Search results for: nursing aide trainees

Authors: Chinlun Lai, Yu-Mei Chang

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In this paper, an augmented reality learning support system is proposed to replace the traditional teaching tool thus to help students improve their learning motivation, effectiveness, and efficiency. The system can not only reduce the exhaust of educational hardware and realistic material, but also provide an eco-friendly and self-learning practical environment in any time and anywhere with immediate practical experiences feedback. To achieve this, an interactive self-training methodology which containing step by step operation directions is designed using virtual 3D scenario and wearable device platforms. The course of nasogastric tube care of nursing skills is selected as the test example for self-learning and online test. From the experimental results, it is observed that the support system can not only increase the student’s learning interest but also improve the learning performance than the traditional teaching methods. Thus, it fulfills the strategy of learning by practice while reducing the related cost and effort significantly and is practical in various fields.

Keywords: augmented reality technology, learning support system, self-learning, simulation learning method

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Authors: Emily Moore, Dora Amos, Tracy Ellimah, Natasha Parrott

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Postoperative haematoma is a well-recognised complication of thyroid surgery with an incidence of 1-5%. Haematoma formation causes progressive airway obstruction, necessitating emergency bedside haematoma evacuation in up to ¼ of patients. ENT UK, BAETS and DAS have developed consensus guidelines to improve perioperative care, recommending that all healthcare staff interacting with patients undergoing thyroid surgery should be trained in managing post-thyroidectomy haematoma. The aim was to assess the effectiveness of a hybrid simulation model in improving clinician’s confidence in dealing with this surgical emergency. A hybrid simulation was designed, consisting of a standardised patient wearing a part-task trainer to mimic a post-thyroidectomy haematoma in a real patient. The part-task trainer was an adapted C-spine collar with layers of silicone representing the skin and strap muscles and thickened jelly representing the haematoma. Both the skin and strap muscle layers had to be opened in order to evacuate the haematoma. Boxes have been implemented into the appropriate post operative areas (recovery and surgical wards), which contain a printed algorithm designed to assist in remembering a sequence of steps for haematoma evacuation using the ‘SCOOP’ method (skin exposure, cut sutures, open skin, open muscles, pack wound) along with all the necessary equipment to open the front of the neck. Small-group teaching sessions were delivered by ENT and anaesthetic trainees to members of the multidisciplinary team normally involved in perioperative patient care, which included ENT surgeons, anaesthetists, recovery nurses, HCAs and ODPs. The DESATS acronym of signs and symptoms to recognise (difficulty swallowing, EWS score, swelling, anxiety, tachycardia, stridor) was highlighted. Then participants took part in the hybrid simulation in order to practice this ‘SCOOP’ method of haematoma evacuation. Participants were surveyed using a Likert scale to assess their level of confidence pre- and post teaching session. 30 clinicians took part. Confidence (agreed/strongly agreed) in recognition of post thyroidectomy haematoma improved from 58.6% to 96.5%. Confidence in management improved from 27.5% to 89.7%. All participants successfully decompressed the haematoma. All participants agreed/strongly agreed, that the sessions were useful for their learning. Multidisciplinary team simulation teaching is effective at significantly improving confidence in both the recognition and management of postoperative haematoma. Hybrid simulation sessions are useful and should be incorporated into training for clinicians.

Keywords: thyroid surgery, haematoma, teaching, hybrid simulation

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Authors: Jacob Dangerfield, Jacob Pollard, Jennifer DeCou

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Introduction: Burnout, anxiety, and depression are three conditions that are prevalent in medical providers. This is especially the case in the field of anesthesia, which has a high number of providers suffering from burnout and burnout syndrome. A major contributor to this issue is isolation in the workplace, with a perceived lack of peer support as a major risk factor for burnout. Two organizational interventions that can be done to help improve this issue are small group sessions and providing affordable mental health services. Per American College of Graduate Medical Education (ACGME) Guidelines, these affordable mental health services are a requirement of all residency programs, but for a variety of reasons, many residents do not access them. As physicians, we are often not good at asking for help. With this in mind, we hypothesized that carrying out small group resiliency sessions facilitated by Graduate Medical Education (GME) Wellness Counselors would improve both resident peer support as well as the likelihood that a resident will reach out to GME Wellness in a time of need. Methods: We held small group resiliency sessions with the GME Wellness Mental Health Professionals during protected didactic time. These sessions were small groups, including the members of one’s class (i.e., first-year residents on their own), and were facilitated by 1-2 mental health professionals. After these sessions, we surveyed residents who attended using a short Google Forms survey and using a 5-point Likert Scale, asked residents about some outcomes from the session. A “strongly agree” or “agree” was considered a positive response. Results: Results from our survey showed that the resident sessions had multiple positive outcomes. This survey was sent to 29 residents, and we had a 62% response rate. We found out through this survey that these small group sessions had a perceived positive impact on resident personal well-being, increased perceived peer support from classmates, and made residents more likely to reach out to GME Wellness in the future. Perceived positive impact on well-being was found in 83% of resident respondents, improved perceived peer support in 83% of respondents, and 78% of resident respondents stated that this session increased their likelihood of reaching out to mental health professionals. Conclusions: Through this study, we can conclude that our hypothesis was correct in that Small Group Resiliency Sessions that are facilitated by GME Wellness Counselors improve both resident peer support as well as the likelihood a resident reaches out to these mental health professionals in time of need. We believe these findings are very important as they address two important factors that can aid in decreasing a provider’s risk of experiencing burnout. Through this simple means, we believe other residency programs can help the well-being of their residents, and together, we can decrease the number of cases of burnout in anesthesia.

Keywords: anesthesiology, burnout, wellness, depression, residents, trainees, mental health

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Authors: D. Mulligan, D. Casey

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Introductory Statement: Delegation is when a registered nurse (RN) transfers a task or activity that is normally within their scope of practice to another person (delegatee). RN delegation is common practice with unregistered staff, e.g., student nurses and health care assistants (HCAs). As the role of the HCA is increasingly embedded as a direct care and support role, especially in long-term residential care for older adults, there is RN uncertainty as to their role as a delegator. The assignment is when a task is transferred to a person that is within the role specification of the delegatee. RNs in long-term care (LTC) for older people are increasingly working in teams where there are less RNs and more HCAs providing direct care to the residents. The RN is responsible and accountable for their decision to delegate and assign tasks to HCAs. In an interpretive, multiple case studies to explore how delegation of tasks by RNs to HCAs occurred in long-term care settings in Ireland the importance of the RN understanding their scope of practice emerged. Methodology: Focus group interviews and individual interviews were undertaken as part of a multiple case study. Both cases, anonymized as Case A and Case B, were within the public health service in Ireland. The case study sites were long-term care settings for older adults located in different social care divisions, and in different geographical areas. Four focus group interviews with staff nurses and three individual interviews with CNMs were undertaken. The interactive data analysis approach was the analytical framework used, with within-case and cross-case analysis. The theoretical lens of organizational role theory, applying the role episode model (REM), was used to understand, interpret, and explain the findings. Study Findings: RNs and CNMs understood the role of the nurse regulator and the scope of practice. RNs understood that the RN was accountable for the care and support provided to residents. However, RNs and CNM2s could not describe delegation in the context of their scope of practice. In both cases, the RNs did not have a standardized process for assessing HCA competence to undertake nursing tasks or interventions. RNs did not routinely supervise HCAs. Tasks were assigned and not delegated. There were differences between the cases in relation to understanding which nursing tasks required delegation. HCAs in Case A undertook clinical vital sign assessments and documentation. HCAs in Case B did not routinely undertake these activities. Delegation and assignment were influenced by the organizational factors, e.g., model of care, absence of delegation policies, inadequate RN education on delegation, and a lack of RN and HCA role clarity. Concluding Statement: Nurse staffing levels and skill mix in long-term care settings continue to change with more HCAs providing more direct care and support. With decreasing RN staffing levels RNs will be required to delegate and assign more direct care to HCAs. There is a requirement to distinguish between RN assignment and delegation at policy, regulation, and organizational levels.

Keywords: assignment, delegation, registered nurse, scope of practice

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Authors: Julianne Mullen-Williams

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This paper will provide an overview of a three year mixed methods research project that explores if methods from the supervision of dramatherapy can augment the occupational psychology of newly qualified secondary school teachers. It will consider how creativity and the use of metaphor, as applied in the supervision of dramatherapists, can be translated to an educational context in order to explore the explicit / implicit dynamics between the teacher trainee/ newly qualified teacher and the organisation in order to support the super objective in training for teaching; how to ‘be a teacher.’ There is growing evidence that attrition rates among teachers are rising after only five years of service owing to too many national initiatives, an unmanageable curriculum and deteriorating student discipline. The fieldwork conducted entailed facilitating a reflective space for Newly Qualified Teachers from all subject areas, using methods from the supervision of dramatherapy, to explore the social and emotional aspects of teaching and learning with the ultimate aim of improving the occupational psychology of teachers. Clinical supervision is a formal process of professional support and learning which permits individual practitioners in frontline service jobs; counsellors, psychologists, dramatherapists, social workers and nurses to expand their knowledge and proficiency, take responsibility for their own practice, and improve client protection and safety of care in complex clinical situations. It is deemed integral to continued professional practice to safeguard vulnerable people and to reduce practitioner burnout. Dramatherapy supervision incorporates all of the above but utilises creative methods as a tool to gain insight and a deeper understanding of the situation. Creativity and the use of metaphor enable the supervisee to gain an aerial view of the situation they are exploring. The word metaphor in Greek means to ‘carry across’ indicating a transfer of meaning form one frame of reference to another. The supervision support was incorporated into each group’s induction training programme. The first year group attended fortnightly one hour sessions, the second group received two one hour sessions every term. The existing literature on the supervision and mentoring of secondary school teacher trainees calls for changes in pre-service teacher education and in the induction period. There is a particular emphasis on the need to include reflective and experiential learning, within training programmes and within the induction period, in order to help teachers manage the interpersonal dynamics and emotional impact within a high pressurised environment

Keywords: dramatherapy supervision, newly qualified secondary school teachers, professional development, teacher education

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Authors: M. Patterson, R. Bond, K. Cowan, M. Mulvenna, C. Reid, F. McMahon, P. McGowan, H. Cormican

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This paper outlines the design of a simulator to allow for the optimisation of clinical workflows through a pathology laboratory and to improve the laboratory’s efficiency in the processing, testing, and analysis of specimens. Often pathologists have difficulty in pinpointing and anticipating issues in the clinical workflow until tests are running late or in error. It can be difficult to pinpoint the cause and even more difficult to predict any issues which may arise. For example, they often have no indication of how many samples are going to be delivered to the laboratory that day or at a given hour. If we could model scenarios using past information and known variables, it would be possible for pathology laboratories to initiate resource preparations, e.g. the printing of specimen labels or to activate a sufficient number of technicians. This would expedite the clinical workload, clinical processes and improve the overall efficiency of the laboratory. The simulator design visualises the workflow of the laboratory, i.e. the clinical tests being ordered, the specimens arriving, current tests being performed, results being validated and reports being issued. The simulator depicts the movement of specimens through this process, as well as the number of specimens at each stage. This movement is visualised using an animated flow diagram that is updated in real time. A traffic light colour-coding system will be used to indicate the level of flow through each stage (green for normal flow, orange for slow flow, and red for critical flow). This would allow pathologists to clearly see where there are issues and bottlenecks in the process. Graphs would also be used to indicate the status of specimens at each stage of the process. For example, a graph could show the percentage of specimen tests that are on time, potentially late, running late and in error. Clicking on potentially late samples will display more detailed information about those samples, the tests that still need to be performed on them and their urgency level. This would allow any issues to be resolved quickly. In the case of potentially late samples, this could help to ensure that critically needed results are delivered on time. The simulator will be created as a single-page web application. Various web technologies will be used to create the flow diagram showing the workflow of the laboratory. JavaScript will be used to program the logic, animate the movement of samples through each of the stages and to generate the status graphs in real time. This live information will be extracted from an Oracle database. As well as being used in a real laboratory situation, the simulator could also be used for training purposes. ‘Bots’ would be used to control the flow of specimens through each step of the process. Like existing software agents technology, these bots would be configurable in order to simulate different situations, which may arise in a laboratory such as an emerging epidemic. The bots could then be turned on and off to allow trainees to complete the tasks required at that step of the process, for example validating test results.

Keywords: laboratory-process, optimization, pathology, computer simulation, workflow

Procedia PDF Downloads 286

Authors: Reisy Tane

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Asthma is the common health problems in adolescents. Self-management is one way to improve health status in adolescent with asthma. Mobile technology has the potential to improve self-management in adolescents with asthma. Objective: the aim of this study to determine the effectiveness of using the mobile technology Asthma Action Plan to improve self management. Method: this study is Systematic review approach using PRISM template. The literature search started on first September 2017 by using electronic data Pro Quest and Google Scholars with keywords ‘Mobile AAP’ and ‘Adolescent Asthma’. Results and Conclusion: M-AAP is effective to improve adolescent self-management with asthma because it is easy to use and provide information appropriately. The improvement of self-management in teenagers will enhance the quality of life of adolescents with asthma. The recommendation of this study is the addition of parental control content in the application appropriate with Family Centered Care (FCC) philosophy on pediatric nursing. In addition, it is expected the development of applications for other chronic diseases such as diabetes mellitus and congestive heart failure.

Keywords: asthma, mobile AAP, adolescent, self-management

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Authors: Maham Malik, Amjad Ali, Muhammad Asif

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Current study aims to examine the relationship of emotional labor strategies - deep acting and surface acting - with employees' job satisfaction, organizational commitment and intentions to quit. The study also examines the mediating role of job satisfaction and organizational commitment for relationship of emotional labor strategies with intentions to quit. Data were conveniently collected from 307 nurses by using self-administered questionnaire. Linear regression test was applied to find the relationship between the variables. Mediation was checked through Baron and Kenny Model and Sobel test. Results prove the existence of partial mediation of job satisfaction between the emotional labor strategies and quitting intentions. The study recommends that deep acting should be promoted because it is positively associated with quality of work life, work engagement and organizational citizenship behavior of employees.

Keywords: emotional labor strategies, intentions to quit, job satisfaction, organizational commitment, nursing

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Authors: Amira A. Alshowkan, Aleya M. Gamal

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Background: Patient safety is a vital element in providing high quality health care. In psychiatric wards, numerous of physical and emotional factors have been found to affect patient safety. In addition, organization, healthcare provider and patients were identified to be significant factors in patient safety. Aim: This study aims to discover nurses' perception of patient safety in psychiatric wards in Saudi Arabian. Method: Date will be collected through semi-structure face to face interview with nurses who are working at psychiatric wards. Data will be analysed thought the used of thematic analysis. Results: The results of this study will help in understanding the psychiatric nurses' perception of patient safety in Saudi Arabia. Several suggestions will be recommended for formulation of policies and strategies for psychiatric wards. In addition, recommendation to nursing education and training will be tailored in order to improve patient safety culture.

Keywords: patient safety culture, psychiatric, qualitative, Saudi Arabia

Procedia PDF Downloads 349

Authors: Valerie A. Conrade

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Introduction: A large body of literature suggests patients who complete fecal immunochemical testing (FIT) kits are likely to identify colorectal cancer sooner than those who do not complete FIT kits. Background: Patients who do not participate in preventative measures such as the FIT kit are at a higher risk of colorectal cancer growing unnoticed. The objective was to see if the method the principal investigator (PI) uses to educate clinical staff on the importance of FIT kit administration provides an increased amount of FIT kit dissemination to patients post clinical education. Methodologies: Data collection via manual tallies took place before and after the clinical staff was educated on the importance of FIT kits. Results: The results showed an increase in FIT kit dissemination post clinical staff education. Through enhanced instruction to the clinical staff regarding the importance of FIT kits, expanding their knowledge on preventative measures to detect colorectal cancer positively impacted nurses and, in turn, their patients.

Keywords: colon cancer, education, fecal immunochemical testing, nursing

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Authors: Sibel Çaynak, Nur Elçin Boyacıoğlu

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This study was conducted to evaluate the bereavement experiences of families of elderly individuals who died due to the COVID-19 pandemic. One of the qualitative research methods, the case study method, was used in the study. The sample of the research consisted of 19 people who agreed to participate in the research between April and July 2022. The research data were collected using a Personal Information Form and a Semi-Structured Interview Form, which was created to conduct individual in-depth interviews. As a result of the descriptive analysis, four main themes, the ability to perform religious rituals related to the bereavement experience, feelings and thoughts about death, attitudes of those around after death, and coping strategies in the COVID-19 process. It was determined that individuals had difficulty accepting death, felt inadequate about spirituality due to limited religious rituals, had feelings of despair and guilt, and limitedly utilized social support systems.

Keywords: COVID-19 pandemic, bereavement, psychiatric nursing, qualitative study

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Authors: Mahesh Vishwakarma, Sadhana Vishwakarma

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Vocational education includes all kind of education which can help students to acquire skills related to a certain profession, art, or activity so that they are able to exercise that profession, art or activity after acquiring such qualification. However, in this global economy of the modern world, job seekers are expected to have certain soft skills over and above the technical knowledge and skills acquired in their areas of expertise. These soft skills include but not limited to interpersonal communication, understanding, personal attributes, problem-solving, working in team, quick adaptability to the workplace environment, and other. Not only the hands-on, job-related skills, and competencies are now being sought by the employers, but also a complex of attitudinal dispositions and affective traits are being looked by them in their prospective employees. This study was performed to identify the employability skills of technical students from an Industrial Training Centre (ITC) in central India. It also aimed to convey a message to the students currently on the role, that for them to remain relevant in the job market, they would need to constantly adapt to changes and evolving requirements in the work environment, including the use of updated technologies. Five hypotheses were formulated and tested on the employability skills of students as a function of gender, trade, work experience, personal attributes, and IT skills. Data were gathered with the help of center’s training officers who approached 200 recently graduated students from the center and administered the instrument to students. All 200 respondents returned the completed instrument. The instrument used for the study consisted of 2 sections; demographic details and employability skills. To measure the employability skills of the trainees, the instrument was developed by referring to the several instruments developed by the past researchers for similar studies. The 1st section of the instrument of demographic details recorded age, gender, trade, year of passing, interviews faced, and employment status of the respondents. The 2nd section of the instrument on employability skills was categorized into seven specific skills: basic vocational skills; personal attributes; imagination skills; optimal management of resources; information-technology skills; interpersonal skills; adapting to new technologies. The reliability and validity of the instrument were checked. The findings revealed valuable information on the relationship and interdependence of vocational education and employability skills of students in the central Indian scenario. The findings revealed a valuable information on supplementing the existing vocational education programs with few soft skills and competencies so as to develop a superior workforce much better equipped to face the job market. The findings of the study can be used as an example by the management of government and private industrial training centers operating in the other parts of the Asian region. Future research can be undertaken on a greater population base from different geographical regions and backgrounds for an enhanced outcome.

Keywords: employability skills, vocational education, industrial training centers, students

Procedia PDF Downloads 132

Authors: Lauren G. Coggins

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Catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) are among the most common healthcare-associated infections (HAI), contributing to prolonged lengths of stay, greater costs of patient care, and increased patient mortality. Evidence-based preventative care bundles exist to establish consistent, safe patient-care practices throughout an entire organization, helping to ensure the collective application of care strategies that aim to improve patient outcomes and minimize complications. The cardiac intensive care unit at a nationally ranked teaching and research hospital in the United States exceeded its annual CAUTI and CLABSI targets in the fiscal year 2019, prompting examination into the unit’s infection prevention efforts that included preventative care bundles for both HAIs. Adherence to the CAUTI and CLABSI preventative care bundles was evaluated through frequent audits conducted over three months, using standards and resources from The Joint Commission, a globally recognized leader in quality improvement in healthcare and patient care safety. The bundle elements with the lowest scores were identified as the most commonly missed elements. Three elements from both bundles, six elements in total, served as key content areas for the educational interventions targeted to bedside nurses. The CAUTI elements included appropriate urinary catheter order, appropriate continuation criteria, and urinary catheter care. The CLABSI elements included primary tubing compliance, needleless connector compliance, and dressing change compliance. An integrated, multi-platform education campaign featured content on each CAUTI and CLABSI preventative care bundle in its entirety, with additional reinforcement focused on the lowest scoring elements. One-on-one educational materials included an informational pamphlet, badge buddy, a presentation to reinforce nursing care standards, and real-time application through case studies and electronic health record demonstrations. A digital hub was developed on the hospital’s Intranet for quick access to unit resources, and a bulletin board helped track the number of days since the last CAUTI and CLABSI incident. Audits continued to be conducted throughout the education campaign, and staff were given real-time feedback to address any gaps in adherence. Nearly every nurse in the cardiac intensive care unit received all educational materials, and adherence to all six key bundle elements increased after the implementation of educational interventions. Recommendations from this implementation include providing consistent, comprehensive education across multiple teaching tools and regular audits to track adherence. The multi-platform education campaign brought focus to the evidence-based CAUTI and CLABSI bundles, which in turn will help to reduce CAUTI and CLABSI rates in clinical practice.

Keywords: education, healthcare-associated infections, infection, nursing, prevention

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Authors: Aliya Moreira, Blake Duffy, Sam Kosinski, Kate Heckman, Erika Steensma

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Introduction: The One Health initiative promotes recognition of the interrelatedness between people, animals, plants, and their shared environment. The field of comparative medicine studies the similarities and differences between humans and animals for the purpose of advancing medical sciences. Currently, medical school education is narrowly focused on human anatomy and physiology, but as the COVID-19 pandemic has demonstrated, a holistic understanding of health requires comprehension of the interconnection between health and the lived environment. To prepare future physicians for unique challenges from emerging zoonoses to climate change, medical students can benefit from exposure to and experience with One Health and Comparative Medicine content. Methods: In January 2020, an elective course for medical students on One Health and Comparative Medicine was created to provide medical students with the background knowledge necessary to understand the applicability of animal and environmental health in medical research and practice. The 2-week course was continued in January 2021, with didactic and experiential activities taking place virtually due to the COVID-19 pandemic. In response to student feedback, lectures were added to expand instructional content on zoonotic and wildlife diseases for the second iteration of the course. Other didactic sessions included interprofessional lectures from 20 physicians, veterinarians, public health professionals, and basic science researchers. The first two cohorts of students were surveyed regarding One Health and Comparative Medicine concepts at the beginning and conclusion of the course. Results: 16 medical students have completed the comparative medicine course thus far, with 87.5% (n=14) completing pre-and post-course evaluations. 100% of student respondents indicated little to no exposure to comparative medicine or One Health concepts during medical school. Following the course, 100% of students felt familiar or very familiar with comparative medicine and One Health concepts. To assess course efficacy, questions were evaluated on a five-point Likert scale. 100% agreed or strongly agreed that learning Comparative Medicine and One Health topics augmented their medical education. 100% agreed or strongly agreed that a course covering this content should be regularly offered to medical students. Conclusions: Data from the student evaluation surveys demonstrate that the Comparative Medicine course was successful in increasing medical student knowledge of Comparative Medicine and One Health. Results also suggest that interprofessional training in One Health and Comparative Medicine is applicable and useful for medical trainees. Future iterations of this course could capitalize on the inherently interdisciplinary nature of these topics by enrolling students from veterinary and public health schools into a longitudinal course. Such recruitment may increase the course’s value by offering multidisciplinary student teams the opportunity to conduct research projects, thereby strengthening both the individual learning experience as well as sparking future interprofessional research ventures. Overall, these efforts to educate medical students in One Health topics should be reproducible at other institutions, preparing more future physicians for the diverse challenges they will encounter in practice.

Keywords: medical education, interprofessional instruction, one health, comparative medicine

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Authors: Innocent Atuhe, Babra Nalwadda, Grace Mulyowa Kitunzi, Annabella Haninka Ejiri

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Background: Atopic Dermatitis (AD) is one of the most prevalent and growing chronic inflammatory skin diseases in African prisons. AD care is limited in African due to lack of information about the disease amongst primary care workers, limited access to dermatologists, lack of proper training of healthcare workers, and shortage of appropriate treatments. We designed and implemented the Prisons Telederma project based on the recommendations of the International Society of Atopic Dermatitis. Our overall goal was to increase access to dermatologist-led care for prisoners with AD through teledermatology in Uganda. We aimed to; i) to increase awareness and understanding of teledermatology among prison health workers; and ii) to improve treatment outcomes of prisoners with atopic dermatitis through increased access to and utilization of consultant dermatologists through teledermatology in Uganda prisons: Approach: We used Store-and-forward Teledermatology (SAF-TD) to increase access to dermatologist-led care for prisoners and prisons staff with AD. We conducted a five days training for prison health workers using an adapted WHO training guide on recognizing neglected tropical diseases through changes on the skin together with an adapted American Academy of Dermatology (AAD) Childhood AD Basic Dermatology Curriculum designed to help trainees develop a clinical approach to the evaluation and initial management of patients with AD. This training was followed by blended e-learning, webinars facilitated by consultant Dermatologists with local knowledge of medication and local practices, apps adjusted for pigmented skin, WhatsApp group discussions, and sharing pigmented skin AD pictures and treatment via zoom meetings. We hired a team of Ugandan Senior Consultant dermatologists to draft an iconographic atlas of the main dermatoses in pigmented African skin and shared this atlas with prison health staff for use as a job aid. We had planned to use MySkinSelfie mobile phone application to take and share skin pictures of prisoners with AD with Consultant Dermatologists, who would review the pictures and prescribe appropriate treatment. Unfortunately, the National Health Service withdrew the app from the market due to technical issues. We monitored and evaluated treatment outcomes using the Patient Oriented Eczema Measure (POEM) tool. We held four advocacy meetings to persuade relevant stakeholders to increase supplies and availability of first-line AD treatments such as emollients in prison health facilities. Results: Draft iconographic atlas of the main dermatoses in pigmented African skin Increased proportion of prison health staff with adequate knowledge of AD and teledermatology from 20% to 80% Increased proportion of prisoners with AD reporting improvement in disease severity (POEM scores) from 25% to 35% in one year. Increased proportion of prisoners with AD seen by consultant dermatologist through teledermatology from 0% to 20% in one year. Increased the availability of AD recommended treatments in prisons health facilities from 5% to 10% in one year

Keywords: teledermatology, prisoners, reaching, un-reachable

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Authors: Chanpen Meenakorn

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This research aimed to examine the relationships between customer expectations and service quality management of Banpaew Hospital Samutsakorn in Thailand. The study sample consisted of 360 customers in patient unit. Data were collected using self-administered questionnaire. Descriptive statistics used were percentage, mean, and standard deviation. The analytical statistics comprised Pearson’s product moment correlation coefficient analysis. The result showed that service quality of nurses was very good with sustainable development trend. Physical evidence was at a high level, and the process and personal were rated at a high level. Additional, the study suggested that head nurse should be encouraged to improve service quality management, management training. Nurse administrators should create an appropriate nursing department climate, and provide necessary resources in the department. In addition, the nurse administrators should continuously follow up the results of customer expectations and focus on patients/customers, process management, information and knowledge management, and evaluation of service quality also.

Keywords: Banpaew Hospital, Customer Expectations, Service Provided, Samutsakorn

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Authors: Maeah Stephanie A. Macapaz Abadejos

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Covid-19 shook the whole world. Every person on all sides of the world was affected by the pandemic. All the nations and world leaders were searching for a variety of cures and solutions to stop the spread of the virus. In connection with this, this investigative case study aims to show a relationship between COVID-19 vaccinations to the immune system of the seniors and elderly. The seniors and elderly are one of the most vulnerable populations that show high morbidity and mortality in any illnesses and diseases. This study will show lived experiences of the senior’s immune system and health status, how it is being affected by the COVID-19 virus and its vaccines, Risk for COVID-19 Infection, Hospitalization, and Death by Age Group. Participants of this study are from 3 Cebu City Barangays and 2 from Barangays of the Cities of the Cebu Province. To conclude, this study shall serve its purpose of providing clear and concise results in strengthening the evidence of the effects of the COVID-19 virus infection, especially the free vaccinations, on the health and overall well-being of the elderly and seniors.

Keywords: gerontology nursing, vaccination, protection and immunity, seniors and the elderly

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Authors: Ç. Erdoğan, T. Turan

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Pediatric cancer patients experience multiple distressing, challenges, physical symptom such as fatigue, pain, sleep disturbance, and balance impairment that continue years after treatment completion. In recent years, yoga is often used in children with cancer to cope with these symptoms. Yoga practice is defined as a unique physical activity that combines physical practice, breath work and mindfulness/meditation. Yoga is an increasingly popular mind-body practice also characterized as a mindfulness mode of exercise. This study aimed to evaluate the impact of yoga intervention of children with cancer. This article planned searching the literature in this field. It has been determined that individualized yoga is feasible and provides benefits for inpatient children, improves health-related quality of life, physical activity levels, physical fitness. After yoga program, children anxiety score decreases significantly. Additionally, individualized yoga is feasible for inpatient children receiving intensive chemotherapy. As a result, yoga is an alternative and complementary medicine that can be safely used in children with cancer.

Keywords: cancer treatment, children, nursing, yoga

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Authors: Nuno Biga

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The integration of serious games with gamification in management education and training has gained significant importance in recent years as innovative strategies are sought to improve target audience engagement and learning outcomes. This research builds on the author's previous work in this field and presents a case study that evaluates the ex-post impact of a sample of applications of the BIGAMES management simulator in the training of top managers from various hospital institutions. The methodology includes evaluating the reaction of participants after each edition of BIGAMES Accident & Emergency (A&E) carried out over the last 3 years, as well as monitoring the career path of a significant sample of participants and their feedback more than a year after their experience with this simulator. Control groups will be set up, according to the type of role their members held when they took part in the BIGAMES A&E simulator: Administrators, Clinical Directors and Nursing Directors. Former participants are invited to answer a questionnaire structured for this purpose, where they are asked, among other questions, about the importance and impact that the BIGAMES A&E simulator has had on their professional activity. The research methodology also includes an exhaustive literature review, focusing on empirical studies in the field of education and training in management and business that investigate the effectiveness of gamification and serious games in improving learning, team collaboration, critical thinking, problem-solving skills and overall performance, with a focus on training contexts in the health sector. The results of the research carried out show that gamification and serious games that simulate real scenarios, such as Business Interactive Games - BIGAMES©, can significantly increase the motivation and commitment of participants, stimulating the development of transversal skills, the mobilization of group synergies and the acquisition and retention of knowledge through interactive user-centred scenarios. Individuals who participate in game-based learning series show a higher level of commitment to learning because they find these teaching methods more enjoyable and interactive. This research study aims to demonstrate that, as executive education and training programs develop to meet the current needs of managers, gamification and serious games stand out as effective means of bridging the gap between traditional teaching methods and modern educational and training requirements. To this end, this research evaluates the medium/long-term effects of gamified learning on the professional performance of participants in the BIGAMES simulator applied to healthcare. Based on the conclusions of the evaluation of the effectiveness of training using gamification and taking into account the results of the opinion poll of former A&E participants, this research study proposes an integrated approach for the transversal application of the A&E Serious Game in various educational contexts, covering top management (traditionally the target audience of BIGAMES A&E), middle and operational management in healthcare institutions (functional area heads and professionals with career development potential), as well as higher education in medicine and nursing courses. The integrated solution called “BIGAMES A&E plus”, developed as part of this research, includes the digitalization of key processes and the incorporation of AI.

Keywords: artificial intelligence (AI), executive training, gamification, higher education, management simulators, serious games (SG), training effectiveness

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Authors: N. R. N. Mendis, S. N. Silva

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Introduction: Patient satisfaction of services provided by primary care health services depends on many factors. One key factor in this depends on is the nursing services received in primary care. Since majority of the primary care in Sri Lanka is provided by the private sector, it is important to assess patient satisfaction on this. Objective: To assess the satisfaction among the public on nurses working in dispensaries in Sri Lanka. Methods: A descriptive study was done on 200 individual selected using convenient sampling among dispensaries in Gampaha district, Sri Lanka. Results: 59.3% of the sample had long term illnesses or disabilities and all of them preferred speaking to a nurse. 70.9% of the sample used to make appointments with nurses while 57.8% out of them were comfortable in discussing their health concerns. 98.9 % agreed that they get individual attention by the nurses. Majority of the sample that is 34.2% spends around 20 minutes with the nurse without even making any pay. Significantly, the whole sample believes that the nurses are professional and admits that the care given is of high quality. All 100% of the sample said that the nurses could understand their concerns while 93.5% admitted that it was very useful in their recovery. Conclusions: Majority of the public were very much satisfied with the nurses and their practice at the dispensaries.

Keywords: health education, nurses practices, patient satisfaction, primary care

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Authors: Jalal Abdulkareem Sultan, Abdulhakeem Luqman Hasan

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With the development of health care systems competition, hospitals face more and more pressures. Meanwhile, resource allocation has a vital effect on achieving competitive advantages in hospitals. Selecting the appropriate number of beds is one of the most important sections in hospital management. However, in real situation, bed allocation selection is a multiple objective problem about different items with vagueness and randomness of the data. It is very complex. Hence, research about bed allocation problem is relatively scarce under considering multiple departments, nursing hours, and stochastic information about arrival and service of patients. In this paper, we develop a fuzzy multiobjective bed allocation model for overcoming uncertainty and multiple departments. Fuzzy objectives and weights are simultaneously applied to help the managers to select the suitable beds about different departments. The proposed model is solved by using Artificial Bee Colony (ABC), which is a very effective algorithm. The paper describes an application of the model, dealing with a public hospital in Iraq. The results related that fuzzy multi-objective model was presented suitable framework for bed allocation and optimum use.

Keywords: bed allocation problem, fuzzy logic, artificial bee colony, multi-objective optimization

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Authors: Jonathan H. Westover, Ruthann Cunningham, Jaron Harvey

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Purpose: Job satisfaction is one of the most critical attitudes among employees. Understanding whether employees are satisfied with their jobs and what is driving that satisfaction is important for any employer, but particularly for healthcare organizations. This study looks at the question of job satisfaction and drivers of job satisfaction among healthcare professionals at a global scale, looking for trends that generalize across 37 countries. Study: This study analyzed job satisfaction responses to the 2015 Work Orientations IV wave of the International Social Survey Programme (ISSP) to understand differences in antecedents for and levels of job satisfaction among healthcare professionals. A total of 18,716 respondents from 37 countries participated in the annual survey. Findings: Respondents self-identified their occupational category based on corresponding International Standard Classification of Occupations (ISCO-08) codes. Results suggest that mean overall job satisfaction was highest among health service managers and generalist medical practitioners and lowest among environmental hygiene professionals and nursing professionals. Originality: Many studies have addressed the issue of job satisfaction in healthcare, examining small samples of specific healthcare workers. In this study, using a large international dataset, we are able to examine questions of job satisfaction across large groups of healthcare workers in different occupations within the healthcare field.

Keywords: job satisfaction, healthcare industry, global comparisons, workplace

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Authors: Innocent Atuhe, Babra Nalwadda, Grace Mulyowa, Annabella Habinka Ejiri

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Background: Atopic Dermatitis (AD) is one of the most prevalent and growing chronic inflammatory skin diseases in African prisons. AD care is limited in African due to a lack of information about the disease amongst primary care workers, limited access to dermatologists, lack of proper training of healthcare workers, and shortage of appropriate treatments. We designed and implemented the Prisons Telederma project based on the recommendations of the International Society of Atopic Dermatitis. We aimed at; i) increase awareness and understanding of teledermatology among prison health workers and ii) improve treatment outcomes of prisoners with atopic dermatitis through increased access to and utilization of consultant dermatologists through teledermatology in Uganda prisons. Approach: We used Store-and-forward Teledermatology (SAF-TD) to increase access to dermatologist-led care for prisoners and prison staff with AD. We conducted five days of training for prison health workers using an adapted WHO training guide on recognizing neglected tropical diseases through changes on the skin together with an adapted American Academy of Dermatology (AAD) Childhood AD Basic Dermatology Curriculum designed to help trainees develop a clinical approach to the evaluation and initial management of patients with AD. This training was followed by blended e-learning, webinars facilitated by consultant Dermatologists with local knowledge of medication and local practices, apps adjusted for pigmented skin, WhatsApp group discussions, and sharing pigmented skin AD pictures and treatment via zoom meetings. We hired a team of Ugandan Senior Consultant dermatologists to draft an iconographic atlas of the main dermatoses in pigmented African skin and shared this atlas with prison health staff for use as a job aid. We had planned to use MySkinSelfie mobile phone application to take and share skin pictures of prisoners with AD with Consultant Dermatologists, who would review the pictures and prescribe appropriate treatment. Unfortunately, the National Health Service withdrew the app from the market due to technical issues. We monitored and evaluated treatment outcomes using the Patient-Oriented Eczema Measure (POEM) tool. We held four advocacy meetings to persuade relevant stakeholders to increase supplies and availability of first-line AD treatments such as emollients in prison health facilities. Results: We have the very first iconographic atlas of the main dermatoses in pigmented African skin. We increased; i) the proportion of prison health staff with adequate knowledge of AD and teledermatology from 20% to 80%; ii) the proportion of prisoners with AD reporting improvement in disease severity (POEM scores) from 25% to 35% in one year; iii) increased proportion of prisoners with AD seen by consultant dermatologist through teledermatology from 0% to 20% in one year and iv)Increased the availability of AD recommended treatments in prisons health facilities from 5% to 10% in one year. Our study contributes to the use, evaluation, and verification of the use of teledermatology to increase access to specialist dermatology services to the most hard to reach areas and vulnerable populations such as that of prisoners.

Keywords: teledermatology, prisoners, reaching, un-reachable

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Authors: Liqun Zou, Ling Wang, Xiaoli Chen

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Objective: Through the questionnaire about emergency nurses’ knowledge and attitudes regarding pain management to understand whether they are well mastered and practiced the related knowledge about pain management, providing a reference for continuous improvement of the quality of nursing care in acute pain and for improving the effect of management on emergency pain patients. Method: The Chinese version questionnaire about KASRP (knowledge and attitudes survey regarding pain) was handed out to 132 emergency nurses to do a study about the knowledge and attitude of pain management. Meanwhile, SPSS17.0 was used to do a descriptive analysis and variance analysis on collected data. Results: The emergency nurses’ correct answer rate about KASRP questionnaire is from 25% to 65% and the average correct rate is (44.65 + 7.85)%. In addition, there are 10 to 26 items being given the right answer. Therefore, the average correct items are (17.86 ± 3.14). Moreover, there is no statistical significant on the differences about the correct rate for different age, gender and work experience to answer; however, the difference of the correct rate in different education background and the professional title is significant. Conclusion: There is a remarkable lack of knowledge and attitude towards pain management in emergency nurses, whose basic knowledge of pain is sufficient. Besides, there is a deviation between the knowledge of pain management and clinical practice, which needs to be improved.

Keywords: emergency nurse, pain, KASRP questionnaire, pain management

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Authors: Natalie Cutler, Lorna Moxham, Moira Stephens

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Safety is a priority in mental health services, and no more so than in the acute inpatient setting. Mental health service policies and accreditation frameworks commonly approach safety from a risk reduction or elimination perspective leading to service approaches that are arguably more focused on risk than on safety. An exploration what safety means for people who have experienced admission to an acute mental health inpatient unit is currently under way in Sydney, Australia. Using a phenomenographic research approach, this study is seeking to understand the meaning of safety from the perspective of people who use, rather than those who deliver mental health services. Preliminary findings suggest that the meanings of safety for users of mental health services vary from the meanings inherent in the policies and frameworks that inform how mental health services and mental health practice are delivered. This variance has implications for the physical and environmental design of acute mental health inpatient facilities, the policies and practices, and the education and training of mental health staff in particular nurses, who comprise the majority of the mental health workforce. These variances will be presented, along with their implications for the way quality and safety in mental health services are evaluated.

Keywords: acute inpatient, mental health, nursing, phenomenography, recovery, safety

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Authors: Vaisnavy Govindasamy, Saba Ishrat

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Introduction: The Dexamethasone Intravitreal Implant 0.7 mg (OzurdexTM, Allergan®) is a biodegradable corticosteroid implant approved by the FDA for managing diabetic macular edema (DMO), macular edema following branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO), and posterior segment non-infectious uveitis. This implant can release dexamethasone over a six-month period, exhibiting peak effectiveness between 60 and 90 days post-administration. The intravitreal injection should be performed under sterile conditions. At James Cook University Hospital (JCUH), Ozurdex injections are currently administered in the Vitreo-Retinal (VR) theatre. This study aimed to evaluate the feasibility and potential advantages of establishing a dedicated clinic for Ozurdex administration separate from the VR theatre setting. Method: Retrospectively, data of all Ozurdex injections administered between October 2021 to October 2022 was collected from operating theatre registers at JCUH. Data pertaining to the indications for Ozurdex; waiting times from referral date to date of injection; duration of theatre time consumed; and post-injection complications were collected from electronic notes. The resources needed to establish a dedicated Ozurdex clinic were evaluated. Over a six-month period from October 2023 to March 2024, we gathered data on utilization of theatre 28. Results: A total of 135 Ozurdex injections were administered. Among the indications, uveitis represented 47.3% of cases, DMO with 23.6% and RVO with 22.9%. Remaining cases lacked sufficient data. Each Ozurdex injection procedure consumed 15 minutes in the VR theatre list. Complications arose in 5% of injections, totaling 7 cases. These included glaucoma, ocular hypertension, subconjunctival haemorrhage and implant migration. Waiting times averaged 6 weeks from date for referral to procedure date. We also found that, on an average theatre 28 was offered but remained unused for 4 days, totalling eight sessions in a month. Analysis: Establishing a sperate Ozurdex clinic would improve the quality of patient care in following ways: 1.Decrease injection waiting times (currently averaging 6 weeks), leading to better visual outcomes. 2.Free up approximately three hours of theatre time in Vitreo-Retina theatres each month, allowing for 3-4 additional surgeries. Reduce waiting times for critical retinal surgeries and enhance visual outcomes. 3.Provide additional training opportunities for trainees and retina fellows, improving their skills. 4.Optimize the use of empty theatre slots (theatre 28) currently experiencing underutilization of resources. Conclusion: These findings support the implementation of a separate clinic for administering Ozurdex injections at JCUH. It is evident that introducing a dedicated clinic will enhance operational efficiency, optimise resource utilsation, and improve overall quality of care for patients undergoing this treatment.

Keywords: opthalmology, ozurdex, efficiency, complication

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Authors: Muhammad Shuaibu Birniwa

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Automobile Independent Workshop Service Technicians (popularly called roadside mechanics) are technical personals that repairs most of the automobile vehicles in Nigeria. Majority of these mechanics acquired their skills through apprenticeship training. Modern vehicle imported into the country posed greater challenges to the present automobile technicians particularly in the area of carrying out maintenance repairs of these latest automobile vehicles (autotronics vehicle) due to their inability to possessed autotronic skills competency. To source for solution to the above mentioned problems, therefore a research is carried out in North – Western region of Nigeria to produce a suitable maintenance training modules that can be used to train the technicians for them to upgrade/acquire the needed competencies for successful maintenance repair of the autotronic vehicles that were running everyday on the nation’s roads. A cluster sampling technique is used to obtain a sample from the population. The population of the study is all autotronic inclined lecturers, instructors and independent workshop service technicians that are within North – Western region of Nigeria. There are seven states (Jigawa, Kaduna, Kano, Katsina, Kebbi, Sokoto and Zamfara) in the study area, these serves as clusters in the population. Five (5) states were randomly selected to serve as the sample size. The five states are Jigawa, Kano, Katsina, Kebbi and Zamfara, the entire population of the five states which serves as clusters is (183), lecturers (44), instructors (49) and autotronic independent workshop service technicians (90), all of them were used in the study because of their manageable size. 183 copies of autotronic maintenance training module questionnaires (AMTMQ) with 174 and 149 question items respectively were administered and collected by the researcher with the help of an assistants, they are administered to 44 Polytechnic lecturers in the department of mechanical engineering, 49 instructors in skills acquisition centres/polytechnics and 90 master craftsmen of an independent workshops that are autotronic inclined. Data collected for answering research questions 1, 3, 4 and 5 were analysed using SPSS software version 22, Grand Mean and standard deviation were used to answer the research questions. Analysis of Variance (ANOVA) was used to test null hypotheses one (1) to three (3) and t-test statistical tool is used to analyzed hypotheses four (4) and five (5) all at 0.05 level of significance. The research conducted revealed that; all the objectives, contents/tasks, facilities, delivery systems and evaluation techniques contained in the questionnaire were required for the development of the autotronic maintenance training modules for independent workshop service technicians in the north – western zone of Nigeria. The skills upgrade training conducted by federal government in collaboration with SURE-P, NAC and SMEDEN was not successful because the educational status of the target population was not considered in drafting the needed training modules. The mode of training used does not also take cognizance of the theoretical aspect of the trainees, especially basic science which rendered the programme ineffective and insufficient for the tasks on ground.

Keywords: autotronics, roadside, mechanics, technicians, independent

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Authors: Elzbieta Sikorska-Simmons

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Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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Authors: Nelomi Anandagoda, Leanne J. Eveson

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During the COVID-19 pandemic, the surge in in-patient admissions across the medical directorate of a district general hospital necessitated the implementation of an incident rota. Conscious of the impact on training and professional development, the idea of developing a virtual teaching programme was conceived. The programme initially aimed to provide junior doctors, specialist nurses, pharmacists, and allied healthcare professionals from medical specialties and those re-deployed from other specialties (e.g., ophthalmology, GP, surgery, psychiatry) the knowledge and skills to manage the deteriorating patient with COVID-19. The programme was later developed to incorporate the general internal medicine curriculum. To facilitate continuing medical education whilst maintaining social distancing during this period, a virtual platform was used to deliver teaching to junior doctors across two large district general hospitals and two community hospitals. Teaching sessions were recorded and uploaded to a common platform, providing a resource for participants to catch up on and re-watch teaching sessions, making strides towards reducing discrimination against the professional development of less than full-time trainees. Thus, creating a learning environment, which is inclusive and accessible to adult learners in a self-directed manner. The negative impact of the pandemic on the well-being of healthcare professionals is well documented. To support the multi-disciplinary team, the virtual teaching programme evolved to included sessions on well-being, resilience, and work-life balance. Providing teaching for learners across the multi-disciplinary team (MDT) has been an eye-opening experience. By challenging the concept that learners should only be taught within their own peer groups, the authors have fostered a greater appreciation of the strengths of the MDT and showcased the immense wealth of expertise available within the trust. The inclusive nature of the teaching and the ease of joining a virtual teaching session has facilitated the dissemination of knowledge across the MDT, thus improving patient care on the frontline. The weekly teaching programme has been running for over eight months, with ongoing engagement, interest, and participation. As described above, the teaching programme has evolved to accommodate the needs of its learners. It has received excellent feedback with an appreciation of its inclusive, multi-disciplinary, and holistic nature. The COVID-19 pandemic provided a catalyst to rapidly develop novel methods of working and training and widened access/exposure to the virtual technologies available to large organisations. By merging pedagogical expertise and technology, the authors have created an effective online learning environment. Although the authors do not propose to replace face-to-face teaching altogether, this model of virtual multidisciplinary team, cross-site teaching has proven to be a great leveler. It has made high-quality teaching accessible to learners of different confidence levels, grades, specialties, and working patterns.

Keywords: cross-site, cross-speciality, inter-disciplinary, multidisciplinary, virtual teaching

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Authors: Wladislaw Mill, Hariet Kirschner, Anna Zimmermann, Sashi Singh, Simon Forstmeier, Uwe Berger, Bernhard Strauss, Benedikt Werner

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Introduction: A promising method to improve mental health of elderly people are structured life-reviews. We report the evaluation of our newly developed manual for structured life-reviews. The manual was created with the emphasis on straightforward application so that it can be used by professionals and lay people alike. Method: A within-subjects pre-post design is used to evaluate the manual using a geriatric depression scale and a self-integrity measure. Participants are elderly people living by themselves and in nursing homes. Findings: It is shown that elderly people perceive the structured life-review as a very positive experience. More importantly, it is shown that a negative trend of self-integrity and geriatric depression is significantly reduced by the intervention. Conclusion: The data suggest that the manual contributes positively to self- perception and mental health. We conclude that this newly developed device is very valuable to augment elderly care.

Keywords: structured life-review, self-integrity, geriatric depression, preventation research

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