Blended learning in a health assessment course: A mixed-methods study

Objective: The purpose of this study was to get students’ perceptions about changes made to the health assessment course delivery format from face to face to blended learning (BL). Health assessment is a foundational course in nursing undergraduate programs. Research has suggested that students have high levels of satisfaction with a blended learning format.Methods: A survey was used to gather students’ perceptions about changing a health assessment course from face-to-face delivery format to a blended learning format. All second year BSN students who were registered for the course (N = 88) were invited to participate in the survey at the end of the semester.Results: Most students in this study preferred face to face course delivery. Qualitative results were grouped together into themes: 1) Engagement, 2) E-learning tool, and 3) Confidence. Opinions were mixed concerning the e-learning materials that were used. Overall, students felt they were confident in their assessment skills as they prepared to enter the clinical environment.Conclusions: Findings from this study will impact methods of teaching health assessment and other nursing courses in the future.

Patient engagement with PEAR-008, a game-based digital therapeutic for the treatment of opioid use disorder: protocol for a randomized controlled open-label, decentralized trial (Preprint)

BACKGROUND Prescription digital therapeutics (PDTs) are software-based disease treatments that are regulated by the U.S. Food and Drug Administration (FDA). The reSET-O® PDT was FDA-authorized in 2018 and delivers behavioral treatment for individuals receiving buprenorphine for opioid use disorder (OUD). Although reSET-O improves outcomes for individuals with OUD, most of the therapeutic content is delivered as narrative text. PEAR-008 is an investigational device based on reSET-O that uses an interactive, game-based platform to deliver similar therapeutic content designed to enhance patient engagement, which may further improve treatment outcomes. OBJECTIVE The primary objective of this trial is to compare PEAR-008 to reSET-O to investigate how participants interact with the PDT’s changed delivery format. Secondary objectives include evaluating treatment success, symptoms of co-occurring mental health disorders, recovery capital, and skill development. METHODS A decentralized, randomized controlled trial (RCT) design will be utilized to compare PEAR-008 with reSET-O and evaluate differences in patient engagement with the therapeutics. The study population will consist of approximately 130 individuals with OUD (based on DSM-5 criteria) who have recently started buprenorphine for OUD (MOUD) treatment. Participants will be virtually recruited and randomly assigned to receive either PEAR-008 or reSET-O. All study sessions will be virtual and the duration of the study is 12 weeks. The primary outcome measure of engagement is operationalized as the number of active sessions per week with PEAR-008 vs. reSET-O. (An active session is any session that contains some active participation in the application such as navigating to a different screen, engaging with a learning module, or responding to a notification.) The hypothesis is that PEAR-008 will have significantly greater participant engagement compared to reSET-O. RESULTS Due to the COVID-19 pandemic, this study was re-designed using a de-centralized model as it was not possible to conduct medication initiation and study visits in person, as initially intended. Digital treatments like PDTs lend themselves well to a virtual study design. Furthermore, shifting to virtual recruitment has the added benefit of allowing a broader pool of study participants than is typically recruited by the participating study sites. This trial is actively enrolling. CONCLUSIONS This randomized controlled trial will use a decentralized study model and investigate if changing the delivery format and enhancing the content of a PDT for OUD will affect how participants use and interact with the PDT. The study design may serve as a useful model for conducting decentralized studies in this patient population.

How Do Patients with Life-Limiting Illness and Caregivers Want End-Of-Life Prognostic Information Delivered? A Pilot Study

We aimed to identify the level of prognostic disclosure, type of prognostic information and delivery format of prognostic communication that older adults diagnosed with a life-limiting illness or caregivers prefer to receive. We developed and pilot tested an open-ended survey to 15 older patients and caregivers who had experience in health services for life-limiting illness either for a relative, friend or themselves. Five hypothetical clinical scenarios of prognostic options were presented to ascertain preferences. The preferred format to receive prognostic information was verbal delivery by the clinician with a written summary. Photos and videos were less favoured, and a table with numbers/percentages was least preferred. Distress levels to the prognostic scenarios were low, with the exception of a photo. We conclude that older patients/caregivers want end-of-life prognostic information delivered the traditional way, verbally by clinicians. Options to deliver prognostic information may vary across patient groups but empower clinicians in introducing end-of-life discussions with patients/caregivers. Our study illustrates the feasibility of involving terminal patients and caregivers in research that contributes to eliciting prognostic preferences. Further research is needed to understand whether the prognostic preferences of hospitalized patients with life-limiting illness differ.

International educators’ attitudes, experiences, and recommendations after an abrupt transition to remote physiology laboratories

The COVID-19 pandemic triggered university lockdowns, forcing physiology educators to rapidly pivot laboratories into a remote delivery format. This study documents the experiences of an international group of 10 physiology educators surrounding this transition. They wrote reflective narratives, framed by guiding questions, to answer the research question: “What were the changes to physiology laboratories in response to the COVID-19 pandemic?” These narratives probed educators’ attitudes toward virtual laboratories before, during, and after the transition to remote delivery. Thematic analysis of the reflections found that before COVID-19 only a few respondents had utilized virtual laboratories and most felt that virtual laboratories could not replace the in-person laboratory experience. In response to university lockdowns, most respondents transitioned from traditional labs to remote formats within a week or less. The most common remote delivery formats were commercially available online physiology laboratories, homemade videos, and sample experimental data. The main challenges associated with the rapid remote transition included workload and expertise constraints, disparities in online access and workspaces, issues with academic integrity, educator and student stress, changes in learning outcomes, and reduced engagement. However, the experience generated opportunities including exploration of unfamiliar technologies, new collaborations, and revisiting the physiology laboratory curriculum and structure. Most of the respondents reported planning on retaining some aspects of the remote laboratories postpandemic, particularly with a blended model of remote and on-campus laboratories. This study concludes with recommendations for physiology educators as to how they can successfully develop and deliver remote laboratories.

Patient perceptions of physical rehabilitation education and treatment after breast cancer surgery: A mixed methods study

Purpose To investigate the content and delivery of physical rehabilitation education and treatment received by women following breast cancer surgery and to establish patient perceptions of this physical rehabilitation.Methods 509 Australian women (55 years SD 6.5) who previously had breast cancer surgery retrospectively completed an online survey about the content, delivery, satisfaction with and perceptions of the physical rehabilitation they received for six physical side-effects. The percentage of respondents who received each delivery format for the six physical side-effects and their satisfaction levels were tabulated. A thematic analysis was conducted on patients’ perceptions of the physical rehabilitation they received.Results Pamphlets were the most common delivery format of physical rehabilitation following breast cancer surgery. Common physical side-effects, however, were not included in the content and at less than 50% of women were satisfied with their physical rehabilitation. Three major themes emerged: Women perceived (i) they were unaware of and unprepared for the physical side-effects of their surgery/treatment, (ii) information delivery was unsuitable in terms of the timing, delivery format and cognisance of patient needs, and (iii) follow-up was insufficient at critical time points of recovery.Conclusion The physical rehabilitation received by women after all types of breast cancer surgery is perceived to be poor in terms of its content, delivery format and follow-up and women perceive that their needs at various stages of recovery are not being met. Physical rehabilitation needs to improve after all types of breast cancer surgery.

Effect of Delivery Format on Student Outcomes and Perceptions of a Veterinary Medicine Course: Synchronous Versus Asynchronous Learning

The COVID-19 pandemic prompted instruction at many veterinary schools to switch to an emergency remote teaching format to prevent viral transmission associated with in-person synchronous lectures. This study surveyed student perspectives and academic performance in a pre-planned online second-year veterinary toxicology course given at North Carolina State University in Spring 2020. This course relied on asynchronous narrated presentations for content delivery. This method of delivery predated the pandemic and was used throughout the course. Academic performance and patterns of access to materials in the online course was compared with the access patterns and performance of students given classroom-based synchronous teaching in Spring 2019. Assessments evaluated in this study were identical across courses. Students’ academic performance was unaffected by delivery method. Lack of instructor interaction was an important perceived barrier in the asynchronous course. Asynchronous course materials were uniformly accessed across all days of the week, while supplemental materials for the face-to-face course showed a weekly pattern. Moving from letter grades to pass/fail did not change access frequency to supplemental course materials but led to decreased video usage in the asynchronous course. Results suggest that although some veterinary students perceived the switch in delivery format negatively, the method of delivery did not adversely affect performance in this preclinical course.