The use of electronic health records in advanced practice nursing education: a scoping review.

Electronic health records are integral to the advanced practice registered nurse role, yet access and training during academic preparation are profoundly limited. Lack of exposure to electronic health records prevents students from becoming fully prepared for the responsibilities of clinical practice and potentially impacts quality of care, patient safety, and communication among patients and providers. This scoping review of 20 articles on electronic health record use in advanced practice registered nursing student education shows significant gaps in current research. Nine articles were classified as research. The remaining 11 were non-research reports of teaching innovations describing the use of simulated electronic health records in graduate nursing education or the use of an electronic health record in interprofessional education activities. Most of the limited research did not use valid and reliable instruments or robust designs, employed disparate approaches and tools to study the phenomenon, and measured low-level outcomes such as student navigation and confidence in using electronic health records. The non-research literature draws attention to the deficits in educational resources, including unaffordable electronic health records for academic use. Although rigorous evidence is lacking, a common theme throughout the reviewed literature was the benefit of simulation to develop electronic health record skills.

Postgraduate Medical Education in Sub-Saharan Africa: A Scoping Review Spanning 26 Years and Lessons Learned.

BACKGROUND: Investments in training physician specialists through postgraduate medical education (PGME) are critical for Sub-Saharan Africa, given the increasing burden of non-communicable diseases. OBJECTIVES: The objectives of this scoping review were to (1) understand the breadth of publications on PGME from Sub-Saharan Africa, and (2) conduct a thematic analysis of lessons learned by specific training programs. METHODS: We conducted a literature search of 7 databases for PGME literature published between January 1991 and December 2016. Two reviewers independently reviewed titles and abstracts for inclusion. Full-text articles were then reviewed, and bibliometric data were extracted to create a profile of PGME-related publications. Two authors coded the manuscripts to identify articles written about specific PGME programs. These were analyzed for lessons learned. RESULTS: We identified 813 publications that reported on postgraduate medical education in Sub-Saharan Africa. Most articles were published between 2005 and 2016. Nations leading in publication were South Africa and Nigeria, followed by Ethiopia, Uganda, Kenya, Ghana, and Malawi. The largest number of articles related to general surgery training, followed by family medicine, emergency medicine, and anesthesiology. Thematic analysis revealed advantages of training programs for health facilities, challenges related to teaching, resourcing, and standardizing of training, and lessons learned related to international partnerships, faculty engagement, and research support for trainees. CONCLUSIONS: PGME in Sub-Saharan Africa has evolved over the past 26 years. Future growth will require strategic support to scale programs, support new specialties, trainees, and teachers, and leverage best practice models to sustain PGME programs.

Evaluating function of transmembrane protein tyrosine phosphatase CD148 in lymphocyte biology.

The transmembrane protein tyrosine phosphatase CD148 is expressed on numerous cell types, including most cells of the hematopoietic lineage. CD148 has been shown to regulate density-dependent inhibition of cell growth as well as cellular differentiation in nonhematopoietic cells and has been shown to regulate signal transduction processes in several nonlymphoid hematopoietic cell types. Analysis of CD148 expression on lymphoid cells has demonstrated that CD148 is expressed at low levels on T cells and that it is upregulated in response to activation. Several groups have observed that CD148 negatively regulates T cell activation in response to crosslinking of the T cell antigen receptor, suggesting that it may play a role in feedback inhibition of the T cell immune response. In the B cell compartment, CD 148 expression appears to be restricted to the memory subpopulation, raising the possibility that it serves a unique function in these cells, which has yet to be determined. Recent studies have shown that CD148 interacts with the PDZ domain-containing protein syntenin, raising the possibility that its function or its localization with substrates in T and B cells may be controlled through this or a related interaction with another PDZ domain protein.