Student-led interprofessional global health course: learning impacts during a global crisis.

BACKGROUND: This study assesses the impact of the Interprofessional Global Health Course (IPGHC) on students' fundamental global health knowledge and personal viewpoints on global health domains. It explores the evolution of students' understanding of global health specifically in relation to the COVID-19 pandemic. METHODS: Ninety-nine students were selected from 123 McGill student applicants based on their motivation and commitment to take part in IPGHC's ten-week 2020 curriculum. These IPGHC students were eligible to participate in the study. The study's design is sequential explanatory mixed methods. The cross-sectional survey (quantitative phase) appraises students' global health learning outcomes using pre- and post-course surveys, with the use of 5-point Likert-scale questions. The descriptive qualitative survey (qualitative phase) further explores the impact of IPGHC on student's understanding of global health and the reflections of students on the COVID-19 pandemic after IPGHC. The post-course survey included a course evaluation for quality improvement purposes. RESULTS: Of the 99 students, 81 students across multiple undergraduate and graduate disciplines participated in the study by completing the course surveys. Mean knowledge scores of the following 11 global health topics were increased between pre- and post-course survey: Canadian Indigenous health (P < 0.001), global burden of disease (P < 0.001), global surgery (P < 0.001), infectious diseases and neglected tropical diseases (P < 0.001), refugee and immigrant health (P < 0.001), research and development of drugs (P < 0.001), role of politics and policies in global health (P = 0.02), role of technology in global health (P < 0.001), sexual violence (P < 0.001), systemic racism in healthcare (P = 0.03), and trauma in the global health context (P < 0.001). A positive change in student viewpoints was observed in response to questions regarding their perception of the importance of global health education in their own professional health care programs (P < 0.001), and their understanding of the roles and responsibilities of other healthcare professionals (P < 0.001). In the post-course survey open-ended questions, students exemplified their knowledge gained during the course to create a more informed definition of global health. Several recurring themes were identified in the student reflections on the COVID-19 pandemic, notably policy and politics, followed by access to healthcare and resources. CONCLUSION: This study emphasizes the need for interprofessional global health education at the university level and demonstrates how rapidly global health learners can apply their knowledge to evolving contexts like the COVID-19 pandemic.

Delays in Discharge in Neuro-Oncology: Using a Lean Six Sigma-Inspired Approach to Identify Internal Causes.

Discharge planning processes have implications for patients and families, healthcare providers, and organizations at large. As such, delays in discharge may result in suboptimal patient outcomes, increased resource utilization, and overall disruptions to patient flow. A quality improvement project was conducted using a Lean Six Sigma approach to identify internal causes of delays in discharge in newly diagnosed patients with a high grade glioma on a neurosurgical unit. Internal causes of delays in discharge were related to communication. The main subthemes were multidisciplinary rounds, incongruent messages being delivered to patients and families, and discrepancies between team members resulting in unclear plans. Findings from this project may be used to promote more effective communication that will facilitate safe and timely discharge for neuro-oncology patients.

Pseudoprogression: Patient experience and nursing in uncertainty.

Glioblastoma Multiforme (GBM) is the most common primary brain malignancy in humans and has a limited survival (median of 14.6 months). The goal of treatment is supportive rather than curative. Patients with a GBM struggle with uncertainty related to the illness trajectory. This uncertainty is compounded when possible progression is noted on imaging. Pseudoprogression (PsP) is an early treatment-related effect where there are apparent imaging changes suggesting progression, which then improve or stabilize through time. This paper provides a review of the literature on PsP in patients with high-grade gliomas. Insights in the patient and family experience of PsP will be informed by Mishel's Uncertainty in Illness Theory, research on patients' and families' neuro-oncology experience, and the author's nursing practice. Nursing implications will be proposed.