Tuberculosis (TB) cases worldwide have declined over the last 10 years, but strong barriers to detection and treatment of TB still exist, especially among 2 special subgroups of low-income populations, immigrants and the homeless, where the incidence of TB can be up to 20 times higher than the general population even in affluent countries. A systematic review of literature was performed, aimed at identifying the main (1) barriers to and (2) effective interventions for the improved detection and treatment of TB in homeless and immigrant populations. Data were collected from 22 studies out of 80 potentially relevant citations worldwide published between 1998 and 2012. Key findings show that hard-to-reach groups like immigrants and the homeless seem willing to obtain care if they believe it is important, but any new detection/treatment efforts must go beyond current bio-medical models to bio-psychosocial models of the target populations' cultural values. Preliminary results also suggest that the best interventions for the homeless and immigrant populations will be a combination of, at least, monetary incentive and improved accessibility of care.
Attitudes toward interprofessional education are positive overall, but inferences about its key elements are hard to draw. Studies with qualitative strands examining interprofessional education’s key elements (communication, collaboration/teamwork, learning in practice, and understanding of roles) are especially needed. This mixed quantitative/qualitative standardized patient simulation involved 10 family nurse practitioner and 10 medical students. Both cohorts expressed improved teamwork confidence but were concerned about the complexity of teamwork and pressures on communication. At the complexity/communication nexus, nurse practitioner students thought interprofessional trust and equality were key; medical students saw the importance of strategizing multiple professional perspectives.
Interprofessional education (IPE) typically involves clinical simulation exercises with students from medical and nursing schools. Yet, healthcare requires patient-centered teams that include diverse disciplines. Students from public health and informatics are rarely incorporated into IPE, signaling a gap in current educational practices. In this study, we integrated students from administrative and non-clinical disciplines into traditional clinical simulations and measured the effect on communication and teamwork. From July 2017–July 2018, 408 students from five schools (medicine, nursing, dentistry, public health, and informatics) participated in one of eight three-hour IPE clinical simulations with Standardized Patients and electronic health record technologies. Data were gathered using a pre-test–post-test interventional Interprofessional Collaborative Competency Attainment Survey (ICCAS) and through qualitative evaluations from Standardized Patients. Of the total 408 students, 386 (94.6%) had matched pre- and post-test results from the surveys. There was a 15.9% improvement in collaboration overall between the pre- and post-tests. ICCAS competencies showed improvements in teamwork, communication, collaboration, and conflict management, with an average change from 5.26 to 6.10 (t = 35.16; p < 0.001). We found by creating new clinical simulations with additional roles for non-clinical professionals, student learners were able to observe and learn interprofessional teamwork from each other and from faculty role models.
Nursing schools use diagnostic readiness tests (DRTs) to prepare family nurse practitioner (FNP) graduates to pass certification exams, but overall effectiveness estimates of DRTs are scant in the nursing literature. This pilot investigation used statistical analysis and Likert attitude scales with a convenience sample of FNP students to 1) discover any correlations between score results of two DRTs and 2) elicit test-takers' perceptions of their effectiveness. Perceptions of effectiveness were sometimes less positive than statistical indicators of test effectiveness. Disconnects between effectiveness and student perceptions need further study to guarantee optimal employment of DRTs in FNP program curricula.
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