Student-Led Organizations Advocating for Inclusivity in Healthcare and Healthcare Professions

Abstract Background Adequate vaccination coverage among healthcare workers, including students in healthcare professions (SHPs), is crucial in order to prevent spreading of infections within healthcare facilities. However, vaccination coverage among SHPs is often inadequate. We aimed to describe the vaccination/immunization status of SHPs of the University of Milan. Methods We spread an e-survey to the academic e-mail addresses of postgraduate medical residents and to first- and last-year undergraduate SHPs. The questionnaire covered sociodemographic data (age, sex, education, municipality of residence, internship in high-risk wards) and the reported vaccination/immunization status for Influenza (previous flu season), Varicella, MPR and DTaP vaccines. Results Among 5743 invited SHPs, 884 participated in the survey. The study sample comprised 462 medical residents and 422 undergraduate SHPs (medicine 176, nursery 186, midwifery 4, healthcare assistance 32, prevention techniques 24). Median age was 27 years (IQR 7); 68.4% participants were female; 91.3% had attended high school in a lyceum, while others in a professional (2.9%) or technical (5.8%) institute; 36.7% lived in municipalities of < 20.000 inhabitants, while 26.1% of > 250.000. Traineeships took place in high-risk wards for 46% of participants. Reported vaccination coverage for Influenza was 33,7% (with higher coverage for pediatric nursing and midwifery students, medicine students and medical residents). Participants reported immunity (either vaccine or natural immunity) to Varicella in 93,3% cases. Declared vaccination coverage for Hepatitis B was 94,1%; 91,7% participants reportedly completed the MPR schedule, 76,2% the recommended DTaP booster. Conclusions Influenza vaccination coverage was suboptimal in our sample of SHPs, suggesting the need of specific educational programs and targeted vaccination campaigns, which may help shaping a positive vaccination attitude for future healthcare professionals. Key messages Immunization status for VPDs is suboptimal among Italian students in healthcare professions. The monitoring of the immunization status should include healthcare students actively involved in healthcare activities.

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A national cross-sectional survey of the attitudes, skills and use of evidence-based practice amongst Spanish osteopaths

BMC Health Services Research ◽

10.1186/s12913-021-06128-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Gerard Alvarez ◽

Cristian Justribo ◽

Tobias Sundberg ◽

Oliver P. Thomson ◽

Matthew J. Leach

Keyword(s):

Evidence Based Practice ◽

Evidence Based ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Professional Literature ◽

Media Campaigns ◽

Participant Engagement ◽

Online Databases ◽

Research Findings ◽

Healthcare Professions

Abstract Background Although evidence-based practice (EBP) is largely supported across healthcare professions, its implementation in manual therapy professions such as osteopathy remains limited and debated. There is currently little knowledge of how Spanish osteopaths relate to EBP. Objectives The main aim of this study was to investigate the attitudes, skills and use of EBP among Spanish osteopaths. A secondary aim was to identify barriers and facilitators for the adoption of EBP in the Spanish osteopathic context. Methods National cross-sectional survey of Spanish osteopaths registered and non-registered to an osteopathic association in Spain. Eligible participants were invited by a range of recruitment strategies including email and social media campaigns to complete the Spanish-translated Evidence-Based practice Attitude and utilization Survey (EBASE) anonymously online. Results A total of 567 osteopaths completed the survey which represents an approximate response rate of 9%. Participant’s attitudes toward EBP were largely positive. Most respondents agreed or strongly agreed that EBP was necessary in the practice of osteopathy (89.6%) and that professional literature and research findings were useful to their day-to-day practice (88.9%). Levels of perceived skill in EBP were reported as low to moderate with lowest levels for items related to ‘research conduct’. Except reading/reviewing professional literature and using online search engines to find practice-related literature, participant engagement in all other EBP-related activities was generally infrequent. The perceived proportion of clinical practice that was based on clinical research evidence was reported to be very small. Main barriers to EBP uptake included a lack of clinical evidence in osteopathy and insufficient skills for applying research findings. Main facilitators of EBP uptake included access to full-text articles, internet at the workplace and online databases. Conclusions Spanish osteopaths were largely supportive of evidence-based practice, had low to moderate skills in EBP and engaged in EBP activities infrequently. Formal regulation of the profession in Spain and the inclusion of osteopathic programs into the university sector would potentially improve EBP skills and use.

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Burnout Syndrome during Residency Training in Jordan: Prevalence, Risk Factors, and Implications

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041557 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1557

Author(s):

Abdullah Nimer ◽

Suzan Naser ◽

Nesrin Sultan ◽

Rawand Said Alasad ◽

Alexander Rabadi ◽

...

Keyword(s):

Risk Factors ◽

Working Hours ◽

Cross Sectional Study ◽

University Hospital ◽

Burnout Syndrome ◽

Online Questionnaire ◽

Cross Sectional ◽

Factors Associated ◽

Resident Physicians ◽

Healthcare Professions

Burnout syndrome is common among healthcare professions, including resident physicians. We aimed to assess the prevalence of burnout among resident physicians in Jordan, and a secondary aim was to evaluate the risk factors associated with the development of burnout syndrome in those residents, including gender, working hours, psychological distress, training sector, and specialty. In this cross-sectional study, 481 residents were recruited utilizing multistage stratified sampling to represent the four major health sectors in Jordan. Data were collected using an online questionnaire, where the Copenhagen Burnout Inventory (CBI) was used to assess the prevalence of burnout. The prevalence, group differences, and predictors of burnout were statistically analyzed using STATA 15. Overall, 373 (77.5%) residents were found to have burnout. Factors associated with higher levels of burnout were psychological stress (β = 2.34, CI = [1.88–2.81]), longer working hours (β = 4.07, CI = [0.52–7.62], for 51–75 h a week, β = 7.27, CI = [2.86–11.69], for 76–100 h a week and β = 7.27, CI = [0.06–14.49], for >100 h a week), and obstetrics/gynecology residents (β = 9.66, CI = [3.59–15.73]). Conversely, medical sub-specialty residents, as well as private and university hospital residents, had lower burnout levels. We concluded that decreasing the workload on residents, offering psychological counseling, and promoting a safety culture for residents might help in mitigating burnout consequences.

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Structure and processes of emergency observation units with a geriatric focus: a scoping review

BMC Geriatrics ◽

10.1186/s12877-021-02029-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Pieter Heeren ◽

Annabelle Hendrikx ◽

Janne Ceyssens ◽

Els Devriendt ◽

Mieke Deschodt ◽

...

Keyword(s):

Scoping Review ◽

Emergency Care ◽

Older Patients ◽

Clinical Care ◽

Care Needs ◽

Post Discharge ◽

Care Services ◽

Observation Units ◽

Primary Care Services ◽

Healthcare Professions

Abstract Background Combining observation principles and geriatric care concepts is considered a promising strategy for risk-stratification of older patients with emergency care needs. We aimed to map the structure and processes of emergency observation units (EOUs) with a geriatric focus and explore to what extent the comprehensive geriatric assessment (CGA) approach was implemented in EOUs. Methods The revised scoping methodology framework of Arksey and O’Malley was applied. Manuscripts reporting on dedicated areas within hospitals for observation of older patients with emergency care needs were eligible for inclusion. Electronic database searches were performed in MEDLINE, EMBASE and CINAHL in combination with backward snowballing. Two researchers conducted data charting independently. Data-charting forms were developed and iteratively refined. Data inconsistencies were judged by a third researcher or discussed in the research team. Quality assessment was conducted with the Methodological Index for Non-Randomized Studies. Results Sixteen quantitative studies were included reporting on fifteen EOUs in seven countries across three continents. These units were located in the ED, immediately next to the ED or remote from the ED (i.e. hospital-based). All studies reported that staffing consisted of at least three healthcare professions. Observation duration varied between 4 and 72 h. Most studies focused on medical and functional assessment. Four studies reported to assess a patients’ medical, functional, cognitive and social capabilities. If deemed necessary, post-discharge follow-up (e.g. community/primary care services and/or outpatient clinics) was provided in eleven studies. Conclusion This scoping review documented that the structure and processes of EOUs with a geriatric focus are very heterogeneous and rarely cover all elements of CGA. Further research is necessary to determine how complex care principles of ‘observation medicine’ and ‘CGA’ can ideally be merged and successfully implemented in clinical care.

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A reasoned action approach to understand vaccination intention among healthcare professions students

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1431 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

F De Nard ◽

S Rivolta ◽

M Letzgus ◽

M Gaiazzi ◽

D Carnevali ◽

...

Keyword(s):

Reasoned Action ◽

Behavioral Control ◽

Medical Residents ◽

Perceived Behavioral Control ◽

Reasoned Action Approach ◽

Flu Vaccination ◽

Vaccination Behavior ◽

Healthcare Professions ◽

Prevention Techniques ◽

Vaccination Knowledge

Abstract Background Understanding the predictors of vaccination intention among healthcare workers, including students in healthcare professions (SHPs), is crucial for policy making and for the development of evidence-driven training programs. The reasoned action approach (RAA) model includes three components to predict intention: attitude (experiential/instrumental), perceived norm (injunctive/descriptive), and perceived behavioral control (capacity/autonomy). We aimed to investigate the predictors of seasonal Flu vaccination intention among SHPs of the University of Milan. Methods We spread an e-survey to all medical residents and first- and last-year SHPs (medicine, nursery, midwifery, healthcare assistance and prevention techniques). The strength of association between measures of RAA components (as well as sociodemographic data, past vaccination behavior, vaccination knowledge, and perceived vaccination facilitation strategies), and vaccination intention was estimated using uni- and multivariate logistic regression models. Results Among 5743 invited SHPs, 884 participated in the survey and were included in the descriptive analyses (52,3% medical residents, 19,9% medicine, 21,1% nursing, 3,6% healthcare assistance, 2,7% prevention techniques and 0,5% midwifery students). Twenty-nine psycho-attitudinal items with an overall Cronbach alpha >0.7 were included in the analyses. The regression analyses were performed on 751 subjects who filled in completely the survey. Past vaccination behavior, vaccination knowledge, experiential attitudes, and perceived vaccination facilitation strategies were positive predictors of Flu vaccination intention (OR 8.16, 2.42, 1.96 and 1.15 respectively, p < 0.05). Conclusions Our results indicated knowledge, experiential attitudes and facilitation strategies as modifiable predictors of vaccination intention among SHPs. Targeted and lasting interventions are needed in order to pursue a change in the strongest predictor, past vaccination behavior. Key messages Past vaccination is the strongest predictor of vaccination intention among students in healthcare professions. Knowledge, attitudes and perceived facilitators predict vaccine propensity among students in healthcare professions.

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Poor Sleep Health and Next Day Work Impairment: The Mediating Role of Fatigue

Innovation in Aging ◽

10.1093/geroni/igaa057.1384 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 428-429

Author(s):

Breann LaRocque ◽

Christina Mu ◽

Soomi Lee

Keyword(s):

Sleep Quality ◽

Work Performance ◽

Multilevel Models ◽

Poor Sleep ◽

Sleep Health ◽

Work Impairment ◽

Mediating Role ◽

Life Threatening ◽

Healthcare Professions ◽

Ecological Momentary

Abstract Nightly sleep impacts next-day alertness and cognitive functioning. For healthcare professions, work impairment can be life-threatening for patients. Thus, understanding how sleep affects work quality is imperative to promoting medical safety and overall health of workers. The current study investigated whether nightly sleep health is associated with next-day work impairment in nurses and whether this association is mediated by daily fatigue. Sixty nurses reported their sleep characteristics, fatigue, and work impairment using ecological momentary assessment for two weeks. We used a series of multilevel models (a path: sleep→fatigue, b path: fatigue→work impairment, c path: sleep→work impairment, c′ path: sleep and fatigue→work impairment), adjusting for sociodemographics and work shift. At the between-person level, poorer sleep quality was associated with greater work impairment (βc=-23.36, p<.001). This association was mediated by fatigue such that poorer sleep quality was associated with greater fatigue (βa=-19.54, p<.01), which was further associated with greater work impairment (βb=0.79, p<.001). After including fatigue, the association of sleep quality with work impairment was reduced (βc′ =-7.07, p=.08). Similarly, fatigue mediated the relationship between sleep sufficiency and work impairment (βa=-16.49; βb=0.79; βc=-19.36; p<.001; βc′ =-6.32, p=.05). At the within-person level, on days after long sleep duration (>8hrs), nurses reported greater work impairment (βc=10.08, p<.01), however, this was not mediated by fatigue. Our results suggest that poor sleep health may impair next-day work performance, mostly through increased fatigue. Future interventions for nurses can target daily fatigue to reduce the adverse effects of poor sleep on work impairment.

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Empowering students to innovate health services: Teaching transferability of health interventions

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.673 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

T Schloemer ◽

P Schröder-Bäck

Keyword(s):

Health Services ◽

Implementation Research ◽

Research Process ◽

Practice Change ◽

Practical Training ◽

Master Program ◽

Public Health Professionals ◽

High Workload ◽

Healthcare Professions ◽

Different Populations

Abstract Background To improve the health of different populations, health systems need healthcare professionals who are able to innovate health services. In order to empower students from various healthcare professions to change health service practice in a sustainable way, a training was developed based on the PIET-T models of transferability (Schloemer & Schröder-Bäck, 2018). It was evaluated at three universities in Germany and the Netherlands. Objective The aims of the training were to enable students to: 1. Critically analyze existing evidence about successful and unsuccessful transfers of evidence-based interventions to specific “real-world” contexts (1 day), 2. Conduct an assessment of transferability with case studies using problem-based learning (1 day), 3. Practice implementation research in a healthcare organization (4 months, 4 hours/week). The training was evaluated through discussions, a written reflection and a questionnaire in order to understand students' learning experiences. Results Two bachelor programs for occupational, physical and speech therapists, and one master program for public health professionals took part from 09/2019 to 03/2020, including 66 students. Students valued the training as important, 73 % found it helpful for professional practice. They reflected various ideas how to use the PIET-T models for practice change. Although the implementation research process was perceived as high workload, students valued the experience of getting to know barriers and solutions in a practical setting. Conclusions The students of all programs value the practical relevance of teaching with profession-related specifications. Practical application of the PIET-T models opens up new approaches in teaching in order to educate knowledge on improvement of health services in different contexts. Key messages Empowering students to improve healthcare requires practical training. Training on transferability helps students develop skills for improvement of health services.

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Commentary: Beyond Common or Uncommon Morality

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s096318012000016x ◽

2020 ◽

Vol 29 (3) ◽

pp. 426-428

Author(s):

LESLIE FRANCIS

Keyword(s):

Medical Ethics ◽

Common Morality ◽

Medical Professionals ◽

Ethical Standards ◽

Overlapping Consensus ◽

Healthcare Professions

In “Medical Ethics: Common or Uncommon Morality,”1 Rosamond Rhodes defends a specialist view of medical ethics, specifically the ethics of physicians. Rhodes’s account is specifically about the ethics of medical professionals, rooted in what these professionals do. It would seem to follow that other healthcare professions might be subject to ethical standards that differ from those applicable to physicians, rooted in what these other professions do, but I leave this point aside for purposes of this commentary. Rhodes’s view includes both a negative and a positive thesis. The negative thesis is that precepts in medical ethics—understood as the ethics of physicians—cannot be derived from principles of common morality. The positive thesis is two-fold: that precepts in medical ethics must be derived from an account of the special nature of what physicians do, and that this account is to be understood through an overlapping consensus of rational and reasonable medical professionals. While I agree emphatically with, and have learned a great deal from, Rhodes’s defense of the negative thesis, I disagree with both claims in Rhodes’s positive thesis, for reasons I will now explain after a brief observation about the negative thesis.

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Mixed-methods research: A tutorial for speech-language therapists and audiologists in South Africa

South African Journal of Communication Disorders ◽

10.4102/sajcd.v65i1.573 ◽

2018 ◽

Vol 65 (1) ◽

Cited By ~ 2

Author(s):

Anna-Marie Wium ◽

Brenda Louw

Keyword(s):

Mixed Methods ◽

South African ◽

Mixed Methods Research ◽

Communication Disorders ◽

Research Approach ◽

Multiple Perspectives ◽

Language Therapy ◽

Research Issues ◽

Healthcare Professions ◽

Approach Method

Background: Mixed-methods research (MMR) offers much to healthcare professions on clinical and research levels. Speech-language therapists and audiologists work in both educational and health settings where they deal with real-world problems. Through the nature of their work, they are confronted with multifaceted questions arising from their efforts to provide evidence-based services to individuals of all ages with communication disorders. MMR methods research is eminently suited to addressing such questions. Objective: The aim of this tutorial is to increase awareness of the value of MMR, especially for readers less familiar with this research approach. Method: A literature review was conducted to provide an overview of the key issues in MMR. The tutorial discusses the various issues to be considered in the critical appraisal of MMR, followed by an explanation of the process of conducting MMR. A critical review describes the strengths and challenges in MMR. Results: MMR is less commonly used or published in the fields of speech-language therapy and audiology. Conclusion: Researchers working in teams can draw on the strengths of different disciples and their research approaches. Such collaborative enterprises will contribute to capacity building. Researchers, SLTs and audiologists are encouraged to make use of MMR to address the complex research issues in the multicultural, multifaceted South African context. MMR makes an important contribution to the understanding of individuals with communication disorders, and in turn, researchers in the two disciplinary fields of speech-language therapy and audiology can contribute to the development of this research approach. MMR is well suited to the complexity of South African contexts and its populations, as it can provide multiple perspectives of a topic.

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