RESUMEN
BACKGROUND: Cancer patients often experience severe financial distress due to the high cost of their treatment, and strategies are needed to objectively measure this financial distress. The COmprehensive Score for financial Toxicity-Functional Assessment of Chronic Illness Therapy (COST-FACIT) is one instrument used to measure such financial distress. This study aimed to translate the COST-FACIT (Version 2) [COST-FACIT-v2] instrument into traditional Chinese (COST-FACIT-v2 [TC]) and evaluate its psychometric properties. METHODS: The Functional Assessment of Chronic Illness Therapy (FACIT) translation method was adopted. The translated version was reviewed by an expert panel and by 20 cancer patients for content validity and face validity, respectively, and 640 cancer patients, recruited from three oncology departments, completed the translated scale. Its reliability was evaluated in terms of internal consistency and test-retest reliability. Confirmatory factor analysis has been used to evaluate the one- and two-factor structures of the instrument reported in the literature. The convergent validity was examined by the correlation with health-related quality of life (HRQoL) and psychological distress. Known-group validity was examined by the difference in the COST-FACIT-v2 (TC) total mean score between groups with different income levels and frequency of health care service use. RESULTS: The COST-FACIT-v2 (TC) showed good content and face validity and demonstrated high internal consistency (Cronbach's alpha, 0.86) and acceptable test-retest reliability (intraclass correlation coefficient, 0.71). Confirmatory factor analysis showed that the one- and two-factor structures of the instrument that have been reported in the literature could not be satisfactorily fitted to the data. Psychological distress correlated significantly with the COST-FACIT-v2 (TC) score (r = 0.47; p < 0.001). HRQOL showed a weak to moderate negative correlation with the COST-FACIT-v2 (TC) score (r = - 0.23 to - 0.46; p < 0.001). Significant differences were seen among the COST-FACIT-v2 (TC) scores obtained in groups of different income level and frequency of health care service use. CONCLUSIONS: The COST-FACIT-v2 (TC) showed some desirable psychometric properties to support its validity and reliability for assessing cancer patients' level of financial toxicity.
Asunto(s)
Enfermedad Crónica/economía , Enfermedad Crónica/terapia , Costo de Enfermedad , Neoplasias/economía , Psicometría/instrumentación , Adulto , Anciano , Pueblo Asiatico , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Factores Socioeconómicos , Encuestas y Cuestionarios , TraduccionesRESUMEN
PURPOSE: To identify a cut-off score for the COmprehensive Score for financial Toxicity (COST) to predict a clinical implication of a high level of financial toxicity (FT). METHODS: A total of 640 cancer patients were recruited from three regional hospitals in Hong Kong. They completed a questionnaire comprising the COST measure and the Functional Assessment of Cancer Therapy - General (FACT-G) instrument. The cut-off score for the COST that predicts the lowest quartile of the FACT-G total score was identified by receiver operating characteristic (ROC) analysis. The sample was then stratified by this cut-off score, and characteristics were compared using Fisher's exact, chi-squared or independent sample t-test. RESULTS: The mean scores were 20.1 ± 8.8 for the COST and 71.6 ± 15.5 for the FACT-G. The ROC analysis suggested that the cut-off of 17.5 yielded an acceptable sensitivity and specificity. Characteristics of patients with a higher level of FT included being younger, having a monthly household income of < 10,000 HKD (approximately 1290 USD), being more likely not employed, having stage IV cancer and receiving targeted and/or immunotherapy. In terms of financial support, a higher proportion of these patients had discussed financial issues with health care professionals and had received financial assistance. In addition, fewer of them were covered by private health insurance. CONCLUSION: Our findings suggest a cut-off for the COST that can be used to screen for FT in clinical settings. In addition, while a considerable proportion of high-FT patients received targeted therapy, they often received financial assistance. There is a gap between financial hardship and assistance that warrants attention.
Asunto(s)
Neoplasias , Calidad de Vida , Costo de Enfermedad , Gastos en Salud , Humanos , Seguro de Salud , Neoplasias/terapia , Encuestas y CuestionariosRESUMEN
Extended-spectrum-beta-lactamase (ESBL)- or AmpC beta-lactamase (ACBL)-producing Escherichia coli bacteria are the most common cause of community-acquired multidrug-resistant urinary tract infections (UTIs) in New Zealand. The carriage of antimicrobial-resistant bacteria has been found in both people and pets from the same household; thus, the home environment may be a place where antimicrobial-resistant bacteria are shared between humans and pets. In this study, we sought to determine whether members (pets and people) of the households of human index cases with a UTI caused by an ESBL- or ACBL-producing E. coli strain also carried an ESBL- or ACBL-producing Enterobacteriaceae strain and, if so, whether it was a clonal match to the index case clinical strain. Index cases with a community-acquired UTI were recruited based on antimicrobial susceptibility testing of urine isolates. Fecal samples were collected from 18 non-index case people and 36 pets across 27 households. Eleven of the 27 households screened had non-index case household members (8/18 people and 5/36 animals) positive for ESBL- and/or ACBL-producing E. coli strains. Whole-genome sequence analysis of 125 E. coli isolates (including the clinical urine isolates) from these 11 households showed that within seven households, the same strain of ESBL-/ACBL-producing E. coli was cultured from both the index case and another person (5/11 households) or pet dog (2/11 households). These results suggest that transmission within the household may contribute to the community spread of ESBL- or ACBL-producing E. coliIMPORTANCEEnterobacteriaceae that produce extended-spectrum beta-lactamases (ESBLs) and AmpC beta-lactamases (ACBLs) are important pathogens and can cause community-acquired illnesses, such as urinary tract infections (UTIs). Fecal carriage of these resistant bacteria by companion animals may pose a risk for transmission to humans. Our work evaluated the sharing of ESBL- and ACBL-producing E. coli isolates between humans and companion animals. We found that in some households, dogs carried the same strain of ESBL-producing E. coli as the household member with a UTI. This suggests that transmission events between humans and animals (or vice versa) are likely occurring within the home environment and, therefore, the community as a whole. This is significant from a health perspective, when considering measures to minimize community transmission, and highlights that in order to manage community spread, we need to consider interventions at the household level.
Asunto(s)
Proteínas Bacterianas/metabolismo , Enfermedades de los Gatos/microbiología , Enfermedades de los Perros/microbiología , Infecciones por Escherichia coli/microbiología , Infecciones por Escherichia coli/veterinaria , Escherichia coli/aislamiento & purificación , beta-Lactamasas/metabolismo , Anciano , Animales , Gatos , Perros , Escherichia coli/enzimología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nueva ZelandaRESUMEN
This study explores the overnight usage of Chi Wah Learning Commons and The University of Hong Kong Libraries on the same campus. By adopting quantitative research, it investigates students' preferences in these areas and levels of social capital in the library, further, it explores the similarities and differences of user behavior between the university's undergraduate and postgraduate students. Our findings showed that HKUL had not taken full advantage of its prime location and comprehensive collection in the main library, and the full potential of overnight services. The results of this study contribute to the library management in understanding the changing needs of users and propose the potential enhancements on social capital among students and the community.
RESUMEN
AIMS AND OBJECTIVES: The aim of this study was to assess a community-women health ambassadors programme and report the areas that were successful and those that required improvement. The objectives were to assess the feasibility, effectiveness, implementation and sustainability of the programme. BACKGROUND: Health promotion for the prevention of chronic diseases has always been the top priority in the health sector. To ensure that the relevant health messages are well received in local communities, a health promotion programme must be accessible, acceptable and culturally relevant. DESIGN: We conducted and evaluated a women health ambassador programme based on the lay health advisor model for health promotion in Hong Kong during November 2014 to February 2015. Health needs and the subsequent focus of the programme were determined by underprivileged Chinese women. METHODS: University health educators from different disciplines trained the women (N = 80) to be health ambassadors through mini-lectures and training workshops. The trained women raised awareness about the importance of health within their families and social networks. The programme was evaluated through attendance rates, questionnaires and quizzes, changes in knowledge and behaviour, as well as qualitative discussion. RESULTS: While the majority of participants found the programme valuable and useful, retention rates were unideal. A statistically significant improvement was found in eating habits, but no significant change was identified for other knowledge and behaviour assessments. CONCLUSIONS: The programme empowered underprivileged women to reflect on the importance of health, take responsibility for their own health and actively promote health to their families and personal communities. RELEVANCE TO CLINICAL PRACTICE: Our study supports that health promotion programmes based on the lay health advisor model are effective and encourage large-scale programmes of this nature. Our results also support that future health promotion efforts should deliver brief, clear and simple content as opposed to intricate information.
Asunto(s)
Promoción de la Salud/métodos , Evaluación de Programas y Proyectos de Salud , Salud Pública/normas , Salud de la Mujer , Adulto , Enfermedad Crónica/prevención & control , Estudios de Factibilidad , Femenino , Conocimientos, Actitudes y Práctica en Salud , Hong Kong , Humanos , Persona de Mediana Edad , Investigación Cualitativa , Encuestas y CuestionariosRESUMEN
International concerns relating to healthcare professionals' failure to rescue deteriorating patients exist. Web-based training programs have been developed and evaluated in Western settings but further testing is required before application in non-Western countries, as traditional modalities of learning may differ between cultures. We trialed an Australian English language online simulation program for the management of deteriorating patients, Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST(2) ACTWeb), to test cultural acceptability, transferability, and educational impact. The study was designed as a quasi-experimental evaluation of the FIRST(2) ACTWeb program with final year nursing students from a Bachelor of Nursing program at the University of Hong Kong. Participants completed pre-course and post-course tests, three interactive scenarios, and program evaluations. The program was positively evaluated, with significant improvements in knowledge, skills, self-rating of performance, confidence, and competence. Outcomes were comparable to earlier evaluations with Australian students, demonstrating that an interactive simulation-based program of patient deterioration management has cultural and language acceptability and transferability across communities with significant educational impact.
Asunto(s)
Aprendizaje , Evaluación en Enfermería/métodos , Evaluación en Enfermería/normas , Atención de Enfermería/normas , Simulación de Paciente , Estudiantes de Enfermería/psicología , Femenino , Hong Kong , Humanos , Masculino , Programas Informáticos/normas , Adulto JovenRESUMEN
A highly oxidized form of a chitosan/dextran-based hydrogel (CD-100) containing 80% oxidized dextran aldehyde (DA-100) was developed as a post-operative aid, and found to significantly prevent adhesion formation in endoscopic sinus surgery (ESS). However, the CD-100 hydrogel showed moderate in vitro cytotoxicity to mammalian cell lines, with the DA-100 found to be the cytotoxic component. In order to extend the use of the hydrogel to abdominal surgeries, reformulation using a lower oxidized DA (DA-25) was pursued. The aim of the present study was to compare the antimicrobial efficacy, in vitro biocompatibility and wound healing capacity of the highly oxidized CD-100 hydrogel with the CD-25 hydrogel. Antimicrobial studies were performed against a range of clinically relevant abdominal microorganisms using the micro-broth dilution method. Biocompatibility testing using human dermal fibroblasts was assessed via a tetrazolium reduction assay (MTT) and a wound healing model. In contrast to the original DA-100 formulation, DA-25 was found to be non-cytotoxic, and showed no overall impairment of cell migration, with wound closure occurring at 72 h. However, the lower oxidation level negatively affected the antimicrobial efficacy of the hydrogel (CD-25). Although the CD-25 hydrogel's antimicrobial efficacy and anti-fibroblast activity is decreased when compared to the original CD-100 hydrogel formulation, previous in vivo studies show that the CD-25 hydrogel remains an effective, biocompatible barrier agent in the prevention of postoperative adhesions.
Asunto(s)
Antiinfecciosos/química , Materiales Biocompatibles/química , Quitosano/química , Dextranos/química , Hidrogeles/química , Aldehídos/química , Antiinfecciosos/farmacología , Materiales Biocompatibles/farmacología , Línea Celular , Fibroblastos/efectos de los fármacos , Humanos , Hidrogeles/farmacología , Oxidación-ReducciónAsunto(s)
Enfermedad de Alzheimer/fisiopatología , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Aislamiento Social , Brote de los Síntomas , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/tratamiento farmacológico , Enfermedad de Alzheimer/psicología , COVID-19 , Infecciones por Coronavirus/prevención & control , Femenino , Humanos , Control de Infecciones , Masculino , Pandemias/prevención & control , Neumonía Viral/prevención & controlAsunto(s)
Infecciones por Coronavirus/prevención & control , Coronavirus , Prestación Integrada de Atención de Salud , Demencia/terapia , Neumonía Viral/prevención & control , Betacoronavirus , COVID-19 , Infecciones por Coronavirus/epidemiología , Demencia/epidemiología , Demencia/psicología , Humanos , Pandemias , Neumonía Viral/epidemiología , SARS-CoV-2Asunto(s)
Infecciones por Coronavirus , Demencia/enfermería , Familia , Conducta Alimentaria/psicología , Cuidados a Largo Plazo , Desnutrición/prevención & control , Pandemias , Neumonía Viral , Aislamiento Social , Anciano , Anciano de 80 o más Años , COVID-19 , Infecciones por Coronavirus/prevención & control , Femenino , Humanos , Masculino , Pandemias/prevención & control , Neumonía Viral/prevención & controlRESUMEN
A novel isoquinoline-containing C^N^C ligand and its phosphorescent triphenylamine-based alkynylgold(III) dendrimers have been synthesized. These alkynylgold(III) dendrimers serve as phosphorescent dopants in the fabrication of efficient solution-processable organic light-emitting devices (OLEDs). The photophysical, electrochemical, and electroluminescence properties were studied. A saturated red emission with CIE coordinates of (0.64, 0.36) and a high EQE value of 3.62% were achieved. Unlike other red-light-emitting iridium(III) dendrimers, a low turn-on voltage of less than 3â V and a reduced efficiency roll-off at high current densities were observed; this can be accounted for by the enhanced carrier transporting ability and the relatively short lifetimes in the high-generation dendrimers. This class of alkynylgold(III) dendrimers are promising candidates as phosphorescent dopants in the fabrication of solution-processable OLEDs.
RESUMEN
INTRODUCTION: Rapid response team (RRT) and code activation events occur relatively commonly in inpatient settings. RRT systems have been the subject of a significant amount of analysis, although this has been largely focused on the impact of RRT system implementation and RRT events on patient outcomes. There is reason to believe that the structured assessment of RRT and code events may be an effective way to identify opportunities for system improvement, although no standardised approach to event analysis is widely accepted. We developed and refined a protocolised system of RRT and code event review, focused on sustainable, timely and high value event analysis meant to inform ongoing improvement activities. METHODS: A group of clinicians with expertise in process and quality improvement created a protocolised analytic plan for rapid response event review, piloted and then iteratively optimised a systematic process which was applied to all subsequent cases to be reviewed. RESULTS: Hospitalist reviewers were recruited and trained in a methodical approach. Each reviewer performed a chart review to summarise RRT events, and collect specific variables for each case (coding). Coding was then reviewed for concordance, at monthly interdisciplinary group meetings and 'Action Items' were identified and considered for implementation. In any 12-month period starting in 2021, approximately 12-15 distinct cases per month were reviewed and coded, offering ample opportunities to identify trends and patterns. CONCLUSION: We have developed an innovative process for ongoing review of RRT-Code events. The review process is easy to implement and has allowed for the timely identification of high value improvement opportunities.
Asunto(s)
Equipo Hospitalario de Respuesta Rápida , Mejoramiento de la Calidad , Humanos , Equipo Hospitalario de Respuesta Rápida/normas , Equipo Hospitalario de Respuesta Rápida/estadística & datos numéricos , Equipo Hospitalario de Respuesta Rápida/tendenciasRESUMEN
BACKGROUND: Empathy and self-efficacy for smoking cessation counseling can be enhanced through smoking cessation training. Narrative videos and virtual reality (VR) games have been applied in medical education, but their application in smoking cessation training is limited and understudied. OBJECTIVES: To evaluate the effect of smokers' narrative videos and mini-VR games on nursing students' empathy towards smokers (State Empathy Scale), confidence in practicing empathy, self-efficacy in smoking cessation counseling, and learning satisfaction. DESIGN: An open-labeled randomized controlled trial, registration number: NCT05440877 (ClinicalTrials.gov). SETTING AND PARTICIPANTS: Master of nursing students from the University in Hong Kong who enrolled in a smoking cessation course. METHODS: All students attended a tutorial including case-based discussions and role-play. The intervention group could additionally access the narrative videos and mini-VR games of smokers' cases. Linear mixed models and Cohen's d were used to evaluate the intervention effect on the self-reported learning outcomes after the intervention. RESULTS: 26 students enrolled in this trial, with 13 in each trial arm. All completed the trial. Post-test state empathy scores were significantly higher in the control group than in the intervention group (Cohen's d = 0.814, p = 0.049). No significant group differences were observed in the change of confidence in practicing empathy (ß = -11.154, p = 0.073), self-efficacy (ß = 4.846, p = 0.096), and students' learning satisfaction (Cohen's d = 0.041, p = 0.917). Both groups showed a significant increase in self-efficacy post-test (p < 0.001). CONCLUSIONS: Narrative videos showing smoking scenes and reluctance to quit, and our mini-VR games may weaken nursing students' empathy towards smokers. Smoking cessation training involving narrative videos should be modified. Debriefing and guidance to understand smokers' difficulties and express empathy are needed. VR games for smoking cessation training can involve more frame stories and challenging tasks to increase engagement.
Asunto(s)
Consejo , Empatía , Autoeficacia , Cese del Hábito de Fumar , Estudiantes de Enfermería , Juegos de Video , Humanos , Femenino , Masculino , Hong Kong , Estudiantes de Enfermería/psicología , Estudiantes de Enfermería/estadística & datos numéricos , Cese del Hábito de Fumar/métodos , Cese del Hábito de Fumar/psicología , Juegos de Video/psicología , Adulto , Consejo/métodos , Consejo/educación , Narración , Grabación en Video , Educación de Postgrado en Enfermería/métodosRESUMEN
Emission control: carbazole-based dendritic alkynylgold(III) complexes have been evaluated as phosphorescent emitters in organic light-emitting devices. The energy as well as the bathochromic shift of the emissions can be tuned effectively through a control of the dendrimer generation. The optimized devices show high current and external quantum efficiencies of up to 24.0 cd A(-1) and 7.8 %, respectively.
RESUMEN
BACKGROUND: Nurse-administered blood transfusion (BT) is a common form of medical treatment, but nursing students are often excluded from participating in and observing BTs during clinical placements. To address clinical placement limitations, nursing educators have increasingly adopted technology-guided simulation pedagogies, including virtual reality (VR) simulation, for nursing students' clinical skills education. OBJECTIVES: To develop VR simulation for BT practice and investigate its effectiveness with nursing students. DESIGN: A single-blinded, two-arm randomised controlled trial. SETTINGS: One university in Hong Kong. PARTICIPANTS: A total of 151 nursing students enrolled in a nursing undergraduate course at a university in Hong Kong were recruited via convenience sampling in March 2022. METHODS: Evidence-based VR simulation videos consisting of 1) animated blood formation physiology and side effects of BT and 2) 360° BT nursing practice were developed. The nursing students were randomly allocated into intervention and control groups. The intervention group (n = 75) received the usual BT education (i.e. Zoom lecture) with the developed VR video education, whereas the control group (n = 76) received the usual BT education (Zoom). The BT knowledge (RBTKQ-O), student satisfaction and self-confidence (SSSC) and self-efficacy (GSES) of BT practice were measured before and after BT education. Intention-to-treat analyses were performed. RESULTS: The primary and secondary outcomes (RBTKQ-O, SSCS and GSES, respectively) improved over time in both groups. Analysis of covariance revealed that students who received VR simulation reported higher post-intervention measurement scores in BT knowledge and SSCS than those who did not receive VR simulation. CONCLUSIONS: VR simulation-enhanced BT education effectively enhances the knowledge and SSCS of BT practice amongst nursing students. Nurse educators may adopt VR simulation to enhance the effectiveness of existing BT education for nursing students.
Asunto(s)
Bachillerato en Enfermería , Educación en Enfermería , Estudiantes de Enfermería , Realidad Virtual , Humanos , Transfusión Sanguínea , Competencia ClínicaRESUMEN
BACKGROUND: It is unknown whether financial well-being mediates the impact of multimorbidity on the health-related quality of life (HRQoL) of cancer patients. METHODS: Participants were recruited from three outpatient oncology clinics of Hong Kong public hospitals. Multimorbidity was assessed using the Charlson Comorbidity Index. Financial well-being, the mediator of the association between multimorbidity and HRQoL outcomes, was assessed using the Comprehensive Score for Financial Toxicity Functional Assessment of Chronic Illness Therapy. The HRQoL outcomes were assessed using the Functional Assessment of Cancer Therapy - General (FACT-G) and its four sub-dimensions. Mediation analyses were conducted using SPSS PROCESS v4.1. RESULTS: Six-hundred and forty cancer patients participated in the study. Multimorbidity had a direct effect on FACT-G scores independent of financial well-being (ß for path c' = -0.752, p < 0.001). In addition, multimorbidity had an indirect effect on FACT-G scores through its effect on financial well-being (ß for path a = -0.517, p < 0.05; ß for path b = 0.785, p < 0.001). Even after adjustments were made for the covariates, the indirect effect of multimorbidity on FACT-G via financial well-being remained significant, accounting for 38.0% of the overall effect, indicating partial mediation. Although there were no statistically significant associations between multimorbidity, social well-being, and emotional well-being, the indirect effects of multimorbidity on physical and functional well-being through financial well-being remained significant. CONCLUSIONS: Poor financial well-being attributable to multimorbidity partially mediates the direct impact of chronic conditions on HRQoL in Chinese cancer patients, particularly their physical and functional well-being.
Asunto(s)
Multimorbilidad , Neoplasias , Humanos , Calidad de Vida/psicología , Enfermedad Crónica , Neoplasias/epidemiología , Análisis de MediaciónRESUMEN
Minimally invasive endodontic access cavities have gained popularity in academic discussions for their clinical applications in recent years. Although some studies showed an improved fracture resistance of endodontically-treated teeth accessed with a minimally invasive access cavity design, the resulting effectiveness and efficiency of subsequent root canal treatment procedures may be impaired. Aspects that may be impaired are canal detection and negotiation, chemomechanical debridement of the root canal system, quality of the obturation. These are potentially complicated by the increased incidence of procedural mishaps and compromised aesthetic outcomes. In addition, the inherent flaws presented in the methodology of some in vitro studies and the lack of a universal classification system are also of concern. This literature review aims to present a comprehensive overview of the development of the minimally invasive endodontic access cavity and summarise the currently available from a clinical context.
Asunto(s)
Caries Dental , Diente no Vital , Estética Dental , Humanos , Preparación del Conducto Radicular/métodos , Tratamiento del Conducto RadicularRESUMEN
BACKGROUND: Engaging students in interprofessional education for higher order thinking and collaborative problem-solving skills is challenging. This study reports the development of Virtual ER, a serious game played on a virtual platform, and how it can be an innovative way for delivering interprofessional education to medical and nursing undergraduates. OBJECTIVE: We report the development of a serious online game, Virtual ER, and evaluate its effect on teamwork enhancement and clinical competence. We also explore if Virtual ER can be an effective pedagogical tool to engage medical and nursing students with different learning styles. METHODS: Virtual ER is a custom-made, learning outcome-driven, case-based web app. We developed a game performance scoring system with specific mechanisms to enhance serious gaming elements. Sixty-two students were recruited from our medical and nursing programs. They played the games in teams of 4 or 5, followed by an instructor-led debriefing for concept consolidation. Teamwork attitudes, as measured by the Human Factors Attitude Survey, were compared before and after the game. Learning style was measured with a modified Honey and Mumford learning style questionnaire. RESULTS: Students were satisfied with Virtual ER (mean satisfaction score 5.44, SD 0.95, of a possible 7). Overall, Virtual ER enhanced teamwork attitude by 3.02 points (95% CI 1.15-4.88, P=.002). Students with higher scores as activists (estimate 9.09, 95% CI 5.17-13.02, P<.001) and pragmatists (estimate 5.69, 95% CI 1.18-10.20, P=.01) had a significantly higher degree of teamwork attitude enhancement, while students with higher scores as theorists and reflectors did not demonstrate significant changes. However, there was no difference in game performance scores between students with different learning styles. CONCLUSIONS: There was considerable teamwork enhancement after playing Virtual ER for interprofessional education, in particular for students who had activist or pragmatist learning styles. Serious online games have potential in interprofessional education for the development of 21st century life skills. Our findings also suggest that Virtual ER for interprofessional education delivery could be expanded locally and globally.
RESUMEN
Introduction: Debriefing plays a vital role in effective simulation-based learning by providing feedback to students to foster their development of critical thinking in the learning. Objectives: We evaluated the effects of rubric-based debriefing on students' critical thinking, level of confidence in performing tasks and communication. Method: This is a quasi-experimental study. Final year nursing undergraduates (n=204) of a local university participated in the study. In the intervention group, students performed two 20 min simulation sessions individually with simulated patients followed by a 15 min individual rubric-based debriefing between the two sessions and had a 5 min of that at the end. In the control group, students performed the same simulation sessions followed by a 20 min individual rubric-based debriefing at the end. The primary outcome was comparing the critical thinking of students between two groups, which was assessed by The Northeastern Illinois University Critical Thinking Rubric. The qualitative data were collected by an open-ended question. Results: Based on generalised estimating equation models, the intervention effect over time was found to be statistically significant (ß=2.06, 95% CI 1.04 to 3.08) in enhancing students' critical thinking. No statistically significant differences were reported in the self-perceived confidence levels between the intervention group and control group. Qualitative data reflected positive feedback from students on simulation activities. Conclusions: This is the first study to provide evidence that a rubric-based debriefing enhances students' critical thinking in simulation learning.