RÉSUMÉEn Ontario (Canada), on a mené une enquête sur l'importance du recours aux directives cliniques dans les établissements de maladies chroniques et de soins de longue durée et de la prise en compte de l'opinion du personnel en matière de conditions cliniques ou de problèmes reliés au développement des directives de pratique clinique et sur les facteurs qui initient les changements de la pratique clinique. Cinq cent cinquante questionnaires ont été envoyés en deux étapes et 306 d'entre eux ont été retournés. Quarante pour cent des établissements connaissaient les directives fondées sur les résultats mais seulement 21,6 pour cent les utilisaient. Elles sont surtout utilisées par les organismes financés par le gouvernement, plus par les établissements de soins aigus qui disposent de lits pour les malades chroniques et par les centres d'accueil et moins par les organismes qui ne sont pas financés par le gouvernement. Les problèmes cliniques que les organismes jugent les plus importants pour l'élaboration des directives sont les problèmes de comportement, l'incontinence, les problèmes d'alimentation et les problèmes de soins de la peau. Les conclusions du sondage pourront servir à fixer le financement des établissements et à déterminer les cas où il faudra fonder les soins sur les résultats et ceux où l'on dispose de résultats sur lesquels constituer les soins sans toutefois s'y fier et pour comprendre les raisons de cette approche.
#2105 Introduction: Physical examination remains an important method of breast cancer detection. Unfortunately, many health care professionals express concerns about missing breast lesions and current methods of teaching this essential skill are limited. Through an interdisciplinary collaboration, we created an immersive virtual patient to teach health professions students history-taking and breast examination skills.
 Methods: Fifteen physician's assistant (PA) and 13 medical students (MS) interacted with a mixed reality human (MRH, a computer avatar with a mannequin-based breast simulator) with a breast complaint (Figure 1).
 
 Students spoke to and touched the MRH to take a history and examine a simulated breast with two masses of differing size and consistency. Subjects were surveyed regarding the usefulness of the virtual teaching tool and composed a patient note documenting pertinent history and physical examination findings. Students received feedback regarding the content of their patient note (number of 17 essential content items documented) and on the completeness of their breast examination (percentage area covered) using a color-coded touch map.
 Results: Student feedback related to the utility of this virtual educational tool was positive. Students only documented a mean of 7.8±2.7 (range=4-15) essential content items in the breast history. The completeness of the breast exam was a mean of 82% (range=62% to 97%) of total breast area examined (Figure 2, green=area examined, red=area missed).
 
 More clinically experienced students (MS 3 and 4, N=9) performed better than those with no clinical experience (MS 1 and PA 1, N=19) in both history-taking (58% vs. 40%, p<0.05) and completeness of exam (90% vs. 84%, p<0.05). Fifty percent of students were able to locate at least one mass but only 14% were able to correctly document the location of both lesions.
 Conclusions: The simulated experience differentiated performance among students with varying levels of clinical experience and identified a need for improved teaching and greater practice among all students. MRH scenarios provide a less anxious learning environment for students to practice breast history-taking and examination. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2105.
Background Acquisition of clinical skills for current trainees is difficult due to the reduction hours, increased number of trainees and decreased opportunity for procedures. At appraisal trainees repeatedly highlight lack of opportunity for chest drain insertion and intubation. Hence confidence is low. Consequently the Eastern Perinatal Network and Deanery examined innovative and affordable ways to train the doctors of the future. Aims To ensure all paediatric trainees in the East of England received free practical training in intubation and insertion of chest drains. Methods Network funds enabled a ‘hands on’ regional study day to be delivered by 3 local consultants and nurse educators on behalf of the Eastern Perinatal Network and Deanery. The first course in November 2010 was free for the 17 delegates. In small groups they were taught chest drain insertion (both conventional and Seldinger techniques) using a variety of animal models to simulate neonatal patients and ETT insertion using resuscitation and simulator mannekins. Results The first course was well received with very positive feedback. Comments included ‘especially useful having animal carcasses to practice on’, ‘very useful course for SHOs and registrars … , it should be offered to all paediatric trainees; we as a whole are concerned about skill development’. Conclusions With appropriate regional support it is possible to develop a free programme to train local paediatricians in essential neonatal skills reducing risk and improving neonatal patient care. Should this become now become mandatory?
Purpose: To ascertain whether physical therapists (PTs) were accurately applying hospital criteria when assigning patients to weekend PT services in an acute care hospital. Methods: A retrospective chart review was performed on patients assigned to weekend PT services while staying in an inpatient orthopedic unit. Data extraction forms were completed to establish the accuracy of 299 entries to the weekend list. Quantitative analysis was performed to determine the percentage of inaccurate assignments and the percentage of patients who were treated on the weekend and to compare the patient profiles of those accurately and inaccurately assigned with the weekend list. Results: The percentage of subjects inaccurately assigned to weekend PT services (7.4 per cent) was relatively small. Profiles of those inaccurately assigned were not found to differ significantly from those accurately assigned. Weekend therapy staff treated the majority of inaccurately assigned patients. However, this was not found to reduce the availability of treatment to accurately assigned patients. Conclusions: These findings suggest that criteria are being used by PTs with an acceptable level of accuracy to assign patients to weekend PT services. However, further investigation is required for validation and standardization of weekend PT services criteria.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.