Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Knowledge of Depression and Malingering: An Exploratory Investigation

Malingering mental disorder for financial compensation can offer substantial rewards to those willing to do so. A recent review of UK medico-legal experts’ practices for detecting claimants evidenced that they are not well equipped to detect those that do. This is not surprising, considering that very little is known regarding why individuals opt to malinger. A potential construct which may influence an individual’s choice to malinger is their knowledge of the disorder, and when one considers the high levels of depression literacy within the UK, it is imperative that this hypothesis is investigated. A brief depression knowledge scale was devised and administered to undergraduate students (N = 155) alongside a series of questions exploring how likely participants were to malinger in both workplace stress and claiming for benefit vignettes. Depression knowledge did not affect the likelihood of engaging in any malingering strategy in either the workplace stress vignettes or the benefit claimant vignettes. Differences were found between the two vignettes providing evidence for the context-specific nature of malingering, and an individual’s previous mental disorder was also influential

Online case-based learning in medical education: a scoping review

Abstract Background Case-Based Learning (CBL) in medical education is a teaching approach that engages students as learners through active learning in small, collaborative groups to solve cases from clinical patients. Due to the challenges afforded by the COVID-19 pandemic, small group learning such as CBL, transitioned quickly to include technology-enhanced learning to enable distance delivery, with little information on how to apply pedagogical frameworks and use learning theories to design and deliver online content. Methods To extend understanding of online CBL a scoping review protocol following the PRISMA-ScR framework explored the literature that describes the use of online CBL application in medical education and the outcomes, perceptions, and learning theories. A literature search was conducted in January 2022 followed by a subsequent review in October 2022. After peer review using the PRESS guidelines, the CASP appraisal tool was used to assess the rigor of each study design. Results The scoping review identified literature published between 2010 and 2022 (n = 13 articles), on online CBL in the field of medical education with 11 observational studies describing student and facilitator perceptions and two randomized controlled studies. Positive perceptions of online learning included a flexible work-life balance, connection with learners, and improved accessibility. Negative experiences of online CBL included poor internet access, a distracting learning environment, and loss of communication. In the studies that collected student performance data, results showed equivalent or improved outcomes compared to the control. The CASP appraisal tool highlighted the deficiencies in most study designs, lack of framework or learning theory, and poor reproducibility of the methods to answer the research questions. Conclusion This scoping review identified literature to describe the academic outcomes, and student and facilitator perceptions of online CBL in medical education. However, the CASP tool uncovered deficiencies in study descriptions and design leading to poor quality evidence in this area. The authors provide recommendations for frameworks and learning theories for the future implementation of online CBL

An eLearning module is comparable to face-to-face teaching in a nursing human pathophysiology subject

BackgroundHuman pathophysiology is important in undergraduate nursing education to help students develop clinical reasoning skills. Traditionally pathophysiology education in undergraduate nursing is taught face-to-face. However, eLearning in nursing curricula may provide flexible delivery options.ObjectiveWith increased inclusion of technology enhanced learning in nursing curricula, a hematology eLearning module was evaluated in a pathophysiology subject to determine whether it was comparable to face-to-face learning.DesignSingle-blind randomized pre-test/post-test controlled trial.SettingSchool of Health and Behavioural Sciences, University of the Sunshine Coast.ParticipantsA total of 271 second-year undergraduate students enrolled in Human Pathophysiology were included in the study. Students were from three bachelor programs: Nursing Science; Paramedic Science; and Clinical Exercise Physiology. Students were randomly allocated to either the experimental group (n = 85) or the control group (n = 186).MethodsA hematology eLearning module was designed to be self-directed and learner-centered, guided by constructivist learning theories for delivery in the human pathophysiology subject. The experimental “eLearning” group completed the module independently, and the control “face-to-face” group completed equivalent paper-based activities facilitated by a tutor. All students completed a pre-test assessment and two post-test assessments two weeks after the intervention and at the end of the subject.ResultsThere was no significant difference in assessment scores between the experimental and control groups, or between nursing and other programs.ConclusioneLearning was comparable to face-to-face teaching in this study. We recommend further research to strengthen the links between pathophysiology theory to clinical reasoning skills using eLearning

Collusion is still a tricky topic: student perspectives of academic integrity using assessment-specific examples in a science subject

Academic integrity is important, not just in the university setting but beyond, as students graduate and move into professional fields. Discrepancies in the understanding of what constitutes academic dishonesty exist between institutional policies, discipline areas and individual educators, which creates challenges for students trying to uphold academic integrity. We examined the student perspective and understanding of academic integrity in the context of subject-specific assessment. Three sequential online academic integrity modules were presented in a large first-year biology subject (n = 631). Modules consisted of scenarios describing academic dishonesty in subject-specific assessment. Students received feedback which also highlighted the importance of academic integrity in future professions and were surveyed at the end of the semester. Students clearly identified examples of cheating, fraud and contract cheating. However, they did not recognise collusion when it happened with close and social contacts. Most students felt confident that they could apply their newly acquired knowledge of academic integrity in their future studies and professions. This study showed that the use of contextual and carefully curated subject-specific scenarios can create more knowledgeable and confident students who can successfully approach assessment with integrity. Additionally, it is important to make explicit to students what is deemed collusion in subject-specific contexts. Supplemental data for this article is available online at https://doi.org/10.1080/02602938.2022.2040947.</p

A plethora of choices: an anatomists’ practical perspectives for the selection of digital anatomy resources

The use of digital resources in the new learning environment has drastically influenced how human topographic anatomy is taught and assessed. An array of digital technologies for anatomy teaching have been recently adopted in medical and health science schools in both undergraduate and postgraduate courses. This resulted from a surging demand for digital anatomy technologies in the wake of the coronavirus disease 2019 (COVID-19) pandemic and required rapid digital up-skilling of anatomists. Despite the wide adoption of digital technologies in anatomy teaching, there is little comprehensive information on the selection and implementation of these digital resources from a practical perspective. Based on the authors’ experience and supported by literature, this article describes their implementation of digital anatomy resources for teaching gross anatomy in eleven Australian universities. This paper highlights the advantages and limitations that the authors encountered and their recommendations for using these current digital technologies in anatomy teaching