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  • 11
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 101, No. 2 ( 2022-01-14), p. e28570-
    Abstract: Virtual reality (VR)-based simulation in hospital settings facilitates the acquisition of skills without compromising patient safety. Despite regular text-based training, a baseline survey of randomly selected healthcare providers revealed deficiencies in their knowledge , confidence , comfort , and care skills regarding tracheostomy. This prospective pre–post study compared the effectiveness of regular text- and VR-based intervention modules in training healthcare providers ’ self-efficacy in tracheostomy care skills. Methods: Between January 2018 and January 2020, 60 healthcare providers, including physicians, nurses, and respiratory therapists, were enrolled. For the intervention, a newly developed head-mounted display (HMD) and web VR materials were implemented in training and clinical services. Subsequently, in-hospital healthcare providers were trained using either text or head-mounted display virtual reality (HMD-VR) materials in the regular and intervention modules, respectively. For tracheostomy care skills, preceptors directly audited the performance of trainees and provided feedback. Results: At baseline, the degree of trainees ’ agreement with the self-efficacy-related statements, including the aspects of familiarity, confidence , and anxiety about tracheostomy-related knowledge and care skills, were not different between the control and intervention groups. At follow-up stage, compared with the regular group, a higher percentage of intervention group ’ trainees reported that they are “strongly agree” or “somewhat agree” that the HMD-VR simulation increases their self-efficacy, including the aspects of familiarity and confidence , and reduced their anxiety about tracheostomy-related knowledge and care skills. After implementation, a higher degree of trainees ’ average satisfaction with VR-based training and VR materials was observed in the intervention group than in the regular group. Most reported that VR materials enabled accurate messaging and decreased anxiety. The increasing trend of the average written test and hands-on tracheostomy care skills scores among the intervention group trainees was significant compared to those in the regular group. The benefits of HMD-VR simulations and web-VR material-based clinical services for in-hospital healthcare providers and patient families persisted until 3 to 4 weeks later. Conclusion: The current study suggests that VR materials significantly enhance trainees’ self-efficacy (increased familiarity, increased confidence, and reduced anxiety) and their satisfaction with the training, while motivating them to use acquired knowledge and skills in clinical practice.
    Type of Medium: Online Resource
    ISSN: 0025-7974 , 1536-5964
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2049818-4
    detail.hit.zdb_id: 80184-7
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  • 12
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Journal of the Chinese Medical Association Vol. 85, No. 9 ( 2022-09), p. 909-914
    In: Journal of the Chinese Medical Association, Ovid Technologies (Wolters Kluwer Health), Vol. 85, No. 9 ( 2022-09), p. 909-914
    Abstract: In real-world medical education, there is a lack of reliable predictors of future clinical competencies. Hence, we aim to identify the factors associated with clinical competencies and construct a prediction model to identify “improvement required” trainees. Methods: We analyzed data from medical students who graduated from National Yang-Ming University with clerkship training and participated in the postgraduate year (PGY) interview at Taipei Veterans General Hospital. Clinical competencies were evaluated using grades of national objective structured clinical examination (OSCEs). This study used data from medical students who graduated in July 2018 as the derivation cohort (N = 50) and those who graduated in July 2020 (n = 56) for validation. Results: Medical school grades were associated with the performance of national OSCEs (Pearson r = 0.34, p = 0.017), but the grades of the structured PGY interviews were marginally associated with the national OSCE (Pearson r = 0.268, p = 0.06). A prediction model was constructed to identify “improvement required” trainees, defined: trainees with the lowest 25% of scores in the national OSCEs. According to this model, trainees with the lowest 25% medical school grades predicted a higher risk of the “improvement required” clinical performance (Q1–Q3 vs Q4 = 15% vs 60%, odds ratio = 8.5 [95% confidence interval = 1.8-39.4], p = 0.029). In the validation cohort, our prediction model could accurately classify 76.7% “improvement required” and “nonimprovement required” students. Conclusion: Our study suggests that interventions for students with unsatisfactory medical school grades are warranted to improve their clinical competencies.
    Type of Medium: Online Resource
    ISSN: 1726-4901
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2107283-8
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  • 13
    Online Resource
    Online Resource
    Korea Health Personnel Licensing Examination Institute ; 2019
    In:  Journal of Educational Evaluation for Health Professions Vol. 16 ( 2019-10-11), p. 30-
    In: Journal of Educational Evaluation for Health Professions, Korea Health Personnel Licensing Examination Institute, Vol. 16 ( 2019-10-11), p. 30-
    Abstract: Purpose: In contrast to the core part of the clinical interviewing and physical examination (PE) skills course, corresponding to the basic, head-to-toe, and thoracic systems, learners need structured feedback in the cluster part of the course, which includes the abdominal, neuromuscular, and musculoskeletal systems. This study evaluated the effects of using Dreyfus scale-based feedback, which has elements of continuous professional development, instead of Likert scale-based feedback in the cluster part of training in Taiwan.Methods: Instructors and final-year medical students in the 2015–2016 classes of National Yang-Ming University, Taiwan comprised the regular cohort, whereas those in the 2017–2018 classes formed the intervention cohort. In the intervention cohort, Dreyfus scale-based feedback, rather than Likert scale-based feedback, was used in the cluster part of the course.Results: In the cluster part of the course in the regular cohort, pre-trained standardized patients rated the class climate as poor, and students expressed low satisfaction with the instructors and course and low self-assessed readiness. In comparison with the regular cohort, improved end-of-course group objective structured clinical examination scores after the cluster part were noted in the intervention cohort. In other words, the implementation of Dreyfus scale-based feedback in the intervention cohort for the cluster part improved the deficit in this section of the course.Conclusion: The implementation of Dreyfus scale-based feedback helped instructors to create a good class climate in the cluster part of the clinical interviewing and PE skills course. Simultaneously, this new intervention achieved the goal of promoting medical students’ readiness for interviewing, PE, and self-directed learning.
    Type of Medium: Online Resource
    ISSN: 1975-5937
    Language: English
    Publisher: Korea Health Personnel Licensing Examination Institute
    Publication Date: 2019
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    SSG: 5,3
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  • 14
    Online Resource
    Online Resource
    Korea Health Personnel Licensing Examination Institute ; 2023
    In:  Journal of Educational Evaluation for Health Professions Vol. 20 ( 2023-12-26), p. 37-
    In: Journal of Educational Evaluation for Health Professions, Korea Health Personnel Licensing Examination Institute, Vol. 20 ( 2023-12-26), p. 37-
    Abstract: Purpose: Coronavirus disease 2019 (COVID-19) has heavily impacted medical clinical education in Taiwan. Medical curricula have been altered to minimize exposure and limit transmission. This study investigated the effect of COVID-19 on Taiwanese medical students’ clinical performance using online standardized evaluation systems and explored the factors influencing medical education during the pandemic.Methods: Medical students were scored from 0 to 100 based on their clinical performance from 1/1/2018 to 6/31/2021. The students were placed into pre-COVID-19 (before 2/1/2020) and midst-COVID-19 (on and after 2/1/2020) groups. Each group was further categorized into COVID-19-affected specialties (pulmonary, infectious, and emergency medicine) and other specialties. Generalized estimating equations (GEEs) were used to compare and examine the effects of relevant variables on student performance.Results: In total, 16,944 clinical scores were obtained for COVID-19-affected specialties and other specialties. For the COVID-19-affected specialties, the midst-COVID-19 score (88.513.52) was significantly lower than the pre-COVID-19 score (90.143.55) (P 〈 0.0001). For the other specialties, the midst-COVID-19 score (88.323.68) was also significantly lower than the pre-COVID-19 score (90.063.58) (P 〈 0.0001). There were 1,322 students (837 males and 485 females). Male students had significantly lower scores than female students (89.333.68 vs. 89.993.66, P=0.0017). GEE analysis revealed that the COVID-19 pandemic (unstandardized beta coefficient=-1.99, standard error [SE]=0.13, P 〈 0.0001), COVID-19-affected specialties (B=0.26, SE=0.11, P=0.0184), female students (B=1.10, SE=0.20, P 〈 0.0001), and female attending physicians (B=-0.19, SE=0.08, P=0.0145) were independently associated with students’ scores.Conclusion: COVID-19 negatively impacted medical students' clinical performance, regardless of their specialty. Female students outperformed male students, irrespective of the pandemic.
    Type of Medium: Online Resource
    ISSN: 1975-5937
    Language: English
    Publisher: Korea Health Personnel Licensing Examination Institute
    Publication Date: 2023
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    SSG: 5,3
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  • 15
    In: BMJ Open, BMJ, Vol. 12, No. 1 ( 2022-01), p. e055953-
    Abstract: This study aims to develop preprocedural communication-specific framework that emphasises the use of audiovisual materials and compares its acceptability by trainees with a regular module. Trainees Between October 2018 and July 2021, 96 medical clerks were enrolled and randomly divided into regular and intervention groups. Another 48 trainees whose did not join the framework-based training but complete self-assessments were enrolled as the control group. Interventions In the intervention training module, the key steps of preprocedural communication-specific skills were structuralised into a framework using the acronym of OSCAR. Primary and secondary outcome measures This study compared the acceptability of trainees for two modules by measuring the degree of increase in the end-of-rotation and follow up (4 weeks later) competency from baseline by trainees’ self-assessments and physician assessments after serial trainings. Results In comparison with regular group trainees, greater degree of improvements (framework-1 statement: 111%±13% vs 27%±5%, p 〈 0.001; framework-2 statement: 77%±9% vs 48%±2%, p 〈 0.05; skill-1 statement: 105%±9% vs 48%±3%, p 〈 0.001); skill-2 statement: 71%±11% vs 50%±9%, p 〈 0.05) were noted in the framework-related and skill-related statement 1–2 (the familiarity and confidence to use the framework and skills) than those of intervention group. At the end-of-rotation stage, the trainees ability to use the ‘ A -step: using audiovisual materials’ of the OSCAR was significantly improved (229%±13%, p 〈 0.001), compared with other steps. In the intervention group, the degree of improvement of the end-of-rotation data of trainees’ self-assessment from baseline was significantly correlated with the degree of the improvement in physicians’ assessment data in the aspects of skills, framework and steps in framework (R=0.872, p 〈 0.01; R=0.813, p 〈 0.001; R=0.914, p 〈 0.001). Conclusions The OSCAR framework-based intervention module is well accepted by medical clerks and motivates them to integrate the acquired skills in clinical practice, which leads to trainees’ primary care patients being satisfied with their preprocedural communication.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    Language: English
    Publisher: BMJ
    Publication Date: 2022
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  • 16
    Online Resource
    Online Resource
    Elsevier BV ; 2023
    In:  European Neuropsychopharmacology Vol. 75 ( 2023-10), p. S243-
    In: European Neuropsychopharmacology, Elsevier BV, Vol. 75 ( 2023-10), p. S243-
    Type of Medium: Online Resource
    ISSN: 0924-977X
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 1082947-7
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  • 17
    In: Psychiatry Research, Elsevier BV, Vol. 210, No. 2 ( 2013-12), p. 601-606
    Type of Medium: Online Resource
    ISSN: 0165-1781
    RVK:
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2013
    detail.hit.zdb_id: 445361-X
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  • 18
    In: Journal of Psychiatric Research, Elsevier BV, Vol. 172 ( 2024-04), p. 16-23
    Type of Medium: Online Resource
    ISSN: 0022-3956
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2024
    detail.hit.zdb_id: 3148-3
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  • 19
    In: The Pharmacogenomics Journal, Springer Science and Business Media LLC, Vol. 23, No. 2-3 ( 2023-05), p. 50-59
    Type of Medium: Online Resource
    ISSN: 1470-269X , 1473-1150
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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    detail.hit.zdb_id: 2051501-7
    SSG: 15,3
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  • 20
    In: BMC Psychiatry, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-08-01)
    Abstract: The treatment efficacy varies across individual patients with major depressive disorder (MDD). It lacks robust electroencephalography (EEG) markers for an antidepressant-responsive phenotype. Method This is an observational study enrolling 28 patients with MDD and 33 healthy controls (mean age of 40.7 years, and 71.4% were women). Patients underwent EEG exams at baseline (week0) and week1, while controls’ EEG recordings were acquired only at week0. A resting eye-closing EEG segment was analyzed for functional connectivity (FC). Four parameters were used in FC analysis: (1) node strength (NS), (2) global efficiency (GE), (3) clustering coefficient (CC), and (4) betweenness centrality (BC). Results We found that controls had higher values in delta wave in the indices of NS, GE, BC, and CC than MDD patients at baseline. After treatment with antidepressants, patients’ FC indices improved significantly, including GE, mean CC, and mean NS in the delta wave. The FC in the alpha and beta bands of the responders were higher than those of the non-responders. Conclusions The FC of the MDD patients at baseline without treatment was worse than that of controls. After treatment, the FC improved and was close to the values of controls. Responders showed better FC in the high-frequency bands than non-responders, and this feature exists in both pre-treatment and post-treatment EEG.
    Type of Medium: Online Resource
    ISSN: 1471-244X
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2050438-X
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