Determining the Role of Employee Engagement in Nurse Retention along with the Mediation of Organizational Culture.

In today's unpredictable environment, the rapid emergence of the COVID-19 pandemic has shaken the world and its healthcare infrastructure immensely. As nurses are the building blocks of the healthcare personnel labor market, organizations should develop tactics that aid in their retention. With a solid theoretical foundation in self-determination theory, this study aims to understand the role of employee engagement in keeping nurses in 51 hospitals in the Northern Indian region, along with the mediation of organizational culture through smart PLS. In a complementary mediation relationship with organizational culture, nurse retention is positively correlated with employee engagement.

Effect of a Three-Dimensional Anatomy Atlas on Medical Education Under Pandemic Restrictions

Introduction The COVID-19 pandemic posed significant challenges to the instruction of in-person cadaveric dissection. Compared to previous years, there was a 66% reduction in student lab dissection times for the first-year medical students (MS1s) at Texas Tech University Health Sciences Center. Complete Anatomy (CA), a three-dimensional (3D) anatomy atlas, was provided as an additional educational resource to supplement the in person cadaveric dissection labs. The aim of this study is to increase student engagement by producing tailored anatomical modules in CA and to evaluate their effects on students? stress levels and summative practical exam performance throughout the Clinically Oriented Anatomy (COA) block. We hypothesized that the CA modules would allow current MS1s to perform to the same academic standard as students who did not have these COVID-19 limitations and reduce their exam stress. Methods Learning modules were created that displayed 3D anatomical structures corresponding to each of the 27 COA in person dissection labs. The CA modules consisted of content and quizzes that MS1s could access either outside or inside the lab. At the end of each of the three COA units and at the end of the COA block, students were surveyed about their participation and satisfaction with the modules. Students? performance on module quizzes was compared to their performance on summative practical exams. Additionally, the Class of 2023?s performance in COA was compared to the Class of 2024?s, with the latter taking the block under pandemic restrictions. Results Throughout the block, 82%-95% (unit 1 n=97/102, unit 2 n=67/72, unit 3 n=107/130) of survey respondents reported using the modules as a study aid and 55%-79% used the modules for all 27 anatomy labs. Additionally, 75%-87% of MS1s rated the modules as ?very useful? or higher on a Likert-scale survey, with a majority of surveyed students using both the content and quizzes. At the end of the block a second survey showed 74% (n=70/94) of students ?strongly agreed? or ?agreed? that using the modules reduced their stress, and 80% (n=75/94) ?strongly agreed? or ?agreed? that modules allowed them to continue their learning outside of the lab. MS1 performance in the COA block was positively correlated with performance on CA quizzes (r=0.46, p<0.0001). Further, there was no significant difference between the 2023 and 2024 MS1 classes in summative practical exam scores for units 1 and 3, as well as in the National Board of Medical Examiners (NBME) exam. However, there was a significant increase in summative practical exam performance in the Class of 2024 for unit 2 (p<0.0001) as compared to the Class of 2023. Conclusion Findings suggest that the CA modules facilitated student engagement in anatomy and positively enhanced their medical education throughout the COA block. Although dissection time and lab access were limited, the CA modules benefitted the students and could have potentially compensated for that lost time.

Incorporation of a clinically oriented case study into a multi-subject medical school block increased student engagement in a remote learning environment

At Texas Tech University Health Sciences Center School of Medicine, our curriculum begins with rigorous and fast-paced basic science blocks followed by clinical clerkships. During the first semester of the first year, medical students take a combined Biochemistry, Cell Biology and Histology block (called BCT) after successfully finishing an anatomy block. Historically, the medical students have had difficulties in both assimilating the amount of content presented and in appreciating how the topics covered in BCT help them better understand the pathophysiology and treatment of diseases. Further, because the COVID-19 environment prompted a change from a categorical to a Pass/Fail grading system and shifted the delivery of didactic material from in-person to remote learning, retention of student engagement became a priority. It has been demonstrated by others that using clinical correlations to teach basic science concepts is an effective way to enhance student engagement and retention of basic science knowledge. The primary hypothesis for this study was that student engagement and interest in basic science knowledge would be enhanced by the incorporation of a clinically oriented, case-based exercise. A second hypothesis was that students would be able to apply information provided during lectures to successfully complete it. The BCT block is 8 weeks long and consists of 3 units primarily focused on medical biochemistry (unit 1), cell biology (unit 2) and histology (unit 3). The case study, focused on diabetes, was designed to run as a ?thread? through all of the units and build in complexity with each unit in order to better understand the pathophysiology of this disease. The case was revealed progressively in three units, each of which consisted of a portion of an hypothetical scenario and a matched, five-question quiz that was offered both at the beginning and the end of each unit. The correct answers were given to the students after completion of each post-quiz. To enhance student participation, 2% was added to their grade after successful completion of at least 3 quizzes. Comparison of the pre- and post-quiz data revealed that for units 1 and 3, students scored significantly higher on post-quizzes as compared to pre-quizzes (unit 1- 86% vs 48%, a 78% change, and unit 3- 66% vs 61%, an 8.9% change). For unit 2, there was a trend toward significance;however, the average post-quiz score (87% vs 83%, a 4.5% change) was not significantly different from the pre-quiz score (p=0.07). Students responded favorably to the exercise (as reported in an end-of-block survey), wherein it was ranked higher as a learning resource than any of the recommended textbooks or atlases. Collectively, these data reveal that addition of a case study effectively enhances students' learning of the didactic material as well as their ability to apply basic science knowledge to a clinical case-based scenario.

Neuro-oncology practice guidelines from a high-volume surgeon at the COVID-19 epicenter.

BACKGROUND: During the coronavirus 19 (COVID-19) pandemic, physicians have begun adapting their daily practices to prevent transmissions. In this study we aimed to provide surgical neuro-oncologists with practice guidelines during the COVID-19 pandemic based on objective data from a high-volume brain tumor surgeon at the current COVID-19 epicenter. METHODS: All outpatient visits and surgeries performed by the senior author during the COVID-19 pandemic were compared between the initial quarantine (3/23/20-5/4/20), the plateau period following quarantine (5/5/20-6/27/20), and the second peak (6/28/20-7/20/20). In-person and telemedicine visits were evaluated for crossovers. Surgeries were subdivided based on lesion type and evaluated across the same time period. RESULTS: From 3/23/20-7/20/20, 469 clinic visits and 196 surgeries were identified. After quarantine was lifted, face-to-face visits increased (P < 0.01) yet no change in telehealth visits occurred. Of 327 telehealth visits, only 5.8% converted to in-person during the 4-month period with the most cited reason being patient preference (68.4%). Of the 196 surgeries performed during the pandemic, 29.1% occurred during quarantine, 49.0% during the plateau, and 21.9% occurred in the second peak. No COVID negative patients developed symptoms at follow-up. 55.6% were performed on malignant tumors and 31.6% were benign with no difference in case volumes throughout the pandemic. CONCLUSIONS: Despite exceptional challenges, we have maintained a high-volume surgical neuro-oncology practice at the epicenter of the COVID-19 pandemic. We provide the protocols implemented at our institution in order to maximize neuro-oncology care while mitigating risk of COVID-19 exposure to both patients and providers.