Exploring the ability of ChatGPT to create quality patient education resources about kidney transplant.

BACKGROUND: Chat Generative Pre-trained Transformer (ChatGPT) is a language model that may have the potential to revolutionize health care. The study purpose was to test whether ChatGPT could be used to create educational brochures about kidney transplant tailored for three target audiences: caregivers, teens and children. METHODS: Using a list of 25 educational topics, standardized prompts were employed to ensure content consistency in ChatGPT generation. An expert panel assessed the accuracy of the content by rating agreement on a Likert scale (1 = <25 % agreement; and 5 = 100 % agreement). The understandability, actionability and readability of the brochures were assessed using the Patient Education Materials Assessment Tool for printable materials (PEMAT-P) and standard readability scales. A caregiver and patient reviewed and provided written feedback. RESULTS: We found mean understandability scores of 69 %, 66 %, and 73 % for caregiver, teen, and child brochures respectively, with 90.7 % of the ChatGPT generated brochures scoring 40 % on the actionability scale. Generated caregiver and teen materials achieved readability levels of grades 9-14, while child-specific brochures achieved readability levels of grades 6-11. Brochures were formatted appropriately but lacked depth. CONCLUSION: ChatGPT demonstrates potential for rapidly generating patient education materials; however, challenges remain in ensuring content specificity. We share the lessons learned to assist other healthcare providers with using this technology.

Guidelines to support the design, and selection and appraisal of multimedia teaching aids for microbiology education.

Microbiology education has a serious handicap - the lack of visibility of the players of the subject and their interactions - which engenders a disproportionate reliance upon multimedia teaching aids (MTAs). The International Microbiology Literacy Initiative (IMiLI) is creating educational resources in societally-relevant microbiology complemented by appropriate MTAs. However, proper guidance supporting microbiology educators in locating and selecting, or commissioning the creation of, adequate MTAs for different target audiences and learning objectives is lacking. The aims of this study were to (i) identify important considerations regarding educational/didactical standards and the design of educational multimedia and (ii) create an evidence-based guideline for selecting and appraising existing, and informing the creation of new, microbiology MTAs. This investigation is based on an exploratory, mixed-methods approach. The results of two literature reviews (covering educational and good practice multimedia design) informed the collation of a preliminary appraisal guideline for videos, animations, comics, and video games. A web-scraping approach was utilised to locate and retrieve existing exemplars of the four multimedia types and create four pertinent multimedia databases (including metadata). The preliminary guideline was piloted (and revised accordingly) by appraising quasi-random (or purposive) samples of each multimedia type. Educational multimedia experts were interviewed to discuss the findings. Finally, the guideline was updated to reflect the expert comments together with the results of the pilot appraisals. The final guideline has four components: (i) central considerations for selecting and appraising multimedia for specific audiences and educational purposes, (ii) multimedia selection tool, (iii) multimedia appraisal tools, and (iv) extensive background information as appendices linking all sections for further comprehension. Broad utilisation of the guideline has significant potential for simplifying and systematising multimedia selection/creation, leading to superior multimedia-based learning outcomes, establishing a rapid selection database (pre-appraised multimedia), reducing disparities in microbiology education and incentivising educational content creators.

[DOG-EyeTeacher: a response by the Teaching Association to the medical study restructuring]. / DOG-EyeTeacher: eine Antwort der Arbeitsgemeinschaft Lehre auf die Umstrukturierungen im Medizinstudium.

BACKGROUND: The Masterplan Medicine 2020 adopted in 2017 entails many changes to the medical studies curriculum. The new structure affects the content of the coursework and its main focus. A major goal of this masterplan is to prepare young physicians by teaching the skills that are essential for the future profession. The National Competence-Based Learning Objectives Catalog for Medicine (NKLM) provides the basis for the teaching content. METHODS: The Working Group Teaching of the German Society of Ophthalmology (Arbeitsgemeinschaft Lehre der DOG) actively supports this transformation. In cross-site collaboration, teaching materials for various teaching formats have been compiled by relying on the NKLM (e.g., recordings of operations, slides for small group instruction, image galleries, case studies). An online library named the DOG-EyeTeacher was then created. RESULTS: The aim of the DOG-EyeTeacher is to relieve the training clinics and to establish basic standards in teaching materials, thereby enabling the necessary focus on medical education. The provision of these teaching materials should deepen the interest in ophthalmology among future doctors. CONCLUSION: The DOG-EyeTeacher is our response to the challenges associated with the planned restructuring of the medical curriculum. Since October 2023, any DOG member involved in teaching can create an account free of charge to use our materials.

Optimizing Readability of Patient-Facing Hand Surgery Education Materials Using Chat Generative Pretrained Transformer (ChatGPT) 3.5.

PURPOSE: To address patient health literacy, the American Medical Association and the National Institutes of Health recommend that readability of patient education materials should not exceed an eighth grade reading level. However, patient-facing materials often remain above the recommended average reading level. Current online calculators provide readability scores; however, they lack the ability to provide text-specific feedback, which may streamline the process of simplifying patient materials. The purpose of this study was to evaluate Chat Generative Pretrained Transformer (ChatGPT) 3.5 as a tool for optimizing patient-facing hand surgery education materials through reading level analysis and simplification. METHODS: The readability of 18 patient-facing hand surgery education materials was compared by a traditional online calculator for reading level and ChatGPT 3.5. The original excerpts were then entered into ChatGPT 3.5 and simplified by the artificial intelligence tool. The simplified excerpts were scored by the same calculators. RESULTS: The readability scores for the original excerpts from the online calculator and ChatGPT 3.5 were similar. The simplified excerpts' scores were lower than the originals, with a mean of 7.28, less than the maximum recommended 8. CONCLUSIONS: The use of ChatGPT 3.5 for the purpose of simplification and readability analysis of patient-facing hand surgery materials is efficient and may help facilitate the conveyance of important health information. ChatGPT 3.5 rendered readability scores comparable with traditional readability calculators, in addition to excerpt-specific feedback. It was also able to simplify materials to the recommended grade levels. CLINICAL RELEVANCE: By confirming ChatGPT3.5's ability to assess and simplify patient education materials, this study offers a practical solution for potentially improving patient comprehension, engagement, and health outcomes in clinical settings.

Validation of Educational Materials for a Mobile Application for Patients with Kidney Disease on Hemodialysis.

Worldwide, chronic kidney disease (CKD) is a public health problem due to its high morbidity and mortality rates. For CKD patients, mobile health applications have functioned as a strategy that promotes patient care through valid and reliable educational materials. This is a prospective and descriptive three-stage study using content experts. Results created three visual and three audiovisual materials with acceptable evaluations. The design and validation of educational materials are a valid and reliable method for patient health education through mobile health applications.

A review of the ethical considerations for the use of 3D printed materials in medical and allied health education and a proposed collective path forward.

3D scanning and printing technologies are quickly evolving and offer great potential for use in gross anatomical education. The use of human body donors to create digital scans and 3D printed models raises ethical concerns about donor informed consent, potential commodification, and access to and storage of potentially identifiable anatomical reproductions. This paper reviews available literature describing ethical implications for the application of these emerging technologies, existing published best practices for managing and sharing 2D imaging, and current adherence to these best practices by academic body donation programs. We conclude that informed consent is paramount for all uses of human donor and human donor-derived materials and that currently there is considerable diversity in adherence to established best practices for the management and sharing of 3D digital content derived from human donors. We propose a new and simplified framework for categorizing donor-derived teaching materials and the corresponding level of consent required for digital sharing. This framework proposes an equivalent minimum level of specific consent for human donor and human donor-derived materials relative to generalized, nonidentical teaching materials (i.e., artificial plastic models). Likewise, we propose that the collective path forward should involve the creation of a centralized, secure repository for digital human donor 3D content as a mechanism for accumulating, regulating, and controlling the distribution of properly consented human donor-derived 3D digital content that will also increase the availability of ethically created human-derived teaching materials while discouraging commodification.

Desenredando los nudos en cirugía: creando maestría con un simulador práctico en casa / Untangling the knots in surgery: Creating mastery with a practical at-home simulator

Introducción. Anudar es una de las habilidades quirúrgicas esenciales y de su correcta ejecución dependen procesos de vital importancia. La adquisición de estas competencias requiere trabajo motor, entornos amigables y realistas. Una estrategia para facilitar el aprendizaje de la técnica de anudado es generar instrumentos de simulación accesibles. Métodos. Se presenta un simulador de nudos quirúrgicos, construido con materiales de bajo costo y asequibles para la población en general, con un presupuesto de aproximadamente $5.000 COP (US$ 1,23). Resultados. Se desarrolló un simulador de nudos quirúrgicos que, al fijarse a la extremidad inferior desde una posición sentada, proporciona una superficie estable para llevar a cabo la práctica de anudado de manera efectiva. Conclusión. La cirugía moderna considera la seguridad del paciente como la principal prioridad, por lo que ya no es apropiado adoptar un método de formación de "ver uno, hacer uno, enseñar uno". Es la práctica constante mediante simuladores, el método más adecuado. Este trabajo presenta una alternativa de aprendizaje ininterrumpido de las técnicas quirúrgicas relacionadas con los nudos.

Introduction. Knotting is one of the essential surgical skills and vitally important processes that depends on its correct execution. The acquisition of these skills requires motor work, friendly and realistic environments. A strategy to facilitate learning the knotting technique is to generate accessible simulation instruments. Methods. A surgical knot simulator is presented, built with low-budget materials and affordable for the general population, with a budget of approximately $5,000 COP (US$ 1.23). Results. A surgical knot simulator has been developed in a way that, when attached to the thigh of a lower extremity from a seated position, provides a stable surface to effectively perform knot tying practice. Conclusion. Modern surgery considers patient safety as the top priority, so it is no longer appropriate to adopt a "see one, do one, teach one" training method. Constant practice using simulators is the most appropriate method. This work presents an alternative for uninterrupted learning of surgical techniques related to knots.

[Digital educational materials on culinary skills as a health promotion strategy in Primary Health Care]. / Materiais educativos digitais sobre habilidades culinárias como estratégia de promoção de saúde na Atenção Primária.

This study aims to report on the development and validation of digital educational materials based on the dimensions of home cooking skills (HCS) assessed on a scale destined for PHC professionals, following the recommendations of The Dietary Guidelines for the Brazilian Population and on The Food and Nutrition Education Framework (FNE) for Public Policies. Five videos and graphic materials were developed with proposals for activities to develop HCS and encourage its implementation in actions and guidelines in the community and in professional care. The content of the materials was evaluated by experts using the Two-Round Delphi-based technique and statistical analyses for evidence of consensus. Specialists presented comments to improve the products and their applicability. The materials presented decoded language and playful illustrations with characters representative of the target population. Evidence of satisfactory content validity was presented and can be used in permanent education actions, seeking the qualification of the workforce and in FNE actions within the scope of the law. The graphic materials make it possible to associate the content of the videos with practice in contexts consistent with the reality of the individuals.

Este estudo visa reportar desenvolvimento e validação de materiais educativos digitais baseados nas dimensões de habilidades culinárias domésticas (HCD) avaliadas por escala destinada aos profissionais da APS, nas recomendações do Guia Alimentar Para a População Brasileira e no Marco de Educação Alimentar e Nutricional (EAN) para Políticas Públicas. Foram desenvolvidos 5 vídeos e materiais gráficos com propostas de atividades para desenvolvimento de HCD e estímulo à sua implementação em ações e orientações junto à comunidade e em atendimentos profissionais. O conteúdo dos materiais foi avaliado por especialistas utilizando técnica Delphi de 2 rounds e análises estatísticas para evidência de consenso. Especialistas proferiram comentários para aprimoramento dos produtos e sua aplicabilidade. Os materiais apresentaram linguagem decodificada, ilustrações lúdicas, com personagens representativos da população-alvo. Apresentaram evidência de validade de conteúdo satisfatória e podem ser utilizados em ações de educação permanente, visando a qualificação da força de trabalho, e em ações de EAN junto aos sujeitos de direito. Os materiais gráficos possibilitam associar o conteúdo dos vídeos à prática, em contextos condizentes com a realidade dos sujeitos.

Assessing the Application of Large Language Models in Generating Dermatologic Patient Education Materials According to Reading Level: Qualitative Study.

BACKGROUND: Dermatologic patient education materials (PEMs) are often written above the national average seventh- to eighth-grade reading level. ChatGPT-3.5, GPT-4, DermGPT, and DocsGPT are large language models (LLMs) that are responsive to user prompts. Our project assesses their use in generating dermatologic PEMs at specified reading levels. OBJECTIVE: This study aims to assess the ability of select LLMs to generate PEMs for common and rare dermatologic conditions at unspecified and specified reading levels. Further, the study aims to assess the preservation of meaning across such LLM-generated PEMs, as assessed by dermatology resident trainees. METHODS: The Flesch-Kincaid reading level (FKRL) of current American Academy of Dermatology PEMs was evaluated for 4 common (atopic dermatitis, acne vulgaris, psoriasis, and herpes zoster) and 4 rare (epidermolysis bullosa, bullous pemphigoid, lamellar ichthyosis, and lichen planus) dermatologic conditions. We prompted ChatGPT-3.5, GPT-4, DermGPT, and DocsGPT to "Create a patient education handout about [condition] at a [FKRL]" to iteratively generate 10 PEMs per condition at unspecified fifth- and seventh-grade FKRLs, evaluated with Microsoft Word readability statistics. The preservation of meaning across LLMs was assessed by 2 dermatology resident trainees. RESULTS: The current American Academy of Dermatology PEMs had an average (SD) FKRL of 9.35 (1.26) and 9.50 (2.3) for common and rare diseases, respectively. For common diseases, the FKRLs of LLM-produced PEMs ranged between 9.8 and 11.21 (unspecified prompt), between 4.22 and 7.43 (fifth-grade prompt), and between 5.98 and 7.28 (seventh-grade prompt). For rare diseases, the FKRLs of LLM-produced PEMs ranged between 9.85 and 11.45 (unspecified prompt), between 4.22 and 7.43 (fifth-grade prompt), and between 5.98 and 7.28 (seventh-grade prompt). At the fifth-grade reading level, GPT-4 was better at producing PEMs for both common and rare conditions than ChatGPT-3.5 (P=.001 and P=.01, respectively), DermGPT (P<.001 and P=.03, respectively), and DocsGPT (P<.001 and P=.02, respectively). At the seventh-grade reading level, no significant difference was found between ChatGPT-3.5, GPT-4, DocsGPT, or DermGPT in producing PEMs for common conditions (all P>.05); however, for rare conditions, ChatGPT-3.5 and DocsGPT outperformed GPT-4 (P=.003 and P<.001, respectively). The preservation of meaning analysis revealed that for common conditions, DermGPT ranked the highest for overall ease of reading, patient understandability, and accuracy (14.75/15, 98%); for rare conditions, handouts generated by GPT-4 ranked the highest (14.5/15, 97%). CONCLUSIONS: GPT-4 appeared to outperform ChatGPT-3.5, DocsGPT, and DermGPT at the fifth-grade FKRL for both common and rare conditions, although both ChatGPT-3.5 and DocsGPT performed better than GPT-4 at the seventh-grade FKRL for rare conditions. LLM-produced PEMs may reliably meet seventh-grade FKRLs for select common and rare dermatologic conditions and are easy to read, understandable for patients, and mostly accurate. LLMs may play a role in enhancing health literacy and disseminating accessible, understandable PEMs in dermatology.

The Use of Artificial Intelligence to Improve Readability of Otolaryngology Patient Education Materials.

OBJECTIVE: The recommended readability of health education materials is at the sixth-grade level. Artificial intelligence (AI) large language models such as the newly released ChatGPT4 might facilitate the conversion of patient-education materials at scale. We sought to ascertain whether online otolaryngology education materials meet recommended reading levels and whether ChatGPT4 could rewrite these materials to the sixth-grade level. We also wished to ensure that converted materials were accurate and retained sufficient content. METHODS: Seventy-one articles from patient educational materials published online by the American Academy of Otolaryngology-Head and Neck Surgery were selected. Articles were entered into ChatGPT4 with the prompt "translate this text to a sixth-grade reading level." Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL) were determined for each article before and after AI conversion. Each article and conversion were reviewed for factual inaccuracies, and each conversion was reviewed for content retention. RESULTS: The 71 articles had an initial average FKGL of 11.03 and FRES of 46.79. After conversion by ChatGPT4, the average FKGL across all articles was 5.80 and FRES was 77.27. Converted materials provided enough detail for patient education with no factual errors. DISCUSSION: We found that ChatGPT4 improved the reading accessibility of otolaryngology online patient education materials to recommended levels quickly and effectively. IMPLICATIONS FOR PRACTICE: Physicians can determine whether their patient education materials exceed current recommended reading levels by using widely available measurement tools, and then apply AI dialogue platforms to modify materials to more accessible levels as needed. LEVEL OF EVIDENCE: Level 5.

[Application and advancement of digital teaching materials in teaching epidemiology].

This study aims at examining the application and development of digital teaching materials in the field of epidemiology, encompassing both China and international contexts. The research involved conducting search on websites and literature databases to assess the status of digital teaching materials in epidemiology, nationally and internationally. At present, in China, digital teaching materials used in epidemiology are primarily presented in the form of printed books with added QR codes, providing teaching resources such as videos and exercises. However, issues with the level of interactivity have been identified. In foreign countries, with stronger emphasis placed on personalization, interactivity, and the use of rich media technologies in the digital teaching materials, epidemiologically. Enhanced digitization regarding materials and learning outcomes is achieved through features such as real-time notes, interactive animations, and quizzes. These approaches are considered worth considering for adoption. This study provides valuable insights for the digital transformation of epidemiology education.

Insights into designing educational materials for persons living with dementia: a focus group study.

BACKGROUND: Persons living with dementia (PLWD) may experience communication difficulties that impact their ability to process written and pictorial information. Patient-facing education may help promote discontinuation of potentially inappropriate medications for older adults without dementia, but it is unclear how to adapt this approach for PLWD. Our objective was to solicit feedback from PLWD and their care partners to gain insights into the design of PLWD-facing deprescribing intervention materials and PLWD-facing education material more broadly. METHODS: We conducted 3 successive focus groups with PLWD aged ≥ 50 (n = 12) and their care partners (n = 10) between December 2022 and February 2023. Focus groups were recorded and transcripts were analyzed for overarching themes. RESULTS: We identified 5 key themes: [1] Use images and language consistent with how PLWD perceive themselves; [2] Avoid content that might heighten fear or anxiety; [3] Use straightforward delivery with simple language and images; [4] Direct recipients to additional information; make the next step easy; and [5] Deliver material directly to the PLWD. CONCLUSION: PLWD-facing educational material should be addressed directly to PLWD, using plain, non-threatening and accessible language with clean, straightforward formatting.

[Open educational resources for otorhinolaryngology : A pilot study on needs assessment and implementation]. / Open Educational Resources für die HNO-Heilkunde : Ein Pilotprojekt zur Bedarfsanalyse und Implementierung.

BACKGROUND: Open educational resources (OER) are educational materials licensed openly by authors, permitting usage, redistribution, and in some instances, modification. OER platforms thereby serve as a medium for distributing and advancing teaching materials and innovative educational methodologies. OBJECTIVE: This study aims to determine the present state of OER in otorhinolaryngology and to examine the prerequisites for seamlessly integrating OER into the curricular teaching of medical schools, specifically through the design of two OER blended learning modules. METHODS: OER content in the field of otorhinolaryngology was analyzed on OER platforms, ensuring its relevance to the German medical curriculum. Data protection concerns were addressed with legal counsel. The blended learning modules were developed in collaboration with medical students and subsequently published as OER. RESULTS AND CONCLUSION: This project yielded the first OER from a German ENT department, tailored to the German medical curriculum. One significant barrier to OER use in medicine, more than in other fields, is data protection. This challenge can be navigated by obtaining consent to publish patient data as OER. OER hold the promise to play a pivotal role in fostering cooperation and collaboration among educators, aiding educators in lesson preparation, and simultaneously enhancing didactic quality.

[ChatGPT is an above-average student at the Faculty of Medicine of the University of Zaragoza and an excellent collaborator in the development of teaching materials]. / ChatGPT es un estudiante por encima de la media en la Facultad de Medicina de la Universidad de Zaragoza y un colaborador excelente en la elaboración de material docente.

INTRODUCTION AND OBJECTIVE: Artificial intelligence is fully present in our lives. In education, the possibilities of its use are endless, both for students and teachers. MATERIAL AND METHODS: The capacity of ChatGPT has been explored when solving multiple choice questions based on the exam of the subject «Anatomopathological Diagnostic and Therapeutic Procedures¼ of the first call of the 2022-23 academic year. In addition, to comparing their results with those of the rest of the students presented the probable causes of incorrect answers have been evaluated. Finally, its ability to formulate new test questions based on specific instructions has been evaluated. RESULTS: ChatGPT correctly answered 47 out of 68 questions, achieving a grade higher than the course average and median. Most failed questions present negative statements, using the words «no¼, «false¼ or «incorrect¼ in their statement. After interacting with it, the program can realize its mistake and change its initial response to the correct answer. Finally, ChatGPT can develop new questions based on a theoretical assumption or a specific clinical simulation. CONCLUSIONS: As teachers we are obliged to explore the uses of artificial intelligence and try to use it to our benefit. Carrying out tasks that involve significant consumption, such as preparing multiple-choice questions for content evaluation, is a good example.

Using Large Language Models to Generate Educational Materials on Childhood Glaucoma.

PURPOSE: To evaluate the quality, readability, and accuracy of large language model (LLM)-generated patient education materials (PEMs) on childhood glaucoma, and their ability to improve existing the readability of online information. DESIGN: Cross-sectional comparative study. METHODS: We evaluated responses of ChatGPT-3.5, ChatGPT-4, and Bard to 3 separate prompts requesting that they write PEMs on "childhood glaucoma." Prompt A required PEMs be "easily understandable by the average American." Prompt B required that PEMs be written "at a 6th-grade level using Simple Measure of Gobbledygook (SMOG) readability formula." We then compared responses' quality (DISCERN questionnaire, Patient Education Materials Assessment Tool [PEMAT]), readability (SMOG, Flesch-Kincaid Grade Level [FKGL]), and accuracy (Likert Misinformation scale). To assess the improvement of readability for existing online information, Prompt C requested that LLM rewrite 20 resources from a Google search of keyword "childhood glaucoma" to the American Medical Association-recommended "6th-grade level." Rewrites were compared on key metrics such as readability, complex words (≥3 syllables), and sentence count. RESULTS: All 3 LLMs generated PEMs that were of high quality, understandability, and accuracy (DISCERN ≥4, ≥70% PEMAT understandability, Misinformation score = 1). Prompt B responses were more readable than Prompt A responses for all 3 LLM (P ≤ .001). ChatGPT-4 generated the most readable PEMs compared to ChatGPT-3.5 and Bard (P ≤ .001). Although Prompt C responses showed consistent reduction of mean SMOG and FKGL scores, only ChatGPT-4 achieved the specified 6th-grade reading level (4.8 ± 0.8 and 3.7 ± 1.9, respectively). CONCLUSIONS: LLMs can serve as strong supplemental tools in generating high-quality, accurate, and novel PEMs, and improving the readability of existing PEMs on childhood glaucoma.

Computer-Assisted or Instructor-Led Reading Instructions of Portuguese Words with Orthography Difficulties

This article presents the findings of a study comparing a computer-assisted teaching program to traditional instructor-led teaching for elementary school children. The study evaluated reading and writing skills and employed a group design. Results showed that both teaching approaches were effective in improving reading performance, with slightly better gains in the instructor-led version. Both conditions facilitated learning transfer to new words with spelling difficulties, although the computer-assisted condition demonstrated higher generalization in final tests. Motivational and attentional factors, easily addressed by instructors but challenging in computer programs, were highlighted. The instructor-led condition's personalized feedback and differential consequences potentially contributed to the observed differences in learning gains. Individual differences in learners' input and performance were emphasized, suggesting the need for program adaptations. The advantages of computer-assisted teaching, such as scalability and individualized pacing, were discussed, along with the need for further refinements and automation. Strategies for enhancing teaching sequence flexibility and reducing the instructor's decision-making burden were proposed. The study contributes valuable insights into computer-assisted reading instructions for children with spelling difficulties, emphasizing their benefits and areas for improvement. The research underscores the importance of designing effective technology-mediated interventions and provides guidance for future developments in this field. (AU)

Revisiting Race, Ethnicity, and Disparities in Rheumatology Educational Materials: An Update Since 2020.

OBJECTIVE: In 2020, one study by Strait and colleagues raised awareness that the clinical images in rheumatology educational materials underrepresent people with skin of color (P-SOC). Since then, publishers of rheumatology educational materials have focused on addressing this shortcoming. This study investigates the change in representation of P-SOC following the review of Strait et al. METHODS: We used the methods of the aforementioned study to collect images from commonly referenced rheumatology educational materials and categorized the skin tones within them as "light" or "dark." We calculated the proportional change in images depicting dark skin tones between 2020 and 2022 from the American College of Rheumatology (ACR) Image Library, the 10th edition of Kelley's Textbook of Rheumatology, and New England Journal of Medicine (NEJM) as well as between 2020 and 2024 from rheumatology articles within UpToDate. We compared results using one-sided Z-tests. RESULTS: Overall, the proportion of images depicting dark skin tones increased 40.6% (P < 0.0001). The 10th edition of Kelley's Textbook of Rheumatology most significantly increased inclusion of P-SOC (90.1%; P = 0.0039), with ACR Image Library, UpToDate, and NEJM also enhancing representation (41.9%, P < 0.0001; 31.0%, P = 0.0083; 28.2%, P = 0.3046, respectively). CONCLUSION: This study assesses the progress of rheumatology educational materials toward equitable representation of P-SOC. It demonstrates that awareness coupled with focused efforts from educational publishers can enhance the proportion of images depicting dark skin tones, thereby enriching the quality of foundational knowledge relayed to rheumatology providers with the goal of improving health experiences and outcomes for P-SOC with rheumatic diseases.

Dietary Phosphate Educational Materials for Pediatric Chronic Kidney Disease: Are Confused Messages Reducing Their Impact?

OBJECTIVE: This study aimed to review the quality and content of phosphate educational materials used in pediatric chronic kidney disease. METHODS: The quality of text-based (TB) pediatric phosphate educational materials was assessed using validated instruments for health literacy demands (Suitability Assessment of Materials, Patient Education Material Assessment Tool [PEMAT-P]) readability (Flesch Reading Ease, and Flesch-Kincaid Grade Level). Codes were inductively derived to analyse format, appearance, target audience, resource type, and content, aiming for intercoder reliability > 80%. The content was compared to Pediatric Renal Nutrition Taskforce (PRNT) recommendations. RESULTS: Sixty-five phosphate educational materials were obtained; 37 were pediatric-focused, including 28 TB. Thirty-two percent of TB materials were directed at caregivers, 25% at children, and 43% were unspecified. Most (75%) included a production date, with 75% produced >2 years ago. The median Flesch Reading Easetest score was 68.2 (interquartile range [IQR] 61.1-75.3) and Flesch-Kincaid Grade Level was 5.6 (IQR 4.5-7.7). Using Suitability Assessment of Materials, 54% rated "superior" (≥70), 38% rated "adequate" (40-69), and 8% rated "not suitable" (≤39). Low-scoring materials lacked a summary (12%), cover graphics (35%), or included irrelevant illustrations (50%). Patient Education Material Assessment Tool-P scores were 70% (IQR 50-82) for understandability and 50% (IQR 33-67) for actionability. An intercoder reliability of 87% was achieved. Over half of limited foods are in agreement with PRNT (including 89% suggesting avoiding phosphate additives). Recommendations conflicting with PRNT included reducing legumes and whole grains. Over a third contained inaccuracies, and over two-thirds included no practical advice. CONCLUSIONS: TB pediatric phosphate educational materials are pitched at an appropriate level for caregivers, but this may be too high for children under 10 years. The inclusion of relevant illustrations may improve this. Three-quarters of materials scored low for actionability. The advice does not always align with the PRNT, which (together with the inaccuracies reported) could result in conflicting messages to patients and their families.

Construction and validation of an educational booklet for the preparation of healthcare products / Construcción y validación de un folleto educativo para la preparación de productos para la salud / Construção e validação de cartilha educativa para o preparo de produtos para saúde

Objective: To construct and validate an educational booklet for the preparation of healthcare products by the Nursing team at the Materials and Sterilization Center. Method: A methodological study was carried out in four stages: situational diagnosis, literature review, construction of the educational booklet and content validation by six expert judges and 13 representatives of the target audience. Data analysis considered the content validity index above 0.80 and the exact binomial distribution test with a significance level of 5%. Results: The content validity index showed an average of 0.99. In regard to the target audience, the validation of the educational booklet obtained scores that ranged from 92.3 to 100% across the six evaluation categories. Conclusion: A booklet was developed and validated, and it proved to be reliable for use in nursing as an educational tool aimed at preparing healthcare products in the MSC. (AU)

Objetivo: Construir y validar una cartilla educativa para la preparación de productos para la salud el equipo de Enfermería del Centro de Materiales y Esterilización. Método: Estudio metodológico realizado en cuatro etapas: diagnóstico situacional, revisión de literatura, construcción de la cartilla educativa y validación de contenido por seis jueces expertos y 13 representantes del público objetivo. El análisis de datos consideró un índice de validez de contenido superior a 0,80 y la prueba de distribución binomial exacta con un nivel de significancia del 5%. Resultados: El Índice de Validez de Contenido presentó un promedio de 0,99. En cuanto al público objetivo, la validación del folleto educativo obtuvo una puntuación que oscilan entre 92,3 y 100% entre las seis categorías de evaluación. Conclusión: La cartilla fue validada y demostró ser confiable para ser utilizada por la Enfermería como herramienta educativa orientada a la preparación de productos para la salud. (AU)

Objetivo: Construir e validar uma cartilha educativa para o preparo de produtos para saúde pela equipe de Enfermagem no Centro de Materiais e Esterilização. Método: Estudo metodológico realizado em quatro etapas: diagnóstico situacional, revisão da literatura, construção da cartilha educa-tiva e validação do conteúdo por seis juízes especialistas e 13 representantes do público-alvo. A análise de dados considerou o índice de validade de con-teúdo acima de 0,80 e o teste exato de distribuição binomial com nível de significância de 5%. Resultados: O Índice de Validade de Conteúdo apresentou uma média de 0,99. Em relação ao público-alvo, a validação da cartilha educativa obteve pontuação que variou de 92,3 a 100% entre as seis categorias de avaliação. Conclusão: A cartilha foi validada e mostrou-se confiável para ser utilizada pela Enfermagem como uma ferramenta de educação voltada ao preparo de produtos para saúde. (AU)

Teaching the Teacher: Implementing a Tool kit to Standardize Effective Preceptorship of Prelicensure Nursing Students.

BACKGROUND: Faculty can support successful preceptor-led clinical experiences by providing registered nurses with educational resources to guide them in the preceptor role. PURPOSE: To upgrade our institution's educational resources using an online platform that enables just-in-time access. METHOD: This was a quality improvement project to create and implement an educational resource tool kit for prelicensure nursing preceptors. RESULTS: Half of our preceptors (n = 46, 52%) had no formal preceptor education. The preceptors used all the resources and were satisfied with the tool kit's content and ease of use. CONCLUSION: Implementing the tool kit was feasible. Further development includes ( a ) adding content regarding diverse students and trauma-informed nursing care, ( b ) incorporating interactive educational materials, ( c ) exploring avenues to reduce cognitive load, ( d ) creating a prelicensure preceptor preparation course, and ( e ) considering avenues for providing open access for nursing faculty of prelicensure programs.