Interprofessional peer-assisted learning for pharmacy and physical therapy students using inhalers and inhalation devices.

BACKGROUND: Peer-assisted learning (PAL) is exchanging knowledge between learners often from similar professional levels. Limited evidence exists on the effectiveness of PAL between different healthcare professions. The purpose of this study is to evaluate the knowledge, confidence, and perception of students engaged in an interprofessional PAL activity with pharmacy students instructing physical therapy students on the proper technique, cleaning/storage and therapeutic knowledge on inhaler devices for treatment of pulmonary conditions. METHODS: Pharmacy and physical therapy students completed a survey before and immediately after the PAL activity. As instructors, pharmacy students rated their experience with inhalers, their confidence if they were to assist clients on the use of inhaler devices and confidence in teaching peers. Physical therapy students completed surveys on inhaler knowledge with 10 scenario-based multiple-choice questions, and their confidence if they were to assist clients with inhaler devices. The knowledge questions were grouped into three categories: storage and cleaning of inhalers (3 questions), technique of using inhalers (4 questions), and therapeutic knowledge of drugs given by inhalation (3 questions). RESULTS: 102 physical therapy and 84 pharmacy students completed the activity and surveys. For the physical therapy students, the mean improvement of the total score for knowledge-based questions was 3.6 ± 1.8 (p < 0.001). The question with the fewest number of correct answers (13%) before the PAL activity had the highest number of correct answers post-activity (95%). Prior to the activity, no physical therapy students felt certain/very certain about their knowledge on inhalers, yet after PAL activity this proportion increased to 35%. The percent of pharmacy students reporting their confidence as "certain" and "very certain" in teaching peers increased from 46% before the activity to 90% afterwards. Pharmacy students rated the monitoring and follow-up of inhaler devices as the lowest expectation for physical therapists to play a role. Steps taken to prepare for this PAL activity were also discussed. CONCLUSIONS: Interprofessional PAL can increase knowledge and confidence of healthcare students reciprocally learning and teaching in joint activities. Allowing such interactions facilitate students to build interprofessional relationships during their training, which can increase communication and collaboration to foster an appreciation for each other's roles in clinical practice.

Psychometric validation of the Chinese patient- and family satisfaction in the intensive care unit questionnaires.

PURPOSE: To assess the psychometric properties of the Chinese version of the 23-item Patient Satisfaction in the Intensive Care Unit (PS-ICU-23) and 24-item Family Satisfaction in the Intensive Care Unit (FS-ICU-24) questionnaires. MATERIALS AND METHODS: Patients (n = 243) discharged from an intensive care unit (ICU) in Hong Kong and family members (n = 237) completed the translated questionnaires. We used confirmatory factor analysis to assess the construct validity and measurement equivalence across groups (gender, mechanical ventilation, casemix, length of stay in ICU), coefficient alpha for internal consistency (reliability) and concordance correlation coefficient (ρc) for agreement between patients' and family members' perspective on satisfaction. RESULTS: A three-factor model provided a better fit than the two-factor model for both PS-ICU-23 and FS-ICU-24 questionnaires. Factorial equivalence was present across groups in both questionnaires. Internal consistency was adequate for PS-ICU-23 (coefficient alpha overall domain 0.85; care subscale, 0.83; information subscale, 0.90; decision-making process subscale, 0.67) and for FS-ICU-24 (coefficient alpha overall scale 0.86; care subscale, 0.84; information subscale, 0.89; decision-making process subscale, 0.65). Overall ICU satisfaction agreement was moderate (0.40). CONCLUSIONS: Both Chinese PS-ICU-23 and FS-ICU-24 questionnaires have sound psychometric properties but family satisfaction may not be a good proxy for patient satisfaction in ICU.

Probability of bivariate superiority: A non-parametric common-language statistic for detecting bivariate relationships.

Researchers often focus on bivariate normal correlation (r) to evaluate bivariate relationships. However, these techniques assume linearity and depend on parametric assumptions. We propose a new nonparametric statistical model that can be more intuitively understood than the conventional r: probability of bivariate superiority (PBS). Our development of Bp, the estimator of a PBS relationship, extends Dunlap's (1994) common-language transformation of r (CLr) by providing a method to directly estimate PBS-the probability that when x is above (or below) the mean of all X, its paired y score will also be above (or below) the mean of all Y. Probability of superiority is an important form of bivariate relationship that until now could only be accurately estimated when data met the parametric assumptions for r. We specify the copula that forms the theoretical basis for PBS, provide an algorithm for estimating PBS from a sample, and describe the results of a Monte Carlo experiment that evaluated our algorithm across 448 data conditions. The PBS estimate, Bp, is robust to violations of parametric assumptions and offers a useful method for evaluating the significance of probability-of-superiority relationships in bivariate data. It is critical to note that Bp estimates a different form of bivariate relationship than does r. Our working examples show that a PBS effect can be significant in the absence of a significant correlation, and vice versa. In addition to utilizing the PBS model in future research, we suggest that this new statistical procedure be used to find theoretically important but previously overlooked effects from past studies.

Limited Usefulness of Capture Procedure and Capture Percentage for Evaluating Reproducibility in Psychological Science.

In psychological science, there is an increasing concern regarding the reproducibility of scientific findings. For instance, Replication Project: Psychology (Open Science Collaboration, 2015) found that the proportion of successful replication in psychology was 41%. This proportion was calculated based on Cumming and Maillardet (2006) widely employed capture procedure (CPro) and capture percentage (CPer). Despite the popularity of CPro and CPer, we believe that using them may lead to an incorrect conclusion of (a) successful replication when the population effect sizes in the original and replicated studies are different; and (b) unsuccessful replication when the population effect sizes in the original and replicated studies are identical but their sample sizes are different. Our simulation results show that the performances of CPro and CPer become biased, such that researchers can easily make a wrong conclusion of successful/unsuccessful replication. Implications of these findings are considered in the conclusion.

Probability-of-Superiority SEM (PS-SEM)-Detecting Probability-Based Multivariate Relationships in Behavioral Research.

In behavioral research, exploring bivariate relationships between variables X and Y based on the concept of probability-of-superiority (PS) has received increasing attention. Unlike the conventional, linear-based bivariate relationship (e.g., Pearson's correlation), PS defines that X and Y can be related based on their likelihood-e.g., a student who is above mean in SAT has 63% likelihood of achieving an above-mean college GPA. Despite its increasing attention, the concept of PS is restricted to a simple bivariate scenario (X-Y pair), which hinders the development and application of PS in popular multivariate modeling such as structural equation modeling (SEM). Therefore, this study addresses an empirical-based simulation study that explores the potential of detecting PS-based relationship in SEM, called PS-SEM. The simulation results showed that the proposed PS-SEM method can detect and identify PS-based when data follow PS-based relationships, thereby providing a useful method for researchers to explore PS-based SEM in their studies. Conclusions, implications, and future directions based on the findings are also discussed.

Effect size measures in a two-independent-samples case with nonnormal and nonhomogeneous data.

In psychological science, the "new statistics" refer to the new statistical practices that focus on effect size (ES) evaluation instead of conventional null-hypothesis significance testing (Cumming, Psychological Science, 25, 7-29, 2014). In a two-independent-samples scenario, Cohen's (1988) standardized mean difference (d) is the most popular ES, but its accuracy relies on two assumptions: normality and homogeneity of variances. Five other ESs-the unscaled robust d (d r* ; Hogarty & Kromrey, 2001), scaled robust d (d r ; Algina, Keselman, & Penfield, Psychological Methods, 10, 317-328, 2005), point-biserial correlation (r pb ; McGrath & Meyer, Psychological Methods, 11, 386-401, 2006), common-language ES (CL; Cliff, Psychological Bulletin, 114, 494-509, 1993), and nonparametric estimator for CL (A w ; Ruscio, Psychological Methods, 13, 19-30, 2008)-may be robust to violations of these assumptions, but no study has systematically evaluated their performance. Thus, in this simulation study the performance of these six ESs was examined across five factors: data distribution, sample, base rate, variance ratio, and sample size. The results showed that A w and d r were generally robust to these violations, and A w slightly outperformed d r . Implications for the use of A w and d r in real-world research are discussed.

Interprofessional Peer Teaching of Pharmacy and Physical Therapy Students.

OBJECTIVE: To evaluate an interprofessional peer-teaching activity during which physical therapy students instructed undergraduate pharmacy students on 3 ambulatory devices (canes, crutches, walkers). DESIGN: The pre/post evaluation of 2 pharmacy undergraduate classes included 220 students, 110 per year. After pharmacy students completed a 10-point, knowledge-based pretest, they participated in a hands-on activity with physical therapy students teaching them about sizing, use, and safety of canes, crutches, and walkers. A 10-point posttest was completed immediately afterward. ASSESSMENT: The mean difference of pre/post scores was 3.5 (SD 1.9) for the peer-led teaching, and 3.8 (SD 2.2) for the peer learning group. Students had positive responses regarding the learning exercise and recommended further peer teaching. CONCLUSION: The peer-learning activity involving physical therapy students teaching pharmacy students was an effective method of improving knowledge and skills regarding basic ambulatory devices.

Bootstrap confidence intervals for the mean correlation corrected for Case IV range restriction: a more adequate procedure for meta-analysis.

In this study, we proposed to use the nonparametric bootstrap procedure to construct the confidence interval for the mean correlation r corrected for Case IV range restriction in meta-analysis (i.e., ; Hunter, Schmidt, & Le, 2006). A comprehensive Monte Carlo study was conducted to evaluate the accuracy of the parametric confidence interval and 3 nonparametric bootstrap confidence intervals for r(c4). Of the 4 intervals, our results showed that the bootstrap bias-corrected and accelerated percentile interval (BCaI) yielded the most accurate results across different data situations. In addition, the mean-corrected correlation r(c4) was found to be more accurate than the uncorrected estimate. Implications of the mean-corrected correlation r(c4) and BCaI in organizational studies are also discussed.

Bootstrap standard error and confidence intervals for the correlations corrected for indirect range restriction.

The standard Pearson correlation coefficient, r, is a biased estimator of the population correlation coefficient, ρ(XY) , when predictor X and criterion Y are indirectly range-restricted by a third variable Z (or S). Two correction algorithms, Thorndike's (1949) Case III, and Schmidt, Oh, and Le's (2006) Case IV, have been proposed to correct for the bias. However, to our knowledge, the two algorithms did not provide a procedure to estimate the associated standard error and confidence intervals. This paper suggests using the bootstrap procedure as an alternative. Two Monte Carlo simulations were conducted to systematically evaluate the empirical performance of the proposed bootstrap procedure. The results indicated that the bootstrap standard error and confidence intervals were generally accurate across simulation conditions (e.g., selection ratio, sample size). The proposed bootstrap procedure can provide a useful alternative for the estimation of the standard error and confidence intervals for the correlation corrected for indirect range restriction.

Psychometric properties of the Spence Children's Anxiety Scale in a Hong Kong Chinese community sample.

This study evaluated the psychometric properties of a widely used self-report anxiety scale-the Spence Children's Anxiety Scale (SCAS) and the associated parent-report version (PSCAS)-in a Hong Kong Chinese community sample. While good psychometric properties of SCAS and PSCAS had been documented in Western cultural contexts (e.g., Australia), no systematic psychometric evaluation of the Chinese-translated SCAS and PSCAS has been published. In this study, psychometric properties of SCAS and PSCAS were examined with respect to four criteria: (a) factor structure, (b) descriptive statistics, (c) convergent validity with an anxiety cognition measure, and (d) internal consistency. Psychometric properties of SCAS and PSCAS for a Chinese community sample were found to be highly comparable with those published on Australian samples, thus providing a solid conceptual foundation for use of the Chinese version of SCAS and PSCAS.

Effectiveness of group cognitive-behavioral treatment for childhood anxiety in community clinics.

This study evaluated the effectiveness of cognitive-behavioral treatment for childhood anxiety in a community clinic setting in Hong Kong, China. Forty-five clinically-referred children (age 6-11 years) were randomly assigned to either a cognitive-behavioral treatment program or a waitlist-control condition. Children in the treatment condition showed significant reduction in anxiety symptoms-both statistically and clinically-whereas children in the waitlist condition did not. After the waitlist period was over, the control group also received the treatment program and showed a similar reduction in symptoms. For the full sample of 45 children, the effectiveness of the intervention was significant immediately after treatment and in 3- and 6-month follow-ups. In addition, children's anxiety cognition and their ability to cope with anxiety-provoking situations fully mediated the treatment gains. These results offer empirical support for cognitive-behavioral treatment programs in a non-Western cultural context and plausible mediators for how cognitive-behavioral therapy works.