How Has High School Learned from the Global Pandemic?

The study focuses on the consequences of the pandemic for the further development of higher education. The purpose of the article is to summarize the main consequences of the pandemic, which have become the result of scientific analysis and the object of many scientific studies. These are the degree of students' satisfaction with online learning, technological readiness of universities, the impact of new learning conditions on the psychological and emotional sphere, the problem of cheating at examinations, the problem of quality of education. Analysis of studies shows that in the academic environment there are different estimates of the pandemic period, sometimes they are of opposite nature. In spite of possibilities of online education universities tend to return to the full-time form of education. The study emphasizes that there are long-term consequences of the pandemic that are on the periphery of researchers' attention. These are the legal and economic consequences for universities, as the online form of learning has acquired a different legal status. In addition, the introduction of online learning is inevitably associated with additional hardware and software costs. Another important consequence is the impact of the pandemic on academic culture. Under the pandemic, students were isolated from the traditional academic environment, which affected the transformation of social rituals and academic ethics. Academic Values. Since there has been no complete return to previous conditions and the threat of a global pandemic exists, the new experience is integrated into the existing system of academic values and serves as a trigger for change in the long term.

An online training and feedback module enhances the musculoskeletal examination performance of medical interns.

BACKGROUND: Pathologies of the locomotor system are frequent and can cause disability and impact the quality of life of the people affected. In recent years, online training and feedback have emerged as learning tools in many fields of medicine. OBJECTIVE: This study aims to evaluate medical interns' musculoskeletal examination performance after completing an online training and feedback module. METHODS: This study employed a quasi-experimental design. Medical interns were invited to complete a 4-week musculoskeletal physical examination training and feedback module via an e-learning platform. The course included written and audiovisual content pertaining to medical history, physical examination, and specific tests for the diagnosis of the most common knee, spine, shoulder, ankle, and foot conditions. Before and after completing the module, their ability to perform the physical examination was evaluated using an objective structured clinical examination (OSCE) with simulated patients that took place face-to-face. A control group of experts was assessed using the OSCE, and their performance was compared to that of the interns before and after the training. At the end of the module feedback on the OSCE was provided to participants through the platform asynchronously and two evaluation questions about the user experience were conducted at the end of the study. RESULTS: A total of 35 subjects were assessed using the OSCE, including 29 interns and 6 experts. At the beginning of the training module, the group of interns obtained an average score of 50.6 ± 15.1. At the end of the module, 18 interns retook the OSCE, and their performance increased significantly to an average of 76.6 ± 12.8 (p < 0.01). Prior to the training, the experts performed significantly better than the interns (71.2 vs. 50.6; p = 0.01). After the interns received the training and feedback, there were no significant differences between the two groups (71.2 vs. 76.6; p = 0.43). Two evaluation questions were conducted at the end of the study, revealing that 93% of the participants affirm that the training module will be useful in their clinical practice, and 100% of the participants would recommend the training module to a colleague. CONCLUSION: The online training and feedback module enhances the musculoskeletal examination performance of medical interns.

The Use of Tele-Education in Medicine, During and Beyond the COVID-19 Pandemic: A Commentary.

Coronavirus disease 2019 (COVID-19), a disease caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged initially as an isolated illness in December 2019 and later progressed to a global pandemic. Hard-hit areas were lockdown, massively disrupting medical education activities. Tele-education, previously used as a means of long-distance education emerged as a solution in the field of medical education. Tele-rotations for medical students, journal clubs and lectures via Microsoft teams, medical conferences via zoom, residency, and fellowship interviews online, all emerged during this pandemic. Some medical students and trainees found it enjoyable, cost-effective, time saving, feasible, unbiased, and preferred mode of education. Challenges related to supervision, availability, affordability, diminished communication, disturbance of streaming, or distractions due to environment. Tele-education has had a boom in the era of COVID-19. Research is needed further on effective mentoring and supervision of trainees via tele educational teaching models.

An Approach to the Design and Development of an Accredited Continuing Professional Development e-Learning Module on Virtual Care.

Unlabelled: Virtual care appointments expanded rapidly during COVID-19 out of necessity and to enable access and continuity of care for many patients. While previous work has explored health care providers' experiences with telehealth usage on small-scale projects, the broad-level adoption of virtual care during the pandemic has expounded opportunities for a better understanding of how to enhance the integration of telehealth as a regular mode of health care services delivery. Training and education for health care providers on the effective use of virtual care technologies are factors that can help facilitate improved adoption and use. We describe our approach to designing and developing an accredited continuing professional development (CPD) program using e-learning technologies to foster better knowledge and comfort among health care providers with the use of virtual care technologies. First, we discuss our approach to undertaking a systematic needs assessment study using a survey questionnaire of providers, key informant interviews, and a patient focus group. Next, we describe our steps in consulting with key stakeholder groups in the health system and arranging committees to inform the design of the program and address accreditation requirements. The instructional design features and aspects of the e-learning module are then described in depth, and our plan for evaluating the program is shared as well. As a CPD modality, e-learning offers the opportunity to enhance access to timely continuing professional education for health care providers who may be geographically dispersed across rural and remote communities.

Continuing Educational Program in Nursing Informatics for Greek Nurses.

Nurses are required to adapt to a complex and rapidly evolving environment that incorporates new IT technologies. Continuing, lifelong learning, especially in the fast-growing fields of Nursing Informatics, eHealth and related Information and Communication Technologies, is vital to the professionalism of nurses. The study presents the curriculum development and implementation of the educational project entitled "Training of Nurses in Nursing Informatics and Information and Communication Technologies (ICT)" which has been designed and offered to Greek nurses as a continuing - lifelong online educational program by the Health Informatics Laboratory of the National and Kapodistrian University of Athens. The training material was created in three modules and 29 sub-modules, considering the new advancements and recommended competencies, necessary for the nurse, in the fields of Nursing Informatics and ICT. So far, eight training cycle courses have been offered to 1388 nurses, free of charge. Each course integrates synchronous and asynchronous distance learning methods and requires a workload of 70 hours over 10 weeks. The initial evaluation of the course by the participants, concerning its effectiveness, usefulness, and innovation are very encouraging.

The impact of gender, psychology, and cultural dimensions on leadership development in distance education.

The research purpose is to evaluate the effectiveness of leadership in the process of distance learning from the perspective of the psychological theories of leadership, gender, and cross-cultural issues. The present research is based on such methods as surveys, testing, quantitative and qualitative analysis, and statistical data processing. The subjective (the experience of the respondents) and objective (machine calculation of clusters) assessments allowed the scholars to generate more arguments on leadership in the learning process. The sample consisted of 600 female and male students (300 from each sex, respectively) aged 18-20 years from Abu Dhabi University, American University in The Emirates, and the United Arab Emirates University. The research stated that the majority of students, regardless of gender, suppose that both sexes can develop similar leadership traits (80%). The research claims that female leaders have to be more dynamic and demonstrate higher intelligence (26% vs. 20%) and confidence (20% vs. 15%) than male leaders. Cultural and socio-demographic characteristics do not play a significant role in leadership development (10%). The main cause for the choice of a leader is behavioural and communication characteristics (50%) as well as personal qualities (35%). These results can be used for the online design of distance learning courses in universities (both group and individual), as well as for psychologists to study the aspect of individuals' predisposition to leadership. It makes sense for further research to explore the issue of differences in the perception of educational leadership in Asian and Western European countries based on the cross-cultural aspect, that is, the influence of national culture on the choice of leader in the educational environment.

The quality of distance learning during COVID-19: Perspectives of Saudi university students.

Education has rapidly shifted into distance learning after the onset of the COVID-19 pandemic. Students with varying learning levels from Saudi Arabian universities started online lessons through programs and applications. Supporters and opponents of distance learning have different opinions about distance education. In this context, this study focused on actual quality standards of distance learning and identified five axes of education quality to improve learning and develop technical tools for learning. The findings of the study are relevant to the specific context of the crisis and aim to meet international quality standards. We adopted the social survey method using the five axes. A questionnaire and a study sample of 1240 respondents from 42 universities and colleges were used. The data determined the level of quality of distance education and the extent to which students benefit from it. The interactive axis achieved the highest average rating, whereas the evaluation axis achieved the lowest average rating. Furthermore, the study shows that students agreed that distance education was useful during the pandemic, but it is less effective than face-to-face learning, and they value the elements of live lessons and interactions. These findings can be used to develop teaching practices in distance learning through the adoption of technology in line with global trends; through the use of learning to overcome difficulties; through open, unlimited areas of learning during crises; and through the development and activation of these dynamics. These outcomes can deliver higher results at a desired scientific level.

Exploring the factors that influence academic performance in Jordanian higher education institutions.

Since the coronavirus 2019 (COVID-19) pandemic hit the world, many universities have used digital asynchronous learning tools such as Digital Learning Management Systems (DLMS) to continue the educational process. Despite its global usage, only a few studies have investigated its quality in the Jordanian context during the COVID-19 period from a quantitative and qualitative approach perspective. Thus, the current study aims to explore the factors that influence academic performance in Jordanian higher education institutions during the COVID-19 pandemic. A mixed methods research approach was employed to evaluate the quality of the teaching-learning process for Jordanian students in higher education institutions. The triangulated data focused on three core pillars namely if students saw a difference in their grades prior to, during, and after the pandemic, the challenges faced and improvement suggestions. Accordingly, the quantitative approach with an online questionnaire and the qualitative approach with structured interviews were applied to collect the required data from Jordanian students in higher education institutions. The results of the current study revealed that the evaluation of the teaching-learning process quality during the pandemic period affected students' academic performance in different proportions based on their specialization area. In addition, the study results also identified the most important challenges that faced the students during this period and suggested procedures to overcome them and improve the distance learning process. The current study offers empirical evidence on critical success factors underlying digital learning management systems in the COVID-19 era, which can help policymakers in Jordanian universities and the ministry of higher education and scientific research to improve the quality of the teaching-learning process in the Jordanian context.

Virtual Education in Urogynecology: Enhancing Understanding and Management of Pelvic Fistulas.

Introduction: Pelvic fistulas affect a significant number of patients globally, with a relatively low prevalence in the United States. Virtual education offers an effective, scalable solution to bridge this educational gap and lead to a deeper understanding of more common conditions, such as urinary and fecal incontinence. Methods: We developed two virtual cases on rectovaginal and vesicovaginal/ureterovaginal fistulas to enhance medical students' exposure, knowledge, and confidence regarding assessment of pelvic fistulas. The cases could be completed in approximately 30 minutes, asynchronously, and at students' own pace. The cases were integrated into an OB/GYN clerkship. We conducted a survey among students receiving the cases to gather feedback on usability, acceptability, and educational value, which guided subsequent improvements. Results: Forty medical students, ranging from first to third year, participated in the urogynecology elective; 21 (53%) completed the survey. Ninety-one percent agreed or strongly agreed they were satisfied with the cases. All respondents found the format easy to use and appropriate for their level of learning. Most reported the cases improved their confidence in nonsurgical and surgical management options for pelvic fistulas. Discussion: Offering virtual and interactive patient cases on e-learning platforms represents an innovative approach to increasing clinical exposure to urogynecologic disorders. By providing medical students with the opportunity to interact with pelvic fistulas virtually, these cases can help bridge a gap in clinical education. Future exploration is valuable for examining knowledge deficiencies and developing cost-effective, self-paced, easily accessible educational resources to advance medical training and optimize patient care.

Evaluation and Assessment of the ABATE Framework to Enhance Implicit Bias Training for Virtual Interviews in Medical Schools.

Introduction: The influence of implicit biases in virtual interviews must be addressed to ensure equity within the admissions process. ABATE is a mnemonic framework of five specific categories of implicit bias (affinity-based, backdrop-based, appearance-based, technology and media-based, and enunciation-based biases) that should be anticipated and mitigated for faculty, staff, health professionals, and medical students who conduct virtual interviews at medical schools. Methods: A 60-minute workshop was developed to educate medical school admissions interviewers about the ABATE model and strategies to mitigate implicit bias during virtual interviews. Four workshops were held over 1 year totaling 217 individual attendees. The workshops were evaluated using a single-group, pre-post questionnaire designed with the Kirkpatrick evaluation model. Results: Attendees reported that they found the ABATE workshop useful and relevant to improving their ability to minimize implicit bias during virtual interviews. Significant improvements were found in attendee reactions to the utility of implicit bias training (M pre = 2.6, M post = 3.1, p = .002). Significant changes were also reported in attendees' attitudes about interviewing confidence (M pre = 3.0, M post = 3.2, p = .04), bias awareness (M pre = 3.0, M post = 3.4, p = .002), and identifying and applying bias mitigation solutions (M pre = 2.5, M post = 3.0, p = .003). Knowledge specific to backdrop-based biases also significantly increased (M pre = 3.2, M post = 3.4, p = .04). Discussion: The ABATE workshop demonstrates promise in mitigating implicit bias in virtual medical school interviews.

Building Interprofessional Competencies Through a Collaborative Prescribing Activity With Osteopathic, Pharmacy, and Physician Assistant Students.

Introduction: Medication errors can lead to significant adverse events. Nearly 50% of medication errors occur during the prescription-writing stage of the medication use process, and effective interprofessional collaboration and communication are key to reducing error in this process. Methods: We developed a three-part, 60-minute, interprofessional education activity providing medical, physician assistant, and pharmacy students the opportunity to practice collegial interprofessional communication surrounding prescribing practices. Learners met virtually initially as a large group and divided into small groups facilitated by a health professional. Part 1 involved reviewing two prescriptions prepared by learners; part 2 was a discussion about the education, roles, and responsibilities of each profession; and part 3 focused on identifying prescription errors in examples provided by faculty. Students completed a post-pre survey measuring their perception of learning the Interprofessional Collaborative Competency Attainment Survey (ICCAS) areas. Results: Of 317 participants (151 doctor of osteopathy, 68 master of physician assistant studies, and 98 doctor of pharmacy students), 286 completed the post-pre survey, for a 90% response rate. Students reported statistically significant (p < .001) increases in all 20 questions spanning the six ICCAS areas. Discussion: The virtual format allowed multiple institutions to participate from various locations. It broadened the learners' experience by fostering interaction among those with varied perspectives and allowed collaboration between locations and programs that otherwise could not have participated. The activity introduced students to virtual collaboration and key telehealth skills, enhancing their confidence and familiarity with virtual interactions in a professional setting.

Mental well-being of children and adolescents during COVID-19: evidence from the Italian context and possible future developments.

The article aims to discuss the increased emergence of mental health problems among children and adolescents, as an outcome of the COVID-19 pandemic.The results of a research study conducted among various professionals, such as psychiatrists and psychologists specialized in childhood and adolescence, are presented. The study, which uses both qualitative and quantitative methods, investigates the main consequences of the physical social distancing measures undertaken by the Italian government during the pandemic. The results are in line with the main evidence highlighted by international research and underline the particularly negative effects of the pandemic emergency on the mental health of minors. It reports how the limitation of intersubjective relationships and the forced digitalization of relationships has triggered or caused the emergence of multiple and varied disorders of the psyche, also linked to the area of reference (e.g., metropolitan, urban o remote areas), the socio-economic and cultural fragility of families, as well as the presence of previous mental issues within them. Finally, the research emphasizes how the understanding and management of the psychic health of these population groups, also from a health organization point of view, will be crucial to address the medium and long-term effects of such emerging issues among younger cohorts.

Designing an online course using an EXD model: A case of Human-Computer Interaction undergraduate course.

Designing an online course is a complex and resource-intensive activity with a focus on pedagogical and technological aspects. One approach is the e-learning experience design (EXD) model, which combines user-experience design concepts, such as agile methodology and design thinking. This study aimed to design a website and activities for an undergraduate human-computer interaction (HCI) online course based on the EXD model and analyze the students' learning experiences. The students' experiences were captured from two online surveys opened during the first weeks (n = 94 students) and at the end of the semester (n = 93). The surveys utilized the e-Learning Usability Questionnaire (EUS) and asked for suggestions to improve the course delivery. In addition, the students rated their experience in pain points when participating in the course. The findings show that adopting the EXD model for an online course design and implementing some design best practices can promote students' positive attitudes toward the course. The contributions of this study include an example of how an online course can be designed using the EXD model and a description of its effects on student attitudes.

Leveraging technology to improve access to medical education in anatomy and physiology in resource-limited settings: A mixed methods study.

This study assesses the acceptability, appropriateness, feasibility, and efficacy of a novel asynchronous video-based intervention for teaching respiratory physiology and anatomy to medical students in resource-limited settings. A series of short video lectures on pleural anatomy, pulmonary physiology, and pathophysiology was created using Lightboard and screen capture technology. These were uploaded to YouTube and Google Drive and made available to 1st-3rd year medical students at two Latin American universities for 1 week. Employing a parallel-convergent mixed methods design, we conducted surveys, focus groups, interviews, and pre/post testing for qualitative and quantitative data. Thematic Analysis was used to analyze qualitative data and McNemar's test for quantitative analysis. Seventy-six students participated. The videos' short format, interactivity, and Lightboard style were highly valued for their flexibility, time efficiency, and educational impact. Students recognized their clinical relevance and trusted their content, suggesting potential applicability in similar settings. Despite infrastructure and connectivity challenges, the use of flexible streaming and downloadable options facilitated learning. Survey results indicated high levels of feasibility (99%), appropriateness (95%), and acceptability (95%), with significant knowledge gains observed (37% correct pre-test answers vs. 56% post-test, p < 0.0001). Our findings demonstrate high acceptability, appropriateness, feasibility, and efficacy of a targeted asynchronous education centered on short-format videos in resource-limited settings, enabling robust learning despite local barriers. Flexible access is key for overcoming localized barriers. Taking an adaptive, learner-centered approach to content creation and delivery to address constraints was pivotal to success. Our modular videos could serve as versatile models for flexible education in resource-constrained settings.

The effectiveness of the technology-enhanced flipped class on the learning and satisfaction of nursing students in the immunology course: A quasi-experimental study.

BACKGROUND: Health professions graduates are expected to have core competencies and the ability to provide safe, high-quality, patient-centered care. To guarantee this, active learning and learner-oriented learning approaches should be employed. OBJECTIVE: This research was conducted to determine the effect of the technology-enhanced flipped classroom on the learning and satisfaction of nursing students in the medical immunology course. DESIGN: Quasi-experimental study. SETTINGS AND PARTICIPANTS: The participants were 80 nursing students recruited through convenience sampling from the Faculty of Nursing and Midwifery, Tehran University of Medical Sciences who were taking the medical immunology course. METHODS: In the odd sessions, teaching was traditional, and in the even sessions was flipped. The tools of this study included a satisfaction questionnaire and a class test. Data were analyzed using descriptive statistics, paired t-test, and One-sample t-test by SPSS21. RESULTS: Longitudinal analysis showed that there was no change in the level of students' learning in the traditional method over time but in the flipped classroom method, there was a positive effect in increasing students' learning. The comparison of students' average learning scores showed the average learning scores in the traditional approach increased from 10.049 to 10.590 But this difference was not statistically significant (P = 0.247). In the flipped classroom, the average learning scores increased from 7.745 to 10.440 which was significant (P < 0.001). The average score of students' satisfaction with the flipped classroom teaching method was 7.56 ± 1.81 and higher than the average level. CONCLUSION: Technology-enhanced flipped classroom was effective in improving learning and high satisfaction of nursing students which shows that this approach is successful for teaching medical immunology to nursing students. This approach has the potential to be expanded to other nursing courses according to its correct application and implementation.

Being a Postgraduate Nursing Student in Limpopo Province, South Africa: An Exploratory Study.

Research proficiencies for nurses include the ability to search for and evaluate evidence, disseminate findings, and apply findings to practice within the context of caring. Aim: This study explored the experiences of distant postgraduate nursing students in Limpopo Province, South Africa. Methods: The population consists of all students registered for postgraduation studies in a nursing programme at two South African universities in Limpopo Province. Purposive sampling was used to select 23 registered postgraduate nursing students. Data were collected through unstructured one-on-one interviews, including an audio recorder and field notes. The narrative data from interviews were analysed qualitatively through Tesch's open coding descriptive qualitative data analysis method. Results: Three main themes emerged: the reasons behind engaging in postgraduate studies, factors impacting postgraduate studies' success, and a description of challenges associated with conducting research. Conclusions: The students generally have varied experiences about whether or not completing a research project is a valuable learning experience. The relationship between a postgraduate student and their research supervisor is crucial to ensuring that the students advance consistently and complete their theses on time. The study will, therefore, assist HEIs offering postgraduate programmes in nursing in realising the challenges faced by students and coming up with strategies to combat the challenges.

Decision-Making During Asynchronous Electives: Insights From Emergency Medicine-Bound Medical Students.

Introduction While asynchronous learning is gaining popularity, little is known about learners' decisions regarding compliance with assigned asynchronous material. We sought to explore how medical students make decisions about the use of their time when engaging in asynchronous learning during the residency interview season.  Methods After implementing a four-week blended elective for emergency medicine-bound fourth-year medical students, we conducted a mixed methods study with an explanatory sequential design. We analyzed weekly surveys regarding accountability and barriers to assignment completion and conducted semi-structured focus groups exploring the decisions students made regarding compliance with asynchronous assignments. Using a constructivist approach, we performed a thematic analysis of the transcripts. Results The average assignment completion rate was 36%, with the highest rates for podcasts (58%) and the lowest rates for textbook readings (20%). Compliance with assignments was enhanced by a desire for increased ownership of learning but was hindered by a lack of accountability, learner burnout, and higher prioritization of interviews. Students preferentially selected resources that were shorter in length, entertaining, and more convenient for travel. Conclusion Our study highlights factors impacting student compliance when engaging in asynchronous learning and offers insights into educational and institutional strategies that can be utilized to enhance learner motivation.

Evaluating the impact of distance learning on gender-affirming healthcare competence: knowledge acquisition and satisfaction among healthcare professionals in Italy.

Background: Transgender and gender diverse (TGD) individuals face significant healthcare barriers, with one of the most critical being the inadequate knowledge and skills of healthcare professionals (HCPs) in TGD health. To address this issue, we undertook a project to develop a distance learning course for all healthcare professions, encompassing a comprehensive range of topics related to TGD health issues. Objectives: This study aimed to evaluate the impact of a course on gender-affirming healthcare competence, with a focus on knowledge acquisition and satisfaction levels. The hypothesis was that participating in the course would enhance the participants' knowledge on the covered topics. Methods: A distance learning course, designed for all Continuing Medical Education professions, was conducted between March and September 2023. The course was structured according to the Problem-Based Learning methodology. We implemented a pre-test vs. post-test study design to evaluate the enhancement of knowledge, based on a set of Multiple Choice Questions (MCQs), and investigated users' satisfaction through the administration of a semi-structured questionnaire. We examined the pre- and post-course proportions of correct responses to questions, along with the mean score difference, categorized by learners' sex, age, and geographical area. Eventually, a Satisfaction Training Index was created. Results: The maximum capacity was reached, with 29,998 out of 30,000 available spots filled. Of those enrolled, 18,282 HCPs successfully completed the training. Post-test results revealed an increase in correct answers across all MCQs, with overall mean score rising from 48.8 to 68.0 (p < 0.001). Stratified analysis indicated improvements across all participant categories. A higher average increase among female (19.87) compared to male enrollees (17.06) was detected (p < 0.001). Both "over 55" and "46-55" age groups showed the greatest score increases compared to "35-46" and "under 35" groups, despite no significant differences in pre-test scores. Course satisfaction was high, averaging 4.38 out of 5. Top-rated aspects included "learning new concepts" (4.49), "accessibility" (4.46), and "platform functionality" (4.46). Conclusion: Our research hypothesis was confirmed by the significant increase in knowledge going from pre-test to post-test and by the high level of user satisfaction. The obtained results serve as a foundation for planning additional professional education in TGD health.

Employment Outcomes of a Distance Learning System for Formerly Incarcerated Veterans With Mental Illness.

OBJECTIVE: People with previous incarceration and a mental disorder, a substance use disorder, or both are less likely to obtain employment than are those without these characteristics. Distance learning and education (DLE) systems are increasingly being integrated into clinical care and provide a pathway to disseminate vocational services. DLE systems can help reach people with barriers to accessing services, including people without transportation, experiencing homelessness, living in rural areas, or who are homebound. This study evaluated the effectiveness of one DLE system, the COMPASS program, in assisting formerly incarcerated veterans with a mental or substance use disorder to obtain employment. METHODS: The authors used a randomized controlled trial to compare employment outcomes of 39 U.S. veterans receiving the COMPASS intervention with those of 43 veterans receiving a paper self-study vocational manual. All participants had previous legal convictions and had a mental disorder, a substance use disorder, or both. The COMPASS system provided vocational services through asynchronous (online practice assignments, reading, and videos) and synchronous (video and telephone practice interviews and live chats) methods. No in-person vocational services were provided in the COMPASS intervention. RESULTS: At 6 months, participants assigned to receive the COMPASS intervention were more likely to have found employment, defined as 1 day of competitive employment, compared with those assigned to receive the self-study manual (64% vs. 35%, respectively)-and to have found employment faster. CONCLUSIONS: This study's findings provide evidence for the effectiveness of the COMPASS system in providing employment services and suggest that these services may benefit other vulnerable populations.

Online palliative care education and mentorship in Nepal: Project ECHO - a novel approach to improving knowledge and self-efficacy among interprofessional health-care providers.

BACKGROUND: Palliative care access in Nepal is severely limited, with few health-care providers having training and skills to pain management and other key aspects of palliative care. Online education suggests an innovation to increase access to training and mentoring, which addresses common learning barriers in low- and middle-income countries. Project ECHO (Extensions for Community Health Care Outcomes) is a model of online education which supports communities of practices (COPs) and mentoring through online teaching and case discussions. The use of online education and Project ECHO in Nepal has not been described or evaluated. SETTING: An online course, consisting of 14 synchronous weekly palliative care training sessions was designed and delivered, using the Project ECHO format. Course participants included health-care professionals from a variety of disciplines and practice settings in Nepal. OBJECTIVES: The goal of this study was to evaluate the impact of a virtual palliative care training program in Nepal on knowledge and attitudes of participants. METHODS: Pre- and post-course surveys assessed participants' knowledge, comfort, and attitudes toward palliative care and evaluated program acceptability and barriers to learning. RESULTS: Forty-two clinicians, including nurses (52%) and physicians (48%), participated in program surveys. Participants reported significant improvements in their knowledge and attitudes toward core palliative care domains. Most participants identified the program as a supportive COP, where they were able to share and learn from faculty and other participants. CONCLUSION: Project ECHO is a model of online education which can successfully be implemented in Nepal, enhancing local palliative care capacity. Bringing together palliative care local and international clinical experts and teachers supports learning for participants through COP. Encouraging active participation from participants and ensuring that teaching addresses availability and practicality of treatments in the local health-care context addresses key barriers of online education. SIGNIFICANCE OF RESULTS: This study describes a model of structured virtual learning program, which can be implemented in settings with limited access to palliative care to increase knowledge and attitudes toward palliative care. The program equips health-care providers to better address serious health-related suffering, improving the quality of life for patients and their caregivers. The program demonstrates a model of training which can be replicated to support health-care providers in rural and remote settings.