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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.

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.

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.

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.

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.

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.

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.

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.

Intervention evaluations have not always accounted for long-term implementation of interventions. The purpose of this paper is to explore implementation of a primary care intervention during the lifespan of the trial and beyond.

Eight general practices participated in the trial (four control and four intervention). In-depth interviews (with nine GPs and four practices nurses who delivered the intervention) and observation methods were employed. Thematic analysis was utilized and Normalization Process Theory (NPT) constructs were compared with emergent themes.

Macro-level policy imperatives shaped practice priorities which resulted in the “whole system” new intervention not being perceived to be sustainable. Continued routinization of the intervention into usual care beyond the lifespan of the funded study was dependent on individualized monitoring and taking forward tacit knowledge.

The authors discuss the implications of these findings for sociological theories of implementation and understanding outcomes of research led complex interventions.

The study describes the complex interplay between macro processes and individual situated practices and contributes to understanding if, how, and why interventions are sustained beyond initial “research push”. The value of the study lies in describing the conditions and potential consequences of long-term implementation, which might be translated to other contexts.

Patient safety is gaining prominence in health professional curricula. Patient safety must be complemented by teaching and skill development in practice settings. The purpose of this paper is to explore how experienced pharmacists identify, prioritize and communicate adverse drug effects to patients.

A focus group discussion was conducted with cardiology pharmacy specialists working in a Doha hospital, Qatar. The topic guide sought to explore participants’ views, experiences and approaches to educating patients regarding specific cardiovascular therapy safety and tolerability. Discussions were audio-recorded and transcribed verbatim. Data were coded and organized around identified themes and sub-themes. Working theories were developed by the three authors based on relevant topic characteristics associated with the means in which pharmacists prioritize and choose adverse effect information to communicate to patients.

Nine pharmacists participated in the discussion. The specific adverse effects prioritized were consistent with the reported highest prevalence. Concepts and connections to three main themes described how pharmacists further tailored patient counseling: potential adverse effects and their perceived importance; patient encounter; and cultural factors. Pharmacists relied on initial patient dialogue to judge an individual’s needs and capabilities to digest safety information, and drew heavily upon experience with other counseling encounters to further prioritize this information, processes dependent upon development and accessing exemplar cases.

The findings underscore practical experience as a critical instructional element of undergraduate health professional patient safety curricula and for developing associated clinical reasoning.

Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail.

The quality of maternal healthcare training is the most optimal degree of health in the delivery of effective, efficient and quality healthcare in midwifery discipline. Student accoucheurs studying at the Free State School of Nursing are faced with resistance, discrimination, rejection and unacceptability by pregnant women during their clinical placement at the Free State maternal healthcare institutions. This results in poor quality of training of student accoucheurs in maternal healthcare. Considerable studies have been conducted on males in midwifery nursing, but no guidelines have been developed to facilitate student accoucheurs' acceptance and improvement of the quality of training in maternal healthcare, hence the purpose of this study.

A descriptive, explorative qualitative design was used in this study. Qualitative focused group discussions (n = 32) were conducted through purposeful sampling method. Data was analysed thematically.

Three main categories emerged: student accoucheurs' related factors with social interactions and relations as a theme; maternal healthcare users’ related factors with transcultural diversity and socio-economic status as themes; nurse training institutions and maternal healthcare institutions service providers-related factors with gender inequality in the work place as a theme. Ultimately, the guidelines to facilitate acceptance and improvement of quality training of student accoucheurs in maternal healthcare institutions were developed and recommended for implementation.

The paper developed guidelines to facilitate acceptance and improvement of quality training of student accoucheurs in Free State maternal healthcare institutions.

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.

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.

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.

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.

The purpose of this paper is to create a “go-to-guide” of best practices in the creation of asynchronous courses. Due to the global pandemic, millions of students around the world transitioned from in-class instruction to online programs, which ranged from completely synchronous classrooms to completely asynchronous classrooms. Students were forced to learn how to engage within an online classroom environment with minimal notice and instructors were abruptly thrusted into a different operational environment, with many required to construct educational ecosystems in an unfamiliar and digitized interface. This led to several actions and the utilization of a multitude of different teaching techniques, many of which were poorly implemented.

Key words, “Asynchronous learning”, “Learning”, “Feedback”, “Online Instruction”, and “Classroom Design” were searched in online data bases (Google Scholar, PubMed, EBSCO and Data Base of Open Access Journals). These then were read by the authorial team and authoritative papers were selected by the team based on the frequency of utilization by other papers in the field and the utility of these papers for the design of asynchronous courses.

This paper explores asynchronous learning from the perspective of how instructional science and learning science can be applied to create the best classroom for both pupil and instructor.

It looks to provide a go-to-guide for best practices in asynchronous learning and the development of K-12 classrooms, graduate and medical school classrooms and finally continuous medical education classrooms. Finally, this guide looks to facilitate the development of master instructors through statements on how to properly provide feedback to students.

This paper aims to introduce the Empatia video reflection method, designed to enhance care workers’ awareness of empathic care. The method makes the quality of care visible, which is needed when digitalization efforts in elder care focus on the efficiency and adequacy of care work.

The Empatia method leans on previous studies of the interaction between care professionals and clients and elaborates further previous video reflection methods. In empathic care work, the care worker sees the client on their life continuum, rather than focusing on only medical treatments.

The empirical example demonstrates how a care worker gained awareness of their empathic interaction habits. Within the work community, the reflection process sparked discussions on values: the purpose of care work and how to conduct empathic care. Focusing on empathic relationships in care fosters both the client’s and the care worker’s well-being.

The strength of the Empatia method is that it makes empathy visible in interaction and something that is individually and collectively learnable. The Empatia includes an analytical tool for researchers to reveal empathy in client interaction. It can be developed further into a reflection tool for service work to learn how to be empathic in service encounters.

Compared to other video-stimulated recall methods, the Empatia involves contextual understanding of care work. Empowering positive interactions instead of detecting errors and solving problems is a novel concept and is scantily used in studies of organizational learning. The Empatia provides a detailed method description that allows for the replication of the method by anyone.

There are over 40 million amputees globally with more than 185,000 Americans losing their limbs every year. For most of the world, prosthetic devices remain too expensive and uncomfortable. This paper aims to outline advancements made by a multidisciplinary research group, interested in advancing the restoration of human motion through accessible lower limb prostheses.

Customization, comfort and functionality are the most important metrics reported by prosthetists and patients. The work of this paper presents the design and manufacturing of a custom made, cost-effective and functional three-dimensional (3D) printed transtibial prosthesis monocoque design. The design of the prosthesis integrates 3D imaging, modelling and optimization techniques coupled with additive manufacturing.

The successful fabrication of a functional monocoque prosthesis through 3D printing indicates the workflow may be a solution to the worldwide accessibility crisis. The digital workflow developed in this work offers great potential for providing prosthetic devices to rural communities, which lack access to skilled prosthetic physicians. The authors found that using the workflow together with 3D printing, this study can create custom monocoque prostheses (Figure 16). These prostheses are comfortable, functional and properly aligned. In comparison with traditional prosthetic devices, the authors slowered the average cost, weight and time of production by 95%, 55% and 95%, respectively.

This novel digital design and manufacturing workflow has the potential to democratize and globally proliferate access to prosthetic devices, which restore the patient’s mobility, quality of life and health. LIMBER’s toolbox can reach places where proper prosthetic and orthotic care is not available. The digital workflow reduces the cost of making custom devices by an order of magnitude, enabling broader reach, faster access and improved comfort. This is particularly important for children who grow quickly and need new devices every few months or years, timely access is both physically and psychologically important.

In this manuscript, the authors show the application of digital design techniques for fabricating prosthetic devices. The proposed workflow implements several advantageous changes and, most importantly, digitally blends the three components of a transtibial prosthesis into a single, 3D printable monocoque device. The development of a novel unibody transtibial device that is properly aligned and adjusted digitally, greatly reduces the number of visits an amputee must make to a clinic to have a certified prosthetist adjust and modify their prosthesis. The authors believe this novel workflow has the potential to ease the worldwide accessibility crisis for prostheses.

To better understand the reality of living with the diseases and conditions that its drugs and therapies are developed to treat, the Novartis leadership determined a need for more meaningful insights into patients’ lives. They sought to develop a systematic, creative methodology – informed by the psychology of insightful rather than analytical thinking – to properly integrate and deploy the research commissioned into its day-to-day business decision-making. For it is well established that better understanding of the patient reality drives both compliance and adherence “beyond the pill”. The purpose of this paper is to bring the novel methodology of creativity to a wider audience and ensure that many others – notably in patient advocacy organizations – can benefit from this approach.

A core team of Insight and Analytics and Patient Engagement leads from various therapeutic area teams worked in partnership with a psychologist and practitioner in the field of insightful thinking, to develop an effective methodology that could reliably surface and articulate genuine patient insights. This methodology – the i4i Insights Discovery™ process – was developed, piloted, refined and codified in 2020 and implemented across the company in 2021–2022. It uses a combination of convergent and divergent thinking techniques – human rather than artificial intelligence, combining diverse research outputs – to understand patients’ lives better. With enhanced understanding, the insights then shape educational and behavioral strategies to drive adherence and compliance.

At a time of tightening budgets and demands to deliver enhanced impact from research budgets, i4i Insights Discovery™ has enabled Novartis teams to turn existing research outputs into profound and useful understandings of what it means to live with specific diseases and develop evidence-based patient engagement strategies; insight-driven decision-making around the lifecycle of any compound. i4i Insights Discovery™ has been applied across Novartis’s diverse areas of expertise, from heart disease to cancer, from organ transplantation to dermatology, from food allergy to ophthalmology.

The i4i Insights Discovery™ process enables Novartis teams to gain deeper understanding of patients’ lives without the need to commission additional research; to do more with less. These insights enable cross-functional Novartis teams to develop better-informed strategies that better address the needs of patients and their care partners, of health-care professionals and health-care systems. The team creating the process is looking to make the i4i Insights Discovery™ approach a gold standard of insight discovery, both for pharma and health care and in other categories, too.

The i4i Insights Discovery™ process is a practical, novel application of well-established principles in the psychology of insightful thinking to address a clear business imperative. By repurposing and reinterpreting existing research outputs using creative verbal and visual exercises, it delivers a more human and empathetic understanding of the patient reality. It moves teams from “So what?” – this is what the data mean – to “Now what?” – this is what we should do as a result.