Evaluating Virtual Patient Interaction Fidelity With Advanced Communication Skills Learners

Previous research in educational medical simulation has drawn attention to the interplay between a simulation’s fidelity and its educational effectiveness. As virtual patients (VPs) are increasingly used in medical simulations for education purposes, a focus on the relationship between virtual patients’ fidelity and educational effectiveness should also be investigated. In this paper, we contribute to this investigation by evaluating the use of a virtual patient selection interface (in which learners interact with a virtual patient via a set of pre-defined choices) with advanced medical communication skills learners. To this end, we integrated virtual patient interviews into a graduate-level course for speech-language therapists over the course of 2 years. In the first cohort, students interacted with three VPs using only a chat interface. In the second cohort, students used both a chat interface and a selection interface to interact with the VPs. Our results suggest that these advanced learners view the selection interfaces as more appropriate for novice learners and that their communication behavior was not significantly affected by using the selection interface. Based on these results, we suggest that selection interfaces may be more appropriate for novice communication skills learners, but for applications in which selection interfaces are to be used with advanced learners, additional design research may be needed to best target these interfaces to advanced learners.

Digital Mediatization in Medicine: New Models of Clinic-to-Doctor-to-Patient Interaction

Mediatization is an interdisciplinary construct, which allows us to study how the transformation of social institutions is affected by media influence and social theories. Researchers are focusing on peoples digital representations and new interaction models. As digital networks grow and overlap with traditional interaction forms, new models of clinic-doctor-patient interaction emerge. Researching this reveals the efficiency of communicative constructivism. The purpose of the research is to study the transformative effect of mediatization on medicine. The research methodology is based on communicative constructivism and phenomenological approach, including analysis of 70 Instagram accounts of doctors and clinics and in-depth interviews of 10 St. Petersburg-based doctors. The research validates the transformation tendencies in medicine as a social institution.

Pilot Study of the Influence of Equine Assisted Therapy on Physiological and Behavioral Parameters Related to Welfare of Horses and Patients

Different welfare indicators were studied in three patients with psychomotor alterations and in two horses throughout 9–10 equine assisted therapy sessions in each patient. In horses, heart and respiratory rates, blood pressure, temperature and behavioral signs were studied. In patients, heart rate, oxygen saturation, temperature, sleep quality, psychomotor and emotional parameters were analyzed. Data collection was recorded in the anticipatory phase (15 min before the start of the session), two interaction phases (after 30 min of horse-patient interaction on the ground and on horseback, respectively) and the recovery phase (15 min after the end of the session). During the anticipatory phase, most of physiological parameters of patients and horses and the stress behavioral signs of horses increased, followed by a relaxing phase during the horse-patient interaction on the ground. In horse-patient riding phase the heart and respiratory rates of the horses again increased. These results showed that the horses did not seem to suffer stress attributable to the therapy sessions, but only an increase in their parameters associated with activity and external stimuli. The patients improved their gross and fine motor skills, their cognitive and perceptual-sensitive parameters and it led to an improvement in the life quality of their families.

Effects of COVID-19 pandemic on ART Service delivery: perspectives of healthcare workers in a Teaching Hospital in Ghana

Background Ghana has a generalized HIV epidemic and efforts have been made to curb the spread and reverse its effects on the general population. In the wake of COVID-19 pandemic, the health system was unsettled and antiretroviral therapy (ART) care has been impacted in diverse ways. The study sought to explore the effects of COVID-19 on ART service provision in Ghana from the perspectives of the healthcare workers. Methods An exploratory-descriptive qualitative approach was employed in this study. Using maximum variation sampling method, fifteen healthcare workers; nurses, data managers and pharmacists were recruited from an ART clinic in a Teaching Hospital in Ghana. In-depth interviews were conducted and analysed using Braun and Clarke thematic approach. Results Three themes emerged from the data; “… And the pandemic struck”, “Impact of the pandemic on ART service delivery”; “Effecting the needed change”. The healthcare workers’ initial reactions to the pandemic and their show of commitment in ensuring continued ART service was evident. COVID-19 impacted service delivery in three main ways; (1) clients’ clinic attendance was erratic at various stages of the pandemic, (2) irregular resource availability as shortage was reported due to affected last mile delivery as a result of the lockdown in Accra, and (3) the health worker-patient interaction became less engaging because of established COVID-19 protocols. The healthcare workers however instituted strategies such as adjusting the patient appointment schedule, health professionals’ work schedule, establishing several work stations, task-shifting, and ensuring the implementation of all the COVID-19 protocols within the ART unit to ensure consistent service delivery as well as patient and staff safety. The study also found a decline in the implementation of several strategies established in the ART clinic during the initial phases of the pandemic such as a decline in the supply of Personal Protective Equipment (PPEs) by hospital management. Conclusions Although several strategies were implemented to manage the effects of the pandemic on ART care, there is a need to establish pathways of support for healthcare workers within the ART clinic and to consolidate as well as institutionalise the changes that ensured continuous but safe service delivery.

Applications of Healthcare Robots in Combating the COVID-19 Pandemic

Due to the increasing number of COVID-19 cases, there is a remarkable demand for robots, especially in the clinical sector. SARS-CoV-2 mainly propagates due to close human interactions and contaminated surfaces, and hence, maintaining social distancing has become a mandatory preventive measure. This generates the need to treat patients with minimal doctor-patient interaction. Introducing robots in the healthcare sector protects the frontline healthcare workers from getting exposed to the coronavirus as well as decreases the need for medical personnel as robots can partially take over some medical roles. The aim of this paper is to highlight the emerging role of robotic applications in the healthcare sector and allied areas. To this end, a systematic review was conducted regarding the various robots that have been implemented worldwide during the COVID-19 pandemic to attenuate and contain the virus. The results obtained from this study reveal that the implementation of robotics into the healthcare field has a substantial effect in controlling the spread of SARS-CoV-2, as it blocks coronavirus propagation between patients and healthcare workers, along with other advantages such as disinfection or cleaning.

Biomimetic mechanical properties and its role in restorative dentistry

The main aim of introducing biomimetic materials is to achieve successful remineralization using biocompatible and optimally functioning materials that can be used to manage diseased and defective tissues in a minimally invasive process. Recently, evidence shows that many biomimetics was introduced with excellent advantages and favorable outcomes in the different fields of dentistry. A wide acceptance of biomimetics was reported in the field of dentistry as the modalities were efficaciously applied in the different endodontic and restorative procedures. In the present literature review, we have discussed the biomimetic mechanical characteristics of the different restoration materials that are currently used in the field of restorative dentistry. The current evidence supports the use and applications for biomimetics in the field of restorative dentistry based on the extensively reported evidence regarding the mechanical and functional characteristics of these modalities which mimic the functions of normal teeth. Accordingly, these modalities can be used to solve the underlying clinical challenges that are routinely faced in the settings of restoration. Furthermore, different materials were introduced and evaluated for their efficacies, and the clinical decision of these materials is based on many factors and should be taken based on dentist-and-patient interaction.

Why Choose a Pathology Career?

Context.— There is a global decline in medical graduates pursuing pathology careers, resulting in a broadening gap between workforce demand and supply. Objective.— To determine causes of low popularity of pathology as a career and develop strategies to avoid a workforce crisis. Design.— An online survey was distributed and yielded 1247 responses, including 609 Australian medical students from 10 medical schools, 119 prevocational doctors from 10 major teaching hospitals in New South Wales, 175 residents, and 344 pathologists throughout Australia. Results.— Compared with pathology-uninterested peers, students and prevocational doctors interested in pathology careers were more likely to value research opportunities (57 of 166 [34.3%] pathology-interested respondents versus 112 of 521 [21.5%] pathology-uninterested respondents; odds ratio [OR] = 1.91, P < .001), have children (19 of 165 respondents [11.5%] versus 22 of 522 respondents [4.2%]; OR = 2.96, P < .001), and self-identify as introverted (87 of 167 respondents [52.1%] versus 179 of 526 respondents [34%]; OR = 2.1, P < .001). Those uninterested in pathology were more likely to value patient interaction (363 of 524 respondents [69.3%] versus 71 of 166 respondents [42.8%]; OR = 3.02, P < .001). Lack of exposure to pathology was the most-cited reason for rejecting pathology (after lack of patient interaction). There was poor understanding of the role of pathologists and low confidence in the ability to interpret histopathology reports among medical students and prevocational doctors. Negative stereotypes regarding pathologists were identified. Conclusions.— Active interventions increasing exposure of medical students and prevocational doctors to pathology as a career, as well as promotion of research opportunities and potential for work–life balance, are needed to address pending workforce shortages.

Interest and Attitudes of Medical, Dental Students and Graduates Towards Pursuing Career in Basic Sciences

Objectives:To assess attitudes and perception of medical as well as dental students and graduates about a career in basicsciences from a public sector institute of Karachi. Study design and setting:A cross-sectional survey carried out using an online questionnaire amongst medical and dentalfinal year students and graduates from Dow University of Health Sciences, Karachi, Pakistan. Methodology:Data collected was analyzed using SPSS version 24.0. Chi-square test was used to compare categoricalvariables with likert scale responses regarding attitudes and perceptions about a career in basic sciences. Results:Out of 315 participants, 41.3% showed interest in basic sciencescareer. 46.4% of graduates showed interest inbasic sciences compared to 15.4% of students. Chi-square test did not reveal any significant association between medicaland dental students and graduates and their attitudes and perceptions regarding a career in basic sciences. Conclusion:Overall, a more positive response towards basic sciences was observed in our study, with graduates reportedbeing more attracted to a basic sciences career than students. However, majority believed there is lack of motivation andawareness about this career path, limited career and post-graduation options in basic sciences, no patient interaction and pressure from family creates disinterest in this career.

Sealing Behavior in Transcatheter Bicuspid and Tricuspid Aortic Valves Replacement Through Patient-Specific Computational Modeling

Background: Patient-specific computer simulation of transcatheter aortic valve replacement (TAVR) can provide unique insights in device-patient interaction.Aims: This study was to compare transcatheter aortic valve sealing behavior in patients with bicuspid aortic valves (BAV) and tricuspid aortic valves (TAV) through patient-specific computational modeling.Methods: Patient-specific computer simulation was retrospectively performed with FEops HEARTguide for TAVR patients. Simulation output was compared with postprocedural computed tomography and echocardiography to validate the accuracy. Skirt malapposition was defined by a distance larger than 1 mm based on the predicted device-patient interaction by quantifying the distance between the transcatheter heart valve (THV) skirt and the surrounding anatomical regions.Results: In total, 43 patients were included in the study. Predicted and observed THV frame deformation showed good correlation (R2 ≥ 0.90) for all analyzed measurements (maximum diameter, minimum diameter, area, and perimeter). The amount of predicted THV skirt malapposition was strongly linked with the echocardiographic grading of paravalvular leakage (PVL). More THV skirt malapposition was observed for BAV cases when compared to TAV cases (22.7 vs. 15.5%, p < 0.05). A detailed analysis of skirt malapposition showed a higher degree of malapposition in the interleaflet triangles section for BAV cases as compared to TAV patients (11.1 vs. 5.8%, p < 0.05).Conclusions: Patient-specific computer simulation of TAVR can accurately predict the behavior of the Venus A-valve. BAV patients are associated with more malapposition of the THV skirt as compared to TAV patients, and this is mainly driven by more malapposition in the interleaflet triangle region.