Jefferson Digital Commons quarterly report: April-June 2019

This quarterly report includes: Articles CREATE Day Presentations Dissertations From the Archives Grand Rounds and Lectures House Staff Quality Improvement and Patient Safety Posters JCIPE Student Hotspotting Posters Journals and Newsletters MPH Capstone Presentations Posters Sigma Xi Research Day What People are Saying About the Jefferson Digital Common

Optimizing the integration of advanced practitioners in a department of surgery: An operational improvement model

Physician assistants (PAs) and nurse practitioners (NPs) have established themselves as key members of the healthcare team to supplement practicing physicians in patient care. PAs and NPs are collectively referred to as “advanced providers” (APs) and work not only in primary care but in general surgery and surgical subspecialties. Studies have addressed AP integration into the profession of medicine and have examined cost and efficacy of APs, attitudes about APs among residents, and educational impact of APs, but very little literature exists that describes a formalized approach to AP integration into a department of surgery, specifically with AP/resident integration. The purpose of this paper is to describe an initiative for developing an operational improvement model for APs working with residents on surgical inpatient services in a large academic health center. The model consists of four components and each component is described in detail from discovery state towards continuous improvement. Formal professional development opportunities for APs as well as appointing a Clinical Director for Surgical APs have positively impacted AP integration into the department of surgery

Virtual reality simulation for the optimization of endovascular procedures : current perspectives

Endovascular technologies are rapidly evolving, often - requiring coordination and cooperation between clinicians and technicians from diverse specialties. These multidisciplinary interactions lead to challenges that are reflected in the high rate of errors occurring during endovascular procedures. Endovascular virtual reality (VR) simulation has evolved from simple benchtop devices to full physic simulators with advanced haptics and dynamic imaging and physiological controls. The latest developments in this field include the use of fully immersive simulated hybrid angiosuites to train whole endovascular teams in crisis resource management and novel technologies that enable practitioners to build VR simulations based on patient-specific anatomy. As our understanding of the skills, both technical and nontechnical, required for optimal endovascular performance improves, the requisite tools for objective assessment of these skills are being developed and will further enable the use of VR simulation in the training and assessment of endovascular interventionalists and their entire teams. Simulation training that allows deliberate practice without danger to patients may be key to bridging the gap between new endovascular technology and improved patient outcomes

Using 360-degree multi-source feedback to evaluate professionalism in surgery departments: an Iranian perspective

Background: Medical professionalism helps physicians adopt a proper and good healing action for the patients based on their particular circumstance. This study was conducted to assess professionalism in surgical residents, using a 360-degree evaluation technique in several teaching hospitals in Tehran, Iran. Methods: This study was conducted on all the second and third year surgery residents from three university teaching hospitals in Tehran. Multi-source feedback questionnaire contained 10 questions on the residents’ professional behavior and was completed by the faculty and staff members (nurses, operation room staff, and medical assistants) as well as other surgery residents, interns and patients to evaluate each resident. Response rates were used to determine feasibility for each of the respondent groups and the mean and standard deviation score for each question was computed to determine the viability of the items. Reliability was assessed using alpha Cronbach coefficient for each respondent group. The correlation between these scores and the residents’ final and OSCE grade was also assessed. Results: The internal consistency reliability for 360-degree rating was 0.889. There was no significant difference in the residents’ score in different hospitals. While male residents obtained higher total score, there was no significant difference between them. The residents, however, obtained lower scores compared to the staff. The highest score was recorded for question 6, suggesting that the residents treated the patients regardless of their socioeconomic status. Conclusion: This study revealed a strong agreement between the results gathered from different respondents, confirming the reliability of the questionnaire and the respondents’ unbiased response. It also revealed that the residents did well in the whole test, showing they were conscientious and learning to become medical professionals

A review of ten years of implementation and research in aligning learning design with learning analytics at the Open University UK

There is an increased recognition that learning design drives both student learning experience and quality enhancements of teaching and learning. The Open University UK (OU) has been one of few institutions that have explicitly and systematically captured the designs for learning at a large scale. By applying advanced analytical techniques on large and fine-grained datasets, the OU has been unpacking the complexity of instructional practices, as well as providing conceptual and empirical evidence of how learning design influences student behaviour, satisfaction, and performance. This study discusses the implementation of learning design at the OU in the last ten years, and critically reviews empirical evidence from eight recent large-scale studies that have linked learning design with learning analytics. Four future research themes are identified to support future adoptions of learning design approaches

Optimizing Student Team Skill Development Using Evidence-Based Strategies

The critical importance of effective teamwork in engineering is widely recognized. Surprisingly, however, relatively little is known about how to develop teamwork skills in higher education classes, including what factors contribute to effective teamwork, their relative importance in a team\u27s overall performance, and the underlying individual and interpersonal dynamics. Increasing numbers of engineering instructors are adopting instructional practices relying on teamwork, yet many instructors simply form student teams and hope the members individually and collectively learn on their own how to work in teams and succeed in their task(s). Instructors do this because they do not have guidance for a better approach. This research project aims to address this gap in faculty knowledge. The empirical studies conducted as part of this project build on research in engineering education, cognitive psychology, social psychology, and other fields in a coordinated large-scale research project that will provide faculty with needed knowledge and tools to ensure that students learn team skills. The research team is conducting seven separate studies measuring the impact of teamwork training, experience working in teams, practice rating the teamwork of fictitious team members, and giving and receiving peer feedback. The research is measuring each of these effects in real teams on three learning outcomes: improved teamwork knowledge, improved ability to evaluate teamwork, and improved ability to function effectively in teams. These studies will result in practical recommendations for time-pressed faculty to implement

Time Management Strategies for Research Productivity

Researchers function in a complex environment and carry multiple role responsibilities. This environment is prone to various distractions that can derail productivity and decrease efficiency. Effective time management allows researchers to maintain focus on their work, contributing to research productivity. Thus, improving time management skills is essential to developing and sustaining a successful program of research. This article presents time management strategies addressing behaviors surrounding time assessment, planning, and monitoring. Herein, the Western Journal of Nursing Research editorial board recommends strategies to enhance time management, including setting realistic goals, prioritizing, and optimizing planning. Involving a team, problem-solving barriers, and early management of potential distractions can facilitate maintaining focus on a research program. Continually evaluating the effectiveness of time management strategies allows researchers to identify areas of improvement and recognize progress

Engaging sport students in assessment and formative feedback

Sport as a discipline in higher education is grappling with the challenge of providing authentic and relevant assessment that engages students in their learning. The centrality of assessment to the student experience is now well accepted within the research literature (Brown and Knight, 1994; Rust, 2002). In particular, formative assessment, or assessment that creates feedback to support future teaching and learning experiences, can be a powerful tool for enhancing learning (see Black and Wiliam, 1998). Given that feedback is most effective if it is considered or reflected upon, one of the key challenges is to actively engage sport students in formative assessment processes. This guide offers advice in designing and facilitating sport students’ involvement in assessment and enhancing their engagement with the feedback they receive. The aim is to support sport programme teams by taking a pragmatic approach, combining a clear academic rationale based on assessment for learning principles with case study examples of successful formative assessment exercises emphasising innovative approaches to giving feedback. The guide consists of three key sections focused on: 1) Providing staff in HLST with background knowledge of formative assessment and formative feedback and how it relates to their subject. 2) Providing case study examples of how to effectively engage sport students with assessment feedback so that it feeds-forward to aid learning. 3) Providing a resource of references and sources of support for tutors wishing to further their learning in this area

Optimizing Intraprofessional Communication at Patient Handover

This performance improvement project aimed to increase the communication competency of nurses during intraprofessional interactions at patient handover. An educational program focused on optimizing communication among nurses was implemented in a community-based, not-for-profit, rural hospital. The course was designed to incorporate a variety of instructional strategies to meet learner needs. Consistency and standardization of the patient handover process was a central theme. Topics of the course focused on the use of a standardized communication tool, the relationship of communication on patient safety, the importance of clear and effective communication, the role of the nurse as gatekeeper and facilitator of patient-specific information to peers during handover events, and intraprofessional collaboration in an acute care setting. The self-perceived communication competency of participating nurses was measured at pre-test and post-test using a valid and reliable instrument. The data collected from the survey informed this process improvement effort