Motrial, first search engine in clinical trial on non pharmaceutical interventions (NPIs)

Le nombre de publications d’études cliniques évaluant les interventions non médicamenteuses (INM) augmente exponentiellement depuis 2000. Il encourage les chercheurs à réaliser les revues systématiques et les méta-analyses attendues par les professionnels de santé, les patients et les décideurs pour connaître leur efficacité réelle et leur indication pertinente. Seulement, la diversification des supports de communication médicale et scientifique, les stratégies opportunistes de publication, les informations manquantes dans les publications et la non exhaustivité des bases de données biomédicales rendent la recherche bibliographique complexe et à risque de biais. Pour répondre à ce manque, la Plateforme CEPS propose un moteur de recherche, appelé Motrial, qui permet de collecter, de trier et d’organiser les publications d’études cliniques sur les INM.The number of clinical trial publications assessing non-pharmacological intervention (NPI) has been increasing exponentially since 2000. It encourages researchers to carry out the systematic reviews and meta-analyzes expected by health professionals, patients, and decision-makers to learn about their real effectiveness and their relevant indication. However, the diversification of medical and scientific communication media, opportunistic publishing strategies, missing data in publications and non-exhaustiveness of biomedical databases make bibliographic research complex and at risk of bias. To address this shortcoming, the academic Plateforme CEPS offers a search engine, called Motrial, that collects, sorts and organizes publications of NPI clinical trials

Are role perceptions of residents and nurses translated into action?

Abstract Background Effective interprofessional collaboration (IPC) has been shown to depend on clear role definitions, yet there are important gaps with regard to role clarity in the IPC literature. The goal of this study was to evaluate whether there was a relationship between internal medicine residents’ and nurses’ role perceptions and their actual actions in practice, and to identify areas that would benefit from more specific interprofessional education. Methods Fourteen residents and 14 nurses working in internal medicine were interviewed about their role perceptions, and then randomly paired to manage two simulated clinical cases. The authors adopted a general inductive approach to analyze the interviews. They identified 13 different role components that were then compared to data from simulations. Descriptive and kappa statistics were used to assess whether there was a relationship between role components identified in interviews and those performed in simulations. Results from these analyses guided a further qualitative evaluation of the relationship between role perceptions and actions. Results Across all 13 role components, there was an overall statistically significant, although modest, relationship between role perceptions and actions. In spite of this relationship, discrepancies were observed between role components mentioned in interviews and actions performed in simulations. Some were more frequently performed than mentioned (e.g. “Having common goals”) while others were mentioned but performed only weakly (e.g. “Providing feedback”). Conclusions Role components for which perceptions do not match actions point to role ambiguities that need to be addressed in interprofessional education. These results suggest that educators need to raise residents’ and nurses’ awareness of the flexibility required to work in the clinical setting with regard to role boundaries

Details of each case with their relative relevant diagnostic hypotheses^*.

<p>* COPD: chronic obstructive pulmonary disease; NSTEMI: non-ST elevation myocardial infarction.</p

Priority action choices across 11 short clinical scenarios.

*<p>The denominators (84, 69, 63) correspond to the number of valid responses through the cases mentioned as priority actions by the participants.</p

Unmet expectations.

<p>Unmet expectations.</p

Characteristics of selected resident-nurse pair interactions.

<p>A. Pair 13. The presence of a leader in the team (Pair 13, Case 1) or of a truly shared leadership between the resident and the nurse (Pair 13, Case 2) was the first condition for teamwork quality across pairs. B. Pair 2. Leadership was a necessary but insufficient condition. It contributed to teamwork quality only if the leader or both members of the pair demonstrated sufficient autonomy (Pair 2, Case 1). C. Pair 5. Nurse leadership could vary within the same pair, depending on the case type. For example in Pair 5, the resident took the leadership in Case 1 and the nurse tended to stand back, but in the more urgent Case 2 the nurse took the leadership once it appeared that the resident had difficulty in doing so. Each line represents a different case: in blue the non-urgent case (Case 1) and in red the urgent case (Case 2). R: resident; N: nurse. 0: absence of the characteristic; 1: partial presence of the characteristic; 2: strong presence of the characteristic, as determined by consensus among the coders.</p

Residents’ and nurses’ expressions of leadership and autonomy.

<p>* i.v.: intravenous(ly).</p

Overall characteristics of the interactions within resident-nurse pairs.

<p>The pair functioning was generally considered rather traditional, with the residents taking the leadership more often than nurses and with the nurses executing medical prescriptions and assuming their own specific role regarding patient supervision and care. The pairs were globally autonomous, especially in non-urgent cases, there was a good team spirit, and the team members had common management objectives and managed the patients with good, although not always maximal, efficiency. Each line represents a different case: in blue the non-urgent case (Case 1) and in red the urgent case (Case 2). R: resident; N: nurse. 0: absence of the characteristic; 1: partial presence of the characteristic; 2: strong presence of the characteristic, as determined by consensus among the coders.</p

Statements allowing researchers to provide their overall impressions on characteristics of the team members and on the quality of patient management.

<p>* For each statement, the researchers gave their global impression about the absence, the partial presence, or the strong presence of each dimension and could additionally provide free comments.</p