Yoxas/statistical_literacy huggingface dataset:
Shoulder instabilities constitute a large proportion of shoulder injuries and have a wide range of presentations. While evidence regarding glenohumeral dislocations and associated risk factors has been reported, less is known regarding the full spectrum of instabilities and their risk factors. The purpose of this systematic review was to identify modifiable risk factors to guide patient management decisions with regards to implementation of interventions to prevent or reduce the risk of shoulder instability. Systematic Review. A systematic, computerized search of electronic databases (CINAHL, Cochrane, Embase, PubMed, SportDiscus, and Web of Science) was performed. Inclusion criteria were: (1) a diagnosis of shoulder instability (2) the statistical association of at least one risk factor was reported, (3) study designs appropriate for risk factors, (4) written in English, and (5) used an acceptable reference standard for diagnosed shoulder instability. Titles and abstracts were independently screened by at least two reviewers. All reviewers examined the quality studies using the Newcastle-Ottawa Scale (NOS). At least two reviewers independently extracted information and data regarding author, year, study population, study design, criterion standard, and strength of association statistics with risk factors. Male sex, participation in sport, hypermobility in males, and glenoid index demonstrated moderate to large risk associated with first time shoulder instability. Male sex, age \<30 years, and history of glenohumeral instability with concomitant injury demonstrated moderate to large risk associated with recurrent shoulder instability. There may be an opportunity for patient education in particular populations as to their increased risk for suffering shoulder instability, particularly in young males who appear to be at increased risk for recurrent shoulder instability. Level III.
Sickness insurance systems and their processes have been studied in terms of transparency, comprehensibility and fairness, highlighting the importance of just procedures that make sense to clients. Related research demonstrates differences between groups of clients, pointing towards a social gradient. The concept of social insurance literacy and the Social Insurance Literacy Questionnaire (SILQ) was recently developed and serves as a measure for client's ability to obtain, understand and act on information in a sickness insurance system, relating to the comprehensibility of the information that the system provides. The purpose of this study was to investigate social insurance literacy among clients on sick leave and its associations with perceived justice, being granted sickness benefits and background factors. This was a questionnaire study with clients on sick leave in Sweden. In the selection process 3993 clients were invited, of which 1173 recently had their sickness benefits withdrawn. Those who answered the SILQ (n = 1152) also answered a perceived justice measure and accepted sharing register data from the Swedish Social Insurance Agency. Data were analyzed through regression analysis. The findings demonstrate that clients' perceptions of system comprehensibility and the status of their sick leave case was significantly associated with perceived justice, and being granted sickness benefits, while their individual abilities to obtain, understand, and act on information had lesser influence. The system's ability to provide understandable information seems more important than clients' abilities to comprehend it. From a client perspective, a just system seems to be related to their experiences of the sick leave process (i,e., whether they had an ongoing or closed case) rather than their skills to obtain the correct information.
Sign language is the main means of communication for deaf people; consists of the combination of manual, body and facial movements with specific meanings. Among the main barriers faced by this community are the lack of communication, shortage of health services, added to the inexperience and lack of knowledge of sign language by the health professional. This article aims to raise awareness of the importance and need of sign language in dental clinical care and professional training, as well as strategies, tools and recommendations for better care for deaf people. Databases such as SciELO, Google Scholar, PubMed and ScienceDirect were included during the years 2007 and 2021 It was concluded that the main barriers during communication are the little knowledge of sign language in dentists, the little access to interpreters and difficulties in obtaining appointments; affecting the susceptibility to develop oral diseases. The inclusion of sign language courses within the university curriculum provides academic and professional ethics benefits; however, follow-up is necessary to confirm compliance with the requested parameters. Among the main tools and strategies, the use of educational videos, the accompaniment of interpreters and, in view of technological development, the use of mobile applications, can facilitate communication. Likewise, a set of recommendations is proposed for the approach of adult and child deaf patients.
Significant progress has been achieved in universal basic education in African countries since the late 1990s. This study provides empirical evidence on the within- and across-country variation in numeracy skills performance among children based on nationally representative data from eight African countries (DR Congo, The Gambia, Ghana, Lesotho, Sierra Leone, Togo, Tunisia, and Zimbabwe). We assess whether and to what extent children with disabilities lag in numeracy skills and how much it depends on their type of disabilities. More specifically, we explore whether disabled children benefit equally from better school system quality. The assessment is analysed as a natural experiment using the performance of non-disabled children as a benchmark and considering the different types of disabilities as random treatments. We first evaluate the variation in average numeracy skills in the eight African countries. They can roughly be divided into low- and high-numeracy countries. We apply Instrumental Variable (IV) methods to control the endogeneity of completed school years when assessing subjects' school performance and heterogeneous disability effects. Children with vision and hearing disabilities are not especially challenged in numeracy skills performance. The low numeracy skills among physically and intellectually disabled children are mainly attributable to their limited school attendance. Children with multiple disabilities are constrained both by low school attendance and by poor numeracy skills return to schooling. The average differences in school performance across the high- versus low-numeracy skill country groups are larger than the within-group average differences for disabled versus non-disabled kids. This indicates that school enrolment and quality are crucial for children's learning of numeracy skills, and that disabled children benefit equally from better school quality across these African countries.
Significant temporal variations of radon and other air pollutants can be observed in any room, even one with permanently closed windows and doors. Therefore, a question arises: how can one assess the conformity of a room with a normative and make a reliable decision if the test lasts <1 year (days or months)? The measurement protocol fundamentally differs between Europe with its long-term testing tradition lasting several months, and the US where short-term tests of several days are more common. Neither the European nor the American protocols considers the temporal uncertainty of indoor radon, a factor that usually exceeds the instrumental uncertainty (including in long-term tests) and is 2-3 times higher the coefficient of variation (COV) commonly used to estimate temporal variations. This problem significantly complicates the creation of a rational and harmonized ISO standard. At the same time, strict adhering to the fundamental ISO/IEC rules within such concepts as "measurement uncertainty" and "conformity assessment" allows to control the coverage probability or reliability of decision making. Within ISO/IEC, proposed are a criterion of conformity assessment of a room with a normative for both short- and long-term measurements, as well as a statistical algorithm for determining the temporal uncertainty considering mode and measurements duration.
Simulated cases are widely used in medical education to develop clinical reasoning skills and discuss key topics around patient care. Such cases present an opportunity to demonstrate real world encounters with diverse patient and health provider identities, impacts of social and structural determinants of health, and demonstrate a generalist approach to problems. However, despite many calls-to-action for medical schools to better incorporate equity, diversity and inclusion (EDI) and generalism, it remains difficult to evaluate how well these goals are being met. A quality improvement project was completed at a single medical school to evaluate the domains of generalism and EDI within simulated cases used in the preclinical curriculum. Generalism was evaluated using the Toronto Generalism Assessment Tool (T-GAT). EDI was evaluated using a locally developed novel tool. Analysis included descriptive statistics and Pearson correlation coefficient. A total of 49 simulated cases were reviewed. Twelve generalism and 5 EDI items were scored on a 5-point Likert scale, with higher scores indicating better demonstration of generalism or EDI within a case. Average generalism score across all cases was 45.6/60. Average EDI score across all cases was 11.7/25. Only 21/49 cases included representation of one or more diverse identity categories. The most common diverse identity represented was non-white races/ethnicities, and the identity represented the least was diversity in language fluency. Generalism and EDI scores demonstrated a weak positive correlation (R2 = 0.25). Quantitative evaluation of simulated cases using specific generalism and EDI scoring tools was successful in generating insight into areas of improvement for teaching cases. This approach identified key content areas for case improvement and identities that are currently underrepresented in teaching cases. Similar approaches could be feasibly used by other medical schools to improve generalism and EDI in teaching cases or other curricular materials.
Simulation based medical education (SBME) is fast becoming embedded into undergraduate medical curricula with many publications now describing its various modes and student self-reported impacts. This systematic review synthesizes the available literature for evidence of performance effects of SBME as an adjunct within traditional teaching programmes. A narrative systematic review was conducted according to PRISMA guidelines using Ovid MEDLINE, EMBASE, and PubMed databases for studies, published in English, reporting on general medical and surgical undergraduate SBME between 2010 to 2020. Two reviewers independently assessed potential studies for inclusion. Methods and topics of simulation with their assessments were evaluated. Descriptive statistics were used to describe pooled student cohorts. 3074 articles were initially identified using the search criteria with 92 full-text articles then screened for eligibility. Nineteen articles, including nine randomised trials, concerning 2459 students (median 79/study), were selected for review. Cardiac scenarios were commonest (n=6) with three studies including surgical topics. Nine studies used mannequin simulators (median time/session 17.5minutes) versus standardised patients in seven (median time/session=82 minutes). Educational impact was measured by written (n=10), checklist (n=5) and OSCEs (n=3) assessment either alone or in combination (n=1, OSCE/written assessment). All articles reported a positive effect of SBME on knowledge including improved retention in three. SBME, as an adjunct to existing curricula, improves knowledge-based performance of medical students at least in the short-term. Future studies should broaden its topics, assess longer term impacts and cost-effectiveness while also considering whether and what areas of traditional undergraduate learning it can replace.
Simulation in the preclinical medical education setting is a beneficial tool for students to develop clinical skills, supplement preexisting knowledge, and prepare for clinical rotations and beyond. We detail the complete simulation scenario, including a participant postresponse questionnaire, of a 28-year-old male who developed bacterial meningitis after experiencing an upper respiratory infection in the days prior. Simulation fellows and faculty at the Alabama College of Osteopathic Medicine created a simulation scenario pertaining to bacterial meningitis. The scenario utilized a high-fidelity patient simulator, one standardized participant for patient voiceover, one standardized participant as a patient family member, and one standardized participant as a physician consultant on an as-needed basis. Sixteen preclinical medical students from various specialty interest groups were recruited to participate in the scenario and complete the postscenario questionnaire. The simulation scenario was well received by the participants, and 15 of 16 completed the postscenario questionnaire. Ninety-three percent strongly agreed the simulation was a valuable clinical experience. Additionally, 73% of participants strongly agreed that the simulation experience was realistic, 80% strongly agreed that it tested their clinical reasoning ability, and 53% strongly agreed it was appropriate for their level of clinical knowledge. Medical simulation is a valuable educational tool tailored to maximize student learning and supplement the traditional didactic curriculum. The successful development and implementation of our meningitis simulation case further supports the continued use of medical simulation in the preclinical setting.
Simulation is a technique used to create an experience without going through the real event. Competency-based medical education focuses on outcomes and ensures professionals have the necessary knowledge, skills, and attitudes. The purpose of this study was to develop a set of competencies for the instructors providing basic and advanced levels of simulation-based training in healthcare. We conducted a qualitative study in three steps, with each next step building on and influenced by the previous one. First, we conducted a literature review, then a consensus development panel, and finally a three-step Delphi process. The participants were experts in the fields of healthcare, education, and simulations. The six main competencies identified for the instructor providing simulation-based training at the basic level in healthcare include knowledge of simulation training, education/training development, education/training performance, human factors, ethics in simulation, and assessment. An instructor providing simulation-based training at an advanced level in healthcare should also possess the following five competencies: policies and procedures, organisation and coordination, research, quality improvement, and crisis management. The identified competencies can serve as a valuable resource for simulation educators and organisations involved in simulation education, to plan curriculum and implement a continuous train-the-trainers programme.
Simulation is an integral part of the healthcare educational landscape and a key element in the future of graduate professional education. For the past three decades, simulation-based educational methodology has been gaining popularity in nurse anesthesia educational programs (NAEP). There is currently limited objective evidence documenting modalities used or educational outcomes addressed through simulation in NAEPs. In 2018, the American Association of Nurse Anesthesiology (AANA) established a Simulation Subcommittee of the AANA Education Committee and tasked the group with two primary goals: 1) to gain a better understanding of the current state of simulation education and 2) to review responses with regard to how NAEPs could best incorporate simulation elements within their curriculum to meet requirements while adhering to the guidelines of the Council on Accreditation of Nurse Anesthesia Educational Programs. A survey tool was developed and distributed to all programs to assess the utilization of simulation, available simulation resources, ongoing faculty development efforts, and barriers to use of this educational approach. Survey results indicated that simulation is valued as an effective method within NAEPs for a variety of teaching and learning activities and is utilized to support achievement of both technical and nontechnical learning outcomes for student registered nurse anesthetists.
Simulation is vital for healthcare training, yet workforce challenges persist. This article details the development of an undergraduate minor program to address these issues and enhance simulation education. Initially conceived for simulation assistants, the program shifted focus to training simulation technicians. Informed by industry insights, the curriculum aligns with accreditation standards, emphasizing practical knowledge. Integrated knowledge translation (iKT) fosters collaboration, ensuring program relevance. Stakeholder feedback guided program refinement, addressing concerns of role delineation and alignment with certification frameworks. The program's evolution involved enhancing competency frameworks, validation through surveys, and forming partnerships for practical training. A certification committee ensures ongoing alignment with industry standards. This collaborative effort aims to produce graduates prepared for the dynamic field of healthcare simulation technology, thereby improving patient outcomes and advancing simulation education.
Simulation is widely utilized in medical education. Exploring the effectiveness of high-fidelity simulation of clinical research within medical education may inform its integration into clinical research training curricula, finally cultivating physician-scientist development. Standard teaching scripts for both clinical trial and cross-sectional study simulation were designed. We recruited undergraduates majoring in clinical medicine at 3th grade into a pre-post intervention study. Additionally, a cross-sectional survey randomly selected medical undergraduates at 4th or 5th grade, medical students in master and doctor degree as external controls. Self-assessment scores of knowledge and practice were collected using a 5-point Likert scale. Changes in scores were tested by Wilcoxon signed-rank test and group comparisons were conducted by Dunn's tests with multiple corrections. Multivariable quantile regressions were used to explore factors influencing the changes from baseline. Seventy-eight undergraduates involved the clinical trial simulation and reported improvement of 1.60 (95% CI, 1.48, 1.80, P < 0.001) in knowledge and 1.82 (95% CI, 1.64, 2.00, P < 0.001) in practice score. 83 undergraduates involved in the observational study simulation and reported improvement of 0.96 (95% CI, 0.79, 1.18, P < 0.001) in knowledge and 1.00 (95% CI, 0.79, 1.21, P < 0.001) in practice. All post-intervention scores were significantly higher than those of the three external control groups, P < 0.001. Higher agreement on the importance of clinical research were correlated with greater improvements in scores. Undergraduates in pre-post study showed high confidence in doing a future clinical research. Our study provides evidence supporting the integration of simulation into clinical research curriculum for medical students. The importance of clinical research can be emphasized during training to enhance learning effect.
Simulation training is an important component of medical education. In former studies, diagnostic simulation training for direct and indirect funduscopy was already proven to be an effective training method. In this prospective controlled trial, we investigated the effect of simulator-based fundus biomicroscopy training. After completing a 1-week ophthalmology clerkship, medical students at Saarland University Medical Center (n = 30) were block-randomized into two groups: The traditional group received supervised training examining the fundus of classmates using a slit lamp; the simulator group was trained using the Slit Lamp Simulator. All participants had to pass an Objective Structured Clinical Examination (OSCE); two masked ophthalmological faculty trainers graded the students' skills when examining patient's fundus using a slit lamp. A subjective assessment form and post-assessment surveys were obtained. Data were described using median (interquartile range [IQR]). Twenty-five students (n = 14 in the simulator group, n = 11 in the traditional group) (n = 11) were eligible for statistical analysis. Interrater reliability was verified as significant for the overall score as well as for all subtasks (≤ 0.002) except subtask 1 (p = 0.12). The overall performance of medical students in the fundus biomicroscopy OSCE was statistically ranked significantly higher in the simulator group (27.0 [5.25]/28.0 [3.0] vs. 20.0 [7.5]/16.0 [10.0]) by both observers with an interrater reliability of IRR < 0.001 and a significance level of p = 0.003 for observer 1 and p < 0.001 for observer 2. For all subtasks, the scores given to students trained using the simulator were consistently higher than those given to students trained traditionally. The students' post-assessment forms confirmed these results. Students could learn the practical backgrounds of fundus biomicroscopy (p = 0.04), the identification (p < 0.001), and localization (p < 0.001) of pathologies significantly better with the simulator. Traditional supervised methods are well complemented by simulation training. Our data indicate that the simulator helps with first patient contacts and enhances students' capacity to examine the fundus biomicroscopically.
Simulation-based education (SBE) is common in healthcare education and is increasingly being incorporated in preclinical curriculum. Preclinical students typically have had little exposure to the clinical setting (i.e. hospital patient rooms, equipment) and often feel uncomfortable when first placed in the simulated clinical environment. Prebriefing, a standard of best practice in simulation, prepares learners for simulation exercises. To successfully integrate SBE in preclinical education, we recommend expanding the prebriefing to include: multiple activities that orient learners to the learning space and the structure of a simulation activity, the goals of simulation as a learning process, faculty modeling of a simulated patient encounter, and expected learner outcomes. This approach increases student familiarity with the simulation learning environment and performance expectations, which can reduce cognitive load and improve learning outcomes. We describe 12 tips for increasing the scope of the prebriefing to promote effective learner participation and development during preclinical SBE.