Evaluation & the Health Professions最新文献

This study aimed to adapt the Social Participation Restrictions Questionnaire (SPaRQ) into Turkish (SPaRQ-T) and assess its validity and reliability for evaluating participation restrictions in adults with hearing loss. A cross-sectional, multicenter study was conducted with 278 individuals with hearing loss who had used hearing aids for at least one year. The adaptation process followed international guidelines, including back-translation and expert evaluation. Rasch analysis, test-retest reliability, and concurrent validity assessments were performed.The SPaRQ-T demonstrated strong internal consistency (Cronbach's α = 0.926 for Social Behaviors and 0.871 for Social Perceptions) and test-retest reliability (ICC = 0.928 and 0.773, respectively). Rasch analysis confirmed the unidimensionality of both subscales and supported good model fit. The SPaRQ-T is a reliable and valid instrument for assessing social participation restrictions in Turkish-speaking adults with hearing loss. It provides a comprehensive evaluation of the social and emotional dimensions of participation and can be used in clinical and research settings.

Clinical empathy is central to the physician-patient relationship, and there is an increasing need for valid and reliable instruments to assess self-reported clinical empathy. Although the Consultation and Relational Empathy (CARE) Measure is widely used in its patient-reported form, it has not been validated for physician self-assessment. This study examined the construct validity and internal consistency of the Portuguese self-report version of the CARE Measure in 221 physicians who completed an online survey. The sample was randomly divided into two subsamples for exploratory and confirmatory factor analyses (EFA and CFA). Measurement invariance was tested across gender, age, and professional status. Internal consistency, convergent validity, and known-groups validity were also evaluated. EFA revealed a two-factor structure - Cognitive and Affective Empathy - supported by CFA. Measurement invariance was confirmed across gender, age, and professional status. The scale showed good internal consistency for both factors. Convergent validity was indicated by correlations with communication competence and therapeutic relationship quality. Known-groups validity was demonstrated by higher cognitive empathy scores among physicians aged 41 and older and among men. These findings provide robust evidence for the validity and reliability of the Portuguese self-report CARE Measure, supporting its use in clinical training, self-assessment, and empathy research.

Active, student-centred teaching strategies are increasingly being adopted to bridge the gap between biomedical knowledge and clinical performance in health-profession education. This systematic review and meta-analysis aims to evaluate the comparative effectiveness of five student-centred educational approaches in medical students' knowledge acquisition and clinical skills performance. We conducted a systematic review with random-effects meta-analysis of 21 controlled trials enrolling 1,028 intervention and 961 control participants. Outcomes were classified as knowledge based (MCQ or written exams; n = 11) or skills based (Objective Structured Clinical Examination, Objective Structured Assessment of Technical Skills, Script Concordance Test; n = 10). Interventions were grouped into five categories: case-based methods, conventional simulation, virtual reality (VR)/video simulation, artificial intelligence-guided tutoring and flipped/outcome-based formats. Heterogeneity was assessed using I² and τ², with leave-one-out and trim-and-fill sensitivity analyses, and subgroup differences were tested by χ². Knowledge-based outcomes showed a pooled Hedges' g of 1.40 (95% confidence interval [CI] 0.78-2.01; I² = 95.0%), whereas skills-based outcomes yielded 3.11 (95% CI 1.83-4.39; I² = 97.7%), with a significant domain difference (χ² = 5.60, p = 0.018). Subgroup analysis by pedagogical mechanism demonstrated significant effect variation (χ² = 15.03, df = 4, p = 0.018), with conventional simulation and VR/video simulation producing the largest gains. It should be noted that some categories, such as AI-guided tutoring, were represented by only a single study. Despite extreme heterogeneity, sensitivity analyses confirmed robustness, and publication bias minimally attenuated skills-based estimates. Student-centred approaches markedly outperform lectures for both knowledge acquisition and clinical skills, notably with simulation-based methods. Educators should integrate these strategies according to learning objectives and context. This study provides novel comparative evidence that the magnitude of benefit varies substantially across pedagogical approaches, with conventional simulation showing the greatest impact on skill acquisition, a distinction crucial for strategic curriculum design. Future research should explore long-term outcomes, cost-effectiveness and patient-care impact.

The objective was to analyze the factorial structure, reliability, and cross-national measurement invariance of the 8-item Short Form Health Survey (SF-8) in 1,940 individuals from five Latin American countries (El Salvador, Honduras, Guatemala, Colombia, and Venezuela). Five CFA models were estimated based on previous findings and considerations of the content validity. The results indicated that the two-factor model (physical and mental health) without items 1 and 5 provided the best fit across all countries. Item 5 was removed due to low factor loadings in all estimated models and across all countries, while item 1 was removed because it was too general, making it difficult to determine whether it measured physical or mental health. The six-item version (SF-6) demonstrated adequate reliability and strict invariance across all countries in the invariance sequence models. The reported differences in physical and mental health dimensions were negligible and minor among all countries. In conclusion, a 6-item version of the Short Form Health Survey (SF-6) was proposed, which is better represented by two dimensions (physical and mental health) and is invariant across Latin American countries.

Psychosocial factors such as organizational cynicism and work motivation are associated with clinical outcomes, along with the knowledge and skills of medical professionals. Oncology surgeons, in particular, represent a critical group in terms of patient safety and mortality due to the high-risk surgical environment. The study aims to examine the association of organizational cynicism, work motivation, and professional and demographic characteristics of oncology surgeons with patient mortality. Face-to-face interviews were conducted with 107 surgeons practicing in Türkiye to collect data. A cross-sectional, descriptive approach was selected as the research design. The study followed the STROBE checklist for observational research. The Multidimensional Work Motivation Scale (MWMS) and the Organizational Cynicism Scale (OCS) were used as measurement tools. To predict patient mortality rate, negative binomial regression analysis was used. Increased cognitive cynicism (IRR = 1.033, p < .001) and identified regulation (IRR = 1.188, p < .001) were associated with higher patient mortality rate. Contrastingly, increased intrinsic motivation (IRR = 0.944, p < .001) was associated with decreased mortality rate. Furthermore, gender and managerial position were associated with clinical outcomes as control variables. Reducing organizational cynicism and supporting autonomous motivation may inform strategic approaches to strengthening patient safety.

Program evaluation is essential for medical schools to demonstrate social accountability and identify areas for improvement in medical education (MEd). Although stakeholder engagement is crucial in program evaluation, no previous review has specifically examined the stakeholders involved in MEd program evaluation. This scoping review addresses this gap by identifying the stakeholders, their roles, and their levels of engagement in evaluating MEd programs, along with the facilitators and barriers to their participation. Through a systematic search across four databases, we identified 53 relevant studies out of 7206 screened. Our findings reveal seven primary stakeholder groups, with students and program directors being the most frequent participants. However, a significant gap exists in the representation of community members and patients, indicating a need for greater inclusion of these key stakeholders. Additionally, we found that stakeholders are primarily engaged as passive participants providing feedback rather than actively shaping the evaluation process. Facilitators and barriers to participation were identified from the participants' perspective, highlighting the need for further research to understand the viewpoints of active stakeholders, such as faculty and administrators. Future studies should also explore the impact of different evaluation approaches on stakeholder engagement to develop more inclusive and effective MEd program evaluations.

This systematic review provides an overview of the unique challenges allied health professions face in the translation and implementation of evidence into practice, which remain relatively under reported and uninformed by a theoretical basis of behaviour change. MEDLINE, EMBASE, CINAHL and Scopus databases from 2010 to 2022 were searched for primary study designs resulting in 21 articles included in this review (PROSPERO: 2022 CRD42022314996). Allied health disciplines reported in the review were mainly from occupational therapy, physiotherapy, dietetics, and speech pathology. The most frequently reported implementation determinants across the Theoretical Domains Framework were identified as 'environmental context and resources', and 'knowledge'. The results also identified a greater influence of 'social influences' and 'beliefs about consequences' in implementation. Implementing evidence into clinical practice is a multifaceted, complex process, and the use of the Theoretical Domains Framework provided a systematic approach to understanding the drivers behind the target behaviours. However, there is a paucity of studies across the allied health professions that describe implementation strategies used and their impact. Many of the studies focused on implementation by the individual clinician rather than the role organizations can play in the translation of evidence into practice.

The goal of maintenance of certification (MOC) activities is to ensure physicians are up to date on current practices and demonstrate the knowledge and skills required to provide patients with optimal care. The program's aim is to promote professional development, lifelong learning and quality assurance for the public and medical community. However, physicians are not happy with the current structure of the program, claiming it to be time-consuming, expensive and ineffective for their practice. The lack of concrete evidence confirming the efficacy of MOC in improving knowledge and clinical outcomes causes many to question how this system can be improved to better serve practitioners and the public. In this commentary, we provide an overview of the current MOC situation for U.S. specialists and highlight the importance of increasing research to inform evidence-based changes that can be applied to clinical situations.

Effective feedback is crucial for educating health professions students. This systematic review investigates the impact of extrinsic feedback on health professions students, encompassing medical, dental, and nursing fields. Through meticulous gathering and analysis of 37 studies, this review highlights verbal and visual feedback as predominant forms, often delivered immediately by instructors and supplemented by peer or simulated input. Notably, technology is increasingly utilised to enhance the provision of feedback. The impacts of feedback span various domains, including surgical skills and patient communication, revealing notable improvements in procedural skills such as suturing and knot-tying, as well as general patient communication proficiency. Meta-analyses underscore significant enhancements in communication skills and provide nuanced insights into chest compression techniques. Overall, the findings provide initial evidence that extrinsic feedback enhances surgical procedural skills and general patient communication proficiency among health professions students. The evolving role of technology in feedback provision is promising. Future studies should assess extrinsic feedback across different health professions to better understand its impacts and alignment with specific educational needs and accreditation standards, thereby enhancing learning outcomes.

This study's purpose was to assess the prevalence and characteristics of highly and poorly rated attending physicians as well as the evaluation's reliability and validity. Medicine residents evaluated attending physicians (2013-2024) on eight teaching domains (clarity, supervision, skills, decision-making, expectations, feedback, approachability and overall effectiveness). Overall teaching effectiveness was dichotomized into "highly rated" (scores of 5) and "poorly rated" (scores of ≤3). We assessed correlates of highly and poorly rated attending physicians using generalized latent and linear and mixed methods. Validity and reliability were assessed using factor analysis, Cronbach's alpha and intra-class correlation coefficients. Among 20,150 evaluations of 668 attending physicians by 814 residents, 67% were rated highly (n = 12,801) and 9% were poorly rated (n = 1,754). Highly rated attendings explained decisions (OR: 5.1, 95% CI: 3.l-7.0), were clear (OR: 3.2, 95% CI: 2.4-4.4), approachable (OR: 2.9, 95% CI: 2.2-3.9) and demonstrated skills (OR: 3.2, 95% CI: 2.4-4.3). Poorly rated attending physicians received multiple poor ratings (74%) and lower scores on all teaching domains. Ratings were reliable and consistent, but had low levels of agreement by residents. We conclude that attending physicians were commonly highly rated. While uncommon, poor ratings are better discriminators of teaching quality than highly rated ones.