scholarly journals The emotional brainbow

2019 ◽  
Vol 10 (3) ◽  
pp. e117-118
Author(s):  
Luckshi Rajendran
Keyword(s):  
Interpersonal Relationships ◽  
Health Care Professionals ◽  
Clinical Training ◽  
Medical Training ◽  
Fluorescent Proteins ◽  
First Year ◽  
Evidence Based ◽  
Neural Connections ◽  
Axonal Connections ◽  
The Brain

It was early in my first year of medical school that I learned about the “brainbow” - an innovative means of using genetic expression of various fluorescent proteins to colourfully label individual neurons, allowing for the visualization of neural networks within the brain. I was fascinated by the beautiful complexity of these axonal interconnections. In reflection, I drew parallels to my journey through medicine, and the intricacies of navigating human interpersonal relationships. Medical practice includes both the soft and the hard sciences. Academic institutions teach us the hard sciences: the pathophysiology of disease, and the evidence-based practice for diagnosis and management. Over the years of my clinical training, I am learning that much of the soft science of medicine is in the human connection. It is in our ongoing practice of communication and interpersonal skills, and the subsequent relationships that we develop (or sometimes, lose) with our friends, partners, and colleagues, as we face the miracles and the hardships throughout our medical training. It is in our patient interactions: the emotions we share, the empathy we convey, and the rapport that we build in order to provide compassionate patient care. Much like the brain’s neural network, these connections are complex and ever-changing - some connections are strengthened, and others are unfortunately, and perhaps painfully, pruned. My piece “The emotional brainbow” uses fine multicolours of sewn thread to reflect the intricate axonal connections of brain centres involved in processing and expressing emotions: the cortex, the limbic system, the brainstem, and the cerebellum. These crucial structures communicate to facilitate our ability to understand and empathize with others, and contributes towards our continually developing practice of manoeuvering interpersonal relationships. There is a complex, overlapping interplay of these neural connections within the emotion-regulating brain centres, much like the beautifully intricate emotional human connections, which we, as health care professionals, both create and navigate.

scholarly journals Assessing Diagnostic Reasoning Using a Standardized Case-Based Discussion

2019 ◽  
Vol 6 ◽  
pp. 238212051984941 ◽  
Author(s):  
Ruth M Sutherland ◽  
Katharine J Reid ◽  
Neville G Chiavaroli ◽  
David Smallwood ◽  
Geoffrey J McColl
Keyword(s):  
Medical Students ◽  
Student Performance ◽  
Clinical Training ◽  
Medical Training ◽  
Clinical Information ◽  
Performance Standards ◽  
Diagnostic Reasoning ◽  
First Year ◽  
Oral Assessment ◽  
Case Based

Background: Development of diagnostic reasoning (DR) is fundamental to medical students’ training, but assessing DR is challenging. Several written assessments focus on DR but lack the ability to dynamically assess DR. Oral assessment formats have strengths but have largely lost favour due to concerns about low reliability and lack of standardization. Medical schools and specialist medical colleges value many forms of oral assessment (eg, long case, Objective Structured Clinical Examination [OSCE], viva voce) but are increasingly searching for ways in which to standardize these formats. We sought to develop and trial a Standardized Case-Based Discussion (SCBD), a highly standardized and interactive oral assessment of DR. Methods: Two initial cohorts of medical students (n = 319 and n = 342) participated in the SCBD as part of their assessments. All students watch a video trigger (based on an authentic clinical case) and discuss their DR with an examiner for 15 minutes. Examiners probe students’ DR and assess how students respond to new standardized clinical information. An online examiner training module clearly articulates expected student performance standards. We used student achievement and student and examiner perceptions to gauge the performance of this new assessment form over 2 implementation years. Results: The SCBD was feasible to implement for a large student cohort and was acceptable to students and examiners. Most students and all examiners agreed that the SCBD discussion provided useful information on students’ DR. The assessment had acceptable internal consistency, and the associations with other assessment formats were small and positive, suggesting that the SCBD measures a related, yet novel construct. Conclusions: Rigorous, standardized oral assessments have a place in a programme of assessment in initial medical training because they provide opportunities to explore DR that are limited in other formats. We plan to incorporate an SCBD into our clinical assessments for the first year of clinical training, where teaching and assessing basic DR is emphasized. We will also explore further examiners’ understanding of and approach to assessing DR.

The Preschool Stuttering Screen for Health Care Professionals

2011 ◽  
Vol 21 (2) ◽  
pp. 59-62
Author(s):  
Joseph Donaher ◽  
Christina Deery ◽  
Sarah Vogel
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Differential Diagnosis ◽  
Preschool Children ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Evidence Based ◽  
Developmental Profile

Healthcare professionals require a thorough understanding of stuttering since they frequently play an important role in the identification and differential diagnosis of stuttering for preschool children. This paper introduces The Preschool Stuttering Screen for Healthcare Professionals (PSSHP) which highlights risk factors identified in the literature as being associated with persistent stuttering. By integrating the results of the checklist with a child’s developmental profile, healthcare professionals can make better-informed, evidence-based decisions for their patients.

Brain Evidence in Nursing Research: EEG Methodology

2020 ◽  
Vol 10 (1) ◽  
pp. 98-101
Author(s):  
Yueh-O Chuang ◽  
Ren-Jen Hwang
Keyword(s):  
Emotional Health ◽  
Physiological Data ◽  
Evidence Based ◽  
Nursing Research ◽  
Healthy Behaviors ◽  
Alpha Asymmetry ◽  
Role Of Nursing ◽  
Brain Behavior ◽  
Evidence Based Nursing ◽  
The Brain

This aim of the mini-review paper is to introduction the bio-physiologic measures of resting state EEG for nursing scientist. Article specifically addresses the emotional domain as clarified by concepts of brain evidence-based nursing research reviewed that the emotion aspect documented a strong link to frontal brain alpha activities asymmetry.  Extensive nursing research has been performed in emotional, behavioral, and/or psychological matters for healthy and unhealthy populations. Evidence-based nursing can transform the way that data is used to improve health and healthcare. One core role of nursing practice is to promote healthy behaviors. Previous researches have shown out that the brain is the main ambassador of behavioral change. The electroencephalogram (EEG) is an efficient tool to study brain-behavior relations. Evidences show that frontal alpha asymmetry is an important marker suggests that EEG is beneficial for assessment emotional capacities and appraises nursing efficiency. The basic resting alpha frontal asymmetry provides a reliable instrument in conducting nursing researches in order to strengthen the quality of nursing. Furthermore, we provide a viewpoint to show progress in the novel research issue probably for clinical applications. To integrate biological measures in order to gain highly accurate and precise advantages of EEG and beneficial assessment of the emotional capacities are suggested. Nursing promotes healthy behaviors including emotional health. Human behavior changes originate in the brain. EEG enables objective and biological insights into the cognitive process. As a foundation, the neuroscience research requires profound knowledge and tools to analyze bio-physiological data. Creating Cross-disciplinary cooperation must be inevitable alliances to advance nursing research.

Systematic review of the effects of evidence-based psychotherapies on neurocognitive functioning in mood disorders

2021 ◽  
pp. 000486742110314
Author(s):  
Samantha J Groves ◽  
Katie M Douglas ◽  
Melissa Milanovic ◽  
Christopher R Bowie ◽  
Richard J Porter
Keyword(s):  
Systematic Review ◽  
Mood Disorders ◽  
Interpersonal Relationships ◽  
Neurocognitive Impairment ◽  
Neurocognitive Functioning ◽  
Evidence Based ◽  
Current Standard ◽  
Treatment Protocols ◽  
Analytic Review ◽  
Evidence Based Psychotherapy

Objective: Neurocognitive impairment is considered a core feature of mood disorders. Research has shown that neurocognitive impairment often persists beyond mood symptom resolution and can have significant deleterious effects on interpersonal relationships, academic achievement, occupational functioning and independent living. As such, neurocognitive impairment has become an important target for intervention. In this systematic review, we aimed to examine the extant literature to ascertain whether current standard evidence-based psychotherapies can improve neurocognitive functioning in mood disorders. Method: Studies examining changes in neurocognitive functioning following evidence-based psychotherapy were identified using MEDLINE, PsycINFO and Web of Science databases. Given the heterogeneity of study procedures, treatment protocols and patient samples, a narrative rather than meta-analytic review technique was employed. Results: Nineteen studies (21 articles) met inclusion criteria. There was preliminary evidence of improved executive functioning following evidence-based psychotherapy for Major Depressive Disorder and Bipolar Disorder. There was also some signal of reduced negative biases in emotional information processing following psychotherapy in depression. Due to methodological variability across studies however, it was difficult to draw clear conclusions. Conclusion: Findings from the current review suggest that evidence-based psychotherapies may influence some aspects of neurocognitive functioning in mood disorders. This continues to be an ongoing area of importance and warrants further research.

scholarly journals Web-based Medical Education During COVID-19 Lockdown: A Step Back or a Leap to the Future?

2021 ◽  
pp. 153473462110118
Author(s):  
Anna Eleftheriou ◽  
Aikaterini Rokou ◽  
Christos Argyriou ◽  
Nikolaos Papanas ◽  
George S. Georgiadis
Keyword(s):  
Medical Education ◽  
Clinical Training ◽  
Medical Training ◽  
Medical Schools ◽  
Web Based ◽  
Clinical Exposure ◽  
Virtual Teaching ◽  
Based Medicine ◽  
The Impact

The impact of coronavirus infectious disease (COVID-19) on medical education has been substantial. Medical students require considerable clinical exposure. However, due to the risk of COVID-19, the majority of medical schools globally have discontinued their normal activities. The strengths of virtual teaching now include a variety of web-based resources. New interactive forms of virtual teaching are being developed to enable students to interact with patients from their homes. Conversely, students have received decreased clinical training in certain medical and surgical specialities, which may, in turn, reduce their performance, confidence, and abilities as future physicians. We sought to analyze the effect of telemedicine on the quality of medical education in this new emerging era and highlight the benefits and drawbacks of web-based medical training in building up future physicians. The COVID-19 pandemic has posed an unparalleled challenge to medical schools, which are aiming to deliver quality education to students virtually, balancing between evidence-based and experience-based medicine.

scholarly journals Building capacity for implementation—the KT Challenge

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Agnes T. Black ◽  
Marla Steinberg ◽  
Amanda E. Chisholm ◽  
Kristi Coldwell ◽  
Alison M. Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

Quality Assessment of HTA reports: a Critical Appraisal Toolkit within an institutional HTA program

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Bossi ◽  
M Tringali ◽  
P Colombo ◽  
C Mazzali ◽  
G Puleo ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Critical Appraisal ◽  
Population Aging ◽  
Clinical Effectiveness ◽  
Evidence Based ◽  
Lombardy Region ◽  
Double Blinded ◽  
Sustainable Health ◽  
Local Healthcare

Abstract Issue With population aging, increased demand for healthcare and limited availability of economic and human resources, well-functioning and sustainable health systems have to rely on rigorous and evidence-based assessments of complex technologies' clinical effectiveness and safety. The Lombardy Region in Northern Italy has a well-established HTA program that offers technical support to its hospitals' network to produce and to review Health Technology Assessment (HTA) reports. Description of the Problem To better coordinate the HTA network and to reduce self-referencing of University and Community hospitals, Lombardy Region carried out an intense field training and distance learning from year 2017, with a project aimed at involving health care professionals in an accurate evaluation of technologies in 18 HTA reports. The regional HTA Supporting Centre developed a Toolkit for the critical appraisal of reports and supporting literature to improve the quality of hospital-based reports. Results In compliance with the regional Law DGR XI/1046 17.12.2018 and the framework proposed, during year 2019 hospitals used the Toolkit to help writing complete and good quality HTA reports on 37 different technologies. With a Public Health resident internship, the Toolkit was revised, extended and then used in 2020 by the hospital's HTA network during the double blinded peer review, mandated by the regional Law DGR XI/2672 16.12.2019, of the year 2019 HTA reports. Detailed results will be presented at the conference. Lessons We observed an increase in number of HTA reports from 2018 to 2019, a greater language's and format's homogeneity and an improvement in the quality of some reports, which will be submitted to the Regional HTA Committee for appraisal and reimbursement. Key messages The development and use of a Critical Appraisal Toolkit in an Regional HTA program can help hospitals write complete and good quality HTA reports. A centrally supported quality improvement of distributed assessment activities in a network of hospitals can enhance the production of HTA reports, relevant to the needs of a local healthcare system.

scholarly journals Variations in regulations to control standards for training and licensing of physicians: a multi-country comparison

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Wafa Aftab ◽  
Mishal Khan ◽  
Sonia Rego ◽  
Nishant Chavan ◽  
Afifah Rahman-Shepherd ◽  
...  
Keyword(s):  
Medical Education ◽  
Health Systems ◽  
Clinical Training ◽  
Medical Training ◽  
Grey Literature ◽  
Analytical Framework ◽  
Online News ◽  
Country Comparison ◽  
Education Delivery ◽  
The Right

Abstract Background To strengthen health systems, the shortage of physicians globally needs to be addressed. However, efforts to increase the numbers of physicians must be balanced with controls on medical education imparted and the professionalism of doctors licensed to practise medicine. Methods We conducted a multi-country comparison of mandatory regulations and voluntary guidelines to control standards for medical education, clinical training, licensing and re-licensing of doctors. We purposively selected seven case-study countries with differing health systems and income levels: Canada, China, India, Iran, Pakistan, UK and USA. Using an analytical framework to assess regulations at four sequential stages of the medical education to relicensing pathway, we extracted information from: systematically collected scientific and grey literature and online news articles, websites of regulatory bodies in study countries, and standardised input from researchers and medical professionals familiar with rules in the study countries. Results The strictest controls we identified to reduce variations in medical training, licensing and re-licensing of doctors between different medical colleges, and across different regions within a country, include: medical education delivery restricted to public sector institutions; uniform, national examinations for medical college admission and licensing; and standardised national requirements for relicensing linked to demonstration of competence. However, countries analysed used different combinations of controls, balancing the strictness of controls across the four stages. Conclusions While there is no gold standard model for medical education and practise regulation, examining the combinations of controls used in different countries enables identification of innovations and regulatory approaches to address specific contextual challenges, such as decentralisation of regulations to sub-national bodies or privatisation of medical education. Looking at the full continuum from medical education to licensing is valuable to understand how countries balance the strictness of controls at different stages. Further research is needed to understand how regulating authorities, policy-makers and medical associations can find the right balance of standardisation and context-based flexibility to produce well-rounded physicians.

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