A systematic scoping review and content analysis of organizational health literacy responsiveness assessment tools.

The characteristics of health literate organizations have been variously described in recognition that it is important for organizations to respond to the diversity of people's health literacy strengths and challenges. A systematic scoping review was conducted to identify, assess and classify international self-assessment tools aimed at measuring the capability of organizations to embody health literate characteristics. Following the JBI Scoping Manual, a search was conducted in six databases and identified 2693 articles. After screening, 16 studies published between 2007 and 2023 across eight countries were eligible for inclusion. Results were summarized and a finite list of items from existing tools was generated. Content analysis was performed to classify these items. Whilst most assessment tools in the included studies were healthcare-focused, other settings included schools and government departments. The 16 assessment tools included a total of 661 items, and 647 items were retained that met the definition of health literacy responsiveness. Items were classified into six domains (communication; navigation of resources; culture; policies and practice; involvement or engagement and workforce development), with high agreement between two researchers (91.5%). The 647 items were reviewed to exclude items that were too contextually specific, focused solely on service users, were too broad or had suitable alternatives; 210 items were finally retained. This research is two-fold: provides a synthesis of existing organizational health literacy responsiveness assessment tools across settings; and provides a list of items, which will be essential to developing context specific assessment tools through Delphi methods in the future.

ChatGPT's Performance on the Hand Surgery Self-Assessment Exam: A Critical Analysis.

Purpose: To assess the performance of Chat Generative Pre-Trained Transformer (ChatGPT) when answering self-assessment exam questions in hand surgery and to compare correct results for text-only questions to those for questions that included images. Methods: This study used 10 self-assessment exams from 2004 to 2013 provided by the American Society for Surgery of the Hand (ASSH). ChatGPT's performance on text-only questions and image-based questions was compared. The primary outcomes were ChatGPT's total score, score on text-only questions, and score on image-based questions. The secondary outcomes were the proportion of questions for which ChatGPT provided additional explanations, the length of those elaborations, and the number of questions for which ChatGPT provided answers with certainty. Results: Out of 1,583 questions, ChatGPT answered 573 (36.2%) correct. ChatGPT performed better on text-only questions than image-based questions. Out of 1,127 text-only questions, ChatGPT answered 442 (39.2%) correctly. Out of the 456 image-based questions, it answered 131 (28.7%) correctly. There was no difference between the proportion of elaborations among text-only and image-based questions. Although there was no difference between the length of elaborations for questions ChatGPT got correct and incorrect, the length of elaborations provided for image-based questions were longer than those provided for text-only questions. Out of 1,441 confident answers, 548 (38.0%) were correct; out of 142 unconfident answers, 25 (17.6%) were correct. Conclusions: ChatGPT performed poorly on the ASSH self-assessment exams from 2004 to 2013. It performed better on text-only questions. Even with its highest score of 42% for the year 2012, the AI platform would not have received continuing medical education credit from ASSH or the American Board of Surgery. Even when only considering questions without images, ChatGPT's high score of 44% correct would not have "passed" the examination. Clinical relevance: At this time, medical professionals, trainees, and patients should use ChatGPT with caution as the program has not yet developed proficiency with hand subspecialty knowledge.

A practical stakeholder-focused approach for assessing the biosecurity system in Pacific Island countries.

AIMS: To develop a structured process for a transparent, efficient, high-level review of a low-resource biosecurity system (limited by physical infrastructure, financial, and human resources), in order to identify and prioritise key areas for future focus which could then lead to interventions, tailored by country, to improve the system. A key requirement was that the approach developed was culturally sensitive and respectful to Pasifika people within the country. METHODS: Animal health and biosecurity systems need to be urgently strengthened by Pacific Island countries and territories (PICTs) if they are to respond to current and future threats. Understanding where additional resources should be allocated to maximise benefit and ensuring buy-in from PICT stakeholders are critical for uptake of any recommendations made. However, there is little available literature on reviewing biosecurity systems, particularly where there is a need for efficiency, simplicity, and cultural sensitivity. A framework was developed through initial in-person consultation between four New Zealand experts who had experience working in international animal health development and support programmes. This was followed by input from informal discussions with selected heads of agriculture in PICTs and included their experiences with previous system reviews, as well as general advice from experts in Pasifika culture. Foundational objectives included simplicity, local inclusivity, and a structured approach, which could be undertaken over a relatively short period of time.A rapid evidence assessment methodology was used to search the available literature (published and grey, search terms biosecurity, system, Pacific, animal, framework, and review used in AND/OR combinations), to establish an evidence base for other methods of biosecurity system review. The developed framework for review of biosecurity systems in low-resource PICTs was based on elements from expert elicitation frameworks, the SurF surveillance evaluation framework and the Performance of Veterinary Services tool from The World Organisation for Animal Health. RESULTS: The developed framework involved bringing stakeholders together in a workshop environment and comprised up to 10 steps including mapping the PICT biosecurity system and exploring attributes of component activities. Understanding the system at a high level enables stakeholders to make informed recommendations on improvements to address future needs. Using the Delphi method, recommendations were then prioritised by stakeholders. CONCLUSIONS AND CLINICAL RELEVANCE: A distinctive difference flowing from the use of the needs analysis described in this process was the empowerment of PICT stakeholders to determine their own needs and priorities, rather than have these developed by external parties.

Perception of aesthetic impairment in patients with systemic sclerosis determined using a semi-quantitative scale and its association with disease characteristics.

Background: Systemic sclerosis is a fibrotic disease. Body image assessments could be key in optimizing care; however, data are scarce. The main objective was to assess the perception of aesthetic impairment using a visual aesthetic evaluation scale in patients with systemic sclerosis compared with healthy subjects. The secondary objectives were to assess associations between the perception of aesthetic impairment and scores on standardized questionnaires for aesthetic impairment as well as clinical, psychological/quality of life, and functional parameters of patients with systemic sclerosis. Methods: This study evaluated and compared the perception of aesthetic impairment in two populations: patients with systemic sclerosis from a referral center at Lille Hospital, France, and healthy controls. Results: This study included 88 patients (69 (78.4%) women) with a median age of 52 years and 88 controls (49 (55.7%) women) with a median age of 45 years. The perception of aesthetic impairment assessed using the aesthetic evaluation scale was poorer in systemic sclerosis patients than in controls (3.7 ± 0.3 vs 2.8 ± 0.3, p = 0.028) and was statistically correlated with assessments using the adapted satisfaction with appearance, a specific aesthetic impact assessment questionnaire for patients with systemic sclerosis. Patients with anxiety or depressive symptoms had significantly higher aesthetic evaluation scale scores. Systemic sclerosis patients with facial involvement and pitting scars had a worse perception of aesthetic impairment. Compared with healthy controls, systemic sclerosis patients had a worse perception of aesthetic impairment, especially systemic sclerosis patients with anxiety or depression and those with facial and hand involvement. Conclusion: The aesthetic evaluation scale appears to be an easy-to-use tool to evaluate body image. Correlations of the aesthetic evaluation scale score with psychological and quality of life parameters reflect the importance of these parameters for body image evaluation and its complex assessment. Trial registration: Clinical Trial NCT03271320 (Registered 9 January 2017, https://www.clinicaltrials.gov/ct2/show/NCT03271320?term=NCT03271320&cntry=FR&draw=2&rank=1).

Establishing TELLme - an online platform for self-directed, formative assessment of knowledge acquisition across an undergraduate medical curriculum.

PURPOSE: The purpose of this study is to report on the design, implementation, use and evaluation of TELLme, an online platform with annotated multiple-choice questions (MCQs) for formative assessment of knowledge acquisition covering an entire undergraduate medical curriculum. MATERIALS AND METHODS: We used the Educational Design Research (EDR) framework to develop TELLme as an online platform with 24/7 access for students in a co-creation process between educators, faculty and students. EDR cycle 1 focused on prototyping, while EDR cycle 2 focused on upscaling, usage analysis and evaluation. Database entries were analysed for TELLme usage. Online surveys evaluated platform usability and support for student learning. RESULTS: At the end of EDR cycle 2, TELLme contained 6,713 fully annotated MCQs aligned with the cognitive learning objectives of the curriculum. Up to 600 students per day used TELLme to self-assess their knowledge, answering 3,168,622 MCQs in two semesters. Surveys indicated good usability of TELLme, 75% of students indicated that TELLme helped them to identify knowledge gaps, and 72% agreed that TELLme supported their learning. CONCLUSIONS: Medical students use TELLme extensively to formatively assess their learning in a self-directed manner across the entire curriculum. TELLme aligns with the existing summative and formative system of assessment of the study programme.

Tracking progress on antimicrobial resistance by the quadripartite country self-assessment survey (TrACSS) in G7 countries, 2017-2023: opportunities and gaps.

Antimicrobial resistance (AMR) poses serious challenges to the healthcare systems worldwide. Multiple factors and activities contribute to the development and spread of antimicrobial-resistant microorganisms. Monitoring progress in combating AMR is fundamental at both global and national levels to drive multisectoral actions, identify priorities, and coordinate strategies. Since 2017, the World Health Organization (WHO) has collected data through the Tracking AMR Country Self-Assessment Survey (TrACSS). TrACSS data are published in a publicly-available database. In 2023, 71 (59.9%) out of 177 responding countries reported the existence of a monitoring and evaluation plan for their National Action Plan (NAP) on AMR, and just 20 countries (11.3%) the allocation of funding to support NAP implementation. Countries reported challenges including limited financial and human resources, lack of technical capacity, and variable political commitment. Even across the Group of Seven (G7) countries, which represent some of the world's most advanced economies, many areas still need improvement, such as full implementation of infection prevention and control measures, adoption of WHO access/watch/reserve (AWaRe) classification of antibiotics, effective integration of laboratories in AMR surveillance in the animal health and food safety sectors, training and education, good manufacturing and hygiene practices in food processing, optimising pesticides use and environmental residues of antimicrobial drugs. Continuous and coordinated efforts are needed to strengthen multisectoral engagement to fight AMR.

Development and psychometric properties of the Turkish version of the Orofacial Esthetic Scale.

OBJECTIVE: This study aimed to develop the Turkish version of the Orofacial Esthetic Scale (OES-Tr) and to evaluate its psychometric properties. MATERIALS AND METHODS: The OES-Tr questionnaire was obtained from the English version of OES by translation and back-translation. The current version's psychometric properties were evaluated in a cohort of 221 participants (81 dental students, 70 dentists with 1-10 years of clinical experience, and 70 dentists with 11-20 years of clinical experience). To assess the test-retest reliability, the OES was administered twice to all participants, with a time interval of 2-4 weeks. The reliability and validity of the questionnaire were assessed. Also, in validity studies, OES total scores were correlated with Oral Health Impact Profile-Turkish Version (OHIP-Tr) total scores. RESULTS: The Cronbach's alpha value obtained from seven items was 0.866 in the examination performed on all individuals. Reliability results show that all questionnaire items are consistent within the test. Bartlett's test of sphericity was statistically significant (p < 0.05) and Kaiser-Meyer-Olkin test was 0.794. The results of the exploratory factor analysis indicated the creation of a single-factor structure. The examinations conducted on all participants revealed a statistically significant weak negative correlation between OES and OHIP scores (r = -0.144). CONCLUSIONS: OES-Tr can be utilized as a reliable tool to evaluate an individual's perception of their orofacial appearance. With its excellent psychometric properties, it serves as a valuable instrument for assessing self-perceived orofacial esthetics. CLINICAL SIGNIFICANCE: OES-Tr is a valuable instrument for assessing the appearance of the orofacial region, with good psychometric properties.

Test-retest reliability and agreement of remote home-based functional capacity self-administered assessments in community-dwelling, socially isolated older adults.

Objectives: To determine the test-retest reliability and agreement of home-based functional capacity self-administered assessments in socially isolated older adults. Methods: Fourteen community-dwelling older adults (eight females, 67.9 ± 7.7 years) volunteered for this study. Before testing, participants were screened online for eligibility and received instructional videos explaining test set-up and execution. Participants underwent the 30-second sit-to-standing test, gait speed tests at the usual pace, and timed-up-and-go tests administered 4 weeks apart. For the 30-second sit-to-standing protocol, participants were instructed to repeatedly sit and stand from a chair (with a height of ∼ 43 cm and without armrests) for 30 s, with the number of repetitions recorded. In the gait speed test protocol, participants were instructed to walk at their usual and comfortable pace, with the time taken recorded (seconds). In the timed-up-and-go, participants stood up from a chair, walked as fast as possible for 3 m, circled a marked point, and returned to the chair to sit down, completing the test, with the score recorded (seconds). A trained researcher conducted the scoring virtually via synchronous video. Results: 30-second sit-to-standing, gait speed test, and timed-up-and-go showed excellent mean coefficient of variation values (2.0-4.9), small standard error of measurement (0.08-1.27), excellent intraclass coefficient (0.97-0.99), very strong correlations (0.97-0.99) and good agreement between the two days of testing. Conclusion: Self-administered functional capacity tests performed by older adults at home were reliable with good agreement. Healthcare professionals and older adults should take advantage of simple remote self-administered assessments performed at home to evaluate older adults' health status.

A Symptom-Checker for Adult Patients Visiting an Interdisciplinary Emergency Care Center and the Safety of Patient Self-Triage: Real-Life Prospective Evaluation.

BACKGROUND: Symptom-checkers have become important tools for self-triage, assisting patients to determine the urgency of medical care. To be safe and effective, these tools must be validated, particularly to avoid potentially hazardous undertriage without leading to inefficient overtriage. Only limited safety data from studies including small sample sizes have been available so far. OBJECTIVE: The objective of our study was to prospectively investigate the safety of patients' self-triage in a large patient sample. We used SMASS (Swiss Medical Assessment System; in4medicine, Inc) pathfinder, a symptom-checker based on a computerized transparent neural network. METHODS: We recruited 2543 patients into this single-center, prospective clinical trial conducted at the cantonal hospital of Baden, Switzerland. Patients with an Emergency Severity Index of 1-2 were treated by the team of the emergency department, while those with an index of 3-5 were seen at the walk-in clinic by general physicians. We compared the triage recommendation obtained by the patients' self-triage with the assessment of clinical urgency made by 3 successive interdisciplinary panels of physicians (panels A, B, and C). Using the Clopper-Pearson CI, we assumed that to confirm the symptom-checkers' safety, the upper confidence bound for the probability of a potentially hazardous undertriage should lie below 1%. A potentially hazardous undertriage was defined as a triage in which either all (consensus criterion) or the majority (majority criterion) of the experts of the last panel (panel C) rated the triage of the symptom-checker to be "rather likely" or "likely" life-threatening or harmful. RESULTS: Of the 2543 patients, 1227 (48.25%) were female and 1316 (51.75%) male. None of the patients reached the prespecified consensus criterion for a potentially hazardous undertriage. This resulted in an upper 95% confidence bound of 0.1184%. Further, 4 cases met the majority criterion. This resulted in an upper 95% confidence bound for the probability of a potentially hazardous undertriage of 0.3616%. The 2-sided 95% Clopper-Pearson CI for the probability of overtriage (n=450 cases,17.69%) was 16.23% to 19.24%, which is considerably lower than the figures reported in the literature. CONCLUSIONS: The symptom-checker proved to be a safe triage tool, avoiding potentially hazardous undertriage in a real-life clinical setting of emergency consultations at a walk-in clinic or emergency department without causing undesirable overtriage. Our data suggest the symptom-checker may be safely used in clinical routine. TRIAL REGISTRATION: ClinicalTrials.gov NCT04055298; https://clinicaltrials.gov/study/NCT04055298.

Peer evaluation as an alternative assessment method for case presentations: A cross-sectional study of dental students' perception.

INTRODUCTION: Peer assessment in dental and medical education is a key tool for evaluating attitudes and communication skills, serving as an effective formative learning method. It not only boosts academic performance and encourages lifelong learning and reflective practice but also fosters collaboration, effective communication, and constructive feedback among peers. OBJECTIVE: This study aimed to assess dental students' satisfaction and perceptions regarding implementing peer assessment in case presentations, including contribution to their learning. METHODS: This cross-sectional study involved third (n = 26), fourth (n = 54), and sixth (n = 71) dental students divided into five groups. Each student received peer assessments (n = 8) from the students of the other groups regarding their clinical presentation. At the end of the process, students were invited to complete an anonymous 9-item questionnaire to assess student perceptions of the peer-assessment process. Data were analyzed to evaluate students' perception and satisfaction with the peer assessment task. The bivariate analysis explored associations among questionnaire items. RESULTS: A total of 151 students participated in the current study. Results showed a high level of agreement for most of the students regarding their preparedness for peer and self-assessment. More than 75% of the students at all academic levels found it challenging to evaluate their peers. Student satisfaction scores increased with the level of education, (4.076, 4.214, and 4.246 out of five, respectively) with moderate correlations between peer evaluation characteristics. CONCLUSION: Peer assessment appears to enhance learning and professional development in dental students. Students' satisfaction with peer assessment grows with education level, reflecting its role in fostering critical evaluation skills and feedback.

The Performance of ChatGPT on the American Society for Surgery of the Hand Self-Assessment Examination.

BACKGROUND: This study aims to compare the performance of ChatGPT-3.5 (GPT-3.5) and ChatGPT-4 (GPT-4) on the American Society for Surgery of the Hand (ASSH) Self-Assessment Examination (SAE) to determine their potential as educational tools. METHODS: This study assessed the proportion of correct answers to text-based questions on the 2021 and 2022 ASSH SAE between untrained ChatGPT versions. Secondary analyses assessed the performance of ChatGPT based on question difficulty and question category. The outcomes of ChatGPT were compared with the performance of actual examinees on the ASSH SAE. RESULTS: A total of 238 questions were included in the analysis. Compared with GPT-3.5, GPT-4 provided significantly more correct answers overall (58.0% versus 68.9%, respectively; P = 0.013), on the 2022 SAE (55.9% versus 72.9%; P = 0.007), and more difficult questions (48.8% versus 63.6%; P = 0.02). In a multivariable logistic regression analysis, correct answers were predicted by GPT-4 (odds ratio [OR], 1.66; P = 0.011), increased question difficulty (OR, 0.59; P = 0.009), Bone and Joint questions (OR, 0.18; P < 0.001), and Soft Tissue questions (OR, 0.30; P = 0.013). Actual examinees scored a mean of 21.6% above GPT-3.5 and 10.7% above GPT-4. The mean percentage of correct answers by actual examinees was significantly higher for correct (versus incorrect) ChatGPT answers. CONCLUSIONS: GPT-4 demonstrated improved performance over GPT-3.5 on the ASSH SAE, especially on more difficult questions. Actual examinees scored higher than both versions of ChatGPT, but the margin was cut in half by GPT-4.

High Body Fat as a Predictor of Osteoporosis Risk in Postmenopausal Women: Insights From a Community-Based Cross-Sectional Study in Rural South India.

INTRODUCTION: Osteoporosis poses a significant health burden, particularly among postmenopausal women. While obesity in the form of BMI has been implicated in various health conditions, the relationship between waist-hip ratio (WHR) and osteoporosis remains debated. This study aims to estimate the prevalence of osteoporosis risk and explore the association between WHR and osteoporosis risk among postmenopausal women in rural South India. METHODS: A community-based cross-sectional study was conducted in the Chengalpattu district of Tamil Nadu. The study enrolled 435 postmenopausal women aged 45 years and above and the data were collected on socio-demographic characteristics, anthropometric measurements, and osteoporosis risk assessment using the Osteoporosis Self-assessment Tool for Asian Women (OSTA) scale. Logistic regression analysis was performed to identify factors associated with osteoporosis risk with 95%CI. RESULTS: The mean (SD) age of participants was 54.5 (8.6) years, 87% were married, 33% were illiterate with mean (SD) WHR of 0.88 (0.1). Around 80.5% of the participants were categorized as low risk, 16.1% as intermediate risk, and 3.5% as high risk based on OSTA scores. Older age, lower educational attainment, and higher waist-hip ratio were significantly associated with increased osteoporosis risk. CONCLUSION: This community-based study found a 20% osteoporosis risk among postmenopausal women using the OSTA scale, with age, lower education, and waist-hip ratio as key determinants. Early identification and interventions, particularly targeting older and obese individuals, are crucial to alleviate the burden and complications of osteoporosis.

Population characteristics and self-assessment of speaking and singing voice in Polish contemporary commercial music singers-an exploratory, cross-sectional study.

Background: The domination of the Contemporary Commercial Music (CCM) industry in music markets has led to a significant increase in the number of CCM performers. Performing in a wide variety of singing styles involves exposing CCM singers to specific risk factors potentially leading to voice problems. This, in turn, necessitates the consideration of this particular group of voice users in the Occupational Health framework. The aim of the present research was threefold. First, it sought to profile the group of Polish CCM singers. Second, it was designed to explore the prevalence of self-reported voice problems and voice quality in this population, in both speech and singing. Third, it aimed to explore the relationships between voice problems and lifetime singing involvement, occupational voice use, smoking, alcohol consumption, vocal training, and microphone use, as potential voice risk factors. Materials and methods: The study was conducted in Poland from January 2020 to April 2023. An online survey included socio-demographic information, singing involvement characteristics, and singers' voice self-assessment. The prevalence of voice problems was assessed by the Polish versions of the Vocal Tract Discomfort Scale (VTDS) and the Singing Voice Handicap Index (SVHI). Also, a self-reported dysphonia symptoms protocol was applied. The perceived overall voice quality was assessed by a Visual Analogue Scale (VAS) of 100 mm. Results: 412 singers, 310 women and 102 men, completed the survey. Nearly half of the studied population declared lifetime singing experience over 10 years with an average daily singing time of 1 or 2 h. 283 participants received vocal training. For 11.4% of respondents, singing was the primary income source, and 42% defined their career goals as voice-related. The median scores of the VTDS were 11.00 (0-44) and 12.00 (0-40) for the Frequency and Severity subscales, respectively. The median SVHI score of 33 (0-139) was significantly higher than the normative values determined in a systematic review and meta-analysis (2018). Strong positive correlations were observed between SVHI and both VTD subscales: Frequency (r = 0.632, p < 0.001) and Severity (r = 0.611, p < 0.001). The relationships between most of the other variables studied were weak or negligible. Conclusion: The examined CCM singers exhibited substantial diversity with regard to musical genre preferences, aspirations pertaining to singing endeavors, career affiliations, and source of income. Singing voice assessment revealed a greater degree of voice problems in the examined cohort than so far reported in the literature, based on the SVH and VTDS.

An e-Learning Course to Train General Practitioners in Planetary Health: Pilot Intervention Study.

BACKGROUND: According to the World Health Organization, climate and ecological emergencies are already major threats to human health. Unabated climate change will cause 3.4 million deaths per year by the end of the century, and health-related deaths in the population aged ≥65 years will increase by 1540%. Planetary health (PH) is based on the understanding that human health and human civilization depend on flourishing natural systems and the wise stewardship of those natural systems. Health care systems collectively produce global emissions equivalent to those of the fifth largest country on earth, and they should take steps to reduce their environmental impact. Primary care in France accounts for 23% of greenhouse gas emissions in the health care sector. General practitioners (GPs) have an important role in PH. The course offers first-year GP residents of the Montpellier-Nîmes Faculty of Medicine a blended-learning course on environmental health. An e-learning module on PH, lasting 30 to 45 minutes, has been introduced in this course. OBJECTIVE: The objective of this study was to assess the impact of the e-learning module on participants' knowledge and behavior change. METHODS: This was a before-and-after study. The module consisted of 3 parts: introduction, degradation of ecosystems and health (based on the Intergovernmental Panel on Climate Change report and planetary limits), and ecoresponsibility (based on the Shift Project report on the impact of the health care system on the environment). The questionnaire used Likert scales to self-assess 10 points of knowledge and 5 points of PH-related behavior. RESULTS: A total of 95 participants completed the pre- and posttest questionnaires (response rate 55%). The mean scores for participants' pretest knowledge and behaviors were 3.88/5 (SD 0.362) and 3.45/5 (SD 0.705), respectively. There was no statistically significant variation in the results according to age or gender. The pretest mean score of participants who had already taken PH training was statistically better than those who had not taken the PH training before this course (mean 4.05, SD 0.16 vs mean 3.71, SD 0.374; P<.001). CONCLUSIONS: The PH module of the Primary Care Environment and Health course significantly improved self-assessment knowledge scores and positively modified PH behaviors among GP residents. Further work is needed to study whether these self-declared behaviors are translated into practice.

Oral health-related quality of life in the Myanmar population: The first national oral health survey 2016 - 2017.

OBJECTIVES: To describe the oral health-related quality of life (OHRQoL) and its potential influencing factors within the Myanmar population. METHODS: Data were from the first national oral health survey, involving 3,513 participants aged 15-18 years, 35-44 years, and 60-74 years from 21 selected townships in Myanmar. Self-administered questionnaire-based surveys, conducted from December 2016 to January 2017, included socio-demographics, behavioral factors, self-reported oral conditions (number of teeth present, teeth and gingival conditions), and inquiries regarding OHRQoL (a set of 12 questions with 5 response options) using the recommended questions from WHO Oral Health Surveys. RESULTS: The most prevalent oral health issues were difficulties in chewing (32.2%) and biting foods (30.8%). In bivariate analysis, older individuals, rural residents, and participants with higher educational levels were associated with OHRQoL. In multiple regression analysis, self-reported number of teeth, teeth and gingival conditions were strong predictors of OHRQoL in all age groups. CONCLUSION: Self-rated oral health conditions predicted quality of life due to oral problems. The development of national oral health policies and strategies is imperative to facilitate early detection of oral health problems and promote the awareness of oral health importance.

Small programs, big challenges: Reimagining the evaluation of clinical teaching in genetic counseling.

Within the health professions education system, a significant proportion of teaching and learning occurs in the clinical setting. As such, the need to measure effective teaching for accreditation standards, faculty development, merit pay, academic promotion, and for monitoring the safety of the learning environment has led to numerous universities developing instruments to evaluate teaching effectiveness in this context. To date; however, these instruments typically focus on the student perspective, despite evidence demonstrating that student evaluations of teaching (SETs) lack correlation with learning outcomes and are not a true measure of teaching effectiveness. This issue is further exacerbated in small health professional training programs, such as genetic counseling, where clinical teachers may only supervise 1-3 students per year. As a result, not only are SETs more confounded due to small sample sizes, but a direct conflict exists between respecting learner anonymity and providing timely and relevant feedback to faculty. In such contexts, even using SETs to evaluate the nature of the learning environment may be unreliable due to student concerns about identifiability and fear of retaliation for unfavorable evaluation. This paper will review the literature regarding SETs, barriers to this process within the clinical setting, and the unintended downstream consequences. Options for addressing issues related to the use of SETs will be considered, with particular focus on the process of reflection and the use of teaching consultations or peer support groups as a means to improve teaching effectiveness in this learning environment.

Differences between resident self-assessments and faculty- assessments on Anesthesiology Milestones and associated factors: a cross-sectional study.

BACKGROUND: Accurate self-assessment is crucial for the professional development of physicians. There has been sparse data on the accuracy of self-assessments on Anesthesiology Milestones. The aim of this study was to investigate the differences between resident self-assessments and faculty-assessments on Anesthesiology Milestones and the associated factors. METHODS: This was a cross-sectional study conducted in a general tertiary university-affiliated hospital. We included anesthesia residents who were enrolled in the standardized residency training program in postgraduate year two and three at the time of the Milestone evaluation. We requested evaluations of competencies from both the Clinical Competency Committee faculty and the anesthesia residents themselves, utilizing the Chinese version of Anesthesiology Milestones in January 2023 and January 2024. The primary outcome was the differences between self- and faculty-assessments, calculated by subtracting the faculty-rated score from the self-rated score on each subcompetency. RESULTS: A total of 46 and 42 residents were evaluated in year 2023 and 2024, respectively. The self-rated sum score was significantly higher than that rated by faculty [mean (standardized deviation): 120.39 (32.41) vs. 114.44 (23.71), P = 0.008 in paired t test] with an intraclass correlation coefficient of 0.55 [95% confidence interval (CI): 0.31 to 0.70]. The Bland-Altman plots revealed significant overestimation in patient care (bias 0.32, 95% CI: 0.05 to 0.60), practice-based learning and improvement (bias 0.45, 95% CI: 0.07 to 0.84), and professionalism (bias 0.37, 95% CI: 0.02 to 0.72). Ratings from residents with master's degrees (mean difference: -1.06, 95% CI: -1.80 to -0.32, P = 0.005) and doctorate degrees (mean difference: -1.14, 95% CI: -1.91 to -0.38, P = 0.003) were closer to the faculty-assessments than residents with bachelor's degrees. Compared with patient care, the differences between self- and faculty- rated scores were smaller in medical knowledge (mean difference: -0.18, 95% CI: -0.35 to -0.02, P = 0.031) and interpersonal and communication skills (mean difference: -0.41, 95% CI: -0.64 to -0.19, P < 0.001) in the generalized estimating equation logistic regression model. CONCLUSIONS: This study revealed that residents tended to overestimate themselves, emphasizing the need to improve the accuracy of Milestones self-assessment. The differences between self- and faculty-assessments were associated with residents' degrees and domains of competency.

Competency gap among graduating nursing students: what they have achieved and what is expected of them.

BACKGROUND: Nurses' professional competencies play a significant role in providing safe care to patients. Identifying the acquired and expected competencies in nursing education and the gaps between them can be a good guide for nursing education institutions to improve their educational practices. METHODS: In a descriptive-comparative study, students' perception of acquired competencies and expected competencies from the perspective of the Iranian nursing faculties were collected with two equivalent questionnaires consisting of 85 items covering 17 competencies across 5 domains. A cluster sampling technique was employed on 721 final-year nursing students and 365 Iranian nursing faculties. The data were analyzed using descriptive statistics and independent t-tests. RESULTS: The results of the study showed that the highest scores for students' acquired competencies and nursing faculties' expected competencies were work readiness and professional development, with mean of 3.54 (SD = 0.39) and 4.30 (SD = 0.45), respectively. Also, the lowest score for both groups was evidence-based nursing care with mean of 2.74 (SD = 0.55) and 3.74 (SD = 0.57), respectively. The comparison of competencies, as viewed by both groups of the students and the faculties, showed that the difference between the two groups' mean scores was significant in all 5 core-competencies and 17 sub-core competencies (P < .001). Evidence-based nursing care was the highest mean difference (mean diff = 1) and the professional nursing process with the lowest mean difference (mean diff = 0.70). CONCLUSION: The results of the study highlight concerns about the gap between expected and achieved competencies in Iran. Further research is recommended to identify the reasons for the gap between the two and to plan how to reduce it. This will require greater collaboration between healthcare institutions and nursing schools.

Self-Assessment Instruments for Supporting Family Caregivers: An Integrative Review.

Family caregivers take on a variety of tasks when caring for relatives in need of care. Depending on the situation and the intensity of care, they may experience multidimensional burdens, such as physical, psychological, social, or financial stress. The aim of the present study was to identify and appraise self-assessment instruments (SAIs) that capture the dimensions of family caregivers' burdens and that support family caregivers in easily identifying their caregiving role, activities, burden, and needs. We performed an integrative review with a broad-based strategy. A literature search was conducted on PubMed, Google Scholar, Google, and mobile app stores in March 2020. After screening the records based on the eligibility criteria, we appraised the tools we found for their usefulness for family care and nursing practice. From a total of 2654 hits, 45 suitable SAIs from 274 records were identified and analyzed in this way. Finally, nine SAIs were identified and analyzed in detail based on further criteria such as their psychometric properties, advantages, and disadvantages. They are presented in multi-page vignettes with additional information for healthcare professionals. These SAIs have proven useful in assessing the dimensions of caregiver burden and can be recommended for application in family care and nursing practice.