Implementation and evaluation of a curriculum on the assessment and treatment of disruptive behaviour disorders
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SUBMITTER: Doja A
PROVIDER: S-EPMC8711686 | biostudies-literature |
REPOSITORIES: biostudies-literature
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| S-EPMC6483473 | biostudies-literature
Project description:This study evaluates the clinical validity of a five-minute instrument, the Conduct and Oppositional Defiant Disorder Scales (CODDS), for assessing oppositional defiant disorder (ODD) and conduct disorder (CD). Children (N = 428) aged 11-12 years and their caregiver were administered the NIMH DISC-IV (Diagnostic Interview Schedule for Children), the CODDS, and validity measures. A second sample (N = 671) was utilized to develop a brief measure of limited prosocial emotions based on DSM 5. Receiver operating characteristic (ROC) curves documented good sensitivity and specificity for CODDS scales in predicting DISC-IV clinical diagnoses of ODD (85%, 72% respectively) and CD (85%, 88%) diagnoses. Baseline CODDS provided added value over and above baseline clinical DISC- diagnoses in predicting future DISC ODD and CD diagnoses 12 months later, as well as in predicting social and school functioning. Study 2 further established psychometric properties of the CODDS, with brief measures of CODDS limited prosocial emotions (LPE) having a good fit to the hypothesized DSM 5 four-factor structure of LPE. Findings indicates that the CODDS has utility as a five-minute proxy for diagnoses of ODD and CD in clinical research and potentially practice where time and resources are limited.
| S-EPMC10433509 | biostudies-literature
Project description:OBJECTIVE: Women's health knowledge and skills are important for physicians, but training is often inadequate. The objective of this project was to develop, implement, and evaluate a women's health curriculum for an internal medicine residency program. METHODS: After assessing institutional factors, we developed a curriculum for a multidisciplinary clinical rotation with a web-based tutorial. We recruited faculty from several specialties relevant to the care of women to precept for the rotation and/or to provide teaching materials for the tutorial. RESULTS: The curriculum for the 1-month rotation covered most of the recommended women's health topics. Internal medicine residents worked in a variety of clinical settings and were assigned to a web-based tutorial and a pretest and posttest. A statistically significant increase was seen in participants' mean posttest (71.7%) versus pretest (61.1%) scores (difference, 10.7%; 95% confidence interval [CI]: 4.7-16.6; P = .0009). No difference was seen in controls' mean posttest (56.5%) versus pretest (57.2%) scores (difference, -0.7%; 95% CI: -12.1-10.7; P = .9). Mean rotation evaluation responses ranged from 7.09 to 7.45 on a 9-point scale. The majority (93%) of survey respondents agreed that the rotation increased their skills in caring for women, and all agreed the program was well organized and that it increased their awareness of women's health issues. CONCLUSION: A women's health curriculum using a web-based tutorial with a multidisciplinary clinical rotation can be successfully implemented in an internal medicine residency. The curriculum satisfied women's health training requirements, was associated with improvements in learning outcomes, and may be a model for women's health education.
| S-EPMC2951780 | biostudies-other
Project description:Teach Back is a commonly used communication method to improve patient understanding and retention of health information. The method has been shown to be effective in improving patient and healthcare system outcomes, including patient health literacy and hospital readmissions. Community health workers (CHWs) are frontline healthcare workers who can help address patient health and social needs associated with hospital readmissions. However, a gap exists in Teach Back curricula and training methods reflecting the scope of work for CHWs. The objective of this training was to provide CHWs with didactic information and skill building practice curriculum focused on the integration of Teach Back into clinical patient interactions, care coordination, and follow-up support. A multidisciplinary team of academic and clinical partners at a large academic health university developed, implemented, and evaluated a 3-week pilot Teach Back training with CHWs through a quality improvement approach. The CHWs reported overall satisfaction with the training and instructors. The academic clinical partnership allowed the training to be tailored to the daily clinical workflow as reflected in the CHWs agreement that the training was relevant and practical. With the repeated exposure to Teach Back each week, the CHWs also reported an increase in confidence and conviction in using Teach Back. Additional implementation and evaluation of the training curriculum for CHWs is needed to gain further insights into Teach Back and training best practices and translation into practice.
| S-EPMC9669070 | biostudies-literature
Project description:BackgroundIn-person didactic education in residency has numerous challenges including inconsistent availability of faculty and residents, limited engagement potential, and non-congruity with clinical exposure.MethodsAn online curriculum in movement disorders was implemented across nine neurology residency programs (six intervention, three control), with the objective to determine feasibility, acceptability, and knowledge growth from the curriculum. Residents in the intervention group completed ten modules and a survey. All groups completed pre-, immediate post-, and delayed post-tests.ResultsEighty-six of 138 eligible housestaff (62.3%) in the intervention group completed some modules and 74 completed at least half of modules. Seventy-four, 49, and 30 residents completed the pre-, immediate post-, and delayed post-tests respectively. Twenty-five of 42 eligible control residents (59.5%) completed at least one test. Mean pre-test scores were not significantly different between groups (6.33 vs. 6.92, p = 0.18); the intervention group had significantly higher scores on immediate post- (8.00 vs. 6.79, p = 0.001) and delayed post-tests (7.92 vs. 6.92, p = 0.01). Residents liked having a framework for movement disorders, appreciated the interactivity, and wanted more modules. Residents completed the curriculum over variable periods of time (1-174 days), and at different times of day.DiscussionThis curriculum was feasible to implement across multiple residency programs. Intervention group residents showed sustained knowledge benefit after participating, and residents took advantage of its flexibility in their patterns of module completion. Similar curricula may help to standardize certain types of clinical learning and exposure across residency programs.HighlightsInteractive online tools for resident didactic learning are valuable to residents. Residents learn from interactive online curricula, find the format engaging, and take advantage of the flexibility of online educational tools. Beginner learners appreciate algorithms that help them to approach a new topic.
| S-EPMC8462470 | biostudies-literature
Project description:ImportanceDespite common goals of frontal sinus fracture treatment (restoring forehead contour and creating a safe sinus), there remains significant variability in evaluation and treatment.ObjectiveTo describe our experience with a minimally disruptive treatment protocol for the treatment of frontal sinus fractures.Design, setting, and participantsAnalysis of prospectively collected data from 2010 through 2015 at a level 1 trauma center. All patients with frontal sinus fractures treated with our protocol from January 2010 to December 2015. Patients with poor follow-up and/or incomplete medical records were excluded from analysis.Main outcomes and measuresPresence of an aerated frontal sinus and aesthetically acceptable forehead contour. Secondary outcome measures were complications related to frontal sinus fractures.ResultsA total of 39 patients were treated under our minimally disruptive protocol, and 25 patients were included in the study; 18 (72%) were male and 7 (28%) were female. Their ages ranged from 6 to 62 years. After review, 22 patients had both clinical and radiographic follow-up. No patients underwent immediate frontal sinus repair. Five of 22 patients underwent surgery for indications other than their frontal sinus fracture: 1 of 5 patients underwent immediate surgical repair due to bilateral LeFort fractures, and 4 of 5 underwent delayed surgery due to nasal polyps (1 patient), scar revision (1 patient), and concomitant LeFort fractures (2 patients). Two of 22 patients (9%) underwent frontal sinus repair after outpatient surveillance due to persistent cerebrospinal fluid leak (1 patient) and orbital roof fracture (1 patient). The remaining 20 patients were treated nonoperatively, and 19 of 20 (95%) had spontaneous improvement in opacification and/or contour deformity. Twelve of 20 patients (60%) had improvement or resolution in both. One patient had ongoing partial opacification and deformity at the 3-month follow-up but was asymptomatic and had bony contour that was aesthetically acceptable to the patient. There were no complications. The median of all follow-up was 3 months.Conclusions and relevanceFrontal sinus fractures treated nonoperatively had a high rate of spontaneous ventilation and bony autoreduction with aesthetically acceptable frontal bone remodeling. There were no complications in the nonoperative group. The initial results of this study support further study of the safety and efficacy of a minimally disruptive protocol for frontal sinus fractures.Level of evidence4.
| S-EPMC5539999 | biostudies-literature
Project description:BackgroundTo introduce virtual simulation as a strategy of nursing education and provide valid educational content, the best curriculum model of virtual simulation needs to be developed.MethodsCurriculum development process and pilot evaluation was used. The curriculum content and structure was developed by analyzing literature including previous studies and major nursing classification systems, and key words derived from focus group interviews of 14 nurses and 20 faculty members with expertise in simulation education. 35 nursing students participated in the evaluation of the developed virtual simulation curriculum.ResultsThe curriculum developed for virtual simulation in nursing education contained three domains of content areas: (1) enhancing clinical decision-making, (2) experiencing low-exposed situations, and (3) building professional resilience. In addition, seven subdomains of content areas and 35 representative topics in the virtual simulation curriculum were derived. Scenarios of nine representative topics were created, translated into 3D modeling and pilot-evaluated.ConclusionsConsidering that nursing education is encountering new demands and challenges from students and the changing society, the newly suggested curriculum for virtual nursing simulation can help nurse educators to plan better educational opportunities for students.
| S-EPMC10134613 | biostudies-literature
Project description:Objective: This study examined associations between temperament (negative affect, effortful control, and surgency) and symptoms of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) within a diverse preschool sample. Interactions between temperament and parenting in the prediction of ADHD/ODD symptoms before and after an 8-week early intervention program (i.e., Summer Treatment Program for Pre-kindergartners; STP-PreK) were also examined.Method: The sample included 215 children (Mage = 5.0, 80.9% male, 84.7% Latinx) with a diagnosis of ADHD and/or ODD who completed the STP-PreK. Temperament was measured via parent report while ADHD/ODD symptoms were assessed via combination of parent and teacher report. Positive and negative parenting were assessed via rating scales and a standardized parent-child interaction observation.Results: Higher surgency was associated with greater symptom severity of ADHD/ODD pre- and post-treatment. Higher negative affect was associated with greater symptom severity of ODD pre- and post-treatment, while higher effortful control was only associated with lower symptom severity of inattention pre-treatment. Positive parenting predicted lower symptom severity of ADHD/ODD post-treatment. Moderation analyses indicated that the benefits of low levels of negative parenting only occurred when paired with low temperament risk for symptoms of hyperactivity and ODD. Additionally, only the combination of high surgency and high observed negative parenting resulted in greater symptom severity of ODD. Finally, decreases in inconsistent discipline predicted decreases across all symptom domains post-treatment.Conclusions: Our findings add to the temperament-based model of ADHD/ODD by highlighting temperament's unique prediction of treatment response as well as important interactions with the caregiving environment.
| S-EPMC8175459 | biostudies-literature
Project description:IntroductionIntimate partner violence (IPV) is a prevalent problem with profound health consequences. Research suggests that internal medicine (IM) residents are unprepared to screen for and address IPV. We designed a curriculum to improve IM residents' knowledge, attitudes, and practices in caring for IPV survivors.MethodsThe curriculum was delivered to first-year IM residents from 2016 to 2017 at Johns Hopkins Bayview. Part 1 was 60 minutes long, with a video, evidence-based didactic teaching, and case-based discussion. Part 2 was 90 minutes long, with evidence-based didactic teaching, role-play of patient-provider conversations about IPV, and debriefing about strategies for discussing IPV. We evaluated knowledge, confidence, and self-reported behaviors pre- and postintervention using two-tailed paired t tests.ResultsThirty-two residents received IPV training. In comparing precurriculum (n = 29, 91% of total participants) and postcurriculum (n = 28, 88% of total participants) surveys, there was significant improvement in knowledge about IPV (p < .001). Postcurriculum, learners reported greater confidence in detecting IPV (p < .001), documenting IPV (p < .001), and referring to resources (p < .001). Participants reported increased comfort with managing difficult emotions about IPV in patients (p < .01) and themselves (p < .001) and increased comfort in discussing IPV with female (p < .001) and male (p < .001) patients. Postcurriculum, all respondents felt they were more skillful in discussing IPV and would be more likely to screen for IPV.DiscussionOur curriculum improved residents' knowledge, confidence, comfort, and preparedness in screening for and discussing IPV.
| S-EPMC7331963 | biostudies-literature
Project description:BackgroundEffective early intervention to prevent oppositional/conduct disorders requires early identification of children at risk. Patterns of parent-child interaction may predict oppositional/conduct disorders but large community-based prospective studies are needed to evaluate this possibility.MethodsWe sought to examine whether the Mellow Parenting Observational System (MPOS) used to assess parent-infant interactions at one year was associated with psychopathology at age 7. The MPOS assesses positive and negative interactions between parent and child. It examines six dimensions: anticipation of child's needs, responsiveness, autonomy, cooperation, containment of child distress, and control/conflict; these are summed to produce measures of total positive and negative interactions. We examined videos from the Avon Longitudinal Study of Parents and Children (ALSPAC) sub-cohort who attended the 'Children in Focus' clinic at one year of age. Our sample comprised 180 videos of parent-infant interaction: 60 from infants who received a psychiatric diagnostic categorisation at seven years and 120 randomly selected controls who were group-matched on sex.ResultsA negative association between positive interactions and oppositional/conduct disorders was found. With the exception of pervasive developmental disorders (autism), an increase of one positive interaction per minute predicted a 15% (95% CI: 4% to 26%) reduction in the odds of the infant being case diagnosed. There was no statistically significant relationship between negative parenting interactions and oppositional/conduct disorders, although negative interactions were rarely observed in this setting.ConclusionsThe Mellow Parenting Observation System, specifically low scores for positive parenting interactions (such as Responsiveness which encompasses parental warmth towards the infant), predicted later psychiatric diagnostic categorisation of oppositional/conduct disorders.
| S-EPMC4177234 | biostudies-literature