A comparison of electronic and paper-based clinical skills assessment: Systematic review.

Introduction: The aim of this systematic review was to compare the effectiveness of electronic recording with paper-based recording of clinical skills assessments for entry-level health professional students. Methods: A comprehensive database search was undertaken using AMED, CINAHL, CENTRAL, EMBASE, Medline, PsycINFO, Scopus, and Web of Science on 12-16 June 2017, and updated 9 April 2018. Studies investigating electronic and paper-based recordings of clinical skills assessments of students in entry-level health professional programs were eligible for inclusion. Two independent researchers completed screening of studies for inclusion, quality assessments, and data extraction, with discrepancies resolved by consensus. Quality assessment was performed using the Critical Appraisal Skills Program Diagnostic checklist. Results: From 2264 studies identified, five observational cohort studies were included. Published between 2006 and 2016, included studies investigated electronic and paper examinations of clinical skills assessments of students from medical, dentistry, and physical therapy programs. Electronic assessments were reported to be more time efficient than paper-based assessments with an added advantage of no missing data. Quality and quantity of quantitative and qualitative student feedback increased with electronic assessment compared to paper-based assessments. Conclusions: Electronic assessments were used successfully across a range of health professional programs, take significantly less time to complete and provide higher quality feedback to students. Future studies are needed with more robust psychometric testing and cost-effective analysis to inform the increasing uptake of electronic assessment tools in health professional training.

Counseling for health behavior change in people with COPD: systematic review.

Counseling has been suggested as a promising approach for facilitating changes in health behavior. The aim of this systematic review of counseling interventions for people with COPD was to describe: 1) counseling definitions, 2) targeted health behaviors, 3) counseling techniques and 4) whether commonalities in counseling techniques were associated with improved health behaviors. Ten databases were searched for original randomized controlled trials which included adults with COPD, used the term "counseling" as a sole or component of a multifaceted intervention and were published in the previous 10 years. Data extraction, study appraisal and coding for behavior change techniques (BCTs) were completed by two independent reviewers. Data were synthesized descriptively, with meta-analysis conducted where possible. Of the 182 studies reviewed as full-text, 22 were included. A single study provided a definition for counseling. Two key behaviors were the main foci of counseling: physical activity (n=9) and smoking cessation (n=8). Six studies (27%) reported underlying models and/or theoretical frameworks. Counseling was the sole intervention in 10 studies and part of a multicomponent intervention in 12. Interventions targeting physical activity included a mean of 6.3 (±3.1) BCTs, smoking cessation 4.9 (±2.9) BCTs and other behaviors 6.5 (±3.9) BCTs. The most frequent BCTs were social support unspecified (n=22; 100%), goal setting behavior (n=11), problem-solving (n=11) and instructions on how to perform the behavior (n=10). No studies shared identical BCT profiles. Counseling had a significant positive effect for smoking cessation and positive but not significant effect for physical activity. Counseling for health behavior change was rarely defined and effectiveness varied by target behavior. Provision of specific details when reporting studies of counseling interventions (definition, BCTs, dosage) would allow clarification of the effectiveness of counseling as an approach to health behavior change in people with COPD.

The Impact of Antimalarial Use on the Emergence and Transmission of Plasmodium falciparum Resistance: A Scoping Review of Mathematical Models.

The emergence and transmission of resistance to antimalarial treatments continue to hamper malaria elimination efforts. A scoping review was undertaken regarding the impact of antimalarial treatment in the human population on the emergence and transmission of Plasmodium falciparum resistance, to (i) describe the use of mathematical models used to explore this relationship; (ii) discuss model findings; and (iii) identify factors influencing the emergence and transmission of resistance. Search strategies were developed and deployed in six major databases. Thirty-seven articles met the eligibility criteria and were included in the review: nine articles modeled the emergence of resistance, 19 modeled the transmission of resistance, and nine modeled both the emergence and transmission. The proportion of antimalarial use within the population and the presence of residual drug concentrations were identified to be the main predictors of the emergence and transmission of resistance. Influencing factors pertaining to the human, parasite and mosquito populations are discussed. To ensure the prolonged therapeutic usefulness of antimalarial treatments, the effect of antimalarial drug use on the emergence and transmission of resistance must be understood, and mathematical models are a useful tool for exploring these dynamics.