Extended reality therapies for anxiety disorders : a systematic review of patients’ and healthcare professionals’ perspectives

1) Background: Anxiety disorders are among the most common psychiatric conditions and have a rising prevalence. Patients with anxiety disorders can, however, be deterred from seeking treatment due to associated stigmas and medication side effects. Evidence indicates that promising digital health solutions to address those concerns reside in the growing field of extended reality (XR). The limited literature synthesis from the perspectives of patients and healthcare professionals (HCPs) regarding the experiences and effectiveness of XR-based anxiety disorder therapies motivated the undertaking of this systematic review. (2) Methods: A systematic search of the literature was conducted according to the PRISMA 2020 guidelines on the following databases: CINAHL, APA PsycNet and PubMed. The search was completed on 23 January 2024 with no restriction on the time of publication. Studies were screened based on a predetermined selection criteria relevant to the research aims. (3) Results: Five studies fulfilled the inclusion requirements. The majority investigated the use of XR tools for individual therapy and indicated that they can be as effective for patients as traditional methods and can aid in HCPs’ therapeutic tasks. (4) Conclusions: XR-based anxiety disorder therapies are generally perceived as immersive and with minimal side effects by patients, while HCPs mostly consider XR tools as practical and assistive. However, refinements with the XR setup could further improve the experience. Such modalities represent potent drug-free alternatives or supplements to traditional therapy and could be considered for remote, individual care. The findings’ generalisability requires further research into more conditions within the anxiety disorder group, as well as larger sample sizes.Peer reviewe

Forward Thinking and Adaptability to Sustain and Advance IPECP in Healthcare Transformation Following the COVID-19 Pandemic

The proliferation of the novel SARS-CoV-2 (COVID-19) virus across the globe in 2020 produced a shared trauma internationally of unprecedented devastation, disruption, and death. At the same time, the pandemic has been a transformation catalyst accelerating the implementation and adoption of long overdue changes in healthcare education and practice, including telehealth and virtual learning. The COVID-19 pandemic has placed healthcare at a crossroads, either viewing it as a temporary situation that requires short-term solutions, or as a major disruption that presents opportunities for innovation for sustainable development and transformation. As COVID-19 transitions from pandemic to endemic, we have a unique opportunity to leverage lessons learned that can foster healthcare transformation through innovation, forward thinking, and interprofessional education and collaborative practice (IPECP). With the changing landscape of higher education and healthcare, IPECP leaders need to reflect on and implement ‘Forward Thinking and Adaptability’ and ‘Sustainability and Growth’ in their IPECP approaches and strategies to achieve the Quintuple Aim. To capitalize on this opportunity and based on a recent publication by InterprofessionalResearch Global, this paper explores and debates (from a global perspective) the impact and application of healthcare education and practice transformation on IPECP with the goal to identify best practices in integrating and sustaining IPECP and building a resilient workforce

Interprofessional Education and Collaborative Practice (IPECP) in Post-COVID Healthcare Education and Practice Transformation Era – Discussion Paper. Joint Publication by InterprofessionalResearch.Global, American Interprofessional Health Collaborative & Canadian Interprofessional Health Collaborative

In the past two years the world has experienced unprecedented devastation, disruption, and death due to the COVID-19 global Pandemic. At the same time, the Pandemic acts as a transformation catalyst that accelerated the implementation and adoption of long overdue changes in healthcare education and practice, including telehealth and virtual learning.Interprofessional collaboration during the pandemic was able to foster healthcare transformation in several ways at the policy and legislative level, such as the fast-tracking of internationally trained professions. The role and use of digital technologies in healthcare education and practice have been extended and solidified by the pandemic. Macro-level policies acknowledging the importance ofpopulation health are key for future interprofessional collaboration of stakeholders to address inequalities. Similarly, interprofessional collaboration is key to addressing the proliferation of misinformation. Interprofessional education and collaborative practice (IPECP) can be effectively utilized to combat misinformation by increasing health literacy amongst health professions and the communities they serve.Despite IPECP being an integral component of promoting patient safety, and holistic, quality care, silos continue to exist. Furthermore, implementation of the Quintuple Aim (better health, better care, better value, better work experience, and better health equity), particularly through the lens of equity, remains elusive. Going forward, the integration and sustainability of IPECP are crucial and the experience of IPECP within the context of the COVID-19 pandemic should be reflected on, researched, and evaluated to inform future global healthcare systems and the workforce to provide and achieve the Quintuple Aim; the goal ofall in healthcare.As we are emerging out of the Pandemic, we have a unique opportunity to leverage on the lessons learned from the pandemic in fostering the healthcare transformation through innovation and IPECP. To capitalize on this opportunity and in a collaborative effort, the InterprofessionalResearch.Global (IPR.Global), the American Interprofessional Health Collaborative (AIHC), and the CanadianInterprofessional Health Collaborative (CIHC) have developed this e-book as a Discussion Paper to explore and discuss (from a global perspective) the impact and application of healthcare education and practice transformation on IPECP as we emerge from the COVID Pandemic with the goal to identify best practicesto integrate and sustain IPECP. We call the interprofessional educators, practitioners, leaders, scholars, and policy makers to utilize ‘Forward Thinking and Adaptability’ and ‘Sustainability and Growth’ in their IPECP approaches and strategies, to achieve Quintuple Aim. As learned during the Pandemic, working together – across professions, institutions, nationally, and globally – is essential in emerging stronger and in transforming our healthcare education and practice

Acceptance and experiences of telecommunication and teleconsultation by medical undergraduate students and medical educators during the COVID-19 pandemic

BackgroundDuring the COVID-19 pandemic virtual patient contact became standard in patient care. Technological solutions challenged educational and practical work around the world; health workers were challenged to offer the same standards and high-quality of care to their patients. Therefore, it is of interest how students and professionals perceived the use of teleconsultation, and which difficulties they were facing. MethodsThe study utilises a quantitative approach based on the Technology Acceptance Model (TAM) to evaluate the level of acceptance of teleconsultations among medical students and medical educators in the UK. The measured constructs are perceived usefulness, perceived ease of use, attitudes, intention to use, and difficulties in use. ResultsTo date results are preliminary. Data collection continues until mid-May 2021. Cronbach’s alpha was ≥.718 for all TAM subscales. Perceived usefulness, perceived ease of use, and attitudes toward teleconsultations are significantly correlated. ConclusionThe results will indicate how students and medical educators perceived the changes to teleconsultations in clinical and simulated settings. Moreover, the TAM is a good model to understand students’ and educators’ level of acceptance and intention to use teleconsultations after the COVID-19 pandemic. The results can help to inform medical education guidelines and foster the implementation of telemedicine<br/

Improvements in biometric health measures among individuals with intellectual disabilities:a controlled evaluation of the Fit 5 program

Background: Individuals with intellectual disabilities (ID) have poorer health statuses compared to the general population. Actions are needed to address health disparities and promote healthy lifestyles among individuals with ID. Moreover, studies that consider program settings for this population are needed.Objective: The Special Olympics health program, Fit 5, was evaluated to assess effectiveness in improving health measures for individuals with ID. The settings of programs' implementation were also considered.Methods: Four Special Olympics basketball teams participated as an intervention group, and three teams as a control group, in a study of the Fit 5 program that was implemented during, and as part of, a regular 8-week basketball season. Resting heart rate (RHR) and blood pressure, and height and weight to calculate Body Mass Index (BMI), were measured before and after the program. Differences in pre- and post-measures were compared between the two groups with paired samples t-tests and ANCOVA.Results: Participants in the intervention group had significantly greater improvements in resting systolic and diastolic blood pressures (p = 0.02 and 0.03, respectively) and RHR (p = 0.003). BMI increased for both groups; however, the increase in the intervention group was significantly less (p = 0.006). The Special Olympics setting was considered familiar and supportive and effectively reached individuals with ID.Conclusion: The Fit 5 program positively impacts RHR and blood pressure, and could help reduce extents of BMI increases, in individuals with ID when implemented in a common setting. Further investigation of the impact of Fit 5 and similar programs in additional settings is warranted

“I think it’s a lot harder” – fundamentals for developing a core curriculum in telecommunication and teleconsultation in undergraduate medical education in the UK

Telehealth has become increasingly important in modern healthcare systems, as remote communication with colleagues (i.e. telecommunication) and remote consultations with patients (i.e. teleconsultations) increased in the last decades. The workforce should be prepared for working in digitised healthcare systems which demand different skills, competencies, and attitudes. A systematic literature review has shown limited evidence-informed training regarding telecommunication and teleconsultation (TC) at undergraduate level. These results led to the aim of this PhD study: exploring factors that can inform a core curriculum on TC in UK undergraduate medical education. An additional coverage mixed-methods design was conducted, utilising an online questionnaire and semi-structured interviews. Medical educators and undergraduate medical students in the UK were invited to participate in this study. The development of the questionnaire was based on the Technology Acceptance Model and the results of a test-retest cycle. Quantitative data was analysed descriptively, and qualitative data was analysed inductively and deductively using thematic analysis. Results indicated that most students and educators have had experiences with TC during the pandemic. Medical schools adapted their curriculum quickly, yet most study participants could not report on the formalities and content of teaching taking place in academic learning environments. The opinions on TC were mixed but students as well as educators think that it requires efficacious triaging systems and different communication skills. Globally, healthcare systems are increasing the use of telehealth. It is essential to prepare the future workforce for those changes. This study contributed to building the foundation for the development of a TC core curriculum in UK undergraduate medical education

Teleconsultation skills: Differences between online and face-to-face OSCE results in undergraduate medical students

Introduction: Due to the COVID-19 pandemic assessments in medical education had to be reconsidered. Some universities introduced online OSCEs to ensure a continuous learning experience and to uphold the quality in medical education. The aim of this work is to evaluate how communication skills and clinical skills OSCE results changed during the COVID-19 pandemic compared to pre-pandemic results in undergraduate medical students. Methods: Retrospective analyses of the results of the clinical and communication skills OSCE exams were conducted. The results derived from the years 2018, 2019, and 2021.Results: Students who took the communication skills OSCEs online and the clinical skills OSCEs face-to-face scored on average lower compared to students who took the OSCEs entirely face-to-face. The average results in communication skills in all modules are significant different before and during the COVID-19 pandemic.Discussion: Significantly lower scores in the online communication OSCE compared to the face-to-face communication OSCEs indicate that students might require different competencies and skills in an online consultation.Conclusion: Optimally, medical undergraduate students will be prepared for online and face-to-face consultations during their education. However, further research is warranted to conclude on the comparability of online and face-to-face OSCEs. <br/