Pandemic effects on the reading trajectories of deaf and hard of hearing students: a pilot analysis.

It is important to understand the nature of the effect that the COVID-19 pandemic had upon student learning, especially those at risk such as deaf students. The limited communication that many deaf students have at home may mean less support is available for learning remotely. Reading may be one of the areas where progress was diminished. We collected Measures of Academic Progress (MAP) scores in reading from deaf students in a residential school for the deaf in grades 3 to 12 every fall and spring from 2016 to 2021. A cohort-sequential approach yielded growth data (2570 observations), with 546 students measured up to 10 times each. As is typical of MAP reading achievement in grades 3 to 12, growth was steep in early grades, slowing in later grades. Students in the Alternative Curriculum performed lower and grew slower. Cohorts differed, with more recent cohorts typically having higher performance than older cohorts. Tenure had a substantial effect, suggesting that students who had been in the school for the deaf longer had higher performance compared to students who joined the school as older students. The pandemic appeared to have a strong, but diminishing effect in each semester, but this effect differed widely across demographic groups. This suggests that effects of the pandemic are neither clear nor simple for deaf students even within the same school. These findings have implications for understanding how the impact of pandemic may vary as a function of deaf students' educational experiences and other demographic factors.

Impact of Increased Patient-Clinician Virtual Visits During the COVID-19 Pandemic on Medical Student Enthusiasm for Future General Practice Careers.

BACKGROUND: The COVID-19 pandemic restricted the availability of face-to-face primary care visits. This rapidly increased the proportion of primary care patient-clinician visits conducted virtually and asynchronously (remote consultations via video, telephone, and web-based text/email), altering the educational environment for medical students. Our study explored the impact of the increased proportion of primary care visits conducted virtually and asynchronously, on medical students' self-reported interest in pursuing a career in general (family) practice. METHODS: We conducted a cross-sectional survey study of medical students at six universities within England and Wales to explore the impact of the increased proportion of primary care visits conducted virtually and asynchronously on medical students' interest in pursuing a career in general practice. RESULTS: One hundred fifty-four medical students were recruited between December 2020 and May 2021; 79 (51%) of the participants reported being less interested in pursuing a career in general practice as a result of the increased proportion of virtual and asynchronous primary care visits during the COVID-19 pandemic. This increased to 104 (68%) of the participants reporting being less interested should primary care visits continue to be delivered virtually or asynchronously by default. Analysis of open-ended survey questions identified a poorer educational experience, concerns regarding the impact on patient care, an isolated working environment and technological challenges as key negative themes. CONCLUSIONS: Sociable, supportive working and learning environments and offering equitable care are important motivators for the future workforce. There is a need to develop robust training and assessment in patient-clinician virtual visits and asynchronous communication and to integrate this into curricula.

Pandemic effects on the reading trajectories of deaf and hard of hearing students: a pilot analysis

It is important to understand the nature of the effect that the COVID-19 pandemic had upon student learning, especially those at risk such as deaf students. The limited communication that many deaf students have at home may mean less support is available for learning remotely. Reading may be one of the areas where progress was diminished. We collected Measures of Academic Progress (MAP) scores in reading from deaf students in a residential school for the deaf in grades 3 to 12 every fall and spring from 2016 to 2021. A cohort-sequential approach yielded growth data (2570 observations), with 546 students measured up to 10 times each. As is typical of MAP reading achievement in grades 3 to 12, growth was steep in early grades, slowing in later grades. Students in the Alternative Curriculum performed lower and grew slower. Cohorts differed, with more recent cohorts typically having higher performance than older cohorts. Tenure had a substantial effect, suggesting that students who had been in the school for the deaf longer had higher performance compared to students who joined the school as older students. The pandemic appeared to have a strong, but diminishing effect in each semester, but this effect differed widely across demographic groups. This suggests that effects of the pandemic are neither clear nor simple for deaf students even within the same school. These findings have implications for understanding how the impact of pandemic may vary as a function of deaf students’ educational experiences and other demographic factors.

Moving From Peripheral Project to Integrated Governance: Developing System Sustainability in Excellence Reporting

Aims There has been increasing recognition that healthy cultures within NHS organisations are key to delivering high-quality, safe care (King's Fund). A focus towards developing systems which recognise and learn from excellence has been shown to improve services’ safety and contribute to staff's morale (Kelly et al. 2016). In 2019 Secure Services at Devon Partnership NHS Trust (DPT) developed an Excellence reporting system. Once successfully piloted, the intention was to extend to other departments before expanding to the entire Trust. Our aims initially were SMART: for 13 reports per week in Secure services and 8 in Perinatal (a smaller team). As we expanded the aim became qualitative: for a system to be embedded so staff could as readily and instinctively report Excellence as they could an error. Methods We developed our Theory of Change using Deming's theory of profound knowledge, ran a series of PDSAs, and introduced an Excellence system. We engaged early adopters, sent hand-written cards and shared data widely. Learning included understanding setting up the system, and the importance of a team rather than an individual holding the system. We took this forward to bring the system to Perinatal. We continued to run PDSAs, then ran monthly trust-wide meetings providing space to learn from other directorates. Results Staff were initially excited, reports submitted, feedback good, then a plateau and slump. Something was stopping the system perpetuating. When staff received timely thanks, and others heard about it, staff would go on to promote excellence. However, this was not possible without sufficient admin resources. In early 2021 we changed tact and approached the top: we presented data to Directors who recognised the value and agreed to support. We then set about publicising the system, and demonstrating at trust-wide meetings. By July 2021 we saw 10 reports per week in the Specialist Directorate. By early 2022 reports were being inputted from staff across all directorates and our monthly meetings began to focus on sharing the learning. Conclusion We recognised the system's potential impact on safety and staff morale but struggled to sustain the system and support dwindled when staff were stretched. After approaching leaders, then allocated resources, it allowed for more success. However, it is not yet fully embedded in our Trust's culture. A lot of our work happened during COVID-19 and despite challenges there has been a new-found flexibility to innovate, greater ease to negotiate, and instigate change.

Impact of Exercise on Susceptibility and Severity of COVID-19 in Patients with Cancer: A Retrospective Study.

BACKGROUND: Modifiable lifestyle-related factors heighten the risk and severity of coronavirus disease 2019 (COVID-19) in patients with cancer. Whether exercise lowers susceptibility or severity is not known. METHODS: We identified 944 cancer patients from Memorial Sloan Kettering Cancer Center (mean age: 64; 85% female; 78% White) completing an exercise survey before receiving a confirmed positive or negative SARS-CoV-2 test. Exercise was defined as reporting moderate-intensity ≥5 days per week, ≥30 minutes/session or strenuous-intensity ≥3 days per week, ≥20 minutes/session. Multivariable logistic regression was used to determine the relationship between exercise and COVID-19 susceptibility and severity (i.e., composite of hospital admission or death events) with adjustment for clinical-epidemiologic covariates. RESULTS: Twenty-four percent (230/944) of the overall cohort were diagnosed with COVID-19 and 35% (333/944) were exercisers. During a median follow-up of 10 months, 26% (156/611) of nonexercising patients were diagnosed with COVID-19 compared with 22% (74/333) of exercising patients. The adjusted OR for risk of COVID-19 was 0.65 [95% confidence interval (CI), 0.44-0.96, P = 0.03] for exercisers compared with nonexercisers. A total of 20% (47/230) of COVID-19 positive patients were hospitalized or died. No difference in the risk of severe COVID-19 as a function of exercise status was observed (P > 0.9). CONCLUSIONS: Exercise may reduce the risk of COVID-19 infection in patients with a history of cancer, but not its severity. IMPACT: This study provides the first data showing that exercise might lower the risk of COVID-19 in cancer patients, but further research is required.

Can nutrition education mitigate the impacts of COVID-19 on dietary quality? Cluster-randomised controlled trial evidence in Myanmar's Central Dry Zone.

We evaluate the immediate impact of a nutrition and gender behaviour change communication on dietary quality in rural communities in Myanmar and assess whether the communication helped mitigate the effect of the COVID-19 crisis on dietary quality. The intervention was designed and implemented as a cluster-randomised controlled trial in which 15 villages received the intervention and 15 control villages did not. The intervention was implemented from June to October 2020. This paper provides an assessment of the intervention's impact on dietary quality based on the results of two phone surveys conducted in August and October 2020. Immediate impacts of the intervention indicate an improvement in women's dietary diversity scores by half a food group out of 10. At baseline, 44% of women were likely to have consumed inadequately diverse diets; results indicate that 6% (p-value: 0.003, SE: 0.02) fewer sample women were likely to have consumed inadequately diverse diets. More women in treatment villages consumed pulses, nuts, eggs and Vitamin A-rich foods daily than in control villages. In response to economic shocks related to COVID-19, households in the treatment villages were less likely to reduce the quantity of meat and fish consumption than in control villages. The long-term impacts of the intervention need to be continuously evaluated.

Creating Diversity in Tomorrow's Doctors: A Student Led, Widening Participation Outreach Programme.

Since its founding in 2017, InsideMed, an entirely voluntary medical student led innovation, has offered local London state school students a unique perspective exploring the application process and realities of a career in medicine. Our aim of promoting diversity and widening participation (WP) amongst future medical school applicants is reflected in the fact 80.2% of the students enrolled are from Black Asian and Minority Ethnic groups (BAME). Over an 18 month period, our students are invited to monthly seminars hosted at King's College London (KCL), where all things "medical school" are explored. Students are paired with current KCL medical student ambassadors and are grouped into 'Families'. Between sessions, students and ambassadors are facilitated to communicate freely, but safely through the online platform Brightside. Early establishment of our key stakeholders allowed us to anticipate how InsideMed would impact each in turn and, therefore, design our scheme to ensure maximal mutual benefit. Continual feedback and review ensures that we are constantly improving to meet the needs of our students. Feedback also allows us to identify how closely we have served our aims for each cohort; common themes which consistently arise include the creation of community, learning more about specifics of the medical application process, and building self-confidence and student independence. InsideMed has the unique quality of being designed by WP students and constantly updated to ensure the support provided best meets WP needs. This has fed into our tangible and impressive impact, whereby 7 out of 18 respondents from our 2017 cohort of students have been accepted into medical school. Going forward, we hope to expand our scope to include a wider catchment area and will continue online in the COVID era. We aim to create an expansive alumni community to inspire other students from comparable socioeconomic backgrounds that they too can have a career in medicine.

Evaluation of a delirium awareness podcast for undergraduate nursing students in Northern Ireland: a pre-/post-test study.

BACKGROUND: Delirium is a common disorder affecting several people in primary, secondary, and tertiary settings. The condition is frequently under-diagnosed leading to long-lasting physical and cognitive impairment or premature death. Despite this, there has been limited research on the impact of innovative approaches to delirium education amongst undergraduate nursing students. The aim of this study was to evaluate the effect of a delirium awareness podcast on undergraduate nursing student knowledge and confidence related to the condition in Northern Ireland. METHODS: The intervention was a 60-min delirium awareness podcast, available throughout May 2020, to a convenience sample of year one undergraduate nursing students (n = 320) completing a BSc Honours Nursing degree programme in a Northern Ireland University. The podcast focused on how nursing students could effectively recognise, manage, and prevent delirium. Participants had a period of 4 weeks to listen to the podcast and complete the pre and post questionnaires. The questionnaires were comprised of a 35-item true-false Delirium Knowledge Questionnaire (DKQ), a 3-item questionnaire about professional confidence and a 7-item questionnaire evaluating the use of podcasting as an approach to promote knowledge and confidence about delirium. Data were analysed using paired t-tests and descriptive statistics. RESULTS: Students improved across all three core areas in the post-test questionnaire, demonstrating improvements in knowledge about symptoms of delirium (7.78% increase), causes and risk factors of delirium (13.34% increase) and management of delirium (12.81% increase). In relation to perceived confidence, students reported a 46.50% increase in confidence related to recognition of delirium, a 48.32% increase in relation to delirium management and a 50.71% increase their ability to communicate about delirium. Both questionnaires were statistically significant (P < 0.001). The final questionnaire illustrated that nursing students positively evaluated the use of podcast for promoting their knowledge and confidence about delirium and 96.32% of nursing students believed that the podcast met their learning needs about delirium. CONCLUSIONS: A 60-min podcast on delirium improved first year student nurse knowledge about delirium. Nursing students also expressed that this approach to delirium education was effective in their learning about the condition.