Zoekresultaten

The effect of a dermoscopy training program on the diagnostic accuracy and management decisions regarding pigmented skin lesions

Background: Dermoscopy is known to increase the diagnostic accuracy of pigmented skin lesions (PSLs) when used by trained professionals. The effect of dermoscopy training on the diagnostic ability of dermal therapists (DTs) has not been studied so far. Objectives: This study aimed to investigate whether DTs, in comparison with general practitioners (GPs), benefited from a training programme including dermoscopy, in both their ability to differentiate between different forms of PSL and to assign the correct therapeutic strategy. Methods: In total, 24 DTs and 96 GPs attended a training programme on PSLs. Diagnostic skills as well as therapeutic strategy were assessed, prior to the training (pretest) and after the training (post-test) using clinical images alone, as well as after the addition of dermatoscopic images (integrated post-test). Bayesian hypothesis testing was used to determine statistical significance of differences between pretest, post-test and integrated post-test scores. Results: Both the DTs and the GPs demonstrated benefit from the training: at the integrated post-test, the median proportion of correctly diagnosed PSLs was 73% (range 30–90) for GPs and 63% (range 27–80) for DTs. A statistically significant difference between pretest results and integrated test results was seen, with a Bayes factor>100. At 12 percentage points higher, the GPs outperformed DTs in the accuracy of detecting PSLs. Conclusions: The study shows that a training programme focusing on PSLs while including dermoscopy positively impacts detection of PSLs by DTs and GPs. This training programme could form an integral part of the training of DTs in screening procedures, although additional research is needed.

Developing design ability for innovation in healthcare practices

In solving systemic design challenges designers co-create with professionals from various fields. In the context of innovation in healthcare practices, this study investigates design abilities that healthcare professionals develop by participating in co-design projects. We conducted a mixed-methods research approach consisting of five retrospective interviews with healthcare researchers involved in co-design projects, and a multiple case study (three cases) on the collaboration between design researchers and healthcare professionals. The three cases all aimed at designing tools for healthcare innovation. The cases differ in the healthcare context and the professionals involved: Paediatric physical therapists in the treatment of babies (0-2 years), supervisors (e.g. in assisted living) of people with intellectual disabilities, and academic researchers in social sciences and design research developing e-health applications for elderly people with early stages of dementia. Literature states that healthcare professionals may be competent in specific abilities related to design, but they are not trained to mode-shift and to use two different ways of working for creativity. We found that the healthcare professionals involved in co-design projects developed design ability over time, and that the research setting was supportive. Based on design abilities that the five healthcare researchers explicated in the interviews as having adopted, we suggest eight mode-shift practices related to design, which we investigated in the cases. Findings of the case-study show that two mode-shift practices related to design and innovation are difficult to adopt for healthcare professionals: Generate and synthesize; and keeping track on overview and details. These two design abilities require more training and/or experience than the other six design abilities that ran smoothly in the cases, if healthcare professionals were facilitated in the process. Healthcare professionals specifically relate two of these practices to design: Collaboration and slow down – sprint. This study discusses these findings by referring to an analogy of kayaking on a wild water river: The collaboration aspect of switching between working in a group and by yourself, like a group of kayakers who collaborate in going down stream a river but peddle by themselves in their own boats; the slowdown and sprint aspect, like kayakers who oversee the river in turning waters and sprint in between, rather than go with the flow in a raft.

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Evaluation of an interaction-skills training for reducing the burden of family caregivers of patients with severe mental illness

afstudeerscriptie van studente Psychologie Yasmin Gharavi gepubliceerd in BMC Psychiatry: Background: Family members who care for patients with severe mental illness experience emotional distress and report a higher incidence of mental illness than those in the general population. They report feeling inadequately prepared to provide the necessary practical and emotional support for these patients. The MAT training, an Interaction- Skills Training program (IST) for caregivers, was developed to meet those needs. This study used a single-arm pretestposttest design to examine the impact of the training on caregivers’ sense of competence (self-efficacy) and burden.

Designing chatbots for training professionals in child and youth social care

Introduction:Various subjects in child and youth social care, such as sexuality and sexual violence, are quite sensitive, and professionals may experience a certain reluctance to discuss these subjects with their clients (e.g., the young people they work with, as well as their families) and colleagues. An example of such a subject is sexual abuse and unacceptable behavior that may occur with their clients, whether at home, at the youth care institution or somewhere else.It is essential that youth care professionals do not shy away from such a sensitive subject as sexual abuse and know how to talk about it with their clients in a healthy way. Professionals in child and youth social care should dare to educate on this topic, and be trained to deal with the enormous diversity of young people and parents they encounter in their work.Research on application of trained methods shows that receiving training on itself is often not enough to develop strong applicable competences about subjects like sexual abuse and to continue to apply these acquired practical skills in the field in the long term. In order to be able to apply ‘what is learned’ successfully, it is necessary to practice the learned skills in a safe environment, and to regularly refresh those skills. In order to create an opportunity for practicing skills in a safe environment, we have explored the extent to which innovative chatbot technologies can be used to better equip (future) professionals to apply and practice their skills.

Assessing Cranial Nerves in Physical Therapy Practice

Background and objective: Serious pathologies of the neck can potentially result in cranial nerve palsy. Knowledge about cranial nerve examination (CNE) seems sparse, and its use is still unknown. We aim to investigate the knowledge, skills, and utilization of CNE of Italian physiotherapists. Materials and Methods: An online cross-sectional survey. Results: 396 completed the survey, reaching the required sample size. Although Italian physiotherapists consider CNE relevant (mean ± SD = 7.6/10 ± 2.0), over half of all responders (n = 229 (57.8%)) were not trained in the fundamentals and around a third did not use it in their daily practice (n = 138 (34.8%)). Additionally, participants were unconfident and insecure in conducting (n = 152 (38.4%) and n = 147 (37.1%)), interpreting (n = 140 (35.4%) and n = 164 (41.4%)), and managing the CNE (n = 141 (35.6%) and n = 154 (38.9%)). Possessing a musculoskeletal specialization was associated with an increased value attributed to clinical practice guidelines and reduced the lack of confidence in conducting, interpreting, and managing the CNE (respectively, n = 35 (25.5%), p = 0.0001; n = 32 (23.4%) p = 0.0002; n = 32 (23.4%) p = 0.0002). Working in a direct access setting significantly increased the considered relevance of guidelines and the concerns about arterial (p = 0.004) and other serious pathologies (p = 0.021). Pain and visual disturbances were considered the main indicators to CNE, demonstrating limited knowledge of signs and symptoms’ indicating CNE. Participants considered specific training in CNE as relevant (mean ± SD = 7.6/10 = 2.1). Conclusions: a substantial proportion of Italian physiotherapists are not schooled in the fundamentals of cranial nerve examination. Given the number of physiotherapists who work in first contact roles, this is a professional concern.