording of the performance. For a control group the video recording was of an unrelated variety show excerpt. Actors' initial attributions were less situational than observers'. Both actors and observers became more situational after the video replay but this effect occurred in both experimental and control groups. It was suggested the passage of time between first and second recording of attributions could account for the findings and care should be taken when interpreting Storms' (1973) study and others which did not adequately control for temporal effects.

Changes in Perceptions of Filipino Immigrants about Themselves and of Americans Before and After Coming to the United States

2019 ◽  
Author(s):  
Gremil Alessandro Naz
Keyword(s):  
United States ◽  
Symbolic Interaction ◽  
The United States ◽  
The Philippines ◽  
Appraisal Theory ◽  
American Values ◽  
The Us ◽  
Before And After ◽  
Symbolic Interaction Theory ◽  
Filipino Immigrants

<p>This paper examines the changes in Filipino immigrants’ perceptions about themselves and of Americans before and after coming to the United States. Filipinos have a general perception of themselves as an ethnic group. They also have perceptions about Americans whose media products regularly reach the Philippines. Eleven Filipinos who have permanently migrated to the US were interviewed about their perceptions of Filipinos and Americans. Before coming to the US, they saw themselves as hardworking, family-oriented, poor, shy, corrupt, proud, adaptable, fatalistic, humble, adventurous, persevering, gossipmonger, and happy. They described Americans as rich, arrogant, educated, workaholic, proud, powerful, spoiled, helpful, boastful, materialistic, individualistic, talented, domineering, friendly, accommodating, helpful, clean, and kind. Most of the respondents changed their perceptions of Filipinos and of Americans after coming to the US. They now view Filipinos as having acquired American values or “Americanized.” On the other hand, they stopped perceiving Americans as a homogenous group possessing the same values after they got into direct contact with them. The findings validate social perception and appraisal theory, and symbolic interaction theory.</p>

Hiring Practices of Exercise Physiologist in Cardiac Rehabilitation Programs among Mid-Atlantic States in the United States

2016 ◽  
Vol 5 (3) ◽  
pp. 32-36 ◽  
Author(s):  
Allison Hope Bowersock ◽  
William Alexander Breeding ◽  
Carmel Alexander Sheppard
Keyword(s):  
United States ◽  
Patient Education ◽  
Cardiac Rehabilitation ◽  
Science Curriculum ◽  
Exercise Physiology ◽  
Clinical Skill ◽  
The United States ◽  
Hiring Practices ◽  
Clinical Settings ◽  
Rehabilitation Programs

Purpose: The purpose of this survey was to identify factors that may be influencing the appreciation of exercise physiology as a discipline as demonstrated by hiring practices in regional clinical settings. Methods: A telephone survey was administered to 33 cardiac rehabilitation programs in 5 states in the Mid-Atlantic region of the United States (Kentucky, North Carolina, Tennessee, Virginia, and West Virginia). Results: The distribution of nurses and exercise physiologists (EPs) employed by the 33 facilities varied by state, but overall there were 86 nurses and 55 EPs working among the surveyed facilities. Of the 33 surveyed facilities, 12 (36%) reported a preference for hiring nurses over EPs; only 4 (12%) reported a preference for hiring EPs over nurses. The remaining facilities (n = 17; 52%) reported no preference (n = 12; 36%) or that the decision depends on a variety of factors (n = 5; 15%). Several common themes were identified from respondents. These included that, compared to nurses, EPs have greater expertise in exercise prescription and better understanding of safe exercise progression for patients. However, nurses were believed to possess greater assessment and clinical skill with an emphasis on emergency response preparedness and greater general patient education skills. Conclusion: Academic programs that prepare students for careers as EPs employed in clinical settings may benefit from additional coursework and internship site selection that focus on clinical assessment skills, emergency preparedness, and patient education to reinforce their work in an exercise science curriculum.

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