Perception of teachers and students about the experience in the use of the Hyflex model in anatomy / Percepción de docentes y alumnos sobre la experiencia en el uso del modelo Hyflex en anatomía

RESUMEN: La pandemia por COVID-19 obligó a las universidades a impartir de forma abrupta sus asignaturas en un formato en línea o semi presencial. Es así como el uso del modelo educativo Hyflex surgió como alternativa. El objetivo del presente estudio fue conocer la percepción de los alumnos y docentes sobre la experiencia en el uso de Hyflex en anatomía. Estudio descriptivo de tipo mixto con una muestra por conveniencia de 115 alumnos y 7 docentes que participaban en Anatomía Aplicada durante el año 2021 en las Salas de Habilidades del Hospital de Simulación de la Universidad Andrés Bello, sede Viña del Mar, Chile. La recogida de datos fue a través de un cuestionario de auto aplicación con escala tipo Likert de 5 niveles y la realización de focus group con guión de 9 preguntas semi-estructuradas. Los datos cuantitativos fueron analizados con estadística descriptiva y la aplicación del test Mann- White para comparar entre grupos con un P < 0.05. Los datos cualitativos fueron analizados mediante teoría fundamentada para identificar las categorías principales y subcategorías. Tanto los docentes como estudiantes tuvieron una buena percepción sobre el uso de Hyflex. En ambos grupos lo más destacado fue que posibilitaba el acceso a contenidos y actividades en línea que complementaban las actividades presenciales. Sin embargo, ambos grupos coincidieron en que no aprenden más en el formato en línea que presencial. Además, en las entrevistas de focus group emergieron dos categorías principales, la satisfacción (destacando las subcategorías comprensión de contenidos, aspectos administrativos, acceso a la información) y modalidad (calidad de aprendizaje, rendimiento, participación, recepción de la información y aspectos sociales). Hyflex es una alternativa para impartir los contenidos de anatomía, aunque los estudiantes y docentes perciben que la presencialidad es fundamental para brindar una adecuada experiencia de aprendizaje.

SUMMARY: The COVID-19 pandemic forced universities to abruptly teach their subjects in an online or semi-face-to-face format. This is how the use of the Hyflex educational model emerged as an alternative. The objective of this study was to know the perception of students and teachers about the experience in the use of Hyflex in anatomy. Mixed-type descriptive study was carried out, with a convenience sample of 115 students and 7 teachers who participated in Applied Anatomy during the year 2021 in the Skills Rooms of the Simulation Hospital of the Andrés Bello University, Viña del Mar, Chile. Data collection was through a self-application questionnaire with a 5-level Likert-type scale and a focus group with a script of 9 semi-structured questions. The quantitative data were analyzed with descriptive statistics and the application of the Mann-White test to compare between groups with a P < 0.05. Qualitative data were analyzed using grounded theory to identify main categories and subcategories. Both teachers and students had a good perception of the use of Hyflex. In both groups, the highlight was that it enabled access to online content and activities that complemented face-to-face activities. However, both groups agreed that they do not learn more in the online format than in person. In addition, in the focus group interviews two main categories emerged, satisfaction (highlighting the subcategories content understanding, administrative aspects, access to information) and modality (quality of learning, performance, participation, reception of information and social aspects). Hyflex is an alternative to teach anatomy content, although students and teachers perceive that attendance is essential to provide an adequate learning experience.

A Culturally Competent Vaccine Hesitancy Educational Model for Community Pharmacists to Increase Vaccine Uptake, Louisiana, 2021-2022.

In February 2022, an educational model was launched to train Louisiana pharmacists to become positive influencers of vaccination decisions via targeted, culturally competent interventions, with the objective of improving COVID-19 vaccine uptake in communities. A total of 47 pharmacists completed the course, and more than 90% noted that the education would help them optimize vaccine acceptance in their community practice settings. The pharmacists will participate in vaccine surveillance to assess the success of the educational model intervention and predictors of vaccine uptake. (Am J Public Health. 2022;112(S9):S900-S903. https://doi.org/10.2105/AJPH.2022.307070).

Confronting implicit bias toward patients: a scoping review of post-graduate physician curricula.

BACKGROUND: Physicians' behavior may unknowingly be impacted by prejudice and thereby contribute to healthcare inequities. Despite increasingly robust data demonstrating physician implicit bias (The Office of Minority Health. Minority Population Profiles, 2021; COVID-19 Shines Light on Health Disparities, National Conference of State Legislatures 2021), the evidence behind how to change this with training programs remains unclear. This scoping review therefore reports on the implementation, outcomes, and characteristics of post-graduate physician implicit bias curricula. METHODS: The authors conducted a literature review using scoping review methodology. They searched 7 databases in February and November 2020 for English-language academic and gray literature on implicit bias curricula for physicians at all levels of post-graduate training. Ten reviewers screened studies for eligibility independently, then extracted data from these studies and compiled it into a chart and analytical summary. RESULTS: Of the 4,599 articles screened, this review identified 90 articles on implicit bias interventions for post-graduate physicians. Inductive data analysis revealed a spectrum of educational approaches, which were categorized int o 4 educational models called Competence, Skills-Based, Social Contact, and Critical Models. The most commonly reported strength was the interactive nature of the curricula (26%), and the most frequently identified challenges were related to time and resources available (53%). Half of the interventions discussed facilitator preparation, and the majority (62%) evaluated outcomes using pre and post self-assessments. CONCLUSIONS: This review provides a comprehensive synthesis of the literature on physician implicit bias curricula. It is our goal that this supports medical educators in applying and improving aspects of these interventions in their own programs.

The State of the Evidence about the Family and Community Nurse: A Systematic Review.

INTRODUCTION: The increase in chronic degenerative diseases poses many challenges to the efficacy and sustainability of healthcare systems, establishing the family and community nurse (FCN) who delivers primary care as a strategic role. FCNs, indeed, can embrace the complexity of the current healthcare demand, sustain the ageing of the population, and focus on illness prevention and health promotion, ensuring a continuous and coordinated integration between hospitals and primary care ser. The literature on FCNs is rich but diverse. This study aimed to critically summarise the literature about the FCN, providing an overall view of the recent evidence. METHODS: A state-of-art systematic review was performed on PubMed, CINAHL, and Scopus, employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and checklist to guide the search and reporting. RESULTS: Five interpretative themes emerged from the 90 included articles: clinical practice, core competencies, outcomes, Organisational and educational models, and advanced training program. CONCLUSIONS: FCNs can make a major contribution to a population's health, playing a key role in understanding and responding to patients' needs. Even if the investment in prevention does not guarantee immediate required strategies and foresight on the part of decisionmakers, it is imperative to invest more political, institutional, and economic resources to support and ensure the FCNs' competencies and their professional autonomy.

How to One Up a Pandemic: University of Minnesota's Physical Medicine and Rehabilitation Virtual Clerkship-A Model for Alternative Clinical Training and Preliminary Validation Study.

ABSTRACT: Drastic and rapid changes to medical education are uncommon because of regulations and restrictions designed to ensure consistency among medical school curriculums and to safeguard student well-being. As a consequence of the COVID-19 pandemic, medical education had to break away from its conventions and transition from time-honored teaching methods to innovative solutions. This article explores the anticipated and actual efficacy of the swift conversion of a specialty elective from a traditional in-person format to a fully virtual clerkship. In addition, it includes a noninferiority study to determine where a virtual classroom may excel or fall short in comparison with conventional clinical rotations.

An integrated model for interdisciplinary graduate education: Computation and mathematics for biological networks.

The current challenges at the forefront of data-enabled science and engineering require interdisciplinary solutions. Yet most traditional doctoral programs are not structured to support successful interdisciplinary research. Here we describe the design of and students' experiences in the COMBINE (Computation and Mathematics for Biological Networks) interdisciplinary graduate program at the University of Maryland. COMBINE focuses on the development and application of network science methods to biological systems for students from three primary domains: life sciences, computational/engineering sciences, and mathematical/physical sciences. The program integrates three established models (T-shaped, pi-shaped and shield-shaped) for interdisciplinary training. The program components largely fall into three categories: (1) core coursework that provides content expertise, communication, and technical skills, (2) discipline-bridging elective courses in the two COMBINE domains that complement the student's home domain, (3) broadening activities such as workshops, symposiums, and formal peer-mentoring groups. Beyond these components, the program builds community through both formal and informal networking and social events. In addition to the interactions with other program participants, students engage with faculty in several ways beyond the conventional adviser framework, such as the requirement to select a second out-of-field advisor, listening to guest speakers, and networking with faculty through workshops. We collected data through post-program surveys, interviews and focus groups with students, alumni and faculty advisors. Overall, COMBINE students and alumni reported feeling that the program components supported their growth in the three program objectives of Network Science & Interdisciplinarity, Communication, and Career Preparation, but also recommended ways to improve the program. The value of the program can be seen not only through the student reports, but also through the students' research products in network science which include multiple publications and presentations. We believe that COMBINE offers an effective model for integrated interdisciplinary training that can be readily applied in other fields.

The Resurgence of Medical Education in Sociology: A Return to Our Roots and an Agenda for the Future.

From 1940 to 1980, studies of medical education were foundational to sociology, but attention shifted away from medical training in the late 1980s. Recently, there has been a marked return to this once pivotal topic, reflecting new questions and stakes. This article traces this resurgence by reviewing recent substantive research trends and setting the agenda for future research. We summarize four current research foci that reflect and critically map onto earlier projects in this subfield while driving theoretical development elsewhere in the larger discipline: (1) professional socialization, (2) knowledge regimes, (3) stratification within the profession, and (4) sociology of the field of medical education. We then offer six potential future directions where more research is needed: (1) inequalities in medical education, (2) socialization across the life course and new institutional forms of gatekeeping, (3) provider well-being, (4) globalization, (5) medical education as knowledge-based work, and (6) effects of the COVID-19 pandemic.

Sports Ultrasound Training During a Pandemic: Developing a "Hands-on" Skill Through Distance Learning.

"Hands-on" teaching is an important part of sports ultrasound (US) education in sports medicine fellowships. However, physical distancing requirements during a global pandemic have resulted in cancellation and/or postponement of "in-person" educational sessions, ultrasound conferences, and clinical diagnostic and interventional ultrasound cases that enhance ultrasound training. For "hands-on" sports ultrasound teaching to continue during these uncertain times, the educational model must be adapted. The use of virtual meeting platforms to display ultrasound images is possible, and this not only allows for instructor demonstration but also gives the instructor an opportunity to observe the learner scanning and provide direct feedback in real-time. Moving forward, virtual ultrasound teaching methods will likely continue to be of educational value, as they provide increased access to individualized instruction from skilled instructors and eliminate travel time and cost of conferences and instructional sessions.

Redesigning and teaching veterinary microbiology laboratory exercises with combined on-site and online participation during the COVID-19 pandemic.

The COVID-19 (coronavirus disease 2019) pandemic has forced universities to find new ways to conduct learning and teaching, as traditional face-to-face teaching has been prevented or restricted to an absolute minimum in many instances. Therefore, we redesigned and taught second-year veterinary student microbiology laboratory exercises (labs) with a hybrid learning approach. For this, a novel 'remote partner' model was implemented in which students present on-site in the laboratory worked synchronously pairwise with their remote partner present online. A student feedback survey revealed that in this remote partner model, both on-site and online participation in the labs were experienced as being useful in improving their laboratory skills. The students' overall performance in hands-on microbiological laboratory skills and safe working practices was similar in the hybrid learning approach (the 2021 class) and in the traditional on-site participation approach (the 2018-20 classes). This study suggests that the remote partner model is an effective way to acquire microbiological laboratory skills. This learning approach can be used in the non-pandemic future and/or also be applied to other fields.

Power of the collective: A review of multimodal internet-based surgical education resources in the 21st century.

Electronic resources have changed surgical education in the 21st century. Resources spanning from digital textbooks to multiple choice question banks, online society meetings, and social media can facilitate surgical education. The COVID pandemic drastically changed the paradigm for education. The ramifications of Zoom lectures and online surgical society meetings will last into the future. Educators and learners can be empowered by the many available electronic resources to enhance surgical training and education.

Application of the inverted classroom model in the teaching module "new classification of periodontal and peri-implant diseases and conditions" during the COVID-19 pandemic.

Background: Due to the need for patient-free dental education during the COVID-19 pandemic, Hannover Medical School (MHH) implemented a new periodontology module. Its didactic structure was based on the "inverted classroom model" (ICM) in combination with elements of case-based learning. The educational objective was to increase the diagnostic confidence of dental students in the classification of periodontal patients (staging & grading), based on 33 digitized patient cases. To assess the suitability of the module for future dental curricula, this study aimed to evaluate student satisfaction and skills acquisition. Methods: The periodontology module, which was attended by final year dental students of MHH (n=55, mean age: 26.5±3.9 years, male/female ratio: 24.1%/75.9%) was evaluated in a two-tiered way. Student satisfaction was recorded using a questionnaire. Learning success was assessed by comparing error rates in patient case classifications before (T0) and after (T1) participation in the periodontology module. Results: The study found a high level of student satisfaction with the ICM format and a significant reduction in error rates (T0 error rate=28.3%; MV±SD=3.12±1.67 vs. T1 error rate=18.7%; MV±SD=2.06±1.81; Δ=9.6%). However, of the 11 diagnostic decisions required, only four parameters (extent, grading, percentage of bone loss per age, phenotype) showed significant improvements, with effect sizes ranging from small to medium. Conclusions: The ICM-based teaching concept is definitely not an alternative to patient-based learning. However, in regard to student satisfaction and learning success, it might be superior to conventional classroom-based lectures, especially when complex topics are covered. In summary, the newly developed periodontology module may be a useful addition to traditional dental education in future curricula, even for the time after the COVID-19 pandemic.

Robotics in Teaching-Learning: But in Nursing?

In this teaching-learning column, the use of robotic technology is explored as a possible adjunctive assistant to faculty. Given the advances in technology and the imposed restrictions of the recent COVID-19 pandemic, a discussion of using robotic technology in the teaching-learning of nursing seems timely and relevant. Questions to consider are explored. Then a concern and a possibility are presented for incorporating this advancing technology into teaching-learning from a humanbecoming perspective. Faculty are encouraged to enter into a deeper dialogue with colleagues in exploring options for incorporating robots with the caveat that the core of teaching-learning must remain the presence of teacher with student on the co-created never ending journey of the unfolding mystery in coming-to-know.

Harnessing the Potential Futures of CBME Here and Now.

The COVID-19 pandemic of 2020 exposed the reactive nature of the medical education community in response to a disruption that, at one time, may have seemed preposterous. In this article, the author reflected on the impact of an unpredictable plight on a system of medical education that (1) is continuous but doesn't function as a continuum and (2) requires adaptation but is steeped in a fixed mindset and structure that resists change. As a result, innovations which were previously considered impossible, such as time variable education and training, were forced into being. Inspired by the changes brought about by the pandemic, the ensuing decade is explored through a lens of possible futures to envision a path forward based on resilience rather than reactivity.

Building Mental Health Capacity: Exploring the Role of Adaptive Expertise in the ECHO Virtual Learning Model.

INTRODUCTION: With the proliferation of virtual learning programs during the COVID-19 pandemic, there is increased need to understand learner experiences and impact on developing expertise. Project Extension for Community Healthcare Outcomes (Project ECHO®) is an established hub-and-spoke tele-education model aimed at building capacity and expertise in primary care providers. Our qualitative study explored how learning experiences within an ECHO mental health care program supported provider learning and ability to solve complex clinical problems. METHODS: We sampled ECHO sessions across a 34-week cycle and analyzed audio transcribed data. Two individuals coded participant interactions during 2-hour recorded sessions using an iterative, constant comparative methodology. RESULTS: The authors identified four key mechanisms of learning in ECHO: (1) fostering participants' productive struggle with cases, (2) development of an integrated understanding, (3) collaborative reformulation of cases, and (4) generation of conceptual solutions based on a new understanding. Throughout the ECHO sessions, learning was observed to be multidirectional from both the hub-to-spoke and between spoke sites. DISCUSSION: Despite the widespread implementation of Project ECHO and other virtual learning models, a paucity of research has focused on mechanisms of virtual learning within these models. Our study demonstrated a bidirectional exchange of knowledge between hub specialist teams and primary care provider spokes that aligned with the development of adaptive expertise through specific learning experiences in Project ECHO. Moreover, the ECHO structure may further support the development of adaptive expertise to better prepare participants to address patients' complex mental health needs.

A Faculty Development Workshop for Planning and Implementing Interactive Virtual Case-Based Teaching.

Introduction: The virtual learning environment has become increasingly important due to physical distance requirements put in place during the COVID-19 pandemic. The transition to a virtual format has been challenging for case-based teaching sessions, which involve substantial audience participation. We developed a faculty development workshop aimed at teaching health professions educators how to use various interactive virtual tools within videoconferencing platforms to facilitate virtual case-based sessions. Methods: Two 90-minute workshops were piloted as a faculty development initiative. The facilitators demonstrated interactive teaching tools that could be used within virtual case-based sessions. Then, participants discussed how to incorporate these tools into case-based teaching sessions of different class sizes in small-group breakout sessions. Participants completed an online survey following each workshop to evaluate the sessions. Results: A total of 18 and 26 subjects participated in the first and second workshops, respectively. Survey response rates were 100% (n = 18) and 65% (n = 17) for the first and second workshops, respectively. Both groups provided overall high ratings and reported that the workshop was clear, organized, and relevant. Participants were more familiar and comfortable with the use of various interactive tools for online teaching. Discussion: Distance online teaching will be increasingly required for an undetermined time. Faculty development efforts are crucial to facilitate effective interactive teaching sessions that engage learners and maximize learning. This virtual teaching workshop is a simple and straightforward way to introduce a more interactive format to virtual case-based teaching in the health professions.