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MOTIVATION: Deep learning models have achieved remarkable success in a wide range of natural-world tasks, such as vision, language, and speech recognition. These accomplishments are largely attributed to the availability of open-source large-scale datasets. More importantly, pre-trained foundational modellearnings exhibit a surprising degree of transferability to downstream tasks, enabling efficient learning even with limited training examples. However, the application of such natural-domain models to the domain of tiny Cryo-Electron Tomography (Cryo-ET) images has been a relatively unexplored frontier. This research is motivated by the intuition that 3D Cryo-ET voxel data can be conceptually viewed as a sequence of progressively evolving video frames. RESULTS: Leveraging the above insight, we propose a novel approach that involves the utilization of 3D models pre-trained on large-scale video datasets to enhance Cryo-ET subtomogram classification. Our experiments, conducted on both simulated and real Cryo-ET datasets, reveal compelling results. The use of video initialization not only demonstrates improvements in classification accuracy but also substantially reduces training costs. Further analyses provide additional evidence of the value of video initialization in enhancing subtomogram feature extraction. Additionally, we observe that video initialization yields similar positive effects when applied to medical 3D classification tasks, underscoring the potential of cross-domain knowledge transfer from video-based models to advance the state-of-the-art in a wide range of biological and medical data types. AVAILABILITY AND IMPLEMENTATION: https://github.com/xulabs/aitom.
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Knowledge transfer-the extent to which one unit learns from or is affected by the experience of another-has the potential to improve the performance of organizations. Through knowledge transfer, developments made in one unit of an organization can benefit others. Studies have found, however, considerable variation in the extent to which knowledge transfers across organizational units. In some cases, knowledge transfers seamlessly, whereas in others, knowledge transfer is far from complete. This article reviews research with the aim of explaining the variation observed in knowledge transfer. Key factors identified as explaining the variation include knowledge transfer opportunities, knowledge characteristics, mechanisms for knowledge transfer, motivation for transfer, and the depth of consideration of knowledge. These factors are integrated into a theoretical framework that predicts when knowledge transfer will be successful. The article concludes with a discussion of directions for future research to increase our understanding of knowledge transfer in organizations.
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Aprendizagem , Motivação , HumanosRESUMO
RNA binding proteins (RBPs) are critical for the post-transcriptional control of RNAs and play vital roles in a myriad of biological processes, such as RNA localization and gene regulation. Therefore, computational methods that are capable of accurately identifying RBPs are highly desirable and have important implications for biomedical and biotechnological applications. Here, we propose a two-stage deep transfer learning-based framework, termed RBP-TSTL, for accurate prediction of RBPs. In the first stage, the knowledge from the self-supervised pre-trained model was extracted as feature embeddings and used to represent the protein sequences, while in the second stage, a customized deep learning model was initialized based on an annotated pre-training RBPs dataset before being fine-tuned on each corresponding target species dataset. This two-stage transfer learning framework can enable the RBP-TSTL model to be effectively trained to learn and improve the prediction performance. Extensive performance benchmarking of the RBP-TSTL models trained using the features generated by the self-supervised pre-trained model and other models trained using hand-crafting encoding features demonstrated the effectiveness of the proposed two-stage knowledge transfer strategy based on the self-supervised pre-trained models. Using the best-performing RBP-TSTL models, we further conducted genome-scale RBP predictions for Homo sapiens, Arabidopsis thaliana, Escherichia coli, and Salmonella and established a computational compendium containing all the predicted putative RBPs candidates. We anticipate that the proposed RBP-TSTL approach will be explored as a useful tool for the characterization of RNA-binding proteins and exploration of their sequence-structure-function relationships.
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Proteínas de Ligação a RNA , RNA , Sítios de Ligação/genética , Genoma , Humanos , Aprendizado de Máquina , RNA/química , Proteínas de Ligação a RNA/metabolismo , Análise de Sequência de RNA/métodosRESUMO
Global survival disparities among children with cancer and other catastrophic diseases are the driving force behind Cure4Kids' sustained outreach to healthcare professionals. Congruent with this need, Cure4Kids was redesigned to meet the emergent demands of diverse healthcare professionals seeking free, web-based pediatric hematology/oncology education. Herein, we present an overview of each phase of the design and development process for the transformation and describe key features of the new Cure4Kids and future opportunities for expansion.
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Neoplasias , Humanos , Neoplasias/terapia , Oncologia/educação , Criança , Internet , Pessoal de Saúde/educação , Hematologia/educação , PediatriaRESUMO
BACKGROUND: The existing evidence base indicates increased interest in knowledge translation (KT), or, the dissemination of research to ensure uptake and impact. Given this definition, this study aimed to review existing scholarship on knowledge translation (KT) of health research to people living with disabilities (PLWD), and assess the current state of accessibility of health knowledge for people living with disabilities. METHODS: Given existing heterogeneity in literature as well as a number of varying definitions for both disability and knowledge translation, a reflexive, three-phase approach was utilized to improve methodological soundness. Phase I recognizes that existing review-style studies have been conducted on disability-KT. An existing systematic review on KT specific to the field of rehabilitation and physical medicine was analyzed to assess potential best practices towards inclusivity and accessibility for people living with disability. Phase II used the Center on Knowledge Translation for Disability and Rehabilitation Research (KTDRR) database as an information-source with high-specificity to disability-health KT. Phase III sought to rapidly assess the current landscape of systematic reviews relevant to disability-health KT, with four systematic reviews meeting the inclusion criteria across Cochrane, Psycinfo, CINAHL, PubMed, Web of Science, and EMBASE. RESULTS: The current landscape of disability-health KT is primarily targeted at health professionals who serve PLWD. PLWD are included in KT, mostly as key informants, or as study participants in KT-studies designed as health interventions. Multiple systematic reviews on disability-health KT exist, presenting vastly different foci which prevent assessment of best practices. CONCLUSIONS: KT efforts are abundant and can be seen across health research related to disabilities, generating considerable literature and systematic reviews. With regards to meeting the public health objective of equalizing and enhancing access to health knowledge, future knowledge translation efforts intending to provide PLWD with up-to-date health research can be of significant value.
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Pessoas com Deficiência , Humanos , Revisões Sistemáticas como Assunto , Bases de Dados Factuais , Pessoal de Saúde , Saúde PúblicaRESUMO
BACKGROUND: PRiVENT (PRevention of invasive VENTilation) is an evaluation of a bundle of interventions aimed at the prevention of long-term invasive mechanical ventilation. One of these elements is an e-learning course for healthcare professionals to improve weaning expertise. The aim of our analysis is to examine the implementation of the course in cooperating intensive care units. METHODS: The course has been developed through a peer review process by pulmonary and critical care physicians in collaboration with respiratory therapists, supported by health services researchers and a professional e-learning agency. The e-learning platform "weLearn" was made available online to participating healthcare professionals. Feedback on the e-learning programme was obtained and discussed in quality circles (QCs). We measured the acceptance and use of the programme through access statistics. RESULTS: The e-learning course "Joint Prevention of Long-Term Ventilation" consists of 7 separate modules with practice-oriented training units as well as a cross-module area and corresponding interactive case studies. Users can receive 23 CME (continuing medical education) credits. The platform was released on July 1, 2021. By June 28, 2023, 214 users from 33 clinics had registered. Most users (77-98%) completed the modules, thus performing well in the test, where 90-100% passed. In the QCs, the users commended the structure and practical relevance of the programme, as well as the opportunity to earn CME credits. CONCLUSION: Especially for medical staff in intensive care units, where continuous training is often a challenge during shift work, e-learning is a useful supplement to existing medical training. TRIAL REGISTRATION: The PRiVENT study is registered at ClinicalTrials.gov (NCT05260853) on 02/03/2022.
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Instrução por Computador , Humanos , Desmame do Respirador , Aprendizagem , Pessoal de Saúde/educação , Cuidados CríticosRESUMO
Globally, agriculture is a significant pressure on water quality. While nutrient and sediment loss from agricultural land to water can be scientifically complex, mitigation measures primarily focus on reducing farm nutrient stocks or blocking loss pathways. The appropriateness of mitigation measures is dependent on the identification of specific context-related risks on individual farms. However, advisers also need to consider the likelihood of uptake of measures by farmers. Past research has looked at uptake of particular mitigation measures or a small range of measures. This research expands the literature with an analysis of uptake of a broad and diverse range of measures. Farm characteristics, farmer norms, knowledge required and costs (direct and indirect) associated with individual mitigation measures are investigated to identify factors that could influence greater adoption. Results show that alignment to farmer norms and lower specific costs were associated with high adoption rates. These results have implications for advisers in relation to the selection of measures most likely to be adopted by farmers, and also for policy-makers in relation to the need to incentivise the adoption of high-cost measures.
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Agricultura , Fazendas , Qualidade da ÁguaRESUMO
BACKGROUND: Evidence-based practice, in conjunction with optimum care quality, improves patients' clinical outcomes. However, its implementation in daily clinical practice continues to present difficulties. The aim of this study was to identify the strategies applied by Advanced Practice Nurses (APNs) to foster adherence to clinical practice guideline recommendations. METHODS: An exploratory qualitative study was conducted with six focus groups at three public hospitals belonging to the Balearic Islands Health Care Service (Spain). The study participants were 32 ward nurses and 5 advanced practice nurses working routinely with inpatients at these hospitals. The study was conducted from November 2020 to January 2021, using thematic analysis, based on the COREQ checklist. RESULTS: Four major themes related to the facilitation process were identified either by RNs and APNs: the context of the project, APN contribution to nursing team management, healthcare provision on the ward, and the acquisition and application of knowledge. CONCLUSIONS: The APNs adapted their actions to the characteristics and needs of the local context, employing strategies aimed at improving teamwork, healthcare, and knowledge management. Each of these contributions enhanced the sustainability of the changes made.
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BACKGROUND: Although knowledge sharing online has been recognised as an important strategy for health professionals to apply research findings to their practice, limited research exists on how to develop and implement these platforms to help facilitate collaboration and knowledge sharing. OBJECTIVES: This study evaluated an online knowledge sharing platform and community of practice developed in the North East of England and Yorkshire during COVID-19 to support UK health and care professionals to reduce the impact of the wider consequences of COVID-19. METHODS: Semi-structured interviews with stakeholders (n = 8) and users of C-WorKS (n = 13), followed by an online survey (n = 19) among a wider group of users to analyse knowledge use. RESULTS: Interview and survey findings highlighted several strengths, weaknesses, opportunities and threats to support future development of online knowledge sharing platforms. DISCUSSION: Online knowledge sharing supports six 'pillars' of successful research and innovation partnerships. This requires distributed forms of leadership and linking of different knowledge sharing strategies, and careful combination of platforms with communities of practice. CONCLUSION: Online knowledge sharing provides pragmatic and timely strategies for health professionals in the UK to apply research evidence to their practice. Our study provides generalisable, practical insights in how to develop and implement a knowledge sharing platform.
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BACKGROUND: Turkey has faced a notable escalation in earthquake disasters in the last two decades. Despite initiating a health and disaster management system, nurses' pivotal roles and experiences in handling such crises have been disregarded. AIM: This qualitative study analyzed nurses' experiences before, during, and after deployment in response to the 2023 Turkey earthquakes to enhance disaster-response efforts. METHODS: This descriptive qualitative study was conducted between March and May 2023 using semistructured interviews with 15 nurses purposively sampled among those who volunteered to work in the earthquake zone. The MIRACLE and COREQ guidelines were followed for reporting qualitative research. FINDINGS: The analysis exposed five main themes for pre-tasking: moral obligation, motivation, insufficient experience, balancing responsibilities, and preparation challenges. The peri-task themes include responsibilities, skills, bravery and characteristics, workload management, teamwork, and outcomes. Post-tasking has three themes: competence assessment, career goals and aspirations, and support. Training and coping with anxiety and stress are common themes for all phases. CONCLUSIONS: Disaster relief requires a comprehensive and coordinated response from healthcare organizations, government agencies, and support systems. Providing adequate training, ensuring safety protocols, offering mental health support, and fostering a fair and supportive work environment are crucial steps in mitigating the adverse effects on nurses and, by extension, the patient care process in earthquake-affected areas. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurse training in disaster preparedness should cover various response methods and involve multiple disciplines. Managers can help by arranging drills, simulations, online courses, and workshops and promoting partnerships for improved collaboration. Psychological support should be included to address emotional challenges. Regularly updating response policies based on past experiences is crucial for preparedness and efficiency.
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RATIONALE: In 2016, Belgium launched the Next Generation Sequencing (NGS) Roadbook, consisting in 10 Actions, across the health care system, to facilitate the uptake of NGS in routine clinical practice. We compiled feedback on deployment of the NGS Roadbook from governmental stakeholders and beneficiaries: health policy makers, insurance providers, pathologists, geneticists, and oncologists. MAIN FINDINGS: The Roadbook ensured the establishment of a Commission on Personalized Medicine and NGS testing guidelines. A national benchmarking trial ensued, and 10 networks of hospitals and laboratories adopted a reimbursement convention with the Belgian Health Insurance Agency. The Healthdata.be platform centralizes the collection of NGS metrics, and citizens were consulted on their views about NGS and genomics. CONCLUSION: The Roadbook facilitated the implementation of NGS in routine (hemato-)oncology care in Belgium. Some challenges remain linked to data sharing and access by a wider range of stakeholders. Next steps include continuous monitoring of health outcomes and the budgetary impact.
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Neoplasias , Medicina de Precisão , Bélgica , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Oncologia , Neoplasias/genética , Neoplasias/terapiaRESUMO
OPINION STATEMENT: Cardio-oncology is going under rapid development in various areas across an increasing number of provinces in China. However there are still a myriad of challenges that need to be overcome in order to ensure its gradual and consistent expansion. The Cardio-Oncology Knowledge Transfer Model (KTM) forms the basis to allow exponential development of effective cardio-oncology services. This would ensure the implementation of precision-based practice while dynamically evolving cardio-oncology to integrate both Western and Chinese medical practices to become an official clinical sub-speciality in its own right in China, for the ultimate benefit of the patient.
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Doenças Cardiovasculares , Neoplasias , Humanos , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Neoplasias/epidemiologia , Neoplasias/terapia , Oncologia , China/epidemiologiaRESUMO
BACKGROUND: The burden of emergency general surgery (EGS) is higher compared to elective surgery. Acute appendicitis (AA) is one of the most frequent diseases and its management is dictated by published international clinical practice guidelines (CPG). Adherence to CPG has been reported as heterogeneous. Barriers to clinical implementation were not studied. This study explored barriers to adherence to CPG and the clinico-economic impact of poor compliance. METHODS: Data were extracted from the three-year data lock of the REsiDENT-1 registry, a prospective resident-led multicenter trial. We identified 7 items from CPG published from the European Association of Endoscopic Surgery (EAES) and the World Society of Emergency Surgery (WSES). We applied our classification proposal and used a five-point Likert scale (Ls) to assess laparoscopic appendectomy (LA) difficulty. Descriptive analyses were performed to explore compliance and group comparisons to assess the impact on outcomes and related costs. We ran logistic regressions to identify barriers and facilitators to implementation of CPG. RESULTS: From 2019 to 2022, 653 LA were included from 24 centers. 69 residents performed and coordinated data collection. We identified low compliance with recommendations on peritoneal irrigation (PI) (25.73%), abdominal drains (AD) (34.68%), and antibiotic stewardship (34.17%). Poor compliance on PI and AD was associated to higher infectious complications in uncomplicated AA. Hospitalizations were significantly longer in non-compliance except for PI in uncomplicated AA, and costs significantly higher, exception made for antibiotic stewardship in complicated AA. The strongest barriers to CPG implementation were complicated AA and technically challenging LA for PI and AD. Longer operative times and the use of PI negatively affected antibiotic stewardship in uncomplicated AA. Compliance was higher in teaching hospitals and in emergency surgery units. CONCLUSIONS: We confirmed low compliance with standardized items influenced by environmental factors and non-evidence-based practices in complex LA. Antibiotic stewardship is sub-optimal. Not following CPG may not influence clinical complications but has an impact in terms of logistics, costs and on the non-measurable magnitude of antibiotic resistance. Structured educational interventions and institutional bundles are required.
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Apendicite , Laparoscopia , Humanos , Doença Aguda , Antibacterianos/uso terapêutico , Apendicectomia , Apendicite/tratamento farmacológico , Apendicite/cirurgia , Hospitalização , Estudos Prospectivos , Estudos Multicêntricos como AssuntoRESUMO
PURPOSE: The purpose of this study is to investigate the use of a VR Headset in routine clinical practice as an additional source of information for patients with diabetic macular edema (DME) and their companions. METHODS: Survey including 121 patients with DME, 22 companions, and 14 healthcare professionals from 8 ophthalmology centers in Germany. Patients' and their companions' health literacy was assessed by questionnaires including knowledge statements before and after watching a VR-based 3-D educational video. HCPs' perspectives on the usability of a VR Headset were also assessed. RESULTS: Patients' mean age was 63.4 ± 12.2 years, 64.5% were men, and 76% (92/121) had previous anti-VEGF (VEGF, vascular endothelial growth factor) injections. After using the VR Headset, over 85% of patients and companions felt better informed about DME and its treatment. Patients' mean (± SD) number of correct answers to knowledge statements increased from 13.2 ± 3.7 before to 15.5 ± 2.3 after using the VR Headset. Over 95% of patients and companions rated content and ease of understanding of the video as "very good" or "good." Most patients and all companions considered the use of a VR Headset as a positive experience, most wishing to obtain information via VR Headset in the future. Most physicians and all medical assistants rated the effect of the VR Headset on patient satisfaction as positive and suggested further VR modules. CONCLUSION: After using the VR Headset, patients with DME and their companions demonstrated knowledge gains that may be meaningful individually and contribute to better adherence. This may offer an additional opportunity for knowledge transfer.
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Diabetes Mellitus , Retinopatia Diabética , Edema Macular , Realidade Virtual , Masculino , Humanos , Pessoa de Meia-Idade , Idoso , Feminino , Edema Macular/diagnóstico , Edema Macular/tratamento farmacológico , Edema Macular/etiologia , Retinopatia Diabética/complicações , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/tratamento farmacológico , Fator A de Crescimento do Endotélio Vascular , Inquéritos e Questionários , PercepçãoRESUMO
Students are often encouraged to learn 'deeply' by abstracting generalizable principles from course content rather than memorizing details. So widespread is this perspective that Likert-style inventories are now routinely administered to students to quantify how much a given course or curriculum evokes deep learning. The predictive validity of these inventories, however, has been criticized based on sparse empirical support and ambiguity in what specific outcome measures indicate whether deep learning has occurred. Here we further tested the predictive validity of a prevalent deep learning inventory, the Revised Two-Factor Study Process Questionnaire, by selectively analyzing outcome measures that reflect a major goal of medical education-i.e., knowledge transfer. Students from two undergraduate health sciences courses completed the deep learning inventory before their course's final exam. Shortly after, a random subset of students rated how much each final exam item aligned with three task demands associated with transfer: (1) application of general principles, (2) integration of multiple ideas or examples, and (3) contextual novelty. We then used these ratings from students to examine performance on a subset of exam items that were collectively perceived to demand transfer. Despite good reliability, the resulting transfer outcomes were not substantively predicted by the deep learning inventory. These findings challenge the validity of this tool and others like it.
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Aprendizado Profundo , Educação Médica , Humanos , Reprodutibilidade dos Testes , Currículo , EstudantesRESUMO
BACKGROUND: The translation of research into healthcare practice relies on effective communication between disciplines, however strategies to address the gap between information sharing and knowledge transfer are still under exploration. Communities of Practice (CoP) are informal networks of stakeholders with shared knowledge or endeavour and present an opportunity to address this gap beyond disciplinary boundaries. However, the evidence-base supporting their development, implementation and efficacy in health is not well described. This review explores the evidence underpinning the use of CoP in health research and translation. METHODS: A scoping review was undertaken using Arksey and O'Malley's methodological framework. A comprehensive search of health databases and grey literature was performed using keywords and controlled vocabulary. Studies were not restricted by date or research method. RESULTS: A total of 1355 potentially relevant articles were identified through the global search strategy. Following screening, six articles were retained for analysis. Included studies were published between 2002 and 2013 in the United Kingdom (n = 3), Canada (n = 2) and Italy (n = 1). Three papers reported primary research; one used a quantitative methodology, one a qualitative, and one a descriptive evaluation approach. The three remaining papers explored seminal and evolving theories of CoP in the context of knowledge transfer and translation to the health sector. CONCLUSIONS: A paucity of evidence exists regarding the development and efficacy of CoP in health research and translation. Further empirical research is required to determine if communities of practice can enhance the translation of research into clinical practice.
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Atenção à Saúde , Disseminação de Informação , Humanos , Serviços de Saúde Comunitária , Gerenciamento de Dados , CanadáRESUMO
BACKGROUND: Communication skills training in patient centered communication is an integral part of the medical undergraduate education and has been shown to improve various components of communication. While the effects of different educational interventions have been investigated, little is known about the transfer from theoretical settings to clinical practice in the context of communication skills courses not integrated in the clinical curriculum. Most studies focus on single factors affecting transfer without considering the comprehensive perspective of the students themselves. The aim of this study is to explore how the students experience the transition to clinical practice and what they perceive as challenges in using patient centered communication. METHODS: Fifteen 4th year medical students were interviewed 3 weeks after the transition from an advanced communication skills course to surgical internship using semi-structured interviews. Qualitative content analysis was used to analyze the interviews. RESULTS: The analysis resulted in a theme 'When theory meets reality- a mismatch in communication'. It was comprised of four categories that encompassed the transfer process, from theoretical education, practical communication training and surgical internship to students' wishes and perceived needs. CONCLUSIONS: We concluded that preparing the students through theoretical and practical training should reflect the reality they will face when entering clinical practice. When educating medical students as a group, their proclivity for perfectionism, high performance environment and achievement-related stress should be taken into consideration. The role of tutors being role models, offering guidance, giving feedback and providing support plays a major part in facilitating transfer of communication skills. To enable transfer to a larger extent, the environment needs to promote patient centeredness and students need more opportunities to practice communication with their patients.
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Educação de Graduação em Medicina , Educação Médica , Estudantes de Medicina , Humanos , Comunicação , Currículo , Pesquisa Qualitativa , Competência Clínica , Educação de Graduação em Medicina/métodosRESUMO
The tunnel construction area poses significant challenges for the use of vision technology due to the presence of nonhomogeneous haze fields and low-contrast targets. However, existing dehazing algorithms display weak generalization, leading to dehazing failures, incomplete dehazing, or color distortion in this scenario. Therefore, an adversarial dual-branch convolutional neural network (ADN) is proposed in this paper to deal with the above challenges. The ADN utilizes two branches of the knowledge transfer sub-network and the multi-scale dense residual sub-network to process the hazy image and then aggregate the channels. This input is then passed through a discriminator to judge true and false, motivating the network to improve performance. Additionally, a tunnel haze field simulation dataset (Tunnel-HAZE) is established based on the characteristics of nonhomogeneous dust distribution and artificial light sources in the tunnel. Comparative experiments with existing advanced dehazing algorithms indicate an improvement in both PSNR (Peak Signal-to-Noise Ratio) and SSIM (Structural Similarity) by 4.07 dB and 0.032 dB, respectively. Furthermore, a binocular measurement experiment conducted in a simulated tunnel environment demonstrated a reduction in the relative error of measurement results by 50.5% when compared to the haze image. The results demonstrate the effectiveness and application potential of the proposed method in tunnel construction.
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AIMS AND OBJECTIVES: To explore the evidence-based nursing practice (EBNP) competencies of clinical and academic nurses and their collaboration needs for supporting EBNP. BACKGROUND: Academic-practice partnerships have strong potential to overcome the key barriers to EBNP. However, there is little known about the collaboration needs of clinical and academic nurses for EBNP. DESIGN: A cross-sectional study. METHODS: We recruited clinical and academic nurses online during November 2021 to January 2022. Using a reliable and validated scale and adapted questionnaires, data were collected relating to demographic information, EBNP-related resources availability, EBNP competencies and EBNP collaboration needs. These data were described using descriptive statistical methods. The t test, χ2 test and Mann-Whitney U test were used to evaluate if the different responses between clinical and academic nurses were statistically significant. This study was reported following the STROBET checklist. RESULTS: Two 240 clinical nurses and 232 academic nurses submitted questionnaires. There was no difference in overall EBNP competence between clinical and academic nurses. However, clinical nurses reported lower levels of competence and stronger intentions to collaborate with academic nurses when searching for, appraising, and synthesising evidence. Academic nurses reported lower levels of competence and stronger intentions to collaborate with clinical nurses for disseminating and implementing evidence. CONCLUSION: Clinical and academic nurses both reported high needs for collaborating to overcome their perceived role limitations. Clinical and academic nurses have different strengths and limitations in EBNP. These role differences and intentions to collaborate for different dimensions of EBNP competence suggest that clinical and academic nursing roles could be complementary to each other, offering opportunities for synergistic collaborations to better support overall EBNP. RELEVANCE TO CLINICAL PRACTICE: Healthcare and academic institutions should promote academic-practice partnerships as opportunities to gain complementary expertise on different dimensions of EBNP, and to improve nurses' competencies and confidence in EBNP overall.
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Enfermagem Baseada em Evidências , Enfermeiras e Enfermeiros , Humanos , Estudos Transversais , Papel do Profissional de Enfermagem , China , Inquéritos e Questionários , Competência ClínicaRESUMO
Online Health Communities (OHCs) are a type of self-organizing platform that provide users with access to social support, information, and knowledge transfer opportunities. The medical expertise of registered physicians in OHCs plays a crucial role in maintaining the quality of online medical services. However, few studies have examined the effectiveness of OHCs in transferring knowledge between physicians and most do not distinguish between the explicit and tacit knowledge transferred between physicians. This study aims to demonstrate the cross-regional transfer characteristics of medical knowledge, especially tacit and explicit knowledge. Based on data collected from 4716 registered physicians on Lilac Garden (DXY.cn), a leading Chinese OHC, Exponential Random Graph Models are used to (1) examine the overall network and two subnets of tacit and explicit knowledge (i.e., clinical skills and medical information), and (2) identify patterns in the knowledge transferred between physicians, based on regional variations. Analysis of the network shows that physicians located in economically developed regions or regions with sufficient workforces are more likely to transfer medical knowledge to those from poorer regions. Analysis of the subnets demonstrate that only Gross Domestic Product (GDP) flows are supported in the clinical skill network since discussions around tacit knowledge are a direct manifestation of physicians' professional abilities. These findings extend current understanding about social value creation in OHCs by examining the medical knowledge flows generated by physicians between regions with different health resources. Moreover, this study demonstrates the cross-regional transfer characteristics of explicit and tacit knowledge to complement the literature on the effectiveness of OHCs to transfer different types of knowledge.