Use of functional near-infrared spectroscopy to evaluate cognitive change when using healthcare simulation tools

This is an accepted manuscript of an article published by BMJ on 01/11/2020, available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936993/ The accepted version of the publication may differ from the final published version.Background The use of brain imaging techniques in healthcare simulation is relatively rare. However, the use of mobile, wireless technique, such as functional nearinfrared spectroscopy (fNIRS), is becoming a useful tool for assessing the unique demands of simulation learning. For this study, this imaging technique was used to evaluate cognitive load during simulation learning events. Methods This study took place in relation to six simulation activities, paired for similarity, and evaluated comparative cognitive change between the three task pairs. The three paired tasks were: receiving a (1) face-toface and (2) video patient handover; observing a simulated scene in (1) two dimensions and (2) 360° field of vision; and on a simulated patient (1) taking a pulse and (2) taking a pulse and respiratory rate simultaneously. The total number of participants was n=12. Results In this study, fNIRS was sensitive to variations in task difficulty in common simulation tools and scenarios, showing an increase in oxygenated haemoglobin concentration and a decrease in deoxygenated haemoglobin concentration, as tasks increased in cognitive load. Conclusion Overall, findings confirmed the usefulness of neurohaemoglobin concentration markers as an evaluation tool of cognitive change in healthcare simulation. Study findings suggested that cognitive load increases in more complex cognitive tasks in simulation learning events. Task performance that increased in complexity therefore affected cognitive markers, with increase in mental effort required

Family-based Childhood Obesity Interventions in the UK: a Systematic Review of Published Studies.

Family-based programmes that emphasise lifestyle and behaviour change using psychological principles have been shown to be effective in targeting childhood obesity. While there is some evidence that evaluates UK family-based obesity interventions at a local level, no review to date has addressed this nationally. This review presents the available evidence from UK family-based childhood obesity interventions. Ten articles that met the inclusion criteria were included for review. The majority of programmes reviewed lasted 12 weeks, with only three studies providing follow-up data at 12 months or longer. Change in adiposity may be a short-term benefit of participation in a child weight management programme, but there is insufficient robust evidence to indicate that this benefit is long lasting and many studies were methodologically weak with limited internal validity. There is insufficient evidence to suggest how the inclusion of parents and the wider family may impact on the effectiveness of UK community based weight management programme for children and young people

Evaluation of the Patients First Programme : Final Report of the Foundation of Nursing Studies, November 2013.

The Patients First practice development programme supports nurse-led projects focused on implementing and evaluating patient-centred improvements in healthcare settings across the UK. The programme is managed by the Foundation of Nursing Studies (FoNS), with funding from the Burdett Trust for Nursing. This evaluation aimed to assess the extent to which the aims of the programme had been achieved; the added value of participation for individuals, their practice and patient care; and the longer term benefits of the programme. A mixed method approach was used, including: a review of project reports; online questionnaire for project leads (n=23, response rate =50%); semi-structured interviews with key stakeholders (n=15) and case studies. The programme has largely achieved its aims, albeit with variable outcomes at project level. The main outcomes have involved increasing the skills and confidence of nursing staff, and enhancing their ability to influence change within their working environment, thereby having a positive impact on patient care and clinical practice. The questionnaire and interviews responses indicated that the programme is worthwhile. Funding was used to facilitate staff engagement and to backfill staff time. Benefits identified by project leads included assistance with reflective practice; feeling more engaged in talking and listening to patients; enhanced skills in practice development techniques; and greater confidence implementing these skills effectively in different settings. Added value at an organisational level was seen through better engagement between team members, improved collaboration and communication between nursing and medical teams, and empowerment of nursing staff to influence change within their workplace. Patient benefits included patients feeling that service provision better met their needs, with an increased awareness amongst staff of issues around user involvement in care planning. Three-quarters of individual projects resulting in changes in care had, at least in part, been continued or mainstreamed. Capacity and capability in implementing practice development approaches appear to have increased in a small number of areas, with several former project leads coaching their colleagues in practice development skills

Improving the ‘victim journey’ when reporting domestic abuse cyberstalking to the police – A pilot project evaluation

CCriminal justice responses to stalking in England and Wales have come under increased scrutiny following the Joint Criminal Justice Inspectorate report in 2017. In response, police forces throughout England and Wales attempted to improve their handling of stalking. In one UK police force, a project was developed to improve the identification, investigation and victim journey for domestic abuse cyberstalking offences. The project included a specialist investigation team along with a dedicated and co-located Independent Domestic Violence Advisor. This article draws on research conducted during the evaluation of the project and will evidence high levels of victim engagement, positive reports from victims and a 100% success rate in obtaining restraining orders. These findings highlight the valuable role of specialist teams with integrated, independent support for victims and suggest that the victim journey can be improved through collaborative projects between the police and specialist organisations

Patient Communication Simulators for Interprofessional Healthcare Education:Work in Progress - Poster Presentation

Background and aim: The use of virtual technology has increased in clinical education since the pandemic, which necessitated a rapid shift to computer-generated experiences [1]. Whilst student placements have essentially returned to a face-to-face model, plans to continue an element of virtual simulation remain [2]. One area where virtual simulation remains of benefit is interprofessional education (IPE). Online delivery can overcome timetabling challenges that present when coordinating multiple programmes across different disciplines [3]. This project aims to build an IPE scenario that follows a virtual patient journey using an extended reality (XR) platform. Method: An existing scenario based on a service user encountered during a physiotherapy placement, was developed into an IPE resource. Collaboration occurred between the university research team, the simulation department and the IPE working groups, in conjunction with the software creation team. Multiple professional scripts were added to the scenario. Two time points were built into a virtual patient with frailty syndrome, to facilitate student interviews with paramedics, emergency clinicians, diagnostic radiographers, geriatricians, physiotherapists, occupational therapists, nurses, operating department practitioners, dietetics, and social workers. Results: To date, 68 user testing sessions have been conducted to allow the software developers to refine the conversational artificial intelligence (AI).Discussion: There were two key lessons. Firstly, the information's volume, complexity and interrelatedness lend best to data collection via a co-creation process, rather than approaching each profession separately (effectively building scenarios in silos). Secondly, appropriate training and setting user testers’ expectations are recommended to maximise participation and engagement.There are three future research directions. Stakeholder interviews of the contributors, co-creation to develop the allied health scripting and recruiting larger numbers of user testers to develop the conversational AI. This is the first custom case of this size and complexity. The resource will be available within the university to support IPE activities. Conclusion: This project is an example of how XR technology can be developed in a clinical context. The resource is intended to illustrate the value of a joined up care pathway, to develop a systems mindset in healthcare students