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The rise in technology-rich learning environments is reflective of a global trend in higher education (HE), recently accelerated because of necessary digital teaching and assessment practices embraced during the COVID-19 pandemic. This qualitative study facilitated through focus groups and an interview explores the teaching and learning experiences of tertiary level students in the COVID-19 era. Data from 24 students based within a UK Higher Education Institution highlights how an expanded digital environment can optimise conditions for some students to independently practise and apply what they are learning at their own pace. Digitally enhanced opportunities to interact with teaching staff and learning resources also increased the options for these students to experience themselves as competent members of the HE community. This was particularly relevant for first-year students new to the processes and practices of tertiary education. In contrast, third year students with more experience of HE appeared less reliant on the provision of online learning resources. Participants also identified some potential problems associated with the enhanced flexibility of online teaching and learning resources in relation to students' ability to be self-regulated. This paper rationalises the need for educators and educational and learning developers who teach and undertake scholarship in teaching and learning to consider the sociocultural context of the student and their learning environment when designing teaching activities and curricula. The data presented here highlight the need for a clearly defined framework to underpin the integration of digital technologies with on-campus activities.

This study aims to investigate Vietnamese pain terms and pain descriptors with a focus on how the McGill Pain Questionnaire (MPQ) words are utilised by the Vietnamese patients. Semi-structured interviews were employed to collect data from twenty-six Vietnamese female cancer patients. The data were analysed using both quantitative and qualitative content analysis. The findings indicated that dau (hurt), nh?c (ache), and dau-nh?c (hurt and ache) are three basic pain terms in Vietnamese, with dau being a super-ordinate pain term. In addition, Vietnamese pain descriptors can be systematically classified into MPQ-VN descriptors and Non-MPQ-VN descriptors, with the latter being used far more frequently than the former. The study also found that MPQ descriptors could not reflect the patients' pain experience comprehensively in the Vietnamese context although the Vietnamese employed the equivalents of MPQ descriptors of different categories. That the limitations of Melzack's (1975) inventory of MPQ descriptors have been validated in Vietnamese has contributed to Vietnamese healthcare professionals' understanding of how the patients communicate about their pain experience using language. The study has also shed lights on applied linguists' research directions which can be extended to areas beyond language education, such as health, therapy, and counselling.

Training the next generation of public health practitioners to promote health equity requires public health graduate programs to cultivate students' skills in community partnership. The Council on Education for Public Health (CEPH) requires Master of Public Health (MPH) students to produce a high-quality written product as part of their culminating Integrative Learning Experience (ILE). Because CEPH recommends that ILE written products be useful to community partners, ILEs can draw lessons from the field of experiential education, especially the social justice aligned principles of critical service-learning (CSL). However, the current literature lacks descriptions of how to operationalize CSL's principles within graduate-level culminating experiences. To help fill this gap, we discuss a CSL ILE for MPH students, called Capstone. We describe CSL's key components and explain and assess how each is operationalized. We hope Capstone's model will help educators engage more deeply with CSL practices to advance health equity.

To increase community health knowledge, the El Paso Health Education and Awareness Team (EP-HEAT) was established at Paul L. Foster School of Medicine. The Medical Student Run Clinic (MSRC) emphasizes community health care access. "Promotores de salud" (community health workers) increase health care awareness and connect predominantly underserved communities with resources. Surveys were conducted to determine how EP-HEAT and MSRC patients' communication with promotores affected their access to health care and communication skills. Surveys demonstrated that 91% of EP-HEAT members agreed that working with promotores improved their communication ability. All MSRC patients surveyed stated interacting with promotores helped improve health care communication in various ways.

University of Maryland, Baltimore CURE Connections (UMB CURE) connects West Baltimore high school students with STEM enrichment including hands-on research and community outreach. This study's purpose was to describe successes and challenges of implementing the virtual Community Health Worker curriculum during the summer programming for UMB CURE high school scholars. This certificate-based program was designed to teach students about the community health field while providing training that demonstrates competence as a community health worker. The training was implemented over two summer sessions (2020 and 2021). Scholars completed a survey to assess program satisfaction. A subset of scholars completed qualitative interviews that focused on scholars' summer program experience and recommendations for program improvement. Engagement metrics (scholar participation, retention) were compiled. Overall themes from qualitative interviews included: (1) overall summer program experience, (2) about the Morehouse curriculum, (3) advice for future scholars, (4) in-person versus virtual summer program, and (5) recommendations for the program. While the program was generally well-received, scholars required more instruction and guidance than anticipated. Many found the required assignments challenging to navigate, citing virtual instruction as a reason. Scholars also requested more hands-on synchronous STEM-focused activities. These data will be used to modify future programming to engage scholars in out-of-school-time STEM initiatives.

Pharmacy practice change is facilitated by delegation, teamwork, leadership and reorganization of personnel structure and roles. The international pharmaceutical federation (FIP) recommends that society should have access to appropriately trained pharmaceutical personnel. Three cadres form the pharmacy workforce: pharmacists, technicians and pharmacy assistants or dispensers. Globally, the training, regulation, scope, and status of technicians and dispensers vary. Role tensions exist between pharmacists and technicians which impact both workplace behaviour and performance. Literature on role expansion for pharmacy technicians excludes (reference to) the contribution of the pharmacy assistant or dispenser. Unlike the technician, the dispenser largely lacks professional recognition. But overlaps between the roles of the technician and dispenser can occur leading to further tensions in the pharmacy workplace. 'Unhealthy'' intra-professional conflicts obstruct the pharmacist practice envisioned by the WHO 7-star pharmacist. A solution that brings together the 3 cadres in joint or shared action is desirable. Social theory suggests that intercadre conflicts could be both necessary and inevitable. Being political nature, the tensions can be moderated by a ''political settlement''. The present paper is a reconstruction of and reflection of the author's journey in building a harmonious pharmacy workforce. Professionalizing the dispenser cadre restructures the hierarchy of the pharmacy workforce leading to harmony which in turn improves organizational performance. Lessons learned from this case can be applied to resolve workplace tensions in other settings.

Background: Research suggests that people with intellectual disabilities have a higher risk for cardiovascular disease than the general population. The aim of this study was to identify barriers for the prevention, diagnosis, and treatment of cardiovascular disease for people with intellectual disabilities. Method: We conducted individual interviews with relatives and general practitioners and focus group interviews with staff working at an assisted home facility, a cardiac ward, an obesity clinic and two rehabilitation centres (n = 33) in Norway. Inductive approach and thematic analysis were used to analyse the data. Results: We identified barriers on an individual and a structural level. The underlying reason for these barriers is that health problems, such as cardiovascular disease, are regularly overlooked as the condition of intellectual disability "overshadows" other possible diagnoses. Conclusion: This focus on intellectual disability rather than other explanations leads to shortcomings in the prevention, diagnoses, and treatment of cardiovascular disease in this group.

Background: Students are required to complete a minimum of 150 hours, respectively, in both community and health system introductory pharmacy practice experience (IPPE) rotations as part of a PharmD programme completion in the USA. The goal is to introduce students to medication use processes; patient and provider communication; interprofessional team dynamics, and inpatient and outpatient healthcare delivery. Context and Objective: Experiential learning environments offer pharmacy students exposure to interactions with patients, pharmacy technicians, suppliers, practitioners and insurance companies. However, an experience gap appears when graduating pharmacy students enter their careers as licenced pharmacists. This study sought to understand this gap and to provide pharmacy schools with insight so that they can better equip future pharmacists with the tools needed for successful pharmacy communication in practice. Method: A total of 14 semi-structured interviews were conducted with pharmacists (N = 14) in various healthcare settings in Florida, USA: community pharmacy, ambulatory care, health system pharmacy and long-term care/mail order environments. Content and thematic analyses were conducted to identify themes in the data. Results: Three overarching themes were developed: staff, management and operations; communicating with healthcare providers; and counselling patients. In addition, the pharmacists offered recommendations pertaining to topics that could be included in curriculum updates. Conclusion: The themes developed from the study highlight competencies that pharmacists had to learn in the field. There are skills that pharmacists need to practise effectively in their area of pharmacy that their pharmacy schools failed to prepare them for. The analysis will be useful to pharmacy schools seeking to update their curriculum to reflect common practices in different areas of pharmacy and ultimately to better prepare their students for future careers.

Community health workers (CHWs) are increasingly being required to perform complex health care activities, especially in community cardiovascular disease and stroke prevention. However, currently, there are no psychometrically validated instruments for assessing CHW competencies in these roles. This article describes the development and validation of the stroke literacy assessment test (SLAT)--pertaining to the Life's Simple Seven (LS7) risk factors for stroke--for evaluating CHWs' competencies in the context of education and training programs. The SLAT was developed using an iterative instrument design protocol, followed by empirically testing the instrument in 68 CHWs from the Columbia University Institute for Training Outreach and Community Health (InTOuCH) in New York. Data collection began in March 2021 and continued through May 2021. The evaluation was based on four types of validity evidence: (a) content validation with expert reviews of items and overall domain, (b) validation on examinee response processes with cognitive interviews, (c) item validation and diagnostic analysis, and (d) validity evidence based on expected directional group differences. In addition, the internal consistency reliability of the total test scores, with the best functioning items, were evaluated. Two such iterative cycles yielded a 34-item, written structured response test that assesses the "factual knowledge" and "application" levels of cognition, and demonstrates sufficient validity and reliability (Cronbach's [alpha] = 0.69) for use with CHWs specializing in stroke prevention efforts. The SLAT is a novel, valid, and reliable instrument that contributes to filling a critical gap in rigorous competency assessments for CHWs deployed in chronic disease prevention.

To explore the existing literature on the effect of Interprofessional Education (IPE) on the work environment of health professionals. The research question was systematized according to the PCC (Population, Concept, and Context) format. A scoping review was performed. A search of multiple bibliographic databases identified 407 papers, of which 21 met the inclusion criteria. The populations of the 21 studies reviewed were composed of professionals in the fields of medicine, nursing, psychology, occupational therapy, physiotherapy, and social work, among others. The study contexts were both academic and nonacademic hospitals, mental health institutions, and community settings, and the topics examined were organizational climate, organizational culture, organizational attachment and job satisfaction. The findings from the reviewed studies showed positive effects of IPE interventions on organizational climate and culture, but the results on job satisfaction and organizational attachment were mixed (i.e., positive and no effects following IPE interventions). Research on IPE is worth more attention as IPE could be an effective alternative for the fulfillment of the Quadruple Aim and achieving the third of the United Nations Sustainable Development Goals, aimed at improving health and well-being. It seems critical for IPE to be positioned as a trend in global health, aiming at boosting human health resources as one of its building blocks and calling the attention of health decision-makers.

The learning environment (LE) includes social interactions, organizational culture, structures, and physical and virtual spaces that influence the learning experiences of students. Despite numerous studies exploring the perception of healthcare professional students (HCPS) of their LE, the validity evidence of the utilized questionnaires remains unclear. This scoping review aimed to identify questionnaires used to examine the perception of undergraduate HCPS of their LE and to assess their validity evidence. Five key concepts were used: (1) higher education; (2) questionnaire; (3) LE; (4) perception; and (5) health professions (HP). PubMed, ERIC, ProQuest, and Cochrane databases were searched for studies developing or adapting questionnaires to examine LE. This review employed the APERA standards of validity evidence and Beckman et al. (J Gen Intern Med 20:1159-1164, 2005) interpretation of these standards according to 5 categories: content, internal structure, response process, relation to other variables, and consequences. Out of 41 questionnaires included in this review, the analysis revealed a predominant emphasis on content and internal structure categories. However, less than 10% of the included questionnaires provided information in relation to other variables, consequences, and response process categories. Most of the identified questionnaires received extensive coverage in the fields of medicine and nursing, followed by dentistry. This review identified diverse questionnaires utilized for examining the perception of students of their LE across different HPs. Given the limited validity evidence for existing questionnaires, future research should prioritize the development and validation of psychometric measures. This will ultimately ensure sound and evidence-based quality improvement measures of the LE in HP education programs.

Background: People with intellectual disabilities living in group homes often have complex health needs, are high health service users and need support from their service provider to access health services. In Australia, little is known about the types and amounts of these supports. Methods: A case study was conducted on a large Western Australian disability provider of group homes to 160 people with intellectual disability. Over an 18-month period, including during the COVID-19 pandemic, the study quantified health service use in hospital- and community-based settings, ways by which the person was supported to access health care and the impact on other people supported by the provider. Economic costs of supporting access to health services were estimated. Findings: Overall, the disability provider supported 160 people in accessing health services an average of 23 times each (n = 3617, median = 20, interquartile range = 10-33) over the 18 months. Support included staff attending with the person (96%), following up with guardian/decision-maker (50%), additional resourcing via overtime or staff backfills (6%) and transport (94%). The average cost of supporting one health visit was estimated at $78.51 AUD (2021). Impact on the person's household included loss of opportunity for housemates (30%), reduced supervision within the home (79%) and longer timeframes to complete care needs (32%). The impact of COVID-19 restrictions saw a reduction in allied and mental health service use that did not return to prepandemic levels following the cessation of restrictions. Primary care, specialist, outpatient, pathology and emergency service use was also lower in the postrestriction period compared to the prepandemic period. Conclusions: For people living in group homes, the disability provider plays an essential role in supporting health service access, primarily through the provision of support staff and transport. The change in health service utilisation following the COVID-19 restriction period indicates that altered health system priorities can potentially exacerbate access inequality for people with intellectual disability.

Objectives: Overweight and obesity among school-aged children pose a threat to both their academic performance and public health. The Healthy Primary School of the Future (HPSF) initiative was established to address this issue. Our objective was to explore the conditions that make HPSF sustainable based on the perspectives of relevant stakeholders. Design: The study utilised Group Concept Mapping, a structured methodology for conducting mixed-methods participative research, combining qualitative data collection with quantitative data analysis measures. Method: Participants included parents, teachers, school directors, politicians, labour unions, educational, nutrition and health scientists and policymakers. They were asked to respond to the prompt, 'A necessary condition to make the HPSF sustainable is . . .'. The statements generated were then assessed for their importance and feasibility. Using multidimensional scaling and hierarchical cluster analyses, we identified the shared vision among the stakeholders. Results: A total of 106 unique statements were generated and grouped statistically into 10 clusters. The most significant clusters were identified as Financing; Accessibility for everyone; and Content/Lifestyle/School Programme. The clusters that were deemed most feasible included Content/Lifestyle/School Programme; Accessibility for everyone; and Evaluation. Conclusion: Achieving sustainability for the HPSF requires a comprehensive approach that addresses the conditions outlined in all 10 clusters. Based on the ratings of feasibility and importance, our recommendation is to prioritise implementation of Content/Lifestyle/School Programme and Accessibility for everyone. Subsequently, efforts should be directed towards realising the less feasible but crucial conditions, such as Financing and Evaluation, followed by the remaining six clusters of conditions as identified.

Medical improvisation (improv) applies theater principles and techniques to improve communication and teamwork with health professionals (HP). Improv curricula have increased over time, but little is known about best practices in curricula development, implementation, and assessment. We sought to complete a state-of-the-art review of medical improv curricula to teach HP learners communication skills. A literature search of MEDLINE and 8 other databases on HP medical education and medical improv communication curricula occurred. We screened 1869 articles published from 2012 to 2022. Seventeen articles were selected for extraction and synthesis. Common curricular goals included improving interprofessional, interpersonal, and empathetic communication. Curricula often lacked alignment between learning objectives and improv exercises. Sessions occurred once (65%) or were longitudinal (35%). Only 24% reported a full description of their intervention. Few reported details on the content of curricula. Evaluations often focused on feasibility and acceptability. Heterogeneity exists in the development, implementation, and assessment of improv curricula. Low-quality evidence was provided to support the use of medical improv to teach communication skills to HP learners. Improv curricula were feasible, and acceptable to learners. We offer recommendations to guide future medical improv curricula development.

To emphasize to learners how factors outside individual control impact health, scholars introduced the concept of structural competency. Structural competency refers to the development of analytical skills that reveal the larger societal context beyond the patient-clinician interaction that shapes health outcomes. The growing adoption of structural competency curricula, however, has revealed that prelicensure and early career health professionals can feel overwhelmed by the mismatch between the wide scale of entrenched problems and the limited scope of their therapeutic skills. In this Reflections paper, I draw on theories from Giddens, Bourdieu, and Foucault to restore a role for individual agency in promoting health. Conceiving of structure and agency as mutually constituting suggests that structures are human-made and can be vulnerable to challenge. Structures, however, disperse power to such an extent that people internalize their rules and discipline themselves to follow them without explicit enforcement. It is precisely in those local sites of power that health professions learners and educators can intervene to interrupt the reproduction of structures harmful to health. As I demonstrate with an example from a reproductive health emergency, being structurally competent may also include contesting agreed upon norms at the level of the learning and clinical environments rather than only macro-level societal forces. Rewriting norms within health professions education and clinical practice is not necessarily a simpler task, but it provides learners and educators with more accessible targets for action.

Objective: Children report needle procedures as one of their most feared and painful experiences. Negative blood test experiences can lead to lifelong implications. Xploro is an online health information platform (app) that uses age-appropriate self-directed augmented reality (AR) techniques. This study evaluated the acceptability, feasibility and self-reported impact of Xploro on children undergoing a planned blood test. Method: Children aged 6-14 years accessed Xploro at home before attending hospital for a planned blood test. Paper data collection booklets were completed by children, their parents and health professionals. We explored participants' views of using Xploro and the perceived impact on a child's ability to undergo the blood test. Data were analysed using descriptive statistics and content analysis procedures. Results: Notably, 24 children, 24 parents and 6 health professionals participated. Children (96%; n = 23/24) reported that Xploro was 'fun' and 'easy to use' and helped them have their blood test (94%, n = 17/18), as they 'knew what to expect' and what would help them. Parents reported that the app helped 'open up a dialogue about the blood test' with their child and helped their child 'know what would happen during the blood test' and how to 'stay calm'. Health professionals (n = 6) reported that Xploro helped children access information 'at their leisure at home'. Conclusion: Xploro was reported as being a useful and engaging self-directed child-friendly information app for children having a planned blood test which helped children know what was going to happen and improved their experiences of having a blood test.

Background: The main goal of a health system is to maintain or improve people's health. The COVID-19 pandemic showed the fragility of health systems worldwide. In Mexico, the pandemic affected the performance of the health system, along with the presence of contextual conditions such as its segmentation and high prevalence of chronic diseases. Aims: To analyze from an approach to the functions of the health system, the service delivery, human resources, financing, and stewardship/governance in the local health services of five states of Mexico, from the perspective of the staff working in health centers. Methods: This is an exploratory qualitative study conducted from November 2020 to August 2021, involving 124 health professionals from 39 health facilities (18 rural and 21 urban). The technique used was the semi-structured interview. Interview guides were developed according to core topics. Subsequently, the thematic analysis method was used. Results: The lack of financial resources delayed prevention efforts and made it difficult for health centers to adapt to the crisis. Inequity was found in the distributive efficiency of staff between rural and urban areas and levels of care. In addition, there was evidence of capacity for coordination, capacity sharing, and joint participation between health institutions, civil authorities, and the population to face the emergency. Conclusions: We identified relevant public health actions that showed the capacity of local health services to organize a response to the pandemic at the level of the actors responsible for these services.

Background: The use of measurement instruments to assess the use of Evidence-Based Practice by health professionals has been frequently reported in studies. Aims: This systematic review aimed to summarize, describe, and evaluate the measurement properties of the instruments that evaluate the use of Evidence-Based Practice in health professionals. Methods: The search was carried out in four databases considering three groups of search terms: evidence-based practice, evaluation, and measurement proprieties. Studies were included that described the use of instruments to assess Evidence-Based Practice in health professionals, with the full-text publication, which analyzed the measurement properties, in English. The methodological quality of the studies was evaluated using COnsensus-based Standards for the selection of health Measurement INstruments. Results: In total, 6,429 were found and only 92 were eligible for data analysis. Forty new instruments were identified most were developed for nursing and physical therapist. The investigators performed at least 1 type of validity test on 73% of the instruments. Reliability was tested at 90%, through internal consistency. Responsiveness was tested on less than half of the instruments (30%). Most of the instruments identified are reliable and valid to measure evidence-based practice in health professionals. Conclusion: Although the Fresno Test remains the most complete instrument, and adequate for use. The COnsensus-based Standards for the selection of health Measurement INstruments checklist classified 7 (seven) instruments as suitable for the target audience.

Background: The COVID-19 pandemic disrupted routine school operations, including school health programs. This study aims to describe the pandemic's impact on school health service delivery from the perspective of Maryland school health partners. Methods: We conducted semi-structured interviews with health service representatives from public schools (K-12) between July and December 2021. Interviews were recorded, transcribed, and coded through an iterative process to develop analytic themes. Results: Twenty school health partners from 15 Maryland school districts participated. Participants identified key impacts of COVID-19 on school health: (1) COVID-19 disrupted delivery of services such as dental, mental health, and preventative care, (2) COVID-19 necessitated changes in service delivery platforms, (3) COVID-19 affected school health staff through increased responsibilities and staffing shortages, and (4) COVID-19 prompted schools to become hubs for community outreach and health education. Implications for School Health Policy, Practice, and Equity: Consideration of school health service disruptions and the increased demands on service providers may inform future priorities for school administrators, health departments, and policymakers. Conclusions: COVID-19 impacted the timing and method of service delivery as well as the roles of school health staff and schools themselves in public health and education.

Objective: This research was conducted to determine the relationships between psychological well-being, social support, and work-life balance and the mediating effect of psychological well-being on the relationship between social support and work-life balance. Methods: Data were collected from a convenience sample of 277 participants. Data analysis was done with regression and the Pearson correlation coefficient. Regression-based mediation analysis developed by Hayes (2013) was used to examine the mediation effect of psychological wellbeing. Results: Work-life balance is negatively related to social support (r=-0.51) and, positively related to psychological well-being (r=0.50). As a result of the mediation analysis based on regression to determine the mediating effects, it was concluded that psychological well-being had a mediating effect on the relationship between social support and work-life balance. The bootstrapp (10000) method was used to determine whether the mediation analysis was significant. Conclusions: These findings suggest that the inverse relationship between social support and work-life balance is at least partly explained by the level of psychological well-being.

Healthcare in Aotearoa New Zealand is changing with the aim of becoming truly universal. Development of a new curriculum model in the education of health professionals can aid this goal through increased focus on community needs and flexibility for multiple health professional registrations. Universal healthcare and disability support are promoted as a defining feature of Aotearoa New Zealand, yet inequities are blatantly evident, with increasing calls for equity. Complexity of the issue and the multitude of stakeholders favour action research founded on Vision Matauranga, a problem-solving philosophy which embraces the potential for innovation of Maori -- people, knowledge and resources. Action research embraces collaboration with stakeholders to identify and implement solutions. Government ministries determine policy, with Responsible Authorities accrediting educational institutions, which in turn provide educational programs. Changing what and how students learn can increase their understanding of equity and community needs when they become practitioners, with the voice of service users being paramount.

Deaf patients who communicate in American Sign Language (ASL) experience communication challenges leading to medical errors, treatment delays, and health disparities. Research on Deaf patient communication preferences is sparse. Researchers conducted focus groups based on the Health Belief Model with culturally Deaf patients and interpreters. The ASL focus groups were interpreted and transcribed into written English, verified by a third-party interpreting agency, and uploaded into NVivo. Deductive coding was used to identify communication methods and inductive coding was used to identify themes within each. Writing back-and-forth introduced challenges related to English proficiency, medical terminology, poor penmanship, and tendencies of providers to abbreviate. Participants had various speechreading abilities and described challenges with mask mandates. Multiple issues were identified with family and friends as proxy interpreters, including a lack of training, confidentiality issues, emotional support, and patient autonomy. Video remote interpreter challenges included technical, environmental, and interpreter qualification concerns. Participants overwhelmingly preferred on-site interpreters for communication clarity. While there was a preference for direct care, many acknowledged this is not always feasible due to lack of providers fluent in ASL. Access to on-site interpreters is vital for many Deaf patients to provide full access to critical medical information. Budget allocation for on-call interpreters is important in emergency settings.

The present research aimed to explore the role of media consumption, governmental distrust, and psychological vulnerability in predicting the practical well-being of university students and healthcare professionals during COVID-19. Two correlational studies were conducted. Study 1 was conducted with 411 university students (206 Women; 205 men), and it was conducted during the first lockdown in Pakistan. Study 2 was conducted during the thigh-intensity phase he COVID-19, and the sample comprised 375 healthcare professionals (198 women; 177 men). Both studies showed that higher levels of media consumption, governmental distrust, and psychological vulnerability were associated with lower levels of well-being. Our path models in both studies (with students and healthcare professionals) indicate that during the pandemic, participants' level of media consumption, trust in the government, and their personal vulnerability were negatively associated with their affective well-being. These findings have implications for individuals' affective well-being during healthcare crises such as the COVID-19 pandemic.

Implicit (unconscious) gender bias and stereotypes can affect clinical decisions and interactions between healthcare professionals, as well as impact careers. However, there is no research exploring the implicit gender bias or stereotypes of occupational therapy students or practitioners. Therefore, the aim of this study was to examine the gender-career bias of occupational therapy students. To do so, occupational therapy students (n = 54) from three Midwestern United States graduate occupational therapy programs completed the gender-career attitudes implicit association test (IAT) -- biases associating women with family, and men with career -- as well as a survey polling demographic information. Participants' scores on the Gender-Career IAT were calculated and analyzed using descriptive statistics and a one-tailed t-test. Independent samples t-tests, one-way analysis of variance, and linear regression models were used to determine differences in implicit attitudes based on participants' demographics. The majority (79.63%) of occupational therapy students in this study implicitly associated men with career, and women with family. There were not statistically significant differences in implicit attitudes based on demographic characteristics. It is critical to be aware of the existence of gender-career implicit biases, like other biases, to identify and reduce negative effects these attitudes could have on professional identity development, professional and clinical interactions, clinical assessments and interventions, as well as personal decisions regarding career trajectory. This study's findings lay the foundation for future research on the effect of this bias on education, clinical practice, and career identity and longevity within the profession, as well as interventions to reduce implicit gender-career biases.

The 2019 coronavirus disease pandemic underlined a shift in attitudes against vaccines and a rise in hesitancy among some members of the population, despite the overwhelming evidence that vaccinations are one of the most successful and safe health interventions. Research has shown that vaccine hesitancy is complex and can result from an intersectionality of multiple factors. Research has also shown that to tackle vaccine hesitancy in the community, health care workers play a pivotal role, as they are trusted sources who can provide reliable information and can address vaccination concerns for the public. Unfortunately, health care workers are also susceptible to vaccine hesitancy. Thus, to curb these negative attitudes and doubts against vaccinations, we propose to improve vaccine competency among health science students, who are the future health workforce. Here, we propose a comprehensive pedagogical approach that aims to improve the vaccine literacy in this student population in two urban community colleges. The approach includes the use of high-impact pedagogical interventions to achieve three main objectives: (i) to teach students the nature and process of science to have them become "competent outsiders"; (ii) to enhance students' knowledge of the complex science behind emerging infectious diseases and vaccine action, adopting a learner-centered and concept-focused instructional design, and (iii) to address the social, cultural, and historical aspects of vaccine development and the historical and present inequities that characterize this health intervention.

Background: The number of children with autism spectrum disorder (ASD) is rapidly increasing globally and requires a supportive educational system to meet the needs of these children. Aim: The study assessed challenges faced by teachers of children with ASD in the public special schools of the Limpopo province, South Africa. Setting: The study was conducted in seven public special schools in the Limpopo province, South Africa. Methods: Face-to-face semistructured interviews were conducted with 12 teachers regarding the challenges they face in educating children with ASD. Tesch's inductive, descriptive open coding technique enabled the researcher to analyse and report, subthemes that emerged from this qualitative explorative and descriptive data. Measures to ensure trustworthiness and ethical considerations were carried out throughout the study. Results: Analysis of the interviews revealed that the structure and systems of special schools do not support the educational needs of children with ASD. The strategic plans and policy framework on inclusive education are not being executed adequately. Learning for ASD children is not supported because of substandard infrastructure, curricula, lack of teaching material, health practitioners, unbalanced teacher-learner ratio, inadequate staff skills, school culture, shared beliefs and lack of management support. Conclusion: The study revealed challenges faced by special education teachers indicating the influence on the provision of high-quality education to children with ASD. The Department of Basic Education at the national level should monitor all special schools regularly, provide the necessary support and ensure that the complex needs of children with ASD are met. Contribution: The study contributes to understanding of the challenges faced by teachers of children with ASD in providing high quality of education and affirm sound basis of advance information to monitor and evaluate the education of children with ASD in special public schools, which is within the scope of the journal.

Mindset is defined as an individual's beliefs about their inherent characteristics and whether or not those characteristics can be developed. Growth mindsets have been associated with improved academic performance and resilience and may benefit students transitioning to graduate health professions education. This study examined the relationships between mindset, learning behaviors, and learning outcomes of first-semester graduate health professions students enrolled in a neuroanatomy course and examined other factors that may impact academic performance. Forty-one participants completed an electronic survey that included demographics and a mindset questionnaire. Learning outcomes, or grades, and learning behaviors, including office hour and tutoring session attendance, participation in bonus activities, and email correspondence with the course instructor, were collected. Based upon the mindset questionnaire, 10 participants were categorized as "strong growth", 28 participants as "growth with some fixed", and 3 participants as "fixed with some growth". There were no significant differences in mindset score based upon demographic characteristics. No significant correlations were found between mindset score, learning behaviors, or learning outcomes. Using a multivariable model, the factors that best predicted overall course grade were undergraduate grade point average (GPA) and number of prerequisite courses taken. While the lack of heterogeneity in mindset impacts the ability to determine potential relationships between studied variables, this study demonstrates that graduate health professions students largely have growth mindsets, perform well on academic assessments, including undergraduate coursework, and demonstrate frequent positive learning behaviors. Developing and reinforcing these behaviors as undergraduates may positively impact future success at the graduate level.

YouTube contains videos that provide information about many health conditions. Patients and healthcare professionals frequently use YouTube to obtain information. The calcaneal spur (heel spur) is a bony outgrowth of the calcaneal tuberosity in the form of osteophytes. In this study, we aimed to determine the quality and reliability of YouTube videos about the calcaneal spur, whose prevalence increases with age and is more common in those with osteoarthritis. Search was made with the keywords 'Calcaneal spur' and 'heel spur'. Of the 300 videos reviewed, 104 were included in the study. The number of days since the videos were uploaded, the number of views, likes, dislikes, comments and the duration of the videos were recorded. The DISCERN tool and the Global Quality Scale (GQS) were used to evaluate the reliability and quality of the videos. Most of the video presenters were healthcare professionals (79.80%). In 65.4%, the target audience was patients. 61.4% of the videos were low quality, 32.69% medium quality, 5.77% high quality. There was no difference between health professionals and non-health professionals in terms of quality and reliability. This study showed that most of the information provided by YouTube videos about the calcaneal spur is not reliable and inconsistent. YouTube should consider collaborating with database platforms, which is constantly updated and equipped with evidence-based information, to provide reliable health information on many health issues, including the calcaneal spur.

This study illuminates community partner perspectives regarding their relationship with a public academic health center (AHC) in a health care shortage area (HCSA). Community-based and statewide leadership invested deeply in the AHC's programs and initiatives to prepare health care providers for practice in the region, to decrease the provider shortage and improve local health care outcomes. The mixed-methods study sought to identify current community engagement partnerships and examine relationships from the perspective of community partners. Phase 1 of the study utilized an adaptation of the Outreach and Engagement Measurement Instrument (OEMI) as a survey to gather data from employees at the institution. Phase 2 of the study gathered data from the community partners through communities of interest focus groups. Data was analyzed using the Kellogg Commission's seven-part test of engagement. Findings from the survey identified community partner perspectives that informed AHC and partner collaborations during a period of multiple crises.

Effective health service delivery hinges on the interface between professionals rendering health services to the sick and the injured. This paper examined the inter-professional collaboration and knowledge management practices among the clinical workforce in Federal Tertiary Hospitals in three Geopolitical Zones of Nigeria. The study employed a non-experimental survey design. 550 questionnaires were administered out of which 479 were completed for analysis comprising 204 Medical Doctors, 180 Nurses and 95 Health Information Management Officers, which resulted into 87% response rate. Findings from the study revealed that knowledge acquisition was the most practiced, closely followed by knowledge application. In addition, cooperation was the most practiced form of inter-professional collaboration, next to it is partnership. The study revealed a significant relationship between inter-professional collaboration and knowledge management practices. It shows that only cooperation significantly influenced knowledge management practices while knowledge capturing and knowledge dissemination significantly influenced inter-professional collaboration. The study concluded that Federal Tertiary Hospitals in Nigeria will perform better if they can sustain the culture of knowledge management practices and inter-professional collaboration.

Health care in the 21st century has emphasised science and technology-centred practice, which might lead to dehumanisation such that healthcare professionals come to treat patients less like persons and more like objects. A programme of humanities for healthcare professionals has been suggested as a solution to overcome the problem of dehumanisation. The OMNIBUS programme was developed in humanities curriculum for a Catholic nursing programme to foster students to have attributes of a 'Good Samaritan', a model for compassionate professional. This paper describes the effect of a four-year nursing programme with a humanities curriculum on students' compassionate attributes including bioethics awareness, cultural competency, empathy, and spirituality. It was a secondary data analysis using time-series data collected from nursing students. The levels of bioethics awareness and spirituality among the nursing students have improved. They maintained cultural competencies and empathy skills over time. Developing a humanities curriculum can be used as a strategy to teach Christian values to professional students without emphasising religious aspects.

This study adds to creativity research by investigating the connection between employees' ruminations about life-threatening crises and their creative work behavior, with a specific focus on the mediating role of their experiences of personal life-to-work conflict and the moderating role of their resilience in this connection. Cross-sectional survey data (N = 710) gathered from employees who operate in the health-related distribution sector indicate that a key factor that underpins the connection between persistent worries about deadly crises and thwarted creativity at work is that personal life worries spill over into the work domain, but this detrimental effect is less salient if employees can bounce back from difficult situations. For organizations, this investigation reveals a critical conduit, personal life - induced work strain, through which employees' struggles to ban negative thoughts about excruciating crises translate into a lower propensity to develop novel ideas for organizational improvement. It also reveals how organizations can mitigate this risk by making their workforce more resilient.

The paper delves into social media mining in the context of medical education programs in the information age. It explores the adaptability of Social Media Analytics (SMA) apps within the structure of online courses in medicine and proposes a conceptual framework for a learning process. This process includes practical exercises based on search and social media mining in the healthcare industry, relying on technology solutions. An online course, "Managing Digital Content for Health Professionals", was developed at I.M. Sechenov First Moscow State Medical University to expand the understanding of digital content management processes, the specific details of in-depth social media analysis, and transforming social data into valuable knowledge for health professionals. The study group consisted of 108 participants. Throughout the course, students were tasked to ascertaining the effects gained during practical training and evaluating them. Participants identified the key professional and socio-personal effects of the practical training. Following the evaluation of the online apps' feature sets, the authors concluded that social media analytics requires a comprehensive approach, the synergy of digital tools, a strategy for adapting the mining to the field of expertise, and the paradigm of data synthesis and use.

Social workers frequent interprofessional healthcare teams. However, there are no identified systematic reviews to analyze efforts in social work education to engage in healthcare-focused interprofessional education (IPE). The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for a systematic scoping review were utilized for reporting purposes. Arksey and O'Malley's methodological framework was used to 1) identify the research question, 2) identify relevant studies, 3) select relevant studies, 4) chart the data, and 5) report results. The final analysis included 49 articles. During data extraction, the following categories were utilized to organize findings: 1) Attitudes, 2) Infrastructure development, 3) Descriptive articles, and 4) Outcomes studies. Most of the IPE interventions include IPE courses, events, and fellowships. The majority of studies provided favorable results for IPE. Infrastructure and institutional support is critical to successful IPE implementation. More research is needed utilizing rigorous designs to assess the longitudinal efficacy of IPE interventions.

This paper considers the ethical and practical issues of recruiting for, and administering a quantitative survey with marginalised populations. These issues were identified through a focus group discussion, which consolidated and expanded upon informal conversations held previously by five researchers about their experiences of conducting a face-to-face survey (using predominantly quantitative questions) with people who used amphetamine type substances in North East England, UK. Inductive and deductive thematic analysis of the focus group discussion led to the generation of three key themes: researcher positionality, emotions, and role dilemmas; study design; and ethics in practice. This paper therefore aims to extend literature which explores ethical and practical issues involved in studies with marginalised populations. It makes methodological suggestions for how work across a range of disciplines could make face-to-face survey research, and future studies with marginalised populations, more inclusive for both participants and researchers.

Objective: To explore experiences, beliefs, and information-seeking behavior around COVID-19 among college students in Oklahoma. Participants: Fifteen college students participated during the pandemic period from April to July 2020. Methods: An exploratory, qualitative research approach method was used to discover students' experiences, beliefs, and information-seeking behaviors around COVID-19. Exploration of beliefs was guided by the Health Belief Model. Results: Students engaged in COVID-19 information-seeking behaviors predominantly through Internet sites, broadcast news, health professionals, and governmental sources. Students experienced emotional burden as a result of COVID-19 misinformation in these sources. While most students perceived a low chance of acquiring the virus due to their lack of underlying medical conditions, they were still concerned about the consequences of becoming infected. Students noted the difficulty of physical distancing while on campus. Conclusions: Colleges/universities should maximize the dissemination of timely, valid health information for the safety of their students and the broader community.

Introduction: Family members are often the main provider of informal support to people with mild intellectual disabilities. In the current study, we explored whether their family-based social capital is prospectively associated with their wellbeing and emotional and behavioral problems. Methods: Sixty-nine participants with mild intellectual disabilities and key (proxy reporting) staff members participated in two waves of data collection (T1, T2). Data were collected about family-based social capital (FNM-ID), subjective wellbeing (PWI-ID), and emotional and behavioral problems (ABCL, BPI-01). Results: People who reported less support provision to family members and more reciprocal family support relationships at T1 experienced higher levels of internalizing behavior problems at T2, after accounting for T1 levels of internalizing behavior problems. No other associations were found between earlier family-based social capital dimensions and psychological outcomes at T2. Conclusion: Our study provides initial insights regarding the prospective associations between the family-based social capital of people with mild intellectual disabilities and their wellbeing and emotional and behavioral problems. Future studies should include larger samples to investigate if our preliminary results are replicated.

Purpose: The purpose of this study is to propose a research model based on the stimulus-organism-response (S-O-R) model to examine whether media richness (MR), human-system interaction (HSI) and human-human interaction (HHI) as technological feature antecedents to medical professionals' learning engagement (LE) can affect their learning persistence (LP) in massive open online courses (MOOCs). Design/methodology/approach: Sample data for this study were collected from medical professionals at six university-/medical university-affiliated hospitals in Taiwan. A total of 600 questionnaires were distributed, and 309 (51.5%) usable questionnaires were analyzed using structural equation modeling in this study. Findings: This study certified that medical professionals' perceived MR, HSI and HHI in MOOCs positively affected their emotional LE, cognitive LE and social LE elicited by MOOCs, which together explained their LP in MOOCs. The results support all proposed hypotheses and the research model accounts for 84.1% of the variance in medical professionals' LP in MOOCs. Originality/value: This study uses the S-O-R model as a theoretical base to construct medical professionals' LP in MOOCs as a series of the psychological process, which is affected by MR and interaction (i.e. HSI and HHI). Noteworthily, three psychological constructs, emotional LE, cognitive LE and social LE, are adopted to represent medical professionals' organisms of MOOCs adoption. To date, hedonic/utilitarian concepts are more commonly adopted as organisms in prior studies using the S-O-R model and psychological constructs have received lesser attention. Hence, this study enriches the S-O-R model into an invaluable context, and this study's contribution on the application of capturing psychological constructs for completely explaining three types of technological features as external stimuli to medical professionals' LP in MOOCs is well-documented.

Background: Pediatric programs focused on treating chronic pain often do not include an educational liaison (EL) to coordinate services between the patient's medical home and school. As chronic pain in youth can have deleterious effects on school functioning, collaboration between the medical home and the school system are needed to assure these students receive appropriate accommodations. Contributions to Theory: This manuscript describes a model of coordinated care for students with chronic pain that includes a systemic strategy for collaborative care across settings. Specifically, the role of an EL is described in the context of advocating for the patient to receive appropriate educational accommodations. Conclusions: This paper provides a guide for caregivers and professionals to assure appropriate access to support services across settings. Recommendations are included for school accommodations and services to improve academic functioning and outcomes for students with chronic pain.

Objective: Over the past three decades, cultural competence has been widely promoted in the health disciplines, including in health education and promotion, as a tool to address health disparities and promote health equity among diverse populations. Cultural intelligence (CQ), or the individual's capability to adjust to cultural situations based on multiple factors including cognitive, metacognitive, motivational and behavioural characteristics, can be another useful tool when addressing the needs of diverse groups. The goal of this study was to assess the level of CQ among health education specialists and its relationship with cultural competence skills (CCS) among members of this group. Design: Five hundred and forty randomly selected health education specialists in the USA completed an online survey. The survey included questions to assess CQ, CCS and demographic information. Descriptive statistics and analysis of variance were used to analyse the data. Results: Results from the study showed that there was a significant variation in CQ among health education specialists based on race/ethnicity, education, the percentage of cultural/racial/ethnic diverse people they serve, and participation in professional development training. There was also a positive correlation between CQ and CCS, and between each of the CQ capabilities and CCS. Finally, both CQ metacognitive and cognitive capabilities were significant predictors of the overall CCS score. Conclusion: Findings from this study showed that CQ is associated with CCS among health education specialists. The results of the study suggest that health education specialists should consider CQ a useful tool with which to increase CCS.