Comparing subspecialty and intensive care providers perspectives on pediatric complex chronic patients: A survey study

Introduction Pediatric complex chronic care patients present unique challenges regarding healthcare provision: complex medical regimes, complicated family/provider dynamics, and multiple healthcare teams that can result in inconsistent care. This study examined subspecialty providers’ perspectives regarding pediatric complex chronic care patients and compared them with acute care providers while exploring opportunities to better facilitate care provided to pediatric complex chronic care patients. Methods This survey study occurring within a Canadian tertiary care pediatric center, utilized REDCap to deploy surveys involving Likert Scale and short answer questions. The Kruskal–Wallis test compared subspecialty provider perspectives when providing care to pediatric complex chronic care patients versus non-pediatric complex chronic care patients; and perspectives between subspecialty and acute care providers. Results Survey response rate was 24/46 (52.2%). Eight overarching themes emerged from Likert scale questions. Short answer questions revealed factors that may facilitate care provided to pediatric complex chronic care patients: access to funding; discharge planning; communication methods between specialists; and healthcare provider continuity. Several differences were identified when working with pediatric complex chronic care patients, compared to non-pediatric complex chronic care patients: increased time/resource burden; managing expectations of patients/families; navigating discrepancies in goals of care; complexity of coordination between services; increased efforts in coordinating discharge from hospital and working with medicalized patients/families. Discussion Exploring pediatric subspecialty provider perspectives of pediatric complex chronic care patients revealed opportunities to enhance care provided: increased resources to ease the strain of care provision for parents, implementation of a discharge coordinator, complex care clinics with a pediatrician to “quarterback” care, and co-management between the complex care pediatrician and acute care physician when admitted to an acute care service. Implementation of these initiatives may improve the care provided to pediatric complex chronic care patients.

Exploring the Value of Using Patient-Oriented MRI Reports in Clinical Practice

Purpose Standard radiology reports (SRR) are designed to communicate information between doctors. With many patients having instantaneous access to SRRs on patient portals, interpretation without guidance from doctors can cause anxiety and panic. We designed a patient-centred prostate MRI template report (PACERR) to address some of these challenges and tested whether PACERRs improve patient knowledge and experience. Materials and Methods Patients booked for clinical prostate MRI were randomly assigned to SRR or SRR + PACERR. Questionnaires included multiple-choice that targeted 4 domains (understanding, usefulness, next steps, emotional experience) hypothesized to improve with patient-centred reports and short answer questions, testing knowledge regarding MRI results. Clinical encounters were observed and recorded to explore whether adding PACERR improved communication. Likert scaled-responses and short-answer questions were compared using Mann-Whitney U test and Kruskal-Wallis test. Results Of the 40 participants, the majority were MRI naïve (70%). Patients receiving a PACERR had higher scores in the categories of patient understanding (mean: 4.17 vs. 3.39, p=0.006), usefulness (mean: 4.58 vs. 3.07, p<0.001), and identifying next steps (mean: 1.89 vs. 3.03, p=0.003) but not emotional experience (mean: 4.18 vs. 3.79, p=0.22). PACERR participants found the layout and design more patient friendly (mean: 4.47 vs. 2.61, p<0.001) and easier to understand (mean: 4.37 vs. 2.38, p<0.001). In the knowledge section, overall, the PACERR arm scored better (87% vs. 56%, p=0.004). Conclusion With the addition of Prostate MRI PACERR, participants had better understanding of their results and felt more prepared to involve themselves in discussions with their doctor.

Dancers’ Perceptions of Accessibility and Quality of the Relationship with Healthcare Professionals in Quebec

OBJECTIVE: To understand dancers’ perception of accessibility to care and quality of the relationship with healthcare practitioners in Quebec; to identify the key elements of an optimal dancer–physician relationship; and to propose recommendations for improvement. METHODS: An online questionnaire consisting of multiple choice, “yes/no,” and short answer questions was sent to professional dance organizations, companies, agencies, and schools in Quebec, Canada. Information regarding the dance artists’ sociodemographics, dance background, dance-related injuries, and access to a primary care physician were collected. Experiences and expectations regarding the dancer–physician relationship were surveyed. One-way ANOVA analyses and Pearson correlations were performed to assess differences of perception between dancers’ demographic characteristics and associations between the variables. RESULTS: Out of 161 participants, 144 met inclusion criteria, consisting of largely French-speaking females, North American or European decent, self-employed contemporary dancers with an average age of 33.13 ± 10.81 yrs. Dance artists sought medical care from osteopaths (47.9%) and physiotherapists (36.1%) more frequently than from physicians (8.3%). Fully employed dancers had more favorable perceptions of the dancer–physician relationship compared to self-employed dancers and those who had mixed streams of income. The perception of most participants was that physicians do not comprehend the unique dance-associated impacts on health (81.8%). The most important aspect affecting perception of the relationship with the physician was diagnostic acumen (41.3%). Most participants (79.0%) selected “works with other health professionals [...] and gives expert advice” as an important expectation from physicians. CONCLUSION: This research is the first investigation of the dancer–physician relationship in Quebec. It reveals a desire amongst the dance artist community to improve the dancer–physician relationship and the overall quality of their unique healthcare requirements.

Gamified lessons support molecular genetics education of first year biology students during COVID-19 lockdown

This study compared the associated impact of gamified molecular genetics lessons on undergraduate student grades for pre-COVID-19 blended delivery and COVID-19 online only delivery of a first-year biology course. When the molecular genetics gamified lessons were used by on- and off-campus students to support their learning, most students had successful learning outcomes in either blended or online only learning environments. In contrast, students who chose not to use these lessons had significantly greater failure rates for both the molecular biology and the genetics short answer questions in the final invigilated exams. Importantly, there was noticeable gamified lesson fatigue observed by both on- and off-campus students and therefore when incorporating gamified lessons into courses, curriculum design needs to be carefully considered. In conclusion, the use of gamified lessons was associated with significantly reduced student failure rates for molecular genetics concepts studied in a university foundational biology course.

Inaugural MSK Medicine Module: An innovative multidisciplinary medical education model

Background Given the increased need to enhance musculoskeletal education, an inaugural musculoskeletal (MSK) focused module was developed and evaluated as part of an orthopedic surgery training program at the University of Toronto. The educational offerings were based on a previously validated MSK Curriculum. Specifically, the aims are to evaluate the effectiveness of the module on 1) improving MSK knowledge and skills expected of graduating Orthopaedic residents and 2) the ability of residents to collaborate professionally with non-surgical MSK clinicians. Methods Nine residents initially selected to participate in the competency based curriculum for orthopaedic surgery completed this module as an essential component of their training. The module was experienced during the mid-point of training (PGY 3 equivalent). An evaluation template was developed using pre and post module multiple choice (MCQ) and short answer questions (SAQ) to assess knowledge; summary of in-training education reports (ITERs) of clinical educational experiences and; feedback obtained for scholarly presentations. Structured feedback was obtained from learners and educators to evaluate the effectiveness of the module and to inform changes to optimize future learning opportunities and environments. Results Nine residents completed the pilot study. The module was 8 weeks long. Learners rotated through clinical settings within five educational pillars. All residents demonstrated improvements in MSK medicine knowledge expected of graduating Orthopaedic residents with a 40% increase in mean MCQ scores (76% vs 60%; p<0.001) and 58% improvement in mean SAQ scores (78% vs 47%; p<0.001). Professionalism evaluations revealed performance above the expected level with a mean in-training education reports score of 4.19 out of 5 (SD: 0.44; range, 3.73 to 5). Conclusion Completing a MSK medicine module at the mid-point of postgraduate Orthopaedic training positively impacts acquisition of relevant MSK knowledge and skill, while facilitating interdisciplinary management of patients with MSK conditions using a new educational paradigm.

Teaching Secondary Mathematics

Secondary mathematics teachers working in the Australian education sector are required to plan lessons that engage with students of different genders, cultures and levels of literacy and numeracy. Teaching Secondary Mathematics engages directly with the Australian Curriculum: Mathematics and the Australian Professional Standards for Teachers to help preservice teachers develop lesson plans that resonate with students. This edition has been thoroughly revised and features a new chapter on supporting Aboriginal and Torres Strait Islander students by incorporating Aboriginal and Torres Strait Islander cultures and ways of knowing into lessons. Chapter content is supported by new features including short-answer questions, opportunities for reflection and in-class activities. Further resources, additional activities, and audio and visual recordings of mathematical problems are also available for students on the book's companion website. Teaching Secondary Mathematics is the essential guide for preservice mathematics teachers who want to understand the complex and ever-changing Australian education landscape.

A CASE STUDY ON STUDENTS’ REASONS FOR NOT SWITCHING ON THEIR CAMERAS DURING ONLINE CLASS SESSIONS

The COVID-19 pandemic has brought academic face-to-face classes to a halt, globally. Schools, higher institutions, and all learning centres were forced into emergency mode searching for platforms to ensure the continuity of teaching and learning (UNESCO, 2020). Online classes were made mandatory, and instructors curated lessons to best deliver their lessons. However, frustrations emerged where teachers shared their experience of talking to the abyss of their computer screens as students did not switch on their cameras during online lessons. A link to a Google form questionnaire which is quantitative (questionnaire), qualitative (short answer questions) in nature was given to the author’s communicative English class students. Fifty students in an English communicative course responded and the chairperson of the course was interviewed (qualitative) to find challenges teachers faced in their online classes. The author focused on one issue - students’ refusal to turn on their cameras. The findings revealed the main reasons for not turning on the cameras during lessons as lack of internet data, poor internet connection, social norms, not being physically presentable, and not being comfortable to be looked at by peers. Instructions from teachers and class assessments affect students’ choice to turn on the camera, too. These findings serve as knowledge contributions for teachers to understand students and to do content curation.

Impact of Fitspiration Content on Social Media among Followers in Singapore Universities

Fitspiration content on social media has been popularized over the last few years, with the intention to influence users to lead healthy and fit lifestyles. The present study aimed to identify the impact of fitspiration content on social media among young adult followers in Singapore. Method: Participants were 124 university students in Singapore who completed a cross-sectional survey. The survey included 16 multiple choice questions, 4 short-answer questions and 8 open-ended questions. Descriptive statistics was adopted for quantitative data and content analysis was utilized for qualitative data. The perceived impact of fitspiration content was explained through three themes: 1) Positive impact of fitspiration content on social media, 2) Negative impact of fitspiration content on social media, and 3) Perceived impact of social media on self. Three other themes were also developed for understanding the conditions influenced by fitspiration content on social media: 1) Evaluation and satisfaction with one’s fitness journey, 2) Motivational levels of participants, and 3) Diet restrictions. Results showed that positive impact were experienced by the majority of the participants, whereas some participants experienced negative impacts. It was concluded that fitspiration content on social media does inspire users to become a better version of themselves both physically and mentally. However, it is also dependent on the perceptions of the users and the extent to which they allowed such content to influence them.

Questionnaire feedback from MBBS second year students about current examination trends and their opinion for perspective changes

Background: All subjects of MBBS do not have same examination pattern especially concerning to question paper pattern and distribution of marks. As a result, students are experiencing variety of examination patterns during their study. Neither is their uniformity of examination pattern throughout the country nor there is uniformity within a university. In such situation, it would be wise to take feedback from students which could help in redesigning the examination pattern. This study was done to collect students’ opinion regarding current examination methods and possible changes that might be required in existing assessment methods.Methods: Questionnaire based study was done on MBBS second year students of Viswabharathi medical college. Questionnaire consisted of 10 questions about examinations faced by the students. Each question had five options arranged according to 5-point Likert scale.Results: 99 students participated in this study. 51.52% students preferred having two essay questions and 42.42% preferred having one essay question in final theory exam. 52.53% preferred to have 40 marks as weightage of one paper. 50.51% supported having illustration-based questions in their final theory examinations. 79.80% stated that at least 30 days of preparation holidays are required for them before their final exams. 48.48% preferred having five very short answer questions. 48.48% stated that weekend tests conducted by their institute were helpful to them. 66.66% disagreed upon increasing number of questions in final examination. 63.63% agreed on having MCQ’s. 48.48% agreed on having viva voce during every internal examination. Consensus could not be reached upon frequency of institutional tests.Conclusions: This study highlighted certain shortcomings in medical education with respect to examinations. Weightage and number of questions might be increased marginally to have a uniform pattern. Question paper should have more very short answer questions and less essay questions. Illustration based questions should also be introduced. 30 days of preparation holidays must be given before final exams for self-study.