PurposeThe aim of this systematic review was to find best teaching strategies for teaching evidence-based practice (EBP) to undergraduate health students that have been adopted over the last years in healthcare institutions worldwide.MethodsThe authors carried out a systematic, comprehensive bibliographic search using Medline database for the years 2005 to March 2015 (updated in March 2016). Search terms used were chosen from the USNLM Institutes of Health list of MeSH (Medical Subject Headings) and free text key terms were used as well. Selected articles were measured based on the inclusion criteria of this study and initially compared in terms of titles or abstracts. Finally, articles relevant to the subject of this review were retrieved in full text. Critical appraisal was done to determine the effects of strategy of teaching evidence-based medicine (EBM).ResultsTwenty articles were included in the review. The majority of the studies sampled medical students (n=13) and only few conducted among nursing (n=2), pharmacy (n=2), physiotherapy/therapy (n=1), dentistry (n=1), or mixed disciplines (n=1) students. Studies evaluated a variety of educational interventions of varying duration, frequency and format (lectures, tutorials, workshops, conferences, journal clubs, and online sessions), or combination of these to teach EBP. We categorized interventions into single interventions covering a workshop, conference, lecture, journal club, or e-learning and multifaceted interventions where a combination of strategies had been assessed. Seven studies reported an overall increase to all EBP domains indicating a higher EBP competence and two studies focused on the searching databases skill.ConclusionFollowings were deduced from above analysis: multifaceted approach may be best suited when teaching EBM to health students; the use of technology to promote EBP through mobile devices, simulation, and the web is on the rise; and the duration of the interventions varying form some hours to even months was not related to the students’ EBP competence.

This study is an evaluation of the problem of noise pollution in operating rooms. The high sound pressure level of noise in the operating theatre has a negative impact on communication between operating room personnel. The research took place at nine Greek public hospitals with more than 400 beds. The objective evaluation consisted of sound pressure level measurements in terms of L(eq), as well as peak sound pressure levels in recordings during 43 surgeries in order to identify sources of noise. The subjective evaluation consisted of a questionnaire answered by 684 operating room personnel. The views of operating room personnel were studied using Pearson's X(2) Test and Fisher's Exact Test (SPSS Version 10.00), a t-test comparison was made of mean sound pressure levels, and the relationship of measurement duration and sound pressure level was examined using linear regression analysis (SPSS Version 13.00). The sound pressure levels of noise per operation and the sources of noise varied. The maximum measured level of noise during the main procedure of an operation was measured at L(eq)=71.9 dB(A), L(1)=84.7 dB(A), L(10)=76.2 dB(A), and L(99)=56.7 dB(A). The hospital building, machinery, tools, and people in the operating room were the main noise factors. In order to eliminate excess noise in the operating room it may be necessary to adopt a multidisciplinary approach. An improvement in environment (background noise levels), the implementation of effective standards, and the focusing of the surgical team on noise matters are considered necessary changes.

Noise sources and levels were evaluated in a six-bed intensive care unit (ICU) in Athens, Greece. Ten patients (six males, four females) completed specifically designed questionnaires, and at the same time nine 8-h sound measuring sessions took place. A Bruel and Kjaer 2231 sound-meter was used on the decibel-A scale combined with observation. Human activity, operating equipment and construction engineering of the hospital building were identified as sources of noise. Noise levels were elevated [LEQ = 60.3-67.4 dB(A)]. No reliable information was obtained from the questionnaires. ICU noise levels were higher by 27 dB(A) than recommended hospitals levels. To counteract noise pollution in ICUs, staff awareness and sensitivity are needed.

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Objective: To validate a Greek version of the structured self-reported 8-item Morisky Medication Adherence Scale (MMAS-8) and determine its psychometric properties in patients with chronic illnesses. Methods: A cross-sectional survey was conducted in a small public hospital and a public health care centre, in a rural town in western Greece. The sample consisted of 100 patients with various chronic illnesses. Data were collected between January-May 2011, on the Greek version of the MMAS-8 and Beliefs about Medicines Questionnaire (BMQ). Results: Scale's reliability analysis revealed an overall Cronbach's alpha of 0.753 and the corrected item to total correlations, were greater than 0.30 for each of the 8 items comprising the medication adherence scale, showing good internal consistency. Convergent validity was supported by a significant correlation between the present scale's total score and the BMQ-Specific Necessity score (Spearman's rho = 0.492, p < 0.001). Conclusion: The current study showed acceptable reliability and validity of the Greek version of the 8-item MMAS to measure adherence to medications for various chronic illnesses. The validated Greek version of the MMAS-8 can help towards understanding adherence barriers in Greece so as to develop effective strategies to increase adherence and reduce the costs.