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Scientific Reports Nov 2023A physical trainer often physically guides a learner's limbs to teach an ideal movement, giving the learner proprioceptive information about the movement to be...
A physical trainer often physically guides a learner's limbs to teach an ideal movement, giving the learner proprioceptive information about the movement to be reproduced later. This instruction requires the learner to perceive kinesthetic information and store the instructed information temporarily. Therefore, (1) proprioceptive acuity to accurately perceive the taught kinesthetics and (2) short-term memory to store the perceived information are two critical functions for reproducing the taught movement. While the importance of proprioceptive acuity and short-term memory has been suggested for active motor learning, little is known about passive motor learning. Twenty-one healthy adults (mean age 25.6 years, range 19-38 years) participated in this study to investigate whether individual learning efficiency in passively guided learning is related to these two functions. Consequently, learning efficiency was significantly associated with short-term memory capacity. In particular, individuals who could recall older sensory stimuli showed better learning efficiency. However, no significant relationship was observed between learning efficiency and proprioceptive acuity. A causal graph model found a direct influence of memory on learning and an indirect effect of proprioceptive acuity on learning via memory. Our findings suggest the importance of a learner's short-term memory for effective passive motor learning.
Topics: Adult; Humans; Young Adult; Memory, Short-Term; Psychomotor Performance; Proprioception; Learning; Kinesthesis
PubMed: 38012253
DOI: 10.1038/s41598-023-48101-9 -
Medical Science Educator Aug 2023Ultrasound (US) is increasingly used across medical specialities as a diagnostic tool and medical faculties are therefore further incorporating imaging into their...
UNLABELLED
Ultrasound (US) is increasingly used across medical specialities as a diagnostic tool and medical faculties are therefore further incorporating imaging into their programmes. Using US within undergraduate instruction has several benefits. US, as a learning instrument, may strengthen existing anatomical knowledge and improve visual understanding of anatomy. The cost-effectiveness, as well as portability of the US, makes it a valuable means to add to traditional anatomy teaching modalities. Furthermore, students have an opportunity to develop skills in interpreting US images and this may add a different element to the learning of anatomy. This study aimed to explore undergraduate clinical anatomy students' perceptions of the use of US as an add-on to cadaveric dissection. Students were invited to participate in virtual focus group discussions. Three virtual focus group discussions were conducted, and 11 participants volunteered to take part. Thematic analysis of the data generated six themes. These are described as , , , , , and . The results suggest that it is feasible and advantageous to implement US sessions as an add-on to the teaching of anatomy during practical dissection sessions of clinical anatomy students. The use of innovative technologies such as US enhances the interest of students and allows them to develop dexterity and competencies in their learning process.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s40670-023-01806-y.
PubMed: 37546191
DOI: 10.1007/s40670-023-01806-y -
Surgery For Obesity and Related... Jan 2024Physical activity (PA) is important for the long-term health and weight management of patients who undergo metabolic and bariatric surgery (MBS). However, the roles of... (Review)
Review
BACKGROUND
Physical activity (PA) is important for the long-term health and weight management of patients who undergo metabolic and bariatric surgery (MBS). However, the roles of exercise professionals in MBS settings have not been systematically determined.
OBJECTIVES
To investigate: (1) who are the professionals implementing PA programming in MBS clinical settings; and (2) what patient-centric tasks do they perform?
SETTING
Clinical and academic exercise settings worldwide.
METHODS
This multimethod study included a scoping review of PA programs in MBS described in the research literature. Data about job tasks were extracted and provided to 10 experts to sort into categories. Cluster analysis was utilized to find the hierarchical structure of tasks. A Delphi process was used to agree on a final model.
RESULTS
The majority of PA professionals were exercise physiologists in the USA and physiotherapists or other types of exercise professionals elsewhere. Forty-three tasks were identified, the most reported being supervision of exercise, fitness testing, and exercise prescription. Seven higher-order categories were determined: (1) Exercise-related health assessment, (2) Body composition and physical fitness assessment, (3) Lifestyle physical activity and sedentary behavior assessment, (4) Education, instruction, and prescription, (5) Exercise monitoring, (6) Behavioral counseling and psychosocial support, and (7) Dietary support. The following statements were rated an average of 9.0, classifying them as "imperative": 1) "Pre- and postoperative PA/exercise guidelines for MBS patients are needed", 2) "MBS programs need to include PA/exercise as part of multidisciplinary care".
CONCLUSIONS
The expert group reached a consensus on 7 major classifications of job tasks for the exercise professional. It is important for governing medical associations across the world to formally recognize experienced exercise professionals as playing pivotal roles in continuing, multidisciplinary care for MBS patients. These findings also provide evidence-based information in the effort to solidify these positions within the greater context of healthcare.
Topics: Humans; Exercise; Bariatric Surgery; Exercise Therapy; Life Style; Physical Fitness
PubMed: 38238107
DOI: 10.1016/j.soard.2023.09.026 -
Journal of Applied Clinical Medical... Oct 2023Northwest Medical Physics Center (NMPC) is a nonprofit organization that provides clinical physics support to over 35 radiation therapy facilities concentrated in the... (Review)
Review
Northwest Medical Physics Center (NMPC) is a nonprofit organization that provides clinical physics support to over 35 radiation therapy facilities concentrated in the Pacific Northwest. Although clinical service is the primary function of NMPC, the diverse array of clinical sites and physics expertise has allowed for the establishment of structured education and research programs, which are complementary to the organization's clinical mission. Three clinical training programs have been developed at NMPC: a therapy medical physics residency program accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), an Applied Physics Technologist (APT) program, and a summer undergraduate internship program. A partnership has also been established with a major radiation oncology clinical vendor for the purposes of validating and testing new clinical devices across multiple facilities. These programs are managed by a dedicated education and research team at NMPC, made up of four qualified medical physicists (QMPs). The education and research work has made a significant contribution to the organization's clinical mission, and it has provided new training opportunities for early-career physicists across many different clinical environments. Education and research can be incorporated into nonacademic clinical environments, improving the quality of patient care, and increasing the number and type of training opportunities available for medical physicists.
Topics: Humans; Clinical Competence; Curriculum; Education, Medical; Health Physics; Internship and Residency; Radiation Oncology
PubMed: 37602785
DOI: 10.1002/acm2.14124 -
BMC Medical Education May 2024Medical simulation is essential for surgical training yet is often too expensive and inaccessible in low- and middle-income countries (LMICs). Furthermore, in... (Review)
Review
BACKGROUND
Medical simulation is essential for surgical training yet is often too expensive and inaccessible in low- and middle-income countries (LMICs). Furthermore, in otolaryngology-head and neck surgery (OHNS), while simulation training is often focused on senior residents and specialists, there is a critical need to target general practitioners who carry a significant load of OHNS care in countries with limited OHNS providers. This scoping review aims to describe affordable, effective OHNS simulation models for early-stage trainees and non-OHNS specialists in resource-limited settings and discuss gaps in the literature.
METHODS
This scoping review followed the five stages of Arksey and O'Malley's Scoping Review Methodology. Seven databases were used to search for articles. Included articles discussed physical models of the ear, nose, or throat described as "low-cost," "cost-effective," or defined as <$150 if explicitly stated; related to the management of common and emergent OHNS conditions; and geared towards undergraduate students, medical, dental, or nursing students, and/or early-level residents.
RESULTS
Of the 1706 studies screened, 17 met inclusion criteria. Most studies were conducted in HICs. Most models were low-fidelity (less anatomically realistic) models. The most common simulated skills were peritonsillar abscess aspiration and cricothyrotomy. Information on cost was limited, and locally sourced materials were infrequently mentioned. Simulations were evaluated using questionnaires and direct observation.
CONCLUSION
Low-cost simulation models can be beneficial for early medical trainees and students in LMICs, addressing resource constraints and improving skill acquisition. However, there is a notable lack of contextually relevant, locally developed, and cost-effective models. This study summarizes existing low-cost OHNS simulation models for early-stage trainees and highlights the need for additional locally sourced models. Further research is needed to assess the effectiveness and sustainability of these models.
Topics: Humans; Otolaryngology; Simulation Training; Clinical Competence; Internship and Residency; Cost-Benefit Analysis; Developing Countries
PubMed: 38693491
DOI: 10.1186/s12909-024-05466-3 -
Revista Brasileira de Enfermagem 2023to outline the teaching of ethics in undergraduate Nursing programs in Brazilian public higher education institutions. (Review)
Review
OBJECTIVES
to outline the teaching of ethics in undergraduate Nursing programs in Brazilian public higher education institutions.
METHODS
descriptive and exploratory study, carried out through the documentary analysis of pedagogical projects of undergraduate Nursing programs in Brazil.
RESULTS
153 active undergraduate Nursing programs were found, of which 106 provide the pedagogical project. In addition to deontological teaching, the teaching of ethics was identified in a transversal way associated with themes such as Social Context, Hospital and Community Care, Pharmacology, Systematization of Nursing Care, Surgical Nursing, Epidemiology, Palliative Care, Management in Nursing, Diversity, Women's, Children's, Adolescent's, Adult's and Older People's Health, and Mental Health.
FINAL CONSIDERATIONS
the challenge in teaching nursing ethics is its integration with each action of caring, teaching and managing.
Topics: Adolescent; Adult; Aged; Child; Female; Humans; Brazil; Curriculum; Education, Nursing; Education, Nursing, Baccalaureate; Ethics, Nursing; Nursing Care; Students, Nursing; Teaching; Public Sector
PubMed: 38055529
DOI: 10.1590/0034-7167-2022-0808 -
PloS One 2023This study measured whether and to what degree Readable English effectively improves reading fluency and comprehension skills of adolescent learners.
OBJECTIVES
This study measured whether and to what degree Readable English effectively improves reading fluency and comprehension skills of adolescent learners.
METHODS
This experimental study (N = 855) measured the efficacy of two different multiple component reading programs for students in grades three, four, and five. Students were pre-and post-tested using EasyCBM Grade Level Reading Benchmarks. Students scoring at/below the 30th percentile on either benchmark were also assessed with the WRMT-3 Passage Reading Comprehension and Oral Reading Fluency measures. Students received 45-60 instructional hours in either Readable English or Amplify CKLA during their regular ELA class.
RESULTS
Students who received Readable English instruction significantly outperformed students in the typical practice condition on all measures of reading fluency and comprehension. The intervention condition's EasyCBM benchmark reading rate (m = 29.6 WCPM), reading accuracy (m = 3.1%), and comprehension (m = 1.9) surpassed the control group's reading rate (m = 17.4 WCPM), accuracy (m = 0.7%), and comprehension (m = 0.7) WRMT-3 ORF showed students in the Readable English intervention condition (m = 13.4 growth scale values [GSV] and m = 1.0 grade equivalency) outscored students in the control condition (m = 7.8 GSV and m = 0.5 grade equivalency). WRMT-3 Passage Comprehension showed Readable English students (m = 11.0 GSV and m = 0.9 grade equivalency) outgrew control condition students (m = 4.4 GSV and m = 0.3 grade equivalency).
CONCLUSIONS
In a school year fraught with pandemic instructional interruptions and learning loss, students in grades 3-5 who received Readable English instruction closed reading gaps. The meaningful gains in reading rate and accuracy experienced by students in the intervention group will give exponential word reading volume dividends to students able to read text faster and more accurately going forward, helping them become more skilled readers.
Topics: Adolescent; Humans; Child; Reading; Comprehension; Learning; Students; Schools
PubMed: 37471394
DOI: 10.1371/journal.pone.0288292 -
MedRxiv : the Preprint Server For... Aug 2023Physical activity (PA) is important for the long-term health and weight management of patients who undergo metabolic and bariatric surgery (MBS). However, the roles of...
BACKGROUND
Physical activity (PA) is important for the long-term health and weight management of patients who undergo metabolic and bariatric surgery (MBS). However, the roles of exercise professionals in MBS settings have not been systematically determined.
OBJECTIVES
To investigate: (1) who are the professionals implementing PA programming in MBS clinical settings; and (2) what patient-centric tasks do they perform?
SETTING
Clinical and academic exercise settings worldwide.
METHODS
This multimethod study included a scoping review of PA programs in MBS described in the research literature. Data about job tasks were extracted and provided to 10 experts to sort into categories. Cluster analysis was utilized to find the hierarchical structure of tasks. A Delphi process was used to agree on a final model.
RESULTS
The majority of PA professionals were exercise physiologists in the USA and physiotherapists or other types of exercise professionals elsewhere. Forty-three tasks were identified, the most reported being: supervision of exercise, fitness testing, and exercise prescription. Seven higher-order categories were determined: (1) Exercise-related health assessment, (2) Body composition and physical fitness assessment, (3) Lifestyle physical activity and sedentary behavior assessment, (4) Education, instruction, and prescription, (5) Exercise monitoring, (6) Behavioral counseling and psychosocial support, and (7) Dietary support. The following statements were rated an average of 9.0, classifying them as "imperative": 1) "Pre- and post-operative PA/exercise guidelines for MBS patients are needed", 2) "MBS programs need to include PA/exercise as part of multidisciplinary care".
CONCLUSIONS
The expert group reached a consensus on 7 major classifications of job tasks for the exercise professional. It is important for governing medical associations across the world to formally recognize experienced exercise professionals as playing pivotal roles in continuing, multidisciplinary care for MBS patients. These findings also provide evidence-based information in the effort to solidify these positions within the greater context of healthcare.
PubMed: 37645986
DOI: 10.1101/2023.04.20.23288698 -
JMIR Medical Education Jul 2023Many health professions faculty members lack training on fundamental lesbian, gay, bisexual, transgender, and queer (LGBTQ+) health topics. Faculty development is needed...
BACKGROUND
Many health professions faculty members lack training on fundamental lesbian, gay, bisexual, transgender, and queer (LGBTQ+) health topics. Faculty development is needed to address knowledge gaps, improve teaching, and prepare students to competently care for the growing LGBTQ+ population.
OBJECTIVE
We conducted a program evaluation of the massive open online course Teaching LGBTQ+ Health: A Faculty Development Course for Health Professions Educators from the Stanford School of Medicine. Our goal was to understand participant demographics, impact, and ongoing maintenance needs to inform decisions about updating the course.
METHODS
We evaluated the course for the period from March 27, 2021, to February 24, 2023, guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. We assessed impact using participation numbers, evidence of learning, and likelihood of practice change. Data included participant demographics, performance on a pre- and postcourse quiz, open-text entries throughout the course, continuing medical education (CME) credits awarded, and CME course evaluations. We analyzed demographics using descriptive statistics and pre- and postcourse quiz scores using a paired 2-tailed t test. We conducted a qualitative thematic analysis of open-text responses to prompts within the course and CME evaluation questions.
RESULTS
Results were reported using the 5 framework domains. Regarding Reach, 1782 learners participated in the course, and 1516 (85.07%) accessed it through a main course website. Of the different types of participants, most were physicians (423/1516, 27.9%) and from outside the sponsoring institution and target audience (1452/1516, 95.78%). Regarding Effectiveness, the median change in test scores for the 38.1% (679/1782) of participants who completed both the pre- and postcourse tests was 3 out of 10 points, or a 30% improvement (P<.001). Themes identified from CME evaluations included LGBTQ+ health as a distinct domain, inclusivity in practices, and teaching LGBTQ+ health strategies. A minority of participants (237/1782, 13.3%) earned CME credits. Regarding Adoption, themes identified among responses to prompts in the course included LGBTQ+ health concepts and instructional strategies. Most participants strongly agreed with numerous positive statements about the course content, presentation, and likelihood of practice change. Regarding Implementation, the course cost US $57,000 to build and was intramurally funded through grants and subsidies. The course faculty spent an estimated 600 hours on the project, and educational technologists spent another 712 hours. Regarding Maintenance, much of the course is evergreen, and ongoing oversight and quality assurance require minimal faculty time. New content will likely include modules on transgender health and gender-affirming care.
CONCLUSIONS
Teaching LGBTQ+ Health improved participants' knowledge of fundamental queer health topics. Overall participation has been modest to date. Most participants indicated an intention to change clinical or teaching practices. Maintenance costs are minimal. The web-based course will continue to be offered, and new content will likely be added.
PubMed: 37477962
DOI: 10.2196/47777 -
Osteoarthritis and Cartilage Open Dec 2023Conservative pain management strategies for knee osteoarthritis (KOA) have limited effectiveness and do not employ a pain-mechanism informed approach. Pain Informed...
OBJECTIVE
Conservative pain management strategies for knee osteoarthritis (KOA) have limited effectiveness and do not employ a pain-mechanism informed approach. Pain Informed Movement is a novel intervention combining mind-body techniques with neuromuscular exercise and pain neuroscience education (PNE), aimed at improving endogenous pain modulation. While the feasibility and acceptability of this program has been previously established, it now requires further evaluation in comparison to standard KOA care.
DESIGN
This protocol describes the design of a pilot two-arm randomized controlled trial (RCT) with an embedded qualitative component. The primary outcome is complete follow-up rate. With an allocation ratio of 1:1, 66 participants (33/arm) (age ≥40 years, KOA diagnosis or meeting KOA NICE criteria, and pain intensity ≥3/10), will be randomly allocated to two groups that will both receive 8 weeks of twice weekly in-person exercise sessions. Those randomized to Pain Informed Movement will receive PNE and mind-body technique instruction provided initially as videos and integrated into exercise sessions. The control arm will receive neuromuscular exercise and standard OA education. Assessment will include clinical questionnaires, physical and psychophysical tests, and blood draws at baseline and program completion. Secondary outcomes are program acceptability, burden, rate of recruitment, compliance and adherence, and adverse events. Participants will be invited to an online focus group at program completion.
CONCLUSION
The results of this pilot RCT will serve as the basis for a larger multi-site RCT aimed at determining the program's effectiveness with the primary outcome of assessing the mediating effects of descending modulation on changes in pain.
PubMed: 37664870
DOI: 10.1016/j.ocarto.2023.100402