OBJECTIVES: A Womans University College of Medicine faces curriculum reform in 2020. To determine what reforms are needed in the premedical curriculum, a needs assessment was conducted.METHODS: This study utilizes qualitative study method. A focus group interview was conducted with four students who completed premedical courses from November to December 2018. Interviews were conducted in two groups by grade level, and each interview was recorded. After transcribing the recorded contents, four researchers analyzed the data using conventional content analysis.RESULTS: Students chose A Womans University College of Medicine considering their future careers as female medical professionals and other considerations such as scholarships. The students expected diverse experiences, exchanges with students in different departments, and fusion of medicine with other fields during their premedical years. Overall, these expectations were met during the course, but individual needs for customized education, such as liberal arts, were unmet. In general, students' attitudes toward premedical courses were very motivated and they actively used resources provided by the university.CONCLUSION: Qualitative research can provide a better understanding of quantitative data, such as a student survey performed to prepare for curriculum reform. Based on this understanding, the curriculum will be reformed to reflect the educational needs of students, to motivate students and to provide satisfactory education.
Curriculum ; Education ; Education, Medical ; Fellowships and Scholarships ; Female ; Focus Groups ; Humans ; Methods ; Needs Assessment ; Program Evaluation ; Qualitative Research ; Students, Premedical

INTRODUCTION: Dental caries, which is prevalent in Singapore preschoolers, is a disease that has a major impact on children's health and places a high cost on the society and health services. Oral health programmes for young children implemented in some parts of the world have been shown to be effective in the prevention of dental caries. We aimed to examine the clinical efficacy of a two-year oral health programme for infants and toddlers in Singapore. METHODS: 90 children and their caregivers participated in the programme, and 64 children, who were 24 months older than the intervention group at the initial visit, were recruited as controls in a quasi-experimental study design. We evaluated the presence of severe early childhood caries (SECC) and dmfs in the control group at the initial visit and in the intervention group after the completion of the two-year programme. RESULTS: Some children in the intervention (7.8%) and control (31.3%) groups (p < 0.001) had SECC (difference 23.5%, 95% confidence interval 11%-36%). A higher percentage of children in the intervention group had dmfs = 0 and habits associated with low risk for caries. The odds of SECC in the control group were three times higher than that for the intervention group, and the effect was significant (p = 0.037) after adjustment for other significant risk factors. CONCLUSION The preventive oral health programme in Singapore was successful in reducing SECC among infants and toddlers when targeted behaviour modifications were implemented.
Caregivers ; Child, Preschool ; Dental Caries ; prevention & control ; Dentistry ; methods ; Female ; Health Care Costs ; Health Promotion ; Humans ; Infant ; Male ; Oral Health ; Pediatrics ; Program Evaluation ; Regression Analysis ; Research Design ; Risk Factors ; Singapore

Objective: To understand the awareness of hepatic disease related knowledge among hepatic physicians in poverty-stricken counties in China, assess the effectiveness of training and provide a reference for the training in the future. Methods: The training was conducted in 90 clinical hepatic physicians selected from county hospitals in poverty-stricken counties (or cities) in Shanxi and Shaanxi provinces. An examination was conducted before the training, immediately after the training and at 5(th) month after the training, respectively. One-way analysis of variance and χ(2) test were conducted to evaluate the score and the correct rate. Results: The knowledge score was (42.96±14.02) before the training, (62.86±13.28) immediately after the training and (59.03±17.92) at 5(t)h month after the training, and the differences were significant. After the training, the awareness of all aspects of related knowledge was improved, the difference was significant compared to knowledge score before training, and at 5(th) month after the training, the difference was still significant. Conclusion: After the training, the awareness of liver disease related knowledge of clinical hepatic physicians in poverty-stricken counties (cities) in Shanxi and Shaanxi provinces was improved, and the improvement could be maintained for nearly half a year.
Awareness ; China/epidemiology* ; Clinical Competence ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Liver Diseases/therapy* ; Physicians ; Poverty Areas ; Program Evaluation ; Staff Development/methods* ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to develop a program outcomes assessment system based on Course Embedded Assessment for nursing education. METHODS: This study was conducted in accordance with the procedures of the developmental research method. RESULTS: The major results are as follows. 1) The program outcomes were measured according to the Analytic Hierarchy Process. 2) The Course Embedded Assessment matrix was made according to program outcomes' weight, the curriculum-organizing principle, and achievement levels. 3) The Course Embedded Assessment rubric was developed in logical process, and consisted of a performance criterion, and rating scale. The content validity index of the Course Embedded Assessment rubric was 0.85. 4) An evaluation guideline and 12 documents were developed to facilitate the performance of the assessment system. 5) The average content validity index of the Course Embedded Assessment-based program outcomes assessment system was as high as 0.89. CONCLUSION: A Course Embedded Assessment-based program outcomes assessment system is more suitable for accreditation of nursing education than previous studies. Because this system evaluates the process of achievement as well as program outcomes, the results can also serve as immediate feedback to improve the educational process. Above all, this system facilitates that students check their achievements and strive to acquire core competencies in nursing.
Accreditation ; Education, Nursing* ; Humans ; Logic ; Methods ; Nursing* ; Outcome Assessment (Health Care)* ; Program Evaluation

PURPOSE: Postoperative nausea and vomiting (PONV) is very common among postoperative orthopedic surgical patients with patient-controlled analgesia (PCA), especially for narcotics. Therefore, the purpose of this study was to investigate the effects of an evidence-based PONV management protocol on nursing and patient outcomes. METHODS: A methodological study was conducted to develop PONV protocol and a quasi-experimental study to evaluate the effectiveness of protocol. The preliminary PONV protocol was drawn by conducting a systematic review and by reviewing clinical guidelines and best practice recommendations. Validation of the content was done by expert clinicians, and the clinical applicability was evaluated by staff nurses and patients. The effect was evaluated in clinical outcomes associated with PONV and nursing outcomes. RESULTS: In the experimental group, the occurrence of vomiting (z=2.147) was significantly decreased, the maintenance PCA (χ²=4.212) and the satisfaction of patients (z=5.007) were significantly higher. In the outcomes of nurses, the PONV knowledge of nursing care (z=3.791), awareness (z=2.982) and self-efficacy (z=2.745) were higher in the experimental group. The attitude towards evidence-based nursing practice (z=2.446) was significantly positive. CONCLUSION: The results show that an evidence-based approach to the implementation of PONV care is effective in improving patient clinical outcomes and quality of care.
Analgesia, Patient-Controlled ; Clinical Protocols ; Evidence-Based Nursing* ; Humans ; Methods ; Narcotics ; Non-Randomized Controlled Trials as Topic ; Nursing ; Nursing Care ; Orthopedics ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting* ; Practice Guidelines as Topic ; Program Development ; Program Evaluation ; Vomiting

BACKGROUND/AIMS: Nosocomial infections caused by multidrug-resistant (MDR) Acinetobacter baumannii have become public-health problem. However, few studies have evaluated the control of endemic MDR A. baumannii in Intensive Care Units (ICUs). Therefore, we investigated the effectiveness of antimicrobial stewardship and comprehensive intensified infection control measures for controlling endemic MDR A. baumannii in ICUs at a tertiary care center. METHODS: Carbapenem use was strictly restricted through antimicrobial stewardship. Environmental cleaning and disinfection was performed at least 3 times per day in addition to basic infection control measures. Isolation using plastic curtains and contact precautions were applied to patients who were colonized or infected with MDR A. baumannii. The outcome was measured as the incidence density rate of hospital-onset MDR A. baumannii among patients in the ICUs. RESULTS: The incidence density rate of hospital-onset MDR A. baumannii decreased from 22.82 cases per 1,000 patient-days to 2.68 cases per 1,000 patient-days after the interventions were implemented (odds ratio, 0.12; 95% confidence interval, 0.03 to 0.4; p < 0.001). The mean monthly use of carbapenems also decreased from 134.99 +/- 82.26 defined daily doses per 1,000 patient-days to 94.85 +/- 50.98 defined daily doses per 1,000 patient-days (p = 0.016). CONCLUSIONS: Concomitant implementation of strict antimicrobial stewardship and comprehensive infection control measures effectively controlled endemic MDR A. baumannii in our ICUs within 1 year.
Acinetobacter Infections/epidemiology/microbiology/*prevention & control/transmission ; Acinetobacter baumannii/*drug effects/pathogenicity ; Anti-Bacterial Agents/adverse effects/*therapeutic use ; Carbapenems/adverse effects/*therapeutic use ; Chi-Square Distribution ; Cross Infection/epidemiology/microbiology/*prevention & control/transmission ; Disinfection ; *Drug Resistance, Multiple, Bacterial ; *Endemic Diseases ; Hand Disinfection ; Humans ; Incidence ; Infection Control/*methods ; Microbial Sensitivity Tests ; Odds Ratio ; Patient Isolation ; Program Evaluation ; Republic of Korea/epidemiology ; Risk Factors ; Tertiary Care Centers ; Time Factors ; Treatment Outcome

PURPOSE: To evaluate workplace health education as practiced by occupational health managers based on standardized job tasks and suggest priority tasks and areas to be trained. METHODS: The study was conducted between November 10, 2013 and April 30, 2014. The tool used in this study was standardized job tasks of workplace health education for occupational health managers which was developed through methodological steps. It was evaluated by 233 worksite occupational health managers. Data were analyzed using SPSS 21.0. RESULTS: Predicting variables of workplace health education performance were the "analysis and planning" factor, type of enterprise, and form of management. Healthcare professionals and occupational health managers who managed the nonmanufacturing industry showed high importance and low performance level in "analysis and planning" factor. CONCLUSIONS: "Analysis and planning" skill is priority training area for healthcare professionals and occupational health managers who managed nonmanufacturing industry. It is necessary to develop a training curriculum for occupational health managers that include improving analysis of worksites and plans for a health education program.
Adult ; Cross-Sectional Studies ; Female ; Health Education/*methods ; Health Priorities ; Humans ; Male ; Occupational Health/*standards ; Occupational Health Services/organization & administration ; Professional Practice/standards ; Program Evaluation ; Republic of Korea ; *Workplace

Established in 1997, the European New Car Assessment Programme (Euro NCAP) provides consumers with a safety performance assessment for the majority of the most popular cars in Europe. Thanks to its rigorous crash tests, Euro NCAP has rapidly become an important driver safety improvement to new cars. After ten years of rating vehicles, Euro NCAP felt that a change was necessary to stay in tune with rapidly emerging driver assistance and crash avoidance systems and to respond to shifting priorities in road safety. A new overall rating system was introduced that combines the most important aspects of vehicle safety under a single star rating. The overall rating system has allowed Euro NCAP to continue to push for better fitment and higher performance for vehicles sold on the European market. In the coming years, the safety rating is expected to play an important role in the support of the roll-out of highly automated vehicles.
Accident Prevention ; methods ; Accidents, Traffic ; prevention & control ; Automobiles ; standards ; Europe ; Female ; Humans ; Male ; Program Evaluation ; Safety ; standards ; Safety Management ; organization & administration

INTRODUCTIONMetacognition is a cognitive debiasing strategy that clinicians can use to deliberately detach themselves from the immediate context of a clinical decision, which allows them to reflect upon the thinking process. However, cognitive debiasing strategies are often most needed when the clinician cannot afford the time to use them. A mnemonic checklist known as TWED (T = threat, W = what else, E = evidence and D = dispositional factors) was recently created to facilitate metacognition. This study explores the hypothesis that the TWED checklist improves the ability of medical students to make better clinical decisions.

METHODSTwo groups of final-year medical students from Universiti Sains Malaysia, Malaysia, were recruited to participate in this quasi-experimental study. The intervention group (n = 21) received educational intervention that introduced the TWED checklist, while the control group (n = 19) received a tutorial on basic electrocardiography. Post-intervention, both groups received a similar assessment on clinical decision-making based on five case scenarios.

RESULTSThe mean score of the intervention group was significantly higher than that of the control group (18.50 ± 4.45 marks vs. 12.50 ± 2.84 marks, p < 0.001). In three of the five case scenarios, students in the intervention group obtained higher scores than those in the control group.

CONCLUSIONThe results of this study support the use of the TWED checklist to facilitate metacognition in clinical decision-making.

Adult ; Checklist ; Clinical Decision-Making ; methods ; Education, Medical ; methods ; Educational Measurement ; Female ; Humans ; Malaysia ; Male ; Metacognition ; Prejudice ; Program Evaluation ; Students, Medical ; Universities ; Young Adult

PURPOSE: This study was done to evaluate the persistency of effects of an integrated nursing simulation program on interest in learning, recognition of importance of communication, communication skills, and problem-solving abilities. METHOD: Forty-seven nursing students were recruited for this quasi-experimental design research. The experimental group (n=23) performed the simulation program for two weeks, and the control group (n=24) performed traditional clinical nursing practice for two weeks. Data were collected at baseline, immediately after the intervention, at 4 weeks, and finally at 8 weeks. RESULTS: With respect to all variables, no significant differences were found between the experimental group and the control group. Interest in learning showed a significant increase in the control group (F=3.59, p=.018) at 4 weeks, and there was a significant increase in problem-solving abilities in the experimental group (F=4.98, p=.004) immediately after the intervention. CONCLUSION: Findings from this study suggest that the integrated nursing simulation program is as effective as the traditional clinical nursing practice, and the integrated nursing simulation program could be used as an alternative.
Humans ; Learning ; Methods ; Nursing* ; Patient Simulation ; Program Evaluation* ; Students, Nursing