Search results

The effect of vicarious learning during clinical or medical internships on graduates' adaptive career behaviours has attracted scant attention from healthcare researchers, particularly, in the developing world context. Drawing upon the social cognitive career theory model of career self-management (SCCT-CSM), the current study examines how vicarious learning influences the clinical graduates' adaptive career behaviours (i.e. career exploration and decision-making) via career exploration and decision-making self-efficacy (CEDSE) and career intention.

Data were collected from 293 nursing graduates undertaking clinical internships in 25 hospitals across Nigeria who willingly participated in this study as they were also assured of confidentiality at two-waves. The proposed hypotheses were tested using a path analysis.

The findings showed that vicarious learning during clinical internship had a direct effect on career exploration, decision-making and career decision self-efficacy among graduate trainees. Also, the findings revealed that the effects of vicarious learning on the graduates' career exploration and career decision-making were significantly mediated by career decision self-efficacy and career intentions.

The findings of this study have important practical implications for higher education institutions and industries that send and receive clinical graduates for clinical internships to gain more skills. More emphasis should be on encouraging learners to learn vicariously in addition to other forms of learning experiences available during clinical internships.

The study explains that the graduates' higher engagement in clinical career exploration and decision-making was based on a higher level of vicarious learning during internships. The results suggest that higher education institutions and healthcare service providers can derive greater benefits from more emphasis on promoting vicarious learning during clinical internships.

The authors propose a blockchain platform for managing clinical trial data to enhance data validity, integrity, trust and transparency in the pharmaceutical research process. The authors also provide an extensive review of how blockchain technology supports the business processes of clinical trials.

A systematic literature review was conducted to identify the existing applications of blockchain in pharmaceutical process management. A conceptual design for a blockchain infrastructure to address clinical trial challenges is developed by outlining the entire clinical trial value chain and identifying the coordination and communication among its stakeholders. A stakeholder analysis is conducted to ensure that the clinical trial processes satisfy the requirements and preferences of each stakeholder.

The proposed blockchain platform offers a promising solution for enhancing integrity, trust and transparency in the clinical trial process. Additionally, blockchain can help streamline communication and collaboration between stakeholders by enabling multiple parties to access and share data in real time, lowering the possibility of delays or errors in data analysis and reporting.

The proposed blockchain platform can benefit patients by empowering them to have better-controlled access to their data and by allowing researchers to maintain adherence to reporting requirements. Additionally, the platform can benefit granting agencies, researchers and decision-makers by ensuring the integrity of clinical trial data and streamlining communication and collaboration between stakeholders.

This study builds on existing blockchain applications in pharmaceutical process management by developing a blockchain framework that can address clinical trial concerns from an integrated perspective.

Insecure and unresolved attachments have been linked to poorer psychological health and interpersonal functioning for people with intellectual disabilities (IDs), but research in this area is limited, especially for adults. Studies using the Adult Attachment Projective (AAP) have been restricted to clinical samples, where insecure and unresolved attachments are typically more prevalent. The purpose of this study is to compare clinical and non-clinical groups of adults with IDs on the AAP, plus measures of psychological health and interpersonal functioning, to investigate whether group differences found in the typically developing population are also present for adults with IDs.

A cross-sectional, between-group design was used. Adults with IDs (clinical group n = 11 and non-clinical group n = 13) completed measures of attachment, psychological distress/positive well-being and interpersonal functioning. Attachment classifications were compared in the clinical versus non-clinical groups. Measures of psychological distress, positive well-being and interpersonal functioning were compared between those with insecure-organised versus unresolved classifications.

No participants were classified as secure, and there were high rates of unresolved attachment. There were no differences between clinical and non-clinical groups with regards to the distribution of insecure-organised (i.e. dismissing or preoccupied) versus unresolved classifications. There were no differences between groups with regards to psychological distress, positive well-being or interpersonal functioning. The authors consider limitations in the method of group differentiation and suggest further research to better understand the development of internal working models of attachment in this population.

To the best of the authors’ knowledge, this study is one of only three to examine attachment state of mind in adults with IDs using the AAP and the first to examine differences between clinical and non-clinical groups.

The Covid-19 pandemic generated significant changes in the operating methods of hospital logistics departments. The objective of this research is to understand how these changes took place, what collaboration mechanisms were developed with clinical authorities and, to what extent, logistics and clinical care activities should be decoupled to maximize each area's contribution?

The case study is selected to investigate practices implemented during the COVID-19 pandemic in hospitals in Canada. The pandemic presented an opportunity to contrast practices implemented in response to this crisis with those historically used in this environment.

The strategy of decoupling logistical tasks of an operational nature from clinical activities is well-founded and helps free clinical staff from tasks for which they are not trained. However, the decoupling of operational tasks should be combined with an integration of the clinical information flow to the logistics hub players. With this clinical information, the logistics hub can generate its full potential enabling better inventory management decisions to be made.

The concept of decoupling is studied to identify configurations that offer the best benefits for clinical staff.

This paper aims to determine the knowledge and attitudes of the physicians regarding human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), to emphasize that these patients exist and they will exist in the future and to raise awareness so as to prevent that their rights to treatment are revoked.

The survey was conducted via a link sent through an online system. Random physicians from 81 cities of the country were invited to the survey. The survey has 41 questions regarding knowledge and attitudes in total, including epidemiological information such as age, gender and title.

A total of 3,107 physicians has voluntarily participated in the study. In total, 2,195 (70.7%) are internal physicians and 912 (29.3%) are surgical physicians among the participant physicians. In total, 1,452 (46.7%) of the participants are specialist physicians, 608 (19.6%) of the participants are practising physician and the rest of it is physician assistants, academicians and dentists, respectively.

In this study, it has been found out that the physicians have a lack of knowledge on HIV/AIDS and they adopt a discriminatory attitude towards HIV-positive persons. HIV-positive patients who are exposed to discrimination and scared of being uncovered refrain from applying to hospitals for treatment, which puts public health into jeopardy due to the high viral load and these patients are faced with difficulties in coping with both medical and emotional load of the disease.

Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

This research study provides insight into students’ perceptions of teaching through virtual and face-to-face clinicals in an introductory education course in a pre-education program at a minority-serving institution.

This study took place at an urban–suburban-centered community college in the Midwestern United States and was reviewed by the higher education institutional review board (IRB). Data were collected from pre-education majors enrolled in a four-hour Introduction to Education with field experiences.

The findings indicated that both virtual and face-to-face clinicals were beneficial to the development of pre-service teachers, particularly in an early introduction to education course.

The finding that virtual clinicals are significant to teacher growth is significant to teacher recruitment and preparation.

The flexibility of a virtual clinical provides greater opportunities for low-income and marginalized populations with limited means and access.

This finding can lead to strategies to diversify teacher candidates.

This study sought to answer the following question: how do pre-education students reflect to understand the roles and responsibilities of teaching through virtual options vs face-to-face clinicals? The interest of this research is to expand pathways into the teaching profession to nontraditional, ethnically and culturally marginalized groups and historically underrepresented groups.

This paper aims to examine the barriers and facilitators of conducting and implementing research in frontline child and youth mental health settings in the UK.

Researchers, clinicians and commissioners who attended a workshop at the Big Emerging Minds Summit in October 2022 provided their expert views on the structural barriers and possible solutions to integrating research in clinical practice based on their experiences of child and young people mental health research.

The identified barriers encompass resource constraints, administrative burdens and misalignment of research priorities, necessitating concerted efforts to foster a research-supportive culture. This paper proposes the potential actionable solutions aimed at overcoming challenges, which are likely applicable across various other health-care systems and frontline NHS services. Solutions include ways to bridge the gap between research and practice, changing perceptions of research, inclusive engagement and collaboration, streamlining ethics processes, empowering observational research and tailored communication strategies. Case examples are outlined to substantiate the themes presented and highlight successful research initiatives within NHS Trusts.

This paper provides an insight into the views of stakeholders in child and youth mental health. The themes will hopefully support and influence clinicians and academics to come together to improve the integration of research into clinical practice with the hope of improving service provision and outcomes for our children and young people.

The purpose of this systematic review was to explore the benefits and challenges in the implementation of simulation-based education (SBE) in the classroom and clinical settings in sub-Saharan Africa. The objectives of this systematic review were to identify the benefits of utilising SBE in the classroom and clinical practice in sub-Saharan Africa and to assess the challenges in the implementation of SBE in the classroom and clinical practice in sub-Saharan Africa.

Five databases were searched for existing English literature (Medline, CINAHL and Science Direct), including grey literature on the subject. Out of 26 eligible studies conducted in sub-Saharan Africa between 2014 and 2021, six studies that used mixed-methods design were included. Hawker et al.’s framework was used to assess the quality of the studies. Quantitative data were presented using descriptive and inferential statistics in the form of means and standard deviations while qualitative data were analysed and presented thematically.

Quantitative findings showed that participants rated SBE highly in terms of teaching (93.2%), learning (91.4%) and skill acquisition (88.6%). SBE improved the clinical skill competency from 30% at baseline to 75% at the end. On the other hand, qualitative findings yielded themes namely: improved confidence and competence; knowledge acquisition and critical thinking; motivation and supervision; independent, self-paced learning; simulation equipment and work schedules; and planning and delivery of simulation activity. Pedagogical skills, competence and confidence are some of the elements that determine the feasibility of implementing SBE in the classroom and clinical settings.

SBE could help to bridge the gap between theory and practice and improve the quality of care provided by nurses. Simulation-based training is effective in improving the clinical skills of midwives and increasing their confidence in providing care. However, SBE trainees require motivation and close supervision in classroom settings if simulation is to be successfully implemented in sub-Saharan Africa. Furthermore, careful planning of scenarios, students briefing and reading of content prior to implementation facilitate effective simulation.

While there may be a lack of literature on the use of SBE for training nurses and midwives in the developing world, there is growing evidence that it can be an effective way to improve clinical skills and quality of care. However, there are also significant challenges to implementing simulation-based training in resource-limited settings, and more research is needed to understand how best to address these challenges. This study fills this gap in the literature.

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.