Transforming the delivery of care from "I" to "We" by developing the crisis resource management skills in pediatric interprofessional teams to handle common emergencies through simulation.

BACKGROUND: The healthcare system is highly complex, and adverse events often result from a combination of human factors and system failures, especially in crisis situations. Crisis resource management skills are crucial to optimize team performance and patient outcomes in such situations. Simulation-based training offers a promising approach to developing such skills in a controlled and realistic environment. METHODS: This study employed a mixed-methods (quantitative-qualitative) design and aimed to assess the effectiveness of a simulation-based training workshop in developing crisis resource management skills in pediatric interprofessional teams at a tertiary care hospital. The effectiveness of the intervention was evaluated using Kirkpatrick's Model, focusing on reaction and learning levels, employing the Collaboration and Satisfaction about Care Decisions scale, Clinical Teamwork Scale, and Ottawa Global Rating Scale for pre- and post-intervention assessments. Focused group discussions were conducted with the participants to explore their experiences and perceptions of the training. RESULTS: Thirty-nine participants, including medical students, nurses, and residents, participated in the study. Compared to the participants' pre-workshop performance, significant improvements were observed across all measured teamwork and performance components after the workshop, including improvement in scores in team communication (3.16 ± 1.20 to 7.61 ± 1.0, p < 0.001), decision-making (3.50 ± 1.54 to 7.16 ± 1.42, p < 0.001), leadership skills (2.50 ± 1.04 to 5.44 ± 0.6, p < 0.001), and situation awareness (2.61 ± 1.13 to 5.22 ± 0.80, p < 0.001). No significant variations were observed post-intervention among the different teams. Additionally, participants reported high levels of satisfaction, perceived the training to be highly valuable in improving their crisis resource management skills, and emphasized the importance of role allocation and debriefing. CONCLUSIONS: The study underscores the effectiveness of simulation-based training in developing crisis resource management skills in pediatric interprofessional teams. The findings suggest that such training can impact learning transfer to the workplace and ultimately improve patient outcomes. The insights from our study offer additional valuable considerations for the ongoing refinement of simulation-based training programs. There is a need to develop more comprehensive clinical skills evaluation methods to better assess the transferability of these skills in real-world settings. The potential challenges unveiled in our study, such as physical exhaustion during training, must be considered when refining and designing such interventions.

Promoting family practice-based model of care: the role of WHO's professional diploma in family medicine in the Eastern Mediterranean Region.

Strengthening Primary Health Care (PHC) through family practice-based model of care is an essential bedrock in achieving Universal Health Coverage (UHC), as called for in Sustainable Development Goal (SDG) 3, target 3.8. However, the shortage of family practitioners worldwide and in most countries of the Eastern Mediterranean Region (EMR) is a daunting challenge. The current production rate of family physicians in the EMR is around 700 annually, against the needed estimate of 21 000 physicians per year based on one family physician/1300 population and the current EMR population growth rate, which reflects the huge shortage of family physicians in the Region.

A Checklist for Implementing Rural Pathways to Train, Develop and Support Health Workers in Low and Middle-Income Countries.

Background: There is an urgent need to scale up global action on rural workforce development. This World Health Organization-sponsored research aimed to develop a Rural Pathways Checklist. Its purpose was to guide the practical implementation of rural workforce training, development, and support strategies in low and middle-income countries (LMICs). It was intended for any LMICs, stakeholder, health worker, context, or health problem. Method: Multi-methods involved: (1) focus group concept testing; (2) a policy analysis; (3) a scoping review of LMIC literature; (4) consultation with a global Expert Reference Group and; (5) field-testing over an 18-month period. Results: The Checklist included eight actions for implementing rural pathways in LMICs: establishing community needs; policies and partners; exploring existing workers and scope; selecting health workers; education and training; working conditions for recruitment and retention; accreditation and recognition of workers; professional support/up-skilling and; monitoring and evaluation. For each action, a summary of LMICs-specific evidence and prompts was developed to stimulate reflection and learning. To support implementation, rural pathways exemplars from different WHO regions were also compiled. Field-testing showed the Checklist is fit for purpose to guide holistic planning and benchmarking of rural pathways, irrespective of LMICs, stakeholder, or health worker type. Conclusion: The Rural Pathways Checklist provides an agreed global conceptual framework for the practical implementation of "grow your own" strategies in LMICs. It can be applied to scale-up activity for rural workforce training and development in LMICs, where health workers are most limited and health needs are greatest.

Socioeconomic determinants affecting the quality of life among diabetic and hypertensive patients in a rural area, Egypt.

BACKGROUND: Diabetes mellitus and hypertension have a high prevalence of growth in all countries threatening to become a global epidemic risk, thus the quality of life this category of patients is extremely important. The aim of this study was to assess the socioeconomic determinants affecting the quality of life among diabetic and hypertensive patients. PATIENT AND METHODS: A descriptive cross-sectional study was conducted in a rural family health care center in El-Batanon village, in the delta region of Menoufia, Egypt. The recruited sample population was 401 participants over six month's context time frame (diabetic and hypertensive participants were 224 and 117 respectively). All participants were interviewed using a questionnaire to assess the demographic characteristics, socioeconomic status, type, duration and treatments of illness and the 36-Item Short Form Health Survey. RESULTS: Patients with Diabetes presented a poorer health related quality of life than those with hypertension in perceived health in the areas of role-physical (RP) (P < 0.05), bodily pain (BP) (P < 0.001), general health (GH) (P < 0.05), vitality (VT) (P < 0.05), social functioning (SF) (P < 0.001) and role-emotional (RE) (P < 0.001). Age, Sex, Family size, socioeconomic score and occupation were the main Socioeconomic Determinants affecting the quality of life among diabetic and hypertensive patients. CONCLUSION: Diabetes and hypertension seem to comparably impair the health-related quality of life. There is a need to develop and implement effective targeted intervention to help the patients to cope with their life in a better way.