How To Hospital: barriers to developing a patient ‘Hospital Survival Guide’ to support information transfer during ward-rounds on the patient journey from admission to hospital to discharge

Clinicians can enable patients to actively participate in their care but communication with patients is often poor and highly variable. The aim of this study was to explore patients’ understanding of their current illness while in hospital and using a codesign process to create prototype tools to facilitate better communication during ward rounds.A mixed-methods, multistep design with step 1: Application of a questionnaire addressing domains of care in the acute medical unit; step 2: Development of communication aids that were codesigned with active help of patients, students and a specialist in user centric design to address patient needs and step 3: Evaluation of tools with patients in four Plan–Do–Study–Act cycles.In the initial survey of 30 patients 12 (40%) patients did not know what their diagnosis was and 5 (17%) did not know the results of recent key tests. 20 (67%) patients felt that staff communication and coordination could be improved.An intervention was prototyped with four variations: (1) An A6 ward-round summary sheet completed by doctors during ward rounds. The system worked well but was highly person dependent. (2) An A4 patient-owned diary (‘How to Hospital’) that contained information about key processes in hospital and space to document conversations from rounds and prompts for questions. 10 patients read the diary and commented favourably but did not complete any pages. (3) ‘Diary-cards’: a basic set of information cards was given to patients on admission to hospital. (4) Patient specific ‘diary-cards’ were completed by clinicians—10 forms were piloted during rounds and improved subsequent day information retention of diagnosis to 80%.Our study identified interventions that were feasible but remained person-dependent. The patients’ ownership of information in relation to their care might facilitate retention and satisfaction but the optimal format for these interventions for enhancing communication remains unclear.

Lubricating culture awareness and critical thinking through humour

There is an ample evidence supporting the benefits of instructional humour, among which increased attention and interest, information retention and learning speed, more productive learning environment, a more positive image of the instructor, more efficient acquisition of linguistic and cultural competencies, an increased conversational involvement, enhanced cultural awareness and more stimulated critical thinking. However, most of the research findings rely on what is termed appropriate humor such as puns, jokes, anecdotes and alike, while potentially offensive humour that relates to sexual, ethnic, religious, political identity is generally labeled inappropriate and advised to be avoided in the classroom environment. It is in this particular context that this study seeks to test the potential of such humour, sexual and ethnic in particular, to act as a tool of increasing cultural awareness and stimulate critical thinking among university students. To do so, the study relies on an experimental class design combining few in-class and extracurricular activities created by using sexual and ethnic humour samples.

Sketch and Speak : An Oral, Written, and Graphic Expository Strategy Intervention for Secondary Students

Purpose This clinical focus article describes an intervention to improve comprehension, retention, and expression of the ideas and language of expository texts. Sketch and Speak intervention links written, graphic, and oral learning strategies through a triadic process of noting an idea simply with written or pictographic notes, then saying it fully, and saying it again. This simple routine engages transformational and retrieval cognitive processes involved in active learning and information retention. We consider the evidence base from the psychological and educational literature and report research evidence with younger students with language-related learning disabilities. We explain how to use Sketch and Speak with students in the secondary grades and suggest how to coach students toward independent, self-regulated use. Conclusions Students in the secondary grades benefit from learning strategies that help them gain control over the ideas and language of informational texts. Sketch and Speak may be a helpful addition to the speech-language pathologist's repertoire for older students with language and learning difficulties.

Feasibility of Virtual Reality based Training for Optimising COVID-19 Case Handling in Uganda

BackgroundEpidemics and pandemics are causing high morbidity and mortality on a still-evolving scale exemplified by the COVID-19 pandemic. Infection prevention and control (IPC) training for frontline health workers is thus essential. However, classroom or hospital ward based training portends an infection risk due to the in-person interaction of participants. We explored the use of Virtual Reality (VR) simulations for frontline health worker training since it trains participants without exposing them to infections that would arise from in-person training. It does away with the requirement for expensive Personal Protective Equipment (PPE) that has been in acute shortage and improves learning, retention and recall. This represents the first attempt in deploying VR-based pedagogy in a Ugandan medical education context.MethodsWe used animated VR-based simulations of bedside and ward-based training scenarios for frontline health workers. The training covered the wearing and stripping of PPE, case management of COVID-19 infected individuals and hand hygiene. It used VR headsets and Graphics Processing Units (GPUs) to actualize an immersive experience, via a hybrid of VR renditions and 360degrees videos. We then compared the level of knowledge acquisition between individuals trained using this method to comparable cohorts previously trained in a classroom setting. That evaluation was supplemented by a qualitative assessment based on feedback from participants about their experience.ResultsThe effort resulted into a well-designed COVID-19 IPC VR curriculum, equivalent VR content and a pioneer cohort of trained frontline health workers. The formalized comparison with classroom-trained cohorts showed relatively better outcomes by way of skills acquired, speed of learning and rates of information retention (P-value =4.0e-09) - suggesting the effectiveness and feasibility of VR as a medium of medical training. Additionally, in the qualitative assessment 90% of the participants rated the method as very good, 58.1% strongly agreed that the activities met the course objectives, and 97.7 % strongly indicated willingness to refer the course to colleagues. ConclusionVR-based COVID-19 IPC training is feasible, effective and achieves enhanced learning while protecting participants from infections within a pandemic context in Uganda. It is a delivery medium transferable to the contexts of other highly infectious diseases.

Fun and Games: Designing a Gamified Central Venous Catheterization Training Simulator

Gamification, or adding elements of games to training systems, has the potential to increase learner engagement and information retention. However, the use of gamification has yet to be explored in Central Venous Catheterization (CVC) trainers which teach a commonly performed medical procedure with high incidence rates. In order to combat these errors, a Dynamic Haptic Robotic Trainer (DHRT) was developed, which focuses on vessel identification and access. A DHRT+ system is currently under development that focuses on whole procedure training (e.g. sterilization and catheter insertion), including a gamified Graphical User Interface. The goal of this paper was to (1) develop a game-like, patient-centered interface to foster personalized learning and (2) understand the perceived utility of gamification for CVC skill development with expert doctors. This paper outlines some of the potential benefits and deficits of the use of gamification in medical trainers that can be used to drive simulation design.

Homework questions designed to require higher-order cognitive skills in an undergraduate animal physiology course did not produce desirable difficulties, testing effects, or improvements in information retention

Studies show that retrieval practices such as homework assignments that are completed during the encoding phase of learning benefit knowledge acquisition and retention. In addition, desirable difficulties, which are strategies that intentionally create a greater challenge during initial learning to enhance encoding and retrieval pathways, also benefit learning long term. Our objective was to determine whether weekly homework questions intended to create desirable difficulties by requiring higher-order cognitive skills (HOCS) benefited students’ long-term retention of physiology concepts compared to questions designed to require lower-order cognitive skills (LOCS). Undergraduate students in a junior-level animal physiology course were presented information during weekly laboratory periods, and then required to complete retrieval practices in the form of online homework assignments 5 d after each lab. Homework questions were formatted per Bloom’s Taxonomy to require HOCS (i.e. level 4 or 5) or LOCS (i.e. level 1 or 2). Information retention was assessed the next week via performance on an in-class quiz and again at semesters’ end via performance on a final practical exam. We observed no differences in performance on the in-class quiz or final practical exam between students randomly assigned to complete homework with HOCS questions compared to LOCS questions. However, students that received homework with HOCS questions had decreased (P < 0.05) performance scores on 9 out of the 11 homework assignments compared to those receiving homework with LOCS questions. These findings indicate that desirable difficulties were not created by our HOCS homework questions because students receiving these more difficult retrieval practices did not achieve equal success on them. As a result, this attempt to create variations in cognitive demand did not enhance retention of knowledge in this study.

Break It Down: Comparing the Effects of Lecture- and Module-Style Design for Additive Manufacturing Educational Interventions on Students’ Learning and Creativity

Given the growing presence of additive manufacturing (AM) processes in engineering design and manufacturing, there has emerged an increased interest in introducing AM and design for AM (DfAM) educational interventions in engineering education. Several researchers have proposed AM and DfAM educational interventions; however, some argue that these efforts might not be sufficient to develop higher-level skills among engineers (e.g., identifying design opportunities that leverage AM capabilities). Prior work has shown that longer, distributed educational interventions are more effective in encouraging learning and information retention; however, these interventions could also be time-consuming and expensive to implement. Therefore, there is a need to test the effectiveness of longer, distributed DfAM educational interventions compared to shorter, lecture-style interventions. Our aim in this research is to explore this research gap through an experimental study. Specifically, we compared two variations of a DfAM educational intervention: (1) a module-style intervention spread over two sessions with the introduction of DfAM evaluation metrics, and (2) a lecture-style intervention completed in a single session with no evaluation metrics introduced. From our results, we see that students who received the module-style intervention reported a greater increase in their DfAM self-efficacy. Additionally, students who received the module-style intervention reported having given a greater emphasis on part consolidation and feature size. Finally, we observe that the structure of the educational intervention did not influence the creativity of ideas generated by the participants. These findings highlight the utility of module-style DfAM educational interventions towards increasing DfAM self-efficacy, but not necessarily design creativity. Moreover, these findings highlight the need to formulate educational interventions that are effective and efficient.