Journal of evaluation in clinical practice最新文献

{"title":"Inter-Practice Variability in General Practice Consultations With Older Patients: A Cross-Sectional Analysis of the Registrar Clinical Encounters in Training Study","authors":"Adele Kincses,&nbsp;Alexandria Turner,&nbsp;Alison Fielding,&nbsp;Amanda Tapley,&nbsp;Andrew Davey,&nbsp;Dominica Moad,&nbsp;Elizabeth Holliday,&nbsp;Jason Dizon,&nbsp;Mieke van Driel,&nbsp;Parker Magin","doi":"10.1111/jep.70139","DOIUrl":"https://doi.org/10.1111/jep.70139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>General practice is central to older patient care provision. For GP registrars (specialist GPs in training), exposure to older patients is also vital for developing chronic disease and multimorbidity management skills. However, registrars see fewer older patients, and are less engaged with older patient care, than established GPs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This study aimed to assess inter-practice variability in the proportion of older patients seen by Australian GP registrars during training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Cross-sectional analysis from the ReCEnT study of GP registrars' clinical experiences (2010–2023). The outcome was consultation with older (65+ years) patients. Inter-practice variability was assessed with Intraclass Correlation Coefficient (ICC) and Median Odds Ratio (MOR). Outcome variance attributable to practice was estimated within the Bayesian modelling framework using a mixed-effects logistic regression with cross-classified random effects for registrar and practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis included 4643 registrars across 978 practices. 19% (129,659/688,281) of consultations were with older patients. The ICC was 0.15 (95% Credible Interval (CrI) [0.14, 0.17]) in a model with a random effect for practice; and, in a model adjusted for time/registrar/patient/practice variables, 0.10 (CrI [0.09, 0.11]). These values (comparable with, or higher than, reported for other general practice variables), indicate registrars' older patient clinical exposure is dependent upon the practice(s) trained in. The MOR was 2.08 (CrI [(2.00, 2.16]); and, adjusted, 1.81 (CrI [1.76, 1.87). By randomly changing practice location, the odds of a registrar's consultation being with an older patient thus approximately doubles (or, alternatively, halves) on average.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The practice itself is the greatest determinant in registrars' exposure to older patients. Practice-level interventions are essential to improve registrars' in-training older patient care experience.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Voices in Pharmacovigilance: Understanding Adverse Drug Reactions Through Consumer Narratives","authors":"Shatavisa Mukherjee,&nbsp;Siddhartha Roy,&nbsp;Nikhil Era","doi":"10.1111/jep.70164","DOIUrl":"https://doi.org/10.1111/jep.70164","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adverse drug reactions (ADRs) are unintended and harmful responses to medications. Although clinicians and researchers often focus on the clinical aspects and prevention of ADRs, consumers—the patients themselves—experience and interpret these events in personal, social, and cultural contexts. Understanding consumers' perspectives on ADRs is essential to improving communication, therapeutic decision-making, and patient safety strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to explore consumers' views and experiences of ADRs, including their perceptions of risk, attribution of causes, and the impact on medication adherence and trust in healthcare providers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative research design was employed. Purposive sampling was used to recruit adult participants who had experienced at least one ADR or were caregivers of someone with an ADR experience. Four focus group discussions (FGDs) were conducted (<i>n</i> = 28). A semi-structured discussion guide elicited participants' personal accounts and interpretations of ADRs. Data were transcribed verbatim and analyzed using thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six major themes emerged: (1) Understanding and Knowledge of ADRs, (2) Severity and Impact on Daily Life, (3) Trust and Communication with Healthcare Providers, (4) Self-Medication Practices and ADR Risk, (5) Emotional and Psychological Responses, and (6) Recommendations for Improved ADR Awareness and Reporting. Participants expressed anxiety about the unpredictability of ADRs, citing both mild and severe reactions. Many shared difficulties with navigating information sources, feeling that healthcare professionals sometimes minimized or overlooked their concerns. The emotional toll of ADRs ranged from worry and frustration to lowered trust in medical recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Consumers' experiences of ADRs are deeply personal, often influenced by prior knowledge, trust in healthcare providers, and the perceived severity of reactions. Patient-centered communication strategies, clearer information on risks and benefits, and robust ADR reporting mechanisms are recommended to empower consumers and enhance medication safety. Understanding the consumer perspective is pivotal for healthcare policy and practice to reduce the burden of preventable ADRs and to improve patient-centered care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity and Reliability of the Berg Balance Scale in Different Tele-Assessment Methods in Patients With Stroke","authors":"Birol Önal,&nbsp;Nezire Köse,&nbsp;Şeyma Nur Önal,&nbsp;Hatice Yağmur Zengin","doi":"10.1111/jep.70141","DOIUrl":"https://doi.org/10.1111/jep.70141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objective</h3>\u0000 \u0000 <p>Balance evaluation is essential for determining treatment and its effectiveness in stroke patients. Considering the widespread use of telehealth services, it is important to evaluate the applicability of balance scales for teleassessment. The aim in this study was to investigate the reliability and validity of the Berg Balance Scale (BBS) applied using synchronous and asynchronous teleassessment methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Teleassessments were performed by two physiotherapists. Synchronous assessments were conducted online in real time using the application Zoom, while asynchronous assessments involved patients recording videos according to a reference evaluation video sent to them. All tests were repeated 10 days later to assess intrarater reliability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-six stroke patients (mean age 55.9 ± 9.5 years) participated in the study. Both synchronous and asynchronous teleassessments of the Berg Balance Scale (BBS) demonstrated excellent interrater reliability, with ICC values of 0.989 for synchronous and 0.997 for asynchronous assessments. Intrarater reliability was also high, with ICCs ranging from 0.982 to 0.997 across raters and methods. Regarding concurrent validity, synchronous teleassessment BBS scores showed a strong correlation with face-to-face BBS (<i>r</i> = 0.970) and Timed Balance Test (TBT) scores (<i>r</i> = 0.901), while asynchronous assessments also demonstrated strong correlations (BBS: <i>r</i> = 0.945; TBT: <i>r</i> = 0.885). Correlations with postural sway parameters were moderate, ranging from <i>r</i> =−0.40 to −0.54.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that synchronous and asynchronous teleassessment of the BBS may be a viable alternative to face-to-face assessments. However, further research with larger samples is needed to support these findings and increase their generalizability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT05263063.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overlapping Systematic Reviews on the Same Topic: A Systematic Literature Review of Quantitative Research","authors":"Shunlong Ou,&nbsp;Jing Luo,&nbsp;Qian Jiang","doi":"10.1111/jep.70148","DOIUrl":"https://doi.org/10.1111/jep.70148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The number of published systematic reviews has exploded in the past three decades, followed by a large number of overlapping systematic reviews on the same topic. We aim to review the frequency and causes of overlap in systematic reviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following PRISMA 2020 guidelines, we searched PubMed and Embase from inception to March 4, 2024, to identify English-language studies quantitatively assessing overlapping systematic reviews on the same topic. Nonempirical studies and duplicates were excluded. Two researchers independently screened and extracted data, with results analyzed descriptively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eleven quantitative studies were included in this study. Findings revealed that 68% of systematic reviews exhibited overlap, with a maximum of 76 overlapping reviews identified on a single topic. Only 36% overlapping systematic reviews referenced previous studies and a mere of 9% reported protocol registrations. The most mentioned causes for overlap were the omission to reference previous systematic reviews (6; 55%), lack of protocol registration (3; 27%), performance-driven incentives among researchers (3; 27%). Key recommendations to mitigate overlap included mandatory protocol registration (7; 64%), explaining the novelty and innovation of research (5; 45%), strengthening the review of overlap (3; 27%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overlapping systematic reviews undermine evidence reliability due to transparency gaps and methodological weaknesses. Mandatory protocol registration, interdisciplinary collaboration, and adherence to tools like AMSTAR 2 are critical to curb redundancy. Journals must enforce rigorous quality checks and support living reviews. Stakeholders urgently need to standardize definitions of overlap, establish update frameworks, and promote ethical research practices. Addressing these challenges will enhance the efficiency and trustworthiness of evidence synthesis in healthcare.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cross-Sectional Study on the Learning Needs and Satisfaction Levels of Orthopedics and Trauma Surgery Patients at Discharge","authors":"Cemile Nida Kayis,&nbsp;Emine Catal","doi":"10.1111/jep.70145","DOIUrl":"https://doi.org/10.1111/jep.70145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Research on the learning needs of patients after orthopedic and trauma surgery during the discharge process is limited, and this situation constitutes an important research gap in improving nursing practice and increasing patient satisfaction. Because when the patient's learning needs priorities are examined at discharge, it is not clear to what extent these needs have been met.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to determine the priorities in the learning needs of the patients who underwent orthopedic and trauma surgery at discharge, the level of meeting these learning needs, and the satisfaction level of the routine discharge education. Secondly, it was aimed to determine the effects of demographic and clinical characteristics on these.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study is descriptive, correlational and cross-sectional. The sample included 184 patients. The data were collected using the Personal Information Form, the Patient Learning Needs Scale and the Discharge Education Satisfaction Scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this study, 36.9% of the patients' medical diagnoses were prostheses and 63.1% of them were fractures. While the patients found their learning needs at discharge ‘very important’ (190.28 ± 10.83), they rated these needs as ‘neither more or less met’. The patients reported that they cared more about information regarding treatment and complications and improving the quality of life. The patients' satisfaction level with discharge education was also determined as ‘partially satisfied’ (74.09 ± 3.83). The analysis revealed that the significance of patients' discharge learning needs and the extent to which these needs were met were influenced by factors including age, gender, education level, employment status, medical diagnosis, hospitalization history, and surgical history (<i>p</i> &lt; 0.05). However, the level of satisfaction with discharge education remained unaffected by any of these variables (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>It was concluded that the priorities of discharge learning needs in patients who underwent orthopedic and trauma surgery were considered very important, but the satisfaction levels of meeting the needs and discharge education were low.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines on Assistive Products Useful in Pharmacy Practice to Optimize and Ensure Medication Use by Individuals With Visual Impairment: An Interdisciplinary Delphi Consensus","authors":"Théodora Merenda,&nbsp;Stéphanie Patris","doi":"10.1111/jep.70149","DOIUrl":"https://doi.org/10.1111/jep.70149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Visual impairment represents a significant public health challenge that can affect patients ability to accurately identify medications and access essential information about them. A potential solution to address these difficulties is the utilization of assistive products. Consequently, guidelines have been developed in French for Belgian community pharmacists to enhance the safety of individuals with a visual impairment when utilizing medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>To build an interdisciplinary consensus on guidelines for the utilization of assistive products in pharmacy practice, with the aim of ensuring the safe administration of medications by individuals with a visual impairment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Delphi survey for consensus building was conducted by a national panel of experts. The interdisciplinary panel was constituted of ophthalmologists with a specialization in low vision, orthoptists, ergotherapists, psychologists, and community pharmacists. The recommendations were encoded in the form of an online questionnaire and the experts were invited to indicate their degree of agreement on a 9-point Likert scale. Descriptive statistics were produced using IBM SPSS 27 software. This process was repeated until a consensus was reached between all the experts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four rounds of the Delphi method were necessary to the panel of 10 experts to evaluate the 47 recommendations initially submitted. Ultimately, an introduction to the guidelines and 39 recommendations, grouped into six main categories, were validated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The consensus process has enabled us to obtain consolidated recommendations and to ensure their relevance, thus facilitating the dissemination of high-quality content to community pharmacists practising their profession in Belgian pharmacies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Manchester Triage System in the Paediatric Emergency Department—Accuracy of the Nonspecific Presentational Flow Charts","authors":"Tobias G. Strapatsas,&nbsp;Monika Kogej,&nbsp;Uwe Baum,&nbsp;Sabine Keiser,&nbsp;Anna-Lena Lubojanski,&nbsp;Ingo Gräff","doi":"10.1111/jep.70161","DOIUrl":"https://doi.org/10.1111/jep.70161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In emergency medicine, validated triage systems, such as the Manchester Triage System (MTS), have been established to ensure proper prioritization of patients. In adult patients, using nonspecific flow charts has been shown to be less accurate. In this study, the accuracy of nonspecific paediatric flow charts compared to the more specific flow charts is systematically examined for the first time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective cohort analysis of 28,128 paediatric emergency patients being triaged between November 2021 and April 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the observation period, the nonspecific presentational flow charts ‘unwell newborn/baby/child’, ‘crying baby’ and ‘irritable child’ were used 2695 times. The equally nonspecific flow chart ‘worried parent’ was used 5133 times. Patients triaged with nonspecific paediatric flow charts were often classified in lower triage levels. The AUC for the nonspecific flow charts and hospitalization in general was 0.604 [0.584–0.624] and the nonspecific chart ‘worried parent’ showed a lower AUC 0.594 [0.578–0.61]. The AUC of patients triaged with the more specific flow charts was 0.661 [0.654–0.669]. The AUC for the MTS nonspecific paediatric flow charts and admission to the ICU was 0.865 [0.752–0.978] and 0.782 [0.55–1] for patients triaged with worried parent as well as 0.771 [0.728–0.814] for patients triaged with more specific flow charts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study is the first to examine the nonspecific paediatric flow charts. Compared to the specific flow charts, the performance of the nonspecific ones shows a significantly worse AUC for admission to the normal ward as a surrogate parameter for accuracy. Since nonspecific paediatric flow charts have many indicator questions at the indicator level that are aimed at nonspecific symptoms compared to the adult range, the poorer performance can be explained by a lack of compliance on the part of the nurse making the initial assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Medical Prescription Skills in Medical Students: A Hands-On Educational Intervention","authors":"Victória Borges Bessa,&nbsp;Alice Ornellas Ferrari,&nbsp;Laura Moreira Sanches,&nbsp;Marcela Viscovini Gomes da Silva,&nbsp;Ricardo Filipe Alves da Costa,&nbsp;Wilson Elias de Oliveira Júnior","doi":"10.1111/jep.70135","DOIUrl":"https://doi.org/10.1111/jep.70135","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Medical prescription forms a crucial link between healthcare providers and patient treatment outcomes. However, inadequate prescription practices pose significant risks, including therapeutic inefficacy and severe health hazards.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>Evaluate the impact of a practical educational course designed to enhance prescription skills among medical students at various stages of their education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The workshop addressed prescription issues in hospital and ambulatory settings by adopting a descriptive, prospective approach. Data were collected pre- and post-intervention using structured questionnaires and analyzed using non-parametric tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analysis indicated substantial improvement in students' prescription skills, with statistically significant knowledge gains noted in both early- and advanced-stage students (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite limitations such as sample size and group variability, the study underscores the necessity of integrating innovative, hands-on educational methods into medical curricula to address the often-overlooked skill of medical prescription in the graduation curricula.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cross-Sectional Study on the Knowledge, Attitudes, and Practices of Medical Students Towards the Use of Plaster of Paris","authors":"Vidmi Taolam Martin,&nbsp;Bin Yu","doi":"10.1111/jep.70095","DOIUrl":"https://doi.org/10.1111/jep.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Plaster of Paris (POP) serves as a fundamental orthopedic material for fracture immobilization and facilitating the healing process. For medical students, mastering anatomical principles and evidence-based practices is paramount, as these competencies significantly enhance patient outcomes. Proper application of POP not only ensures patient comfort but also minimizes the need for repeated casting or surgical interventions to maintain limb immobilization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This study compares the knowledge, attitudes, and practices (KAPs) of three groups of medical students regarding the use of POP to evaluate how structured internship impacts their clinical decision-making and patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A structured questionnaire was administered to senior students of the bachelor's degree (4Y-MS and 5Y-MS) and early master's degree students (1Y-MMed) for comparative analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were notable differences among the three groups (4Y-MS, 5Y-MS and 1Y-MMed) in terms of gender, age, preferred specialty during clinical rotation, and specialty of choice (<i>p</i> = 0.004, <i>p</i> &lt; 0.0001, <i>p</i> = 0.009, and <i>p</i> = 0.504, respectively). The 5Y-MS and 1Y-MMed groups reported higher scores for self-practice in applying a POP cast than did the 4Y-MS group [91 (82.73%), 172 (91.71%), and 76 (80.39%)], as collected through a questionnaire. Furthermore, only a small percentage of participants (n = 61) were postgraduate majors in orthopedic surgery, and even fewer (n = 10) received training from attending orthopedic surgeons. The participants' overall knowledge level was relatively low, with a score of 5.76 ± 1.25. Bloom's cut-off point indicates a moderate overall knowledge score of 71.97%, a positive attitude score of 90.75%, and a good practice score of 94.29%. The linear regression analysis revealed that all participants' knowledge levels were significant, but only the 1Y-MMed group's scores increased with the medical curriculum. The medical curriculum and clinical trainer's academic position influenced knowledge scores and attitudes, with the latter being the only factor that led to increased practice items.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The 5Y-MS or 1Y-MMed have better KAP when using a POP cast than 4Y-MS. Trainers’ implication is a key factor in enhancing appropriate attitudes and practices among students.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Audit and Feedback Supporting New Guideline Implementation in Chronic Kidney Disease","authors":"Megan E. Lanpher,&nbsp;Brooke Patterson,&nbsp;Muhammad Ebrahim,&nbsp;Abbas S. Tavakoli","doi":"10.1111/jep.70132","DOIUrl":"https://doi.org/10.1111/jep.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adults with Type 2 diabetes mellitus and chronic kidney disease experience higher risk for progression to end stage kidney disease, which negatively impacts health, increases medical costs, and decreases quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Determine if an audit and feedback intervention in a local nephrology clinic can increase provider adherence to a clinical practice guideline that supports the prescription of sodium glucose cotransporter-2 inhibitors to delay progression of chronic kidney disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A pretest-posttest design was used to determine if an audit and feedback tool delivered to providers at 3-week intervals would increase provider adherence to the guideline recommendation over the course of 3 months. A clinical decision guide was provided to participants at the onset of the intervention with structured interviews accompanying the audit and feedback cycles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>English speaking physicians and advanced practice providers were recruited from a local nephrology outpatient clinic in the southeastern United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>To evaluate the significance of the intervention, a chi-square test was used to evaluate the change in prescribing of SGLT-2 inhibitors compared to the 3 months before the intervention. Logistic regression assisted with examining the relationship between the intervention and proportion of new SGLT-2 inhibitor prescriptions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this setting, statistical analysis indicated that the intervention significantly increased prescription of SGLT-2 inhibitors in adults with Type 2 diabetes and chronic kidney disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The intervention significantly increased provider adherence to the clinical guideline. Additional implementation on a larger scale is warranted to validate findings and further investigate barriers to prescribing that were reported by participating providers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}