Reimagining rural clinical education from lessons learnt during COVID.

BACKGROUND: Securing access to sufficient and focussed learning experiences is a perennial challenge for medical trainees. This challenge was accentuated during the COVID-19 pandemic lockdowns and with physical isolation processes that decreased in-person patient presentations and a shift to telehealth consultations. This situation has prompted the need to optimise the available experiences and educational responses to overcome the limitations in the number, quantum and range of available clinical learning experiences. METHODS: Semi-structured interviews were conducted with medical practice teams in four rural general practices to understand how medical trainees' education in rural general practices can be sustained in such circumstances. FINDINGS: Key considerations included optimising the available experiences to assist medical trainees to generate the kinds of mental models needed by trainees to conduct medical work, and particularly, when it became even more restricted through remote or physically distanced consultations. It also identified lessons learnt during COVID-19 pandemic lockdowns to inform and improve the provision of trainees' experiences in such practices. DISCUSSION: Providing experiences for trainees to participate fully in clinical activities is imperative. A sequenced set of experiences was proposed to incrementally prepare trainees to engage in and conduct clinical consultations remotely using digital technologies. CONCLUSION: Such an approach may not always be easy or possible to enact but offers a pathway of experiences most likely to lead to positive outcomes for the trainees whilst maintaining patient care and safety considerations.

Learning tools used to translate resilience in healthcare into practice: a rapid scoping review.

BACKGROUND: Historically, efforts to improved healthcare provisions have focussed on learning from and understanding what went wrong during adverse events. More recently, however, there has been a growing interest in seeking to improve healthcare quality through promoting and strengthening resilience in healthcare, in light of the range of changes and challenges to which healthcare providers are subjected. So far, several approaches for strengthening resilience performance have been suggested, such as reflection and simulation. However, there is a lack of studies that appraise the range of existing learning tools, the purposes for which they are designed, and the types of learning activities they comprise. The aim of this rapid scoping review is to identify the characteristics of currently available learning tools designed to translate organizational resilience into healthcare practice. METHODS: A rapid scoping review approach was used to identify, collect, and synthesise information describing the characteristics of currently available learning tools designed to translate organizational resilience into healthcare practice. EMBASE and Medline Ovid were searched in May 2022 for articles published between 2012 and 2022. RESULTS: The review identified six different learning tools such as serious games and checklists to guide reflection, targeting different stakeholders, in various healthcare settings. The tools, typically, promoted self-reflection either individually or collaboratively in groups. Evaluations of these tools found them to be useful and supportive of resilience; however, what constitutes resilience was often difficult to discern, particularly the organizational aspect. It became evident from these studies that careful planning and support were needed for their successful implementation. CONCLUSIONS: The tools that are available for review are based on guidelines, checklists, or serious games, all of which offer to prompt either self-reflection or group reflections related to different forms of adaptations that are being performed. In this paper, we propose that more guided reflections mirroring the complexity of resilience in healthcare, along with an interprofessional collaborative and guided approach, are needed for these tools to be enacted effectively to realise change in practice. Future studies also need to explore how tools are perceived, used, and understood in multi-site, multi-level studies with a range of different participants.

First-in-class trispecific VHH-Fc based antibody with potent prophylactic and therapeutic efficacy against SARS-CoV-2 and variants.

SARS-CoV-2 and its variants have persisted in this ongoing COVID-19 pandemic. While the vaccines have greatly reduced the COVID-19 cases, hospitalizations, and death, about half of the world remain unvaccinated due to various reasons. Furthermore, the duration of the immunity gained from COVID-19 vaccination is still unclear. Therefore, there is a need for innovative prophylactic and treatment measures. In response to this need, we previously reported on the successful computer-aided development of potent VHH-based multispecific antibodies that were characterized in vitro. Here, we evaluated in vivo efficacy and safety of the lead trispecific VHH-Fc, ABS-VIR-001. Importantly, our data showed that ABS-VIR-001 treatment prevented SARS-CoV-2 infection and death when provided as an intranasal prophylaxis in a humanized ACE-2 mouse model. In addition, ABS-VIR-001 post-exposure treatment was shown to greatly reduce viral loads by as much as 50-fold. A detailed panel of metabolic and cellular parameters demonstrated that ABS-VIR-001 treatment was overall comparable to the PBS treatment, indicating a favorable safety profile. Notably, our inhibition studies show that ABS-VIR-001 continued to demonstrate unwavering efficacy against SARS-CoV-2 mutants, associated with key variants including Delta and Omicron, owing to its multiple epitope design. Lastly, we rigorously tested and confirmed the excellent thermostability of ABS-VIR-001 when heated to 45 °C for up to 4 weeks. Taken together, our study suggests that ABS-VIR-001 is an efficacious and durable prophylaxis and post-exposure treatment for COVID-19 with promising safety and manufacturability features for global distribution.