Journal of evaluation in clinical practice
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Background This article responds to one by Graham Martin and colleagues, who offered a critique of my previous publications on face coverings for the lay public in the Covid-19 pandemic. Their paper reflects criticisms that have been made of face coverings policies more generally. Method Narrative rebuttal. ⋯ I challenge my critics' apparent assumption that a particular kind of systematic review should be valorised over narrative and real-world evidence, since stories are crucial to both our scientific understanding and our moral imagination. Conclusion I conclude by thanking my academic adversaries for the intellectual sparring match, but exhort them to remember our professional accountability to a society in crisis. It is time to lay straw men to rest and embrace the full range of evidence in the context of the perilous threat the world is now facing.
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Review
The effect of acute coronary syndrome care pathways on in-hospital patients: A systematic review.
Health care institutions need to construct management strategies for patients diagnosed with acute coronary syndrome (ACS) that focus on evidence-based treatments, adherence to treatment guidelines, and organized care. These help to reduce variations as well as the mortality and morbidity rates, which indicates the critical need for standardized care and adherence to evidence-based practices for patients hospitalized with ACS. The care pathways translate research and guidelines into clinical practice to close the gap between the guidelines and the clinical practices. ⋯ Implementing ACS care pathway helps to organize care processes and decrease treatment delays as well as improve the patient outcomes without adverse consequences for patients or additional resources and costs. While the current level of evidence is inadequate to warrant a formal recommendation, there is a need for more studies with an emphasis on well-designed randomization to measure patient outcomes.
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Seasonal flu represents a major public health issue, especially for health care workers (HCWs). WHO highlights the need of higher awareness and flu vaccine coverage among HCWs. In Europe the coverage is less than 30-40%. Italy reports some of the lowest rates. The paper aims to illustrate the 2017/2018 flu vaccination campaign within Molinette, the third Italian hospital for dimensions, to provide inputs about strategies for increasing HCWs coverage. The campaign objective was to increase the administered doses at least of 30%. ⋯ A combined campaign, that includes actions for education, increase of awareness, improved access to facilities and active offers to workers has potentiality but there is still work to do. The vaccination increase was determined mostly by the re-organization of the occupational medicine, while the MVUs were useful to HCWs of detached offices.
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In 2015, Queen's University embarked on an institution-wide transition to a competency-based medical education (CBME) curriculum for all 29 postgraduate medical education programmes. On 1 July 2017, this goal was accomplished. With this mass transition came the requirement to assess the efficacy of implementation through a programme evaluation process, which included the use of outcome harvesting (Wilson-Grau). Outcome harvesting identified the intended and unintended outcomes of CBME implementation, which helped us understand how the intervention was achieved and how the relationship between behaviours and stakeholders contributed to the successful transition. ⋯ Using outcome harvesting to assess the efficacy of CBME implementation produced a robust set of themes and resultant outcomes that can be categorized as requirements for success of implementation of any curricular innovation. Emergent themes included collaboration, community of practice, and stakeholder commitment. More unique observations noted through the harvest process included new policy development, creation of learner ownership, and an increase in the output of scholarly activity involving CBME.
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Within competency-based medical education, self-regulated learning (SRL) requires residents to leverage self-assessment and faculty feedback. We sought to investigate the potential for competency-based assessments to foster SRL by quantifying the relationship between faculty feedback and entrustment ratings as well as the congruence between faculty assessment and resident self-assessment. ⋯ Minimal and inconsistent associations were found between narrative and numerical feedback. Performance monitoring accuracy and feedback should be included in assessment validation.