Competing interests: digital health and indigenous data sovereignty.

Digital health is increasingly promoting open health data. Although this open approach promises a number of benefits, it also leads to tensions with Indigenous data sovereignty movements led by Indigenous peoples around the world who are asserting control over the use of health data as a part of self-determination. Digital health has a role in improving access to services and delivering improved health outcomes for Indigenous communities. However, we argue that in order to be effective and ethical, it is essential that the field engages more with Indigenous peoples´ rights and interests. We discuss challenges and possible improvements for data acquisition, management, analysis, and integration as they pertain to the health of Indigenous communities around the world.

Falls Risk in Long-Term Care Residents With Cognitive Impairment: Effects of COVID-19 Pandemic.

OBJECTIVES: The aim of this study was to investigate the impact of the COVID-19 pandemic on falls rates in long-term care residents with cognitive impairment. DESIGN: An observational study using routinely collected national interRAI data. SETTING AND PARTICIPANTS: Participants were from long-term care residents (age ≥60 years) who received an interRAI Long Term Care Facility assessment anywhere in New Zealand between August 17, 2018, and August 16, 2022. METHODS: The primary outcome was "At least 1 fall in the last 30 days." Based on the Cognitive Performance Scale (CPS), cognitive impairment was categorized into 3 levels: intact or borderline intact (0-1), mild to moderate impairment (2-3), and moderately to very severe impairment (4-6). The COVID-19 pandemic was divided into 3 periods (First wave: March 21, 2020, to June 8, 2020; Varying level of community outbreaks: June 9, 2020 to August 16, 2021; and Delta-Omicron wave: August 17, 2021, to August 16, 2021) and compared to a pre-COVID-19 period (August 17, 2018, to March 20, 2020). Cox regression modeling was used to study falls and interactions between CPS and COVID-19 pandemic periods, along with other established falls risk factors in the literature. RESULTS: A total of 282,518 interRAI-LTCF assessments from 75,132 unique residents were included. Interactions between CPS and COVID-19 pandemic periods found that cognitive impairment was associated with a higher hazard ratio (ranged from 1.22 to 1.37) in each of the 3 COVID-19 pandemic periods. We also found unstable health, unsteady gait, wandering, and moderate to severe ADL dependency were the strongest risk factors for falls. CONCLUSIONS AND IMPLICATIONS: Cognitively impaired long-term care residents had an increased risk for falls during the COVID-19 pandemic. This risk was influenced by several factors. In future pandemic or infection control related isolation, residents who are most at risk can be identified for targeted falls prevention programs.

Implementation of a Web-Based Educational Intervention for Promoting Flipped Classroom Pedagogy: A Mixed-Methods Study.

Introduction: Flipped classroom pedagogy (FCP) is recognised as an effective and efficient teaching-learning method. However, nursing students and teachers may be hesitant to adopt FCP due to technophobia and time constraints linked to academic and clinical responsibilities. This necessitates the provision of promotional training for adopting FCP. However, there is a dearth of research regarding how the practice of FCP could be promoted and in demonstrating its efficacy in developing countries. Thus, this study aimed to examine the educational impact of a web-based education intervention, branded as the Flipped Classroom Navigator (FCN), for promoting FCP in nursing education in Sri Lanka. Methods: This mixed-methods study employed pre- and post-training knowledge tests, the Instructional Materials Motivation Survey (IMMS), the Perceived Transfer of Learning Questionnaire survey, and collected students' and teachers' open-ended responses to evaluate the impact of the FCN. Fifty-five undergraduate nursing students and 15 university teachers participated in the study from two state universities in Sri Lanka. Repeated-measures ANOVA, t-tests, Levene's test of homogeneity, Cohen's d, and an inductive thematic approach were employed in the data analysis. Results: Post-training knowledge test scores were significantly higher than the pre-training knowledge test scores indicating improved understanding of FCP. Participants were also highly motivated to learn in the FCN instructional materials. Participants exhibited positive attitudes towards FCN training with transfer of learning to their teaching-learning practice. The inductive thematic analysis identified the following themes: user experiences, FCN learning content, behaviour changes, and suggested improvements. Conclusion: Overall, the FCN enhanced both students' and teachers' knowledge and understanding of FCP in undergraduate nursing education. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01706-7.

Developing and evaluating an educational web-based tool for health professions education: the Flipped Classroom Navigator.

BACKGROUND: Flipped classroom pedagogy is a blended learning approach applied in undergraduate health professions education. However, teachers and students may require training to effectively engage in flipped classroom pedagogy. Thus, this study aimed to design, develop, and evaluate a web-based tool for fostering flipped classroom pedagogy in undergraduate health professions education. METHODS: This is an educational design-based research with a descriptive evaluation component which was conducted in two steps: (i) design & development and (ii) evaluation of an educational website. An expert panel was formed to evaluate the website by using a website evaluation questionnaire (WEQ). Descriptive statistics were employed to calculate the experts' agreement level. RESULTS: An innovative website design was used to provide access to a range of digital devices. The development process occurred concurrently in two steps: (i) website development and (ii) learning content development. The educational website was branded as the Flipped Classroom Navigator (FCN). Based on WEQ scores, the FCN obtained a good level of agreement (≥ 80%) for its' ease of use, hyperlinks, structure, relevance, comprehension, completeness, and layout. CONCLUSIONS: The FCN is an effective method for providing training to promote flipped classroom pedagogy in health professions education. The FCN achieved good evaluation scores and comments from experts. However, it is also necessary to obtain acceptance from the end-users, which could be the focus of future research. Nonetheless, the expert panel pinpointed areas for further development before introducing the FCN to end-users.

Utility and Acceptability of a Brief Type 2 Diabetes Visual Animation: Mixed Methods Feasibility Study.

BACKGROUND: Visualizations of illness and treatment processes are promising interventions for changing unhelpful perceptions and improving health outcomes. However, these are yet to be tested in patients with type 2 diabetes mellitus (T2DM). OBJECTIVE: This study assesses the cross-cultural acceptability and potential effectiveness of a brief visual animation of T2DM at changing unhelpful illness and treatment perceptions and self-efficacy among patients and family members in 2 countries, New Zealand and Saudi Arabia. Health care professionals' views on visualization are also explored. METHODS: A total of 52 participants (n=39, 75% patients and family members and n=13, 25% health care professionals) were shown a 7-minute T2DM visual animation. Patients and family members completed a questionnaire on illness and treatment perceptions and self-efficacy before and immediately after the intervention and completed semistructured interviews. Health care professionals completed written open-ended questions. Means and 95% CIs are reported to estimate potential effectiveness. Inductive thematic analysis was conducted on qualitative data. RESULTS: All participants rated the visual animation as acceptable and engaging. Four main themes were identified: animation-related factors, impact of the animation, animation as an effective format for delivering information, and management-related factors. Effect sizes (ranged from 0.10 to 0.56) suggested potential effectiveness for changing illness and treatment perceptions and self-efficacy among patients and family members. CONCLUSIONS: Visualizations are acceptable and may improve the perceptions of patients' with diabetes in a short time frame. This brief visual animation has the potential to improve current T2DM education. A subsequent randomized controlled trial to investigate the effects on illness and treatment perceptions, adherence, glycemic control, and unplanned hospital admission is being prepared.

University teachers' perceptions of readiness for flipped classroom pedagogy in undergraduate nursing education: A qualitative study.

BACKGROUND: Flipped classroom pedagogy is an innovative blended teaching-learning method. Prevailing evidence about flipped classroom pedagogy shows it is an effective and beneficial teaching method from the students' perspective. There is a dearth of evidence about teachers' perceptions of the flipped classroom and its implementation in low-resourced educational contexts. PURPOSE: To assess the university teachers' perceptions of readiness for adopting flipped classroom pedagogy in the Sri Lankan undergraduate nursing education context. METHODS: An exploratory qualitative study using focus group discussions was conducted in three public universities in Sri Lanka. The participants were 24 university teachers who were involved in undergraduate nursing education programmes in Sri Lanka. Four focus group interviews were conducted. Data were transcribed and analysed using inductive thematic analysis. RESULTS: Four themes emerged. Three themes explained the teachers' perceptions of readiness for implementing flipped classrooms: educational technology, acceptability of the flipped classroom pedagogy, and the educational environment. A further theme refers to future requirements for implementing the flipped classroom. CONCLUSIONS: The study revealed teachers' readiness to use flipped classroom pedagogy. Nevertheless, limited resources and existing teacher-centric practice were identified as challenges to implement the flipped classroom.

Perioperative leaders' experience of COVID-19 in Aotearoa: a qualitative interview study.

AIMS: Once it became apparent that COVID-19 would reach Aotearoa New Zealand, perioperative services responded urgently to contain viral spread, keep staff safe and maintain patient care. We aimed to understand how perioperative leaders around the country responded to the pandemic, their experiences, reflections and the lessons learnt. Our goal is to inform future pandemic responses. METHODS: We undertook a qualitative study with thematic analysis of semi-structured interviews. We recruited perioperative leads involved in the COVID-19 response using snowball sampling, following initial contact with anaesthetic and surgical department heads. RESULTS: We interviewed 33 perioperative leads from 16 of the country's 20 district health boards, with representation across hospitals of different sizes and the professional groups working in operating theatres. Four main themes were identified from data. These were: "no one source of truth," with prolific, constantly changing information, limited initial support from hospital senior executives, and siloed approaches and tensions between departments and professional groups; resourcing challenges attributed to limited baseline preparedness and increased workload; deficiencies in PPE and physical facilities; staff stress and anxiety, and the impact this had on workforce capacity; ongoing preparedness for future waves; and reflections on "lessons learnt". These lessons focused strongly on communication, caring for staff, collaboration, downtime to enable preparation, and a need for external, potentially national co-ordination and resources to facilitate planning. CONCLUSIONS: Perioperative leaders' experiences and reflections of COVID-19 paint a picture of limited prior preparation or planning for a pandemic, requiring an immediate pivot from routine care to emergency response. In an environment of uncertainty, information overload and staff stress hospital leaders worked to obtain resources, maintain staff safety and engagement, develop new systems and in some cases, create new facilities. Sharing the experiences and lessons learned about communication and collaboration, policy development and staff training may go some way to facilitate a smoother implementation of a pandemic response the next time around.

Prioritising a culturally safe e-Mental Health research agenda in Aotearoa New Zealand: A sector survey report.

OBJECTIVE: To collect mental health and addiction service providers' opinions about priorities for an e-Mental Health (eMH) research agenda focused on delivering culturally safe eMH in Aotearoa New Zealand. METHOD: Service providers were recruited to participate in an anonymous online survey, which asked participants to rate the importance of potential research domains and items on a continuous scale from 1 to 10. The mean values of each item were normalised to develop a priority index. RESULTS: 48 participants rated at least one of the listed research items. The highest-rated items were (i) identifying strategies to improve access; co-developing eMH with the community (ii) a set of competencies required for delivering culturally safe care, (iii) a set of meaningful clinical outcomes that can be achieved via eMH, (iv) guidelines for the delivery of eMH services and (v) investigating the extent to which eMH could meet the mental health needs of these communities. 'Standards and guidelines' was the domain with the highest priority index. CONCLUSIONS: Mental health and addiction service providers in Aotearoa New Zealand prioritised an eMH research agenda that is focused on pro-equity outcomes and incorporating the voices and experiences of the communities they seek to serve.

Investigating Predictors of Psychological Distress for Healthcare Workers in a Major Saudi COVID-19 Center.

This study investigated the relationship between fear of COVID-19, previous exposure to COVID-19, perceived vulnerability to disease, sleep quality, and psychological distress among healthcare workers (HCWs) in Taif city in Saudi Arabia, which has a population of 702,000 people. A cross-sectional study design was adopted. HCWs (n = 202) completed a survey containing the Fear of COVID-19 Scale (FCV-19S), Perceived Vulnerability to Disease (PVD), Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety, and Stress Scale (DASS-21). FCV-19S and sleep quality were significant predictors for psychological distress. Female gender was a significant predictor for depression and stress. Single, divorced, and widowed marital status were predictive for anxiety. FCV-19S was weakly correlated with PVD but moderately with depression, anxiety, and stress. Of the two PVD subscales, perceived infectability was weakly correlated with psychological distress. PVD and previous experience with COVID-19 were not significant predictors. Sleep quality and FCV-19S were major predictors of psychological distress. Findings indicated that poor sleep quality was strongly associated with psychological distress, while fear of COVID-19 had a moderate association. Such results support the need to design and implement psychological programs to assist HCWs in dealing with the psychological impact of this ongoing pandemic.

Adaptation models, barriers, and facilitators for cultural safety in telepsychiatry: A systematic scoping review.

Introduction: Indigenous peoples, and racial and ethnic minorities around the world experience significant mental health inequities. Telepsychiatry can contribute to addressing these inequities among these populations. However, it is first crucial to ensure the cultural safety of this tool as a critical step toward health equity. This review aimed to collate evidence regarding cultural adaptations, barriers, opportunities, and facilitators for telepsychiatry services supporting minority groups. Method: Using the PRISMA extension for scoping reviews (PRISMA-ScR) guideline, we conducted a systematic scoping review and thematic analysis. Six databases were searched using the PICO framework, i.e., population, intervention, comparison, and outcomes.. Additional literature was identified through reference lists screening. We developed a table for data extraction, and the extracted data were further analyzed following Braun and Clarke's approach for thematic analysis. Results: A total of 1514 citations were screened with a final total of 58 articles included in the review. The themes related to telepsychiatry cultural adaptations emphasize the crucial role of community involvement and quality service delivery. Identified barriers were associated with service and infrastructure, and service users' socioeconomic and cultural contexts. Opportunities and facilitators for telepsychiatry were enhanced access and rapport, and multi-organizational collaborations and partnerships. Discussion: This review identified factors that can guide the adaptation of telepsychiatry evidence-based interventions to meet the needs of Indigenous peoples and racial and ethnic minorities. Telepsychiatry programs must be specifically designed for the population they seek to serve, and this review offers emerging insights into critical factors to consider in their development.

Impact of the first wave of COVID-19 on the health and psychosocial well-being of Maori, Pacific Peoples and New Zealand Europeans living in aged residential care.

OBJECTIVE: To investigate the impact of New Zealand's (NZ) first wave of COVID-19, which included a nationwide lockdown, on the health and psychosocial well-being of Maori, Pacific Peoples and NZ Europeans in aged residential care (ARC). METHODS: interRAI assessments of Maori, Pacific Peoples and NZ Europeans (aged 60 years and older) completed between 21/3/2020 and 8/6/2020 were compared with assessments of the same ethnicities during the same period in the previous year (21/3/2019 to 8/6/2019). Physical, cognitive, psychosocial and service utilisation indicators were included in the bivariate analyses. RESULTS: A total of 538 Maori, 276 Pacific Peoples and 11,322 NZ Europeans had an interRAI assessment during the first wave of COVID-19, while there were 549 Maori, 248 Pacific Peoples and 12,367 NZ Europeans in the comparative period. Fewer Maori reported feeling lonely (7.8% vs. 4.5%, p = 0.021), but more NZ Europeans reported severe depressive symptoms (6.9% vs. 6.3%, p = 0.028) during COVID-19. Lower rates of hospitalisation were observed in Maori (7.4% vs. 10.9%, p = 0.046) and NZ Europeans (8.1% vs. 9.4%, p < 0.001) during COVID-19. CONCLUSIONS: We found a lower rate of loneliness in Maori but a higher rate of depression in NZ European ARC populations during the first wave of COVID-19. Further research, including qualitative studies with ARC staff, residents and families, and different ethnic communities, is needed to explain these ethnic group differences. Longer-term effects from the COVID-19 pandemic on ARC populations should also be investigated.

Assess the feasibility of flipped classroom pedagogy in undergraduate nursing education in Sri Lanka: A mixed-methods study.

BACKGROUND: The nursing education system has evolved with an increased emphasis on student-centred education, such as implementing flipped classroom pedagogy. Given the promising positive educational outcomes, the trend of using flipped classroom pedagogy has become increasingly popular in undergraduate nursing education. However, little is known about how these flipped classroom methods impact on nursing educational practices in limited-resource settings situated in South Asia. OBJECTIVE: To assess the feasibility of implementing flipped classroom pedagogy in undergraduate nursing education from the nursing students' perspective. METHODS: This mixed-methods study employed a quantitative survey and six focus group discussions conducted in three state universities in Sri Lanka. The Nursing Students' Readiness for Flipped Classroom (NSR-FC) questionnaire was used to collect quantitative data. The semi-structured focus group discussions were conducted by using 18 reflective and open-ended questions. Descriptive statistics and multivariate analysis of variance methods were employed when analysing quantitative data. An inductive thematic analysis approach was used to summarize the focus group discussions. RESULTS: The questionnaire survey revealed that nursing students reported high levels of personal, technical, and pedagogical readiness across all three universities, while environmental readiness was perceived as low. The inductive thematic analysis identified three themes, namely: enablers, challenges, and benefits. Specifically, nursing students valued the student-centred approach. They were ready to utilize their own devices to overcome limited technological provision; however, a short training session about how to engage in the flipped classroom was desirable. Also, their exposure to basic educational technology was perceived as adequate and they were aware of the positive outcomes of flipped classroom pedagogy. CONCLUSION: Nursing students were ready to enrol in a flipped classroom programme. The provision of technological resources in the education environment was identified as a great challenge for flipped classroom implementation. Overall, the findings indicate there are promising feasibilities for the flipped classroom implementation.

Exploring the pedagogical design features of the flipped classroom in undergraduate nursing education: a systematic review.

BACKGROUND: In recent years, technological advancement has enabled the use of blended learning approaches, including flipped classrooms. Flipped classrooms promote higher-order knowledge application - a key component of nursing education. This systematic review aims to evaluate the empirical evidence and refereed literature pertaining to the development, application and effectiveness of flipped classrooms in reference to undergraduate nursing education. METHODS: A PRISMA systematic review protocol was implemented to investigate the literature pertaining to the development, implementation and effectiveness of flipped classroom pedagogy in undergraduate nursing education. Seven databases (Scopus, PsycINFO, CINAHL, ERIC, MEDLINE, Cochrane, Web of Science) were utilised to survey the salient literature. Articles were appraised with respect to their level of evidence, the origin of study, study design, the aims/s of the study, and the key outcomes of the study. A qualitative synthesis was then conducted to summarise the study findings. RESULTS: The initial search identified 1263 potentially relevant articles. After comprehensively reviewing the initial catchment using several analytical phases, 27 articles were considered for the final review, most of which were conducted in the USA and South Korea. A range of research designs were applied to measure or discuss the outcomes and design features of the flipped classroom pedagogy when applied to undergraduate nursing education. The review indicated that a common operational flipped classroom model involves three key components, namely pre-classroom activities, in-classroom activities and post-classroom activities, guided by two instructional system design principles. The review predominantly identified positive learning outcomes among undergraduate nursing students, after experiencing the flipped classroom, in terms of skills, knowledge and attitudes. However, a few studies reported contrasting findings, possibly due to the incompatibility of the flipped classroom pedagogy with the traditional learning culture. CONCLUSIONS: Current evidence in this systematic review suggests that incorporating the flipped classroom pedagogy could yield positive educational outcomes in undergraduate nursing education. There are promising pedagogical models available for adapting or developing the flipped classroom pedagogy in undergraduate nursing education.

Ethnic and socio-economic disparities in prostate cancer screening: lessons from New Zealand.

OBJECTIVES: To investigate the presence of ethnic and socio-economic disparities in prostate cancer (PCa) screening and identify its impact on cancer outcomes. MATERIALS AND METHODS: From January 2008 to December 2017, all men in the Northern region of New Zealand who had a prostate-specific antigen (PSA) test performed in the community were identified from the electronic laboratory reports database. Asymptomatic men, with no known diagnosis of PCa, were included. Variables collected were age, ethnicity, social deprivation, medical therapy, PSA test information and cancer data. Disparities were investigated by comparing the frequency of PSA testing, proportions of men screened, and rates of cancer detection, between Maori (indigenous) and non-Maori ethnic groups. RESULTS: The study cohort included 248 491 men, who each received approximately 3.45 PSA tests over the 10-year study period. Maori men were less likely to be tested compared to non-Maori men (25.4% vs 46.1% of the total aged-matched region population; P < 0.001). Moreover, they received less frequent PSA testing irrespective of their deprivation status (mean difference of 0.97 PSA tests per person; P < 0.001). The higher testing frequency in non-Maori men was associated with increased PCa diagnosis rates. Nevertheless, cancers detected in Maori men were 73% more likely to be of high grade (Gleason 8 or above), compared to those in non-Maori men. CONCLUSION: There were significant ethnic disparities in PCa screening rates in the Northern region of New Zealand. Maori men, regardless of other demographic factors, were disproportionately affected. The difference in the rates of screening by ethnicity had influenced the incidence and clinical significance of the diagnosed cancers.

Development and validation of a measurement scale to assess nursing students' readiness for the flipped classroom in Sri Lanka

PURPOSE: The aim of this study was to develop and validate a scale to measure nursing students' readiness for the flipped classroom in Sri Lanka. METHODS: A literature review provided the theoretical framework for developing the Nursing Students' Readiness for Flipped Classroom (NSR-FC) questionnaire. Five content experts evaluated the NSR-FC, and content validity indices (CVI) were calculated. Cross-sectional surveys among 355 undergraduate nursing students from 3 state universities in Sri Lanka were carried out to assess the psychometric properties of the NSR-FC. Principal component analysis (PCA, n=265), internal consistency (using the Cronbach α coefficient, n=265), and confirmatory factor analysis (CFA, n=90) were done to test construct validity and reliability. RESULTS: Thirty-seven items were included in the NSR-FC for content validation, resulting in an average scale CVI of 0.94. Two items received item level CVI of less than 0.78. The factor structures of the 35 items were explored through PCA with orthogonal factor rotation, culminating in the identification of 5 factors. These factors were classified as technological readiness, environmental readiness, personal readiness, pedagogical readiness, and interpersonal readiness. The NSR-FC also showed an overall acceptable level of internal consistency (Cronbach α=0.9). CFA verified a 4-factor model (excluding the interpersonal readiness factor) and 20 items that achieved acceptable fit (standardized root mean square residual=0.08, root mean square error of approximation=0.08, comparative fit index=0.87, and χ2/degrees of freedom=1.57). CONCLUSION: The NSR-FC, as a 4-factor model, is an acceptable measurement scale for assessing nursing students' readiness for the flipped classroom in terms of its construct validity and reliability.

Impact of Using a 3D Visual Metaphor Serious Game to Teach History-Taking Content to Medical Students: Longitudinal Mixed Methods Pilot Study.

BACKGROUND: History taking is a key component of clinical practice; however, this skill is often poorly performed by students and doctors. OBJECTIVE: The study aimed to determine whether Metaphoria, a 3D serious game (SG), is superior to another electronic medium (PDF text file) in learning the history-taking content of a single organ system (cardiac). METHODS: In 2015, a longitudinal mixed methods (quantitative and qualitative) pilot study was conducted over multiple sampling time points (10 weeks) on a group of undergraduate medical students at The University of Auckland Medical School, New Zealand. Assessors involved in the study were blinded to group allocation. From an initial sample of 83, a total of 46 medical students were recruited. Participants were assigned to either a PDF group (n=19) or a game group (n=27). In total, 1 participant left the PDF group after allocation was revealed and was excluded. A total of 24 students in the game group and 14 students in the PDF group completed follow-up 7 weeks later. Using an iterative design process for over a year, with input from a variety of clinical disciplines, a cardiac history-taking game and PDF file were designed and informed by Cognitive Load Theory. Each group completed its intervention in 40 min. A total of 3 levels of Kirkpatrick training evaluation model were examined using validated questionnaires: affective (perception and satisfaction), cognitive (knowledge gains and cognitive load), and behavioral attitudes (Objective Structured Clinical Exam) as well as qualitative assessment. A priori hypotheses were formulated before data collection. RESULTS: Compared with baseline, both groups showed significant improvement in knowledge and self-efficacy longitudinally (P<.001). Apart from the game group having a statistically significant difference in terms of satisfaction (P<.001), there were no significant differences between groups in knowledge gain, self-efficacy, cognitive load, ease of use, acceptability, or objective structured clinical examination scores. However, qualitative findings indicated that the game was more engaging and enjoyable, and it served as a visual aid compared with the PDF file. CONCLUSIONS: Students favored learning through utilization of an SG with regard to cardiac history taking. This may be relevant to other areas of medicine, and this highlights the importance of innovative methods of teaching the next generation of medical students.

Hacking Hackathons: Preparing the next generation for the multidisciplinary world of healthcare technology.

OBJECTIVE: Machine learning in healthcare, and innovative healthcare technology in general, require complex interactions within multidisciplinary teams. Healthcare hackathons are being increasingly used as a model for cross-disciplinary collaboration and learning. The aim of this study is to explore high school student learning experiences during a healthcare hackathon. By optimizing their learning experiences, we hope to prepare a future workforce that can bridge technical and health fields and work seamlessly across disciplines. METHODS: A qualitative exploratory study utilizing focus group interviews was conducted. Eight high school students from the hackathon were invited to participate in this study through convenience sampling Participating students (n = 8) were allocated into three focus groups. Semi structured interviews were completed, and transcripts evaluated using inductive thematic analysis. FINDINGS: Through the structured analysis of focus group transcripts three major themes emerged from the data: (1) Collaboration, (2) Transferable knowledge and skills, and (3) Expectations about hackathons. These themes highlight strengths and potential barriers when bringing this multidisciplinary approach to high school students and the healthcare community. CONCLUSION: This study found that students were empowered by the interdisciplinary experience during a hackathon and felt that the knowledge and skills gained could be applied in real world settings. However, addressing student expectations of hackathons prior to the event is an area for improvement. These findings have implications for future hackathons and can spur further research into using the hackathon model as an educational experience for learners of all ages.

Burnout, quality of life, motivation, and academic achievement among medical students: A person-oriented approach.

BACKGROUND: The aim of this study was to identify burnout and quality of life profiles of medical students and determine their associations with academic motivation and achievement on progress tests using a person-oriented approach. METHODS: Medical students (n = 670) in Year 3 to Year 5 at the University of Auckland were classified into three different profiles as derived from a two-step cluster analysis using World Health Organization Quality of Life-BREF scores and Copenhagen Burnout Inventory scores. The profiles were used as independent variables to assess differences in academic motivation and achievement on progress tests using a multivariate analysis of co-variance and repeated measures analysis of co-variance methods. RESULTS: The response rate was 47%. Three clusters were obtained: Higher Burnout Lower Quality of Life (n = 62, 20%), Moderate Burnout Moderate Quality of Life (n = 131, 41%), and Lower Burnout Higher Quality of Life (n = 124, 39%). After controlling for gender and year level, Higher Burnout Lower Quality of Life students had significantly higher test anxiety (p < 0.0001) and amotivation scores (p < 0.0001); and lower intrinsic motivation (p < 0.005), self-efficacy (p < 0.001), and progress test scores (p = 0.03) compared with the other profiles. CONCLUSION: Burnout and Quality of Life profiles of medical students are associated with differences in academic motivation and achievement over time.

My Home is My Marae: Kaupapa Maori evaluation of an approach to injury prevention.

OBJECTIVE: The objective of this study was to evaluate the New Zealand Accident Compensation Corporation's (ACC) 'My Home is My Marae' approach to injury prevention for whanau (families). SETTING: Over an 18 month period from November 2013 to June 2014, 14 'My Home is My Marae' trials were conducted across the South Auckland and Far North regions of New Zealand. ACC engaged with local Maori providers of healthcare, education and social services to deliver the home safety intervention. PARTICIPANTS: Participants of this evaluation were a purposive sample of 14 staff from six provider organisations in South Auckland and the Far North regions of New Zealand. METHODS: Kaupapa Maori theory-based evaluation and appreciative inquiry methodologies underpinned the evaluation. Interview participants led discussions about strengths and weaknesses of the approach, and partnerships with ACC and other organisations. The evaluation was also supported by pre-existing information available in project documentation, and quantitative data collected by Maori providers. RESULTS: Five key critical success factors of 'My Home is My Marae' were found from interviews: mana tangata (reputation, respect and credibility); manakitanga (showing care for people); kanohi-ki-te-kanohi (face-to-face approach); capacity building for kaimahi, whanau and providers and 'low or no cost' solutions to hazards in the home. Data collected for the Far North area showed that 76% of the hazards identified could be resolved through 'low or no cost' solutions. Unfortunately, similar data were not available for South Auckland. CONCLUSIONS: Injury prevention or health promotion approaches that seek to engage with whanau and/or Maori communities would benefit from applying critical success factors of 'My Home is My Marae'.

The Impact of a Revised Curriculum on Academic Motivation, Burnout, and Quality of Life Among Medical Students.

OBJECTIVE: The purpose of this study was to determine the impact of a revised curriculum on medical student academic motivation, burnout, and quality of life. METHODS: This cross-sectional comparative study involved 2 medical school cohorts of second year and fourth year medical students at The University of Auckland: a cohort under a traditional curriculum (n = 437) and a cohort under a revised curriculum (n = 446). Participants completed self-reported questionnaires measuring academic motivation, burnout, and quality of life. Two multivariate analyses of covariance (MANCOVAs) were conducted. RESULTS: The response rate was 48%. No statistically significant differences were found between curriculum cohorts for mean scores of academic motivation, personal burnout, and quality of life. However, differences were found when comparing preclinical medical students and students in their clinical years of training. In comparison with Year 2 medical students, the MANCOVA for Year 4 students showed a significant main effect for the revised curriculum with respect to both physical and environmental quality of life. CONCLUSIONS: A revised medical curriculum had a differential effect on quality of life for Year 4 students in the latter years of medical school who are based in a clinical learning environment.