Informal antidepressant strategies for nursing home residents: two group concept mapping studies.

OBJECTIVES: To identify and structure potential informal antidepressant strategies that can be used in daily practice for nursing home residents alongside formal treatments. METHODS: In a first Group Concept Mapping study, residents, relatives, and professional caregivers (N = 124) brainstormed on strategies residents could use to prevent or alleviate depression. In a second study, the same participants (N = 110) reported strategies for use by others. Furthermore, participants rated the expected effectiveness and feasibility of the suggested strategies. Simultaneously, all strategies were sorted by experts and clustered using multidimensional scaling and hierarchical cluster analysis. RESULTS: Six clusters emerged for strategies by residents themselves and five clusters for strategies by others. For residents' strategies, the clusters Being socially connected and Participating in activities were perceived as most effective, as was the cluster Offering personal attention for strategies by others. Participants perceived Creating a healthy living environment as the most feasible cluster executed by residents. Within strategies by others, the clusters Offering personal attention, Using positive treatment/approach, and Using or adapting the physical environment were perceived as the most feasible. CONCLUSION: The results indicated the importance of social connectedness, a personalized and positive approach by significant others, and tailored activity programs. The results also suggest that adaptations to the physical environment within nursing homes may be an easy applicable strategy to prevent or alleviate depression in residents. Although more research is needed, these findings may guide daily practice and the development of interventions that include informal strategies.Supplemental data for this article can be accessed online at https://doi.org/10.1080/13607863.2022.2057427 .

Conceptualization and Inventory of the Sexual and Psychological Burden of Women With Pelvic Floor Complaints; A Mixed-Method Study.

INTRODUCTION: Despite the fact that the literature reports various restrictions and types of distress in women with pelvic floor complaints, a comprehensive overview of women's sexual and psychological burden emerging from these complaints is lacking, which compromises our ability to assess and grasp the impact to women. AIM: This study was performed to conceptualize women's sexual and psychological burden and create a more comprehensive overview on this topic from both women's and health care providers' perspectives. Furthermore, this research intended to identify items to populate a to-be-developed instrument to assess sexual and psychological burden. METHODS: In Group Concept Mapping, 125 statements were used about restrictions and distress that women with pelvic floor complaints experienced. Women with, and health care providers with and without pelvic floor complaints (13 women and 3 men) sorted the statements into comprehensive self-labeled clusters and rated their nature and severity. Multidimensional scaling and hierarchical cluster analyses were performed to identify a conceptual model of coherent clusters of statements. Item-total correlations of severity scores were calculated to identify statements that can be used in future research to represent women's sexual and psychological burden. MAIN OUTCOME MEASURE: A conceptual model emerged, and outcomes of item-total correlations were then examined again using the conceptual model. RESULTS: Seven distress clusters were identified, namely, loss of control, sexual distress, feeling insecure, feeling wronged, feeling helpless, feeling angry, and feeling disappointed. Feeling insecure appeared more pervasive than other distresses. Furthermore, 33 statements were identified that can be used in future research to develop an instrument to assess sexual and psychological burden representing both women's and health care providers' perspectives. CONCLUSION: The conceptual model and list of statements may concisely represent the sexual and psychological burden of women with pelvic floor complaints from both women's and health care providers' perspectives on this topic. Brand AM, Rosas S, Waterink W, et al. Conceptualization and Inventory of the Sexual and Psychological Burden of Women With Pelvic Floor Complaints; A Mixed-Method Study. Sex Med 2022;10:100504.

Are the World Health Organization's Patient Safety Learning Objectives Still Up-to-Date: A Group Concept Mapping Study.

BACKGROUND: The World Health Organization (WHO) Patient Safety Curriculum Guide defines learning objectives for patient safety. Current implementation in healthcare education is insufficient. Possible explanations may be obsolescence and/or a shift in needs. We investigated whether overarching topics and specific learning objectives of the WHO Patient Safety Curriculum Guide are still up-to-date, their attributed importance, and their perceived difficulty to achieve. METHODS: Experts on patient safety and medical education from 3 European countries were asked to suggest learning objectives concerning patient safety using group concept mapping. Following 3 successive steps, experts rated ideas by importance and difficulty to achieve. Correlation analyses investigated the relationship between those. Overarching topics of the learning goals (clusters) were identified with multivariate analysis. RESULTS: A total of 119 statements about intended learning objectives on patient safety were generated, of which 86 remained for sorting and rating. Based on multivariate analyses, 10 overarching topics (clusters) emerged. Both the learning objectives and the overarching topics showed high correspondence with the WHO Patient Safety Curriculum Guide. Strong correlations emerged between importance and difficulty ratings for learning objectives and overarching topics. CONCLUSIONS: The WHO Patient Safety Curriculum Guide's learning goals are still relevant and up-to-date. Remarkably, learning objectives categorized as highly important are also perceived as difficult to achieve. In summary, the insufficient implementation in medical curricula cannot be attributed to the content of the learning goals. The future focus should be on how the WHO learning goals can be implemented in existing curricular courses.

The role of digital informal learning in the relationship between students' digital competence and academic engagement during the COVID-19 pandemic.

During the COVID-19 crisis, digital informal learning is important for students' academic engagement. Although scholars have highlighted the importance of students' digital competence in improving digital informal learning (DIL), the mediating role of DIL between digital competence and academic engagement has remained ambiguous. The purpose of this study is to investigate the relationship between students' digital competence and their academic engagement with the mediating role of DIL in the higher education context. This study used a descriptive correlational design, and the data were analyzed using structural equation modelling (SEM). The study sample included 308 students from Shiraz University, Iran. The results showed that digital competence positively and significantly correlated with students' DIL and their academic engagement. Furthermore, DIL, as the mediator variable, was found to mediate the relationship between students' digital competence and their academic engagement. Since higher education institutions have a key role in improving students' academic engagement, particularly in the COVID-19 pandemic, academic administrators should pay more attention to students' digital competencies and provide them with efficient and user-friendly DIL platforms that can increase their academic engagement.

Bridging the divide between medical school and clinical practice: identification of six key learning outcomes for an undergraduate preparatory course in radiology.

BACKGROUND: There exists a significant divide between what is learnt in medical school and subsequently what is required to practice medicine effectively. Despite multiple strategies to remedy this discordance, the problem persists. Here, we describe the identification of a comprehensive set of learning outcomes for a preparation for practice course in radiology. METHODS: Assessment of interns' readiness to interact with the radiology department was conducted using a national survey of both interns and radiologists. In parallel, group concept mapping (GCM) which involves a combination of qualitative and quantitative techniques was used to identify the shared understanding of participants from a diverse range of medical specialties regarding what topics should be included in an intern preparatory course for interacting with the radiology department. RESULTS: The survey demonstrated that most interns and radiologists felt that undergraduate medical training did not prepare interns to interact with the radiology department. GCM identified six learning outcomes that should be targeted when designing a preparatory module: requesting investigations; clinical decision support; radiology department IT and communication; adverse reactions and risks; interpretation of radiology results and urgent imaging. The thematic clusters from the group concept mapping corroborated the deficiencies identified in the national survey. CONCLUSION: We have identified six key learning outcomes that should be included in a preparation for practice module in radiology. Future courses targeting these thematic clusters may facilitate a smoother transition from theory to practice for newly graduated doctors.

Strategies for Enhancing Resilience in Medical Students: a Group Concept Mapping Analysis.

OBJECTIVE: Research has consistently shown that medical students have greater rates of stress and mental-ill health in comparison with non-medical students. The objective of this study was to investigate the resilience strategies employed by medical students in an Irish medical school to inoculate themselves against the deleterious effects of stress on health and wellbeing. METHODS: Group concept mapping was utilized incorporating qualitative and quantitative methodologies. The stages undertaken by year 3 students at an Irish medical school involved brainstorming/idea generation, categorization, and rating of resilience strategies students employed to manage stress during medical school. The data was analyzed utilizing The Concept System® software through multidimensional scaling and hierarchical clustering. RESULTS: Categories of resilience strategies employed included "friends and family," "de-stress through exercise/sport," "extra-curricular non-medical activities," "self-enabled distraction," "organization," and "enhancing emotional and mental wellbeing." Students rated spending time with "friends and family" to be most effective when seeking to relieve stress, whereas students rated "de-stressing through exercise/sport" as being of greatest importance in relation to inclusion in a resilience-based intervention. Students recognized the value of incorporating strategies to enhance emotional and mental wellbeing into a resilience-promoting program. "Self-enabled distraction" rated poorly on both scales. CONCLUSIONS: Strategies rated by students to be important to incorporate in a stress reduction management program are accessible, are feasible, and can be implemented into the medical curriculum.

A national stakeholder consensus study of challenges and priorities for clinical learning environments in postgraduate medical education.

BACKGROUND: High quality clinical learning environments (CLE) are critical to postgraduate medical education (PGME). The understaffed and overcrowded environments in which many residents work present a significant challenge to learning. The purpose of this study was to develop a national expert group consensus amongst stakeholders in PGME to; (i) identify important barriers and facilitators of learning in CLEs and (ii) indicate priority areas for improvement. Our objective was to provide information to focus efforts to provide high quality CLEs. METHODS: Group Concept Mapping (GCM) is an integrated mixed methods approach to generating expert group consensus. A multi-disciplinary group of experts were invited to participate in the GCM process via an online platform. Multi-dimensional scaling and hierarchical cluster analysis were used to analyse participant inputs in regard to barriers, facilitators and priorities. RESULTS: Participants identified facilitators and barriers in ten domains within clinical learning environments. Domains rated most important were those which related to residents' connection to and engagement with more senior doctors. Organisation and conditions of work and Time to learn with senior doctors during patient care were rated as the most difficult areas in which to make improvements. CONCLUSIONS: High quality PGME requires that residents engage and connect with senior doctors during patient care, and that they are valued and supported both as learners and service providers. Academic medicine and health service managers must work together to protect these elements of CLEs, which not only shape learning, but impact quality of care and patient safety.

Concept mapping-An effective method for identifying diversity and congruity in cognitive style.

This paper investigates the effects of cognitive style for decision making on the behaviour of participants in different phases of the group concept mapping process (GCM). It is argued that cognitive style should be included directly in the coordination of the GCM process and not simply considered as yet another demographic variable. The cognitive styles were identified using the Kirton Adaption-Innovation Inventory, which locates each person's style on a continuum ranging from very adaptive to very innovative. Cognitive style could explain diversity in the participants' behaviour in different phases of the GCM process. At the same time, the concept map as a group's common cognitive construct can consolidate individual differences and serves as a tool for managing diversity in groups of participants. Some of the results were that: (a) the more adaptive participants generated ideas that fit to a particular, well-established and consensually agreed paradigm, frame of reference, theory or practice; (b) the more innovative participants produced ideas that were more general in scope and required changing a settled structure (paradigm, frame of reference, theory or practice); and (c) the empirical comparison of the map configurations through Procrustes analysis indicated a strong dissimilarity between cognitive styles.

Designing Learning Outcomes for Handoff Teaching of Medical Students Using Group Concept Mapping: Findings From a Multicountry European Study.

PURPOSE: To develop, by consultation with an expert group, agreed learning outcomes for the teaching of handoff to medical students using group concept mapping. METHOD: In 2013, the authors used group concept mapping, a structured mixed-methods approach, applying both quantitative and qualitative measures to identify an expert group's common understanding about the learning outcomes for training medical students in handoff. Participants from four European countries generated and sorted ideas, then rated generated themes by importance and difficulty to achieve. The research team applied multidimensional scaling and hierarchical cluster analysis to analyze the themes. RESULTS: Of 127 experts invited, 45 contributed to the brainstorming session. Twenty-two of the 45 (48%) completed pruning, sorting, and rating phases. They identified 10 themes with which to select learning outcomes and operationally define them to form a basis for a curriculum on handoff training. The themes "Being able to perform handoff accurately" and "Demonstrate proficiency in handoff in workplace" were rated as most important. "Demonstrate proficiency in handoff in simulation" and "Engage with colleagues, patients, and carers" were rated most difficult to achieve. CONCLUSIONS: The study identified expert consensus for designing learning outcomes for handoff training for medical students. Those outcomes considered most important were among those considered most difficult to achieve. There is an urgent need to address the preparation of newly qualified doctors to be proficient in handoff at the point of graduation; otherwise, this is a latent error within health care systems. This is a first step in this process.

Convergence and translation: attitudes to inter-professional learning and teaching of creative problem-solving among medical and engineering students and staff.

BACKGROUND: Healthcare worldwide needs translation of basic ideas from engineering into the clinic. Consequently, there is increasing demand for graduates equipped with the knowledge and skills to apply interdisciplinary medicine/engineering approaches to the development of novel solutions for healthcare. The literature provides little guidance regarding barriers to, and facilitators of, effective interdisciplinary learning for engineering and medical students in a team-based project context. METHODS: A quantitative survey was distributed to engineering and medical students and staff in two universities, one in Ireland and one in Belgium, to chart knowledge and practice in interdisciplinary learning and teaching, and of the teaching of innovation. RESULTS: We report important differences for staff and students between the disciplines regarding attitudes towards, and perceptions of, the relevance of interdisciplinary learning opportunities, and the role of creativity and innovation. There was agreement across groups concerning preferred learning, instructional styles, and module content. Medical students showed greater resistance to the use of structured creativity tools and interdisciplinary teams. CONCLUSIONS: The results of this international survey will help to define the optimal learning conditions under which undergraduate engineering and medicine students can learn to consider the diverse factors which determine the success or failure of a healthcare engineering solution.

Use of a group concept mapping approach to define learning outcomes for an interdisciplinary module in medicine.

Learning outcomes are typically developed using standard group-based consensus methods. Two main constraints with standard techniques such as the Delphi method or expert working group processes are: (1) the ability to generate a comprehensive set of outcomes and (2) the capacity to reach agreement on them. We describe the first application of Group Concept Mapping (GCM) to the development of learning outcomes for an interdisciplinary module in medicine and engineering. The biomedical design module facilitates undergraduate participation in clinician-mentored team-based projects that prepare students for a multidisciplinary work environment. GCM attempts to mitigate the weaknesses of other consensus methods by excluding pre-determined classification schemes and inter-coder discussion, and by requiring just one round of data structuring. Academic members from medicine and engineering schools at three EU higher education institutions participated in this study. Data analysis, which included multidimensional scaling and hierarchical cluster analysis, identified two main categories of outcomes: technical skills (new advancement in design process with special attention to users, commercialization and standardization) and transversal skills such as working effectively in teams and creative problem solving. The study emphasizes the need to address the highest order of learning taxonomy (analysis, synthesis, problem solving, creativity) when defining learning outcomes.

The Handover Toolbox: a knowledge exchange and training platform for improving patient care.

BACKGROUND: Safe and effective patient handovers remain a global organisational and training challenge. Limited evidence supports available handover training programmes. Customisable training is a promising approach to improve the quality and sustainability of handover training and outcomes. OBJECTIVE: We present a Handover Toolbox designed in the context of the European HANDOVER Project. The Toolbox aims to support physicians, nurses, individuals in health professions training, medical educators and handover experts by providing customised handover training tools for different clinical needs and contexts. METHODS: The Handover Toolbox uses the Technology Enhanced Learning Design Process (TEL-DP), which encompasses user requirements analysis; writing personas; group concept mapping; analysis of suitable software; plus, minus, interesting rating; and usability testing. TEL-DP is aligned with participatory design approaches and ensures development occurs in close collaboration with, and engagement of, key stakeholders. RESULTS: Application of TEL-DP confirmed that the ideal formats of handover training differs for practicing professionals versus individuals in health profession education programmes. Training experts from different countries differed in their views on the optimal content and delivery of training. Analysis of suitable software identified ready-to-use systems that provide required functionalities and can be further customised to users' needs. Interest rating and usability testing resulted in improved usability, navigation and uptake of the Handover Toolbox. CONCLUSIONS: The design of the Handover Toolbox was based on a carefully led stakeholder participatory design using the TEL-DP approach. The Toolbox supports a customisable learning approach that allows trainers to design training that addresses the specific information needs of the various target groups. We offer recommendations regarding the application of the Handover Toolbox to medical educators.

Mapping and assessing clinical handover training interventions.

BACKGROUND: The literature reveals a patchwork of knowledge about the effectiveness of handover and transfer of care-training interventions, their influence on handover practices and on patient outcomes. We identified a range of training interventions, defined their content, and then proposed practical measures for improving the training effectiveness of handover practices. METHODS: We applied the Group Concept Mapping approach to identify objectively the shared understanding of a group of experts about patient handover training interventions. We collected 105 declarative statements about handover training interventions from an exhaustive literature review, and from structured expert interviews. The statements were then given to 21 healthcare and training design specialists to sort the statements on similarity in meaning, and rate them on their importance and feasibility. RESULTS: We used multidimensional scaling and hierarchical cluster analysis to depict the following seven clusters related to various handover training issues: standardisation, communication, coordination of activities, clinical microsystem care, transfer and impact, training methods and workplace learning. CONCLUSIONS: Ideas on handover training interventions, grouped in thematic clusters, and prioritised on importance and feasibility creates a repository of approaches. This allows healthcare institutions to design and test concrete solutions for improving formal training and workplace learning related to handovers, and addressing informal social learning at the organisational level, with the aim of increasing impact on handover practice and patient outcomes. Measures need to be taken to assure a continuum of handover training interventions from formal training through workplace learning through less formal social learning, and to embed this training in the design of the clinical microsystem.