Current provision and HCP experiences of remote care delivery and diabetes technology training for people with type 1 diabetes in the UK during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has led to the rapid implementation of remote care delivery in type 1 diabetes. We studied current modes of care delivery, healthcare professional experiences and impact on insulin pump training in type 1 diabetes care in the United Kingdom (UK). METHODS: The UK Diabetes Technology Network designed a 48-question survey aimed at healthcare professionals providing care in type 1 diabetes. RESULTS: One hundred and forty-three healthcare professionals (48% diabetes physicians, 52% diabetes educators and 88% working in adult services) from approximately 75 UK centres (52% university hospitals, 46% general and community hospitals), responded to the survey. Telephone consultations were the main modality of care delivery. There was a higher reported time taken for video consultations versus telephone (p < 0.001). Common barriers to remote consultations were patient familiarity with technology (72%) and access to patient device data (67%). We assessed the impact on insulin pump training. A reduction in total new pump starts (73%) and renewals (61%) was highlighted. Common barriers included patient digital literacy (61%), limited healthcare professional experience (46%) and time required per patient (44%). When grouped according to size of insulin pump service, pump starts and renewals in larger services were less impacted by the pandemic compared to smaller services. CONCLUSION: This survey highlights UK healthcare professional experiences of remote care delivery. While supportive of virtual care models, a number of factors highlighted, especially patient digital literacy, need to be addressed to improve virtual care delivery and device training.

Understanding Digital Health Technologies Using Mind Maps.

PURPOSE: The purpose of this project was to explore digital health technologies in the healthcare environment through the use of concept and mind mapping tools in a graduate level informatics practicum course. DESIGN: This descriptive course evaluation project was conducted at a large university school of nursing during the 2019-2020 academic year and included a convenience sample of 163 doctor of nursing practice students. METHODS: Students completed four major deliverables exploring digital health technologies and data sources using mind maps. Project goals were evaluated using detailed rubrics and data from a course evaluation questionnaire (CEQ) then analyzed using descriptive statistics. Comments from the CEQ and reflection documents were reviewed for themes and validated by two experts. FINDINGS: The variety and creativity of the mind maps along with student comments indicated their ability to apply critical thinking skills to the specific content and technologies being examined. Overall CEQ mean scores were high (M = 4.35), indicating that the mind mapping deliverables were logical, relevant, appropriate, and meaningful to learning. CONCLUSIONS: Nurse educators and healthcare professionals should consider using mind mapping techniques because this venue allows for expanded understanding of the complexities of the healthcare environment and integration of related digital health technologies. CLINICAL RELEVANCE: The recent pandemic highlighted the necessity for new technologies to continue providing patient care services. Mind maps are a fast and economical tool for understanding and prioritizing the needs of an organization as well as a unique teaching strategy to promote critical thinking and sharing of ideas related to digital health technologies.

Learning, understanding and the use of information technology: a survey study among primary care physician trainees.

BACKGROUND: User understanding of information technology systems (IT-Systems) is a prerequisite for their use. This study aimed to explore how primary care physician trainees learn, understand and use IT-Systems. METHODS: A paper-based survey study among 301 primary care physician trainees in Baden-Wuerttemberg, Germany, was performed. The questionnaire included measures of understanding and use of nine specific system features, five possible learning strategies, a validated scale for affinity for technology interaction, and five individual and three practice characteristics. RESULTS: The sample comprised 94 respondents (31.6% response rate). Between 3.2 and 59.6% said to know specific systems features well; between 13.8 and 42.6% expressed a wish to know more about specific system features. The predominant strategy for learning system features was explanation by others: 51.7 to 66.7% had applied this strategy to learn the features. Between 18.6 and 41.4% had learned the features by trial and error. A better understanding of system features was associated with the use of a trial and error strategy for learning system features (beta = 0.260, p = 0.012). The use of a greater variety of learning strategies was associated with higher affinity for technology interaction (beta = 0.215, p = 0.037). CONCLUSION: The study suggests that many physicians need a better understanding of IT-Systems. The role of manuals, online resources and courses in learning IT-Systems seems limited. The new generation of primary care physicians seem to learn features of IT-Systems through explanation by others and trying in their ambulatory practices. The relevance of IT-Systems in healthcare is high, but physicians need more support in learning to use system features.

Library as the Technology Hub for the Health Sciences.

Academic health sciences libraries have an important role in facilitating the use of technology in health sciences curricula. Serving as a technology hub, the library supports, advocates, and provides access to new technologies. The library introduces many faculty and students to new technology tools, techniques, and equipment for new multimedia creation. As the technology hub grows and expands, library personnel can provide expertise, which demonstrates the library's value in leading the exploration of new technology, including Do-It-Yourself multimedia tools, virtual reality, virtual anatomy, and 3D printing.

Use of Simulation-Based Training to Aid in Implementing Complex Health Technology.

Clinicians are adult learners in a complex environment that historically does not invest in training in a way that is conducive to these types of learners. Adult learners are independent, self-directed, and goal oriented. In today's fast-paced clinical setting, a practical need exists for nurses and clinicians to master the technology they use on a daily basis, especially as medical devices have become more interconnected and complex. As hospitals look to embrace new technologies, medical device companies must provide clinical end-user training. This should be a required part of the selection process when considering the purchase of any complex medical technology. However, training busy clinicians in a traditional classroom setting can be difficult and costly. A simple, less expensive solution is online simulation training. This interactive training provides a virtual, "hands-on" end-user experience in advance of implementing new equipment. Online simulation training ensures knowledge retention and comprehension and, most importantly, that the training leads to end-user satisfaction and the ability to confidently operate new equipment. A review of the literature revealed that online simulation, coupled with the use of adult learning principles and experiential learning, may enhance the experience of clinical end users.

New technology and the chain of safety.

Healthcare is currently experiencing an exponential growth in medical technology but it has not kept pace with similar industries such as the airline industry. New technology has the potential to improve patient safety, but if the introduction of new technology into the healthcare setting is not coordinated in a thoughtful, proactive manner, there may be weak links in the chain of safety that may expose risks for patients. We describe three concepts that represent this chain of safety. We suggest that these are shared among all leadership and frontline staff and that these concepts require their full attention and investment in order to keep the chain of safety intact and avoid a single weak link in implementing new technology.

Les nouvelles technologies et la chaîne de la sécurité.

La technologie médicale connaît une croissance exponentielle dans le milieu de la santé, mais elle n'a toutefois pas suivi le rythme observé dans des industries similaires, telles que l'aéronautique. Les nouvelles technologies ont le potentiel d'accroître la sécurité des patients, mais si leur introduction dans le milieu de la santé n'est pas coordonnée de manière réfléchie et proactive, la chaîne de la sécurité risque de s'en trouver affaiblie, ce qui exposera les patients à des risques. Trois concepts qui représentent la chaîne de la sécurité sont décrits. Les équipes de direction et le personnel de première ligne devraient tous les connaître, les étudier et s'y investir afin de maintenir la chaîne de la sécurité intacte et d'éviter qu'un seul maillon soit affaibli par l'adoption d'une nouvelle technologie.

Integrating technology into practice.

A recent NZNO study has shown patchy use by nurses of electronic devices and files. Nurses need more education and support if e-health is to be integrated successfully into nursing practice.

Experiencing Functional Electrical Stimulation Roots on Education, and Clinical Developments in Paraplegia and Tetraplegia With Technological Innovation.

Cybernetics-based concepts can allow for complete independence for paralyzed individuals, including sensory motor recovery. Spinal cord injuries are responsible for a huge stress on health and a financial burden to society. This article focuses on novel procedures such as functional diagnosis for paraplegics and tetraplegics, cybertherapies toward lessening comorbidities such as cardiovascular diseases, osteoporosis, etc., and the production of new technology for upper and lower limb control. Functional electrical stimulation reflects a unique opportunity for bipedal gait to be achieved by paraplegics and tetraplegics. Education and training of undergraduates and postgraduates in engineering and life sciences have also been a major aim of this work.

The case for advanced physics topics in oral and maxillofacial surgery.

Research in oral and maxillofacial surgery has focused mainly on principles founded in the biological and chemical sciences, which have provided excellent answers to many questions. However, recent technologic advances have begun to gain prominence in many of the medical sciences, providing clinicians with more effective tools for diagnosis and treatment. The era of modern physics has led to the development of diagnostic techniques that could provide information at a more basic level than many of the current biochemical methods used. The goal of this report is to introduce 2 of these methods and describe how they can be applied to oral and maxillofacial surgery.

Can anyone screen for deep infiltrating endometriosis with transvaginal ultrasound?

BACKGROUND: Surgical treatment of deep infiltrating endometriosis (DIE) is complex, and preoperative diagnosis benefits both surgeon and patient. Studies in expert centres have reported high accuracy for transvaginal ultrasound (TVUS) diagnosis of DIE. External validation of these findings has been limited, and no information is available on how quickly these skills can be acquired. The aim of this study was to measure the learning curve of DIE-TVUS and to identify the causes for inaccuracies in the diagnosis of bowel lesions and Pouch of Douglas (POD) obliteration. METHODS: Following one week of training at the University of São Paulo (Brazil), 205 consecutive women with a history of endometriosis symptoms were prospectively assessed by TVUS after minimal bowel preparation. TVUS findings were correlated with laparoscopic findings in eighty-five cases to assess the accuracy. The LC-CUSUM and CUSUM were used to assess the learning curve and maintenance of competency, respectively. RESULTS: The sensitivity and specificity for DIE of the bladder, vagina and bowel were 33% and 100%, 80% and 100%, and 88% and 93%, respectively. The sensitivity and specificity for the presence of POD obliteration were 88% and 90%, respectively. LC-CUSUM analysis confirmed that competency for DIE-TVUS was achieved within 38 scans for the detection of POD obliteration and within 36 scans for the detection of bowel nodules. Competency was maintained for the remainder of the scans as assessed by the CUSUM. CONCLUSIONS: After one week of DIE-TVUS training, competency can be achieved within forty procedures, allowing diagnosis of DIE with similar diagnostic accuracy as reported by centres of excellence.

Multidisciplinary collaboration as a sustainable research model for device development.

The concurrent problems of research sustainability and decreased clinician involvement with medical device development can be jointly addressed through a novel, multidisciplinary solution. The University of Rochester Cardiovascular Device Design Program is a sustainable program in medical device design supported through a collaboration between the Schools of Medicine and Engineering. This article provides a detailed description of the motivation for starting the program, the current structure of the program, the methods of financial sustainability, and the direct impact it intends to have on the national vascular surgery community. The further expansion of this program and encouragement for development of similar programs throughout the country aims to address many of our current challenges in both research funding and device development education.

[First South american network of biomedical research. Education and biotechnology for health]. / Primera Red Sudamericana de Biomedicina. Investigación, educación y biotecnología aplicadas a la salud.

It is in our interest, in this brief manuscript, to report the creation of the first program of regional integration of a network of research institutes in Biomedicine belonging to members of the MERCOSUR countries. We discuss some of the foundations that gave sustenance to its creation and its objectives in the medium and long term. In addition, we consider the potential of the results of this program in the fields of applied medical research, education and biotechnology.