TY - JOUR AU - Katta, Sravya AU - Davoody, Nadia PY - 2025/3/6 TI - Exploring Health Care Professionals? Perspectives on Education, Awareness, and Preferences for Digital Educational Resources to Support Transgender, Nonbinary, and Intersex Care: Interview Study JO - JMIR Med Educ SP - e67993 VL - 11 KW - health care professionals KW - transgender, nonbinary, and intersex KW - communication challenges KW - systematic barriers KW - information and communication technology N2 - Background: Health care professionals often face challenges in providing affirming and culturally competent care to transgender, nonbinary, and intersex (TNBI) patients due to a lack of understanding and training in TNBI health care. This gap highlights the opportunity for tailored educational resources to enhance health care professionals? interactions with TNBI individuals. Objective: This study aimed to explore health care professionals? perspectives on education and awareness of health issues related to TNBI individuals. Specifically, it aimed to identify their needs, challenges, and preferences in accessing and using digital educational resources to enhance their knowledge and competence in providing inclusive and effective care for this population. Methods: A qualitative research approach was used in this study. In total, 15 health care professionals were recruited via convenience sampling to participate in semistructured interviews. Thematic analysis was applied to identify recurring codes and themes. Results: The study identified several themes and subthemes related to gender diversity awareness, inclusive communication and understanding the needs of TNBI individuals, societal and structural challenges, regulatory gaps in training and support infrastructure, education and training needs for health care professionals on TNBI care, educational resources and training tools for TNBI care, challenges and design considerations for eHealth tools integrations, and evaluating eHealth impact. Participants identified communication barriers, the need for health care providers to use inclusive language, and gaps in both health care system infrastructure and specialized training for gender-affirming care. In addition, participants expressed a need for comprehensive education on transgender and nonbinary health issues, resources for mental health professionals, user-friendly design, and accessibility features in eHealth tools. Conclusions: The study revealed substantial deficiencies in health care professionals? knowledge of gender diversity, cultural competency, and the importance of inclusive communication. Addressing the identified barriers and challenges through targeted interventions, such as providing training and support for health care professionals, investing in user-friendly design and data security, and promoting cultural competence in TNBI health care, is essential. Despite integration challenges, eHealth tools have the potential to improve patient?health care professional relationships and access to care. UR - https://mededu.jmir.org/2025/1/e67993 UR - http://dx.doi.org/10.2196/67993 UR - http://www.ncbi.nlm.nih.gov/pubmed/40053815 ID - info:doi/10.2196/67993 ER - TY - JOUR AU - Gil-Hernández, Eva AU - Carrillo, Irene AU - Martin-Delgado, Jimmy AU - García-Torres, Daniel AU - Mira, Joaquín José PY - 2025/2/5 TI - Development of a Web-Based Intervention for Middle Managers to Enhance Resilience at the Individual, Team, and Organizational Levels in Health Care Systems: Multiphase Study JO - JMIR Hum Factors SP - e67263 VL - 12 KW - resilience KW - health care professionals KW - web-based intervention KW - middle management KW - well-being KW - patient safety N2 - Background: Health care institutions face high systemic risk due to the inherent uncertainty and complexity of their operations. This often leads to stressful incidents impacting the well-being of health care professionals, which can compromise the effectiveness of health care systems. Enhancing resilience among health care professionals is essential for maintaining high-quality care and ensuring patient safety. The role of middle managers is essential to ensure the response capacity of individuals and teams. Objective: This study aims to develop a web-based intervention aimed at middle management to enhance individual, team, and organizational resilience. Methods: An observational study was conducted in 3 phases: design, validation, and pilot study. The study was initiated in February 2022 and concluded in June 2023. Phase 1 involved designing the content for the web-based tool based on a comprehensive review of critical elements around resilience. Phase 2 included validation by an international panel of experts who reviewed the tool and rated it according to a structured grid. They were also encouraged to highlight strengths and areas for improvement. Phase 3 involved piloting the tool with health care professionals in Ecuador to refine the platform and assess its effectiveness. A total of 458 people were invited to participate through the Institutional Course on Continuous Improvement in Health Care Quality and Safety offered by the Ministry of Public Health of Ecuador. Results: The tool, eResiliencia, was structured into 2 main blocks: individual and team resilience and organizational resilience. It included videos, images, PDFs, and links to dynamic graphics and additional texts. Furthermore, 13 (65%) of the 20 experts validated the tool, rating content clarity at an average of 4.5 (SD 0.7) and utility at an average of 4.7 (SD 0.5) out of 5. The average overall satisfaction was 9.3 (SD 0.6) out of 10 points, and feedback on improvements was implemented. A total of 362 health care professionals began the intervention, of which 218 (60.2%) completed preintervention and postintervention questionnaires, with significant knowledge increases (P<.001). Of the 362 health care professionals, 146 (40.3%) completed the satisfaction questionnaire, where overall satisfaction was rated at an average of 9.4 (SD 1.1) out of 10 points. Conclusions: The eResiliencia web-based platform provides middle managers with resources to enhance resilience among their teams and their components, promoting better well-being and performance, even under highly stressful events. Future research should focus on long-term impacts and practical applications in diverse clinical settings. UR - https://humanfactors.jmir.org/2025/1/e67263 UR - http://dx.doi.org/10.2196/67263 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/67263 ER - TY - JOUR AU - Oliveira, de Nathalia Hanany Silva AU - Oliveira, de Renata Fonsêca Sousa AU - Soares, Pontes Juliana AU - Castro, de Janete Lima PY - 2024/12/9 TI - Sustainability of Interprofessional Education: Protocol for a Scoping Review JO - JMIR Res Protoc SP - e60763 VL - 13 KW - college education KW - health training KW - interprofessional education KW - IPE KW - sustainability KW - collaborative practice KW - training of human resources in health KW - undergraduate medical education KW - students KW - student learners KW - professional development KW - health care professional training N2 - Background: Interprofessional education (IPE) is an approach that can improve health care quality, contribute to the qualification of health care professionals, and train undergraduate students. Although this strategy has made significant progress in the last decade, integration, sustainability, and institutional growth are still priorities worldwide. Thus, maintaining strategies is essential for their full development and evolution. Objective: This study aimed to identify discussions about the sustainability of IPE and map its actions or strategies (or both). Methods: The scoping review will follow the Joanna Briggs Institute methodology. This scoping review protocol follows the JBI Reviewers? Manual, with 6 stages: identifying the research question; identifying relevant studies; study selection; data extraction and coding; analysis and interpretation of results; and consultation with stakeholders. Two independent and blind reviewers will evaluate and select studies available in English, Portuguese, and Spanish based on the eligibility criteria. Searches will be conducted on LILACS, Embase, Scopus, PubMed/MEDLINE, ERIC, Web of Science, CINAHL, Google Scholar databases; ProQuest Dissertations & Theses Global, and Brazilian Digital Library of Theses and Dissertations. The main research question is as follows: What have been the sustainability strategies for IPE actions? This scoping review will incorporate studies (empirical or theoretical-reflective) that address strategies or actions (or both) for IPE sustainability. They must present a quantitative, qualitative, or mixed methods approach and be available in full text. Data on strategies or actions for IPE sustainability will be extracted and inserted into a spreadsheet for analysis. Quantitative data will be analyzed using descriptive statistics, while qualitative analysis will identify meanings and patterns through thematic analysis. Thus, the aim is to present the compiled findings in tables and charts. Results: The database search was conducted on March 22, 2024. In April and May 2024, duplicate studies were excluded. From July to November 2024, study selection will be carried out. In December 2024, data extraction and tabulation will take place, as well as consultation with stakeholders. The aim is to publish the results in scientific journals in January 2025. Conclusions: This protocol will guide this scoping review to identify discussions on the sustainability of IPE and map its actions or strategies (or both); summarize the definitions and institutions that develop or promote IPE; and present the main recommendations for the area under study. Additionally, possible research gaps can be identified to guide future studies. This review will shed light on existing knowledge gaps and the current state of research, which could provide support for future research, programs, and policy responses to foster collaboration and interprofessional practice and, consequently, improve the quality of user care. This information will be useful in supporting decision-making by government officials, managers, teachers, facilitators, and students in the implementation, maintenance, and development of IPE. Trial Registration: Open Science Framework 5VNJS; https://osf.io/5vnjs/ International Registered Report Identifier (IRRID): DERR1-10.2196/60763 UR - https://www.researchprotocols.org/2024/1/e60763 UR - http://dx.doi.org/10.2196/60763 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/60763 ER - TY - JOUR AU - Dixon, Eric AU - Pannu, Jayden AU - Dhaliwal, Kabir AU - Cheng, Rachel AU - Deol, Gurpal AU - Frangos, Sophie AU - Tawil, Emma AU - Oliveira, Ana AU - Wojkowski, Sarah AU - Quach, Shirley PY - 2024/11/20 TI - Effects of Interprofessional Education on Readiness for Interprofessional Learning in Rehabilitation Science Students From Professional Health Care Programs: Protocol for a Systematic Review JO - JMIR Res Protoc SP - e60830 VL - 13 KW - interprofessional education KW - rehabilitation science KW - health care students KW - interprofessional collaboration KW - prelicensure health care professionals KW - patient care KW - interdisciplinary education KW - rehabilitation education KW - curriculum development KW - team-based learning N2 - Background: The World Health Organization defines interprofessional education (IPE) as a process in which students from different health care programs work together to provide effective care while deepening their knowledge of each other?s roles. Previous literature shows a strong argument for early exposure to IPE as a facilitator for high quality patient care. The goal of IPE is to improve interprofessional collaboration (IPC), the ?gold standard? of care to enhance patients' quality of life, functional ability, and health status, especially for patients who require expertise from a variety of health care professionals. IPC has shown improvements in quality of life, functional ability, and health status. IPE can occur in the form of structured interventions or spontaneously in student placements. Literature has demonstrated that IPE facilitates skill, knowledge development, teamwork, communication skills, and mutual respect among health care professional students. Objective: This systematic review aims to examine IPE outcomes, including readiness for IPC, IPE perceptions, attitudes toward collaborative learning, student confidence, practice efficiency, and team dynamics after IPE interventions in rehabilitation science students. Methods: The study will be conducted as outlined by the Cochrane Handbook for Systematic Reviews and will be reported per the PRISMA (Preferred Reporting of Items for Systematic Reviews and Meta-Analyses) 2015 guidelines. Students have performed literature searches across the databases MEDLINE, Embase, CINAHL, ERIC, Web of Science, and AMED. Studies will be included if their IPE intervention included multiple prelicensure health care professional students in a health care or health care education setting. Based on timelines presented in the Institute of Medicine?s report on the impacts of IPE, relevant studies from 2016 to the present will be included. The Risk of Bias 2 tool will be used to study sources of bias. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) working group?s methods will be used to evaluate the quality of the evidence presented. The final 3 authors are assisting as supervisors, providing oversight and feedback as needed. Any deviations from this protocol will be reported in the final paper. Results: The search strategy was finalized and searched across the databases by March 8, 2024. The systematic review was registered with PROSPERO on March 31, 2024. A total of 10,692 citations were retrieved for abstract and title screening, beginning in March 2024, and 756 were eligible for full-text screening in April 2024. Six articles were considered for inclusion and data extraction, which began in July 2024. Finalization of the extracted data and paper will occur in September 2024. Conclusions: This systematic review will provide a summary of the effects of IPE interventions in prelicensure rehabilitation science students. It will provide educators, health care providers, and students with valuable information for understanding the relevance of IPE. It will also shed light on research gaps and highlight areas for further study. Trial Registration: PROSPERO CRD42024506081; https://tinyurl.com/3tf2h9er International Registered Report Identifier (IRRID): PRR1-10.2196/60830 UR - https://www.researchprotocols.org/2024/1/e60830 UR - http://dx.doi.org/10.2196/60830 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/60830 ER - TY - JOUR AU - Neher, N. Andrea AU - Wespi, Rafael AU - Rapphold, D. Benjamin AU - Sauter, C. Thomas AU - Kämmer, E. Juliane AU - Birrenbach, Tanja PY - 2024/11/4 TI - Interprofessional Team Training With Virtual Reality: Acceptance, Learning Outcome, and Feasibility Evaluation Study JO - JMIR Serious Games SP - e57117 VL - 12 KW - medical education KW - simulation KW - virtual reality KW - VR KW - emergency medicine KW - interprofessional team training KW - nursing students KW - medical students KW - evaluation study KW - assessment KW - effectiveness KW - patient care KW - simulation-based training KW - hemorrhage KW - epileptic seizure KW - headache N2 - Background: Effective interprofessional teamwork is vital for ensuring high-quality patient care, especially in emergency medicine. However, interprofessional education often fails to facilitate meaningful interaction among health care disciplines. It is therefore imperative to afford early opportunities for cultivating interprofessional teamwork skills. While in-person simulation-based training has been shown to improve performance, this is resource-intensive, especially if it involves multiple professions. Virtual reality (VR)?based training is an innovative instructional approach that demands fewer resources and offers the flexibility of location-independent learning. Objective: This study aimed to develop and evaluate the acceptance, learning outcome, and feasibility of an interprofessional team (INTEAM) training course that included a VR simulation of a neurological emergency case. Methods: This 1-group study used a pre- and posttest design to evaluate the 2-hour INTEAM training course for nursing and medical students. The course included an e-learning part, VR simulation, and debriefing. The main learning objectives were derived from the entrustable professional activity 6, namely to handle a common problem in emergency medicine (headache due to subarachnoid hemorrhage and epileptic seizure) that requires interprofessional collaboration, including a structured handover. We used validated and self-constructed questionnaires, pre- and posttests, and open questions to assess the acceptance, learning outcome, and feasibility of the course. Results: The data of 42 students (21 nursing and 21 medical students) were analyzed and showed good usability in the System Usability Scale (median 72.5, IQR 65?80). The perception of usefulness (median 6, IQR 5.8?6.9) and ease of use (median 5.9, IQR 5.1?6.3) was good among all students. There was a significant increase in the handover performance from pre- (median 8, IQR 6?9) to posttraining (median 8, IQR 7?9; z=?2.01; P=.045; r=0.33) and of the confidence in caring for patients with seizures (median 3, IQR 2?3 and median 3.5, IQR 3?4, respectively; z=?3.8; P<.001; r=0.60). In 67% (14/21) of the simulations, technical issues occurred, but all simulations could be carried out completely. Conclusions: The new INTEAM training course was well received by nursing and medical students. The handover skills and confidence in caring for patients with seizures were improved after the course. Despite technical challenges with the VR simulations, none required termination, and this demonstrates that our approach is feasible. These promising results encourage the use of VR simulations for team training in the education of nursing and medical students. UR - https://games.jmir.org/2024/1/e57117 UR - http://dx.doi.org/10.2196/57117 ID - info:doi/10.2196/57117 ER - TY - JOUR AU - Gimenes, Escobar Fernanda Raphael AU - Stabile, Maria Angelita AU - Bernardes, Magri Rodrigo AU - Santos, Batista Vinicius AU - Menegueti, Gonçalves Mayra AU - do Prado, Rezende Patricia AU - Ribeiro, Serra Mauricio AU - Camerini, Giron Flavia AU - Rabeh, Nasbine Soraia Assad PY - 2024/10/23 TI - Advancing Digital Education Technologies by Empowering Nurses With Point-of-Care Ultrasound: Protocol for a Mixed Methods Study JO - JMIR Res Protoc SP - e58030 VL - 13 KW - ultrasound KW - bedside ultrasound KW - patient safety KW - advanced practice nursing KW - digital technology in education KW - empowerment KW - nurses KW - Point-of-Care Ultrasound KW - PoCUS KW - quality care KW - decision-making KW - nursing assessment N2 - Background: Bedside ultrasonography, also known as point-of-care ultrasound (PoCUS), is a promising technological tool that enhances clinical assessment, enriching diagnostic capabilities and clinical reasoning. Its use in nursing spans various patient populations and health care settings, providing nurses with a valuable health assessment tool to improve care quality and patient safety. Despite its growing integration into clinical practice, PoCUS training has mainly focused on physicians, leaving a gap for trained nurses who demonstrate similar proficiency in conducting scans and interpreting images. Previous research highlights the value of digital tools in PoCUS training, showing their role in improving professionals? and students? knowledge, image interpretation skills, and clinical acumen. Objective: This study aimed to (1) establish an assessment instrument gauging nurses? competency milestones in PoCUS and evaluate its content and appearance validity, (2) develop a series of 5 educational videos focused on PoCUS and assess their content and appearance validity, and (3) construct an online learning environment tailored to nurses? PoCUS training needs and evaluate its content and appearance validity. Methods: We will conduct a methodological study of technological production guided by Rogers? diffusion of innovations theory. Subproject 1 will design and validate a comprehensive assessment tool for evaluating nurses? competency milestones in PoCUS use. For this purpose, a scoping review will be conducted. The review will be based on JBI Collaboration guidelines and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extended for Scoping Reviews (PRISMA-ScR) checklist. Subproject 2 involves an evaluation of content and appearance validity for a series of 5 educational videos on PoCUS, designed specifically for nurses about applying peripherally inserted central catheter lines, inserting nasogastric feeding tubes, assessing gastric residual volume, assessing pressure injuries and soft tissue conditions, and assessing muscle mass to monitor patient nutritional status. In subproject 3, a comprehensive online learning environment dedicated to PoCUS training for nurses will be developed and validated. The launch of an online learning environment represents a cornerstone of our dissemination strategy, scheduled to coincide with the inaugural Brazilian PoCUS symposium for nurses, an event organized by the project members. This platform will serve as a pivotal resource for continuous learning and professional development. Results: Subproject 1 will start in the second half of 2024 and is expected to be completed by mid-2025. Subproject 2 is currently ongoing and is expected to be completed in early 2026. Subproject 3 is set to begin in early 2025 and is planned to be completed by 2026. Conclusions: Through these concerted efforts, the project aims to bridge the existing gap in PoCUS training for nurses, thereby fostering their proficiency and enhancing patient care outcomes. International Registered Report Identifier (IRRID): PRR1-10.2196/58030 UR - https://www.researchprotocols.org/2024/1/e58030 UR - http://dx.doi.org/10.2196/58030 UR - http://www.ncbi.nlm.nih.gov/pubmed/39441654 ID - info:doi/10.2196/58030 ER - TY - JOUR AU - Wiertz, H. Carolina M. AU - van Meulenbroek, Thijs AU - Lamper, Cynthia AU - Hemmen, Bea AU - Sep, Simone AU - Huijnen, Ivan AU - Goossens, B. Marielle E. J. AU - Burgers, Jako AU - Verbunt, Jeanine PY - 2024/10/11 TI - Effectiveness of a Person-Centered Interdisciplinary Rehabilitation Treatment of Post?COVID-19 Condition: Protocol for a Single-Case Experimental Design Study JO - JMIR Res Protoc SP - e63951 VL - 13 KW - rehabilitation medicine KW - postacute COVID-19 syndrome KW - quality of life KW - long COVID KW - COVID-19 KW - multidisciplinary care KW - interdisciplinary care N2 - Background: Patients with post?COVID-19 condition (PCC) experience a wide range of complaints (physical, cognitive, and mental), sometimes with high levels of disability in daily activities. Evidence of effective interdisciplinary rehabilitation treatment is lacking. A person-centered, biopsychosocial, interdisciplinary rehabilitation program, adapted to expert opinions and the patient?s needs, was therefore developed. Objective: This study aims to present a study protocol for a clinical trial to evaluate the effect of a new, person-centered, interdisciplinary rehabilitation treatment for PCC. It is aimed at improving participation in society and health-related quality of life in patients with PCC who perceive a high level of disability in daily activities or participation. Methods: A total of 20 Dutch adults, aged 18 years or older, with high levels of disability in daily activities and participation in society will be included in this replicated and randomized single-case experimental design study, from October 2023 onward. The replicated and randomized single-case experimental design consists of 3 phases. The baseline phase is the observational period, in which no specific treatment will be given. In the intervention phase, patients will receive the new outpatient treatment 3 times a week for 12 weeks, followed by a 12-week follow-up phase. During the intervention phase, the treatment will be personalized according to the patient?s physical, mental, and cognitive symptoms and goals. The treatment team can consist of a rehabilitation physician, physiotherapist, occupational therapist, speech therapist, and psychologist. The primary outcomes of the study are daily diaries, which consist of 8 questions selected from validated questionnaires (Utrecht Scale for Evaluation of Rehabilitation-Participation, EQ-5D-5L, and the Hospital Anxiety and Depression Scale). The other primary outcome measurements are participation in society (Utrecht Scale for Evaluation of Rehabilitation-Participation) and health-related quality of life (EQ-5D-5L). The secondary outcomes are physical tests and validated questionnaires aimed at physical, mental, and cognitive complaints. Effect evaluation based on daily assessments will include visual analysis, calculation of effect sizes (Nonoverlap of All Pairs), randomization tests, and multilevel analysis. In addition, other analyses will be based on ANOVA or a 2-tailed Student t test. Results: Data collection for this study started in October 2023 and is planned to be completed in July 2024. The results will be published in peer-reviewed journals and presented at international conferences. Conclusions: This is the first study investigating the effect of an interdisciplinary rehabilitation treatment with a person-centered, biopsychosocial approach in patients with PCC. Our findings will help to improve the treatment and support of patients with PCC. Trial Registration: German Clinical Trials Register DRKS00032636; https://drks.de/search/en/trial/DRKS00032636 International Registered Report Identifier (IRRID): DERR1-10.2196/63951 UR - https://www.researchprotocols.org/2024/1/e63951 UR - http://dx.doi.org/10.2196/63951 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/63951 ER - TY - JOUR AU - Carrillo, Irene AU - Skoumalová, Ivana AU - Bruus, Ireen AU - Klemm, Victoria AU - Guerra-Paiva, Sofia AU - Kne?evi?, Bojana AU - Jankauskiene, Augustina AU - Jocic, Dragana AU - Tella, Susanna AU - Buttigieg, C. Sandra AU - Srulovici, Einav AU - Madarasová Gecková, Andrea AU - Põlluste, Kaja AU - Strametz, Reinhard AU - Sousa, Paulo AU - Odalovic, Marina AU - Mira, Joaquín José PY - 2024/10/7 TI - Psychological Safety Competency Training During the Clinical Internship From the Perspective of Health Care Trainee Mentors in 11 Pan-European Countries: Mixed Methods Observational Study JO - JMIR Med Educ SP - e64125 VL - 10 KW - psychological safety KW - speaking up KW - professional competence KW - patient safety KW - education KW - adverse event N2 - Background: In the field of research, psychological safety has been widely recognized as a contributing factor to improving the quality of care and patient safety. However, its consideration in the curricula and traineeship pathways of residents and health care students is scarce. Objective: This study aims to determine the extent to which health care trainees acquire psychological safety competencies during their internships in clinical settings and identify what measures can be taken to promote their learning. Methods: A mixed methods observational study based on a consensus conference and an open-ended survey among a sample of health care trainee mentors from health care institutions in a pan-European context was conducted. First, we administered an ad hoc questionnaire to assess the perceived degree of acquisition or implementation and significance of competencies (knowledge, attitudes, and skills) and institutional interventions in psychological safety. Second, we asked mentors to propose measures to foster among trainees those competencies that, in the first phase of the study, obtained an average acquisition score of <3.4 (scale of 1-5). A content analysis of the information collected was carried out, and the spontaneity of each category and theme was determined. Results: In total, 173 mentors from 11 pan-European countries completed the first questionnaire (response rate: 173/256, 67.6%), of which 63 (36.4%) participated in the second consultation. The competencies with the lowest acquisition level were related to warning a professional that their behavior posed a risk to the patient, managing their possible bad reaction, and offering support to a colleague who becomes a second victim. The mentors? proposals for improvement of this competency gap referred to training in communication skills and patient safety, safety culture, work climate, individual attitudes, a reference person for trainees, formal incorporation into the curricula of health care degrees and specialization pathways, specific systems and mechanisms to give trainees a voice, institutional risk management, regulations, guidelines and standards, supervision, and resources to support trainees. In terms of teaching methodology, the mentors recommended innovative strategies, many of them based on technological tools or solutions, including videos, seminars, lectures, workshops, simulation learning or role-playing with or without professional actors, case studies, videos with practical demonstrations or model situations, panel discussions, clinical sessions for joint analysis of patient safety incidents, and debriefings to set and discuss lessons learned. Conclusions: This study sought to promote psychological safety competencies as a formal part of the training of future health care professionals, facilitating the translation of international guidelines into practice and clinical settings in the pan-European context. UR - https://mededu.jmir.org/2024/1/e64125 UR - http://dx.doi.org/10.2196/64125 UR - http://www.ncbi.nlm.nih.gov/pubmed/39374073 ID - info:doi/10.2196/64125 ER - TY - JOUR AU - Knudsen, Anne-Maj AU - Dalgård Dunvald, Ann-Cathrine AU - Hangaard, Stine AU - Hejlesen, Ole AU - Kronborg, Thomas PY - 2024/8/8 TI - The Effectiveness of Collaborative Care Interventions for the Management of Patients With Multimorbidity: Protocol for a Systematic Review, Meta-Analysis, and Meta-Regression Analysis JO - JMIR Res Protoc SP - e58296 VL - 13 KW - multimorbidity KW - comorbidity KW - multiple chronic conditions KW - patient care team KW - multidisciplinary teams KW - collaborative care KW - quality of life KW - systematic review KW - meta-analysis N2 - Background: Collaborative care interventions have been proposed as a promising strategy to support patients with multimorbidity. Despite this, the effectiveness of collaborative care interventions requires further evaluation. Existing systematic reviews describing the effectiveness of collaborative care interventions in multimorbidity management tend to focus on specific interventions, patient subgroups, and settings. This necessitates a comprehensive review that will provide an overview of the effectiveness of collaborative care interventions for adult patients with multimorbidity. Objective: This systematic review aims to systematically assess the effectiveness of collaborative care interventions in comparison to usual care concerning health-related quality of life (HRQoL), mental health, and mortality among adult patients with multimorbidity. Methods: Randomized controlled trials evaluating collaborative care interventions designed for adult patients (18 years and older) with multimorbidity compared with usual care will be considered for inclusion in this review. HRQoL will be the primary outcome. Mortality and mental health outcomes such as rating scales for anxiety and depression will serve as secondary outcomes. The systematic search will be conducted in the CENTRAL, PubMed, CINAHL, and Embase databases. Additional reference and citation searches will be performed in Google Scholar, Web of Science, and Scopus. Data extraction will be comprehensive and include information about participant characteristics, study design, intervention details, and main outcomes. Included studies will be assessed for limitations according to the Cochrane Risk of Bias tool. Meta-analysis will be conducted to estimate the pooled effect size. Meta-regression or subgroup analysis will be undertaken to explore if certain factors can explain the variation in effect between studies, if feasible. The certainty of evidence will be evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Results: The preliminary literature search was performed on February 16, 2024, and yielded 5255 unique records. A follow-up search will be performed across all databases before submission. The findings will be presented in forest plots, a summary of findings table, and in narrative format. This systematic review is expected to be completed by late 2024. Conclusions: This review will provide an overview of pooled estimates of treatment effects across HRQoL, mental health, and mortality from randomized controlled trials evaluating collaborative care interventions for adults with multimorbidity. Furthermore, the intention is to clarify the participant, intervention, or study characteristics that may influence the effect of the interventions. This review is expected to provide valuable insights for researchers, clinicians, and other decision-makers about the effectiveness of collaborative care interventions targeting adult patients with multimorbidity. Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO) CRD42024512554; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=512554 International Registered Report Identifier (IRRID): DERR1-10.2196/58296 UR - https://www.researchprotocols.org/2024/1/e58296 UR - http://dx.doi.org/10.2196/58296 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/58296 ER - TY - JOUR AU - McBee, C. Joseph AU - Han, Y. Daniel AU - Liu, Li AU - Ma, Leah AU - Adjeroh, A. Donald AU - Xu, Dong AU - Hu, Gangqing PY - 2024/8/7 TI - Assessing ChatGPT?s Competency in Addressing Interdisciplinary Inquiries on Chatbot Uses in Sports Rehabilitation: Simulation Study JO - JMIR Med Educ SP - e51157 VL - 10 KW - ChatGPT KW - chatbots KW - multirole-playing KW - interdisciplinary inquiry KW - medical education KW - sports medicine N2 - Background: ChatGPT showcases exceptional conversational capabilities and extensive cross-disciplinary knowledge. In addition, it can perform multiple roles in a single chat session. This unique multirole-playing feature positions ChatGPT as a promising tool for exploring interdisciplinary subjects. Objective: The aim of this study was to evaluate ChatGPT?s competency in addressing interdisciplinary inquiries based on a case study exploring the opportunities and challenges of chatbot uses in sports rehabilitation. Methods: We developed a model termed PanelGPT to assess ChatGPT?s competency in addressing interdisciplinary topics through simulated panel discussions. Taking chatbot uses in sports rehabilitation as an example of an interdisciplinary topic, we prompted ChatGPT through PanelGPT to role-play a physiotherapist, psychologist, nutritionist, artificial intelligence expert, and athlete in a simulated panel discussion. During the simulation, we posed questions to the panel while ChatGPT acted as both the panelists for responses and the moderator for steering the discussion. We performed the simulation using ChatGPT-4 and evaluated the responses by referring to the literature and our human expertise. Results: By tackling questions related to chatbot uses in sports rehabilitation with respect to patient education, physiotherapy, physiology, nutrition, and ethical considerations, responses from the ChatGPT-simulated panel discussion reasonably pointed to various benefits such as 24/7 support, personalized advice, automated tracking, and reminders. ChatGPT also correctly emphasized the importance of patient education, and identified challenges such as limited interaction modes, inaccuracies in emotion-related advice, assurance of data privacy and security, transparency in data handling, and fairness in model training. It also stressed that chatbots are to assist as a copilot, not to replace human health care professionals in the rehabilitation process. Conclusions: ChatGPT exhibits strong competency in addressing interdisciplinary inquiry by simulating multiple experts from complementary backgrounds, with significant implications in assisting medical education. UR - https://mededu.jmir.org/2024/1/e51157 UR - http://dx.doi.org/10.2196/51157 UR - http://www.ncbi.nlm.nih.gov/pubmed/39042885 ID - info:doi/10.2196/51157 ER - TY - JOUR AU - Acharya, Harshdeep AU - Sykes, J. Kevin AU - Neira, Mirás Ton AU - Scott, Angela AU - Pacheco, M. Christina AU - Sanner, Matthew AU - Ablah, Elizabeth AU - Oyowe, Kevin AU - Ellerbeck, F. Edward AU - Greiner, Allen K. AU - Corriveau, A. Erin AU - Finocchario-Kessler, Sarah PY - 2024/4/1 TI - A Novel Electronic Record System for Documentation and Efficient Workflow for Community Health Workers: Development and Usability Study JO - JMIR Form Res SP - e52920 VL - 8 KW - public health KW - database KW - community health worker KW - social determinants of health KW - health worker KW - health workers KW - CHW KW - CHWs KW - community-based KW - data collection KW - functionality KW - develop KW - development KW - EHR KW - EHRs KW - EMR KW - EMRs KW - dashboard KW - dashboards KW - health record KW - health records KW - documentation KW - medical record KW - medical records KW - equity KW - inequity KW - inequities N2 - Background: The COVID-19 pandemic added to the decades of evidence that public health institutions are routinely stretched beyond their capacity. Community health workers (CHWs) can be a crucial extension of public health resources to address health inequities, but systems to document CHW efforts are often fragmented and prone to unneeded redundancy, errors, and inefficiency. Objective: We sought to develop a more efficient data collection system for recording the wide range of community-based efforts performed by CHWs. Methods: The Communities Organizing to Promote Equity (COPE) project is an initiative to address health disparities across Kansas, in part, through the deployment of CHWs. Our team iteratively designed and refined the features of a novel data collection system for CHWs. Pilot tests with CHWs occurred over several months to ensure that the functionality supported their daily use. Following implementation of the database, procedures were set to sustain the collection of feedback from CHWs, community partners, and organizations with similar systems to continually modify the database to meet the needs of users. A continuous quality improvement process was conducted monthly to evaluate CHW performance; feedback was exchanged at team and individual levels regarding the continuous quality improvement results and opportunities for improvement. Further, a 15-item feedback survey was distributed to all 33 COPE CHWs and supervisors for assessing the feasibility of database features, accessibility, and overall satisfaction. Results: At launch, the database had 60 active users in 20 counties. Documented client interactions begin with needs assessments (modified versions of the Arizona Self-sufficiency Matrix and PRAPARE [Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences]) and continue with the longitudinal tracking of progress toward goals. A user-specific automated alerts-based dashboard displays clients needing follow-up and upcoming events. The database contains over 55,000 documented encounters across more than 5079 clients. Available resources from over 2500 community organizations have been documented. Survey data indicated that 84% (27/32) of the respondents considered the overall navigation of the database as very easy. The majority of the respondents indicated they were overall very satisfied (14/32, 44%) or satisfied (15/32, 48%) with the database. Open-ended responses indicated the database features, documentation of community organizations and visual confirmation of consent form and data storage on a Health Insurance Portability and Accountability Act?compliant record system, improved client engagement, enrollment processes, and identification of resources. Conclusions: Our database extends beyond conventional electronic medical records and provides flexibility for ever-changing needs. The COPE database provides real-world data on CHW accomplishments, thereby improving the uniformity of data collection to enhance monitoring and evaluation. This database can serve as a model for community-based documentation systems and be adapted for use in other community settings. UR - https://formative.jmir.org/2024/1/e52920 UR - http://dx.doi.org/10.2196/52920 UR - http://www.ncbi.nlm.nih.gov/pubmed/38557671 ID - info:doi/10.2196/52920 ER -