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Academic Medicine : Journal of the... Feb 2022For many persons worldwide, mental health is inseparably linked with spirituality and religion (S&R), yet psychiatrists have repeatedly expressed doubts regarding their...
PURPOSE
For many persons worldwide, mental health is inseparably linked with spirituality and religion (S&R), yet psychiatrists have repeatedly expressed doubts regarding their preparedness to address patients' spirituality or religion appropriately. In recent decades, medical educators have developed and implemented curricula for teaching S&R-related competencies to psychiatry residents. The authors reviewed the literature to understand the scope and effectiveness of these educational initiatives.
METHOD
The authors searched 8 databases to identify studies for a scoping review and a systematic review. The scoping review explored educational approaches (topics, methods) used in psychiatry residency programs to teach S&R-related competencies. The systematic review examined changes in psychiatry trainees' competencies and/or in patient outcomes following exposure to these educational interventions.
RESULTS
Twelve studies met criteria for inclusion in the scoping review. All reported providing residents with both (1) a general overview of the intersections between mental health and S&R and (2) training in relevant interviewing and assessment skills. Seven of these studies-representing an estimated 218 postgraduate psychiatry trainees and at least 84 patients-were included in the systematic review. Residents generally rated themselves as being more competent in addressing patients' S&R-related concerns following the trainings. One randomized controlled trial found that patients with severe mental illness who were treated by residents trained in S&R-related competencies attended more appointments than control patients.
CONCLUSIONS
S&R-related educational interventions appeared generally well tolerated and appreciated by psychiatry trainees and their patients; however, some topics (e.g., Alcoholics Anonymous) received infrequent emphasis, and some experiential teaching methodologies (e.g., attending chaplaincy rounds) were less frequently used for psychiatry residents than for medical students. The positive association between teaching S&R-related competencies to psychiatry residents and patient appointment attendance merits further study. Future trainings should supplement classroom learning with experiential approaches and incorporate objective measures of resident competence.
Topics: Curriculum; Education, Medical; Internship and Residency; Psychiatry; Religion; Spirituality; Students, Medical
PubMed: 34010864
DOI: 10.1097/ACM.0000000000004167 -
Journal of Advanced Nursing Jun 2024To synthesize research investigating suicide, suicide attempts, self-harm and suicide ideation in nursing and midwifery students, a group of interest due to high rates... (Review)
Review
AIM
To synthesize research investigating suicide, suicide attempts, self-harm and suicide ideation in nursing and midwifery students, a group of interest due to high rates of suicide among qualified nurses. Specific areas of interest for this review included prevalence, factors which may contribute to or mitigate risk and suicide prevention interventions.
DESIGN
A systematic review was conducted, and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed.
DATA SOURCES
Three electronic databases were searched, and additional articles identified using hand-searching. Studies were included if they examined suicide, suicide attempts, self-harm or suicide ideation in nursing or midwifery students.
REVIEW METHODS
Studies were deduplicated and assessed for inclusion. Data from included studies were extracted, quality of studies assessed and data synthesized, informed by study focus, design and assessed quality.
RESULTS
About 46 studies of largely moderate to low quality were identified. A high-quality study demonstrated increased risk of suicide in Swedish female nursing students, and increased risk of self-harm in nursing students of both sexes. Prevalence of suicide ideation did not appear to differ across course year, or between nursing students and students on other programmes. Psychiatric conditions, particularly depression, were associated with suicide ideation. Three studies related to suicide prevention interventions were identified. Integration of wellness initiatives into the curriculum and peer support were preferred interventions among nursing students and teaching staff.
CONCLUSIONS
To understand the extent of suicide and self-harm among nursing and midwifery students there is a need for further epidemiological research stratified by programme of study. To develop prevention interventions and initiatives for nursing students, high-quality longitudinal studies should examine characteristics associated with suicide and self-harm.
IMPACT
Current findings suggest interventions could include support for students experiencing mental health difficulties, foster peer support, and help develop wellness. No patient or public contribution.
Topics: Humans; Students, Nursing; Suicidal Ideation; Female; Male; Adult; Midwifery; Self-Injurious Behavior; Suicide, Attempted; Young Adult; Suicide Prevention
PubMed: 38010816
DOI: 10.1111/jan.15982 -
Journal of Robotic Surgery Apr 2023Robotic-assisted colorectal surgery (RACS) is steadily increasing in popularity with an annual growth in the number of colorectal procedures undertaken robotically.... (Review)
Review
Robotic-assisted colorectal surgery (RACS) is steadily increasing in popularity with an annual growth in the number of colorectal procedures undertaken robotically. Further upscaling of RACS requires structured and standardised robotic training to safeguard high-quality clinical outcomes. The aims of this systematic review were to assess the structure and assessment metrics of currently established RACS training programmes. A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines was performed. Searches were performed of the Ovid Medline, Embase and Web of Science databases between 2000 and 27th November 2021 to identify studies reporting on training curricula in RACS. Core components of training programmes and their relevant outcome assessment metrics were extracted. Thirteen studies were identified, with all training programmes designed for the da Vinci platform (Intuitive Surgical, Inc., Sunnyvale, CA, USA). Common elements of multimodal programmes included theoretical knowledge (76.9%), case observation (53.8%), simulation (100%) and proctored training (76.9%). Robotic skills acquisition was assessed primarily during the simulation phase (n = 4, 30.1%) and proctoring phase (n = 10, 76.9%). Performance metrics, consisting of time or assessment scores for VR simulation were only mandated in four (30.1%) studies. Objective assessment following proctored training was variably reported and employed a range of assessment metrics, including direct feedback (n = 3, 23.1%) or video feedback (n = 8, 61.5%). Five (38.4%) training programmes used the Global Assessment Score (GAS) forms. There is a broad consensus on the core multimodal components across current RACS training programmes; however, validated objective assessment is limited and needs to be appropriately standardised to ensure reproducible progression criteria and competency-based metrics are produced to robustly assess progression and competence.
Topics: Humans; Robotic Surgical Procedures; Colorectal Surgery; Clinical Competence; Robotics; Curriculum; Simulation Training
PubMed: 35657506
DOI: 10.1007/s11701-022-01421-w -
Journal of Taibah University Medical... Apr 2024This research was aimed at assessing comprehension, attitudes, and perspectives regarding artificial intelligence (AI) in dentistry. The null hypothesis was a lack of... (Review)
Review
OBJECTIVES
This research was aimed at assessing comprehension, attitudes, and perspectives regarding artificial intelligence (AI) in dentistry. The null hypothesis was a lack of foundational understanding of AI in dentistry.
METHODS
This systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted in May 2023. The eligibility criteria included cross-sectional studies published in English until July 2023, focusing solely on dentists or dental students. Data on AI knowledge, use, and perceptions were extracted and assessed for bias risk with the Joanna Briggs Institute checklist.
RESULTS
Of 408 publications, 22 relevant articles were identified, and 13 studies were included in the review. The average basic AI knowledge score was 58.62 % among dental students and 71.75 % among dentists. More dental students (72.01 %) than dentists (62.60 %) believed in AI's potential for advancing dentistry.
CONCLUSIONS
Thorough AI instruction in dental schools and continuing education programs for practitioners are urgently needed to maximize AI's potential benefits in dentistry. An integrated PhD program could drive revolutionary discoveries and improve patient care globally. Embracing AI with informed understanding and training will position dental professionals at the forefront of technological advancements in the field.
PubMed: 38293587
DOI: 10.1016/j.jtumed.2023.12.010 -
Investigacion Y Educacion En Enfermeria Jun 2023To summarize the most recent scientific evidence on the usefulness and implementation of simulation training programs for health science students. (Review)
Review
OBJECTIVE
To summarize the most recent scientific evidence on the usefulness and implementation of simulation training programs for health science students.
METHODS
A search and systematic review were conducted of the literature through the use of the PRISMA guidelines using the terms MESH Simulation AND healthcare AND Professional Training, including 42 articles.
RESULTS
The bibliometric analysis revealed that most of the studies were local in nature, that is, conducted in a single center, or in a few centers in the same region, from the English-speaking world, and using a mixed methodology with pre/post-test measurements. As for the educational aspects, most of the studies were conducted at universities or in the area of continuous education, used multidisciplinary teams as the student target, and used role-playing games as the simulation method. Also, these programs were especially successful in the acquisition of competencies, such as teamwork, communication, and trust.
CONCLUSION
Clinical simulation is a teaching methodology implemented in the last twenty years, mainly in English-speaking countries; it utilizes techniques for its execution and assessment that have been validated in contrasted in many scientific studies, and lastly, it was also observed that it is useful for providing training on general competencies for multidisciplinary groups.
Topics: Humans; Health Education; Curriculum; Students; Clinical Competence
PubMed: 38589326
DOI: 10.17533/udea.iee.v41n2e08 -
Saudi Pharmaceutical Journal : SPJ :... Dec 2023In recent years, flipped classrooms (FCs) have gained popularity in higher education, particularly among healthcare students. The FC model is a blended learning approach... (Review)
Review
BACKGROUND
In recent years, flipped classrooms (FCs) have gained popularity in higher education, particularly among healthcare students. The FC model is a blended learning approach that combines online learning with in-class activity. This has prompted many instructors to assess how they teach and prepare successful graduate students for today's society. Additionally, colleges and universities have been challenged to deliver curricula that are relevant to the needs of students and to provide the rising skills and knowledge that are expected to be acquired by students.
OBJECTIVE
This systematic review aims to evaluate the flipped classroom teaching approach in pharmacy education and to provide a summary of the guidance for the introduction and implementation of the flipped classroom model in pharmacy educational programs.
METHOD
This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Eight databases were cross-screened by four reviewers, following key terms and predefined inclusion and exclusion criteria. A form was developed to extract relevant data from the reviewers. Qualitative data within the studies reporting students' and educators' perceptions and views on the FC model were also analyzed using a thematic analysis. Studies were appraised using the Medical Education Research Quality Instrument (MERSQI) and the Joanna Briggs Institute (JBI) checklist for qualitative research.
RESULTS
The reviewers screened 330 articles, of which 35 were included in the review. The themes identified were implementation, academic performance outcomes, student satisfaction with the flipped classroom model, and long-term knowledge retention. Most studies (68%) have found that flipped learning enhances students' success and exam performance. Six studies reported no statistically significant difference in academic performance. However, two studies reported lower long-term knowledge retention in FC learning than in lecture-based learning. The students' perceptions of the FC approach were assessed in 26 studies, and the majority reported positive feedback. However, some students found the pre-class homework difficult to complete before class, and some expressed dissatisfaction with the inconsistent grading and unclear assessment questions in the FC model. Overall, the FC model was found to enhance the students' critical thinking and communication skills, self-confidence, and time management.
CONCLUSIONS
The findings of this review indicate that pharmacy students generally found the flipped classroom model preferable to traditional lectures. However, this preference is conditional on the effective implementation of this approach and alignment within the core instructional elements. The issue of increased workload for students associated with self-directed pre-class learning may present a challenge.
PubMed: 38033750
DOI: 10.1016/j.jsps.2023.101873 -
BMJ Open Dec 2022Many physicians complete medical school and graduate medical education (GME) burdened by high debt and financial illiteracy. This places them at increased risk for... (Review)
Review
BACKGROUND
Many physicians complete medical school and graduate medical education (GME) burdened by high debt and financial illiteracy. This places them at increased risk for ill-informed financial decisions, which can result in increased stress and anxiety and a lower quality of life. Furthermore, financial concerns impact physicians' specialty selections and may partly explain the scarcity of primary care practitioners. In response, medical wellness programmes have increasingly sought to offer personal finance education, but there is little guidance on optimal curricula. Our objective is to systematically review the existing literature examining physician financial literacy curricula and to recommend a standardised personal finance curriculum.
METHODS
This review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 checklist to report the results of literature searches in PubMed, ERIC, MedEdPortal, EBSCO, JSTOR and Google Scholar. Three researchers used predetermined inclusion and exclusion criteria to select articles, including a focus on financial concepts applicable in the USA. Selected articles published between 2000 and 2022 were assessed using the BEME strength of findings tool, and further assessed using modified Côté-Turgeon and Kirkpatrick model qualitative analyses tools.
FINDINGS
49 articles met all inclusion criteria. Ten specifically described personal finance literacy curricula for medical students or GME trainees, with varied criteria for selecting instructors, topics and outcomes. All studies reported that audiences were ill prepared for making financial decisions but strongly desired financial literacy education. Qualitative analysis revealed Strength of Findings summary scores ranging from 2 to 4, while applicable Kirkpatrick Model scores were all 3 or greater. Based on these findings, a 14-module personal finance curriculum is proposed by the researchers, along with learning objectives.
INTERPRETATION
Although medical students and GME trainees value financial literacy, few publications report the impact of actual curricula. These efforts vary in depth, breadth and measured impact. Future research should focus on development of valid testing instruments specifically for physicians, content standardisation, selection of credible instructors and delivery formats.
Topics: Humans; Quality of Life; Curriculum; Education, Medical, Graduate; Learning; Physicians
PubMed: 36572491
DOI: 10.1136/bmjopen-2022-064733 -
The Lancet. HIV Aug 2023Gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. In Africa, MSM face structural barriers to HIV prevention and treatment... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. In Africa, MSM face structural barriers to HIV prevention and treatment that increase their vulnerability to HIV acquisition and transmission, and undermine the HIV response. In this systematic review, we aimed to explore progress towards increases in HIV testing, improving engagement in the HIV treatment cascade, and HIV incidence reductions among MSM in Africa.
METHODS
We searched Embase, MEDLINE, Global Health, Scopus, and Web of Science for cross-sectional and longitudinal studies reporting HIV testing, knowledge of status, care, antiretroviral therapy (ART) use, viral suppression, and HIV incidence among MSM in Africa published between Jan 1, 1980, and March 3, 2023. We pooled surveys using Bayesian generalised linear mixed-effects models, used meta-regression to assess time trends, and compared HIV incidence estimates among MSM with those of all men.
FINDINGS
Of 9278 articles identified, we included 152 unique studies published in 2005-23. In 2020, we estimate that 73% (95% credible interval [CrI] 62-87) of MSM had ever tested for HIV. HIV testing in the past 12 months increased over time in central, western, eastern, and southern Africa (odds ratio per year [OR] 1·23, 95% CrI 1·01-1·51, n=46) and in 2020 an estimated 82% (70-91) had tested in the past 12 months, but only 51% (30-72) of MSM living with HIV knew their HIV status. Current ART use increased over time in central and western (OR 1·41, 1·08-1·93, n=9) and eastern and southern Africa (OR 1·37, 1·04-1·84, n=17). We estimated that, in 2020, 73% (47-88) of all MSM living with HIV in Africa were currently on ART. Nevertheless, we did not find strong evidence to suggest that viral suppression increased, with only 69% (38-89) of MSM living with HIV estimated to be virally suppressed in 2020. We found insufficient evidence of a decrease in HIV incidence over time (incidence ratio per year 0·96, 95% CrI 0·63-1·50, n=39), and HIV incidence remained high in 2020 (6·9 per 100 person-years, 95% CrI 3·1-27·6) and substantially higher (27-199 times higher) than among all men.
INTERPRETATION
HIV incidence remains high, and might not be decreasing among MSM in Africa over time, despite some increases in HIV testing and ART use. Achieving the UNAIDS 95-95-95 targets for diagnosis, treatment, and viral suppression equitably for all requires renewed focus on this key population. Combination interventions for MSM are urgently required to reduce disparities in HIV incidence and tackle the social, structural, and behavioural factors that make MSM vulnerable to HIV acquisition.
FUNDING
US National Institutes of Health, UK Medical Research Council, Canadian Institutes of Health Research, and Fonds de Recherche du Québec-Santé.
TRANSLATION
For the French translation of the abstract see Supplementary Materials section.
Topics: Male; Humans; HIV Infections; Homosexuality, Male; Incidence; Cross-Sectional Studies; Bayes Theorem; Sexual and Gender Minorities; Canada; HIV Testing; Africa, Southern
PubMed: 37453439
DOI: 10.1016/S2352-3018(23)00111-X -
Vaccine May 2023The World Health Organization's Global Strategy on Human Resources for Health: Workforce 2030 sets policy recommendations and targets for in-service and pre-service... (Review)
Review
INTRODUCTION
The World Health Organization's Global Strategy on Human Resources for Health: Workforce 2030 sets policy recommendations and targets for in-service and pre-service training programs to improve workforce competency. To date, comprehensive reviews on immunization training have mainly focused on in-service trainings. This systematic review aimed to synthesize current literature on pre-service immunization training, including primary immunization competencies covered, methods used, outcomes on improving competencies and behavior change for immunization service delivery, and student readiness for immunization practice, in both low-resource and high-income settings.
METHODS
A systematic search of seven scholarly databases identified published literature on pre-service training on immunization published between January 2001 and November 2021. It included all geographic regions and languages, study designs, and individuals preparing to enter the immunization workforce. Additional search methods included reviewing references of retrieved articles, scanning journals, and engaging pre-service training experts for unpublished reports.
RESULTS
Search results yielded 5,611 articles; 39 articles met the inclusion criteria. Five articles were identified through other search methods. Studies took place mostly in high-income countries (35/44), targeted professional (medical, nursing, and pharmacy) students and tutors at health training institutions. Eight of the ten recommended immunization competencies were included in the curricula and methods used to deliver pre-service training varied. Teaching techniques and applied learning strategies using realistic situations increased students' knowledge, attitudes, and awareness of vaccine benefits; built confidence to administer vaccines and communicate with hesitant patients; and increased the likelihood of recommending vaccines.
CONCLUSION
This review was the first step to understanding pre-service training on immunization. Further research is needed to inform pre-service training programs in low- and middle-income countries, particularly for nurses, vaccinators with low-level educational backgrounds, and other healthcare professional students. Prioritizing essential audiences, designing and delivering practical training, and evaluating results will help prepare students for the immunization challenges of tomorrow.
Topics: Humans; Vaccination; Immunization; Curriculum; Students; Learning
PubMed: 37069032
DOI: 10.1016/j.vaccine.2023.03.062 -
Nurse Education Today Jan 2023The purpose of this study was three-fold: to (1) synthesize evidence from experimental studies regarding educational interventions for developing nursing students' and... (Review)
Review
OBJECTIVES
The purpose of this study was three-fold: to (1) synthesize evidence from experimental studies regarding educational interventions for developing nursing students' and nurses' assertiveness, (2) examine such interventions and identify their effective components, and (3) recommend future research considerations in this area.
DESIGN
A systematic review of the literature.
DATA SOURCES
Literature searches were conducted using three electronic databases (PubMed, CINAHL, and PsycINFO) in addition to hand searches to identify original research articles published between 2012 and 2022.
REVIEW METHODS
Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed for the systematic review and reporting process. Included studies were critically appraised using the Joanna Briggs Institute Critical Appraisal Checklists.
RESULTS
Fourteen articles were included in this review, with most of the studies conducted in Asian countries. Four intervention methods were used for assertiveness education across the studies: (1) simulation-based learning, (2) classroom-based learning, (3) classroom-based learning with peer support, and (4) hybrid learning. Classroom-based learning interventions were the most common. Among all types of interventions, key concepts included assertiveness, differentiating between assertive and non-assertive behaviors, and assertive communication skills. Most studies measured participants' speaking-up behaviors by self-report. Mixed results were observed in terms of intervention effectiveness, but providing participants with opportunities to practice assertive communication skills benefited their speaking-up.
CONCLUSIONS
Educational interventions can strengthen the skills, confidence, and capacity of current and future nurses to employ assertive communication. Intervention developers should create programs that involve classroom teaching and provide participants with opportunities for practice, either through simulation or role-play. Also, researchers should observe participants' post-intervention use of assertive communication in simulations or clinical practice as opposed to surveying participants' intention to speak up.
Topics: Humans; Students, Nursing; Assertiveness; Communication; Learning; Asia
PubMed: 36462396
DOI: 10.1016/j.nedt.2022.105655