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1 – 10 of 384Anna Sigridur Islind, Johan Lundin, Katerina Cerna, Tomas Lindroth, Linda Åkeflo and Gunnar Steineck
Designing digital artifacts is not a linear, straightforward process. This is particularly true when applying a user-centered design approach, or co-design, with users who are…
Abstract
Purpose
Designing digital artifacts is not a linear, straightforward process. This is particularly true when applying a user-centered design approach, or co-design, with users who are unable to participate in the design process. Although the reduced participation of a particular user group may harm the end result, the literature on solving this issue is sparse. In this article, proxy design is outlined as a method for involving a user group as proxy users to speak on behalf of a group that is difficult to reach. The article investigates the following research question: How can roleplaying be embedded in co-design to engage users as proxies on behalf of those who are unable to represent themselves?
Design/methodology/approach
The article presents a design ethnography spanning three years at a cancer rehabilitation clinic, where digital artifacts were designed to be used collaboratively by nurses and patients. The empirical data were analyzed using content analysis and consisted of 20 observation days at the clinic, six proxy design workshops, 21 telephone consultations between patients and nurses, and log data from the digital artifact.
Findings
The article shows that simulated consultations, with nurses roleplaying as proxies for patients ignited and initiated the design process and enabled an efficient in-depth understanding of patients. Moreover, the article reveals how proxy design as a method further expanded the design. The study findings illustrate: (1) proxy design as a method for initiating design, (2) proxy design as an embedded element in co-design and (3) six design guidelines that should be considered when engaging in proxy design.
Originality/value
The main contribution is the conceptualization of proxy design as a method that can ignite and initiate the co-design process when important users are unreachable, vulnerable or unable to represent themselves in the co-design process. More specifically, based on the empirical findings from a design ethnography that involved nurses as proxy users speaking on behalf of patients, the article shows that roleplaying in proxy design is a fitting way of initiating the design process, outlining proxy design as an embedded element of co-design.
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Claire Jane Stewart and Aiesha Ba Mashmous
The changing clinical landscape in psychiatry, both before and after the pandemic, has impacted students’ direct contact with psychiatric patients. It is imperative, therefore…
Abstract
Purpose
The changing clinical landscape in psychiatry, both before and after the pandemic, has impacted students’ direct contact with psychiatric patients. It is imperative, therefore, that medical education keeps pace with evolving clinical pathways to ensure that clinicians are always appropriately trained not just for common presentations but also for low-prevalence, high-risk situations. Simulated-based training is well established. However, it is not without its limitations, many of which could be overcome with the use of virtual simulation. This study aims to analyse the use of virtual simulation within medical education to train clinicians in psychiatric assessments.
Design/methodology/approach
A scoping review was undertaken with a comprehensive literature search of the six most relevant online peer-reviewed databases, including PubMed, PsycINFO, CINAHL, Medline, EMBASE and Cochrane. All published papers in English that discussed simulation in teaching psychiatric assessments were included.
Findings
Virtual patients can be used for educational, diagnostic and therapy purposes attributable to advances in speech-recognition technology. Virtual simulations are well received and positively affect clinicians’ knowledge and skill development. Educational faculties should consider using virtual simulation technologies to improve learning outcomes. Further studies should enhance the fidelity and quality of virtual assessment simulation situations, mainly focusing on the virtual patient’s empathy, gesturing and body language to enable this evidence-based tool to be used effectively and efficiently for the benefit of future patient care.
Originality/value
The changing clinical landscape in psychiatry, both before and after the pandemic, has impacted students’ direct contact with psychiatric patients. This scoping review has reviewed the use of virtual simulation-based education to train clinicians for psychiatric assessments. To the best of the authors’ knowledge, this work has not been conducted before.
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Kimberly B. Garza, Channing R. Ford, Lindsey E. Moseley and Bradley M. Wright
L. Dee Fink proposes that different and more significant kinds of learning should be created in higher education to transition student outcomes from simply “learning” to…
Abstract
L. Dee Fink proposes that different and more significant kinds of learning should be created in higher education to transition student outcomes from simply “learning” to “significant learning,” and these new types of learning should be situated within significant learning experiences (Fink, 2003). Fink also identified a taxonomy of significant learning that included six components: integration, foundational knowledge, application, human dimension, caring, and learning how to learn. Using Fink’s Taxonomy of Significant Learning as a framework, the authors will share the development of a course on navigating the US Healthcare System that resulted in significant learning outcomes for students completing the first semester of a four-year Doctor of Pharmacy curriculum. Each learning experience will link to a component of the taxonomy and will serve as the mechanism for the authors to share the development and implementation associated with each aspect of the semester-long course. The assessment structure of the course is described in detail. The authors present one or more learning experiences to illustrate each component of Fink’s Taxonomy. Finally, lessons learned from the development and implementation of the course are presented to guide programs considering implementation of a similar significant learning experience.
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Gertrude Mwalabu, Annie Msosa, Ingrid Tjoflåt, Kristin Hjorthaug Urstad, Bodil Bø, Christina Furskog Risa, Masauko Msiska and Patrick Mapulanga
The purpose of this study was to explore the clinical readiness of simulation-based education (SBE) in preparing nursing and midwifery students for clinical practice in…
Abstract
Purpose
The purpose of this study was to explore the clinical readiness of simulation-based education (SBE) in preparing nursing and midwifery students for clinical practice in sub-Saharan Africa. This study has synthesised the findings from existing research studies and provides an overview of the current state of SBE in nursing and midwifery programs in the region.
Design/methodology/approach
A qualitative meta-synthesis of previous studies was conducted using the following steps: developing a review question, developing and a search strategy, extracting and meta-synthesis of the themes from the literature and meta-synthesis of themes. Five databases were searched for from existing English literature (PubMed, Cumulative Index for Nursing and Allied Health Professional Literature [CINAHL], PsycINFO, EMBASE and ScienceDirect Medline, CINAHL and Science Direct), including grey literature on the subject. Eight qualitative studies conducted in sub-Saharan Africa between 2014 and 2022 were included. Hawker et al.'s framework was used to assess quality.
Findings
The following themes emerged from the literature. Theme 1: Improved skills and competencies through realism and repetition. Theme 2: Improved skills and competencies through realism and repetition. Theme 3: Improved learning through debriefing and reflection. Theme 4: Constraints of simulation as a pedagogical teaching strategy.
Research limitations/implications
The qualitative meta-synthesis intended to cover articles from 2012 to 2022. Between 2012 and 2013, the authors could not identify purely qualitative studies from sub-Saharan Africa. The studies identified were either mixed methods or purely quantitative. This constitutes a study limitation.
Practical implications
Findings emphasise educator training in SBE. Comprehensive multidisciplinary training, complemented by expertise and planned debriefing sessions, serves as a catalyst for fostering reflective learning. Well-equipped simulation infrastructure is essential in preparing students for their professional competencies for optimal patient outcomes. Additional research is imperative to improve the implementation of SBE in sub-Saharan Africa.
Originality/value
The originality and value of SBE in nursing and midwifery programs in sub-Saharan Africa lie in its contextual relevance, adaptation to resource constraints, innovative teaching methodologies, provision of a safe learning environment, promotion of interprofessional collaboration and potential for research and evidence generation. These factors contribute to advancing nursing and midwifery education and improving healthcare outcomes in the region. This study fills this gap in the literature.
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Holly Hampe, Diane Frndak and Claire Kydonaki
The purpose of this paper is to describe an example of how universities can develop unique synchronous educational opportunities to engage students in an online environment…
Abstract
Purpose
The purpose of this paper is to describe an example of how universities can develop unique synchronous educational opportunities to engage students in an online environment, especially since study abroad opportunities have slowed or halted due to the COVID-19 pandemic crisis.
Design/methodology/approach
Two affiliated universities, in the United States and Scotland, selected a simulated root cause analysis (RCA) of a medical error for a collaborative activity.
Findings
Together the students analyzed the event within assumed roles of healthcare professions in a systematic way using the “Swiss Cheese Model,” identified opportunities for improvement, debriefed using the Promoting Excellence and Reflective Learning in Simulation (PEARLS) method and submitted a reflective assignment. The RCA resulted in several process improvement suggestions and positive feedback from the participants.
Research limitations/implications
The approach was for graduate students from two affiliated universities, in the United States and Scotland, to simulate a RCA of a medical error as a collaborative activity.
Practical implications
This example using simulation of healthcare roles demonstrates the application of international collaboration, problem-solving models and methodologies and recognition of the similarities and differences between the United Kingdom and the United States approaches to patient safety. Especially with the ongoing COVID-19 pandemic, the students' ability to internationally collaborate can be limited without such unique opportunities.
Social implications
The students were provided with a side-by-side comparison of the patient safety efforts in each country and written and didactic material about an RCA and the Swiss cheese model.
Originality/value
Students come from different perspectives of health services administration, nursing and nursing leadership from Scotland and the United States to solve patient safety problems.
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Oscar Y. Moreno Rocha, Paula Pinto, Maria C. Consuegra, Sebastian Cifuentes and Jorge H. Ulloa
This study aims to facilitate access to vascular disease screening for low-income individuals living in remote and conflict areas based on the results of a pilot trial in…
Abstract
Purpose
This study aims to facilitate access to vascular disease screening for low-income individuals living in remote and conflict areas based on the results of a pilot trial in Colombia. Also, to increase the amount of diagnosis training of vascular surgery (VS) in civilians.
Design/methodology/approach
The operation method includes five stages: strategy development and adjustment; translation of the strategy into a real-world setting; operation logistics planning; strategy analysis and adoption. The operation plan worked efficiently in this study’s sample. It demonstrated high sensibility, efficiency and safety in a real-world setting.
Findings
The authors developed and implemented a flow model operating plan for screening vascular pathologies in low-income patients pro bono without proper access to vascular health care. A total of 140 patients from rural areas in Colombia were recruited to a controlled screening session where they underwent serial noninvasive ultrasound assessments conducted by health professionals of different training stages in VS.
Research limitations/implications
The plan was designed to be implemented in remote, conflict areas with limited access to VS care. Vascular injuries are critically important and common among civilians and military forces in regions with active armed conflicts. As this strategy can be modified and adapted to different medical specialties and geographic areas, the authors recommend checking the related legislation and legal aspects of the intended areas where we will implement this tool.
Practical implications
Different sub-specialties can implement the described method to be translated into significant areas of medicine, as the authors can adjust the deployment and execution for the assessment in peripheral areas, conflict zones and other public health crises that require a faster response. This is necessary, as the amount of training to which VS trainees are exposed is low. A simulated exercise offers a novel opportunity to enhance their current diagnostic skills using ultrasound in a controlled environment.
Social implications
Evaluating and assessing patients with limited access to vascular medicine and other specialties can decrease the burden of vascular disease and related complications and increase the number of treatments available for remote communities.
Originality/value
It is essential to assess the most significant number of patients and treat them according to their triage designation. This management is similar to assessment in remote areas without access to a proper VS consult. The authors were able to determine, classify and redirect to therapeutic interventions the patients with positive findings in remote areas with a fast deployment methodology in VS.
Plain language summary
Access to health care is limited due to multiple barriers and the assessment and response, especially in peripheral areas that require a highly skilled team of medical professionals and related equipment. The authors tested a novel mobile assessment tool for remote and conflict areas in a rural zone of Colombia.
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Melanie Barlow, Bernadette Watson, Kate Morse, Elizabeth Jones and Fiona Maccallum
The response of the receiver to a voiced patient safety concern is frequently cited as a barrier to health professionals speaking up. The authors describe a novel Receiver Mindset…
Abstract
Purpose
The response of the receiver to a voiced patient safety concern is frequently cited as a barrier to health professionals speaking up. The authors describe a novel Receiver Mindset Framework (RMF) to help health professionals understand the importance of their response when spoken up to.
Design/methodology/approach
The framework draws on the broader receiver-focussed literature and integrates innovative findings from a series of empirical studies. These studies examined different receiver behaviour within vignettes, retrospective descriptions of real interactions and behaviour in a simulated interaction.
Findings
The authors' findings indicated that speaking up is an intergroup interaction where social identities, context and speaker stance intersect, directly influencing both perceptions of and responses to the message. The authors' studies demonstrated that when spoken up to, health professionals poorly manage their emotions and ineffectively clarify the speaker's concerns. Currently, targeted training for receivers is overwhelmingly absent from speaking-up programmes. The receiver mindset framework provides an evidence-based, healthcare specific, receiver-focussed framework to inform programmes.
Originality/value
Grounded in communication accommodation theory (CAT), the resulting framework shifts speaking up training from being only speaker skill focussed, to training that recognises speaking up as a mutual negotiation between the healthcare speaker and receiver. This framework provides healthcare professionals with a novel approach to use in response to speaking up that enhances their ability to listen, understand and engage in point-of-care negotiations to ensure the physical and psychological safety of patients and staff.
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Amruta Rout, Golak Bihari Mahanta, Bibhuti Bhusan Biswal, Renin Francy T., Sri Vardhan Raj and Deepak B.B.V.L.
The purpose of this study is to plan and develop a cost-effective health-care robot for assisting and observing the patients in an accurate and effective way during pandemic…
Abstract
Purpose
The purpose of this study is to plan and develop a cost-effective health-care robot for assisting and observing the patients in an accurate and effective way during pandemic situation like COVID-19. The purposed research work can help in better management of pandemic situations in rural areas as well as developing countries where medical facility is not easily available.
Design/methodology/approach
It becomes very difficult for the medical staff to have a continuous check on patient’s condition in terms of symptoms and critical parameters during pandemic situations. For dealing with these situations, a service mobile robot with multiple sensors for measuring patients bodily indicators has been proposed and the prototype for the same has been developed that can monitor and aid the patient using the robotic arm. The fuzzy controller has also been incorporated with the mobile robot through which decisions on patient monitoring can be taken automatically. Mamdani implication method has been utilized for formulating mathematical expression of M number of “if and then condition based rules” with defined input Xj (j = 1, 2, ………. s), and output yi. The inputs and output variables are formed by the membership functions µAij(xj) and µCi(yi) to execute the Fuzzy Inference System controller. Here, Aij and Ci are the developed fuzzy sets.
Findings
The fuzzy-based prediction model has been tested with the output of medicines for the initial 27 runs and was validated by the correlation of predicted and actual values. The correlation coefficient has been found to be 0.989 with a mean square error value of 0.000174, signifying a strong relationship between the predicted values and the actual values. The proposed research work can handle multiple tasks like online consulting, continuous patient condition monitoring in general wards and ICUs, telemedicine services, hospital waste disposal and providing service to patients at regular time intervals.
Originality/value
The novelty of the proposed research work lies in the integration of artificial intelligence techniques like fuzzy logic with the multi-sensor-based service robot for easy decision-making and continuous patient monitoring in hospitals in rural areas and to reduce the work stress on medical staff during pandemic situation.
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Haifa Mohammad Algahtani, Haitham Jahrami and Mariwan Husni
The COVID-19 pandemic has had a significant impact on medical education and training, with many medical schools and training programs having to adapt to remote or online learning…
Abstract
Purpose
The COVID-19 pandemic has had a significant impact on medical education and training, with many medical schools and training programs having to adapt to remote or online learning, social distancing measures and other challenges. This paper aimed to examine the disruption for clinical training, as it has reduced the opportunities for students and trainees to gain hands-on experience and interact with patients in person.
Design/methodology/approach
The ethnographic qualitative research design was chosen as the research methodology. Using Gibbs' reflective cycle, the researcher explored the psychiatry clerks' (final-year medical students) reflections on the disruption of their clinical training during the COVID-19 pandemic.
Findings
The findings demonstrated that the students had a significant psychological impact on their coping capacities as the crisis progressed from shock and depression to resilience. The students being the key stakeholders provided a concrete foundation for the development of a framework for improving practices during uncertain times.
Originality/value
Students' reflections provided valuable insight into the pandemic’s impact on their psychosocial lives with uncertainty and incapacity to cope up with changing stressful dynamics. The results will assist in planning how to best support medical students' well-being during interruptions of their educational process brought about by similar future crises.
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