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Critical Care (London, England) Nov 2019The Sequential Organ Failure Assessment or SOFA score was developed to assess the acute morbidity of critical illness at a population level and has been widely validated... (Review)
Review
The Sequential Organ Failure Assessment or SOFA score was developed to assess the acute morbidity of critical illness at a population level and has been widely validated as a tool for this purpose across a range of healthcare settings and environments.In recent years, the SOFA score has become extensively used in a range of other applications. A change in the SOFA score of 2 or more is now a defining characteristic of the sepsis syndrome, and the European Medicines Agency has accepted that a change in the SOFA score is an acceptable surrogate marker of efficacy in exploratory trials of novel therapeutic agents in sepsis. The requirement to detect modest serial changes in a patients' SOFA score therefore means that increased clarity on how the score should be assessed in different circumstances is required.This review explores the development of the SOFA score, its applications and the challenges associated with measurement. In addition, it proposes guidance designed to facilitate the consistent and valid assessment of the score in multicentre sepsis trials involving novel therapeutic agents or interventions.ConclusionThe SOFA score is an increasingly important tool in defining both the clinical condition of the individual patient and the response to therapies in the context of clinical trials. Standardisation between different assessors in widespread centres is key to detecting response to treatment if the SOFA score is to be used as an outcome in sepsis clinical trials.
Topics: Clinical Trials as Topic; Humans; Organ Dysfunction Scores; Program Development; Research; Severity of Illness Index
PubMed: 31775846
DOI: 10.1186/s13054-019-2663-7 -
Implementation Science : IS Apr 2015Implementation science has progressed towards increased use of theoretical approaches to provide better understanding and explanation of how and why implementation...
BACKGROUND
Implementation science has progressed towards increased use of theoretical approaches to provide better understanding and explanation of how and why implementation succeeds or fails. The aim of this article is to propose a taxonomy that distinguishes between different categories of theories, models and frameworks in implementation science, to facilitate appropriate selection and application of relevant approaches in implementation research and practice and to foster cross-disciplinary dialogue among implementation researchers.
DISCUSSION
Theoretical approaches used in implementation science have three overarching aims: describing and/or guiding the process of translating research into practice (process models); understanding and/or explaining what influences implementation outcomes (determinant frameworks, classic theories, implementation theories); and evaluating implementation (evaluation frameworks). This article proposes five categories of theoretical approaches to achieve three overarching aims. These categories are not always recognized as separate types of approaches in the literature. While there is overlap between some of the theories, models and frameworks, awareness of the differences is important to facilitate the selection of relevant approaches. Most determinant frameworks provide limited "how-to" support for carrying out implementation endeavours since the determinants usually are too generic to provide sufficient detail for guiding an implementation process. And while the relevance of addressing barriers and enablers to translating research into practice is mentioned in many process models, these models do not identify or systematically structure specific determinants associated with implementation success. Furthermore, process models recognize a temporal sequence of implementation endeavours, whereas determinant frameworks do not explicitly take a process perspective of implementation.
Topics: Evidence-Based Medicine; Humans; Models, Organizational; Program Development; Translational Research, Biomedical
PubMed: 25895742
DOI: 10.1186/s13012-015-0242-0 -
Clinical Journal of the American... May 2016Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. However, health care...
Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. However, health care professionals often lack training in quality improvement methods, which makes it challenging to participate in improvement efforts. This article familiarizes health care professionals with how to begin a quality improvement project. The initial steps involve forming an improvement team that possesses expertise in the quality of care problem, leadership, and change management. Stakeholder mapping and analysis are useful tools at this stage, and these are reviewed to help identify individuals who might have a vested interest in the project. Physician engagement is a particularly important component of project success, and the knowledge that patients/caregivers can offer as members of a quality improvement team should not be overlooked. After a team is formed, an improvement framework helps to organize the scientific process of system change. Common quality improvement frameworks include Six Sigma, Lean, and the Model for Improvement. These models are contrasted, with a focus on the Model for Improvement, because it is widely used and applicable to a variety of quality of care problems without advanced training. It involves three steps: setting aims to focus improvement, choosing a balanced set of measures to determine if improvement occurs, and testing new ideas to change the current process. These new ideas are evaluated using Plan-Do-Study-Act cycles, where knowledge is gained by testing changes and reflecting on their effect. To show the real world utility of the quality improvement methods discussed, they are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). This provides an example that kidney health care professionals can use to begin their own quality improvement projects.
Topics: Hemodialysis, Home; Humans; Leadership; Models, Organizational; Nephrology; Organizational Innovation; Outcome and Process Assessment, Health Care; Program Development; Quality Improvement; Total Quality Management
PubMed: 27016497
DOI: 10.2215/CJN.11491015 -
MedEdPORTAL : the Journal of Teaching... Aug 2018Effective mentoring can contribute to wellness and career growth and satisfaction. However, the same social forces and interpersonal dynamics affecting all relationships...
INTRODUCTION
Effective mentoring can contribute to wellness and career growth and satisfaction. However, the same social forces and interpersonal dynamics affecting all relationships can compromise mentoring relationships. This is especially true when there are issues that are compounded by structural disadvantage due to racism, gender bias, social class, and other discriminatory factors. The Mentoring Across Differences (MAD) sessions are a workshop designed to develop and nurture skills, tools, self-awareness, and mindful practice in mentors and mentees. The workshop encourages participants to gain confidence in navigating differences across a variety of domains.
METHODS
We designed interactive sessions for faculty as part of a nine-part training series on mentoring in an academic setting. Teaching methods drew from adult learning theory. We used cases distilled from real teaching and mentoring experiences to trigger discussion and activate emotion and intrinsic motivation. Participants' prior knowledge and experience were drawn on to cocreate knowledge through small-group peer learning.
RESULTS
As part of a course, 167 participants completed the sessions; several hundred more people participated in them in faculty development venues. Participants highly rated the open discussions regarding differences and enhanced awareness of their assumptions, specifically highlighting knowledge and tools addressing bias in their roles as mentors and teachers.
DISCUSSION
The MAD sessions function both as an important module in a comprehensive mentoring curriculum and as stand-alone sessions. They fill a critical need of faculty and training institutions to explore difference in order to foster diversity and inclusion.
Topics: Adult; Career Mobility; Choice Behavior; Cultural Competency; Faculty, Medical; Female; Humans; Male; Mentoring; Mentors; Middle Aged; Professional Role; Program Development; Race Factors; Students, Medical
PubMed: 30800943
DOI: 10.15766/mep_2374-8265.10743 -
American Journal of Pharmaceutical... Apr 2023The syllabus is the cornerstone for directing faculty and student interaction within the didactic and experiential settings. Within each syllabus is both essential and... (Review)
Review
The syllabus is the cornerstone for directing faculty and student interaction within the didactic and experiential settings. Within each syllabus is both essential and optional information to guide students, faculty, and administration in course expectations as well as to explain how the course aligns within current curricular requirements to maintain program accreditation. Most syllabi contain a plethora of information that continues to grow each year, warranting concerns of syllabus bloat combined with dwindling student attention to syllabus detail. This paper summarizes best practices related to designing effective course syllabi and recommendations to promote clear and concise communication between students, faculty, and administrators involved in pharmacy education.
Topics: Humans; Education, Pharmacy; Curriculum; Students, Pharmacy; Faculty; Program Development
PubMed: 35487683
DOI: 10.5688/ajpe8995 -
CMAJ : Canadian Medical Association... Nov 2021
Topics: Algorithms; Clinical Decision-Making; Data Accuracy; Decision Support Systems, Clinical; Humans; Implementation Science; Machine Learning; Outcome Assessment, Health Care; Program Development; Program Evaluation; Quality Improvement; Stakeholder Participation; Workflow
PubMed: 34750183
DOI: 10.1503/cmaj.202434-f -
American Journal of Pharmaceutical... Jun 2017To describe characteristics of faculty development programs designed to facilitate interprofessional education, and to compile recommendations for development,... (Review)
Review
To describe characteristics of faculty development programs designed to facilitate interprofessional education, and to compile recommendations for development, delivery, and assessment of such faculty development programs. MEDLINE, CINAHL, ERIC, and Web of Science databases were searched using three keywords: faculty development, interprofessional education, and health professions. Articles meeting inclusion criteria were analyzed for emergent themes, including program design, delivery, participants, resources, and assessment. Seventeen articles were identified for inclusion, yielding five characteristics of a successful program: institutional support; objectives and outcomes based on interprofessional competencies; focus on consensus-building and group facilitation skills; flexibility based on institution- and participant-specific characteristics; and incorporation of an assessment strategy. The themes and characteristics identified in this literature overview may support development of faculty development programs for interprofessional education. An advanced evidence base for interprofessional education faculty development programs is needed.
Topics: Education, Pharmacy; Faculty; Health Occupations; Humans; Interdisciplinary Studies; Interprofessional Relations; Program Development
PubMed: 28720924
DOI: 10.5688/ajpe81596 -
International Journal of Environmental... Jun 2022The SAVING project aimed to create a sustainable and active aging program to promote the transition to sustainable aging in residential structures for the elderly...
The SAVING project aimed to create a sustainable and active aging program to promote the transition to sustainable aging in residential structures for the elderly (RSEs), developing research activities to apply the best strategies and good practices regarding the promotion of an active, healthy, and sustainable aging regarding social, economic, environmental, and pedagogic aspects. All this innovative methodology was built on a living-lab approach applied in one RSE, that was used as a case study. The results showed that the creation of the SAVING Brigade allowed not only increased reflection and mutual learning, but also created better conditions to face uncertainties and obstacles. Moreover, the use of indicators supported the basic themes and enabled comparison with other studies, between institutions or programs. Finally, the Action Plan acted as a tool for the development of previously defined strategies. It is possible to conclude that the breadth of the concept of quality of life encompasses the physical health of the individual, their psychological state, their social relationships, their perceptions, and the relationship with the characteristics of the context in which they are inserted. Therefore, active, sustainable, and healthy aging should be the goal.
Topics: Aged; Aging; Humans; Program Development; Quality of Life
PubMed: 35682385
DOI: 10.3390/ijerph19116803 -
American Journal of Pharmaceutical... Jan 2023To design and assess the use of a pharmacy student-delivered preceptor development program. A student-delivered preceptor development program was developed to ensure...
To design and assess the use of a pharmacy student-delivered preceptor development program. A student-delivered preceptor development program was developed to ensure all preceptors received documented preceptor development. A menu of discussion topics and associated teaching sheets were created by the school's office of experiential education. On each rotation, advanced pharmacy practice experience (APPE) students led discussions with their preceptors on a topic chosen by the preceptor and submitted documentation of the education. Preceptors answered a survey related to the amount of information and time required for the program, their preference for different formats of preceptor development, one important thing they learned through the program, and future development topics of interest. Students were interviewed regarding their perceptions and use of the program. A novel student-delivered preceptor development program resulted in documentation of preceptor development for all APPE rotations. Seventy-nine preceptors (31% response rate) participated in the survey. In their responses, preceptors generally agreed that they were able to customize their development and incorporate what they learned into practice, and that the program had a convenient format and was valuable for preparing students to be future preceptors. Students reported that the program improved their confidence in communicating with a supervisor and prepared them for precepting. A student-delivered preceptor development program improved documented preceptor development. The program allowed preceptors to customize development opportunities in a convenient format. It was perceived positively by preceptors who would recommend the program to other schools of pharmacy.
Topics: Humans; Education, Pharmacy; Students, Pharmacy; Preceptorship; Problem-Based Learning; Curriculum; Program Development
PubMed: 35078766
DOI: 10.5688/ajpe8939 -
Medical Education Online Dec 2024This article provides structure to developing, implementing, and evaluating a successful coaching program that effectively meets the needs of learners. We highlight the... (Review)
Review
This article provides structure to developing, implementing, and evaluating a successful coaching program that effectively meets the needs of learners. We highlight the benefits of coaching in medical education and recognize that many educators desiring to build coaching programs seek resources to guide this process. We align 12 tips with Kern's Six Steps for Curriculum Development and integrate theoretical frameworks from the literature to inform the process. Our tips include defining the reasons a coaching program is needed, learning from existing programs and prior literature, conducting a needs assessment of key stakeholders, identifying and obtaining resources, developing program goals, objectives, and approach, identifying coaching tools, recruiting and training coaches, orienting learners, and evaluating program outcomes for continuous program improvement. These tips can serve as a framework for initial program development as well as iterative program improvement.
Topics: Humans; Mentoring; Education, Medical; Program Development; Curriculum; Clinical Competence
PubMed: 38051864
DOI: 10.1080/10872981.2023.2289262