Educational Challenges in Healthcare Design: Training Multidisciplinary Professionals for Future Hospitals and Healthcare.

BACKGROUND: Healthcare environments are one of the most complex and demanding fields of work. Scientific, technological and research developments along with new discoveries within health promotion and prevention strategies are increasingly requiring a multidisciplinary and interdisciplinary approach. Therefore, it is likely that the current professions will need to be significantly adapted to accommodate new and more specialized roles. OBJECTIVES: To present an overview of the current educational and training courses of the emerging professions, such as hospital planner, physician-engineer, doctor-architect, nurse-architect or engineer, we review the present global training courses (BSc, MSc, specialization and PhD courses) related to healthcare design focusing on the fields of Medicine and Nursing, Architecture and Engineering sciences. RESULTS: The paper analyses the literature review and website analysis about active teaching programs and courses. Several academic institutions offer BSc, MSc and PhD degree programs in Healthcare Design, Environmental and Building Hygiene, and Public Health. In addition, there are several professional postgraduate courses, either in classroom, hybrid-based or online. CONCLUSIONS: A considerable number of international training experiences addresses the topic of training multidisciplinary professionals. Further in-depth investigations are needed to examine the content, teaching format and impact of the courses, student outcomes and professional careers, fields of interest and the degree of collaborations with other institutions.

High School Internship Program in Integrated Mathematical Oncology (HIP IMO): Five-Year Experience at Moffitt Cancer Center.

Modern cancer research, and the wealth of data across multiple spatial and temporal scales, has created the need for researchers that are well versed in the life sciences (cancer biology, developmental biology, immunology), medical sciences (oncology) and natural sciences (mathematics, physics, engineering, computer sciences). College undergraduate education traditionally occurs in disciplinary silos, which creates a steep learning curve at the graduate and postdoctoral levels that increasingly bridge multiple disciplines. Numerous colleges have begun to embrace interdisciplinary curricula, but students who double major in mathematics (or other quantitative sciences) and biology (or medicine) remain scarce. We identified the need to educate junior and senior high school students about integrating mathematical and biological skills, through the lens of mathematical oncology, to better prepare students for future careers at the interdisciplinary interface. The High school Internship Program in Integrated Mathematical Oncology (HIP IMO) at Moffitt Cancer Center has so far trained 59 students between 2015 and 2019. We report here on the program structure, training deliverables, curriculum and outcomes. We hope to promote interdisciplinary educational activities early in a student's career.

Educating the Scientific Workforce on Sex and Gender Considerations in Research: A National Scan of the Literature and Building Interdisciplinary Research Careers in Women's Health Programs.

Background: This study was a national scan of education resources on integrating sex and gender considerations into research. The purpose was to assess capacity for educating researchers and to identify gaps, with implications for implementation of guidelines or mandates to consider sex and gender differences in research. Information sources were U.S. training programs in women's health and sex/gender difference research, Building Interdisciplinary Research Careers in Women's Health (BIRCWH), and published peer-reviewed biomedical literature. Materials and Methods: This descriptive study used multiple methods: a national survey and a comprehensive literature review. BIRCWH leaders responded to a survey regarding education on sex/gender difference research for BIRCWH scholars (response rate 100%, 20 of 20). A comprehensive literature review was conducted for 1993-2018. Results: Nearly half (45%) of BIRCWH institutions offered education on integrating sex or gender differences in clinical translational research; of those, roughly half (54%) offered in-person training and one-third (31%) offered content within existing for-credit courses. Respondents preferred online training (84%) to in-person offerings or reference materials (47% and 42% respectively). Published indexed literature on sex or gender differences has quadrupled since 1993, although growth in these publications remained flat in the most recent six years. Conclusions: Published resources to educate researchers on integrating sex and gender differences into medical research have increased, and BIRCWH programs connect scholars to national resources. Educational gaps remain due to limited access to curricula on applied research approaches, design, and methods for sex/gender difference research. BIRCWH programs desire curricula that are easily accessible online and asynchronously; sanctioned and supported by national thought leaders; linked to required training such as rigor and reproducibility; foster collaboration; and offer practical applications. Evidence-based, high-quality educational curricula and a dissemination plan are needed to enhance the adoption and integration of sex and gender into scientific endeavors.

A good career start can open doors: the plusses and minuses of an international graduate student program-a student's perspective.

There are many Ph.D. programs from various funding agencies that provide excellent starts to a scientific career. Multinational Ph.D. positions attract students because they provide students with much-required exposure to the international scientific community at an early stage of the career. For this reason, multinational Ph.D. positions can be considered as a better career opportunity over Ph.D. positions confined to a single country. In addition, these multidisciplinary research programs connect different organizations to deal with the problems of global interest. One of these multi-disciplinary research programs is the viral and bacterial adhesion network training-innovative training network (ViBrANT). ViBrANT is a multifaceted platform that develops the required skillsets in young researchers and thereby also contributes to building a multidisciplinary research community. Is this the only parameter to be considered or are there other factors that can also stimulate one's career development? In this perspective article, I will discuss the key reasons why I chose a multinational Ph.D. program along with the merits of being part of ViBrANT. I also discuss the challenges I faced while moving from India to the United Kingdom.

Efectividad de una intervención educativa multidisciplinar en pacientes con fractura de fémur: estudio SWEET HOME / Effectiveness of a multidisciplinary educational intervention in patients with hip fracture: SWEET HOME study

Antecedentes y objetivo: La fractura de fémur (FF) es una lesión frecuente en personas de edad avanzada. El objetivo fue evaluar la efectividad de una intervención educativa multidisciplinar en pacientes con FF para favorecer el regreso al domicilio y disminuir las complicaciones hospitalarias. Material y método: Estudio cuasiexperimental con medidas repetidas al ingreso, al alta, a los 30días y al año de seguimiento. Se incluyeron pacientes ≥65años con FF ingresados en la unidad de ortogeriatría entre febrero de 2016 y enero de 2017. La intervención educativa constó de dos actuaciones coordinadas: una educación sanitaria durante la hospitalización y un soporte multimodal durante la transición al domicilio. Resultados: Se incluyeron 67 pacientes (77,6% mujeres; edad 84,19±7,78 años). Regresaron al domicilio el 70,1%, doblando la cifra de los años 2014-2015. Hubo un 8,5% de reingresos a los 30días y al año. Al año, el nivel de dependencia fue cercano al nivel prefractura (Barthel: 86,67±19,31; 94,33±14,66), la movilidad mejoró respecto al alta (Parker: 4,73±1,84; 6,73±2,76; Timed Up and Go test: 38,29±21,27; 21,91±10,97) y el rendimiento cognitivo no empeoró de forma significativa. La percepción de pacientes, cuidadores y profesionales fue que la educación sanitaria mejoró la autonomía del paciente. La satisfacción con el proceso asistencial fue alta. Conclusiones: Este estudio aporta como novedad, a los beneficios ya descritos en los modelos asistenciales ortogeriátricos, el incremento del número de pacientes que regresan al domicilio en condiciones de seguridad

Background and objective: Hip fracture is a common injury among elderly patients. The main goal of our study was to assess the effectiveness of a multidisciplinary educational intervention aimed at hip fracture patients to promote home discharges and reduce in-hospital complications. Material and method: A quasi-experimental study was performed by taking repeated measurements at hospital admission, at hospital discharge, and at both 30days and one year of discharge. Patients aged ≥65years with hip fracture who were admitted to the Orthogeriatric Service between February 2016 and January 2017 were included in the study. The educational intervention consisted in two coordinated actions: patient education administered during their hospitalization and multimodal support provided during their discharge home. Results: A total of 67 patients were included in the study (77.6% of whom were women; 84.19±7,78 years old). Of these, 70.1% were discharged home, which doubles the figures recorded in the 2014-2015 period. The rate of readmission at 30days and one year of the discharge was 8.5%. At the one-year follow-up, the patient's dependence to perform basic activities of daily living was nearer to the pre-fracture level (Barthel: 86.67±19.31; 94.33±14.66), their mobility had improved in comparison with the time of discharge (Parker: 4.73±1.84; 6.73±2.76; Timed Up and Go Test: 38.29±21.27; 21.91±10.97), and their cognitive function had not worsened significantly. The patient education measures improved the patients' autonomy as perceived by the patients, the caregivers, and the healthcare providers. Satisfaction with the healthcare received was high. Conclusions: As a novelty to the already described benefits in orthogeriatric care models, this study would contribute by proving an increase of the number of patients discharged home in a safe condition

Innovating the outreach of comprehensive cancer centers.

In many countries, a majority of cancer patients are not treated at comprehensive cancer centers. Even for those that are, parts of the treatment or follow-up may be carried out in local community hospitals or in private practices. How to assure quality in cancer care and create innovation? How to integrate decentralized versus centralized patient care, education, and cancer research? Outlined here is a 360° view of outreach to include all stakeholders-most importantly patients and their families, patient advocacy groups, healthcare providers, health insurers, and policymakers.

Interdisciplinary Dissertation Research Among Public Health Doctoral Trainees, 2003-2015.

OBJECTIVES: Given the call for more interdisciplinary research in public health, the objectives of this study were to (1) examine the correlates of interdisciplinary dissertation completion and (2) identify secondary fields most common among interdisciplinary public health graduates. METHODS: We analyzed pooled cross-sectional data from 11 120 doctoral graduates in the Survey of Earned Doctorates, 2003-2015. The primary outcome was interdisciplinary dissertation completion. Covariates included primary public health field, sociodemographic characteristics, and institutional attributes. RESULTS: From 2003 to 2015, a total of 4005 of 11 120 (36.0%) doctoral graduates in public health reported interdisciplinary dissertations, with significant increases observed in recent years. Compared with general public health graduates, graduates of environmental health (odds ratio [OR] = 1.74; P < .001) and health services administration (OR = 1.38; P < .001) doctoral programs were significantly more likely to report completing interdisciplinary dissertation work, whereas graduates from biostatistics (OR = 0.51; P < .001) and epidemiology (OR = 0.76; P < .001) were less likely to do so. Completing an interdisciplinary dissertation was associated with being male, a non-US citizen, a graduate of a private institution, and a graduate of an institution with high but not the highest level of research activity. Many secondary dissertation fields reported by interdisciplinary graduates included other public health fields. CONCLUSION: Although interdisciplinary dissertation research among doctoral graduates in public health has increased in recent years, such work is bounded in certain fields of public health and certain types of graduates and institutions. Academic administrators and other stakeholders may use these results to inform greater interdisciplinary activity during doctoral training and to evaluate current and future collaborations across departments or schools.

Unifying interdisciplinary education: designing and implementing an intern simulation educational curriculum to increase confidence in critical care from PGY1 to PGY2.

BACKGROUND: A longitudinal, multidisciplinary critical care simulation curriculum was developed and implemented within a teaching hospital to address the need for consistent, safe, efficient, and unified critical care training within graduate medical education. Primary goals were to increase learner confidence in critical care topics and procedural skills across all specialties. Secondary goals included improving communication skills and obtaining a high level of learner satisfaction. All interns caring for adult patients within our hospital participated in three 4-h simulation-based sessions scheduled over the second half of their intern year. Pre- and postcurricular surveys evaluated self-confidence in critical care topics, procedures, and communication skills. The Debriefing Assessment for Simulation in Healthcare Student Version (DASH-SV) Short Form was used to evaluate facilitator debriefing. Data were compared with Wilcoxon rank sum and signed rank test. RESULTS: Pre- and postcurricular surveys were collected from 51 of 52 interns (98% response rate) in curricular year 1 and 59 of 59 interns (100% response rate) in curricular year 2 in six programs within the hospital. Resident confidence significantly improved in all areas (p < .05). DASH-SV demonstrated overall effective facilitator debriefing and > 75% of interns in both curricular years 1 and 2 expressed a desire for future educational sessions. CONCLUSIONS: The implemented curriculum increased learner confidence in select critical care topics, procedures, and communication skills and demonstrated a high level of learner satisfaction. The curriculum has expanded to learners from three other teaching hospitals within our system to unify critical care education for all interns caring for adult patients.

White paper on the study of birth defects.

Birth defects are the leading cause of infant death in the United States and among the top causes of pediatric death and hospitalization. Despite the devastating impact of birth defects, we understand little of their etiology impeding progress towards treatment and prevention. Moreover, while surgical interventions have improved survival for many children to beyond their first year, our inability to accurately predict, diagnose and treat the common sequelae of birth defects leaves the economic, social and public health burden of birth defects unacceptably high. An estimated one-third of all pediatric hospital beds are occupied by a child with a genetic diagnosis, and emerging genomic sequencing technologies provide an unprecedented opportunity to identify the genetic variants, including those that cause birth defects. It is essential that we leverage these advances to enhance our understanding of birth defects. Such an effort will lead to new avenues for treatment and provide benefits to families, including improved understanding of the cause of a child's condition and the risks to any future children. Understanding the genetics of human birth defects presents many challenges, some shared with other pathologies and some unique. This White Paper outlines the need for a birth defect genomics initiative, the challenges to overcome, and suggested solutions. Ultimately, we conclude that understanding birth defects must be a trans-NIH effort and involve the development of a new type of interdisciplinary team comprised of clinicians, geneticists, genomicists, epidemiologists, biostatisticians and basic cellular and developmental biologists working together in all aspects of the enterprise. Birth Defects Research 109:180-185, 2017. © 2017 Wiley Periodicals, Inc.