Using Health Impact Assessment as an Interdisciplinary Teaching Tool.
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ABSTRACT:
SUBMITTER: Chinchilla M
PROVIDER: S-EPMC5551182 | biostudies-other | 2017 Jul
REPOSITORIES: biostudies-other
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Project description:IntroductionHealth care professionals who identify as members of underrepresented and racial minority groups may experience bias from patients and patient families. These occurrences disrupt the educational and therapeutic environments, distress the targeted individuals and allies, and create potential legal liability. Yet there are few educational opportunities for individuals to brainstorm and implement strategies for responding professionally during such instances.MethodsPresented first as a grand rounds, then an invited workshop, and finally an invited series, this educational activity was developed in a stepwise manner over the course of a year. Each format was sequentially modified based on feedback from participants-more than 200 physicians and other health care professionals-using evaluation forms that were voluntary and anonymous. The educational activity used an adaptation of forum theater, in which participants role-played an instance of oppression with a goal of altering the ultimate outcome. This approach provided participants with the opportunity to develop and rehearse responses to workplace bias in a way that preserved the provider-patient relationship.ResultsFeedback for these educational sessions was overwhelmingly positive. Participants noted the importance of acknowledging and addressing bias in the workplace and encouraged facilitators to expand the sessions in length, frequency, and scope.DiscussionForum theater is a methodology that can be employed in health care to teach appropriate and authentic responses to expressed patient bias while maintaining the therapeutic relationship. The positive reception from participants in our preliminary sessions established a strong foundation for future improvements to this work.
| S-EPMC7678028 | biostudies-literature
Project description:In 2007, the World Health Organization (WHO) received a criticism for a lack of transparency and systematic methods in the development of guidelines, which were at that time perceived as substantially driven by expert opinion. In this paper we assessed the quality of maternal and perinatal health guidelines developed since then. We used the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool to evaluate the quality of methodological rigour and transparency of four different WHO guidelines published between 2007 and 2011. Our findings showed high scores among the most recent guidelines on maternal and perinatal health suggesting higher quality. However, there is still potential for improvement, especially in including different stakeholder views, transparency of guidelines regarding the role of the funding body and presentation of the guideline document.
| S-EPMC3418264 | biostudies-other
Project description:BACKGROUND: The concerns of patients suffering from life-threatening disease and end-of-life care aspects have gained increasing attention in public perception. The increasing focus on palliative medicine questions can be considered to be paradigmatic for this development. Palliative medicine became a compulsory subject of the undergraduate curriculum in Germany to be implemented until 2013. The preexisting conditions and qualifications at the medical faculties vary, though. We describe the conceptual process, didactic background, and first experiences with the new interdisciplinary course "Delivering bad news" as a compulsory part of the palliative medicine curriculum. METHODS: Since autumn 2009, this course has been taught at the University Medical Center Göttingen, consisting of two double lessons in the final year of medical education. Considering the curriculum-based learning goals in Göttingen, the focus of this course is to impart knowledge, attitudes and communication skills relating to "bad news". RESULTS: Although the seminar requires adequate staff and is time-consuming, students have accepted it and gave high marks in evaluations. In particular, the teachers' performance and commitment was evaluated positively. DISCUSSION AND CONCLUSIONS: We describe the first experiences with a new course. Didactic structure, theoretical contents, role-plays and usage of media (film, novel) are well- suited to communicate topics such as "bad news". Additional experiences and evaluations are necessary. According to the progressive nature of learning, it might be worthwhile to repeat communication- centered questions several times during medical studies.
| S-EPMC3244731 | biostudies-other
Project description:BackgroundDigital innovations have the potential to enhance current graduate medical education strategies.ObjectiveWe assessed the scope, reach, and effectiveness of Nephrology Simulator (NephSIM), a free, mobile-optimized, nephrology educational tool designed to teach pathophysiology with a diagnostic approach using interactive cases.MethodsNephSIM, launched in June 2018, was designed as a mobile-optimized website with peer-reviewed content in WordPress. Content, including interactive cases with iterative feedback, infographics, and tutorials, was developed by nephrology fellows and attending nephrologists. The teaching tool was shared via an e-mail subscriber list and Twitter. Website usage data and Twitter analytics were reviewed. Case content was categorized, and the case completion rate was calculated. A self-report survey was sent to subscribers to assess their demographics and experience.ResultsThirty-four cases have been published to date and represent a variety of nephrology topics. There have been 100 745 page views between June 2018 and June 2019, representing 17 922 unique visitors from more than 100 countries. There are 1929 accounts that follow NephSIM on Twitter. Tweets received 124 200 impressions and a 3% engagement rate. Median case completion rate was 69% (interquartile range 64%-78%). Our survey response rate was 17% (76 of 445). Nearly all NephSIM users rated the platform highly in terms of satisfaction and usability, and planned to continue using in the future.ConclusionsThe development of a mobile-optimized, case-based teaching approach by nephrology fellows and faculty is feasible and has demonstrated global participation and high levels of learner satisfaction.
| S-EPMC6919163 | biostudies-literature
Project description:It has been widely recognised that a significant proportion of the world's population suffer inequalities in accessing high quality healthcare and wider services. Within healthcare, antimicrobial resistance (AMR) is a global threat to public health affecting all healthcare systems and growing at an alarming pace. To ensure that national AMR campaigns developed by Public Health England are inclusive of all populations within the target audience a health equity assessment tool (HEAT) was used. The project leads for each campaign completed the HEAT independently with a follow up meeting with the study team to discuss and clarify the responses. A trend analysis was carried out with common themes being used to provide recommendations. The campaigns have demonstrated equality and diversity based on the requirements of the Equality Act 2010, particularly age, sex, and race protected characteristics. Some notable results include the translation of website materials in over 30 languages and reaching individuals in 122 countries. It was however noted that several of the protected characteristics were not applicable. The continuous development of resources with collaboration from a variety of diverse user groups would be advantageous towards aiding future campaign reach. The use of the HEAT has demonstrated the ease and cost-effective way to assess any health inequalities and would be a useful addition to antimicrobial stewardship and public health campaigns.
| S-EPMC6784169 | biostudies-literature
Project description:BackgroundThere has been limited evaluation of tools for teaching social determinants of health (SDOH).ObjectiveWe evaluated a field trip as a tool for teaching SDOH to incoming medical interns.MethodsIncoming interns from The George Washington University participated in a bus field trip of Washington, DC, guided by community partners. The field trip introduced trainees to local neighborhoods. Pre- and postactivity surveys developed by the authors were analyzed using a Wilcoxon signed rank test. Reflection responses were recorded and counted for recurrent themes.ResultsIncoming interns participated in 2015 (85 of 90, 94%) and in 2016 (96 of 116, 83%). Postactivity, basic knowledge of DC geographic health disparities increased, and a greater percentage of interns reported being at least somewhat comfortable understanding the neighborhoods from which their patients come (2015: 58% versus 89%, P < .0001; 2016: 65% versus 88%, P < .0001); identifying challenges to health care that affect low-income patients (2015: 74% versus 90%, P < .0023); describing community resources (2015: 29% versus 67%, P < .0001; 2016: 29% versus 50%, P < .0001); and referring patients to local community resources (2015: 25% versus 64%, P < .0001; 2016: 36% versus 52%, P < .0001). Interns reported that this experience improved their understanding of patients' background and local resources, and that they would change the way they practice.ConclusionsA bus field trip guided by community partners is a feasible way to increase residents' perception of their understanding of local disparities and comfort in addressing SDOH.
| S-EPMC5319610 | biostudies-literature
Project description:IntroductionThe coronavirus pandemic forced universities to transfer academic curricula into the digital realm and calls for the introduction of new teaching methods to adequately compensate for the limited in-patient training. Especially in the field of dermatology, the use of 3D models presents an interesting opportunity to maintain the teaching of diagnostically essential sensory and haptic characteristics of primary lesions.ObjectivesWe developed a prototype silicone model and presented it to the medical service of the Department of Dermatology of the Ludwig-Maximilians University for evaluation.MethodsSilicone models demonstrating primary skin lesions were produced by using negative 3D-printed molds and different types of silicone. An online survey obtained evaluations from a group of dermatologists regarding the quality of previously supplied silicone 3D models and their potential use in medical education. Data from 58 dermatologists were collected and analyzed.ResultsThe majority of the participants rated the models overall as positive and innovative, providing constructive feedback for additional modifications, and recommended further implementation into the regular curriculum as an additional tool after the end of the pandemic.ConclusionsOur study underlined the possible advantages of using 3D models as a supplement in educational training even after the end of the SARS-CoV-2 pandemic.
| S-EPMC9946078 | biostudies-literature
Project description:BackgroundThe need to more collaboratively measure the impact of health research and to do so from multidimensional perspectives has been acknowledged. A scorecard was developed as part of the Collective Research Impact Framework (CRIF), to engage stakeholders in the assessment of the impacts of health research and innovations. The purpose of this study was to describe the developmental process of the MULTI-ACT Master Scorecard (MSC) and how it can be used as a workable tool for collectively assessing future responsible research and innovation measures.MethodsAn extensive review of the health research impact literature and of multistakeholder initiatives resulted in a database of 1556 impact indicators. The MSC was then cocreated by engaging key stakeholders and conducting semi-structured interviews of experts in the field.ResultsThe MSC consists of five accountability dimensions: excellence, efficacy, economic, social and patient-reported outcomes. The tool contains 125 potential indicators, classified into 53 impact measurement aspects that are considered the most relevant topics for multistakeholder research and innovation initiatives when assessing their impact on the basis of their mission and their stakeholders' interests. The scorecard allows the strategic management of multistakeholder research initiatives to demonstrate their impact on people and society. The value of the tool is that it is comprehensive, customizable and easy to use.ConclusionsThe MSC is an example of how the views of society can be taken into account when research impacts are assessed in a more sustainable and balanced way. The engagement of patients and other stakeholders is an integral part of the CRIF, facilitating collaborative decision-making in the design of policies and research agendas. In policy making, the collective approach allows the evaluation perspective to be extended to the needs of society and towards responsible research and innovation. Multidimensionality makes research and innovations more responsive to systemic challenges, and developing more equitable and sustainable health services.
| S-EPMC9063051 | biostudies-literature
Project description:BACKGROUND: The Accreditation Council for Graduate Medical Education requires programs to educate and evaluate residents in 6 competencies, including systems-based practice. We designed a survey and assessment tool to address the competency as it pertains to anesthetic drug costs in an academic center. METHODS: Residents, certified registered nurse anesthetists, and faculty were asked to complete an anesthetic drug-cost survey without relying on reference materials. After a combination of compulsory in-class didactic sessions and web-based education, the participants were asked to design an anesthetic, give example cases, and determine costs. The initial task was repeated 1 year later. RESULTS: Our preintervention survey revealed that most practitioners knew very little about anesthetic drug costs, regardless of level of training or degree. All residents completed the mandatory online education tool, more than 80% attended the departmental grand rounds program, and 100% met the goal of designing an anesthetic for all cases within the preset price limit. A repeat of the cost estimate produced an improvement in cost estimates with reduction in variability (P < .05, Student unpaired t test), although estimates of volatile anesthetic and reversal agent costs did not achieve significance at the .05 level for any of the 3 cases. CONCLUSION: Introducing a formalized teaching and assessment tool has improved our residents' understanding of anesthetic drug costs, and improved our ability to teach and assess the systems-based practice competency.
| S-EPMC2930315 | biostudies-other