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79 result(s) for "Sikora, Lindsey"
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Digital storytelling in health professions education: a systematic review
Background Digital stories are short videos that combine stand-alone and first-person narratives with multimedia. This systematic review examined the contexts and purposes for using digital storytelling in health professions education (HPE) as well as its impact on health professionals’ learning and behaviours. Methods We focused on the results of HPE studies gleaned from a larger systematic review that explored digital storytelling in healthcare and HPE. In December 2016, we searched MEDLINE, EMBASE, PsycINFO, CINAHL, and ERIC. We included all English-language studies on digital storytelling that reported at least one outcome from Levels 2 (learning) or 3 (behaviour) of The New World Kirkpatrick Model. Two reviewers independently screened articles for inclusion and extracted data. Results The comprehensive search (i.e., digital storytelling in healthcare and HPE) resulted in 1486 unique titles/abstracts. Of these, 153 were eligible for full review and 42 pertained to HPE. Sixteen HPE articles were suitable for data extraction; 14 focused on health professionals’ learning and two investigated health professionals’ learning as well as their behaviour changes. Half represented the undergraduate nursing context. The purposes for using digital storytelling were eclectic. The co-creation of patients’ digital stories with health professionals as well as the creation and use of health professionals’ own digital stories enhanced learning. Patients’ digital stories alone had minimal impact on health professionals’ learning. Conclusions This review highlights the need for high-quality research on the impact of digital storytelling in HPE, especially on health professionals’ behaviours. PROSPERO registration number CRD42016050271 .
Barriers and facilitators to cultural competence in rehabilitation services: a scoping review
Background There is an important need to evaluate whether rehabilitation services effectively address the needs of minority culture populations with North America’s increasingly diverse population. The objective of this paper was therefore to review and assess the state of knowledge of barriers and facilitators to cultural competence in rehabilitation services. Method Our scoping review focused on cultural competence in rehabilitation services. Rehabilitation services included in this review were: audiology, speech-language pathology, physiotherapy, and occupational therapy. A search strategy was developed to identify relevant articles published from inception of databases until April 2015. Titles and abstracts were screened by two independent reviewers according to specific eligibility criteria with the use of a liberal-accelerated approach. Full-text articles meeting inclusion criteria were then screened. Key study characteristics were abstracted by the first reviewer, and findings were verified by the second reviewer. Results After duplicates were removed, 4303 citations were screened. Included articles suggest that studies on cultural competence occur most frequently in occupational therapy ( n  = 17), followed by speech language pathology ( n  = 11), physiotherapy ( n  = 6), and finally audiology ( n  = 1). Primary barriers in rehabilitation services include language barriers, limited resources, and cultural barriers. Primary facilitators include cultural awareness amongst practitioners, cultural awareness in services, and explanations of health care systems. Conclusion To our knowledge, this review is the first to summarize barriers and facilitators to cultural competence in rehabilitation fields. Insufficient studies were found to draw any conclusions with regards to audiological services. Minimal perspectives based on patient/caregiver experiences in all rehabilitation fields underscore a research gap. Future studies should aim to explore both patient/caregiver and practitioner perspectives as such data can help inform culturally competent practices.
A systematic review of the association between coping strategies and quality of life among caregivers of children with chronic illness and/or disability
Background Parents of children with chronic illness have reported decreased psychological and physical quality of life (QoL) relative to parents of children without such illness, which may be associated with the extent of complexity involved in the caregiving role. Given that coping strategies have been reported to influence QoL, our goal was to synthesize existing research about the association between coping strategies and QoL in caregivers of children with chronic illness. We were particularly interested in whether coping strategies may mediate the association between caregiving complexity and QoL, or may modify the association. Methods We developed an electronic search strategy to identify relevant citations in Medline, EMBASE, PsycINFO and CINAHL. Two reviewers independently assessed retrieved citations against pre-specified inclusion criteria in two stages of screening. One reviewer abstracted data on study characteristics, methods to address confounding, measurement tools, risk of bias, and results with respect to associations of interest. A second reviewer validated extracted data. We summarized results narratively. Results 2602 citations were screened and 185 full-text articles reviewed. The 11 articles that met inclusion criteria addressed 5 diseases and included a total of 2155 caregivers. Ten of the 11 included studies were cross-sectional. We identified some evidence that coping was associated with QoL: in three studies, coping strategies considered to be adaptive were positively associated with psychological QoL while in one study, maladaptive strategies were negatively associated with psychological QoL. Only two studies considered coping as a potential mediating variable in the association between caregiving complexity and parental QoL, with inconsistent findings and challenges in interpreting cross-sectional associations. No studies considered coping as a moderating variable. The variability among instruments used to measure key constructs, particularly coping strategies, made it difficult to synthesize results. Conclusions We found that coping strategies may be associated with psychological QoL among parents of children with chronic illness. We also identified important research gaps related to the consistent and clear measurement of coping strategies and their prospective association with QoL. Understanding how coping strategies are associated with QoL is important to inform the development of interventions to support families of children with chronic illness.
Seasonality and symptoms of depression: A systematic review of the literature
Lay opinions and published papers alike suggest mood varies with the seasons, commonly framed as higher rates of depression mood in winter. Memory and confirmation bias may have influenced previous studies. We therefore systematically searched for and reviewed studies on the topic, but excluded study designs where explicit referrals to seasonality were included in questions, interviews or data collection. Systematic literature search in Cochrane database, DARE, Medline, Embase, PsychINFO and CINAHL, reporting according to the PRISMA framework, and study quality assessment using the Newcastle-Ottawa scale. Two authors independently assessed each study for inclusion and quality assessment. Due to large heterogeneity, we used a descriptive review of the studies. Among the 41 included studies, there was great heterogeneity in regards to included symptoms and disorder definitions, operationalisation and measurement. We also observed important heterogeneity in how definitions of 'seasons' as well as study design, reporting and quality. This heterogeneity precluded meta-analysis and publication bias analysis. Thirteen of the studies suggested more depression in winter. The remaining studies suggested no seasonal pattern, seasonality outside winter, or inconclusive results. The results of this review suggest that the research field of seasonal variations in mood disorders is fragmented, and important questions remain unanswered. There is some support for seasonal variation in clinical depression, but our results contest a general population shift towards lower mood and more sub-threshold symptoms at regular intervals throughout the year. We suggest future research on this issue should be aware of potential bias by design and take into account other biological and behavioural seasonal changes that may nullify or exacerbate any impact on mood.
Influence of emotions on clinical performance in acute care: A scoping review
Acute care is a high stake, emotionally charged environment. Although emotions are increasingly recognized as integral to various aspects of healthcare, research examining how they influence and interact with clinical performance in acute care settings remains relatively limited. This scoping review aims to summarize relevant empirical research on the influence of emotions on clinical performance in acute care settings. The following databases were searched by a health sciences librarian: Medline and Medline in Process, Embase Classic and Embase, Cochrane’s CENTRAL, APA PsycINFO, CINAHL, and ERIC, from inception to June 2024. Empirical research in English related to the effect of emotions on clinical performance in acute care settings were included. The screening was conducted in duplicate independently, and data extraction was done by the lead author and reviewed by a second author. Among 6430 references assessed, 22 studies were analyzed. Three themes were identified based on the research setting: simulated/educational acute care settings, real-world acute care settings, and end-of-life care settings. Overall, negative emotions, most commonly stress, were inversely correlated with clinical performance in some simulated or educational settings and discouraged patient contact in real clinical settings, while positive emotions encouraged more comprehensive care. Experiencing fear and uncertainty led to more cautious care decisions, and negative emotions associated with patient’s families were prevalent in end-of-life care. Emotions had varying effects on clinical performance and decision-making in acute care settings, depending on the types of emotions and the clinical contexts. More research is needed to find strategies to help clinicians manage those emotions.
Interventions to prevent hemodynamic instability during renal replacement therapy in critically ill patients: a systematic review
Background Hemodynamic instability related to renal replacement therapy (HIRRT) may increase the risk of death and limit renal recovery. Studies in end-stage renal disease populations on maintenance hemodialysis suggest that some renal replacement therapy (RRT)-related interventions (e.g., cool dialysate) may reduce the occurrence of HIRRT, but less is known about interventions to prevent HIRRT in critically ill patients receiving RRT for acute kidney injury (AKI). We sought to evaluate the effectiveness of RRT-related interventions for reducing HIRRT in such patients across RRT modalities. Methods A systematic review of publications was undertaken using MEDLINE, MEDLINE in Process, EMBASE, and Cochrane’s Central Registry for Randomized Controlled Trials (RCTs). Studies that assessed any intervention’s effect on HIRRT (the primary outcome) in critically ill patients with AKI were included. HIRRT was variably defined according to each study’s definition. Two reviewers independently screened abstracts, identified articles for inclusion, extracted data, and evaluated study quality using validated assessment tools. Results Five RCTs and four observational studies were included ( n = 9; 623 patients in total). Studies were small, and the quality was mostly low. Interventions included dialysate sodium modeling ( n = 3), ultrafiltration profiling ( n = 2), blood volume ( n = 2) and temperature control ( n = 3), duration of RRT ( n = 1), and slow blood flow rate at initiation ( n = 1). Some studies applied more than one strategy simultaneously ( n = 5). Interventions shown to reduce HIRRT from three studies (two RCTs and one observational study) included higher dialysate sodium concentration, lower dialysate temperature, variable ultrafiltration rates, or a combination of strategies. Interventions not found to have an effect included blood volume and temperature control, extended duration of intermittent RRT, and slower blood flow rates during continuous RRT initiation. How HIRRT was defined and its frequency of occurrence varied widely across studies, including those involving the same RRT modality. Pooled analysis was not possible due to study heterogeneity. Conclusions Small clinical studies suggest that higher dialysate sodium, lower temperature, individualized ultrafiltration rates, or a combination of these strategies may reduce the risk of HIRRT. Overall, for all RRT modalities, there is a paucity of high-quality data regarding interventions to reduce the occurrence of HIRRT in critically ill patients.
Antenatal and postpartum prevention of Rh alloimmunization: A systematic review and GRADE analysis
Existing systematic reviews of Rh immunoprophylaxis include only data from randomized controlled trials, have dated searches, and some do not report on all domains of risk of bias or evaluate the certainty of the evidence. Our objective was to perform an updated review, by including new trials, any comparative observational studies, and assessing the certainty of the evidence using the GRADE framework. We searched MEDLINE, Embase and the Cochrane Library from 2000 to November 26, 2019. Relevant websites and bibliographies of systematic reviews and guidelines were searched for studies published before 2000. Outcomes of interest were sensitization and adverse events. Risk of bias was evaluated with the Cochrane tool and ROBINS-I. The certainty of the evidence was performed using the GRADE framework. Thirteen randomized trials and eight comparative cohort studies were identified, evaluating 12 comparisons. Although there is some evidence of beneficial treatment effects (e.g., at 6-months postpartum, fewer women who received RhIg at delivery compared to no RhIg became sensitized [70 fewer sensitized women per 1,000 (95%CI: 67 to 71 fewer); I2 = 73%]), due to very low certainty of the evidence, the magnitude of the treatment effect may be overestimated. The certainty of the evidence was very low for most outcomes often due to high risk of bias (e.g., randomization method, allocation concealment, selective reporting) and imprecision (i.e., few events and small sample sizes). There is limited evidence on prophylaxis for invasive fetal procedures (e.g. amniocentesis) in the comparative literature, and few studies reported adverse events. Serious risk of bias and low to very low certainty of the evidence is found in existing RCTs and comparative observational studies addressing optimal effectiveness of Rh immunoprophylaxis. Guideline development committees should exercise caution when assessing the strength of the recommendations that inform and influence clinical practice in this area.
Stakeholder perceptions and experiences of competency-based training with entrustable professional activities (SPECTRE): protocol of a systematic review and thematic synthesis of qualitative research
Background Competency-Based Medical Education (CBME) aims to align educational outcomes with the demands of modern healthcare. Entrustable Professional Activities (EPAs) serve as key tools for feedback and professional development within CBME. With the growing body of literature on EPAs, there is a need to synthesize existing research on stakeholders’ experiences and perceptions to enhance understanding of the implementation and impact of EPAs. In this synthesis, we will address the following research questions: How are Entrustable Professional Activities experienced and perceived by stakeholders in various healthcare settings, and what specific challenges and successes do they encounter during their implementation? Methods Using Thomas and Harden’s thematic synthesis method, we will systematically review and integrate findings from qualitative and mixed-methods research on EPAs. The process includes a purposive literature search, assessment of evidence quality, data extraction, and synthesis to combine descriptive and analytical themes. Discussion This study aims to provide insights into the use of EPAs for competency-based education, reflecting diverse contexts and viewpoints, and identifying literature gaps. The outcomes will guide curriculum and policy development, improve educational practices, and set future research directions, ultimately aligning CBME with clinical realities. Trial Registration Not required.
Exploring librarians’ practices when teaching advanced searching for knowledge synthesis: results from an online survey
Objective: There is little research available regarding the instructional practices of librarians who support students completing knowledge synthesis projects. This study addresses this research gap by identifying the topics taught, approaches, and resources that academic health sciences librarians employ when teaching students how to conduct comprehensive searches for knowledge synthesis projects in group settings. Methods: This study applies an exploratory-descriptive design using online survey data collection. The final survey instrument included 31 open, closed, and frequency-style questions. Results: The survey received responses from 114 participants, 74 of whom met the target population. Some key results include shared motivations to teach in groups, including student learning and curriculum requirements, as well as popular types of instruction such as single session seminars, and teaching techniques, such as lectures and live demos. Conclusion: This research demonstrates the scope and coverage of librarian-led training in the knowledge synthesis research landscape. Although searching related topics such as Boolean logic were the most frequent, librarians report teaching throughout the review process like methods and reporting. Live demos and lectures were the most reported approaches to teaching, whereas gamification or student-driven learning were used rarely. Our results suggest that librarian’s application of formal pedagogical approaches while teaching knowledge synthesis may be under-utilized, as most respondents did not report using any formal instructional framework.