Leadership during airway management in the intensive care unit: A video-reflexive ethnography study.

Effective leadership is crucial to team performance within the intensive care unit. This novel study aimed to explore how staff members from an intensive care unit conceptualize leadership and what facilitators and barriers to leadership exist within a simulated workplace. It also aimed to identify factors that intersect with their perceptions of leadership. This study was underpinned by interpretivism, and video-reflexive ethnography was chosen as the methodology for the study. The use of both video recording (to capture the complex interactions occurring in the ICU) and team reflexivity allowed repeated analysis of those interactions by the research team. Purposive sampling was used to recruit participants from an ICU in a large tertiary and private hospital in Australia. Simulation groups were designed to replicate the typical clinical teams involved in airway management within the intensive care unit. Twenty staff participated in the four simulation activities (five staff per simulation group). Each group simulated the intubations of three patients with hypoxia and respiratory distress due to severe COVID-19. All 20 participants who completed the study simulations were invited to attend video-reflexivity sessions with their respective group. Twelve of the 20 participants (60%) from the simulations took part in the reflexive sessions. Video-reflexivity sessions (142 min) were transcribed verbatim. Transcripts were then imported into NVivo software for analysis. The five stages of framework analysis were used to conduct thematic analysis of the video-reflexivity focus group sessions, including the development of a coding framework. All transcripts were coded in NVivo. NVivo queries were conducted to explore patterns in the coding. The following key themes regarding participants' conceptualizations of leadership within the intensive care were identified: (1) leadership is both a group/shared process and individualistic/hierarchical; (2) leadership is communication; and (3) gender is a key leadership dimension. Key facilitators identified were: (1) role allocation; (2) trust, respect and staff familiarity; and (3) the use of checklists. Key barriers identified were: (1) noise and (2) personal protective equipment. The impact of socio-materiality on leadership within the intensive care unit is also identified.

Community of Inquiry framework to evaluate an online obstetric and neonatal emergency simulation workshop for health professional students in India.

BACKGROUND: We transitioned our obstetric neonatal emergency simulation (ONE-Sim) workshops to an online format during the COVID-19 pandemic. In this study, we evaluated key learning acquired by undergraduate medical and nursing students attending the online ONE-Sim workshops from a low- and middle-income country (LMIC). METHODS: Student perception of online workshops was collected using electronic questionnaires. Data was analysed using thematic analysis by employing the Community of Inquiry (CoI) framework. RESULTS: One hundred sixty medical and nursing students who attended the online ONE-Sim workshops completed the questionnaires. There was evidence in the data to support all three aspects of the CoI framework-social, cognitive and teacher presence. CONCLUSIONS: The use of the CoI framework helped to describe key learning from online interprofessional simulation workshops conducted for a LMIC.

Student and Educator Perspectives of Adapting to Remote Health Professions Education: A Mixed-Methods Study.

During the COVID-19 pandemic, universities across the world transitioned rapidly to remote education. Engaging with a curriculum that has been transitioned from in-person to remote education mode is likely to impact how students and educators adapt to the changes and uncertainties caused by the pandemic. There is limited knowledge about individual differences in students' and educators' adaptability to remote education in response to the pandemic. This paper explored healthcare students' and educators' adaptability experiences to remote education. Drawing on pragmatism, a convergent mixed-methods design was adopted. Data were collected between May and August in 2020 using an online survey, followed by interviews with students and educators of five large health courses at an Australian research-intensive University. Data included 476 surveys and seven focus group interviews with 26 students, and 95 surveys and 17 individual interviews with educators. Results were interpreted through an integration of quantitative and qualitative elements from student and educator experiences. Findings indicated that students were less adaptable than educators. Whilst remote learning was less appealing than in-person learning, some students adapted well to the new learning environment. Limited social learning, transmissive pedagogy, and lack of technical and non-technical skills were identified as factors that impacted upon the experience of students and educators. Navigating the challenges associated with remote education provided students and educators with a unique opportunity to improve adaptability-an attribute critical for future uncertainties in healthcare practice.

"Lockdown Dermatoses" during COVID-19-A Series of 127 Patients from the Indian Subcontinent.

Lockdown was enforced in many countries across the globe to flatten the coronavirus disease (COVID-19) curve. In these difficult times, people with skin diseases faced unique challenge, as major clinical facilities came to a standstill. Teledermatology helped to an extent to bridge this provider-seeker gap to an extent. We compiled data of patients seeking dermatology services during this period in Bangladesh, India, and Nepal. Most of the patients were middle-aged (70%) and had good access to teledermatology. Dermatoses were primarily due to frequent handwashing, use of alcohol-based sanitizers, excessive use of water (12.6%), improper skin care (43.3%), sun exposure (20.5%), lockdown-induced stress (22.04%), infections (15.75%), flare of preexisting diseases (8.66%), and hair disorders (11%). Many dermatoses had a causal overlap. Teledermatology proved to be useful for patients with skin diseases who were unable to access direct face-to-face consultations.

Culture and understanding the role of feedback for health professions students: realist synthesis protocol.

INTRODUCTION: Clinical education has moved to a 'competency-based' model with an emphasis on workplace-based learning and assessment which, in turn, depends on feedback to be effective. Further, the understanding of feedback has changed from information about a performance directed to the learner performing the task, to a dialogue, which enables the learner to act and develop.In health professional education, feedback is a complex interaction between trainee, supervisor and the healthcare system. Most published research on feedback in health professional education originates in Europe and North America. Our interest is on the impact of Culture on this process, particularly in the context of Asian cultures.The (scientific) realist approach of Pawson and Tilley provides a means to examine complex interventions in social situations, and thus is an appropriate lens to use for this study. This is a protocol for a realist synthesis which asks how, why and in what circumstances do Asian Cultures influence health professional trainees to seek, respond to and use feedback given in the clinical environment, if at all. METHODS AND ANALYSIS: An initial search was performed to help define the scope of the review question and develop our initial programme theory. The formal electronic search was carried out in February 2020 and included: CINAHL, ERIC, Medline and PsycInfo, and repeated in October 2020. Retrieved articles were imported into Covidence for screening and data extraction, after which components of the Context-Mechanisms-Outcomes configurations will be sought to refine the initial programme theory. ETHICS AND DISSEMINATION: As this study is a literature review, ethics approval is not required.The findings will be documented in line with the RAMESES (Realist And MEta-narrative Evidence Syntheses: Evolving Standards) publications standards for Realist syntheses, and we plan to disseminate the findings by means of a peer-reviewed journal article and conference presentation(s).

Early Childhood Educators as COVID Warriors: Adaptations and Responsiveness to the Pandemic Across Five Countries.

The ongoing COVID-19 pandemic has seriously impacted countries across the globe. The pandemic has created a completely new teaching-learning environment of interaction for early childhood educators. In many countries, face-to-face teaching has been replaced by remote teaching, while in others, there have been intermittent lockdowns and limited interruptions to regular teaching norms. Given the play-based nature of preschool teaching-learning activities in most countries, educators are required to reimagine the sociocultural relationships to their pedagogical practices in their everyday teaching-learning contexts. This paper sheds light on educators' experiences and the dramatic shift in their indoor-outdoor teaching-learning environment due to the evolving health measures. The study draws on notions of teachers' identities and Vygotsky's cultural-historical concept of social situation of development (Vygotsky, 1994) to capture the new forms of relationships that early childhood educators experienced with their pedagogical environments across different countries during the pandemic. Data were collected from preschool teachers across five countries-Australia, Bangladesh, Norway, Singapore and India using online surveys which included open- and close-ended questions. Findings reveal the on-ground realities and teachers' adaptations to new pedagogies emerging across the five countries. The new digital environments provided an equally new dimension for change. These changes were seen in interactions, relationships within the everyday pedagogical contexts, as well as the shifting physical and social environment of early years educators.

La pandémie actuelle de COVID-19 a gravement touché les pays du monde entier. La pandémie a créé un tout nouvel environnement d'interaction enseignement-apprentissage pour les éducateurs de la petite enfance. Dans de nombreux pays, l'enseignement en face à face a été remplacé par l'enseignement à distance, tandis que dans d'autres, il y a eu des blocages intermittents et des interruptions limitées des normes d'enseignement régulières. Étant donné la nature ludique des activités d'enseignement-apprentissage préscolaires dans la plupart des pays, les éducateurs sont tenus de réimaginer les relations socioculturelles avec leurs pratiques pédagogiques dans leurs contextes d'enseignement-apprentissage quotidiens. Cet article met en lumière les expériences des éducateurs et le changement radical de leur environnement d'enseignement-apprentissage intérieur-extérieur en raison de l'évolution des mesures de santé. L'étude s'appuie sur les notions d'identité des enseignants et le concept culturel et historique de Vygotsky de situation sociale de développement (Vygotsky, 1994) pour saisir les nouvelles formes de relations que les éducateurs de la petite enfance ont vécues avec leurs environnements pédagogiques dans différents pays pendant la pandémie. Les données ont été recueillies auprès d'enseignants du préscolaire dans cinq pays­Australie, Bangladesh, Norvège, Singapour et Inde à l'aide d'enquêtes en ligne comprenant des questions ouvertes et fermées. Les résultats révèlent les réalités sur le terrain et les adaptations des enseignants aux nouvelles pédagogies émergentes dans les cinq pays. Les nouveaux environnements numériques ont fourni une dimension tout aussi nouvelle pour le changement. Ces changements ont été observés dans les interactions, les relations au sein des contextes pédagogiques quotidiens, ainsi que dans l'environnement physique et social changeant des éducateurs de la petite enfance.

La pandemia de COVID-19 en curso ha afectado gravemente a países de todo el mundo. La pandemia ha creado un entorno de interacción de enseñanza-aprendizaje completamente nuevo para los educadores de la primera infancia. En muchos países, la enseñanza presencial ha sido reemplazada por la enseñanza a distancia, mientras que en otros, ha habido bloqueos intermitentes e interrupciones limitadas de las normas de enseñanza regulares. Dada la naturaleza basada en el juego de las actividades de enseñanza-aprendizaje preescolar en la mayoría de los países, los educadores deben reinventar las relaciones socioculturales con sus prácticas pedagógicas en sus contextos cotidianos de enseñanza-aprendizaje. Este documento arroja luz sobre las experiencias de los educadores y el cambio dramático en su entorno de enseñanza-aprendizaje interior y exterior debido a la evolución de las medidas de salud. El estudio se basa en las nociones de las identidades de los maestros y el concepto histórico-cultural de Vygotsky sobre la situación social del desarrollo (Vygotsky, 1994) para capturar las nuevas formas de relaciones que los educadores de la primera infancia experimentaron con sus entornos pedagógicos en diferentes países durante la pandemia. Se recopilaron datos de maestros de preescolar en cinco países: Australia, Bangladesh, Noruega, Singapur e India mediante encuestas en línea que incluían preguntas abiertas y cerradas. Los hallazgos revelan las realidades sobre el terreno y las adaptaciones de los profesores a las nuevas pedagogías que surgen en los cinco países. Los nuevos entornos digitales proporcionaron una dimensión igualmente nueva para el cambio. Estos cambios se observaron en las interacciones, las relaciones dentro de los contextos pedagógicos cotidianos, así como en el entorno físico y social cambiante de los educadores de la primera infancia.

Impact of the COVID-19 pandemic on teaching and learning in health professional education: a mixed methods study protocol.

BACKGROUND: Due to the complex nature of healthcare professionals' roles and responsibilities, the education of this workforce is multifaceted and challenging. It relies on various sources of learning from teachers, peers, patients and may focus on Work Integrated Learning (WIL). The COVID-19 pandemic has impacted many of these learning opportunities especially those in large groups or involving in person interaction with peers and patients. Much of the curriculum has been adapted to an online format, the long-term consequence of which is yet to be recognized. The changed format is likely to impact learning pedagogy effecting both students and teachers. This requires a systematic approach to evaluation of online teaching and learning adaptation, in comparison to the previous format, where, in person education may have been the focus. METHODS: The proposed study is a broad based evaluation of health professional education in a major Australian University. The protocol describes a mixed methods convergent design to evaluate the impact of online education on students and teachers in health professional courses including Medicine, Nursing, Allied Health and Biomedical Science. A framework, developed at the university, using Contribution Analysis (CA), will guide the evaluation. Quantitative data relating to student performance, student evaluation of units, quantity of teaching activities and resource utilization will be collected and subjected to relevant statistical analysis. Data will be collected through surveys (500 students and 100 teachers), focus groups (10 groups of students) and interviews of students and teachers (50 students beyond graduation and 25 teachers, for long term follow up to 12 months). Application of CA will be used to answer the key research questions on the short term and long-term impact of online education on teaching and learning approaches. DISCUSSION: The protocol describes the study, which will be widely implemented over the various courses in Health Professional Education and Biomedical Science. It will evaluate how students and teachers engage with the online delivery of the curriculum, student performance, and resources used to implement these changes. It also aims to evaluate longitudinal outcome of student learning attributes and impact on graduate outcomes, which is poorly reported in educational literature.

Perspectives of pregnant women during the COVID-19 pandemic: A qualitative study.

BACKGROUND: The current COVID-19 pandemic has been shown to have profound effects on pregnant women globally, particularly, on their psycho-social wellbeing. Despite this, there has been limited qualitative inquiry into the experiences of pregnant women during the pandemic. AIM: This original research aimed to study the perspectives of pregnant women in Australia in relation to the impact of the COVID-19 pandemic on their pregnancy experience. METHODS: A qualitative descriptive study design with semi-structured interviews was adopted. The study was performed in Melbourne, Australia. A total of fifteen interviews were conducted. Data was analysed thematically to develop major themes and subthemes. RESULTS: A total of four major themes were developed: support for a positive experience, impact on preparedness in pregnancy and beyond, facing uncertainty of a pandemic, and retaining resilience and optimism. CONCLUSIONS: The COVID-19 pandemic has affected the experience of pregnant women with potential to compromise their psycho-social wellbeing. The major themes identified in this study offer insight to organisations to develop woman-centred care during the pandemic and optimise the psycho-social wellbeing of pregnant women.