Yoxas/statistical_literacy huggingface dataset:
The COVID-19 pandemic led to many changes across medical organizations and graduate medical education programs nationwide including the rapid implementation of telemedicine as a modality for delivering health care. The purpose of this study was to investigate the telemedicine experiences of residents and fellows with their self-reported level of preparedness, impact on their education including precepting, skill development, and patient-physician relationships, and perceptions of telehealth platforms and curricula in the future. A total of 365 Mayo Clinic residents and fellows across three sites (Florida, Arizona, and Minnesota) were identified as trainees who conducted at least one telemedicine encounter from January 1, 2020 to June 30, 2020 and were sent an electronic survey by e-mail. There was a total of 103 completed surveys across various specialties with 58.3% female respondents, 63.1% residents, 35.0% fellows and 77.7% of respondents who attended medical school in the United States. Most trainees reported having very little to no exposure to telemedicine in their medical careers before the pandemic. The majority were satisfied with their first telemedicine encounter and found precepting comparable to in-person visits. The trainees in this study had a favorable view with 98.1% believing telemedicine will play a more prevalent role in the future and most agreed this should be included in medical school and residency training. Our survey found that after the implementation of telemedicine during the COVID-19 pandemic, the experiences of trainees at a multi-site academic center were overall positive. More research is needed on the perceptions of skill development (physical exam and history taking) during a telemedicine encounter and outlining an optimal telemedicine curriculum that can improve confidence in trainees.
The COVID-19 pandemic led to temporary closures of schools in Germany that were unpredictable, either short-term or sustained over many weeks depending on local COVID-19 incidence rates which varied in different regions over time. The COVID-19 pandemic created new stressors in schools to deliver the curriculum with reduced lessons and online teaching. COVID-19 also had a marked effect on research in schools. The INSIDE project is a nationwide German study that investigates the effects of inclusive schooling in secondary education. The data collection started in 2018 and is still ongoing. During the COVID-19 pandemic the drop-out of many schools lead to a sample attrition down to 39.3 % of the original sample. It is investigated whether imputation of missing values in the dependent variables school grades (N = 2999) produces different results than listwise deletion of cases (N = 383). It is hypothesized that missing data in the longitudinal data design were not missing at random (NMAR). It is further hypothesized based on previous research that in the larger, imputed sample, Math grades will deteriorate more than German grades. Two datasets with observed, respectively, imputed data showed no difference in parents' educational attainment and gender proportion. Larger integrative schools were less likely to drop out than smaller single type schools. Pupils of 'surviving' schools showed equivalent grades for German and Mathematics, while including predicted grades of pupils in 'stressed' drop-out schools showed a decline in Mathematics but not in German subject grades.
The COVID-19 pandemic led to vast changes in working life and conditions in which we work. These changes may affect people with multiple sclerosis (PwMS) differently. We aimed to describe the working situation of PwMS during the COVID-19 pandemic and the pandemic's impact on their working lives. All individuals aged 20-50 listed in the Swedish Multiple Sclerosis Registry were invited to participate in an online survey in 2021. Closed and open-ended responses linked to individual-level register data were used in this exploratory mixed-methods study. Differences in the proportions reporting specific impacts were assessed with chi-square tests by sex, MS severity, education, and profession. The open-ended answers were analysed through content analysis. Over 8500 PwMS were invited (52% response rate). We included the 3887 respondents who answered questions about the impact of the pandemic on working life. Most (93.7%) reported being in paid work. An impact of the ongoing pandemic to one's daily occupation was reported by 26.2%, with different characteristics observed across the impacts. Four categories of type of answers were identified from the open-ended answers: Direct impact on one's occupation, Disclosing or concealing MS in the workplace, Worry and uncertainty, and Broader impact to life situation. PwMS navigated the pandemic by interrupting as well as continuing their working lives. Many PwMS reported that the pandemic did not affect their work situation. However, the reported impacts differed among the participants and a sense of uncertainty and worry was often underlying their statements. Lessons from the pandemic may support future work participation.
The COVID-19 pandemic motivated considerable educational innovation in technology-enhanced learning (TEL), and educators must now thoughtfully apply identified best practices to both in-person and virtual learning experiences through instructional design and reflective practice. This paper describes the development and evaluation of an innovation utilising TEL to enhance our core curriculum content and students' learning. The curriculum-linked media (CLM) was introduced as a part of a doctoring and clinical skills course for pre-clinical medical students as a structured curriculum that pairs audio and/or video-based content with reflection prompts designed to prime students for active, in-person learning upon arrival to their classrooms. The CLM aimed to help students (1) gain a deeper understanding of the course content, (2) partake in reflective practice and (3) explore diverse perspectives on a particular topic. All students completed a survey at the end of their academic year to evaluate the activity. Some students found the innovation helpful in that it facilitated perspective taking and prepared them for their in-person class. The reflection questions that paired with the media prompted discussion in class and a deeper connection with the materials. Making the content relevant to the local community and highlighting regional issues made the activity more relatable. Our experience demonstrated that the CLM model can be a helpful and efficient tool to stretch the educational reach of the classroom. Future applications may consider the implementation and evaluation of the model with clinical students and postgraduate trainees.
The COVID-19 pandemic produced acute effects on health inequities, yet more enduring impacts in vulnerable populations in rural Appalachia are understudied. This qualitative study included three focus groups with thirty-nine adults (74% female, mean age 52.7 years) to obtain perspectives on the impact of the COVID-19 pandemic on well-being in Martin County, Kentucky, in fall 2022. Grounded Theory was employed using an iterative inductive-deductive approach to capture the lasting effects of the COVID-19 pandemic on health practices and status. Three prominent themes emerged: (1) increased social isolation; (2) household cost of living strains caused by inflation; and (3) higher food prices and diminished food availability causing shifts in food purchasing and consumption. Participants noted that the rising cost of living resulted in residents having to "choose between medication, food and utilities". Increased food prices resulted in residents "stretching" their food, modifying how they grocery shopped, and limiting meat consumption. Persistent food shortages were exacerbated by there being few grocery stores in the county. Lastly, increased social isolation was profoundly articulated as widely impacting mental health, especially among youth. Our findings underscore the ongoing deleterious effects of inflation and food supply chain disruptions in this rural, geographically isolated community, which resulted in difficult spending choices for residents.
The COVID-19 pandemic profoundly impacted medical education systems worldwide. Between March 2020 and December 2021, 111 MD students at the University of Toronto completed two-week quarantines due to hospital or community exposures and experienced disrupted clinical instruction. We explored the experiences, barriers, and supports of these quarantined medical students to identify program development opportunities and improve student supports. We used a qualitative descriptive approach to explore experiences of clerkship students quarantined due to COVID-19 exposure. Methods included an online survey with open-ended questions and an audio-recorded interview. We analysed the demographic survey responses using descriptive statistics. Subsequently, we conducted descriptive thematic analysis of the narrative survey responses and transcribed interview recordings. Concerns reported in surveys (n = 23, response rate 20.7%) and interviews (n = 5) included themes of illness uncertainty, racial tensions, confidentiality of COVID-19 status, unclear academic expectations, and financial burden. Supports included friends, family, and MD program administration. Recommendations related to communication, administration, equity considerations, supports, confidentiality/privacy, and academics. Supporting student wellbeing and learning is at the core of medical training. Enhanced understanding of health profession trainee needs during COVID can improve institutional supportive responses to students routinely and during times of crisis.
The COVID-19 pandemic radically changed nursing education. To map the existing literature on learning environments (LEs) in undergraduate nursing education during COVID-19 and identify the LE elements based on the 4 domains of Gruppen's conceptual framework: personal, social, organizational, and physical and virtual spaces. Eligible articles were reviewed using the Joanna Briggs framework. The search retrieved 5003 articles, of which 80 met the inclusion criteria. Most studies were cross-sectional and conducted in the United States. Of the studies included, 68 studies focused on the personal component of students, 67 investigated physical and virtual space components, 19 examined the social domain, and 15 examined organizational aspects. The COVID-19 pandemic significantly influenced the LE of nursing students. Based on the current review of LE in nursing education, nurse educators and researchers can develop interventions to maintain the quality and accessibility of nursing education in future crises.
The COVID-19 pandemic rapidly accelerated the adoption of virtual learning in medical education, including departmental grand rounds lectures in radiology. This retrospective study sought to assess the impact of an open access virtual grand rounds program. We tested the hypothesis that virtual grand rounds would advance learning equity by increasing access to learners outside of our institution. Twenty-two open access virtual grand rounds lectures were presented and recorded using an online videoconferencing platform. After the lecture, registrants received online access to the lecture recording for later on-demand viewing. The email address, geographical location, institutional affiliation, and medical specialty for all virtual registrants and attendees were retrospectively collected from a required online registration form. The primary outcome measure included an assessment of geographical diversity using descriptive statistics. Attendees of the virtual lectures were from 75 academic institutions and 27 non-academic institutions and located in 32 states, 88 cities, and 9 countries. Twenty-seven medical specialties were represented. The virtual grand rounds program in radiology contributes to free and open access educational content online for learners around the world. To address learning equity and promote international inclusion, we recommend that grand rounds organizers consider including a virtual option that allows free sharing of knowledge.
The COVID-19 pandemic rapidly changed the landscape of clinical practice in the United States; telehealth became an essential mode of health care delivery, yet many components of telehealth use remain unknown years after the disease's emergence. We aim to comprehensively assess telehealth use and its associated factors in the United States. This cross-sectional study used a nationally representative survey (Health Information National Trends Survey) administered to US adults (≥18 years) from March 2022 through November 2022. To assess telehealth adoption, perceptions of telehealth, satisfaction with telehealth, and the telehealth care purpose, we conducted weighted descriptive analyses. To identify the subpopulations with low adoption of telehealth, we developed a weighted multivariable logistic regression model. Among a total of 6252 survey participants, 39.3% (2517/6252) reported telehealth use in the past 12 months (video: 1110/6252, 17.8%; audio: 876/6252, 11.6%). The most prominent reason for not using telehealth was due to telehealth providers failing to offer this option (2200/3529, 63%). The most common reason for respondents not using offered telehealth services was a preference for in-person care (527/578, 84.4%). Primary motivations to use telehealth were providers' recommendations (1716/2517, 72.7%) and convenience (1516/2517, 65.6%), mainly for acute minor illness (600/2397, 29.7%) and chronic condition management (583/2397, 21.4%), yet care purposes differed by age, race/ethnicity, and income. The satisfaction rate was predominately high, with no technical problems (1829/2517, 80.5%), comparable care quality to that of in-person care (1779/2517, 75%), and no privacy concerns (1958/2517, 83.7%). Younger individuals (odd ratios [ORs] 1.48-2.23; 18-64 years vs ≥75 years), women (OR 1.33, 95% CI 1.09-1.61), Hispanic individuals (OR 1.37, 95% CI 1.05-1.80; vs non-Hispanic White), those with more education (OR 1.72, 95% CI 1.03-2.87; at least a college graduate vs less than high school), unemployed individuals (OR 1.25, 95% CI 1.02-1.54), insured individuals (OR 1.83, 95% CI 1.25-2.69), or those with poor general health status (OR 1.66, 95% CI 1.30-2.13) had higher odds of using telehealth. To our best knowledge, this is among the first studies to examine patient factors around telehealth use, including motivations to use, perceptions of, satisfaction with, and care purpose of telehealth, as well as sociodemographic factors associated with telehealth adoption using a nationally representative survey. The wide array of descriptive findings and identified associations will help providers and health systems understand the factors that drive patients toward or away from telehealth visits as the technology becomes more routinely available across the United States, providing future directions for telehealth use and telehealth research.
The COVID-19 pandemic resulted in greater use of remote patient monitoring (RPM). However, the use of RPM has been modest compared to other forms of telehealth. To identify and describe barriers to the implementation of RPM among primary care physicians (PCPs) that may be constraining its growth. We conducted 20 semi-structured interviews with PCPs across the USA who adopted RPM. Interview questions focused on implementation facilitators and barriers and RPM's impact on quality. We conducted thematic analysis of semi-structured interviews using both inductive and deductive approaches. The analysis was informed by the NASSS (non-adoption and abandonment and challenges to scale-up, spread, and sustainability) framework. PCPs who practiced at least 10 h per week in an outpatient setting, served adults, and monitored blood pressure and/or blood glucose levels with automatic transmission of data with at least 3 patients. While PCPs generally agreed that RPM improved quality of care for their patients, many identified barriers to adoption and maintenance of RPM programs. Challenges included difficulties handling the influx of data and establishing a manageable workflow, along with digital and health literacy barriers. In addition to these barriers, many PCPs did not believe RPM was profitable. To encourage ongoing growth of RPM, it will be necessary to address implementation barriers through changes in payment policy, training and education in digital and health literacy, improvements in staff roles and workflows, and new strategies to ensure equitable access.
The COVID-19 pandemic resulted in significant disruptions for children and youth around the world, especially given school closures and shifts in teaching modes (on-line and hybrid). However, the impact of these disruptions remains unclear given data limitations such as a reliance on cross-sectional and/or short-interval surveys as well as a lack of broad indicators of key outcomes of interest. The current research employs a quasi-experimental design by using an Australian four-year longitudinal survey with student responses from Grade 7 to 10 (aged 12-15 years old) (N = 8,735 from 20 schools) in one education jurisdiction. Responses are available pre-pandemic (2018 and 2019) and during the pandemic (2020 and 2021). Importantly the survey included measures of well-being, mental health and learning engagement as well as potential known school-environment factors that could buffer against adversity: school climate and school identification. The findings were generally in line with key hypotheses; 1) during COVID-19 students' learning engagement and well-being significantly declined and 2) students with more positive school climate or stronger school identification pre-COVID-19 fared better through the disruption of the pandemic. However, these same students suffered from a steeper decline in well-being and engagement which may be explained through the impact of losing meaningful social or group connections. This decline was evident after controlling for gender, academic grade (as a proxy of age), parental education, and socioeconomic status. It is concluded that investing in the social environment of schools is important in crisis preparedness and can facilitate better crisis response among youth.
The COVID-19 pandemic saw physical therapist (PT) education programs in 2020 add virtual options to prepare students for hands-on clinical skills. The purpose of this research was to investigate student confidence, preparation, and clinical performance based on their choice of virtual or in-person laboratory immersion. Secondary analysis compared 2020 cohort outcomes with the previous cohort in 2019 (prepandemic). Virtual skill acquisition has been studied with support for effectiveness in didactic and psychomotor skill acquisition. The impact on clinical education performance is unknown. Student records from an accelerated hybrid, PT education program in 2020 (n = 91) and 2019 (n = 86). In this mixed-method observational study, researchers analyzed a Qualtrics survey and the PT Clinical Performance Instrument (CPI) to compare student outcomes. Statistical analyses included chi-square, two-way multivariate analysis of variance (MANOVA), and Mann-Whitney U test. MAXQDA software was used to code student and clinical instructor narrative responses from the CPI related to strengths and areas for further development. All students in 2020 attended laboratory virtually for 9 full days, and 24% of students chose virtual laboratory for the remaining 8.5 days; 97% of students reported feeling confident going into their clinical experience (66% inpatient). No statistically significant differences were found based on instructional method (virtual or in-person) or clinical practice setting (inpatient or outpatient) for confidence, preparation, or CPI performance. Themes of wanting more time to prepare and more confidence in clinical decision making emerged from the qualitative analysis. Results indicate no statistically significant difference for virtual versus in-person laboratory and no difference compared with the 2019 cohort. Virtual instruction effectively prepared students for their clinical experiences across all settings. Although an in-person laboratory experience may be preferred, it is possible to deliver effective experiences in a virtual setting without compromising student performance. Further research is needed to confirm findings.
The COVID-19 pandemic significantly affected access to healthcare services, particularly among individuals living with Non-Communicable Diseases (NCDs) who require regular healthcare visits. Studies suggest that knowledge about a specific disease is closely linked to the ability to access services for that condition. In preparation for the future, we conducted the study to assess knowledge of NCDs and access to healthcare services among adults residing in rural areas before and during the COVID-19 pandemic. We conducted a community-based cross-sectional study in rural Tanzania in October 2022, a few months after the end of the third wave of the COVID-19 pandemic. A total of 689 community residents participated in the study. The level of knowledge of NCDs was assessed using an 11-item Likert questionnaire, which was later dichotomized into adequate and inadequate levels of knowledge. In addition, access to healthcare was assessed before and during the pandemic. We summarized the results using descriptive statistics and logistic regression was applied to determine factors associated with adequate levels of knowledge of NCDs. All statistical tests were two-sided; a p-value <0.05 was considered statistically significant. All data analyses were performed using SPSS. Among 689 participants, more than half 369 (55%) had adequate knowledge of whether a disease is NCD or not; specifically, 495 (73.8%), 465 (69.3%), and 349 (52%) knew that hypertension, diabetes mellitus, and stroke are NCDs while 424 (63.2%) know that UTI is not NCD. Of the interviewed participants, 75 (11.2%) had at least one NCD. During the COVID-19 pandemic the majority 57 (72.2%) accessed healthcare services from nearby health facilities followed by traditional healers 10 (12.7%) and community drug outlets 8 (10.1%). Residence and education level were found to be significantly associated with knowledge of NCDs among participants. The study revealed that the community has a moderate level of knowledge of NCDs, and during the COVID-19 pandemic outbreaks, people living with NCD (s) relied on nearby health facilities to obtain healthcare services. Health system preparedness and response to pandemics should take into account empowering the community members to understand that NCD care is continuously needed even during pandemic times. We further advocate for a qualitative study to explore contextual factors influencing the knowledge of NCDs and access to healthcare services beyond the big domains of education and residence.