Effect of teaching tools in spatial understanding in health science education: a systematic review.

Background: The concept of spatial orientation is integral to health education. Students studying to be healthcare professionals use their visual intelligence to develop 3D mental models from 2D images, like X-rays, MRI, and CT scans, which exerts a heavy cognitive load on them. Innovative teaching tools and technologies are being developed to improve students' learning experiences. However, the impact of these teaching modalities on spatial understanding is not often evaluated. This systematic review aims to investigate current literature to identify which teaching tools and techniques are intended to improve the 3D sense of students and how these tools impact learners' spatial understanding. Methods: The preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines were followed for the systematic review. Four databases were searched with multiple search terms. The articles were screened based on inclusion and exclusion criteria and assessed for quality. Results: Nineteen articles were eligible for our systematic review. Teaching tools focused on improving spatial concepts can be grouped into five categories. The review findings reveal that the experimental groups have performed equally well or significantly better in tests and tasks with access to the teaching tool than the control groups. Conclusion: Our review investigated the current literature to identify and categorize teaching tools shown to improve spatial understanding in healthcare professionals. The teaching tools identified in our review showed improvement in measured, and perceived spatial intelligence. However, a wide variation exists among the teaching tools and assessment techniques. We also identified knowledge gaps and future research opportunities.

Contexte: Le concept d'orientation spatiale fait partie intégrante de l'enseignement des professions de la santé. Les étudiants utilisent leur intelligence visuelle pour se représenter mentalement en 3D des images en 2D comme des radiographies, de l'IRM et des coupes tomodensitométriques, ce qui constitue une lourde charge cognitive. On développe actuellement des technologies et des outils pédagogiques innovants pour améliorer l'expérience d'apprentissage des étudiants. Cependant, l'impact de ces ressources pédagogiques sur la perception spatiale est rarement évalué. L'objectif de cette revue systématique de la littérature était de recenser les outils et techniques pédagogiques destinés à améliorer la perception 3D des apprenants et d'évaluer les effets de ces outils sur leur perception spatiale. Méthodes: Suivant les lignes directrices PRISMA, nous avons consulté quatre bases de données avec des termes de recherche multiples, analysé les articles recensés en fonction de critères d'inclusion et d'exclusion, et évalué leur qualité. Résultats: Dix-neuf articles correspondaient aux critères d'inclusion. Les outils pédagogiques axés sur l'amélioration de la perception spatiale peuvent être regroupés en cinq catégories. L'examen a révélé que les résultats obtenus par les groupes expérimentaux ayant utilisé l'outil pédagogique pour effectuer les tests et les tâches demandés sont aussi bons ou significativement meilleurs que les résultats obtenus par les groupes témoins. Conclusion: Notre revue de la littérature visant à recenser et catégoriser les outils pédagogiques disponibles a montré que ces derniers améliorent la perception spatiale, notamment l'intelligence spatiale mesurée et perçue, des professionnels de la santé. Toutefois, il existe une grande variation entre les divers outils pédagogiques et techniques d'évaluation. Nous avons également relevé des lacunes dans nos connaissances et des pistes de recherche future.

Empowering Patients With a Shared Communication Tool: A Patient-Oriented Multimethods Pilot Study.

Not all patients feel empowered to take on the expanding role as active members in their healthcare journey. Healthcare services must shift attention to supporting patients and families in this emerging role. This support includes providing communication tools designed for patients and families to empower them to speak up. Two Plan-Do-Study-Act (PDSA) cycles were conducted to test a communication tool, the Jargon Alert!/WAIT card, with patients/families and providers in a Canadian rehabilitation hospital. After the first PDSA cycle, feedback from patients/families (n = 24), and providers (n = 4), informed modifications. The new Question Alert! card was retested in the same clinics. Patients/families (n = 13) reported the new card was a valuable tool enabling them to ask questions, although not all patients or family members expressed the need to use the card. The participating providers (n = 4) thought the Question Alert! card was helpful for quieter patients or family members who normally shy away from asking questions. The shared communication tool designed with patients improved the patient-centered experience and empowered patients/families to be more involved in their care.

"Building Your Neurology Acumen": A Flipped Classroom Approach for Internal Medicine Residents.

Globally, internal medicine (IM) residents often feel they lack the knowledge and skills to approach patients presenting with neurologic issues. We conducted a multiple method needs assessment to determine the feasibility of a novel neurology flipped classroom (FC) curriculum for internal medicine residents. Our primary findings include participants: (1) finding neurology a useful rotation; (2) feeling uncomfortable with the neurological examination; and (3) endorsing flipped classroom as a potential alternative but with significant barriers. Our findings elucidate upon the various extrinsic/intrinsic motivators for resident education and illustrate the need to re-examine the way in which neurology is being taught to off-service residents.

Learner Drawings of Interprofessional Education and Collaborative Practice: An Exploratory, Arts-Based Interview Study.

Interprofessional education and collaborative practice (IPECP) is a concept that supports the theory-to-practice transition of health professional students. Aligning with the global research priorities on building the science and scholarship through innovative evidence-informed strategies, the benefits of understanding stakeholder perspectives, notably learners, were considered an asset for this project. Informed by intergroup contact theory, this exploratory case study sought to gain insight into what perspectives and experiences rehabilitation medicine students encounter throughout their program that impacted their collaborative learning and practice experiences. The aim of this exploratory case study was to gain insight into learner perspectives in order to better inform how interprofessional education and practice is both taught and applied. The analysis of the drawings and interviews resulted in three themes: 1) Situate your client as an active member of the team; 2) Share professional perspectives across your team; and 3) Create team supports that are context specific. A thematic model using client engagement, team connectedness, and context-specific support was offered to describe how the emerging themes contribute to the socialization of health professionals within IPECP. In such a way, this study contributes to the body of literature by focusing on the student perspective. Additionally, it aims to contribute to methods used in interprofessional interview-based literature by using unique learner-driven drawings to elicit personal reflections of collaborative learning. The findings resulted in understanding the social impacts involving client engagement, team connectedness, and context-specific support.

Technology Acceptance of a Mobile Application to Support Family Caregivers in a Long-Term Care Facility.

BACKGROUND: Family caregivers are unpaid individuals who provide care to people with chronic conditions or disabilities. Family caregivers generally do not have formal care-related training. However, they are an essential source of care. Mobile technologies can benefit family caregivers by strengthening communication with care staff and supporting the monitoring of care recipients. OBJECTIVE: We conducted a mixed-method study to evaluate the acceptance and usability of a mobile technology called the Smart Care System. METHODS: Using convenience sampling, we recruited 27 family caregivers to evaluate the mobile Smart Care System (mSCS). In the quantitative phase, we administered initial and exit questionnaires based on the Unified Theory of Acceptance and Use of Technology. In the qualitative phase, we conducted focus groups to explore family caregivers' perspectives and opinions on the usability of the mSCS. With the quantitative data, we employed univariate, bivariate, and partial least squares analyses, and we used content analysis with the qualitative data. RESULTS: We observed a high level of comfort using digital technologies among participants. On average, participants were caregivers for an average of 6.08 years (standard deviation [SD] = 6.63), and their mean age was 56.65 years (SD = 11.62). We observed a high level of technology acceptance among family caregivers (7.69, SD = 2.11). Behavioral intention (ß = 0.509, p-value = 0.004) and facilitating conditions (ß = 0.310, p-value = 0.049) were statistically significant and related to usage behavior. In terms of qualitative results, participants reported that the mobile application supported care coordination and communication with staff and provided peace of mind to family caregivers. CONCLUSION: The technology showed high technology acceptance and intention to use among family caregivers in a long-term care setting. Facilitating conditions influenced acceptance. Therefore, it would be important to identify and optimize these conditions to ensure technology uptake.

Technology Acceptance and Usability of a Mobile App to Support the Workflow of Health Care Aides Who Provide Services to Older Adults: Pilot Mixed Methods Study.

BACKGROUND: Health care aides are unlicensed support personnel who provide direct care, personal assistance, and support to people with health conditions. The shortage of health care aides has been attributed to recruitment challenges, high turnover, an aging population, the COVID-19 pandemic, and low retention rates. Mobile apps are among the many information communication technologies that are paving the way for eHealth solutions to help address this workforce shortage by enhancing the workflow of health care aides. In collaboration with Clinisys EMR Inc, we developed a mobile app (Mobile Smart Care System [mSCS]) to support the workflow of health care aides who provide services to older adult residents of a long-term care facility. OBJECTIVE: The purpose of this study was to investigate the technology acceptance and usability of a mobile app in a real-world environment, while it is used by health care aides who provide services to older adults. METHODS: This pilot study used a mixed methods design: sequential mixed methods (QUANTITATIVE, qualitative). Our study included a pre- and post-paper-based questionnaire with no control group (QUAN). Toward the end of the study, 2 focus groups were conducted with a subsample of health care aides (qual, qualitative description design). Technology acceptance and usability questionnaires used a 5-point Likert scale ranging from disagree (1) to agree (5). The items included in the questionnaires were validated in earlier research as having high levels of internal consistency for the Unified Theory of Acceptance and Use of Technology constructs. A total of 60 health care aides who provided services to older adults as part of their routine caseloads used the mobile app for 1 month. Comparisons of the Unified Theory of Acceptance and Use of Technology constructs' summative scores at pretest and posttest were calculated using a paired t test (2-tailed). We used the partial least squares structural regression model to determine the factors influencing mobile app acceptance and usability for health care aides. The α level of significance for all tests was set at P≤.05 (2-tailed). RESULTS: We found that acceptance of the mSCS was high among health care aides, performance expectancy construct was the strongest predictor of intention to use the mSCS, intention to use the mSCS predicted usage behavior. The qualitative data support the quantitative findings and showed health care aides' strong belief that the mSCS was useful, portable, and reliable, although there were still opportunities for improvement, especially with regard to the mSCS user interface. CONCLUSIONS: Overall, these results support the assertion that mSCS technology acceptance and usability are high among health care aides. In other words, health care aides perceived that the mSCS assisted them in addressing their workflow issues.

Conformity, obedience, and the Better than Average Effect in health professional students.

Background: Compliance, through conformity and obedience to authority, can produce negative outcomes for patient safety, as well as education. To date, educational interventions for dealing with situations of compliance or positive deviance have shown variable results. Part of the challenge for education on compliance may result from disparities between learners' expectations about their potential for engaging in positive deviance and the actual likelihood of engaging in positive deviance. More specifically, students may demonstrate a Better Than Average Effect (BTAE), the tendency for people to believe they are comparatively better than the average across a wide range of behaviours and skills. Methods: Four vignettes were designed and piloted using cognitive interviews, to investigate the BTAE. Conformity and obedience to authority were each addressed with two vignettes. The vignettes were included in a survey distributed to Canadian health professional students across multiple programs at several different institutions during the Winter 2019 semester. Self-evaluation of behaviour was investigated using a one-sample proportion test. Demographic data were investigated using logistic regression to identify predictors of the BTAE. Results: Participants demonstrated the BTAE for expected behaviour compared to peers for situations of conformity and obedience to authority. Age, sex, and program year were identified as potential predictors for exhibiting the BTAE. Conclusions: This study demonstrated that health professional students expect that they will behave better than average in compliance scenarios. Health professional students are not exempt from this cognitive bias in self-assessment. The results have implications for education on compliance, positive deviance, and patient safety.

Contexte: La conformité, par le biais du respect des normes et de l'obéissance à l'autorité, peut avoir des effets négatifs tant pour la sécurité des patients que pour l'éducation des médecins. À ce jour, les interventions éducatives portant sur la conformité ou la déviance positive se sont soldées par des résultats mitigés. Une des difficultés auxquelles se heurte l'enseignement de la conformité provient de l'écart entre les attentes des apprenants quant à la possibilité d'appliquer la déviance positive et la probabilité qu'ils adoptent réellement ce comportement. Plus précisément, les étudiants peuvent faire preuve de supériorité illusoire, c'est-à-dire la tendance à se croire supérieur à la moyenne des gens par rapport à un éventail de comportements et d'habiletés. Méthodes: Quatre vignettes, deux sur la conformité et deux sur l'obéissance à l'autorité, ont été conçues et mises à l'essai dans le cadre d'entretiens cognitifs afin d'étudier la présence du phénomène de supériorité illusoire. Les vignettes faisaient partie d'une enquête menée auprès d'étudiants de différents programmes en sciences de la santé offerts par divers établissements canadiens au cours de la session d'hiver 2019. L'auto-évaluation du comportement a été examinée à l'aide d'un test de proportion pour échantillon unique. Les données démographiques ont été étudiées à l'aide d'une régression logistique pour identifier les prédicteurs de la supériorité illusoire. Résultats: L'effet de supériorité illusoire par rapport aux pairs était présent chez les participants en ce qui concerne le comportement qu'on attend d'eux dans des situations en lien avec la conformité et l'obéissance à l'autorité. L'âge, le sexe et l'année de formation ont été repérés comme prédicteurs potentiels de la manifestation de supériorité illusoire. Conclusions: Cette étude montre que les étudiants en sciences de la santé s'attendent à avoir un comportement supérieur à la moyenne dans les situations où la conformité est en jeu. Ils ne sont pas exempts de ce biais cognitif dans leur auto-évaluation. Les résultats obtenus ont des implications pour l'éducation en matière de conformité, de déviance positive et de sécurité des patients.

A behavioural study of obedience in health professional students.

Interprofessional Education and Collaborative Practice (IPECP) is a field of study suggested to improve team functioning and patient safety. However, even interprofessional teams are susceptible to group pressures which may inhibit speaking up (positive deviance). Obedience is one group pressure that can inhibit positive deviance leading to negative patient outcomes. To examine the influence of obedience to authority in an interprofessional setting, an experimental simulated clinical scenario was conducted with Respiratory Therapy (RT) (n = 40) and Advanced Care Paramedic (ACP) (n = 20) students. In an airway management scenario, it was necessary for students to challenge an authority, a senior anesthesiologist, to prevent patient harm. In a 2 × 2 design cognitive load and an interventional writing task designed to increase positive deviance were tested. The effect of individual characteristics, including Moral Foundations, and displacement of responsibility were also examined. There was a significant effect for profession and cognitive load: RT students demonstrated lower levels of positive deviance in the low cognitive load scenario than students in other conditions. The writing task did not have a significant effect on RT or ACP students' behaviour. The influence of Moral Foundations differed from expectations, In Group Loyalty was selected as a negative predictor of positive deviance while Respect for Authority was not. Displacement of responsibility was influential for some participants thought not for all. Other individual variables were identified for further investigation. Observational analysis of the simulation videos was conducted to obtain further insight into student behaviour in a compliance scenario. Individual differences, including experience, should be considered when providing education and training for positive deviance. Simulation provides an ideal setting to use compliance scenarios to train for positive deviance and for experimentation to study interprofessional team behaviour.

Exploring the Educational Impact of Using a Single-Point Rubric Through Validation in Interprofessional Education.

There have been few studies regarding the impact on inter¬professional education (IPE) assessments and instruments to support learning and teaching. In this study, a single-point rubric was developed and evaluated to explore its educational impact on supporting learning and teaching. The research question was: To what degree does the single-point rubric support student learning and assist facilitators in developing feedback within the context of IPE? We tested the single-point rubric in the assessments within both interprofessional (IP) foundational and elective courses. One hundred eighty-seven rubrics across two IP courses were completed and collected. Of the 49 students and 17 facilitators who responded to the surveys, 3 students and 5 facilitators completed follow-up interviews. Two of the foundational course developers also participated in interviews. Kane's validity framework guided the validation process. Results showed that facilitators used the single-point rubric to provide structured and potentially helpful feedback. Students agreed with the feedback and could efficiently identify the strengths and weaknesses of their performance from the feedback. Students could use the suggestions from facilitators and their own engagement with the feedback to improve future IP learning. However, some facilitators did not provide students with suggestions for improvement, perhaps because they felt that they were not experienced enough to provide suggestions. Additional training is essential for facilitators to learn how to provide suggestions for improvement. The overall educational impact of the single-point rubric is positive, but future investigation with a larger sample size is required.

Automated essay scoring (AES) of constructed responses in nursing examinations: An evaluation.

Nursing students' higher-level thinking skills are ideally assessed through constructed-response items. At the baccalaureate level in North America, however, this exam format has largely fallen into disuse owing to the labor-intensive process of scoring written exam papers. The authors sought to determine if automated essay scoring (AES) would be an efficient and reliable alternative to human scoring. Four constructed-response exam items were administered to an initial cohort of 359 undergraduate nursing students in 2016 and to a second cohort of 40 students in 2018. The items were graded by two human raters (HR1 & HR2) and an AES software platform. AES approximated or surpassed agreement and reliability measures achieved by the HR1 and HR2 with each other, and AES surpassed both human raters in efficiency. A list of answer keywords was created to increase the efficiency and reliability of AES. Low agreement between human raters may be explained by rater drift and fatigue, and shortcomings in the development of Item 1 may have reduced its overall agreement and reliability measures. It can be concluded that AES is a reliable and cost-effective means of scoring constructed-response nursing examinations, but further studies employing greater sample sizes are needed to establish this definitively.

A case of validity evidence for the Interprofessional Attitudes Scale.

Numerous measures have been developed for the assessment of interprofessional attitudes, including the Interprofessional Attitudes Scale (IPAS). The purpose of this study was to assess, and contribute to, the validity evidence for the IPAS. The IPAS was used in a three-year longitudinal study to collect data from first year health professionals. Three forms of assessment were conducted to accrue validity evidence for the IPAS: Exploratory Factor Analysis, Item Analysis, and analysis using Item Response Theory. Data was collected from 337 participants over three years. Separately, and cumulatively, the Exploratory Factor Analysis, Item Analysis and analysis using Item Response Theory identified issues with the content, response process, internal structure, and consequential validity of the IPAS. The outcomes of the present study call into question the use of the IPAS, and other measures, for the assessment of interprofessional attitudes. The present study contributes several pieces of evidence to the validity of the IPAS and the reevaluation of the use of attitude assessment in interprofessional education.

Longitudinal evaluation of attitudes to interprofessional collaboration: time for a change?

Longitudinal evaluation of interprofessional programming is necessary to understand the impact of interprofessional education (IPE) for collaborative practice. Attitude is one measure of intended behavior. The Interprofessional Attitude Scale (IPAS) was developed as an improved measure to examine the readiness for interprofessional education and collaborative practice. As a means to pilot a protocol for a longitudinal comprehensive evaluation of an interprofessional program with 13 health professional programs in 6 health science faculties, the IPAS was administered over a 3-year period to three cohorts of students. The results of the IPAS indicated no significant differences detected across the 3 years. Although there was a significant difference on the Patient Centredness subscale for Cohorts 2 and 3 the effect size was small. Previous experience in an interprofessional course was a predictor of more positive patient centeredness attitudes, but other IPE experience and years of education were not predictors of any interprofessional attitudes. Students from the Medicine & Dentistry (M&D) faculty ranked significantly lower on the teamwork roles and responsibilities subscale compared to the other faculties, except Rehabilitation Medicine (RM). However, once the outliers in RM were removed, there was a significant difference on this subscale between RM and M&D. This paper outlines the challenges with using the IPAS as part of a comprehensive program evaluation and identifies issues with longitudinal data collection for evaluation with large student cohorts.

A multi-method exploratory study of health professional students' experiences with compliance behaviours.

BACKGROUND: Research in healthcare, including students as participants, has begun to document experiences with negative compliance, specifically conformity and obedience. There is a growing body of experimental and survey literature, however, currently lacking is a direct measure of the frequency at which health professional students have negative experiences with conformity and obedience integrated with psychological factors, the outcomes of negative compliance, and students' perceptions. METHODS: To develop empirical knowledge about the frequency of negative compliance and student perceptions during health professional education a multi-methods survey approach was used. The survey was administered to health professional students across ten disciplines at four institutions. RESULTS: The results indicated students regularly experience obedience and conformity and are influenced by impression management and displacement of responsibility. Moral distress was identified as a consistent negative outcome. Student self-reported experiences aligned with the empirical findings. CONCLUSIONS: The findings of the present study demonstrate the pervasiveness of experiences with negative compliance during health professional's education along with some attendant psychological factors. The findings have educational and practical implications, as well as pointing to the need for further integration of social and cognitive psychology in explaining compliance in healthcare. The results are likely generalizable to a population level however replication is encouraged to better understand the true frequency of negative compliance at a health professional population level.

Medical education leadership: from diversity to inclusivity.

Both in Canada and globally, medical schools are prioritizing diversity in medical education. The ensuing development of innovative approaches to augmenting the representation, comfort, and success of students from under-represented groups has been increasing. Curricula have also expanded to better prepare graduates for the realities of effectively meeting the needs of a diverse patient population. Leadership has however, not kept up with this progress. Evidence shows that diverse leadership teams develop innovative solutions to complex problems, recruit and retain the best talent, and remain relevant to the communities they serve. Our international conference workshop included a literature review on the current state of diversity in medical education and in leadership for medical educators, and case-based models of lived experiences to initiate conversations in three different facets of diversity to stimulate reflection, engagement and discussion. The oft-forgotten side of the conversation in conference offerings, the audience's perspective, was purposefully included in planning the workshop and presenters adhered to this principle throughout the session. Participants recognized the importance of addressing diversity with leadership in medical education. Themes included the need for communication training, cultural education, sharing these data more broadly with faculty in medical education and continuing these conversations. A final theme "we will never represent all minorities", led us to a conclusion that a culture of inclusivity and not diversity would be required to successfully meet this challenge.

Taking the classroom to camp: The facilitators' role in creating an impactful interprofessional experiential learning opportunity.

A case study approach was used to describe faculty facilitators' perspectives on the creation and implementation of an interprofessional experiential learning opportunity for students at an aphasia camp. The facilitators serendipitously created an interprofessional experiential learning opportunity for speech-language pathology, occupational therapy, and physical therapy students volunteering at the aphasia camp. During focus groups several weeks after the camp, students discussed the interprofessional nature of their camp experiences and stated they had learned more about collaborative practice while volunteering at the aphasia camp than they had in any interprofessional course work, simulation experience, or clinically based fieldwork they had previously engaged in. The students spoke very highly of the facilitators' creation of the interprofessional experience. The interviewer, an interprofessional educator, wanted to know what the 'magic' was from the facilitators. Facilitators were asked to document their teaching philosophies and reflections and participate in a group interview. Three key themes emerged: educational philosophy, the environment, and facilitator characteristics. The facilitators created an environment where there was a balance between providing structure and clear expectations, with a flexible learning space where students could make mistakes yet feel supported. It was within this psychologically safe learning space that students had autonomy over many camp activities and opportunities to experiment and problem solve. The results from the study were compared to the characteristics of experiential learning. The article concludes with a summary of facilitators' characteristics that led to an impactful interprofessional experiential learning experience.

Evaluating Best Methods for Crisis Resource Management Education: Didactic Teaching or Noncontextual Active Learning.

INTRODUCTION: Health care training traditionally focuses on medical knowledge; however, this is not the only component of successful patient management. Nontechnical skills, such as crisis resource management (CRM), have significant impact on patient care. This study examines whether there is a difference in CRM skills taught by traditional lecture in comparison with low-fidelity simulation consisting of noncontextual learning through team problem-solving activities. METHODS: Two groups of multidisciplinary preclinical students were taught CRM through lecture or noncontextual active learning. Both groups were given a cardiopulmonary resuscitation simulation and clinical performance assessed by basic life support (BLS) checklist and CRM skills by Ottawa Global Rating Scale. The groups were reassessed at 4 months. A third group, who received no CRM education, served as a control group. RESULTS: The mean BLS scores after CRM education were 18.9 and 24.9 with mean Ottawa Global Rating Scale (GRS) scores of 22.4 and 29.1 in the didactic teaching and noncontextual groups, respectively. The difference between intervention groups was significant for BLS (P = 0.02) and Ottawa GRS (P = 0.03) score. At 4-month follow-up, there was no statistically significant difference in BLS (P = 1.0) or Ottawa GRS score (P = 0.55) between intervention groups. In comparison with the control group, there was a marginally significant difference in Ottawa GRS score (P = 0.06) at 4-month follow-up. CONCLUSIONS: Noncontextual active learning of CRM using low-fidelity simulation results in improved CRM performance in comparison with didactic teaching. The benefits of CRM education do not seem to be sustained after one education session, suggesting the need for continued education and practice of skills to improve retention.

A Validity Study of the Interprofessional Collaborative Competency Attainment Survey: An Interprofessional Collaborative Competency Measure.

BACKGROUND: In health care, there is a shift toward competency assessment, including in interprofessional collaboration and education. The Interprofessional Collaborative Competency Attainment Survey (ICCAS) has been designed to assess self-reported change in interprofessional competency. METHOD: The current study collects validity evidence for the ICCAS by replicating and expanding previous research, examining internal structure, item functioning, concurrent validity, response process, and consequential validity, including theoretical interpretation of the instrument's application and outcomes. RESULTS: The ICCAS shows good reliability, a single-factor structure, adequate item discrimination, and a moderate concurrent validity. Insight was gained to response process and potential consequences that lend caution to the interpretation of ICCAS results dependent on learner populations. CONCLUSION: The ICCAS has shown stability, making it a potentially useful instrument in assessing self-reported competency but one that should be applied over multiple time points with an awareness of the specific characteristics and knowledge of the sample. [J Nurs Educ. 2019;58(8):454-462.].

Learning to Bounce Back: A Scoping Review About Resiliency Education.

BACKGROUND: Health care professionals face high levels of stress from working in a demanding environment. Resiliency training has emerged as an approach to overcome occupational stress. The purpose of this study was to understand what is known about educational strategies for teaching resilience. METHOD: The five-stage approach from Arksey and O'Malley was used as the methodological framework. Resources were evaluated thematically to identify key strategies and interventions. RESULTS: Included resources (N = 25) were organized into six themes: (a) Reflective Practice; (b) Storytelling; (c) Peer Support and Mentoring; (d) Professional Support and Mentoring; (e) Mindfulness and Meditation Practice; and (f) Enhancing Self-Knowledge and Personal Competencies. CONCLUSION: This scoping review has confirmed that there are relevant education strategies to assist students in developing resilience. Recommendations for integrating resilience education at the undergraduate level are included. Preparing nursing students to persevere through adversities is essential for maintaining physical, mental, and emotional health throughout their career. [J Nurs Educ. 2019;58(6):321-329.].

Identification of Frailty in Primary Care: Feasibility and Acceptability of Recommended Case Finding Tools Within a Primary Care Integrated Seniors' Program.

Background: Case finding for frailty is recommended as part of routine clinical practice. We aimed to test feasibility and acceptability of three recommended case finding tools in primary care as part of an integrated seniors' program. Method: Program of Research to Integrate Services for the Maintenance of Autonomy-7 (PRISMA-7), 4-m walk test, and electronic frailty index (eFI) were used as frailty case finding tools for a target population of community-dwelling seniors ≥65 years of age enrolled in a seniors' program within an academic primary care clinic in Alberta, Canada. Feasibility was measured by percent completion rate and requirements for training/equipment/space/time, and acceptability by health care providers was measured using focus groups. Results: Eighty-five patients underwent case finding and 16 health care providers participated in the focus groups. Completion rate for PRISMA-7, 4-m walk test, and eFI was 97.6%, 93%, and 100%, respectively. No special training or equipment was required for PRISMA-7; brief training, equipment, and space were required for 4-m walk test. Both tools took less than 5 min to complete. Despite eFI requiring 10 to 20 min/patient chart, providers found it less intrusive. Conclusion: Despite feasibility of the tests, acceptance was higher for tools with minimal clinic interruption, low requirements for resources, and those with added benefit.