Development of an Innovative Drug Information Evidence-Based Medicine Advanced Pharmacy Practice Experience

Aim: To describe the development, implementation, and structure of an innovative evidence-based medicine (EBM) advanced pharmacy practice experience (APPE) rotation and evaluate student pharmacists’ perceptions of the course. Methods: A five-week, EBM APPE rotation was designed by seven faculty. Students worked remotely in teams and individually to complete pre- and post-assessments, journal clubs, journal scans, drug information questions, and clinical debates, as well as self- and peer-assessments. Students were asked to rate their perceptions of the course on a 5-point Likert scale. Results: A total of eighteen students, precepted by seven faculty members, completed the rotation. Students completed three group journal clubs, three individual journal scans, one individual journal club, one drug information question, and one clinical debate. Students survey data indicated that confidence in EBM skills was high following the rotation. Conclusion: This EBM APPE rotation was successful. The structure of this rotation may be transferable to a variety of settings.

A Systematic Approach to Identifying and Developing Implementation Strategies to Support the Uptake of a Risk Tool to Aid in Clinical Management of Patients with Syncope: A Qualitative Study

Background: The Canadian Syncope Risk Score (CSRS) is a validated risk stratification tool developed to optimize the accuracy of emergency department decisions and inform evidence-based clinical actions. While preliminary work has been undertaken to understand the barriers to CSRS use, no work to date has explored how to implement the CSRS to overcome these barriers in practice. This study aimed to identify which implementation strategies are most appropriate to address these barriers and how they should be implemented to mitigate the possibility of poor uptake. Methods: We conducted a series of three iterative online user-centered design workshops with emergency medicine physicians from three hospital sites in Ontario, Canada. The objective of the workshops was to engage participants in identifying acceptable strategies to promote CSRS uptake and how they should be operationalized. To support this, we systematically mapped previously identified barriers to corresponding behaviour change techniques to identify the most likely strategies to effect change. The sessions were audio-recorded and dialogue relating directly to the study objective were transcribed. We performed a qualitative content data analysis according to pre-defined objectives for each workshop. Results: Fourteen physicians participated across the three workshops. The main implementation strategies identified to overcome identified barriers were: education in the format of meetings, videos, journal clubs, and posters (uncertainty around when and how to apply the CSRS); an online calculator and integration of the CSRS into electronic medical record (uncertainty in how to apply the CSRS), local champion (lack of team buy-in); and dissemination of evidence summaries and feedback through email communications (lack of evidence about impact). Conclusions: The ability of the CSRS to effectively improve patient safety and syncope management relies on broad buy-in and uptake across physicians. To ensure the CSRS is well-positioned for impact, a comprehensive suite of implementation strategies was identified to address known barriers. This next phase of work will provide insight into whether these strategies facilitated better alignment with barriers, higher physician engagement with the implementation strategies, and broader uptake of the CSRS, with the objective of improving the likelihood that the CSRS will positively influence patient outcomes.

Tailoring Research Evidence and Theory (TREAT) into Allied Health Journal Clubs: A Hybrid Effectiveness-Implementation Study

BackgroundAllied Health Professionals (AHPs) commonly use journal clubs (JCs) to support Evidence-Based Practice (EBP). There is however little research regarding implementing JCs in the long term, and their impact on EBP use and skills in AHPs. This study investigated the impact of implementing a structured JC format, called “TREAT” that was specifically tailored for each club, on EBP skills, confidence, use and resultant changes in clinical practice over 16 sessions for AHPs in a public health service. The study also investigated AHP’s attendance, adherence, satisfaction and barriers and enablers to implementing the format.MethodsA mixed methods hybrid-effectiveness implementation design was employed, guided by the Knowledge-to-Action cycle. EBP skills, confidence, use, and attitudes were assessed (Adapted Fresno Test, EBPQ, tailored journal club culture questionnaire) at baseline, and after 10 and 16-monthly JC sessions. Satisfaction and impact on clinical practice were explored using questionnaires at the latter two time-points, with free-form responses identifying enablers and barriers to EBP culture and implementation. Data on attendance and adherence to the TREAT format were also collected. ResultsSix JCs comprising a total of 132 unique participants from seven Allied Health professions were assessed across three time points. EBP skills significantly improved on the Adapted Fresno Test after 10-monthly (6.6 points: 95% CI, 0.43 to 12.7) and 16-monthly sessions (7.8 points, 95% CI, 0.85 to 14.7), and on self-reported total EBPQ ratings of confidence at 10-months (4.9 points: 95% CI, 2.2 to 7.5) and 16-months (5.7 points: 95% CI 2.7 to 8.7). Across sessions, 88 AHPs reported adopting new treatments/resources and 64 AHPs reported updating clinical procedures. Mean attendance was 5.7 sessions (SD= 3.8), and average adherence to TREAT components each session was 86% (95% CI, 83 to 89). Most participants recommended the format and reported desire to continue TREAT JCs. Enablers to the JC included using clinically relevant topics and active participation, while reported barriers included limited time to prepare. ConclusionsTREAT JCs can be implemented and sustained by AHPs for 16 monthly-sessions. Participation improved EBP skills and confidence and led to changes in clinical practice. Contextual enablers and barriers should be considered when implementing locally.

Introducing evidence based public health practice through a journal club for public health officers in Somaliland

Evidence based public health is one of the basic training tools of public health students and young officers in decision making. The training tools for early career specialists and trainees in public health is journal clubs (JC). It keeps the knowledge of professionals up to date and assist them in receiving information to design, plan, implement health care services, policies and strategies. The intention of the JC team was to raise awareness of methods for public health literature search, appraising it and applying this knowledge in their daily practices. A senior public health practitioner in Somaliland (the corresponding author) invited medical students and residents to have JCs as a part of their training. They did not accept the offer so the organizer invited practicing junior public health professionals instead. The JC team members were a general practitioner and 3 public health workers from Ministry of Health, public hospital physician, public health school and field public health officer. A weekly or twice weekly journal club took place to train them in critical appraisal. This continued for 15 months in a hybrid mentorship for the health care professionals. The team mentor selected a paper for discussion. Mentees choose a study design appraisal tool from the Critical Appraisal Skills Program (CASP) that matched the study to present. In the process of appraisal, a team member led the discussion using the checklist. The mentees presented their critical appraisal either orally or via a presentation. The checklist and paper were compared for assessing the study design and structure of the paper of the week. This approach of empowering junior public health officers in Somalia is a way forward for encouraging the professionals to use evidence based practice in their daily practices. This will improve their selection of research tools and translating the scientific work into their practice and services.

EP.TU.19Are virtual journal clubs a viable alternative in the Covid-19 era?

Introduction During the COVID-19 pandemic, face to face journal clubs have been curtailed due to Governmental guidance for social distancing. We present an example of a virtual journal club set up for Orthopaedic senior house officers (SHOs) & trainees in the North West Thames (NWT) Deanery from April to August 2020. Methods Our aims were to establish a regular online journal club for orthopaedic trainees in NWT that successfully met the objectives of the more established face to face meetings. Assessment of each session was evaluated using a post attendance survey created using an established online generator. Results 64.4% (16/25 participants) had not attended a virtual journal club before, with 100% (33/33) reporting that they would attend another virtual journal club. 39.4% (13/33) of attendees agreed or strongly agreed that they could participate in sessions over more conventional meetings. 24.2% (8/33) of participants reported experiencing technical issues during the sessions. 90.9% (30/33) of respondents reporting the virtual model to be more convenient than standard journal clubs. Conclusion The potential benefits of significantly increased accessibility, increased visiting expert contribution whilst still adhering to government guidelines; weighed against marginally less effective teaching nonetheless results in an overall benefit

Biomedical omics: first insights of a new MSc degree of the University of Milan

The advent of technologies allowing the global analysis of biological phenomena, referred to as "omics" (genomics, epigenomics, proteomics, metabolomics, microbiomics, radiomics, and radiogenomics), has revolutionized the study of human diseases and traced the path for quantitative personalized medicine. The newly inaugurated Master of Science Program in Biomedical Omics of the University of Milan, Italy, aims at addressing the unmet need to create professionals with a broad understanding of omics disciplines. The course is structured over 2 years and admits students with a bachelor’s degree in biotechnology, biology, chemistry, or pharmaceutical sciences. All teaching activities are fully held in English. A total of nine students enrolled in the first academic year and attended the courses of radiomics, genomics and epigenomics, proteomics, and high-throughput screenings, and their feedback was evaluated by means of an online questionnaire. Faculty with different backgrounds were recruited according to the subject. Due to restrictions imposed by the coronavirus disease 2019 (COVID-19) pandemic, laboratory activities were temporarily suspended, while lectures, journal clubs, and examinations were mainly held online. After the end of the first semester, despite the difficulties brought on by the COVID-19 pandemic, the course overall met the expectations of the students, specifically regarding teaching effectiveness, interpersonal interactions with the lecturers, and courses organization. Future efforts will be undertaken to better calibrate the overall workload of the course and to implement the most relevant suggestions from the students together with omics science evolution in order to guarantee state-of-the-art omics teaching and to prepare future omics specialists.