Instrument Development: Knowledge, Attitudes, and Confidence in Palliative Care Concepts Held by Trauma and Neuroscience Intensive Care Nurses.

BACKGROUND AND PURPOSE: Unique pressures impact trauma intensive care unit (TICU) nurses in their provision of care for severely injured patients. When it becomes clinically obvious that these patients may not survive, TICU nurses must continue life-saving measures while at the same time consider a palliative care consultation. In order to facilitate this referral, TICU nurses need to have the appropriate knowledge, attitude, and confidence in doing so. The purpose of this study is to refine an instrument that aims to support this process. METHODS: A convenience sample of 42 respondents completed the Knowledge, Attitudinal, and Experiential Survey on Advance Directive (KAESAD). RESULTS: Domains with the highest Cronbach's alpha value were "professional attitudes" (α = .995) and "clinical experiences" (α = .999). CONCLUSIONS: Reliability assessments suggest that most domains of the instrument have strong internal consistency, and with a larger sample size, future studies may elucidate how nurse educators can use this instrument to target areas for continuing education.

Developing Interprofessional Competence: Results of Embedding TeamSTEPPS® in All Semesters of an Accelerated and Traditional BSN Program.

This study assessed the effectiveness of a curriculum designed to teach interprofessional communication and teamwork skills to traditional and accelerated baccalaureate nursing students. The curriculum was designed to incorporate TeamSTEPPS concepts using incremental learning experiences and a variety of instructional techniques throughout all clinical program semesters; more than 200 students representing four cohorts were enrolled in the study. Three tools were used to evaluate program effectiveness. Both accelerated and traditional groups demonstrated varying degrees of improvement on all tools. The curriculum design positively influenced students' communication and teamwork skills, advancing their interprofessional competency.

Assessment of medical students' leadership traits in a problem/case-based learning program.

BACKGROUND: Healthcare delivery is shifting to team-based care and physicians are increasingly relied upon to lead and participate in healthcare teams. Educational programs to foster the development of leadership qualities in medical students are needed to prepare future physicians for these roles. OBJECTIVE: Evaluate the development of leadership attributes in medical students during their first 2 years of medical school while participating in leadership training integrated into a problem/case-based learning program utilizing the Leadership Traits Questionnaire assessment tool. DESIGN: Ninety-eight students enrolled at Zucker School of Medicine participated in Patient-Centered Explorations in Active Reasoning, Learning and Synthesis (PEARLS), a hybrid problem/case-based learning program, during the first and second years of medical school. The Leadership Traits Questionnaire, designed to measure 14 distinct leadership traits, was utilized. It was administered to students, peers in students' PEARLS groups and their faculty facilitators. Participants completed questionnaires at three-time points during the study. Likert scale data obtained from the questionnaire was analyzed using a two-level Hierarchal Linear Model. RESULTS: Complete data sets were available for 84 students. Four traits, including self-assured, persistent, determined, and outgoing, significantly increased over time by measurements of both peer and facilitator-rated assessments. Six additional traits significantly increased over time by measurement of facilitator-rated assessment. By contrast, a majority of student self-rated assessments trended downward during the study. CONCLUSIONS: Medical students demonstrated development of several important leadership traits during the first 2 years of medical school. This was accomplished while participating in the PEARLS program and without the addition of curricular time. Future work will examine the impact of third year clerkships on leadership traits.

Measuring Sexual Orientation: A Review and Critique of U.S. Data Collection Efforts and Implications for Health Policy.

The U.S. Department of Health and Human Services' (HHS) Healthy People 2020 goals sought to improve health outcomes among sexual minorities; HHS acknowledged that a dearth of sexual orientation items in federal and state health surveys obscured a broad understanding of sexual minority-related health disparities. The HHS 2011 data progression plan aimed to advance sexual orientation data collection efforts at the national level. Sexual orientation is a complex, multidimensional construct often composed of sexual identity, sexual attraction, and sexual behavior, thus posing challenges to its quantitative and practical measurement and analysis. In this review, we (a) present existing sexual orientation constructs; (b) evaluate current HHS sexual orientation data collection efforts; (c) review post-2011 data progression plan research on sexual minority health disparities, drawing on HHS survey data; (d) highlight the importance of and (e) identify obstacles to multidimensional sexual orientation measurement and analysis; and (f) discuss methods for multidimensional sexual orientation analysis and propose a matrix for addressing discordance/branchedness within these analyses. Multidimensional sexual orientation data collection and analysis would elucidate sexual minority-related health disparities, guide related health policies, and enhance population-based estimates of sexual minority individuals to steer health care practices.

Failure of many United States Department of Health Web sites to provide accurate information about the female condom.

Uptake of the female condom (FC) in the United States has historically been low; inadequate promotion may be one barrier faced by potential users. We performed a content analysis of state and municipal health department Web sites to describe how the FC is being promoted for pregnancy and disease prevention. We found that only a slim majority (60.8%) of health department Web sites mention the FC at all and those that do include numerous inaccuracies in their messaging. These inaccuracies may discourage uptake of the FC or have a detrimental impact on the experience when using the product for the first time.

Inconsistencies on U.S. Departments of Health Websites Regarding Anal Use of the Female Condom.

The female condom (FC) is FDA approved to prevent pregnancy and sexually transmitted infections during vaginal intercourse, but not for use during anal intercourse. Studies suggest that a sizeable proportion of men who have sex with men use the FC for anal intercourse despite lack of safety and efficacy information. We reviewed Department of Health (DOH) websites for U.S. states (n = 50) and major municipalities (population >500,000; n = 29) regarding anal use of the FC. Forty-eight (60.8 %) websites mentioned the FC, of which only 21 (45.8 %) mentioned anal use. Of those that mention anal use, 8 (38.1 %) supported, 13 (61.9 %) were neutral, and 1 (4.8 %) discouraged this use. Ten websites (47.6 %) provided instructions for anal use of the FC-ranging from removal of the inner ring, leaving the inner ring in place, and either option. In the absence of safety and efficacy data, U.S. DOH websites are providing different and often contradictory messages about the FC for anal sex.