A Framework for Developing Holistic Leaders.

Advocating for holistic leaders' development, holistic leadership is defined and contrasted with other developmental approaches. A model that frames four dimensions of development is presented. These dimensions include self-awareness and values identification, relational capacity, problem solving and action orientation, and other orientation. [J Contin Educ Nurs. 2021;52(5):211-213.].

Increasing the availability of Tai Chi to veterans through a training of trainers course.

PURPOSE: The purpose of this nurse-led project was to increase the number of interprofessional Tai Chi instructors for veterans through a 5-week (32 hours) training of trainers (ToT) course led by a Tai Chi master trainer. METHODS: This project was designed to evaluate the effectiveness of using the ToT model to increase the availability of Tai Chi to veterans. To understand how well the ToT course met learners' needs, a two-phase course evaluation was conducted. RESULTS: Fifteen interprofessional employees enrolled in and completed the course. Most learners were white (67%) females (67%) with a median age of 50 years. All agreed that the training provided the skills, materials, and confidence to lead Tai Chi classes. Most (93%) indicated experiencing positive health benefits from the training and none experienced any negative effects. The 3-month follow-up evaluation indicated that 10 (67%) were teaching veterans in individual or group classes with two others assisting. Twelve instructors taught more than 150 veterans. CONCLUSIONS: Overall, learners evaluated this ToT course positively and indicated their needs were met and felt prepared to teach Tai Chi despite being inexperienced. The course was a success with 80% of new instructors teaching or coteaching Tai Chi to veterans.

Mindfulness in Education and Paulo Freire: a reflective approach / Mindfulness en la Educación y Paulo Freire: un abordaje reflexivo / Mindfulness na Educação e Paulo Freire: uma abordagem reflexiva

This essay makes a theoretical reflection upon possible conceptual proximities between the contemporary application of Mindfulness in education and the educational proposals of Paulo Freire. The study manages to approximate Freire to Mindfulness through a few concepts such as "openness to the new" and 'critical curiosity', which are related to a certain kind of development of awareness. We conclude that the contributions of mindfulness to the educational process as understood by Paulo Freire are related to the ability to develop a state of presence that brings more awareness to mental and emotional states, as much as it leads to conscious actions opposed to actions in the autopilot. Awareness (which is close to the concept of action-reflection in Freire) becomes, thus, a keyword for transformation towards lesser mental, emotional, physical and social/interpersonal suffering, both in Freire and in Mindfulness.(AU)

Este ensayo proporciona una reflexión teórica sobre la posible proximidad conceptual entre la aplicación contemporánea de Mindfulness (atención plena) en la educación y las propuestas educativas de Paulo Freire. El estudio consigue aproximar los conceptos de Freire del cuadro de referencia de la Atención Plena, por medio de conceptos tales como "apertura a lo nuevo" y "curiosidad crítica", relacionados con cierto tipo de desarrollo de la conciencia (awareness). Se concluye que las contribuciones de la atención plena para el proceso educativo, conforme entendido por Paulo Freire, se relacionan con la capacidad de desarrollar un estado de presencia que brinde más conciencia de los estados mentales y emocionales, además de llevar las acciones conscientes en oposición a las inconscientes. La conciencia, concepto próximo al de reflexión-acción en Freire, se convierte, por lo tanto, en una palabra clave para la transformación hacia la disminución del sufrimiento mental, emocional, físico y social/interpersonal, tanto en Freire como en Mindfulness.(AU)

Este ensaio traz uma reflexão teórica sobre a possível proximidade conceitual entre a aplicação contemporânea de Mindfulness (Atenção Plena) na Educação e as propostas educacionais de Paulo Freire. O estudo consegue aproximar os conceitos de Freire do quadro referencial da Atenção Plena, por meio de conceitos como "abertura ao novo" e "curiosidade crítica", relacionados a certo tipo de desenvolvimento da consciência (awareness). Conclui-se que as contribuições da Atenção Plena para o processo educacional, conforme entendido por Paulo Freire, relacionam-se à capacidade de desenvolver um estado de presença que traga mais consciência aos estados mentais e emocionais, além de levar a ações conscientes em oposição a ações inconscientes. Consciência, conceito próximo ao de reflexão-ação em Freire, torna-se, portanto, uma palavra-chave para a transformação em direção à diminuição do sofrimento mental, emocional, físico e social/interpessoal, tanto em Freire quanto no Mindfulness.(AU)

Teaching Nurses From a Holistic Comfort Perspective.

Nursing students in various degree programs experience an array of stressful and demanding circumstances. As such, nursing faculty have a unique opportunity to provide student-centered teaching from a holistic comfort perspective. Holistic comfort is a concept supported by evidence symbolizing more than just the relief of pain. It involves caring for the whole person. The majority of research surrounding holistic comfort has been focused on patients-but, what about students in nursing? In this article, the authors aim to explain and expand upon the role of teaching from a holistic comfort perspective. Holistic comfort has been well documented in the literature and it is delivered in one (or more) of 4 different contexts: the physical, psychospiritual, sociocultural, and/or environmental context. Implementing a program of teaching focused on comforting students has implications for nursing education, organizational policy, and nursing practice.

Implementation of alcohol and drug screening, brief intervention, and referral to treatment: Nurse practitioner learner perspectives on a mobile app.

BACKGROUND AND PURPOSE: Screening, brief Intervention, and referral to treatment (SBIRT) is a widely trained evidence-based strategy to identify and address alcohol and drug use problems. The purpose of this qualitative study was to explore the experience of family nurse practitioner (FNP) learners in the implementation of SBIRT and the perceived clinical utility of an SBIRT mobile app. METHODS: Twenty-two FNP learners completed didactic SBIRT training and orientation to an SBIRT mobile app. At the conclusion of the study, participant focus groups explored overall SBIRT delivery (N = 19) and SBIRT mobile app utilization (N = 14). Focus group data were analyzed within a Theory of Planned Behavior framework. RESULTS: Participants indicated that the mobile app was useful in the ongoing development of SBIRT knowledge, skill confidence, and motivation. Learners identified the clinical context as a major factor in facilitating the delivery of SBIRT overall. Participants who did not deliver SBIRT indicated that the most significant barriers to SBIRT implementation were lack of support from clinical preceptors and health systems. CONCLUSIONS: Findings suggest that a mobile app is an acceptable and feasible tool to improve the delivery of SBIRT. However, collaboration with preceptors and clinical training organizations is essential to optimize clinical translation.

Dietary Intake in Relation to Military Dietary Reference Values During Army Basic Combat Training; a Multi-center, Cross-sectional Study.

INTRODUCTION: The military dietary reference intakes (MDRIs), outlined in Army Regulation 40-25, OPNAVINST 10110.1/MCO10110.49, AFI 44-141, establish standards intended to meet the nutrient requirements of Warfighters. Therefore, the purpose of this study was to comprehensively compare the revised MDRIs, published in 2017, with estimated dietary intakes in U.S. military personnel. MATERIALS AND METHODS: During this cross-sectional study, Block food frequency questionnaires were administered at the end of the 9-week basic combat training course to estimate dietary intake during basic combat training in male (n = 307) and female (n = 280) recruits. The cut-point method was used to determine nutrient adequacy in comparison to the MDRIs. This study was approved by the Institutional Review Board of the U.S. Army Research Institute of Environmental Medicine. RESULTS: Recruits consumed an adequate amount of vitamins A, C and K, as well as the B-vitamins, and phosphorus, selenium, zinc, and protein and carbohydrate as a percentage of total calories when compared with MDRI standards. Vitamin D was the short-fall nutrient affecting the greatest number of participants, as 55 and 70% of males and females, respectively, consumed less than 33% of the MDRI. In addition, less than 50% of males met the MDRI for linoleic and α-linolenic acid, fiber, vitamin E, magnesium, and potassium, and less than 50% of females met the MDRI for α-linolenic acid, fiber, vitamin E, calcium, iron, magnesium, and potassium. In contrast, fat and sodium were over-consumed by both males (78 and 87%, respectively) and females (73 and 72%, respectively). CONCLUSION: The main findings of this study were that vitamins D and E, magnesium, potassium, α-linolenic acid, and fiber were under consumed by male and female recruits while males also did not consume adequate linoleic acid and females did not consume adequate calcium and iron. Future prospective research studies are needed to determine possible health and performance impacts that may be associated with suboptimal intake of these nutrients.

VER-SUS project: Influences on the training and performance of nurses.

OBJECTIVE: To analyze the influences of the Vivências e Estágios na Realidade do Sistema Único de Saúde (Brazilian Unified Health System), in the training and performance of nurses. METHOD: A qualitative study was carried out with 14 nurses who participated in the VER-SUS project in Rio Grande do Sul State. The data were collected through a semi-structured interview technique. The data were analyzed, interpreted and discussed, through the technique of Content Analysis. RESULTS: The categories "VER-SUS Influences on Nursing Training for SUS" and "VER-SUS Contributions for Nurses Performance in the SUS" were highlighted. FINAL CONSIDERATIONS: It was possible to identify the influences of the VER-SUS project in the training and performance of the nursing professionals, pointing out the revision of the Pedagogical Projects of Course and the preparation of the teachers, as a way to carry out the training with emphasis in the Brazilian Unified Health System.

Rethinking the Health Care Model through the reorientation of training.

OBJECTIVE: to understand the contributions of the National Program of Reorientation of Professional Training in Health (Pró-Saúde) for the change in the model of care and training of health professionals. METHODS: a case study with representatives of the teaching, care, management and social control, participants of the management units of the Pró-Saúde (Charitable institution for social and hospital assistance), in a municipality of the south of Brazil. Data collection took place through interviews and observations between October 2012 and February 2013. RESULTS: the Program acts as a device for the transition of health care and training models, by promoting the problematization of daily work and the approximation between teaching and service. Emphasis is placed on the importance of the subjects' commitment and the different perspectives on the community. CONCLUSION: Pró-Saúde leaves visible marks in the process of qualifying students and professionals, as well as promoting collaborative action in the fields of management, care, teaching and social control in the SUS (Brazilian Unified Health System).

Rethinking the Health Care Model through the reorientation of training / Repensando el modelo de Atención en Salud mediante la reorientación de la formación / Repensando o modelo de Atenção em Saúde mediante a reorientação da formação

ABSTRACT Objective: to understand the contributions of the National Program of Reorientation of Professional Training in Health (Pró-Saúde) for the change in the model of care and training of health professionals. Methods: a case study with representatives of the teaching, care, management and social control, participants of the management units of the Pró-Saúde (Charitable institution for social and hospital assistance), in a municipality of the south of Brazil. Data collection took place through interviews and observations between October 2012 and February 2013. Results: the Program acts as a device for the transition of health care and training models, by promoting the problematization of daily work and the approximation between teaching and service. Emphasis is placed on the importance of the subjects' commitment and the different perspectives on the community. Conclusion: Pró-Saúde leaves visible marks in the process of qualifying students and professionals, as well as promoting collaborative action in the fields of management, care, teaching and social control in the SUS (Brazilian Unified Health System).

RESUMEN Objetivo: comprender las contribuciones del Programa Nacional de Reorientación de la Formación Profesional en Salud (Pró-Saúde) para el cambio en el modelo de atención y de formación de profesionales de salud. Métodos: estudio de caso con representantes de la enseñanza, atención, gestión y control social, participantes de las instancias gestoras del Pró-Saúde, en un municipio del sur de Brasil. La recolección de datos ocurrió mediante entrevistas y observaciones, entre octubre de 2012 y febrero de 2013. Resultados: el Programa actúa como dispositivo para la transición de modelos de atención y formación en salud, al promover la problematización del cotidiano del trabajo y la aproximación entre enseñanza y servicio. Se destaca la importancia del compromiso de los sujetos y de las diferentes miradas sobre la comunidad. Conclusión: el Pró-Saúde deja marcas visibles en el proceso de calificación de estudiantes y profesionales, además de promover la actuación colaborativa en los campos de la gestión, atención, enseñanza y control social en el SUS.

RESUMO Objetivo: compreender as contribuições do Programa Nacional de Reorientação da Formação Profissional em Saúde (Pró-Saúde) para a mudança no modelo de atenção e de formação de profissionais de saúde. Métodos: estudo de caso com representantes do ensino, atenção, gestão e controle social, participantes das instâncias gestoras do Pró-Saúde, em um município do sul do Brasil. A coleta de dados ocorreu mediante entrevistas e observações, entre outubro de 2012 e fevereiro de 2013. Resultados: o Programa atua como dispositivo para a transição de modelos de atenção e formação em saúde, ao promover a problematização do cotidiano do trabalho e a aproximação entre ensino e serviço. Salienta-se a importância do comprometimento dos sujeitos e dos diferentes olhares sobre a comunidade. Conclusão: o Pró-Saúde deixa marcas visíveis no processo de qualificação de estudantes e profissionais, além de promover a atuação colaborativa nos campos da gestão, atenção, ensino e controle social no SUS.

Stakeholder Views of Nanosilver Linings: Macroethics Education and Automated Text Analysis Through Participatory Governance Role Play in a Workshop Format.

The Nanosilver Linings role play case offers participants first-person experience with interpersonal interaction in the context of the wicked problems of emerging technology macroethics. In the fictional scenario, diverse societal stakeholders convene at a town hall meeting to consider whether a nanotechnology-enabled food packaging industry should be offered incentives to establish an operation in their economically struggling Midwestern city. This original creative work was built with a combination of elements, selected for their established pedagogical efficacy (e.g. active learning, case-based learning) and as topical dimensions of the realistic scenario (e.g. nanosilver in food packaging, occupational safety and health). The product life cycle is used as a framework for integrated consideration of scientific, societal, and ethical issues. The Nanosilver Linings hypothetical case was delivered through the format of the 3-hour workshop Ethics when Biocomplexity meets Human Complexity, providing an immersive, holistic ethics learning experience for STEM graduate students. Through their participation in the Nanosilver Linings case and Ethics when Biocomplexity meets Human Complexity workshop, four cohorts of science and engineering doctoral students reported the achievement of specific learning objectives pertaining to a range of macroethics concepts and professional practices, including stakeholder perspectives, communication, human values, and ethical frameworks. Automated text analysis of workshop transcripts revealed differences in sentiment and in ethical framework (consequentialism/deontology) preference between societal stakeholder roles. These resources have been recognized as ethics education exemplars by the U.S. National Academy of Engineering .

Effect of a spiritual care training program for staff on patient outcomes.

OBJECTIVE: Physicians and nurses do not assess spirituality routinely, even though spiritual care is a vital part of palliative care for patients with an advanced serious illness. The aim of our study was to determine whether a training program for healthcare professionals on spirituality and the taking of a spiritual history would result in improved patient quality of life (QoL) and spiritual well-being. METHOD: This was a cluster-controlled trial of a spiritual care training program for palliative care doctors and nurses. Three of seven clinical teams (clusters) received the intervention, while the other four served as controls. Included patients were newly referred to the palliative care service, had an estimated survival of more than one month, and were aware of their diagnosis and prognosis. The primary outcome measure was the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) patient-reported questionnaire, which patients completed at two timepoints. Total FACIT-Sp score includes the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire, which measures overall quality of life, as well as a spiritual well-being score. RESULTS: Some 144 patients completed the FACIT-Sp at both timepoints-74 in the control group and 70 in the intervention group. The change in overall quality of life, measured by change in FACT-G scores, was 3.89 points (95% confidence interval [CI 95%] = -0.42 to 8.19, p = 0.076) higher in the intervention group than in the control group. The difference between the intervention and control groups in terms of change in spiritual well-being was 0.32 (CI 95% = -2.23 to 2.88, p = 0.804). SIGNIFICANCE OF RESULTS: A brief spiritual care training program can possibly help bring about enhanced improvement of global patient QoL, but the effect on patients' spiritual well-being was not as evident in our participants. Further study with larger sample sizes is needed to allow for more definite conclusions to be drawn.

A new holistic way of assessment: programmatic assessment / Una nueva forma holística de evaluación: la evaluación programática

Programmatic assessment is a holistic view on assessment since it considers the full assessment program as a focus. Deliberate choices are being made on methods of assessment, their arrangement in time and purpose. Each moment of assessment is considered to be one single data point. Any decision on a single data point is fl awed and therefore pass/fail decisions are not being made. A single data point will only give quantitative or qualitative feedback relevant for learning. The follow-up of feedback, e.g. in learning objectives and reflective activities, learners are mentored by staff members. Decisions on learner progress are made when sufficient data points are being gathered and when the information is clear. Decision-making is done by committees and due process measures are taken to make these decisions robust. Programmatic assessment fits to a modern constructivist view on learning

La evaluación programática es una visión integral de la evaluación, dado que considera como su objetivo el programa completo de evaluación. Se toman decisiones explícitas sobre los métodos de evaluación, su disposición en el tiempo y su propósito. Cada momento de la evaluación se considera que es un solo punto de información. Cualquier decisión basada en un solo dato de información es insuficiente y, por lo tanto, la decisión sobre si un alumno pasa o no pasa (aprueba o suspende) no se puede tomar únicamente en base a esto. Un único dato de información sólo proporcionará feedback cuantitativo o cualitativo relevante para el aprendizaje. En el proceso de seguimiento del feedback, por ejemplo respecto al cumplimiento de los objetivos de aprendizaje y de las actividades de reflexión, los docentes aconsejan a los estudiantes. Las decisiones sobre el progreso del alumno se hacen cuando se han recogido suficientes datos y cuando la información es clara. La toma de decisiones se realiza a través de comités y se toman las debidas medidas durante el proceso para que estas decisiones sean robustas. La evaluación programática se ajusta a la visión constructivista moderna en el aprendizaje

Responding to challenging interactions with families: A training module for inpatient oncology nurses.

INTRODUCTION: Sustaining the well-being of the caregiving family is a critical agenda in cancer care. In the multidisciplinary team, nurses often serve as a bridge between the family and oncology team. Evidence suggests that dealing with difficult family dynamics is a common source of stress for oncology nurses, yet nurses typically receive very little guidance on how to achieve an effective partnership with families under these circumstances. We report on the application and preliminary evaluation of a new training module for improving nurses' skills in responding collaborative to challenging family situations. METHOD: Training was delivered to 282 inpatient oncology nurses at a comprehensive cancer center over 2 years. Posttraining surveys measured perceived changes in confidence working with families, as well as the utility and relevance of this training. A 6-month follow-up survey measured continued use of skills. RESULTS: Of the nurses, 75%-90% reported that the skills learned were useful and relevant to their setting. Retrospective pre-post ratings suggested increased confidence in managing stressful encounters with families. DISCUSSION: Further investigation is needed to observe how nurses transport these skills into their practice settings and to understand the role of the nurse-as-family champion within the larger multidisciplinary team. (PsycINFO Database Record

[Approach to Teaching Kampo Medicine at Kyoto Pharmaceutical University].

An approach to educating our pharmaceutical students about Kampo medicine in the six-year system of undergraduate pharmacy education at Kyoto Pharmaceutical University is introduced, including the author's opinions. Curriculum revisions have been made in our university for students entering after 2012. In teaching Kampo medicine at present, a medical doctor and an on-site pharmacist share information difficult to give in a lecture with the teaching staff in my laboratory. For example, before the curriculum revision, we conferred with a pharmacist and a doctor in the course "Kampo Medicine A, B" for 4th year students, in which students were presented a basic knowledge of Kampo medicine, the application of important Kampo medicines, combinations of crude drugs, etc. Further, in our "Introduction to Kampo Medicine" for 6th year students, presented after they have practiced in hospitals and community pharmacies, we again lecture on the pharmacological characteristics of Kampo medicines, on "pattern (Sho)", and on evidence-based medicine (EBM) and research studies of important Kampo medicines. After our curriculum revision, "Kampo Medicine A, B" was rearranged into the courses "Kampo and Pharmacognosy" and "Clinical Kampo Medicine". "Kampo and Pharmacognosy" is now provided in the second semester of the 3rd year, and in this course we lecture on the basic knowledge of Kampo medicine. An advanced lecture will be given on "Clinical Kampo Medicine" in the 6th year. We are searching for the best way to interest students in Kampo medicine, and to counteract any misunderstandings about Kampo medicine.

[How to Teach Kampo Medicine in the Age of Internationalization?].

Given the universal prevalence of complementary and alternative medicines, as well as integrative medicine, the usage of traditional medicine has been gaining in popularity worldwide. Japanese Kampo medicine and traditional Chinese medicine (TCM) are both derived from ancient medicines used in East Asia in the 5th-7th centuries, and have developed independently since the 14th century. Now Kampo medicine and TCM have different theories for the diagnosis and use of crude drugs. Unfortunately, Kampo medicine is not well known in Europe and the Americas; as a matter of practice, TCM is the international standard for traditional medicines derived from ancient East Asia. In the teaching of Kampo medicines to undergraduate students in a school of pharmacy, the author considers that a minimum requirement is to explain the differences between TCM and Kampo medicine. For graduate students of pharmaceutical science, the students must know the distinct medical theories of both TCM and Kampo medicine, and furthermore, must be able to read and write articles in English about traditional medicines, in order to help put Kampo medicine on the world map.