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We also found that whereas the relationship between ACO participation and intra- and interorganizational HIE practices remains unchanged irrespective of the degree of competition in the health care market, the relationship between ACO participation and provider-patient HIE practices holds true only for hospitals operating in noncompetitive markets.
Our results showed that hospitals participating in ACOs vary in their HIE practices, and attributes of the local market in which ACO participants operate in contribute to this variation. These insights should provide guidance to researchers, policymakers, and hospital administrators who aim to improve the effectiveness of ACOs.
Our results showed that hospitals participating in ACOs vary in their HIE practices, and attributes of the local market in which ACO participants operate in contribute to this variation. These insights should provide guidance to researchers, policymakers, and hospital administrators who aim to improve the effectiveness of ACOs.
The outbreak of COVID-19 has led to a profound change in the organization of work in the health care sector. As frontline health care workers are essential in battling the pandemic and their work is appreciated in society, we argue that health care workers who are forced to work from home are likely to perceive their jobs as less meaningful, which in turn may negatively affect their engagement at work. Cognitive crafting, or the altering of the perceptions one has about their tasks and relationships with the aim to enhance the meaningfulness of work, may be a fruitful cognitive strategy to counter the problems remote health care workers face.
The primary purpose was to study the relationship between cognitive crafting, working from home (WFH), and work engagement.
We collected cross-sectional survey data between May 7 and June 2, 2020, from a single hospital in the Netherlands (n = 278). The central hypothesis was tested using multiple regression analysis.
The relationship between cognitive crafting anerally, we recommend organizations to engage in effective top-down work design and foster a climate for cognitive as well as behavioral job crafting strategies.
Peppermint oil is often used to treat irritable bowel syndrome (IBS); however, the overall quality of previous studies is low, and findings have been heterogeneous. This study aimed to compare the effects of peppermint oil vs placebo in relieving IBS symptoms.
In a 6-week, randomized, double-blind, placebo-controlled trial at a single academic center in the United States, individuals diagnosed with IBS (Rome IV criteria), with moderate to severe symptoms based on the IBS Severity Scoring System (IBS-SSS score ≥175), were randomized to enteric-coated peppermint oil 180 mg 3 times daily vs placebo in a 12 ratio. The primary outcome was mean change in IBS-SSS scores from baseline to 6-week endpoint.
A modified intent-to-treat analysis revealed that there were substantial mean improvements from baseline to 6-week endpoint in the main outcome measure (IBS-SSS) for both peppermint oil (90.8, SD = 75.3) and placebo (100.3, SD = 99.6). Although the peppermint oil group reported numerically lower improvement thae of peppermint oil for the treatment of IBS.
Hematology/oncology fellows must achieve bone marrow biopsy proficiency. However, opportunities for fellows to perform bone marrow biopsies on patients are highly dependent on clinical volume. An easily accessible and feasible system to practice these procedures repetitively has not been described. Other specialties use 3-dimensional (3D)-printed models to practice procedures, but hematology/oncology has not yet incorporated this novel medical education tool, which has the potential to provide such an accessible and feasible system for procedural practice.
We used design thinking to develop and pilot a bone marrow biopsy simulation using 3D-printed pelvis models. We printed and optimized 2 models through iterative prototyping. In July 2019, we conducted a 1-hour session with 9 fellows. After an anatomy review, fellows practiced biopsies using the models with faculty feedback. To evaluate feasibility, we reviewed session evaluations, measured fellow comfort, surveyed supervising attendings, and gathered feporate user feedback to optimize model utility.
Nonaccredited simulation fellowships have multiplied resulting in fellowship differences. Standardization of fellowship content and requirements is needed, especially if accreditation is to be achieved. Simulation fellowship criteria were developed using expert consensus and the Accreditation Council for Graduate Medical Education requirements to frame the supporting pillars for accreditation.
Core curricular components, subelements, and requirements for graduation were derived from a literature review and existing fellowship curricula. A modified Delphi process was performed to establish fellowship program content and requirements. A priori criteria for inclusion or exclusion were used during 3 iterative rounds. Experts could recommend items for inclusion.
Fourteen publications and 71 curricula were reviewed with 7 core curriculum components and 44 subelements identified for subsequent expert panel review. All core components were included by consensus application of teaching and debriefing, business ats, graduation requirements, and maximum number of clinical hours to establish Accreditation Council for Graduate Medical Education accreditation criteria for a simulation standardization of simulation fellowships for physicians. Further work is needed to define other parameters including program infrastructure and assessment.
The purpose of this study was to develop a caregiver and healthcare provider assessment tool to evaluate essential tracheostomy skills using a simulated task trainer.
Three tracheostomy skill checklists were developed closed suctioning, open suctioning, and tracheostomy change. Checklist items were developed based on institutional guidelines and a literature review. Items were revised based on iterative expert review and pilot testing. A total of 64 intensive care staff and 24 caregivers were evaluated using the checklists, of which 29 staff members and 4 caregivers were rated simultaneously by 2 raters to estimate interrater reliability. The relationships between checklist performance and staff demographics (experience and discipline) were calculated. A survey examining the selection of automatic fail items and minimum passing score was sent to 660 multidisciplinary staff members.
Intraclass correlations were 0.93 for closed suctioning, 0.93 for open suctioning, and 0.76 for tracheostomy change. Staff performance only correlated with experience for the tracheostomy change checklist and was inconsistently associated with discipline (respiratory therapy vs nursing). A large, multidisciplinary survey with 132 of 660 respondents confirmed the selection of automatic fail items and minimum passing score. A total of 92.9% of the survey respondents agreed with a minimum passing score of 80%.
We developed 3 essential tracheostomy skill checklists with multiple sources of validity evidence to support their use in a simulation-based assessment of tracheostomy skills.
We developed 3 essential tracheostomy skill checklists with multiple sources of validity evidence to support their use in a simulation-based assessment of tracheostomy skills.
The use of simulation to develop clinical reasoning and medical decision-making skills for common events is poorly established. Validated head trauma rules help identify children at low risk for clinically important traumatic brain injury and guide the need for neuroimaging. We predicted that interns trained using a high-fidelity, immersive simulation would understand and apply these rules better than those trained using a case-based discussion. Our primary outcomes were to determine the effectiveness of a single targeted intervention on an intern's ability to learn and apply the rules.
This was a prospective randomized controlled trial. Interns were randomized to participate in either a manikin-based simulation or a case discussion. Knowledge and application of the Pediatric Emergency Care Applied Research Network Head Trauma tool were assessed both under testing conditions using standardized vignettes and in clinical encounters. In both settings, interns completed a validated assessment tool to test thestudy suggests that information delivery and comprehension may be improved through a single targeted simulation-based education.
On-site interprofessional education (IPE) simulation is primarily used to teach students teamwork, communication, and crisis resource management. Participants view it as an educational environment in which to acquire and consolidate skills. Virtual IPE simulation is traditionally seen as an opportunity to supplement, complement, and reinforce on-site IPE (OI). We used VI as the sole simulation method during the COVID-19 pandemic to provide IPE because of constraints of social distancing. The VI resulted in substantially achieving similar learning outcomes to OI. This suggests that VI, which has the advantage of being cheaper and more easily scalable than OI, may be an effective remote learning modality for IPE.
On-site interprofessional education (IPE) simulation is primarily used to teach students teamwork, communication, and crisis resource management. Participants view it as an educational environment in which to acquire and consolidate skills. Virtual IPE simulation is traditionally seen as an opportunity to supplement, complement, and reinforce on-site IPE (OI). We used VI as the sole simulation method during the COVID-19 pandemic to provide IPE because of constraints of social distancing. The VI resulted in substantially achieving similar learning outcomes to OI. Sulfosuccinimidyl oleate sodium in vitro This suggests that VI, which has the advantage of being cheaper and more easily scalable than OI, may be an effective remote learning modality for IPE.
The literature lacks description of the incidence of nursing students failing and repeating courses. Nursing student repeaters delay graduation and entry into the workforce; they are also at risk for attrition.
The aim of the study was to describe the incidence of nursing student repeaters and progression policies in the United States.
A national survey of prelicensure nursing program deans and directors was conducted.
Invitations were sent to 2,055 nursing programs; the response rate was 32 percent. The annual incidence of nursing student course repetition was found to be 11.5 percent. Progression policies varied widely.
Nursing student repeaters are a significant population, and examination of progression policies is warranted.
Nursing student repeaters are a significant population, and examination of progression policies is warranted.
This study aimed to determine if correlations existed between overall science prerequisite grade point average (GPA) and successful completion of pathophysiology and overall science GPA and the Test of Essential Academic Skills Version V (TEAS V) science subscore. The quantitative study design was used with 73 students who were conditionally admitted to the baccalaureate nursing program. No statistically significant correlation was found between overall science GPA and successful completion of pathophysiology; a weak low correlation was found between overall science GPA and TEAS V science subscore. These findings suggest that TEAS V science subscores used as a standalone assessment do not predict success in pathophysiology.
This study aimed to determine if correlations existed between overall science prerequisite grade point average (GPA) and successful completion of pathophysiology and overall science GPA and the Test of Essential Academic Skills Version V (TEAS V) science subscore. The quantitative study design was used with 73 students who were conditionally admitted to the baccalaureate nursing program.
