Development of an assessment instrument for student engagement in design thinking projects for health innovation

Student engagement is a dynamic and multifaceted concept encompassing physical, emotional, and cognitive components. Various instruments to assess student engagement exist; however, these are not intended to assess how students engage with one another and with community stakeholders in participatory health projects. Although instruments exist to assess participation and power-sharing in participatory health research projects, none of the available tools are suitable for assessing student engagement in such projects. Accordingly, this study set out to develop an assessment instrument for student engagement in design thinking projects for health innovation. An adapted form of the survey development guide for medical education research was applied. The development process included triangulation of data, which included collating student input from an initial literature informed instrument, an analysis of written reflective reports and a focus group discussion with students enrolled in a master’s level course called Health Innovation & Design (HID), and design thinking practitioner validation. A final assessment instrument for student engagement in design thinking projects is presented. Note that our instrument incorporates the design thinking phases according to the Innovation Design Engineering Organization (IDEO) design thinking approach, an educational definition of student engagement, and recommendations by students, course lecturers and facilitators of the HID course. The instrument can assess engagement in academic and non-academic settings when design thinking is applied for health innovation

Chronic cough in primary health care attendees, Harare, Zimbabwe: diagnosis and impact of HIV infection.

BACKGROUND: Cough lasting for > or = 3 weeks (i.e., chronic cough) indicates that a patient has suspected tuberculosis (TB). At the primary health care level, the spectrum of disease that causes chronic cough has not been previously investigated in a setting with a high prevalence of human immunodeficiency virus (HIV) infection. METHODS: A total of 544 adults with chronic cough were recruited systematically from 2 primary health care clinics, and they were evaluated using preset first- and second-line investigations and diagnostic case definitions. RESULTS: The overall prevalence of HIV infection among the study cohort was 83%. TB was the most common diagnosis, with 207 HIV-positive patients (46%) and 27 HIV-negative patients (30%) having confirmed or probable TB. Of these, 145 HIV-positive patients with TB (70%) and 20 HIV-negative patients with TB (74%) had smear-positive cases of TB. Only 17 HIV-positive and 2 HIV-negative patients had smear-negative but culture-positive cases of TB. Lower respiratory tract infections (n = 178; HIV prevalence, 79%) and pneumonia (n = 87; HIV prevalence, 89%) were the next most common diagnoses. Asthma (n = 26; HIV prevalence, 46%), posttuberculous disease and other fibrotic lung disease (n = 34; HIV prevalence, 88%), and cardiac disease (n = 15; HIV prevalence, 93%) were more common than were Pneumocystis jiroveci pneumonia and cryptococcosis (n = 8 and n = 5, respectively; HIV prevalence, 100%), and we found no cases of nocardiosis or histoplasmosis. CONCLUSIONS: TB was diagnosed for 43% of patients who presented with chronic cough to primary health care clinics in Harare, with 71% having smear-positive disease. The findings of TB culture added relatively little to the findings of fluorescent microscopy of concentrated sputum specimens. The prevalence of HIV infection was high across a range of diagnoses, suggesting that an HIV test should be recommended in the initial investigation of chronic cough