Development of a remote learning educational model for international Emergency Medicine trainees in the era of COVID-19

Background The COVID-19 pandemic has pressured post-graduate medical education programs to shift from traditional in-person teaching to remote teaching and learning. Remote learning in medical education has been described in the literature mostly in the context of local in-country teaching. International remote medical education poses unique challenges for educators, especially in low-middle income countries (LMICs) who need continued Emergency Medicine (EM) specialty development. Our objective is to describe the development and implementation of our remote educational curriculum for EM trainees in West Bengal, India, and to assess trainee satisfaction with our remote learning curriculum. Methods Our curriculum was developed by adapting remote learning techniques used in Western post-graduate medical education, conducting literature searches on remote learning modalities, and through collaboration with local faculty in India. We assessed resident satisfaction in our curriculum with feedback surveys and group discussions. Results The remote educational curriculum had overall high trainee satisfaction ratings for weekly livestream video lectures and throughout our monthly educational modules (median ratings 9-10 out of a 10-point Likert scale). Qualitative feedback regarding specific lecture topics and educational modules were also received. Conclusions International remote education in LMICs poses a unique set of challenges to medical educators. Residents in our study reported high satisfaction with the curriculum, but there is a lack of clarity regarding how a remote curriculum may impact academic and clinical performance. Future studies are needed to further evaluate the efficacy and academic and clinical implications of remote medical education in LMICs.

Ethical challenges of interpreter training at the University of Ljubljana

Modern society is changing and becoming increasingly multilingual and multicultural. There is a growing need for interpreting in different contexts and for languages that were previously rarely required in the Slovene context (e.g., Albanian, Arabic, and Persian). This paper is based on the premise that if higher interpreter education is to be performed ethically, it must respond to these changes within its capacity and educate interpreters for the languages and fields that society actually needs, thus ensuring respect of human rights in medical, asylum or judicial procedures. In the past, interpreter training at the University of Ljubljana was limited to conference interpreting. However, due to changes in practice the Faculty of Arts has responded to the emerging needs and also formed educational modules for interpreters working in court and asylum procedures, state administration and in medical settings. It continues to invest efforts to expand the range of language combinations to include languages of lesser diffusion, and to offer quality interpreter training to the interpreters of Slovenian sign language. In the academic environment, we are also constantly confronted with internal ethical dilemmas related to the assessment, enrolment, and accreditation processes. It is the latter that significantly slow down the response of the Faculty to needs in society. Despite the numerous administrative, financial and human resources challenges, we may conclude that the Faculty of Arts is committed to investing its maximum efforts and responding with a high level of awareness to the changing interpreting profession which has experienced, through the rapidly growing use of online interpreting platforms, the greatest leap since the introduction of simultaneous interpreting. All this can only be achieved in close cooperation with all the related stakeholders: professional associations, long-standing external trainers and state authorities.

The Feasibility of a Stroke Rehabilitation Educational Program for Occupational Therapy Students and Practitioners (Preprint)

BACKGROUND Gaps in knowledge translation of current evidence-based practice regarding stroke assessment and rehabilitation delivered through teletherapy can prevent occupational therapy students and practitioners from implementing current research findings to obtain the best possible results in practice. The purpose of this pilot feasibility study was to create an educational program to translate knowledge into practice about the remote delivery of stroke assessment and rehabilitation to occupational therapy students and practitioners. This study examined knowledge gained from specific educational modules and feedback of delivery with regards to design, feasibility, acceptability, and usability. Four areas of focus were addressed in the educational program including: knowledge translation (KT), task-oriented training (TOT), stroke assessments, and telerehabilitation. OBJECTIVE The purpose of this pilot feasibility study was to create an educational program to translate knowledge into practice about the remote delivery of stroke assessment and rehabilitation to occupational therapy students and practitioners. This study examined knowledge gained from specific educational modules and feedback of delivery with regards to design, feasibility, acceptability, and usability. Four areas of focus were addressed in the educational program including: knowledge translation (KT), task-oriented training (TOT), stroke assessments, and telerehabilitation. METHODS Two feasibility studies were conducted to assess knowledge gained via pretests and posttests of knowledge, followed by a System Usability Scale (SUS) and general feedback questionnaire. Participants in Study 1 were five current occupational therapy practitioners and one occupational therapy assistant. Initial recruitment of participants in Study 2 included ten current occupational therapy students, however only nine students participated in the modules. Four, one-hour modules were emailed weekly to participants over the course of four weeks, with each module covering a different topic (KT, TOT, stroke assessments, and telerehabilitation). Preliminary results were reviewed with median comparisons and nonparametric analyses of pretests and posttests of knowledge for each module. Descriptive statistics from the SUS and a general feedback questionnaire were used to gain overall comments regarding the educational program. RESULTS This study revealed statistically significant results related to increased scores of knowledge through a Wilcoxon Signed-Ranks Test for students, practitioners, and combined. The stroke assessments module for the practitioner study and the stroke assessments and telerehabilitation modules for the student study were found to be statistically significant for increases in knowledge. Task-oriented training, stroke assessments, and telerehabilitation were statistically significant for the combination of the two studies. The task-oriented training module for students and practitioners, and the knowledge translation and telerehabilitation modules for practitioners also demonstrated a notable trend towards significance. The majority of the educational modules had an above average score regarding feasibility as well as positive feedback for the educational program as a whole from the participants. CONCLUSIONS Overall, the results of this pilot study indicate that an online educational program is a feasible, informational method of increasing the translation of knowledge in the remote delivery of stroke assessment and rehabilitation. Occupational therapy students and practitioners found the information presented to be valuable and relevant to their future profession and current practice.

Systematic review support received and needed by researchers: a survey of libraries supporting Ontario medical schools

Introduction: Finding efficient ways to meet the growing demand for library systematic review support is imperative for facilitating the production of high-quality research. The objectives of this study were threefold: 1) to ascertain the systematic review support provided by health sciences libraries at Ontario medical schools and their affiliated hospitals, 2) to determine the perceived educational needs by researchers at these institutions, and 3) to assess the potential usefulness of freely available, online educational modules for researchers that discuss all stages of the systematic review process. Methods: We conducted a cross-sectional survey in June and July of 2020. Data were analyzed and presented using median and interquartile range (IQR) for continuous measures, and in proportions for categorical measures. Results: Thirteen of 19 libraries invited provided usable data. Most libraries spent more time supporting systematic reviews via collaboration/participation than by providing educational support. The perceived needs of library users were contrary to the perceived gaps in researcher support provided by the library/institution. All libraries reported they would find freely available, online educational modules useful for training researchers. Discussion: The next steps for our inter-professional research team will be to develop freely available, online education modules that introduce researchers to all stages of the systematic review process. These modules cannot replace the value that direct support from librarians, biostatisticians or methodology experts can provide, however, they may offer a more efficient way for libraries to familiarize researchers and trainees with best practices and universally accepted reporting guidelines for performing a high-quality review.

Impact of a multifaceted and multidisciplinary intervention on pain, agitation and delirium management in an intensive care unit: an experience of a Canadian community hospital in conducting a quality improvement project

BackgroundClinical guidelines suggest that routine assessment, treatment, and prevention of pain, agitation, and delirium (PAD) is essential to improving patient outcomes as delirium is associated with increased mortality and morbidity. Despite the well-established improvements on patient outcomes, adherence to PAD guidelines is poor in community intensive care units (ICU). This quality improvement (QI) project aims to evaluate the impact of a multifaceted and multidisciplinary intervention on PAD management in a Canadian community ICU and to describe the experience of a Canadian community hospital in conducting a QI project.MethodsA ten-member PAD advisory committee was formed to develop and implement the intervention. The intervention consisted of a multidisciplinary rounds script, poster, interviews, visual reminders, educational modules, pamphlet and video. The 4-week intervention targeted nurses, family members, physicians, and the multidisciplinary team. An uncontrolled, before-and-after study methodology was used. Adherence to PAD assessment guidelines by nurses was measured over a 6-week pre-intervention and over a 6-week post-intervention periods.ResultsData on 430 and 406 patient-days (PD) were available for analysis during the pre- and post- intervention periods, respectively. The intervention did not improve the proportion of PD with guideline compliance to the assessment of pain (23.4% vs. 22.4%, p=0.80), agitation (42.9% vs. 38.9%, p=0.28), nor delirium (35.2% vs. 29.6%, p=0.10) by nurses.DiscussionThe implementation of a multifaceted and multidisciplinary intervention on PAD assessment did not result in significant improvements in guideline adherence in a community ICU. Barriers to knowledge translation are apparent at multiple levels including the personal level (low completion rates on educational modules), interventional level (under-collection of data), and organisational level (coinciding with hospital accreditation education). Our next steps include reintroduction of education modules using organisation approved platforms, updating existing ICU policy, updating admission order sets, and conducting audit and feedback.

Patient Experience and Satisfaction with an e-Health Care Management Application for Inflammatory Bowel Diseases

Background: Rising healthcare expenditures have been partially attributed to suboptimal management of inflammatory bowel diseases (IBD). Electronic health interventions may help improve care management for IBD patients, but there is a need to better understand patient perspectives on these emerging technologies. Aims: The primary aim was to evaluate patient satisfaction and experience with the UCLA eIBD mobile application, an integrative care management platform with disease activity monitoring tools and educational modules. The secondary objective was to capture patient feedback on how to improve the mobile application. Methods: We surveyed IBD patients treated at the UCLA Center for Inflammatory Bowel Diseases. The patient experience survey assessed the patients’ overall satisfaction with the application, perception of health outcomes after participation in the program, and feedback on educational modules as well as areas for application improvement. Results: 50 patients were included. The responses indicated that the patients were greatly satisfied with the ease of patient–provider communication within the application and appointment scheduling features (68%). A majority of respondents (54%) also reported that program participation resulted in improved perception of disease control and quality of life. Lastly, a majority of participants (79%) would recommend this application to others. Conclusions: Mobile tools such as UCLA eIBD have promising implications for integration into patients’ daily lives. This patient satisfaction study suggests the feasibility of using this mobile application by patients and providers. We further showed that UCLA eIBD and its holistic approach led to improved patient experience and satisfaction, which can provide useful recommendations for future electronic health solutions.

Personalized Learning Strategy as a Tool to Improve Academic Performance and Motivation of Students

The purpose of the research is to study and scientifically substantiate personalized strategies as the basis for personalized learning aimed at improving academic performance and student motivation. The study involved 65 teachers and 700 students of various specialties from three Russian and Kazakhstan universities. The survey analysis showed that the modern generation of students is no longer motivated to receive standardized educational services, and in this context, personalized strategies as a form of personalized learning are a key trend that has permeated all aspects of professional training. Unfortunately, currently, universities find it difficult to implement such an approach as personalized learning makes educational modules highly adapted and individualized to meet the needs of each particular student. To apply personalized strategies in the educational process, it is necessary to study the structure of a particular institution, to analyze educational programs, to conduct classes based on personalized learning strategies.

Promoting Interest in Transportation Careers Among Young Women

Transportation remains the largest source of U.S.-based carbon emissions, and reducing emissions from this source continues to challenge experts. Addressing challenging problems requires diverse modes of thinking—and at present the transportation workforce is not diverse in terms of gender, with women occupying only about 14% of the transportation workforce. This research developed and tested a school-based intervention that uses pro-environmental framing and exposure to women transportation role models to help attract more women to transportation careers. To investigate the efficacy of the intervention, the research team studied control and treatment groups of university students using pre- and post-surveys to measure changes in student understanding and interest in transportation fields and careers. Students in both groups were enrolled in a climate change course, and students in the treatment group completed an additional transportation learning module designed to stimulate interest in transportation careers. The results showed that by the end of the semester, student awareness that the transportation industry can provide green and sustainable careers increased by 39.7% in the treatment group compared to no change in the control group. In addition, student openness to working in a transportation related career increased by 17.5% for females in the treatment group compared to no change in the male treatment group and no change in the control group. Given the success of this intervention, similar educational modules at various educational levels could increase the number of women working in transportation. Should such approaches be successful, society will be better prepared to respond to environmental challenges like climate change.