Effectiveness of a standard clinical training program in new graduate nurses’ competencies in Vietnam: A quasi-experimental longitudinal study with a difference-in-differences design

Objective This study aimed to estimate the effectiveness of a standard clinical training program for new graduate nurses in Vietnam. Methods A quasi-experimental longitudinal study with a difference-in-differences design was conducted. A total of 280 new graduate nurses completed a self-administered questionnaire. The intervention group consisted of 206 respondents (those having participated in standard clinical training) and the control group (those that did not receive training) of 74. Differences in mean increases in competency scores between the intervention and control groups were estimated. The effect size of the intervention was estimated by calculating Cohen’s d. A generalized linear model was employed to identify the factors associated with mean increases. Results The mean increase in total competency scores (range: 0–6 points) in the intervention group was 0.73 points greater than in the control group with an intermediate effect size (Cohen’s d = 0.53; 95% CI 0.26 to 0.80). A greater reduction in standard deviation of total competency scores in the intervention group was confirmed. Participation in standard clinical training produced a positive association with a mean increase in total competency score without significance (β = 0.04, P = 0.321). Provincial hospitals as clinical training venues had a significantly positive association (β = 0.11, P = 0.007) with the mean increase in total competency scores. Competency at pre-clinical training was negatively (β = -0.75, P < 0.001) associated with the mean increase. Conclusion Findings implied that the standard clinical training program could contribute to both increasing and standardizing new graduate nurses’ competencies in Vietnam. Further studies are needed to more precisely examine the attribution of standard clinical training to better increase new graduate nurses’ competencies.

Challenges in clinical performance of dentistry clinicians: towards strengthening areas of outcomes or competencies

The study investigated the phenomenon of challenges and difficulties in the clinical performance of students in a university. All eighteen faculty clinical consultants who were supervising the 7 Clinical Departments in the College of Dentistry in a university were invited to participate in the study, wherein questionnaires were given in two stages to identify and recall the frequency of occurrence of errors or weaknesses in the clinical performance of student clinicians in the 3rd and 4th year proper levels of the Dentistry Program. The seven Clinical Departments included the Restorative Dentistry Department, Oral Diagnosis Department, Periodontics Department, Oral Surgery Department, Endodontics Department, Prosthodontics Department, and the Pediatric Dentistry Department. The findings revealed several errors or weaknesses in clinical performance of students and some of these weaknesses were seen by the clinical consultants to be frequently performed. Some of these are critical in the proper training of future dentists and thus interventions in the target outcomes in the clinical training program, as well as target outcomes and competencies in the area of pre-clinical training, were recommended to be addressed.

A Clinical Training Program for Hybrid Closed Loop Therapy in a Pediatric Diabetes Clinic

Background: Hybrid closed loop (HCL) therapy is now available in clinical practice for treatment of type 1 diabetes; however, there is limited research on how to educate patients on this new therapy. The purpose of this quality improvement project was to optimize a HCL education program for pediatric patients with type 1 diabetes (T1D). Methods: Our multidisciplinary team developed a novel HCL clinical training program for current insulin pump users, using a quality improvement process called the Plan-Do-Study-Act model. Seventy-two patients participated in the HCL training program, which included (1) an in-person group class to reinforce conventional insulin pump and CGM use on the new system, (2) a live video conference class to teach HCL use, and (3) three follow-up phone calls in the first 4 weeks after HCL training to assess system use, make insulin adjustments, and provide targeted reeducation. Diabetes educators collected data during follow-up calls, and patients completed a training satisfaction survey. Results: The quality improvement process resulted in a training program that emphasized education on HCL exits, CGM use, and optimizing insulin to carbohydrate ratio settings. Patients successfully sustained time in HCL in the initial weeks of use and rated the trainings and follow-up calls highly. Conclusions: Ongoing educational support is vital in the early weeks of HCL use. This quality improvement project is the first to examine strategies for implementation of HCL therapy into a large pediatric diabetes center, and may inform best practices for implementation of new diabetes technologies into other diabetes clinics.

A Review of a Psychology Intern's Insights Presented in Brooklyn Zoo: The Education of a Psychotherapist

Brooklyn Zoo: The Education of a Psychotherapist delves into the world of psychiatric care and clinical training within the walls of Kings County Hospital in Brooklyn, New York. The aim of this commentary is to discuss several ethical dilemmas which were repeatedly presented to the author, Darcy Lockman, throughout her year-long internship. Such dilemmas include psychiatrists' overreliance on medicine, the total disregard for patient comfort, the difference in standards of care for white patients and patients of color, as well as the supervisory neglect in the clinical training program.

Approaches to Capacity Building for Machine Learning and Artificial Intelligence Applications in Health

Many health systems and research institutes are interested in supplementing their traditional analyses of linked data with machine learning (ML) and other artificial intelligence (AI) methods and tools. However, the availability of individuals who have the required skills to develop and/or implement ML/AI is a constraint, as there is high demand for ML/AI talent in many sectors. The three organizations presenting are all actively involved in training and capacity building for ML/AI broadly, and each has a focus on, and/or discrete initiatives for, particular trainees. P. Alison Paprica, Vector Institute for artificial intelligence, Institute for Clinical Evaluative Sciences, University of Toronto, Canada. Alison is VP, Health Strategy and Partnerships at Vector, responsible for health strategy and also playing a lead role in “1000AIMs” – a Vector-led initiative in support of the Province of Ontario’s \$30 million investment to increase the number of AI-related master’s program graduates to 1,000 per year within five years. Frank Sullivan, University of St Andrews Scotland. Frank is a family physician and an associate director of HDRUK@Scotland. Health Data Research UK \url{https://hdruk.ac.uk/} has recently provided funding to six sites across the UK to address challenging healthcare issues through use of data science. A 50 PhD student Doctoral Training Scheme in AI has also been announced. Each site works in close partnership with National Health Service bodies and the public to translate research findings into benefits for patients and populations. Yin Aphinyanaphongs – INTREPID NYU clinical training program for incoming clinical fellows. Yin is the Director of the Clinical Informatics Training Program at NYU Langone Health. He is deeply interested in the intersection of computer science and health care and as a physician and a scientist, he has a unique perspective on how to train medical professionals for a data drive world. One version of this teaching process is demonstrated in the INTREPID clinical training program. Yin teaches clinicians to work with large scale data within the R environment and generate hypothesis and insights. The session will begin with three brief presentations followed by a facilitated session where all participants share their insights about the essential skills and competencies required for different kinds of ML/AI application and contributions. Live polling and voting will be used at the end of the session to capture participants’ view on the key learnings and take away points. The intended outputs and outcomes of the session are: Participants will have a better understanding of the skills and competencies required for individuals to contribute to AI applications in health in various ways Participants will gain knowledge about different options for capacity building from targeted enhancement of the skills of clinical fellows, to producing large number of applied master’s graduates, to doctoral-level training After the session, the co-leads will work together to create a resource that summarizes the learnings from the session and make them public (though publication in a peer-reviewed journal and/or through the IPDLN website)

Clinician Response to Child Abuse Presentations in the Vietnamese Hospital Emergency Setting

Ongoing fiscal stability has enabled the National Assembly in Vietnam to turn its attention to improving the health and well-being of women and children. Training pediatric health care professionals in the recognition and response to child abuse presentations in the emergency setting has the potential to improve outcomes for the disproportionate number of vulnerable children presenting to the emergency setting with nonaccidental injuries. This study explored the training needs and expectations of the staff preparing to undertake such a clinical training program. This qualitative study is based on semistructured interviews with 16 clinicians from the emergency setting of a leading pediatric hospital in Vietnam. Interview questions focused on current practice in recognizing and responding to child abuse and neglect presentations, the level of training and experience of participants, and subjective reports of confidence in recognizing abuse. Interviews were conducted in English and Vietnamese, with check-translation of transcripts performed by an independent translator. A culture of collegiality and innovative workplace practices was revealed. Analysis revealed two overarching themes that were related to the need for evidence, forensic analysis, respecting families, and consultation. Despite participant confidence in recognizing and reporting child abuse and neglect presentations, knowledge deficits were found. This article presents a critical analysis of the context within which the first evidence-based clinical training program of its kind in Vietnam was developed and implemented in a pediatric children’s hospital. Clinicians felt a strong moral obligation to protect children from further harm, however encountered a number of barriers inhibiting this process. Findings significantly shaped the Safe Children Vietnam training program and will also contribute to the development of protocols and improvement of community support services at the study site.