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2.
BMJ Open ; 13(1): e066322, 2023 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-36599634

RESUMO

OBJECTIVES: Medical artificial intelligence (AI) has been used widely applied in clinical field due to its convenience and innovation. However, several policy and regulatory issues such as credibility, sharing of responsibility and ethics have raised concerns in the use of AI. It is therefore necessary to understand the general public's views on medical AI. Here, a meta-synthesis was conducted to analyse and summarise the public's understanding of the application of AI in the healthcare field, to provide recommendations for future use and management of AI in medical practice. DESIGN: This was a meta-synthesis of qualitative studies. METHOD: A search was performed on the following databases to identify studies published in English and Chinese: MEDLINE, CINAHL, Web of science, Cochrane library, Embase, PsycINFO, CNKI, Wanfang and VIP. The search was conducted from database inception to 25 December 2021. The meta-aggregation approach of JBI was used to summarise findings from qualitative studies, focusing on the public's perception of the application of AI in healthcare. RESULTS: Of the 5128 studies screened, 12 met the inclusion criteria, hence were incorporated into analysis. Three synthesised findings were used as the basis of our conclusions, including advantages of medical AI from the public's perspective, ethical and legal concerns about medical AI from the public's perspective, and public suggestions on the application of AI in medical field. CONCLUSION: Results showed that the public acknowledges the unique advantages and convenience of medical AI. Meanwhile, several concerns about the application of medical AI were observed, most of which involve ethical and legal issues. The standard application and reasonable supervision of medical AI is key to ensuring its effective utilisation. Based on the public's perspective, this analysis provides insights and suggestions for health managers on how to implement and apply medical AI smoothly, while ensuring safety in healthcare practice. PROSPERO REGISTRATION NUMBER: CRD42022315033.


Assuntos
Inteligência Artificial , Opinião Pública , Humanos , Atenção à Saúde , Instalações de Saúde , Ocupações em Saúde
3.
Nurse Educ Today ; 121: 105707, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36640451

RESUMO

BACKGROUND: Frameworks in higher education can support strategic curriculum change in complex systems. The impact of these frameworks in achieving their stated purpose is less known. An interprofessional education (IPE) framework and related multi-activity curriculum designed to develop health profession graduates with the requisite skills for collaborative care, was introduced in a large university, across eleven health professions. OBJECTIVE: To determine the utility of an interprofessional framework and impact upon perceived work readiness for collaborative practice. METHOD: A multimethod design using the context, input, process, product (CIPP) evaluation model was selected taking a social constructivist theoretical stance. Data collection included staffing allocation to IPE, curriculum audit, and reflections from representatives of all health professions courses offered at the institution. Data was analyzed using framework analysis. PARTICIPANTS: Interviews or focus groups were undertaken with academic Faculty (n = 13), recent graduates (n = 24) and clinical supervisors/employers of recent graduates (n = 17). RESULTS: The framework assisted the systematic implementation of interprofessional curriculum across the different health courses at the university. Collaborative work-ready learning outcomes were identified in graduates where targeted curriculum had been implemented across all four domains of the framework. Gaps identified in framework implementation were consistent with gaps identified in graduate knowledge and skills related to collaborative practice. The combination of formal university-based IPE and informal workplace learning as part of clinical placements contributed to achieving the desired learning outcomes. CONCLUSIONS: These findings offer insights into the use of shared frameworks to drive specific learning activities related to collaborative practice.


Assuntos
Ocupações em Saúde , Educação Interprofissional , Humanos , Ocupações em Saúde/educação , Currículo , Aprendizagem , Grupos Focais , Relações Interprofissionais
4.
AMA J Ethics ; 25(1): E7-14, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36623299

RESUMO

Motivating health equity requires taking deliberate steps toward desegregating health care, especially in academic health centers. One step should incorporate rigorous measurement and assessment of patients' access to health services and ongoing collection and review of patients' health outcomes data. Another step should develop, fund, incorporate and administer initiatives with community members that address social determinants of community and individual health, including academic health centers' inpatient and outpatient service delivery sites, insurance programs, and federal policy. Academic health centers must also be accountable for monitoring initiatives' successes and failures over short- and long-term trajectories and for modifying initiatives' methods as needed to achieve equity in access to health services and health outcomes.


Assuntos
Atenção à Saúde , Equidade em Saúde , Humanos , Serviços de Saúde , Ocupações em Saúde
5.
AMA J Ethics ; 25(1): E21-30, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36623301

RESUMO

One expression of structural injustice in the United States is delivery of health care according to patients' race and insurance status. This de facto segregation in academic health centers limits community organizations' and leaders' capacity to dismantle racism and undermines health equity. This commentary on a case considers this problem, argues why academic health centers are ethically obliged to respond, and offers strategies to do so.


Assuntos
Equidade em Saúde , Racismo , Estados Unidos , Humanos , Organizações , Atenção à Saúde , Instalações de Saúde , Ocupações em Saúde/educação
7.
Int J Nurs Educ Scholarsh ; 20(1)2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36608319

RESUMO

OBJECTIVES: During the COVID-19 pandemic, educators shifted from traditional lectures to videoconferencing. This systematic review explored the use of videoconferencing as a teaching tool in response to the pandemic as well as issues related to digital equity and inclusion. CONTENT: The review was conducted using the Joanna Briggs Institute for Systematic Reviews methodology and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. SUMMARY: A total of nine studies met eligibility criteria. The participants in the included studies were medical students from various parts of the world. Technical difficulties and lack of human interactions were identified as barriers to learning through videoconferencing. OUTLOOK: To achieve full success, pedagogical videoconferencing must prioritize digital equity and a universal design for learning. Although useful for maintaining education during the pandemic, in the future, videoconferencing will present challenges related to the digital divide as well as opportunities as a teaching tool for nurse educators globally.


Assuntos
COVID-19 , Exclusão Digital , Humanos , Pandemias , COVID-19/epidemiologia , Ocupações em Saúde , Comunicação por Videoconferência
8.
PLoS One ; 18(1): e0280493, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36701397

RESUMO

BACKGROUND: Situational judgments tests have been increasingly used to help training programs for the health professions incorporate professionalism attributes into their admissions process. While such tests have strong psychometric properties for testing professional attributes and are feasible to implement in high-volume, high-stakes selection, little is known about constructed-response situational judgment tests and their validity. METHODS: We will conduct a systematic review of primary published or unpublished studies reporting on the association between scores on constructed-response situational judgment tests and scores on other tests that measure personal, interpersonal, or professional attributes in training programs for the health professions. In addition to searching electronic databases, we will contact academics and researchers and undertake backward and forward searching. Two reviewers will independently screen the papers and decide on their inclusion, first based on the titles and abstracts of all citations, and then according to the full texts. Data extraction will be done independently by two reviewers using a data extraction form to chart study details and key findings. Studies will be assessed for the risk of bias and quality by two reviewers using the "Quality In Prognosis Studies" tool. To synthesize evidence, we will test the statistical heterogeneity and conduct a psychometric meta-analysis using a random-effects model. If adequate data are available, we will explore whether the meta-analytic correlation varies across different subgroups (e.g., race, gender). DISCUSSION: The findings of this study will inform best practices for admission and selection of applicants for training programs for the health professions and encourage further research on constructed-response situational judgment tests, in particular their validity. TRIAL REGISTRATION: The protocol for this systematic review has been registered in PROSPERO [CRD42022314561]. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022314561.


Assuntos
Hospitalização , Julgamento , Humanos , Psicometria , Ocupações em Saúde , Metanálise como Assunto , Revisões Sistemáticas como Assunto
9.
BMC Med Educ ; 23(1): 60, 2023 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-36698164

RESUMO

The design of faculty development courses requires a contextually aware theoretical foundation. Therefore, the study aimed to determine the feasibility of a specific conjecture map as a model for designing online health professions education faculty development courses in sub-Saharan Africa through a heuristic evaluation approach. The authors hypothesise that using heuristic evaluation strengthens an educational model's theoretical basis and feasibility.Twenty-five health professions educators from nine sub-Saharan African countries participated in this multi-phased study. In the first phase, the participants completed a survey evaluating the model and the accompanying author-generated heuristics. Then, participants' recommendations were used to make revisions. In the subsequent phase, participants reviewed these revisions and commented on the feasibility of the model within their local context.All six heuristics were revised following the initial phase, where 80 problems had been identified. Upon revision, the model was deemed feasible by all except one participant. There was a strong relationship and inter-rater agreement of feasibility between 0.84 and 0.95 regarding the model's practicality, demand, acceptability, and adaptability. Revisions to the final model and guidance documents incorporated all changes the participants recommended, confirming the model's feasibility.Theoretical models are often developed through a top-down approach, omitting the practice-based considerations that could change the formulation of the model. This study demonstrates the convergence of a theoretical and process model with theoretical, expert and end-user data triangulation. Further research is needed to test this empirically developed model.


Assuntos
Educação à Distância , Docentes , Ocupações em Saúde , Humanos , África ao Sul do Saara , Modelos Teóricos
10.
Nurse Educ Pract ; 66: 103532, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36563599

RESUMO

AIM: This study explored the lived experiences of racial bias for Black, Asian and Minority Ethnic students undertaking an undergraduate or post-graduate degree in nursing, midwifery and allied health courses in the United Kingdom. BACKGROUND: Previous research indicates that students from Black, Asian and Minority Ethnic groups have fewer opportunities to succeed at university and this has brought about a race awarding gap in their degree attainment. The reasons for this awarding gap are complex and multi-factorial and it is crucial that the lived experiences of racial bias are explored from the student perspective. DESIGN: A hermeneutic phenomenological approach was adopted to elicit individual and collective experiences in the practice environment, a mandatory component of the student's degree. METHODS: A focus group and individual semi-structured interviews were conducted to collect data from sixteen participants and analysed using thematic analysis RESULTS: Three encompassing themes were identified which included a sense of not belonging, trauma impact on mental health and understanding covert and overt racism. Participants reported incidences of racism and appeared to be traumatised by their experiences within practice and the university. They also reported poor mental health and well-being as shared experiences and a lack of confidence in the university and practice to mitigate racial issues. CONCLUSIONS: Meaningful action must be taken by universities and practice partners to advance racial inequality initiatives by having robust anti-racism action plans and processes. These should be co-created with students and staff to reduce the race awarding gap.


Assuntos
Ocupações em Saúde , Grupos Minoritários , Racismo , Estudantes , Humanos , Hermenêutica , Grupos Minoritários/estatística & dados numéricos , Pesquisa Qualitativa , Racismo/etnologia , Racismo/estatística & dados numéricos , Estudantes/estatística & dados numéricos , /estatística & dados numéricos , Enfermagem/estatística & dados numéricos , Ocupações Relacionadas com Saúde/estatística & dados numéricos , Tocologia/estatística & dados numéricos , Ocupações em Saúde/estatística & dados numéricos
11.
Patient Educ Couns ; 106: 92-97, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36266155

RESUMO

Moving towards person-centered care, with equal partnership between healthcare professionals and patients, requires a solid role for the patient in the education of students and professionals. Patients can be involved as teachers, assessors, curriculum developers, and policy-makers. Yet, many of the initiatives with patients are isolated, small events for targeted groups and there is a lack of patient involvement at the institutional level. To support educators in involving patients, both at the institutional level and at single educational encounters, we offer twelve practical tips. This paper came about through an innovative collaboration between healthcare professionals, educators, teachers, and patients. These tips can be used as a tool to start or reinforce patient involvement in health professions education and provide guidance on how to make it a sustainable part of the curriculum. The article involves organizational conditions for success, tips for sustainable partnerships, ideas for curriculum design and proposes concrete teaching strategies. Finally, besides practical tips, we stress that involving patients in education is not business as usual, and paradoxically this needs to be acknowledged before it can become business as usual.


Assuntos
Currículo , Participação do Paciente , Humanos , Estudantes , Pessoal de Saúde , Ocupações em Saúde
12.
Acad Med ; 98(1): 17-20, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36576764

RESUMO

A preprint is a version of a research manuscript posted by its authors to a preprint server before peer review. Preprints are associated with a variety of benefits, including the ability to rapidly communicate research, the opportunity for researchers to receive feedback and raise awareness of their research, and broad and unrestricted access. For early-career researchers, preprints also provide a mechanism for demonstrating research progress and productivity without the lengthy timelines of traditional journal publishing. Despite these benefits, few health professions education (HPE) research articles are deposited as preprints, suggesting that preprinting is not currently integrated into HPE culture. In this article, the authors describe preprints, their benefits and related risks, and the potential barriers that hamper their widespread use within HPE. In particular, the authors propose the barriers of discordant messaging and the lack of formal and informal education on how to deposit, critically appraise, and use preprints. To mitigate these barriers, several recommendations are proposed to facilitate preprints in becoming an accepted and encouraged component of HPE culture, allowing the field to take full advantage of this evolving form of research dissemination.


Assuntos
Revisão por Pares , Editoração , Humanos , Pesquisadores , Ocupações em Saúde
13.
Yearb Med Inform ; 31(1): 303-306, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36463888

RESUMO

The evolution of the informatics field, now with a well-accepted and crucial role in modern biomedicine and health care delivery, is the result of creative research over seven decades. The success is due in part to recognition that, throughout the process, investigators have documented not only what they have done but what they have learned, stimulating and guiding the next generation of projects. Such iterative experimentation, learning, sharing, and progressing is typical of all scientific disciplines. Yet progress depends on identifying key lessons, insights, and methods so that others can use them. This paper addresses the nature of scientific progress in informatics, recognizing that while the field is motivated by applications that can improve biomedicine and health, the scientific underpinnings must be identified and shared with others if the field is to progress optimally.


Assuntos
Ocupações em Saúde , Informática , Humanos , Aprendizagem , Resolução de Problemas , Pesquisadores
14.
Perspect Biol Med ; 65(4): 569-585, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36468385

RESUMO

Many of humanity's most serious problems are global, intergenerational, and ecological, yet current institutions are poorly placed to confront such problems. In part, this institutional challenge reflects difficulties with our basic concepts and theories. Bioethics is a central area where such questions arise. Although some have argued for an environmentalized bioethics since its inception, biomedicine has thus far failed to embrace the challenge, and some accuse most bioethicists of being "asleep at the wheel" (Schenck and Churchill 2021). This paper discusses the basic ethical challenge, offers the "perfect moral storm" analysis, and explores one promising new concept for bioethics, planetary health, in light of that analysis. Drawing on the foundational report of the Rockefeller Foundation-Lancet Commission (Whitmee et al. 2015) and using climate change as the example, the author argues that planetary health has significant strengths but also some weaknesses, and that identifying both is helpful in charting a path forward for environmentalized bioethics.


Assuntos
Bioética , Princípios Morais , Humanos , Eticistas , Ocupações em Saúde
15.
Front Public Health ; 10: 1036586, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36452959

RESUMO

This paper addresses the spatial pattern of urban biomedicine innovation networks by separately using four scales, i.e., the national scale, interregional scale, urban agglomeration scale, and provincial scale, on the basis of Chinese biomedicine patent data from the incoPat global patent database (GPD) (2001-2020) and using the method of social network analysis (SNA). Through the research, it is found that (1) on the national scale, the Chinese biomedicine innovation network becomes denser from west to the east as its complexity continuously increases. Its spatial structure takes the form of a radial network pattern with Beijing and Shanghai as its centers. The COVID-19 pandemic has not had an obvious negative impact on this network at present. (2) On the interregional scale, the strength of interregional network ties is greater than that of intraregional network ties. The eastern, central and western biomedicine innovation networks appear to be heterogeneous networks with regional central cities as the cores. (3) At the urban agglomeration scale, the strength of intraurban-agglomeration network ties is greater than that of interurban-agglomeration network ties. The three major urban agglomerations have formed radial spatial patterns with central cities as the hubs. (4) At the provincial scale, the intraprovincial networks have poor connectivity and low internal ties strength, which manifest as core-periphery structures with the provincial capitals as centers. Our research conclusion helps to clarify the current accumulation of technology and offer guidance for the development of China's biomedicine industry.


Assuntos
COVID-19 , Pandemias , Humanos , COVID-19/epidemiologia , China , Ocupações em Saúde
16.
Intellect Dev Disabil ; 60(6): 477-483, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36454614

RESUMO

Self-perceived confidence of health professions students at one university in caring for adults with intellectual disability (ID) was examined via an electronic survey using the Therapy Confidence Scale - Intellectual Disabilities (TCS-ID). A stepwise multiple regression of data collected from 232 completed surveys revealed that prior training and prior experience were predictors of TCS-ID total score. Adults with ID experience healthcare disparities due, in part, to poor provider communication and a lack of confidence. Results from this novel study suggest that opportunities for experiential learning and training with people with ID are important considerations for health professions curricula. Further research is needed for generalizability of results.


Assuntos
Deficiência Intelectual , Adulto , Humanos , Ocupações em Saúde , Currículo , Estudantes , Disparidades em Assistência à Saúde
17.
BMC Med Educ ; 22(1): 853, 2022 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-36482331

RESUMO

BACKGROUND: Despite the long-standing faculty development initiatives for improving teaching skills in the health professions, there is still a growing need for educators who are formally trained in educational theory and practice as health professions schools experience dramatic demand and growth. Graduate programs in health professions education (HPE) provide an avenue for health professions' faculty continuing professional development to enhance their knowledge and skills for teaching and curriculum leadership roles. There has been a proliferation of certificate, master's, and doctoral programs in HPE over the last two decades to respond to the growing need for well-prepared faculty educators and program leadership. The purpose of this study was to identify and describe current HPE doctoral programs in United States (U.S.) and Canada. METHODS: The study first examined doctoral programs in HPE identified in earlier studies. Next, we searched the literature and the web to identify new doctoral programs in the U.S. and Canada that had been established between 2014, when the prior study was conducted, and 2022. We then collated and described the characteristics of these programs, highlighting their similarities and differences. RESULTS: We identified a total of 20 doctoral programs, 17 in the U.S. and 3 in Canada. Of these, 12 programs in the U.S. and 1 program in Canada were established in the last 8 years. There are many similarities and some notable differences across programs with respect to degree title, admission requirements, duration, delivery format, curriculum, and graduation requirements. Most programs are delivered in a hybrid format and the average time for completion is 4 years. CONCLUSIONS: The workforce shortage facing health professional schools presents an opportunity, or perhaps imperative, for continuing professional development in HPE through certificate, master's, or doctoral programs. With the current exponential growth of new doctoral programs, there is a need to standardize the title, degree requirements, and further develop core competencies that guide the knowledge and skills HPE graduates are expected to have upon graduation.


Assuntos
Currículo , Instituições Acadêmicas , Humanos , Canadá , Nível de Saúde , Ocupações em Saúde
18.
GMS J Med Educ ; 39(5): Doc52, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36540564

RESUMO

Objective: Interprofessional education (IPE) is when two or more students from different professions learn with, from, and about each other to improve collaboration and quality of healthcare. In October 2019, a first interprofessional education (IPE) day was held in the canton of Zurich with the aim of teaching interprofessional skills to participating students. Methodology: The IPE day was developed by an interprofessional team of students. After a short introduction, the roles and tasks of the professional groups involved were discussed. This was followed by two case studies with simulation persons and reflection rounds. For the evaluation of the day, 15 semi-structured interviews with students and lecturers were conducted and qualitatively evaluated by means of thematic analysis. Results: The students and lecturers had a very positive experience of the IPE day. Especially the participation of medical and pharmacy students, the practical case studies with simulation persons and the informal exchange during the breaks were appreciated. There was room for improvement in the development of role models. Through an open attitude and good communication, the students learned to know and appreciate the competencies of the other professional groups. All those interviewed wished for more interprofessional teaching opportunities and the students felt encouraged to apply what they had learned in their later professional practice. Conclusion: The IPE day could be carried out successfully and the didactic concept worked largely well. The evaluation provided subjective evidence that the students were able to improve the interprofessional competencies of teamwork, communication, openness, appreciation and reflectiveness. In the future, the IPE day should be anchored in the curricula.


Assuntos
Estudantes de Ciências da Saúde , Humanos , Relações Interprofissionais , Educação Interprofissional , Currículo , Ocupações em Saúde/educação
19.
Harefuah ; 161(11): 718-720, 2022 Nov.
Artigo em Hebraico | MEDLINE | ID: mdl-36578246

RESUMO

INTRODUCTION: During the late 19th century and the 20th century, many allied health and technical professions, joined physicians and nurses in their formal medical and surgical comprehensive work. The professionalization process of the various medical and surgical fields demanded true incorporation of allied health professions into the medical infrastructure. Non-academic professions such as the "feldsher ", barber-surgeon, bone-setters and the midwife, transferred into realms of the academic medical and the health professions fields.


Assuntos
Tocologia , Assistentes Médicos , Médicos , Gravidez , Humanos , Feminino , Ocupações em Saúde , Tocologia/história
20.
PLoS One ; 17(12): e0278872, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36516177

RESUMO

Peer-assisted learning (PAL)-especially peer tutorials-are gaining momentum in health professions education, particularly in interprofessional education. As little is known about the use of peer tutorials or the preparation of tutors in this context in Germany and in other countries, this study aims to provide an overview of these interventions. A cross-sectional study with a descriptive-exploratory design was conducted. German institutions for health professions education were contacted, and individuals with pedagogical responsibilities were invited to participate in an online survey. The survey was informed by two studies in which seven domains were identified as important. These included facts about the institution, the offer of PAL, the use of tutorials, and the design of tutor training. The survey used mostly closed-ended questions. The questionnaire was completed by n = 100 participants. Overall, n = 46 participants indicated that PAL was offered at their institution. Of these 46 participants, 32 (70%) indicated that uniprofessional PAL was offered, 2 (4%) indicated that interprofessional PAL was offered, and 12 (26%) indicated that both forms of PAL were offered. Peer tutoring was the most common format in both cases (73% for uniprofessional and 64% for interprofessional PAL), and mandatory interventions were mostly used to prepare the tutors. These interventions were held by educators or lecturers and were offered mostly face-to-face as workshops or as discussions. Deepening the tutors' social competencies through training was given high relevance. Regarding content, focus was placed on communication, (self-)reflection, and group management. Eighty-eight participants expressed recommendations for future directions in terms of preparing tutors for interprofessional PAL. Minor differences between the use of uniprofessional and interprofessional PAL and tutor training were found. Nevertheless, implementation strategies varied. In future, preparatory measures for tutors should be more uniformly designed and geared to the specific requirements of uniprofessional and interprofessional learning, and that at best on an empirical basis.


Assuntos
Educação de Graduação em Medicina , Estudantes de Medicina , Humanos , Estudos Transversais , Grupo Associado , Currículo , Ocupações em Saúde , Alemanha , Ensino
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