Search results for: health satisfaction survey

Authors: Pranab Kumar Goswami

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According to WHO, over 1000 million people worldwide are employed in small-scale industries. The ‘garment’ industry’ is one such industry in developing countries. These garment SMEs are mostly run by private establishments in the unorganized sector to avoid legal obligations of OSH provisions. The OSH standards are very poor and even basic health and safety provisions are not provided in such units. The study has been conducted in India among workers employed in the ‘garment’ industry with the objectives to analyze the types and extent of occupational health hazards of the garment workers and to assess the relationship of sociodemographic and occupational factors with various health hazards. The survey method, the tabular method followed by applying simple statistical technique, has been taken into account to analyze the data collected from three SME garment industries in Delhi (India-Asia). The study was conducted in Delhi from August-2019 to October-2020. A random sampling of 70 workers from three factories has been chosen for this study. The study shows that most of the workers were males (82%) and were in the 18-50 age group (78%), with none below 18 years of age. It was found that 26% of the workers were illiterate and most of them belonged to poor socioeconomic status. The study revealed that the nature of the hazards in garment industries in India is mostly physical and mechanical. We found that musculoskeletal problems (54%) were the commonest health problem. The body areas commonly affected were neck, low back, hand, wrist, finger, and shoulder. If garment workers’ health is affected by occupational hazards, it will impact on national health and economic growth of developing countries. Health is a joint responsibility of both government and employing authority.

Keywords: garment, MSD, health hazard, social factor

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Authors: Upasana Sharma, Jayanti Dutta, Amarjeet Singh

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Background: Ayurveda is a comprehensive natural health care system. It is widely used in India as a system of primary health care, and interest in it is growing worldwide. Objectives: 1) To assess the extent and pattern of use of Ayurvedic medicines/ products by the people of Chandigarh. 2) To assess the perceived impact of use of Ayurvedic medicines/ products among the users. Methods: A cross-sectional community based study was conducted in a city of North India. Overall 371 households were covered from rural, urban and slum areas from December 2010 to April 2011. Respondents were interviewed regarding practices about Ayurveda products. Results: Around 160 (43%; 95% CI= 38.15, 47.85) of the respondents were using Ayurvedic products in one form or the other. Out of them, 91 (57%) had used Ayurvedic medicines in combination with some other system of medicine rather than as a standalone therapy. Most of them (81%) preferred Ayurveda products for chronic digestive system related problems. Conclusion: The present study revealed that respondents had keen interest in Ayurveda. A section of population was taking Ayurvedic treatment for their health ailments. There was a great level of satisfaction among the users but high cost bothered them at times.

Keywords: ayurveda, alternative medicine, chronic diseases, complimentary medicine

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Authors: Ching-Yu Lin

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The number of patients with aphasia has been gradually increasing; however, public awareness of aphasia is still limited. Moreover, surveys about public awareness of aphasia have been conducted in several countries, but there is no research about public awareness of aphasia in Taiwan so far. Therefore, this study aims at the investigation of public awareness of aphasia in Taiwan. In this pilot study, the original English-version questionnaire will be translated into Mandarin Chinese by a speech therapist (the author), and 100 Taiwanese over 18 years old will be recruited to finish the questionnaire. People with an occupation about health or medical will be excluded. In order to reach more people, the questionnaire will be an Internet survey by Google Forms, and the URL of the survey will be distributed by messaging, i.e. e-mail, Facebook Messenger, Instagram DM, or Line. Data will be analyzed via PASW Statistic 18. Descriptive statistics will be used to summarize what proportion of the public have heard of aphasia and what proportion of the public have basic knowledge of aphasia in Taiwan. The sources of information about aphasia will also be investigated. Further, differences in awareness of aphasia due to age, gender, and education level will be discussed.

Keywords: aphasia, public awareness, public knowledge, taiwan

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Authors: Ado Ismail Sabo

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Statement of the Problem: The global trend in tertiary education institutions today is changing and moving towards engagement, promotion and marketing. The reason is to upscale reputation and impact positioning. More prominently, existing rivalry today seeks to draw-in the best and brightest students. A university or college is no longer just an institution of higher learning, but one adapting additional business nomenclature. Therefore, huge financial resources are invested by educational institutions to polish their image and improve their global and national ranking. In Nigeria, which boasts of a vast population of over 180 million people, some of whose patronage can bolster its education sector; standard of education continues to decline. Today, some Nigerian tertiary education institutions are shadows of their pasts, in terms of academic excellence. Quality has been relinquished because of the unquenchable quest by government officials, some civil servants, school heads and educators to amass wealth. It is very difficult to gain student satisfaction and their loyalty. Some of the student’s loyalties factor towards public higher educational institutions might be confusing. It is difficult to understand the extent to which students are satisfy on many needs. Some students might feel satisfy with the academic lecturers only, whereas others may want everything, and others will never satisfy. Due to these problems, this research aims to uncover the crucial factors influencing student loyalty and to examine if students’ satisfaction might impact mediate the relationship between service quality, organisational image and students’ loyalty towards public higher education institutions in Kano State, Nigeria. The significance of the current study is underscored by the paucity of similar research in the subject area and public tertiary education in a developing country like Nigeria as shown in existing literature. Methodology: The current study was undertaken by quantitative research methodology. Sample of 600 valid responses were obtained within the study population comprising six selected public higher education institutions in Kano State, Nigeria. These include: North West University Kano, Bayero University Kano, School of Management Studies Kano, School of Technology Kano, Sa’adatu Rimi College Kano and Federal College of Education (FCE) Kano. Four main hypotheses were formulated and tested using structural equation modeling techniques with Analysis of Moment Structure (AMOS Version 22.0). Results: Analysis of the data provided support for the main issue of this study, and the following findings are established: “Student Satisfaction mediates the relationship between Service Quality and Student Loyalty”, “Student Satisfaction mediates the relationship between Organizational Image and Student Loyalty” respectively. The findings of this study contributed to the theoretical implication which proposed a structural model that examined the relationships among overall Organizational image, service quality, student satisfaction and student loyalty. Conclusion: In addition, the findings offered a better insight to the managerial (higher institution of learning service providers) by focusing on portraying the image of service quality with student satisfaction in improving the quality of student loyalty.

Keywords: student loyalty, service quality, student satisfaction, organizational image

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Authors: Bola Adeleke, Kayode Ogunsusi

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Heritage sites have evolved to preserve culture and heritage and also to educate and entertain tourists. Tourist travel decisions and behavior are influenced by destination image and value of the experience of tourists. Perceived value is one of the important tools for securing a competitive edge in tourism destinations. The model of Ritchie and Crouch distinguished 36 attributes of competitiveness which are classified into five factors which are quality of experience, touristic attractiveness, environment and infrastructure, entertainment/outdoor activities and cultural traditions. The study extended this model with a different grouping of the determinants of destination competitiveness. The theoretical framework used for this study assumes that apart from attractions already situated in the grove, satisfaction with destination common service, and entertainment and events, can all be used in creating a positive image for/and in attracting customers (destination selection) to visit Osun Sacred Osogbo Grove during and after annual celebrations. All these will impact positively on travel experience of customers as well as their spiritual fulfillment. Destination image has a direct impact on tourists’ satisfaction which consequently impacts on tourists’ likely future behavior on whether to revisit a cultural destination or not. The study investigated the variables responsible for destination image competitiveness of the Heritage Site; assessed the factors enhancing the destination image; and evaluated the perceived value realized by tourists from their cultural experience at the grove. A complete enumeration of tourists above 18 years of age who visited the Heritage Site within the month of March and April 2017 was taken. 240 respondents, therefore, were used for the study. The structured questionnaire with 5 Likert scales was administered. Five factors comprising 63 variables were used to determine the destination image competitiveness through principal component analysis, while multiple regressions were used to evaluate perceived value of tourists at the grove. Results revealed that 11 out of the 12 variables determining the destination image competitiveness were significant in attracting tourists to the grove. From the R-value, all factors predicted tourists’ value of experience strongly (R= 0.936). The percentage variance of customer value was explained by 87.70% of the variance of destination common service, entertainment and event satisfaction, travel environment satisfaction and spiritual satisfaction, with F-value being significant at 0.00. Factors with high alpha value contributed greatly to adding value to enhancing destination and tourists’ experience. 11 variables positively predicted tourist value with significance. Managers of Osun World Heritage Site should improve on variables critical to adding values to tourists’ experience.

Keywords: competitiveness, destination image, Osun Osogbo world heritage site, tourists

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Authors: Rachel S. Chang, Samuel P. Massion, Alan Z. Grusky, Heather A. Ridinger

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Introduction Health advocacy is defined as activities that improve access to care, utilize resources, address health disparities, and influence health policy. Advocacy is increasingly being recognized as a critical component of a physician’s role, as understanding social determinants of health and improving patient care are important aspects within the American Medical Association’s Health Systems Science framework. However, despite this growing prominence, educational interventions that address advocacy topics are limited and variable across medical school curricula. Furthermore, few recent studies have evaluated attitudes toward health advocacy among physicians-in-training in the United States. This study examines medical student attitudes towards health advocacy, along with perceived knowledge, ability, and current level of engagement with health advocacy during their clerkships. Methods This study employed a cross-sectional survey design using a single anonymous, self-report questionnaire to all second-year medical students at Vanderbilt University School of Medicine (n=96) in December 2020 during clerkship rotations. The survey had 27 items with 5-point Likert scale (15), multiple choice (11), and free response questions (1). Descriptive statistics and thematic analysis were utilized to analyze responses. The study was approved by the Vanderbilt University Institutional Review Board. Results There was an 88% response rate among second-year clerkship medical students. A majority (83%) agreed that formal training in health advocacy should be a mandatory part of the medical student curriculum Likewise, 83% of respondents felt that acting as a health advocate or patients should be part of their role as a clerkship student. However, a minority (25%) felt adequately prepared. While 72% of respondents felt able to identify a psychosocial need, 18% felt confident navigating the healthcare system and only 9% felt able to connect a patient to a psychosocial resource to fill that gap. 44% of respondents regularly contributed to conversations with their medical teams when discussing patients’ social needs, such as housing insecurity, financial insecurity, or legal needs. On average, respondents reported successfully connecting patients to psychosocial resources 1-2 times per 8-week clerkship block. Barriers to participating in health advocacy included perceived time constraints, lack of awareness of resources, lower emphasis among medical teams, and scarce involvement with social work teams. Conclusions In this single-institutional study, second-year medical students on clerkships recognize the importance of advocating for patients and support advocacy training within their medical school curriculum. However, their perceived lack of ability to navigate the healthcare system and connect patients to psychosocial resources, result in students feeling unprepared to advocate as effectively as they hoped during their clerkship rotations. Our results support the ongoing need to equip medical students with training and resources necessary for them to effectively act as advocates for patients.

Keywords: clerkships, medical students, patient advocacy, social medicine

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Authors: James Beauchemin

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Research indicates that college students are experiencing mental health challenges of greater severity, and an increased number of students are seeking help. Contributing to the compromised wellness of the college student population are the prevalence of unhealthy lifestyle habits and behaviors such as alcohol consumption, tobacco use, dietary concerns, risky sexual behaviors, and lack of physical activity. Alternative approaches are needed for this population that emphasize prevention and holistic lifestyle change that mitigate mental health and wellness challenges and alleviate strain on campus resources. This presentation will introduce a Solution-Focused Wellness (SFW) intervention model and examine wellness domains solution-focused strategies to promote personal well-being, and provide supporting research from multiple studies that illustrate intervention effectiveness with a collegiate population. Given the subjective and personal nature of wellness, a therapeutic approach that provides the opportunity for individuals to conceptualize and operationalize wellness themselves is critical to facilitating lasting wellness-based change. Solution-Focused Brief Therapy (SFBT) is a strength-based modality defined by its emphasis on constructing solutions rather than focusing on problems and the assumption that clients have the resources and capacity to change. SFBT has demonstrated effectiveness as a brief therapeutic intervention with the college population in groups and related to health and wellness. By integrating SFBT strategies with personal wellness, a brief intervention was developed to support college students in establishing lifestyles trends consistent with their conceptualizations of wellness. Research supports the effectiveness of a SFW model in improving college student wellness in both face-to-face and web-based formats. Outcomes of controlled and longitudinal studies will be presented, demonstrating significant improvements in perceptions of stress, life satisfaction, happiness, mental health, well-being, and resilience. Overall, there is compelling evidence that utilization of a Solution-Focused Brief Therapy approach with college students can help to improve personal wellness and establish healthy lifestyle trends, providing an effective prevention-focused strategy for college counseling centers and wellness centers to employ. Primary research objectives include: 1)establish an evidence-based approach to facilitating wellness pro motion among the college student population, 2) examine the effectiveness of a Solution-Focused Wellness (SFW) intervention model in decreasing stress, improving personal wellness, mental health, life satisfaction, and resiliency,3) investigate intervention impacts over time (e.g. 6-week post-intervention), and 4) demonstrate SFW intervention utility in wellness promotion and associated outcomes when compared with no-treatment control, and alternative intervention approaches.

Keywords: wellness, college students, solution-focused, prevention

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Authors: Ioana Dallinger, Vincent P. Magnini

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Due to the many moving parts and high human component, mistakes and failures sometimes occur during transactions in service environments. Because a certain portion of such failures is unavoidable, many service providers constantly look for guidance regarding optimal ways by which they should manage failures and recoveries. Through the use of a scenario-based experiment, the findings of this study run counter to the empowerment approach (i.e. that frontline employees should be empowered to resolve failure situations on their own doing). Specifically, this study finds that customers’ perceptions of distributive, procedural, and interactional justice are significantly higher [p-values < .05] when a manager delivers an apology as opposed to the frontline provider. Moreover, customers’ satisfaction with the recovery and commitment to the firm are also significantly stronger [p-values < .05] when a manager apologizes. Interestingly, this study also empirically tests the effects of combined apologies of both the manager and employee and finds that the combined approach yields better results for customers’ interactional justice perceptions and for their satisfaction with recovery, but not for their distributive or procedural justice perceptions or consequent commitment to the firm. This study can serve a springboard for further research. For example, perceptions and attitudes regarding employee empowerment vary based upon country culture. Furthermore, there are likely a number of factors that can moderate the cause and effect relationship between a failure recovery and customers’ post-recovery perceptions [e.g. the severity of the failure].

Keywords: apology, empowerment, service failure recovery, service recovery

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Authors: Wan Nur'ashiqin Wan Mohamad, Zarina Othman, Mohd Azman Abas, Azizah Ya'acob, Rozmel Abdul Latiff

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Effective doctor-patient interaction is vital to both doctor and patient relationship. It is the cornerstone of good practice and an integral quality of a healthcare institution. This paper presented the hierarchy of the communication elements in doctor-patient interaction during medical consultations in a medical centre in Malaysia. This study adapted The Picker Patient Experience Questionnaire (2002) to obtain the information from patients. The questionnaire survey was responded by 100 patients between the ages of 20 and 50. Data collected were analysed using Rasch Measurement Model to yield the hierarchy of the communication elements in doctor-patient interaction. The findings showed that the three highest ranking on the doctor-patient interaction were doctor’s treatment, important information delivery and patient satisfaction of doctor’s responses. The results are valuable in developing the framework for communication ethics of doctors.

Keywords: communication elements, doctor-patient interaction, hierarchy, Rasch measurement model

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Authors: Kinneret Segal

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Background: The work of a midwife is emotionally challenging, both positively and negatively. Midwives share moments of joy when a baby is welcomed into the world and also attend difficult events of loss and trauma. The relationship that develops with the maternity is the essence of the midwife's care, and it is a fundamental source of motivation and professional satisfaction. This close relationship with the maternity may be used as a double-edged sword in cases of exposure to traumatic events at birth. Birth problems, exposure to emergencies and traumatic events, and loss can affect the professional quality of life and the Compassion satisfaction of the midwife. It seems that the issue of traumatic experiences in the work of midwives has not been sufficiently explored. Aim: The present study examined the associations between exposure to traumatic events, personal resilience and post-traumatic symptoms, professional quality of life, and organizational commitment among midwifery nurses in Israeli hospitals. Methods: 131 midwives from three hospitals in the country's center in Israel participated in this study. The data were collected during 2021 using a self-report questionnaire that examined sociodemographic characteristics, the degree of exposure to traumatic events in the delivery room, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. Results: The three most difficult traumatic events for the midwives were death or fear of death of a newborn, death or fear of the death of a mother, and a quiet birth. The higher the frequency of exposure to traumatic events, the more numerous and intense the onset of post-trauma symptoms. The more numerous and powerful the post-trauma symptoms, the higher the level of professional burnout and/or compassion fatigue, and the lower the level of compassion satisfaction. High levels of compassion satisfaction and/or low professional burnout were expressed in a heightened sense of organizational commitment. Personal resilience, country of birth, traumatic symptoms, and organizational commitment predicted satisfaction from compassion. Conclusions: Midwives are exposed to traumatic events associated with dissatisfaction and impairment of the professional quality of life that accompanies burnout and compassion fatigue. Exposure to traumatic events leads to the appearance of traumatic symptoms, a decrease in organizational commitment, and psychological and mental well-being. The issue needs to be addressed by implementing training programs, organizational support, and policies to improving well-being and quality of care among midwives.

Keywords: organizational commitment, traumatic experiences, personal resilience, quality of life

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Authors: Supattra Kanchanopast

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This article presents the process of change for innovation in the Thai public sector in order to create higher client satisfaction. Change management should concern the potentiality of the change agent or leader, the long-term vision or policy (political side) of the organization, the communication within the organization, suitable organizational culture and structure, preparedness of the personnel, and the fitness of the reward system. Sustaining innovation creation is not sophisticated, as traditionally believed. A basic management principle of identifying clarified and motivating goals needs to be followed by creating support systems after implementation and by ensuring the stakeholders’ benefit, derived from the innovation projects. Finally, creating an amiable atmosphere among the practitioners, including effective evaluation and reward schemes, will support the innovation. However, none of these will ever take place unless support is gained from the leaders of those organizations, and from the staff and clients involved also as well.

Keywords: change management, client satisfaction, innovation management, Thai public sector

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Authors: Luay Alsalmi

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Background: Facial filler is the most common type of cosmetic surgery next to botox. Permanent filler is preferred nowadays due to the low cost brought about by non-recurring injection appointments. However, such fillers pose a higher risk for complications, with even greater adverse effects when the procedure is done using unknown dermal filler injections. AIM: This study aimed to establish an algorithm to categorize and manage patients that receive permanent fillers. Materials and Methods: Twelve participants were presented to the service through emergency or as outpatient from November 2015 to May 2021. Demographics such as age, sex, date of injection, time of onset, and types of complications were collected. After examination, all cases were managed based on an algorithm established. FACE-Q was used to measure overall satisfaction and psychological well-being. Results: The algorithm to diagnose and manage these patients effectively with a high satisfaction rate was established in this study. All participants were non-smoker females with no known medical comorbidities. The algorithm presented determined the treatment plan when faced with complications. Results revealed high appearance-related psychosocial distress was observed prior to surgery, while it significantly dropped after surgery. FACE-Q was able to establish evidence of satisfactory ratings among patients prior to and after surgery. Conclusion: This treatment algorithm can guide the surgeon in formulating a suitable plan with fewer complications and a high satisfaction rate.

Keywords: facial filler, FACE-Q, psycho-social stress, botox, treatment algorithm

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Authors: Devyani Shete, Sudeep Rai

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Background: The COVID-19 pandemic has caused one of the highest disruptions to the NHS (National Health Service), especially to the fundamental cervical cancer screening service. To prioritize screening response effectively, it is vital to understand the underlying disease risks amongst groups of women who are less likely to resume their screening/follow up at General Practices. The current government target is to have>=80% of women have an adequate test within the previous 3.5 years (ages 25-49) or 5.5 years (ages 50-64). Aims/Objectives: To increase the number of eligible people aged 25-49 attending cervical screening by 5% at Lakeside Healthcare (a General Practice in Corby). Methods: An online survey was posted on the Lakeside Healthcare website to find out what the barriers towards cervical screening were. It was apparent that patients needed more information catered to their responses. 6 informational videos and a “Cervical Screening Guide” were created for Lakeside patients about cervical screening, which were posted on the Healthcare website. Lakeside also started sending reminder texts to those eligible, with a link to a booking form. Results: On 18th January 2022, 69.7% of patients aged 25-49 years (7207) had an adequate cervical screening test in the last 3.5 years. There were 80 total responders to the online survey. In response to “which of the following are reasons why you have not attended screening”, 30% ticked “I kept putting it off/did not get around to it,” and 13% ticked “I was worried it would be painful or daunting.” In response to “which of the following would make you more likely to book an appointment”, 23% ticked “More detailed explanations of what the risks are if I don’t have screening,” and 20% ticked “I would like more information about the test and what the smear entails.” 10% of responders had previous trauma, whilst 28% of responders said the pandemic had impacted them getting a smear. Survey results were used to carry out interventions to increase smear uptake. On 23rdMarch 2022 (after a 2-month period), 75%of patients aged 25-49 (7119) attended the screening, which was a 5.3% increase from January. Discussion/Conclusion: The survey was vital in carrying out the exact interventions that were required for patients to increase screening uptake, as it is important to know what the populations’ needs are in order to create personalized invitations. This helps to optimise response during a pandemic. A HPV self-sample kit at home could be a popular method of dealing with further outbreaks.

Keywords: gynaecology, cervical screening, public health, COVID-19

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Authors: Ghaleb Y. Abbasi, Satanay Alhiary

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This paper focused on software testing phase of activities, types, techniques, teams and methods under agile project management (APM) in the Jordanian software industry. The effect of using agile principles and practices on testing process in software development life cycle (SDLC) was analyzed in order to create full view of the agile testing aspects such as phases, levels, types, methods, team and customers. Qualitative and quantitative research methods were utilized to cover earlier literature and collect data via web survey and short interviews in Jordanian software companies. Results indicated that agile testing had positive influence on quality of product, team performance, and customer satisfaction with a rate above 80%. APM is a powerful practice of moving software project forward in current markets with a rate above 51% by early involvement of testing activities in development.

Keywords: agile project management, software development life cycle, agile methods, agile testing, software testing

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Authors: Subas Chandra Biswas, Kazi Sameen Naser, Farzana Misha

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Little is known about the sexual behavior of male youth, particularly unmarried young men in Bangladesh as most of the sexual and reproductive health and rights-related research and intervention are mainly focused on females and married couples. To understand the unmarried youth’s sexual behavior, data from a nationwide survey conducted in all 64 districts of Bangladesh were analyzed. Using multistage systematic random sampling, a survey was conducted among 11,113 male youth aged 15-24 years from May-August, 2019. This article analyzed and presented findings of the sexual behavior of unmarried respondents based on the data collected from 10,026 unmarried male youth. Findings showed that 18% had ever experience of sexual relationship, and the reported mean age of first sexual intercourse was 16.5years. For unmarried male youth, those who had a sexual experience, their first sexual partners were female friends/classmate (57%), female neighbors (16%), and female sex workers (12%), relatives (6%) and girlfriends with whom they had love relationship (4%). However, about 36% reported that they had a love relationship with girlfriends, and among them, 23% reported that they had sexual intercourse with their girlfriend. Those who had sexual relations with their girlfriend, 47% reported that they did not use the condom in their last sex with their girlfriend. Furthermore, 29% reported that they had sexual relationships with others besides their girlfriends. Other reported partners were female sex workers (32%), neighbors (29%), female friends (19%), relatives (12%), and cousins (5%). Also, 46% reported that they did not even use the condom during sex with other partners. About 9% used some sort of sexual stimulant to increase their libido. Among the respondents, 376 reported that they bought sex in the last six months, and the mean expenditure of buying sex for the respondent was 1,140 Taka (13.46 US Dollar). Though premarital sexual relations are not socially accepted, findings showed a large portion of male youth are engaged in these relationships and risky sexual behavior. Lack of awareness of sexual and reproductive health, unprotected sexual intercourse, use of the drug during sexual intercourse also increase the threats to health. Thus these findings are important to understand the sexual behavior of male youth in policy and programmatic implications. Therefore, to ensure a healthy sexual life and wellbeing, an immediate and culturally sensitive sexual health promotion intervention is needed for male youth in Bangladesh.

Keywords: Bangladesh, male youth, sexual and reproductive health, sexual behavior

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Authors: Suvimon Wajeetongratana, Sittichai Thammasane

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This research objective was to study the development training that affecting the work performance of Suan Sunandha Rajabhat University manpower. The sample of 200 manpower was used to collect data for the survey. The statistics for data analysis were frequency percentage, mean value, standard deviation and hypothesis testing using independent samples (t-test). The study indicated that the development training has the most affect to employees in the high level and the second was coaching by the senior follow by the orientation in case of changing jobs task or changing positions. Interms of manpower work performance have three performance areas are quality of the job is better than the original. Moreover the results of hypothesis testing found that the difference personal information including gender, age, education, income per month have difference effectiveness of attitudes and also found the develop training is correlated with the performance of employees in the same direction.

Keywords: development training, employees job satisfaction, work performance, Sunandha Rajabhat University

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Authors: Noor Ismael, Somaya Malkawi, Sherin Al Awady, Taleb Ismael

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Background/Significance: Cancer is a serious health condition that affects individuals’ quality of life during and after the course of this condition. Children who have survived cancer and their caregivers may deal with residual physical, cognitive or social disabilities. There is little research on caregivers’ health and wellbeing after cancer. To the authors’ best knowledge; there is no specific research about how caregivers cope with everyday stressors after cancer. Therefore, this study aimed to explore the coping strategies that caregivers of children who have survived cancer utilize to overcome everyday stressors. Methods: This study utilized a descriptive survey design. The sample consisted of 103 caregivers, who visited the health and wellness clinic at a national cancer center (additional demographics are presented in the results). The sample included caregivers of children who were off cancer treatments for at least two years from the beginning of data collection. The institution’s internal review board approved this study. Caregivers who agreed to participate completed the survey. The survey collected caregiver reported demographic information and the Brief COPE which measures caregivers' frequency of engaging in certain coping strategies. The Brief COPE consisted of 14 coping sub-scales, which are self-distraction, active coping, denial, substance use, use of emotional support, use of instrumental support, behavioral disengagement, venting, positive reframing, planning, humor, acceptance, religion, and self-blame. Data analyses included calculating sub-scales’ scores for the fourteen coping strategies and analysis of frequencies of demographics and coping strategies. Results: The 103 caregivers who participated in this study were 62% mothers, 80% married, 45% finished high school, 50% do not work outside the house, and 60% have low family income. Result showed that religious coping (66%) and acceptance (60%) were the most utilized coping strategies, followed by positive reframing (45%), active coping (44%) and planning (43%). The least utilized coping strategies in our sample were humor (5%), behavioral disengagement (8%), and substance-use (10%). Conclusions: Caregivers of children who have survived cancer mostly utilize religious coping and acceptance in dealing with everyday stressors. Because these coping strategies do not directly solve stressors like active coping and planning coping strategies, it is important to support caregivers in choosing and implementing effective coping strategies. Knowing from our results that some caregivers may utilize substance use as a coping strategy, which has negative health effects on caregivers and their children, there must be direct interventions that target these caregivers and their families.

Keywords: caregivers, cancer, stress, coping

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Authors: Celestina Omoso Isiramen

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The influence of witchcraft belief on disease causation, cure and public health system in Nigeria cannot be underrated. This paper investigated the nexus between witchcraft phenomenon and health-seeking behaviour of HIV sufferers in Edo state, Nigeria. Survey methodology was adopted and stratified random sampling technique was employed in the selection of 600 sample group spread into 200 HIV sufferers, 200 spiritual healers and 200 bio-medics from the three Senatorial districts of the state. Data were collected through the use of structured questionnaire and in-dept interview and analyzed using simple percentage and frequency. Major findings were: belief in witchcraft significantly influenced the people’s perception of HIV causation and wellness and this impacted adversely on public health-care. Poverty, ignorance and dearth of retroviral drugs enhanced the people’s recourse to spiritual healers. Collaboration between spiritual healing techniques and biomedicine was recommended as panacea for curbing HIV/AIDS related morbidity and mortality. It concluded that socio-economic problems must be addressed while the importance of integrating the values of spiritual healing into biomedicine cannot be overstressed.

Keywords: biomedicine, health care, HIV/AIDS, spirituality, witchcraft

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Authors: April Hueimin Lu, Liangj-Ju Yao, Jun-Tin Lin, Susan Siru Liu

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This paper discusses the application of aerial survey technology and 3D laser scanning technology in the surveying and mapping work of the settlements and slate houses of the old Taiwanese aborigines. The relics of old Taiwanese aborigines with thousands of history are widely distributed in the deep mountains of Taiwan, with a vast area and inconvenient transportation. When constructing the basic data of cultural assets, it is necessary to apply new technology to carry out efficient and accurate settlement mapping work. In this paper, taking the old Paiwan as an example, the aerial survey of the settlement of about 5 hectares and the 3D laser scanning of a slate house were carried out. The obtained orthophoto image was used as an important basis for drawing the settlement map. This 3D landscape data of topography and buildings derived from the aerial survey is important for subsequent preservation planning as well as building 3D scan provides a more detailed record of architectural forms and materials. The 3D settlement data from the aerial survey can be further applied to the 3D virtual model and animation of the settlement for virtual presentation. The information from the 3D scanning of the slate house can also be used for further digital archives and data queries through network resources. The results of this study show that, in large-scale settlement surveys, aerial surveying technology is used to construct the topography of settlements with buildings and spatial information of landscape, as well as the application of 3D scanning for small-scale records of individual buildings. This application of 3D technology, greatly increasing the efficiency and accuracy of survey and mapping work of aboriginal settlements, is much helpful for further preservation planning and rejuvenation of aboriginal cultural heritage.

Keywords: aerial survey, 3D scanning, aboriginal settlement, settlement architecture cluster, ecological landscape area, old Paiwan settlements, slat house, photogrammetry, SfM, MVS), Point cloud, SIFT, DSM, 3D model

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Authors: Stephanie Yun Yu Law

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Background: This study aims to investigate into communication between trainee doctors and patients, especially how doctor’s reaction to patient’s emotional issues expressed in the consultation affect patient’s satisfaction. Objectives: Thus, there are three aims in this study, 1.) how do trainee doctors react to patients emotional cues in OSCE station? 2.) Any differences in the respond type to emotional cues between first year students and third year students? 3.) Is response type (reducing space) related to OSCE outcome (patient satisfaction and expert rating)? Methods: Fifteen OSCE stations was videotaped, in which 9 were stations with first-year students and 6 were with third-year students. OSCE outcomes were measured by Communication Assessment Tool and Examiners Checklist. Analyses: All patient’s cues/concerns and student’s reaction were coded by Verona Coding Definitions of Emotional Sequence. Descriptive data was gathered from Observer XT and logistic regression (two-level) was carried out to see if occurrence of reducing space response can be predicted by OSCE outcomes. Results: Reducing space responses from all students were slightly less than a half in total responses to patient’s cues. The mean percentage of reducing space behaviours was lower among first year students when compared to third year students. Patient’s satisfaction significantly (p<0.05) and negatively predicted reducing space behaviours. Conclusions: Most of the medical students, to some extent, did not provide adequate responses for patient’s emotional cues. But first year students did provide more space for patients to talk about their emotional issues when compared to third year students. Lastly, patients would feel less satisfied if trainee doctors use more reducing space responses in reaction to patient’s expressed emotional cues/concerns. Practical implications: Firstly, medical training programme can be tailored on teaching students how to detect and respond appropriately to emotional cues in order to improve underperformed student’s communication skills in healthcare setting. Furthermore, trainee doctor’s relationship with patients in clinical practice can also be improved by reacting appropriately to patient’s emotive cues in consultations (such as limit the use of reducing space behaviours).

Keywords: doctors-patients communication, applied clinical psychology, health psychology, healthcare professionals

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Authors: Mary-Ellen Hooper, Anthony Paul O'Brien, Graeme Browne

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Background: It has been proposed that negative experiences in mental health nursing increase the risk of attrition for newly graduated nurses. The risk of nurse attrition is of particular concern with current nurse shortages worldwide continuing to rise. The purpose of this study was to identify and explore the qualitative experiences of new graduate nurses as they enter mental health services in their first year of clinical practice. Method: An ethnographic research design was utilized in order to explore the sub-cultural experiences of new graduate nurses. Which included 31 separate episodes of field observation (62 hours) and (n=24) semi-structured interviews. A total number of 26 new graduates and recently graduated nurses participated in this study – 14 new graduate nurses and 12 recently graduate nurses. Data collection was conducted across 6 separate Australian, NSW, mental health units from April until September 2017. Results: A major theme emerging from the research is the new graduate nurses experience of communication in their nursing role, particularly within the context of the multidisciplinary team, and the barriers to sharing information related to care. This presentation describes the thematic structure of the major theme 'communication' in the context of the everyday experience of the New Graduate mental health nurse's participation in their chosen nursing discipline. The participants described diminished communication as a negative experience affecting their envisioned notion of holistic care, which they had associated with the role of the mental health nurse. Conclusion: The relationship between nurses and members of the multidisciplinary team plays a key role in the communication of patient care, patient-centeredness and inter-professional collaboration, potentially affecting the role of the mental health nurse, satisfaction of new graduate nurses, and patient care.

Keywords: culture, mental health nursing, multidisciplinary team, new graduate nurse

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Authors: Nelson Kimeli Kemboi Yego, Juma Kasozi, Joseph Nkruzinza, Francis Kipkogei

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The study investigated the low uptake of health insurance in Kenya despite efforts to achieve universal health coverage through various health insurance schemes. Unsupervised machine learning techniques were employed to identify patterns in health insurance uptake based on sociodemographic factors among Kenyan households. The aim was to identify key demographic groups that are underinsured and to provide insights for the development of effective policies and outreach programs. Using the 2021 FinAccess Survey, the study clustered Kenyan households based on their health insurance uptake and sociodemographic features to reveal patterns in health insurance uptake across the country. The effectiveness of k-prototypes clustering, hierarchical clustering, and agglomerative hierarchical clustering in clustering based on sociodemographic factors was compared. The k-prototypes approach was found to be the most effective at uncovering distinct and well-separated clusters in the Kenyan sociodemographic data related to health insurance uptake based on silhouette, Calinski-Harabasz, Davies-Bouldin, and Rand indices. Hence, it was utilized in uncovering the patterns in uptake. The results of the analysis indicate that inclusivity in health insurance is greatly related to affordability. The findings suggest that targeted policy interventions and outreach programs are necessary to increase health insurance uptake in Kenya, with the ultimate goal of achieving universal health coverage. The study provides important insights for policymakers and stakeholders in the health insurance sector to address the low uptake of health insurance and to ensure that healthcare services are accessible and affordable to all Kenyans, regardless of their socio-demographic status. The study highlights the potential of unsupervised machine learning techniques to provide insights into complex health policy issues and improve decision-making in the health sector.

Keywords: health insurance, unsupervised learning, clustering algorithms, machine learning

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Authors: Halimat M. Ajose-Adeogun, Zaynab A. Bello

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Artificial Intelligence (AI) and Natural Language Processing (NLP) have transformed computer language comprehension, allowing computers to comprehend spoken and written language with human-like cognition. NLP, a multidisciplinary area that combines rule-based linguistics, machine learning, and deep learning, enables computers to analyze and comprehend human language. NLP applications in medicine range from tackling issues in electronic health records (EHR) and psychiatry to improving diagnostic precision in orthopedic surgery and optimizing clinical procedures with novel technologies like chatbots. The technology shows promise in a variety of medical sectors, including quicker access to medical records, faster decision-making for healthcare personnel, diagnosing dysplasia in Barrett's esophagus, boosting radiology report quality, and so on. However, successful adoption requires training for healthcare workers, fostering a deep understanding of NLP components, and highlighting the significance of validation before actual application. Despite prevailing challenges, continuous multidisciplinary research and collaboration are critical for overcoming restrictions and paving the way for the revolutionary integration of NLP into medical practice. This integration has the potential to improve patient care, research outcomes, and administrative efficiency. The research methodology includes using NLP techniques for Sentiment Analysis and Emotion Recognition, such as evaluating text or audio data to determine the sentiment and emotional nuances communicated by users, which is essential for designing a responsive and sympathetic chatbot. Furthermore, the project includes the adoption of a Personalized Intervention strategy, in which chatbots are designed to personalize responses by merging NLP algorithms with specific user profiles, treatment history, and emotional states. The synergy between NLP and personalized medicine principles is critical for tailoring chatbot interactions to each user's demands and conditions, hence increasing the efficacy of mental health care. A detailed survey corroborated this synergy, revealing a remarkable 20% increase in patient satisfaction levels and a 30% reduction in workloads for healthcare practitioners. The poll, which focused on health outcomes and was administered to both patients and healthcare professionals, highlights the improved efficiency and favorable influence on the broader healthcare ecosystem.

Keywords: natural language processing, artificial intelligence, healthcare communication, electronic health records, patient care

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Authors: Corina E. Niculaescu, Ivan Sangiorgi, Adrian R. Bell

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The COVID-19 pandemic has been life-changing in many aspects of people’s daily and social lives, but has it also changed attitudes towards investments? This paper explores the effect of the COVID-19 pandemic on retail investors’ levels of investments in the U.S. during the first COVID-19 wave in summer 2020. This is an unprecedented health crisis, which could lead to changes in investment behavior, including irrational behavior in retail investors. As such, this study aims to inform policymakers of what happened to investment decisions during the COVID-19 pandemic so that they can protect retail investors during extreme events like a global health crisis. The study aims to answer two research questions. First, was the level of investments affected by the COVID-19 pandemic, and if so, why? Second, how were investments affected by retail investors’ personal experience with COVID-19? The research analysis is based on primary survey data collected on the Amazon Mechanical Turk platform from a representative sample of U.S. respondents. Responses were collected between the 15th of July and 28th of August 2020 from 1,148 U.S. retail investors who hold mutual fund investments and a savings account. The research explores whether being affected by COVID-19, change in the level of savings, and risk capacity can explain the change in the level of investments by using regression analysis. The dependent variable is changed in investments measured as decrease, no change, and increase. For this reason, the methodology used is ordered probit regression models. The results show that retail investors in the U.S. increased their investments during the first wave of COVID-19, which is unexpected as investors are usually more cautious in crisis times. Moreover, the study finds that those who were affected personally by COVID-19 (e.g., tested positive) were more likely to increase their investments, which is irrational behavior and contradicts expectations. An increase in the level of savings and risk capacity was also associated with increased investments. Overall, the findings show that having personal experience with a health crisis can have an impact on one’s investment decisions as well. Those findings are important for both retail investors and policymakers, especially now that online trading platforms have made trading easily accessible to everyone. There are risks and potential irrational behaviors associated with investment decisions during times of crisis, and it is important that retail investors are aware of them before making financial decisions.

Keywords: COVID-19, financial decision-making, health crisis retail investors, survey

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Authors: Kwei Huan Liw, Sashi B. Darshan

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Background: Double eyelid surgery has become one of the most sought-after aesthetic procedures among Asians. Many surgeons perform surgical blepharoplasty and various other methods of non-incisional blepharoplasty. Face-Q is a validated method of measuring patient satisfaction for facial aesthetic procedures. Here we have analyzed the overall eye satisfaction score, the upper eyelid appraisal score and the adverse effect on eyes score Methods: 274 patients (548 eyes), aged between 18 to 40 years old, were recruited from 2015-2018. Each patient underwent a non-incisional double-eyelid blepharoplasty using a single-knotted continuous buried suture. 3 – 5 stab incisions were made depending on the upper eyelid size. A needle loaded with 7-0 nylon is passed from the lateral most wound through the dermis and the conjunctiva in an alternate fashion into the remaining stab wounds. The suture is then tunneled back laterally in the deeper dermis and knotted securely with the suture end. The knot is then buried within the orbicularis oculi muscle. Each patient was required to fill the Face-Q questionnaire before the procedure and 2 weeks post procedure. The results are described based on the percentage of the maximum achievable score. Patients were reviewed after 12 to 18 months to assess the long-term outcome. Results: The overall eye satisfaction score demonstrated a high level of post-operative satisfaction (97.85%), compared to 27.32% pre-operatively. The appraisal of upper eyelid scores showed drastic improvement in perception post-operatively (95.31%) compared to 21.44% pre-operatively. Adverse effect on eyes score showed a very low post-operative complication rate (0.4%) The long-term follow-up showed 6 cases that had developed asymmetrical folds. Only 1 patient agreed for revision surgery. The other 5 patients were still satisfied with the outcome and were not keen for revision surgery. None of the cases had loosening of knots. Conclusion: Modified single-knot continuous buried suture technique is a simple and non-invasive method to create aesthetically pleasing non-surgical double-eyelids, which has long-term effects. Proper patient selection is crucial and good surgical technique is required to achieve a desirable outcome.

Keywords: blepharoplasty, double-eyelid, face-Q, non-incisional

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Authors: Luca Martignoni, Joseph Nserat, Eric Arand, Marvin Braun

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The increasing application of conversational agents in healthcare and the demand for applications that enable patients to take informed decisions is changing the way patients access healthcare and take decisions. Promising results related to the acceptance of CAs in healthcare have been accomplished. In that regard, understanding how to design CAs in a way that patients trust their recommendations and decisions constitutes an important area of research. Our study examines self-disclosure and transparency as drivers of trust to enhance the medical assistance of CAs for patients. Accordingly, we examined the effects of self-disclosure and transparency on patients trust and service satisfaction by conducting an online experiment with 136 participants. Our results show that the expression of both self-disclosure and conversational agents transparency leads to an increased perception of trust but does not necessarily improve the service satisfaction. Therefore, developers should implement self-disclosure and transparency to create a trustworthy environment.

Keywords: conversational agent, transparency, self-disclosure, healthcare

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Authors: Charirat Kusonwiriyawong, Supha Photichan, Wannarut Chutibutr

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Soil test kits for rapid analysis of the organic matter, available phosphorus and exchangeable potassium were developed to drive a low-cost field testing kit to farmers. The objective was to provide a decision tool for improving soil fertility. One aspect of soil test kit development was ease of use which is a time requirement for completing organic matter, available phosphorus and exchangeable potassium test in one soil sample. This testing kit required only two extractions and utilized no filtration consuming approximately 15 minutes per sample. Organic matter was principally created by oxidizing carbon KMnO₄ using the standard color chart. In addition, modified single extractant (Mehlich I) was applied to extract available phosphorus and exchangeable potassium. Molybdenum blue method and turbidimetric method using standard color chart were adapted to analyze available phosphorus and exchangeable potassium, respectively. Modified single extractant using in soil test kits were highly significant matching with analytical laboratory results (r=0.959** and 0.945** for available phosphorus and exchangeable potassium, respectively). Linear regressions were statistically calculated between modified single extractant and standard laboratory analysis (y=0.9581x-12.973 for available phosphorus and y=0.5372x+15.283 for exchangeable potassium, respectively). These equations were calibrated to formulate a fertilizer rate recommendation for specific corps. To validate quality, soil test kits were distributed to farmers and extension workers. We found that the accuracy of soil test kits were 71.0%, 63.9% and 65.5% for organic matter, available phosphorus, and exchangeable potassium, respectively. The quantitative survey was also conducted in order to assess their satisfaction with soil test kits. The survey showed that more than 85% of respondents said these testing kits were more convenient, economical and reliable than the other commercial soil test kits. Based upon the finding of this study, soil test kits can be another alternative for providing soil analysis and fertility recommendations when a soil testing laboratory is not available.

Keywords: available phosphorus, exchangeable potassium, modified single extractant, organic matter, soil test kits

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Authors: Noorulaine Maqsood, Saeed Khan

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Background: Concern regarding incident reporting and bio-safety training in clinical laboratories in Pakistan has increased remarkably in the last few years due to rapid increase in diagnosis and research on infectious organisms. In order to ensure the safety of employees, this issue needs to be addressed immediately. Bio-safety training sessions and lectures are necessary for the protection of laboratory workers in order to ensure safe practices and minimize the count of incident reporting in the lab. Objective: To carry out an inter-departmental survey in lab regarding the awareness of bio-safety practices among lab employees before and after conducting bio-safety training sessions. Methodology: We conducted a 30 questions survey of laboratory workers in June 2013 (before training session) to gather information related to bio-safety awareness. Afterwards, we conducted another survey after training sessions and workshops related to bio-safety. Result: The survey regarding bio-safety level showed that before the training session 32% of the participants were aware of bio-safety level being used in their lab whereas after the session this percentage increased to 72%. 48% of the participants had information about the proper usage of PPE which increased to 76%. Awareness regarding proper management of hazardous waste increased from 32% to 64%. The incident reporting practice, sample handling and hand hygiene awareness was previously reported to be 40%, 65%, and 52% that increased to 80%, 85% and 88% respectively after the training session was completed. Conclusion: The first survey results showed lack of awareness that suggest nearly all senior scientists, faculty, medical technologist, lab attendant and housekeeping staff working in laboratories are required to have bio-safety training, and required inspection at least twice a year by a bio-safety officer and also required to renew their bio-safety training. After the training session, significant changes in awareness level and attitude of the participants regarding biosafety practices were observed. Therefore, such bio-safety sessions should be carried out regularly in clinical laboratories.

Keywords: biosafety practices, clinical laboratory, Pakistan, survey

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Authors: Shaheeb Abdul Azeez, Siong-Choy Chong

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Background: Talent retention is increasingly becoming a major challenge for many industries due to the high turnover rate. Public higher learning institutions in the Maldives have a similar situation with the turnover of their employees'. This paper is to identify whether Human Resource Management (HRM) practices have any impact on employee retention in public higher learning institutions in the Maldives. Purpose: This paper aims to identify the influence of HRM practices on employee retention in public higher learning institutions in the Maldives. A total of 15 variables used in this study; 11 HRM practices as independent variables (leadership, rewards, salary, employee participation, compensation, training and development, career development, recognition, appraisal system and supervisor support); job satisfaction and motivation as mediating variables; demographic profile as moderating variable and employee retention as dependent variable. Design/Methodology/Approach: A structured self-administered questionnaire was used for data collection. A total of 300 respondents were selected as the study sample, representing the academic and administrative from public higher learning institutions using a stratified random sampling method. AMOS was used to test the hypotheses constructed. Findings: The results suggest that there is no direct effect between the independent variable and dependent variable. Also, the study concludes that no moderate effects of demographic profile between independent and dependent variables. However, the mediating effects of job satisfaction and motivation in the relationship between HRM practices and employee retention were significant. Salary had a significant influence on job satisfaction, whilst both compensation and recognition have significant influence on motivation. Job satisfaction and motivation were also found to significantly influence employee retention. Research Limitations: The study consists of many variables more time consuming for the respondents to answer the questionnaire. The study is focussed only on public higher learning institutions in the Maldives due to no participation from the private sector higher learning institutions. Therefore, the researcher is unable to identify the actual situation of the higher learning industry in the Maldives. Originality/Value: To our best knowledge, no study has been conducted using the same framework throughout the world. This study is the initial study conducted in the Maldives in this study area and can be used as a baseline for future researches. But there are few types of research conducted on the same subject throughout the world. Some of them concluded with positive findings while others with negative findings. Also, they have used 4 to 7 HRM practices as their study framework.

Keywords: human resource management practices, employee retention, motivation, job satisfaction

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Authors: Martina I. Reinhold, Theresa Bacon-Baguley

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Background: Medical knowledge continuously evolves and to help health care providers to stay up-to-date, evidence-based medicine (EBM) has emerged as a model. The practice of EBM requires new skills of the health care provider, including directed literature searches, the critical evaluation of research studies, and the direct application of the findings to patient care. This paper describes the integration and evaluation of an evidence-based medicine course sequence into a Physician Assistant curriculum. This course sequence teaches students to manage and use the best clinical research evidence to competently practice medicine. A survey was developed to assess the outcomes of the EBM course sequence. Methodology: The cornerstone of the three-semester sequence of EBM are interactive small group discussions that are designed to introduce students to the most clinically applicable skills to identify, manage and use the best clinical research evidence to improve the health of their patients. During the three-semester sequence, the students are assigned each semester to participate in small group discussions that are facilitated by faculty with varying background and expertise. Prior to the start of the first EBM course in the winter semester, PA students complete a knowledge-based survey that was developed by the authors to assess the effectiveness of the course series. The survey consists of 53 Likert scale questions that address the nine objectives for the course series. At the end of the three semester course series, the same survey was given to all students in the program and the results from before, and after the sequence of EBM courses are compared. Specific attention is paid to overall performance of students in the nine course objectives. Results: We find that students from the Class of 2016 and 2017 consistently improve (as measured by percent correct responses on the survey tool) after the EBM course series (Class of 2016: Pre- 62% Post- 75%; Class of 2017: Pre- 61 % Post-70%). The biggest increase in knowledge was observed in the areas of finding and evaluating the evidence, with asking concise clinical questions (Class of 2016: Pre- 61% Post- 81%; Class of 2017: Pre- 61 % Post-75%) and searching the medical database (Class of 2016: Pre- 24% Post- 65%; Class of 2017: Pre- 35 % Post-66 %). Questions requiring students to analyze, evaluate and report on the available clinical evidence regarding diagnosis showed improvement, but to a lesser extend (Class of 2016: Pre- 56% Post- 77%; Class of 2017: Pre- 56 % Post-61%). Conclusions: Outcomes identified that students did gain skills which will allow them to apply EBM principles. In addition, the outcomes of the knowledge-based survey allowed the faculty to focus on areas needing improvement, specifically the translation of best evidence into patient care. To address this area, the clinical faculty developed case scenarios that were incorporated into the lecture and discussion sessions, allowing students to better connect the research studies with patient care. Students commented that ‘class discussion and case examples’ contributed most to their learning and that ‘it was helpful to learn how to develop research questions and how to analyze studies and their significance to a potential client’. As evident by the outcomes, the EBM courses achieved the goals of the course and were well received by the students. 

Keywords: evidence-based medicine, clinical education, assessment tool, physician assistant

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