Teaching and Learning in an Active Learning Classroom: A Mixed-Methods Empirical Cohort Study of Dental Hygiene Students.

The aim of this study was to discover how an active learning classroom (ALC) influenced the teaching and learning of dental radiology with dental hygiene students through a mixed-methods approach. A year-long observation of a dental hygiene professor who was teaching two consecutive courses in an ALC was conducted in 2015-16. Nineteen classes were recorded and transcribed, and observational notes on classroom activities were taken. Towards the end of the academic year, the professor was interviewed with use of a 13-question guide, and the students were surveyed with a 25-question survey. Moreover, five-year grades in the same two courses, including four-year historical grades earned in the traditional classrooms (TCs) and one year from the ALC, were collected along with demographic and prior academic performance data. Thirty-two of the 38 students responded to the survey, for a response rate of 84%. The results showed that 63% of the students preferred to take classes in the ALC rather than TC. They especially enjoyed the ALC's spaciousness, mobility, unobstructed views, and ease of information-sharing and engagement in class. However, the ALC presented both the faculty and students with sensory and technique challenges. The analysis of students' grades suggested that GPA was one of the strongest predictors for both courses' final grades in the TCs but had weaker predicting significance in the ALC setting. Overall, the majority of students enjoyed taking classes in the ALC due to its physical charm and dynamic collaboration. Sensory and technique challenges coexisted with benefits.

The Educational Psychology of Clinical Training.

Clinical training is paramount to the educational experience of learners, and the purpose of this training can be categorized into the following 4 categories of learning taxonomies: socialization, clinical reasoning, medical management of patient care and attitudinal change. This article investigates the educational psychology that provides the foundation of the categories of learning that take place in the clinical environment. Understanding this is critically important to create an opportunity for learners to activate their knowledge repertoire at the precise time of appropriate application.

Impact of Operator Positioning on Musculoskeletal Disorders and Work Habits Among Mississippi Dental Hygienists.

Purpose: The purpose of this study was to assess impact of operator positioning on the development of musculoskeletal disorders (MSDs) and workforce issues among practicing dental hygienists in the state of Mississippi.Methods: The sample consisted of all dental hygienists (n=1,553) licensed in the state of Mississippi. A modified 47 item, online version of the Standardized Nordic Questionnaire was used to document the following: types of MSDs, practice history, operator positioning, ergonomic work habits and the impact of MSDs on workforce issues. Descriptive statistics were used to analyze practice history and work habits. Chi-square analysis examined the relationship between operator positioning and MSDs as well as the relationship between the onset of MSDs and their impact on patient workload, work hours, time off from work, and ability to practice clinical dental hygiene. Survival analyses were used to test the onset of MSDs in relationship to operator positioning.Results: The survey yielded a 22% (n=338) response rate. There was no significant difference in the prevalence of MSDs between those sitting in front of the patient as compared to those sitting behind the patient (PL) (χ2 (1) = 1.67, p=0.196), although respondents sitting behind the patient reported developing their MSDs earlier (χ2 (1) = 3.92, p=0.048). Of the participants who had practiced 15 or more years, 85% reported developing MSDs. However, only 13% reported ever having to modify their patient load. Sixteen percent reported reducing work hours and 21% reported taking time off from work due to MSDs.Conclusions: Regardless of the operator position used, the majority of practicing dental hygienists surveyed developed MSDs earlier than has been previously reported in the literature. Workforce related issues were not shown to have a negative impact on this study population.

It's all in the lens: differences in views on obesity prevention between advocates and policy makers.

BACKGROUND: Intervention strategies to reduce obesity include policy and environmental changes that are designed to provide opportunities, support, and cues to help people develop healthier behaviors. Policy changes at the state level are one way to influence access, social norms, and opportunities for better nutrition and increased physical activity among the population. METHODS: Ten states were selected for a broad variance in obesity rates and number of enacted obesity prevention policies during the years of 2006-2009. Within the selected states, a purely qualitative study of attitudes of childhood obesity policy using semistructured telephone interviews was conducted. Interviews were conducted with state policy makers who serve on public health committees. A set of six states that had more than eight childhood obesity policies enacted were selected for subsequent qualitative interviews with a convenience sample of well-established advocates. RESULTS: Policy makers in states where there was more childhood obesity policy action believed in the evidence behind obesity policy proposals. Policy makers also varied in the perception of obesity as a constituent priority. The major differences between advocates and policy makers included a disconnect in information dissemination, opposition, and effectiveness of these policies. CONCLUSIONS: The findings from this study show differences in perceptions among policy makers in states with a greater number of obesity prevention bills enacted. There are differences among policy makers and advocates regarding the role and effectiveness of state policy on obesity prevention. This presents an opportunity for researchers and practitioners to improve communication and translation of evidence to policy makers, particularly in states with low legislation.

Providing healthcare to evacuees in the wake of a natural disaster: opportunities to improve disaster planning.

BACKGROUND: The impending landfall of Hurricane Katrina on the Mississippi Gulf Coast resulted in large numbers of evacuees into the Jackson, Mississippi area. Many evacuees with chronic medical problems had been directed to the Mississippi Coliseum in the downtown area near the University of Mississippi Medical Center. As the storm passed through Jackson, serious damage occurred to the municipal infrastructure. In this article, we asked how that experience has affected health planning for the care of sheltered populations. METHODS: We reviewed the information accumulated in the course of operating a large medical clinic for evacuees at the Mississippi Coliseum. We also contacted representatives of disaster planning agencies and of healthcare planning organizations to determine changes that have occurred in strategic plans subsequent to Katrina. RESULTS: Using the resources of our academic health center, we were able to effectively deliver healthcare to sheltered evacuees. A model has been developed for future use from this experience. Much progress has been made toward preparation for care of the chronically-ill who may be displaced by future disasters. CONCLUSION: Hospitals and clinics on major evacuation routes for natural disasters can expect the sudden necessity to provide care to evacuees. Unless plans to care for chronically-ill individuals are incorporated into hospital disaster plans, local healthcare facilities may be unprepared to provide care. Many evacuees will have limited resources to pay for services. Academic medical centers have unique resources and capabilities to lead in the care plans for these populations.

The pharmacist-physician relationship in the detection of ambulatory medication errors.

BACKGROUND: Expenditures on outpatient prescription drugs have increased enormously in the last decade. Despite this growth in expenditures, prescription medication safety in the ambulatory setting is lacking. Prior research in outpatient care has centered around the physician-patient encounter. What remains unexamined in the ambulatory care literature is the pharmacist's role as interceptor, detector, and reporter of medication errors to the physician. METHODS: Data about the role, responsibilities, and expectations to inform physicians about this subject were collected from pharmacist (N = 30) and patient (N = 31) focus groups conducted between July 2002 and July 2003. Pharmacists in outpatient practices and patients were randomly selected from the state licensure database and the Jackson Metropolitan phonebook, respectively. ANALYSIS: Grounded theory provided the perspective on which data were interpreted. Data patterns were linked using key words and phrases for theme analysis. Arbitration between coders resulted in an inter-rater reliability of 0.85. RESULTS: : Three complementary patterns were identified from the data: 1) patients likely see multiple physicians and only one pharmacist; 2) patients are more likely to report medication errors to the pharmacist than to the physician; and 3) pharmacists are the final interceptors, detecting medication errors before they reach patients. CONCLUSIONS: Ambulatory pharmacists are in a privileged position to gather data regarding adverse responses to prescribed medication or incidents of medication mishaps. The failure of pharmacists to report information back to physicians is a missed opportunity to improve patient safety.

Improving patient safety through information technology.

Health information technology (HIT) is generally accepted as the solution for the nation's medical error crisis. Although limited studies suggest the importance of using HIT in the process of medication management, research has failed to adequately describe how HIT actually works in capturing medication error data and improving patient safety within a healthcare system.1-3 The aim of our study is to identify essential elements in the adoption of technology within the broader context of system change and workflow modification. Using the adoption of an electronic reporting system to improve patient safety, we examine the role of this technology within process improvement, culture, and workflow.