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Medicina (Kaunas, Lithuania) Sep 2023Robotic surgical systems have rapidly become integrated into colorectal surgery practice in recent years, particularly for rectal resections, where the advantages of... (Review)
Review
Robotic surgical systems have rapidly become integrated into colorectal surgery practice in recent years, particularly for rectal resections, where the advantages of robotic platforms over conventional laparoscopy are more pronounced. However, as with any technological advancement, the initial high costs can be a limiting factor, leading to unequal health service access, especially in middle- and lower-income countries. A narrative review was conducted with the objective of providing an overview of the escalating adoption, current training programmes, and certification process of robotic colorectal surgery in Brazil. Brazil has witnessed a rapid increase in robotic platforms in recent years. Currently, there are 106 robotic systems installed nationwide. However, approximately 60% of the medical facilities which adopted robotic platforms are in the Southeast region, which is both the most populous and economically prosperous in the country. The Brazilian Society of Coloproctology recently established clear rules for the training programme and certification of colorectal surgeons in robotic surgery. The key components of the training encompass theoretical content, virtual robotic simulation, observation, assistance, and supervised procedures in colorectal surgery. Although the training parameters are well established, no colorectal surgery residency programme in Brazil has yet integrated the teaching and training of robotic surgery into its curriculum. Thus far, the training process has been led by private institutions and the industry. : Despite the fast spread of robotic platforms across Brazil, several challenges still need to be addressed to democratise training and promote the widespread use of these platforms. It is crucial to tackle these obstacles to achieve greater integration of robotic technology in colorectal surgery throughout the country.
Topics: Humans; Robotic Surgical Procedures; Brazil; Colorectal Surgery; Robotics; Digestive System Surgical Procedures
PubMed: 37763794
DOI: 10.3390/medicina59091675 -
BMC Medical Education Oct 2023Problem-based learning (PBL) is a pedagogy involving self-directed learning in small groups around case problems. Group function is important to PBL outcomes, but there...
BACKGROUND
Problem-based learning (PBL) is a pedagogy involving self-directed learning in small groups around case problems. Group function is important to PBL outcomes, but there is currently poor scaffolding around key self-reflective practices that necessarily precedes students' and tutors' attempts to improve group function. This study aims to create a structured, literature-based and stakeholder-informed tool to help anchor reflective practices on group function. This article reports on the development process and perceived utility of this tool.
METHODS
Tool development unfolded in four steps: 1) a literature review was conducted to identify existent evaluation tools for group function in PBL, 2) literature findings informed the development of this new tool, 3) a group of PBL experts were consulted for engagement with and feedback of the tool, 4) four focus groups of stakeholders (medical students and tutors with lived PBL experiences) commented on the tool's constructs, language, and perceived utility. The tool underwent two rounds of revisions, informed by the feedback from experts and stakeholders.
RESULTS
Nineteen scales relating to group function assessment were identified in the literature, lending 18 constructs that mapped into four dimensions: Learning Climate, Facilitation and Process, Engagement and Interactivity, and Evaluation and Group Improvement. Feedback from experts informed the addition of missing items. Focus group discussions allowed further fine-tuning of the organization and language of the tool. The final tool contains 17 descriptive items under the four dimensions. Users are asked to rate each dimension holistically on a 7-point Likert scale and provide open comments. Researchers, faculty, and students highlighted three functions the tool could perform: (1) create space, structure, and language for feedback processes, (2) act as a reference, resource, or memory aid, and (3) serve as a written record for longitudinal benchmarking. They commented that the tool may be particularly helpful for inexperienced and poor-functioning groups, and indicated some practical implementation considerations.
CONCLUSION
A four-dimension tool to assist group function reflection in PBL was produced. Its constructs were well supported by literature and experts. Faculty and student stakeholders acknowledged the utility of this tool in addressing an acknowledged gap in group function reflection in PBL.
Topics: Humans; Curriculum; Education, Medical, Undergraduate; Learning; Problem-Based Learning; Students, Medical
PubMed: 37817205
DOI: 10.1186/s12909-023-04726-y -
Journal of Educational Evaluation For... 2024Despite explicit expectations and accreditation requirements for integrated curriculum, there needs to be more clarity around an accepted common definition, best... (Review)
Review
Despite explicit expectations and accreditation requirements for integrated curriculum, there needs to be more clarity around an accepted common definition, best practices for implementation, and criteria for successful curriculum integration. To address the lack of consensus surrounding integration, we reviewed the literature and herein propose a definition for curriculum integration for the health professions education audience. We further believe that health professions education is ready to move beyond "horizontal" (one-dimensional) and "vertical" (two-dimensional) integration and propose a model of "six degrees of curriculum integration" to expand the two-dimensional concept for future designs of health professions programs and best prepare learners to meet the needs of patients. These six degrees include: interdisciplinary, timing and sequencing, instruction and assessment, incorporation of basic and clinical sciences, knowledge and skills-based competency progression, and graduated responsibilities in patient care. We encourage medical educators to look beyond two-dimensional integration to best prepare physicians of the future.
Topics: Curriculum; Humans; Education, Medical; Clinical Competence; Accreditation; Models, Educational
PubMed: 38872249
DOI: 10.3352/jeehp.2024.21.15 -
European Journal of Dental Education :... May 2024Community education programmes are vital tools for teaching skills, such as understanding the larger cultural, economic and social determinants of health and how these... (Review)
Review
BACKGROUND
Community education programmes are vital tools for teaching skills, such as understanding the larger cultural, economic and social determinants of health and how these factors impact people's health. It is currently unclear whether community education programmes in the field of dentistry deliver adequate value. This review aims to scope, collate and analyse globally published evidence concerning community education programmes in dentistry from inception, to gain an understanding of the intentions for these programmes and establish whether outcomes have shifted over time from the original intentions.
METHODS
Arksey and O'Malley's framework for scoping reviews was employed to guide the reviewers. A systematic search of electronic databases and the reference lists in key papers was conducted.
RESULTS
A systematic search concerning community education in dentistry identified a total of 140 papers for full-text evaluations. After further exclusions, 115 articles were selected for data charting. There was a lack of clarity in the literature concerning programmes' definitions and strategies for achieving intentions. Origins, intentions and motivations of the programmes were identified. The literature largely focused on assessing students' clinical treatment skills, contradicting the programme's original idea and intentions. Only a few studies incorporated patient and community perspectives, and the majority of assessments were self-reported, primarily by students.
CONCLUSIONS
There is broad interest in integrating community education into dental curricula to teach complex concepts, dental public health principles and to ensure professional skills development. We identified issues in the literature around programme definitions, strategies, measurement approaches and programme success requiring additional research.
Topics: Humans; Education, Dental; Curriculum; Students; Motivation; Intention
PubMed: 38147469
DOI: 10.1111/eje.12986 -
BMC Medical Education Dec 2023Postgraduate medical education in oncology orthopedics confronts obstacles when instructing on pelvic tumors, primarily due to their intricate anatomy and the...
Three-Dimensional Multimodality Image Reconstruction as Teaching Tool for Case-based learning among medical postgraduates: a focus on primary pelvic bone Tumour Education.
BACKGROUND
Postgraduate medical education in oncology orthopedics confronts obstacles when instructing on pelvic tumors, primarily due to their intricate anatomy and the limitations of conventional teaching techniques. The employment of Three-dimensional multimodality imaging (3DMMI) can be considered a valuable teaching tool, as it gracefully elucidates the intricacies of pelvic anatomical structures and the interactions between tumors and surrounding tissues through three-dimensional imaging, thereby providing a comprehensive and nuanced perspective. This study aimed to assess the feasibility and effectiveness of incorporating 3DMMI in combination with a Case-Based Learning (CBL) approach for postgraduate education.
METHODS
The study encompassed a 10-week course involving 90 surgical postgraduates, focusing on common pelvic tumor diseases. Students were assigned representative clinical cases, and each group created a PowerPoint presentation based on these cases. The core educational content included fundamental knowledge of pelvic anatomy, as well as clinical presentations, radiological features, and treatment principles of common pelvic tumor diseases. The research compared two groups: a traditional CBL group (n = 45) and a 3DMMI-CBL group (n = 45). The 3DMMI-CBL group had access to advanced imaging technology for better visualization. Various evaluations, including image interpretation, theoretical knowledge, and questionnaires, were used to assess the learning outcomes.
RESULTS
The 3DMMI-CBL group outperformed the CBL group not only in the imaging diagnosis of common pelvic diseases but also in their mastery of the related theoretical knowledge. Student questionnaires indicated higher scores for the 3DMMI-CBL group in basic pelvic anatomy knowledge (8.08 vs. 6.62, p < 0.01), image interpretation (8.15 vs. 6.69, p < 0.01), learning efficiency (8.07 vs. 7.00, p < 0.01), clinical reasoning (7.57 vs. 6.77, p < 0.01), and learning interest (8.46 vs. 7.00, p < 0.01). Teacher questionnaires revealed that 3DMMI technology enhanced teachers' clinical knowledge, facilitated instruction, and increased overall satisfaction and interest in teaching.
CONCLUSION
Our study introduced an enhancement to the conventional Case-Based Learning (CBL) model by incorporating 3DMMI technology for visualizing pelvic anatomy. In contrast to pure CBL, this adaptation improved teacher instruction, substantially heightened student engagement, ignited greater interest in learning, and boosted overall efficiency, ultimately leading to positive learning outcomes. Consequently, our study demonstrated the potential feasibility and acceptability of the 3DMMI-CBL teaching method for postgraduates in pelvic bone tumor education.
Topics: Humans; Imaging, Three-Dimensional; Pelvic Neoplasms; Learning; Education, Medical; Students; Teaching
PubMed: 38087270
DOI: 10.1186/s12909-023-04916-8 -
Diagnosis (Berlin, Germany) Aug 2023Clinical reasoning is a complex and crucial ability health professions students need to acquire during their education. Despite its importance, explicit clinical...
Clinical reasoning is a complex and crucial ability health professions students need to acquire during their education. Despite its importance, explicit clinical reasoning teaching is not yet implemented in most health professions educational programs. Therefore, we carried out an international and interprofessional project to plan and develop a clinical reasoning curriculum with a train-the-trainer course to support educators in teaching this curriculum to students. We developed a framework and curricular blueprint. Then we created 25 student and 7 train-the-trainer learning units and we piloted 11 of these learning units at our institutions. Learners and faculty reported high satisfaction and they also provided helpful suggestions for improvements. One of the main challenges we faced was the heterogeneous understanding of clinical reasoning within and across professions. However, we learned from each other while discussing these different views and perspectives on clinical reasoning and were able to come to a shared understanding as the basis for developing the curriculum. Our curriculum fills an important gap in the availability of explicit clinical reasoning educational materials both for students and faculty and is unique with having specialists from different countries, schools, and professions. Faculty time and time for teaching clinical reasoning in existing curricula remain important barriers for implementation of clinical reasoning teaching.
Topics: Humans; Curriculum; Learning; Clinical Reasoning
PubMed: 36800998
DOI: 10.1515/dx-2022-0103 -
JMIR Research Protocols Dec 2023Competency-based education (CBE) for midwifery programs is a system of academic instruction and evaluation that aims to achieve proficiency in midwifery student learning...
BACKGROUND
Competency-based education (CBE) for midwifery programs is a system of academic instruction and evaluation that aims to achieve proficiency in midwifery student learning outcomes, which is based on students' ability to demonstrate the knowledge, attitudes, self-perceptions, and skills of a predetermined set of educational activities in theory and practice. CBE focuses on ensuring that midwifery students can develop critical thinking abilities, values, and the clinical decision-making abilities needed for the delivery of safe care in future practice.
OBJECTIVE
The objective of this scoping review is to map and synthesize existing literature on the implementation of CBE for midwifery programs and its sustainability in Africa.
METHODS
We will use the Arksey and O'Malley approach for scoping reviews for the research methodology. The 3-stage search process, proposed by the Joanna Briggs Institute, will be used to determine the eligibility of published and unpublished studies. PubMed, Science Direct, Web of Science, CINAHL, PsycINFO, and Scopus will be searched to screen published articles. ProQuest Dissertations and Theses and Google Scholar will be used to search for unpublished studies. Findings will only apply to studies conducted in Africa from 2010 to the present year in English. The 2 reviewers will work independently to carefully screen and compare the full text of the selected citations to the inclusion criteria. In the event of any disagreements between the 2 reviewers at any stage of the selection process regarding the inclusion of an article, this will be settled by discussion or consultation with a third reviewer. The extracted data will be presented using a PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review) flow diagram with an attached narrative summary. The review will summarize and disseminate findings on the implementation of the CBE for midwifery programs and its sustainability in Africa.
RESULTS
It is intended that this scoping review will be completed within 6 months following the publication of this protocol.
CONCLUSIONS
The conclusions from this scoping review will inform midwifery educators, institutions, policy makers, and other stakeholders on the strategies to implement and sustain CBE for midwifery programs in Africa.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
PRR1-10.2196/47603.
PubMed: 38048157
DOI: 10.2196/47603 -
Bioinformatics (Oxford, England) Aug 2023Many existing software libraries for genomics require researchers to pick between competing considerations: the performance of compiled languages and the accessibility...
SUMMARY
Many existing software libraries for genomics require researchers to pick between competing considerations: the performance of compiled languages and the accessibility of interpreted languages. Go, a modern compiled language, provides an opportunity to address this conflict. We introduce Gonomics, an open-source collection of command line programs and bioinformatic libraries implemented in Go that unites readability and performance for genomic analyses. Gonomics contains packages to read, write, and manipulate a wide array of file formats (e.g. FASTA, FASTQ, BED, BEDPE, SAM, BAM, and VCF), and can convert and interface between these formats. Furthermore, our modular library structure provides a flexible platform for researchers developing their own software tools to address specific questions. These commands can be combined and incorporated into complex pipelines to meet the growing need for high-performance bioinformatic resources.
AVAILABILITY AND IMPLEMENTATION
Gonomics is implemented in the Go programming language. Source code, installation instructions, and documentation are freely available at https://github.com/vertgenlab/gonomics.
Topics: Comprehension; Genomics; Computational Biology; Programming Languages; Documentation
PubMed: 37624924
DOI: 10.1093/bioinformatics/btad516 -
Health Literacy Research and Practice Aug 2023Effective communication with patients and between members of the health care team are important strategies to enhance health care outcomes. Despite the prevalence of low...
Effective communication with patients and between members of the health care team are important strategies to enhance health care outcomes. Despite the prevalence of low health literacy and associated risks in the population, health professionals are often not trained adequately in health literacy communication practices. The purpose of this pilot program is to determine if offering learners an opportunity to practice health literacy communication techniques in a simulated patient care team can increase skills, attitudes, and confidence in this important area of patient care. We implemented a novel, team-based interprofessional Objective Structured Clinical Examination (iOSCE) focused on health literacy. Evaluation took place on three levels: student self-assessment of health literacy communication skills and beliefs about interprofessional teamwork, standardized patient assessment of skills during the clinical encounter, and observer assessment of interprofessional teamwork. Statistically significant gains were seen in students' health literacy communication confidence, as well as beliefs, attitudes and understanding of interprofessional teamwork. The aim of this article is to describe our pilot health literacy iOSCE findings. This pilot shows that an OSCE is an effective assessment tool for a mix of health professional learners at different levels to demonstrate health literacy practices in an interprofessional teamwork environment. [].
Topics: Humans; Interprofessional Relations; Health Literacy; Health Personnel; Patient Simulation
PubMed: 37552489
DOI: 10.3928/24748307-20230713-01