Willingness to Pay for Social Health Insurance and Its Predictors among Government Employees in Mujja Town, Ethiopia.

BACKGROUND: Social health insurance is one of the possible organizational mechanisms for raising and pooling funds to finance health services, private health insurance, community insurance, and others. OBJECTIVE: The study was aimed to assess willingness to pay for social health insurance and associated factors among government employees in Mujja town, Ethiopia. METHODS: An institutional-based cross-sectional study was conducted on the total sample size of 375 study respondents. A simple random sampling technique was employed. Data were entered into EPI info 7 and analyzed by Statistical Package for Social Sciences version 22.0. Multivariable logistic regression was used to identify independent predictors by controlling confounding variables. Statistical significance was declared at p < 0.05. RESULTS: This study revealed that 37.6% (95% CI: 33.1%, 42.61%) respondents were willing to pay for social health insurance. In the final model, respondents who ever heard about health insurance schemes were seven times (AOR = 7.205; 95% CI: 1.385, 37.475) more likely willing to pay for social health insurance. Thos who had history of difficulty and having other source to cover medical bills were 92.6% (AOR = 0.074; 95% CI: 0.009, 0.612) and 94.6% (AOR = 0.054; 95% CI: 0.011, 0.257) less likely to pay, respectively. CONCLUSIONS: Willingness to pay for social health insurance was low. Being heard about health insurance, history of difficulty, and having other sources to cover medical bills were associated factors. Thus, it is recommended that media promotion and these factors should be considered for the successful implementation of the scheme.

Health Education Programs Challenges in Rural Communities: Experiences of Health Educators and Healthcare Authorities.

BACKGROUND: Health education is one of the main areas of primary health care and it is improbable that health promotion will succeed without it. However, studies show that there are some problems when implementing health education programs in rural communities. This study was carried out to illuminate the barriers to health education using Ardabil's health center manager's and health educators' experiences. METHODS: This was a qualitative study using the content analysis approach. Twenty-seven health educators and managers were selected to participate in the study considering the maximum variation. Purposive sampling technique was used to select study participants. Data were collected through semi-structured interviews and focus group discussions. Data analysis was done using a six-stage thematic analysis framework. RESULTS: During the data analysis, four themes were apparent as barriers to health education in rural communities included: inefficient management skills, lack of responsibility among health personnel, inadequate policies, and poor inter-sectoral cooperation. CONCLUSIONS: It seems that changing job descriptions of health workers, reviewing health priorities, increasing lobbying activities are mechanisms that can help overcome barriers to health education in the rural communities.

Testing Boundaries COVID-19 made the USMLE, Clerkships a Moving Target for Med Students.

Medical schools typically have predictable schedules. The timing of lectures, clerkships, exams, and even extracurricular activities tend to follow in the same grooves year after year. Students can reliably block out even minor events months ahead of time and be confident they'll take place. All that changed with COVID-19. Since March, when the pandemic began closing down schools, businesses, and other institutions across the state, figuring out what comes next in medical school has been anything but predictable.

How Medical Educators Can Foster Equity and Inclusion in Their Teaching: A Faculty Development Workshop Series.

PROBLEM: Diversity, equity, and inclusion are increasingly highlighted in medical education, but bias continues to disproportionately impact learners from racial and ethnic groups traditionally underrepresented in medicine. Many faculty struggle to engage with these concepts in their teaching and fear making mistakes, but few opportunities exist for faculty to develop their skills. APPROACH: To advance the goal of fostering an equitable educational environment, the authors envisioned a series of faculty development workshops to cultivate faculty skills and comfort with incorporating equity and inclusion in their teaching, assessment, and curriculum development work. The authors conducted a needs assessment and followed Kern's 6-step process for curriculum development to build the workshop series. OUTCOMES: Using local resources and expertise, the authors built a workshop series that culminated in a certificate in Teaching for Equity and Inclusion. The development process took 24 months; 22 faculty volunteered to design and teach 7 new workshops. Initial workshop offerings have reached 101 participants, and 120 faculty members have enrolled in the certificate. The workshops have been well received and are rated on par with or more highly than other faculty development offerings at the University of California, San Francisco. NEXT STEPS: Future directions include assessing the impact of the certificate on participants and workshop faculty, creating opportunities for workshop faculty to share best practices, and exploring alternative models for participation. The authors' experience demonstrates the feasibility of creating a self-sustaining program that will advance faculty competence in the critical areas of diversity, equity, and inclusion.

Is teaching work? A heuristic study of the views of teachers.

BACKGROUND: Teachers can be at risk of exposure to psychosocial hazards. Improving workplace safety for teachers, within a 'systems thinking' context, should begin with understanding the work. OBJECTIVE: While much is known about what teachers do, little is known about how teachers conceptualize 'work'. Knowing how teachers conceptualize 'work' provides a reference point for exploring attitudes towards work health and safety. METHODS: The paper presents a review of the literature, an overview of heuristic methodology describing and interpreting the lived experience of teachers as workers, and analysis of teachers' accounts of work. The heuristic approach allowed the author to compare their lived experiences and perceptions as a teacher with the lived experience of teachers in the NSW school system. RESULTS: Teaching is work that is both rewarding and hazardous. It is argued that teachers draw on battle motifs, perceive a need for safety within a workplace context, and have an ability to conduct personal risk assessments. CONCLUSIONS: Findings from the study provided direction for the second phase of the project that is aimed at exploring the ways in which teachers conceptualize psychosocial work- related hazards and the extent to which they are visible in teaching practice and policy.

International service learning enhances nurse practitioner students' practice and cultural humility.

Academic and health care institutions are charged with improving quality-of-care outcomes by creating culturally educated health care professionals to practice in a global health care environment. International short-term service learning experiences provide nurse practitioner students an opportunity to meet clinical competency skills aligned with course curricula. Faculty can directly observe students' clinical practice, and students broaden diagnostic reasoning skills while earning credit for clinical hours. As project and research ideas are formulated, students develop system-level thinking to implement evidence-based practices and disseminate their knowledge and experience of caring for the underserved. Students who participate in service-learning opportunities foster their awareness of cultural humility, easing transition into practice. Some academic institutions established short-term service-learning opportunities for students, and evidence supports faculty and students' sense of well-being after participation. We describe an example of a short-term, international service-learning opportunity in Haiti where students work with an interprofessional team and experience the effect of social determinants of health on delivering quality care.

Training and testing for a transformation of fear and avoidance functions via combinatorial entailment using the Implicit Relational Assessment Procedure (IRAP): Further exploratory analyses.

Experiment 1 of the current research attempted to establish fear and avoidance functions for arbitrary stimuli via combinatorial entailment using training and testing versions of the Implicit Relational Assessment Procedure (IRAP). The critical tests for the transformation of functions involved exposure to two separate Test-IRAPs (one for fear and one for avoidance), but both failed to yield any evidence for the transformation of functions. The findings of Experiment 1 contrast with the clear evidence of a transformation of functions via mutually entailed relations that was reported by Leech et al. (2018), thus suggesting a potential boundary condition for the IRAP as a training and testing context (i.e., derived transformation occurs for mutual but not combinatorial entailing). In Experiment 2, we sought to manipulate two of the dimensions of the multi-dimensional multi-level (MDML) framework to determine if they would alter the apparent boundary condition suggested by the results of Experiment 1. Results indicate that levels of derivation and an opportunity to respond to the derived relations play an important role in the transformation of fear and avoidance functions via combinatorial entailment within the IRAP context.

Teachers' knowledge about language constructs related to literacy skills and student achievement in low socio-economic status schools.

Teachers' knowledge is a critical component to students learning to read proficiently. The present research sought to determine the literacy knowledge of 150 urban, elementary school teachers from 11 low socio-economic schools in one of nation's largest cities. Teachers' ability to understand concepts relating to phonological awareness, phonemic awareness, alphabetic principle/phonics, and morphology as well as their knowledge about teaching these fundamental skills were assessed through a standardized measure. Using exploratory factor analysis to understand the latent constructs underlying the survey scores and hierarchical linear modelling on factor scores of each construct, the results revealed that teachers located in low socio-economic status schools did not have explicit knowledge needed to effectively teach struggling readers. Although the teachers possessed a high level of knowledge regarding syllable counting skills, they lacked knowledge related to morphology. Practical implications are provided to assist teachers in increasing their literacy knowledge.

A Reflective Cybernetic Study on the Experiences of a Gay Male Teacher in the Free State Province.

Sexuality education has become a core component in advancing the ideals of social justice and inclusivity within schooling environments. Its implementation has, however, been met with resistance as its sensitive nature often leads to conflicting messages, especially in relation to the myriad cultures and ambiguity thereof when placed against the contrasting values characteristic of multicultural South Africa. This article speaks to my experiences as a gay male teacher within the context of teaching at primary and secondary schools in the Free State province. I draw on the challenges and barriers I experienced, especially as a new teacher, and reflect critically on how this influenced my growth as an educator in the following years. Primarily, my approach and pedagogy were positioned within silence and uncritical reflection as to how my teachings can align with the ideals of social justice and inclusivity. Framed through a cybernetic perspective, I investigate how my pedagogy has adapted and transformed toward a less reactive approach and in turn aligned more actively with these ideals. This study is a self-reflective narrative that accounts for my experiences within different systems and how my presence influenced the systemic dynamics of the schools in which I taught.

Demonstrating the impact of your teaching: benefits of Higher Education Academy Fellowship for librarians.

This feature suggests that health librarians who teach or support Higher Education (HE) students can and should gain accreditation and recognition for their teaching by the route of HEA Fellowship. We outline the process by which Fellowship could be attained by those working within HE and those in NHS libraries who work with HE students, suggesting which aspects of librarianship practice could provide the necessary evidence for Fellowship. The synergies between Fellowship and Chartership are examined and the criteria for HEA (UK Professional Standards Framework or UKPSF) are mapped against those for Chartership (Professional Knowledge and Skills Base (PKSB). D.I.

Perceived challenges of nurse educators while teaching undergraduate nursing students in Pakistan: An exploratory mixed-methods study.

BACKGROUND: Nurse educators are required to equip students with adequate theoretical and practical knowledge to provide effective nursing care. Limited studies have explored educators' challenges while teaching students. Existing studies are limited because of small sample, overreliance on qualitative approaches, and unreliable instruments that have not been tested. OBJECTIVES: To explore nurse educators' perspectives about their clinical and academic teaching, to develop a questionnaire to determine educators' challenges, and to develop a comprehensive understanding of educators' challenges. DESIGN: A sequential exploratory mixed-methods study. SETTINGS: Twelve nursing institutions in five cities of Pakistan. PARTICIPANTS: A purposive sample of 12 educators for interviews and 112 for the survey. METHODS: Semi-structured interviews and survey for data collection and expert consultations for questionnaire development. Thematic analysis for qualitative analysis, descriptive analysis for quantitative, and joint display tables for mixed methods. RESULTS: Educators experience workload and time constraints and struggle to effectively teach students due to inadequate student-educator ratio; underdeveloped curriculum; inadequate resources; inadequate clinical teaching settings for skills, simulation labs; inadequate professional development opportunities; lack of autonomous decision making; lack of educational, management, and research support from the regulatory bodies; and lack of educational research. CONCLUSIONS: Nurse educators' issues and challenges are persistent and require support from regulatory bodies and educational authorities. There is a need to develop policies to improve teaching and learning conditions for educators, provide them with the opportunities to enhance their own learning, and opportunities to collaborate with other educators in order to better prepare student nurses.

Situation, background, assessment, recommendation (SBAR) technique education enhances pharmacy student communication ability and confidence.

BACKGROUND AND PURPOSE: The Situation, Background, Assessment, Recommendation (SBAR) technique is a method that can be incorporated into a professional healthcare curriculum to enhance students' ability to communicate information logically and concisely. This educational research activity was designed to assess the impact of SBAR training on pharmacy students' ability to communicate pharmacotherapy recommendations during a simulated telephone intervention with a prescriber. Secondary objectives were to evaluate the impact of the activity on student self-perception of confidence, potential correlations between prior experience and both performance and confidence, and the activity's overall quality and value. EDUCATIONAL ACTIVITY AND SETTING: Third professional year pharmacy students enrolled in a required communications course completed the simulated telephone intervention both before and after SBAR training. The teaching and learning activity was evaluated by comparing pre- and post-activity intervention scores, and a post-activity survey measuring secondary study objectives. FINDINGS: Of the 198 students enrolled in the course, 197 consented to participate in the study (99% response rate). Median scores on pre- and post-activity interventions were 12/20 and 18/20 points, respectively (p < 0.001). Student-perceived confidence in the ability to deliver a pharmacotherapy-related intervention improved (p < 0.001) and most students (92%) indicated that the activity enhanced their communication skills. There was a significant positive correlation between previous pharmacy-related experience and student confidence, both before and after SBAR training. SUMMARY: SBAR training is a valuable component of pharmacy education. Training will be introduced earlier in the curriculum and incorporated into a variety of activities and courses, including interprofessional educational activities.

Assessment of reliability and validity of the Spanish version of the Nursing Students' Perception of Instructor Caring (S-NSPIC).

The care that clinical instructors demonstrate to students is essential for their education, considering the strong impact it has on their future relationships with patients, relatives, and other health professionals. Nursing Students' Perceptions of Instructor Caring (NSPIC) is an instrument designed to assess nursing students' perceptions of instructor's caring behaviors. A trans-cultural, conceptual, and psychometric validation study was conducted with 315 nursing students at the University of Seville during their clinical practices in three regional hospitals. The NSPIC was translated and adapted to Spanish. The content validity was established by a panel of experts. To assess concurrent validity the culturally adapted Spanish version of the Clinical Placement Evaluation Tool (CPET) was used as a gold standard. The construct validity was determined by an exploratory factor analysis to identify the internal structure of the NSPIC-S. The internal consistency was established by Cronbach's α and the intra-observer reliability for each item was established by test-retest. The content validity index varied between 0.53 and 0.93 and the correlation to the CPET was moderate. The factor analysis revealed a structure of five factors, one of which differed from the original scale. The value of Cronbach's α was 0.95 and intraclass correlation coefficients varied between 0.5 and 0.89. Our study provided a culturally adapted version of the NSPIC, valid and reliable to be used in the Spanish context, the NSPIC-S.

Estratégias utilizadas por professores ante os desafios no processo de escolarização de estudantes do ensino fundamental / Strategies used by teachers to face challenges in the schooling process of elementary school students / Estrategias utilizadas por los maestros frente a los desafíos en el proceso de escolarización de estudiantes de la educación primaria

Este trabalho tem por objetivo compreender as principais estratégias utilizadas por professores para lidar com os desafios presentes no processo de escolarização. A pesquisa, de cunho qualitativo, utilizou o referencial teórico da perspectiva histórico-cultural de Vygotski, empregando as técnicas de observação participante e de grupo focal. Doze docentes participaram de um grupo focal e foram ouvidos em relação às estratégias utilizadas para lidar com os desafios no processo de escolarização. As informações obtidas foram analisadas com base nos núcleos de significação de Aguiar e Ozella (2006, 2013). Os docentes mencionaram recorrer ao auxílio da equipe pedagógica quando sentem que não conseguem lidar com questões de comportamento e aprendizagem dos estudantes. Utilizaram a intervenção de especialistas fora do contexto escolar, pois acreditam que muitos de seus estudantes não aprendem em função de questões cognitivas ou neurológicas. Identificou-se pouca reflexão acerca da implicação dos docentes no processo de escolarização que protagonizam.

This paper aims to understand the main strategies used by teachers to deal with challenges present in the schooling process. The research, based on a qualitative approach, used Vygotsky's Cultural-historical perspective as a theoretical reference, employing participant observation and focus group techniques. Twelve teachers participated in a focus group and were heard in relation to the strategies they used to deal with challenges in the schooling process. The information obtained was analyzed based on the Meaning Cores of Aguiar and Ozella (2006, 2013). Teachers mentioned requesting support from pedagogical teams when they feel they cannot deal with student behavior and learning issues. They used interventions of specialists outside the school context, believing that many of their students do not learn because of cognitive or neurological issues. Little reflection has been identified about the involvement of teachers in the schooling process they perform.

Este trabajo tiene como objetivo comprender las principales estrategias utilizadas por los maestros para hacer frente a los desafíos presentes en el proceso de escolarización. La investigación, de cuño cualitativo, utilizó el referencial teórico de la perspectiva histórico-cultural de Vygotsky, utilizando las técnicas de observación participante y grupo focal. Doce docentes participaron de un grupo focal y fueron escuchados con relación a las estrategias utilizadas para hacer frente a los desafíos en el proceso de escolarización. Las informaciones obtenidas fueron analizadas con base en los núcleos de significación de Aguiar y Ozella (2006, 2013). Los docentes mencionaron recurrir a la ayuda del equipo pedagógico cuando sienten que no logran lidiar con cuestiones de comportamiento y aprendizaje de los estudiantes. Utilizaron la intervención de especialistas afuera del contexto escolar, pues creen que muchos de sus estudiantes no aprenden en función de cuestiones cognitivas o neurológicas. Se identificó poca reflexión acerca de la implicación de los docentes en el proceso de escolarización que protagonizan.

Interprofessional provider educational needs and preferences regarding the provision of sexual and reproductive health care in cystic fibrosis.

BACKGROUND: Sexual and reproductive health (SRH) is an important disease-specific concern for adolescent and young adult (AYA) women that is not consistently addressed in cystic fibrosis (CF) centers. This study identifies educational needs and preferences of interprofessional CF providers regarding SRH in AYA women with CF. METHODS: Interprofessional CF providers participated in an anonymous survey regarding general and CF-specific SRH knowledge and skills, factors for optimizing SRH care, and preferred approaches for SRH training. We calculated descriptive statistics for all respondents and stratified by provider type. RESULTS: A total of 523 providers completed the survey (39% physicians/advanced practice providers, 19% nurses, 20% social workers, and 22% other disciplines). Half reported comfort responding to female AYA SRH concerns; however, only one-third were comfortable asking appropriate questions and confident taking a sexual history. Only 29% were comfortable with their current CF-specific SRH knowledge. Respondents' preferred SRH topics for further training included: pregnancy/parenthood planning, sexual functioning, urinary incontinence, intimate partner violence, and taking a sexual history. Nearly two-thirds felt having connection to women's health specialists familiar with CF would facilitate SRH care. Approximately one-third desired SRH educational materials for providers to view at point-of-care or through online case-based learning; <10% were interested in role playing SRH skills. CONCLUSION: Many interprofessional CF providers lack comfort and skills in addressing SRH with AYA women with CF. Provider training needs and approaches identified in this study can be used to develop tailored educational interventions to improve comprehensive CF care.

Technology-Based Interventions, Assessments, and Solutions for Safe Driving Training for Adolescents: Rapid Review.

BACKGROUND: Safe driving training for adolescents aims to prevent injury and promote their well-being. In that regard, information and communication technologies have been used to understand adolescent driving behavior and develop interventions. OBJECTIVE: The purpose of this review is to explore and discuss existing approaches to technology-based driving interventions, driving assessments, and solutions in the literature. METHODS: We searched the Web of Science and PubMed databases following a review protocol to collect relevant peer-reviewed journal articles. Inclusion criteria were (1) being published in the English language, (2) being published in a peer-reviewed journal, (3) testing the driving behavior of teens with technology-based intervention methods, and (4) being published between January 2000 and March 2018. We appraised the articles by reading their abstracts to select studies matching the inclusion criteria and reading the full text of articles for final refinement. RESULTS: Initial keyword searches on technology-based solutions resulted in 828 publications that we refined further by title screening (n=131) and abstract evaluation against inclusion criteria (n=29). Finally, we selected 16 articles that met the inclusion criteria and examined them regarding the use of technology-based interventions, assessments, and solutions. Use of built-in tracking devices and installation of black box devices were widely used methods for capturing driving events. Smartphones were increasingly adapted for data collection, and use of gamification for intervention design was an emerging concept. Visual and audio feedback also were used for intervention. CONCLUSIONS: Our findings suggest that social influence is effective in technology-based interventions; parental involvement for promoting safe driving behavior is highly effective. However, the use of smartphones and gamification needs more study regarding their implementation and sustainability. Further developments in technology for predicting teen behavior and programs for behavioral change are needed.

Establishing construct validity of AMEET (assessment of medical educational environment by the teachers) inventory.

OBJECTIVE: To establish the construct validity of Assessment of Medical Educational Environment by the Teachers inventory. METHODS: The cross-sectional analytical study was conducted from January to May 2017 and comprised doctors working as faculty in Rawalpindi Medical College, Rawalpindi, Pakistan, and its 3 teaching hospitals. Non-probability (purposive) sampling was used to meet the criteria of 5 participants per item of the Assessment of Medical Educational Environment by the Teachers inventory. Exploratory factor analysis was done using SPSS 20 and confirmatory factor analysis was done with version 16 of the Analysis of Moment Structures software. RESULTS: Of the 250 subjects, 126(50.4%) were males and 124(49.6%) were females. Exploratory factor analysis ended with extraction of 11 components. It showed sufficiency of sample size and no multi-collinearity. Three (50%) of the six domains were finalised on the whole and 10(20%) of the 50 items were debarred from the inventory. All three domains had high reliability. Root mean square residual and chi square / degree of freedom were within acceptable limit. However, comparative fit index, goodness of fit index, normed fit index and root mean square error of approximation portrayed not only poor model fit after re-running confirmatory factor analysis, but also led to omission of further 16(32%) items with poor loadings from the inventory. Thus, there was exclusion of total 26(52%) items from the tool and the finalised Assessment of Medical Educational Environment by the Teachers inventory comprised 24(48%) items. CONCLUSIONS: Construct validity of Assessment of Medical Educational Environment by the Teachers inventory could not be established, but the tool was found to be reliable.

A mixed methods exploratory assessment of the usefulness of Baltimore City Health Department's trauma-informed care training intervention.

Youth exposure to trauma is a significant public health problem in the United States, particularly in urban areas. Although trauma-informed care (TIC) training of service providers to address this challenge is increasing nationwide, we lack empirical evidence regarding the feasibility and acceptability of cross-organizational TIC training, including perspectives of training participants. The purpose of our study was to evaluate participating service providers' self-reported changes in knowledge about trauma, attitudes toward traumatized individuals, and beliefs in their capacity to provide referrals to trauma services after completion of the TIC intervention. Intervention participants represented a range of service sectors, including government health and education agencies, social services, law enforcement, as well as nonprofits. Participants completed a pre-post quantitative survey assessing TIC-related knowledge, attitudes, and beliefs (N = 88). A subset of participants was interviewed using a semistructured interview format (n = 16). Mixed methods were used to evaluate the intervention's impact on participants' knowledge about trauma and to understand participants' experience in the training. Quantitative results revealed significant improvements in TIC-related knowledge and attitudes. Five themes emerged from qualitative analysis of interviews: the intervention provided a framework for understanding TIC; useful lessons were learned from other participants; there was a need for outreach to upper-level management; real-life applicability was lacking; and guidance regarding next steps was wanting. Study findings suggest the training may be a starting point for enhancing service providers' capacity to address traumatized youth. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Exploring the Role of Race and Gender on Perceived Bystander Ability and Intent: Findings Before and After Exposure to an Online Training Program to Prevent Sexual Assault on Campus.

The current study explores the significance of race and gender on bystander attitudes before and after an online bystander intervention program to prevent sexual assault. A diverse sample of 750 college students participated in an online intervention and participants' perceived bystander intervention ability and intent were assessed. The interaction of participant race and gender had a marginally significant impact on bystander ability and intent baseline scores. Furthermore, when analyzing gain scores from pre- to posttest, there was a significant race by gender interaction. Specifically, Latinx and Black men had higher preintervention scores, and White men had higher gains postintervention. Relevant cultural and social factors and directions for future research are discussed.

Difference Matters: Teaching Students a Contextual Theory of Difference Can Help Them Succeed.

Today's increasingly diverse and divided world requires the ability to understand and navigate across social-group differences. We propose that interventions that teach students about these differences can not only improve all students' intergroup skills but also help disadvantaged students succeed in school. Drawing on interdisciplinary research, this article theorizes that teaching students a contextual understanding of difference can accomplish both of these important goals. Understanding difference as contextual means recognizing that social-group differences come from participating in and adapting to diverse sociocultural contexts. This article begins by reviewing research that highlights two distinct understandings of social-group differences-as contextual or essential-and demonstrates their consequences for intergroup outcomes. We then review research on multicultural and social justice education that highlights the potential benefits of educating students about social-group differences. We propose that these educational approaches are associated with intergroup and academic benefits for one key reason: They teach students a contextual theory of difference. Finally, to illustrate and provide causal evidence for our theory of how a contextual understanding of difference affords these benefits, this article provides an overview of the first social psychological intervention to teach students a contextual understanding of difference: difference-education.