From clinical expert nurse to part-time clinical nursing instructor: design and evaluation of a competency-based curriculum with structured mentoring: a mixed methods study

Background Transition from a clinical expert nurse to a part time clinical nursing instructor (PTCNI) poses several challenges. Designing a professional development curriculum to facilitate the transition from a clinical expert nurse to a PTCNI is critical to effective education. A comprehensive competency-based curriculum was developed and implemented with structured mentoring to prepare clinical expert nurses as PTCNIs. Methods A mixed-methods study with a sequential-exploratory approach was conducted in Iran in 2019. In the qualitative phase, Saylor et al.’s (1981) seven-step model was used, consisting of (1) collecting evidence from a systematic review, (2) conducting interviews with learners, (3) setting goals and objectives, (4) design, (5) implementation, (6) evaluation, and (7) feedback. In the quantitative phase, curriculum domains were evaluated. Additionally, the effective professional communication skills module was implemented using a quasi-experimental study with a pre-test post-test single-group design for 5 PTCNIs in a pilot study. Results After integrating the findings of the literature review and field interviews in the analysis stage, a curriculum was developed with a total of 150 h, six modules, and 24 topics. Results of the pilot study showed a significant improvement in the confidence of PTCNIs as a result of the implementation of the effective communication skills module using the mentoring method (t = − 16.554, p = 0.0005). Conclusions This competency-based curriculum was based on the evidence and needs of PTCNIs and provides a complete coverage of their clinical education competencies. It is suggested that managers of educational institutes that offer nursing programs use this curriculum to prepare them in continuing education programs. Further studies are needed to thoroughly evaluate the learning outcomes for students.

Assessing the Transfer of Nursing Competencies: Analysis of the effects of intermediate care training in a hospital setting

This research focuses on evaluating the effectiveness of a training course in a hospital setting, using indicators of effect size and heterogeneity index. The evaluation focused on a training course in intermediate care for nurses. The course lasted 23 days and included clinical teaching at the patient’s bedside. The competencies were measured at the beginning and end of the training course, using an observation grid based on five domains: Clinical Expert, Communicator, Collaborator, Leader and Learner-Trainer. Cohen’s and Glass’s estimators demonstrated significant effects of training on the five domains while the heterogeneity index showed a reduction in behavioural disparities within the nursing group at the end of the training course. The discussion addresses issues relating to the boundaries used to interpret effect sizes.

DEVELOPING AN INTEGRATED MODEL BASED ON AUTOMATED TOOLS FOR AN EARLY DETECTION AND DIAGNOSIS OF CANCER RISK

Malignancy can start in any part of the body and can spread to different factors too. It is wild, and it has many sorts. The proposed theory research paper presents a device for foreseeing some disease risks with five unique malignancy determinations and proposals. For perceiving should need malignant growth sickness number of tests from the patient. In any case, utilizing information mining procedures can reduce these tests. To be sure, an exact expectation of malignancy is an undeniably challenging undertaking for the clinical expert. It is likewise a profound worry to the patients to give better treatment, and it will again build the endurance season of the patients. Our discoveries proposed that a reasonable forecast instrument can successfully diminish the few tests for diagnosing malignant growth and expectation exactness, subsequently expanding the specialized chance of early disease identification. The apparatus's principle highlights harmony between the quantity of important data sources and forecast execution, being versatile, and engaging the programmed improvement of the malignant growth hazard expectation instrument in malignant growth illness.

Work of the clinical expert department of the ophthalmosurgical clinic in the context of a pandemic of the novel coronavirus disease

Changes in work of the clinical expert department of the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution (the Khabarovsk branch) in the context of a pandemic of the novel coronavirus disease were analyzed in the article. The difficulties that have appeared in all sections of the work performed are described, both medical and expert: the time for checking the quality of filling out medical documentation has increased due to the identification of a larger number of defects; the time for medical control and discharge of patients from the hospital has increased due to the impossibility of accumulating patients in one place and the need to maintain social distance; difficulties arose in working with experts from insurance companies due to the lack of direct communication (medical records are checked outside the Khabarovsk branch). The concern of people about the possibility of carrying out surgical treatment in conditions of coronavirus infection was expressed in an increase in the information load of the «Question - Answer» section on the website of the Khabarovsk branch and, accordingly, on the doctors in the clinical expert department working with it. Key words: pandemic, COVID-19, SARSCoV-2, anti-epidemic measures, personal protective equipment, social distance, treatment control, medical documentation, medical and economic expertise.

User Experience of Self-Reported Computerized Medical History Taking for Acute Chest Pain in the Clinical Expert Operating System - Chest Pain Danderyd Study (CLEOS-CPDS): Interview Study Among Patients (Preprint)

BACKGROUND Chest pain is one of the most common complaints in emergency departments (EDs). The effectiveness of care for patients with chest pain requires that individual circumstances and the complexity of the patient's clinical issues are determined by medical history taking. The knowledge base for history taking and for interpreting the clinical significance of the information collected can be formalized by software to enable computerized history taking (CHT) directly from patients and subsequently reporting the findings promptly to physicians. The adoption of CHT in clinical practice depends, among other issues, on reactions and attitudes to the technology from patients and their belief that the technology will have benefits for their medical care. OBJECTIVE The objective of this study was to explore the user experience of the self-reported CHT program CLEOS (Clinical Expert Operating System) in the setting of patients attending an ED for acute chest pain. METHODS This qualitative interview study is part of the ongoing CLEOS-Chest Pain Danderyd Study (CLEOS-CPDS), at a cardiology ED. A subset (n=84) of the larger sample who had taken part in self-reported history taking by the CLEOS program during waiting times at the ED were contacted by telephone and n=54 (64%) accepted participation. An interview guide with open-ended questions developed for this study was used. The text was analyzed using conventional content analysis in a deductive way by using the headings in the interview guide. RESULTS Six categories emerged: Clinical context, Individual context, Time aspect, Acceptability of the program, Usability of the program, and Perceptions of usefulness in a clinical context. A majority of the patients thought CLEOS had worked well. Patients also appreciated the opportunities, of interacting with the program and contributing to information about their own health while waiting for care. The program was generally perceived as easy to use and that the questions were mostly seen as relevant and straight forward. Many patients were of the opinion, however, that too many questions were asked and sometimes they mentioned there was insufficient time for responding to them. Some had found it difficult to find the strength to answer all the questions due to their condition. CONCLUSIONS The patients’ experience of the CLEOS program at a cardiology ED reflects an overall positive attitude. The CLEOS program was by some perceived as extensive, although most found the program user-friendly. Despite the busy ED environment, patients were highly motivated and felt that the program would be helpful in leading to a correct diagnosis. These findings suggest an important role for patient-entered CHT programs such as CLEOS in the setting of an ED from the perspective of the patients. CLINICALTRIAL ClinicalTrials.gov NCT03439449