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From the Editor : Continuous Publication Model
No full textWelcome to the 7th Volume of the Health Education in Practice: Journal of Research for Professional Learning (HEPJ).
We are pleased to open the first volume of HEPJ published under a continuous publication model.
The continuous publication model will allow us to maintain our commitment to increase the visibility of the knowledge published on HEPJ by expediting its dissemination, with articles being published as soon as they undergo our rigorous process of peer review and production. By eliminating the need to wait for a predetermined number of articles to form a volume, we aim to provide authors with the immediacy they desire and, consequently, increase the likelihood of their work receiving timely citations.
I hope you enjoy reading our journal and I look forward to sharing more papers in this volume in the coming months
ISBAR+ a communication tool to advocate for patients
No full textIntroduction
Recognising the importance of social determinants of health is a key part of the curriculum for health practitioners. The ability to advocate on behalf of patients is a competency that demonstrates enacting this understanding in practice. Communication frameworks are used to structure difficult conversations in multiple settings, notably handover. There is no commonly accepted communication framework to structure a patient advocacy conversation.
Approach
We assembled a team with skills in patient advocacy, healthcare communication, community advocacy, education and business negotiation to identify the knowledge, skills and attitudes required and to develop a framework suitable for this purpose. We chose to adapt the ISBAR framework as an existing communication framework commonly used for handover.
Outcomes
ISBAR+ is a framework that is based on a person-centred approach and ‘integrated negotiation’. ‘Intention and Inquiry’ involves a compassionate understanding of the patient’s position. ‘Situation’ is a succinct framing of the problem. ‘Background’ is the information required for the decision-maker to make a person-centred decision. The next step is ‘alignment’ of the priorities of the patient, practitioner and decision-maker. ‘Response’ is the proposed solution, and ‘+’ (‘plus’) is the actions taken for implementation.
Conclusions
ISBAR+ provides a framework for conversations advocating on behalf of patients that draws from the literature around advocacy inside and outside health. A communication framework allows the development and evaluation of interventions to teach and promote this critical function to promote person-centred care
Evaluating the usability of Electronic Medication Management Systems (EMMS) during design and redesign: Time to consider new approaches
No full textTitle: Evaluating the usability of Electronic Medication Management Systems (EMMS) during design and redesign: Time to consider new approaches
Background: Electronic Medication Management Systems (EMMS) support the prescribing, review and administration of medications. Poor EMMS usability can result in inefficiencies and use errors which may lead to patient harm. The application of human factors methods can support the usable and safe design of EMMS.
Aims: To identify human factors methods that have been used to evaluate the usability of hospital EMMS during design or redesign.
Methods: A systematic review, following PRISMA guidelines, was conducted by searching online databases and relevant journals from January 2011 to May 2022. Studies were included if they described the application of human factors methods to evaluate the usability of EMMS during design or redesign.
Results: Nineteen papers met the inclusion criteria and these described 12 human factors methods to evaluate the usability of EMMS designs. The most frequently used were prototyping, usability testing, participant surveys/questionnaires and interviews. These generally aimed to identify usability issues, heuristic violations and design enhancements. Only one paper utilised a safety-oriented method and one, a mental workload assessment method.
Conclusions: While the review identified 12 methods used to evaluate the usability of EMMS designs, these reflect only a subset of available methods. Given the high-risk nature of medication management in complex hospital environments, and the potential for harm due to poorly designed EMMS, there is significant potential to apply methods that aim to identify safety-critical issues during usability evaluations
Cyberscams and Acquired Brain Injury: Developing a measure to assess online risk and safety for people with ABI.
No full textTitle: Cyberscams and Acquired Brain Injury: Developing a measure to assess online risk and safety for people with ABI.
Background: Individuals with acquired brain injury (ABI) may be vulnerable to cyberscams due to cognitive and social changes post-injury. However, lack of existing measures regarding online risk for people with ABI limits our ability to objectively investigate ABI-specific risk factors to cyberscams, assess the frequency of this problem, and evaluate evidence-based interventions. The CyberAbility Scale was developed to assess vulnerability for people with ABI via self-rated statements and a practical scam identification activity.
Aims: This study aimed to develop and refine The CyberAbility Scale through feedback from ABI clinicians and people with ABI. This forms part of a larger ongoing scale development project.
Methods: Scale feedback was collected via three rounds of feedback with ABI clinicians (n=14) using Delphi methods, and two rounds of feedback with participants with ABI (n=8) who participated in a cognitive interview. Following each round, feedback was summarised and revisions were made accordingly.
Results: Key revisions from clinician feedback included removing a total of 12 items deemed clinically irrelevant. Instructions and rating scales were revised to improve clarity. Cognitive interviews identified 15 comprehension errors, and further revisions were made to support recall and response difficulties for participants with ABI. Overall, clinician and ABI participants supported the content and face validity of The CyberAbility Scale. Initial psychometric evaluation will also be discussed.
Conclusions: The CyberAbility Scale has the potential to be an effective screening measure of online vulnerability for persons with ABI with utility within clinical and research settings. Further validation work is currently underway
Health Professionals’ perspectives on Virtual Reality in healthcare
No full textBackground: Research has provided evidence for the effective use of Virtual Reality (VR) for mental health services, pain management, rehabilitation and surgical skills development. Despite the growing interest in VR in healthcare, its implementation as part of routinely delivered care remains a challenge.
Aims: The aim of this study was to understand the barriers and enablers to use of VR in service provision.
Methods: Data was collected via an anonymous online survey between 2019 and 2021. The survey was developed by the researchers to collect data on VR use in health care. It consisted of five demographic questions, twelve structured and Likert style questions and nine open-response questions.
Results: Sixteen health professionals completed the survey. All respondents indicated they had previous experience with VR, but of these only a minority (n=6, 37.50%) indicated that they had used VR in their practice or in the context of health services delivery. The majority of respondents (n=15, 93.75%) felt that VR had value in healthcare. However, respondents identified barriers to using VR in practice including concerns about the time involved using VR in practice (n=7, 43.75%) or setting up the headset (n=6, 37.50%); not having access to organisational infrastructure to use VR (n=10, 62.50%); and not feeling confident using VR in practice (n=7, 43.75%).
Conclusions: Health professionals are interested in using VR to support service delivery, but require infrastructure support and resources to improve their personal confidence for implementing VR with patients
Localisation and usability evaluation of an information diary tool to measure health information access and exposure
No full textTitle: Localisation and usability evaluation of an information diary tool to measure health information access and exposure
Background: It is a challenge to connect data about the health information people are exposed to and their health attitudes and behaviours. A digital information diary tool was developed to address this challenge, and we tested its usability when localised for a specific study.
Methods: We used a mixed methods design to evaluate how participants used the information diary and their perspectives of usability. Participants were recruited from a primary care clinic and used the tool for a week. We measured usability with the System Usability Scale (SUS) questionnaire. We explored issues qualitatively via interviews with participants, analysing the data using thematic analysis.
Results: The tool was updated for use in three languages and tested with 24 participants. The mean SUS score was 69.8±12.9. Five themes emerged related to utility: functioning as a health information diary; discussing information diary with their doctor; learning about the credibility of information; being more aware of what they access because of the tool; and comparing their results with others. Four themes related to usability were: ease of use; confusion about selecting information source categories; capturing offline information with photos; and assigning a trust level.
Conclusions: We evaluated the process of localising an information diary tool and discovered challenges related to balancing the requirements of researchers using the tool for data collection and the way users wanted to use the tool. We did not encounter any major challenges with localisation, suggesting the tool could be quickly adapted to local contexts globally
User experiences of a remote monitoring program during COVID-19
No full textBackground: Virtual care has gained traction during COVID-19 as it allows patients to be remotely monitored while reducing the risk of infection for patients and healthcare professionals. RPA Virtual Hospital (rpavirtual), launched in February 2020, was the first service in NSW to introduce remote monitoring and follow-up for stable COVID-19 patients in quarantine or isolating at home. Patients received a pulse oximeter (PO) to monitor their oxygen saturation levels, critical to identifying signs of health deterioration. Although preliminary patient experience data have been collected, user perceptions of the intervention have not been fully explored.
Aims: Explore the utilisation, performance and acceptability of the PO by patients and clinicians in COVID-19 remote monitoring.
Methods: Semi-structured interviews were conducted with patients ≥18, monitored by rpavirtual with PO, and rpavirtual clinicians who monitored those patients. Interviews were coded using the Theoretical Framework of Acceptability.
Results: Twenty-one patients and 15 clinicians completed the interview. All participants described the key benefits of the PO as allowing patients to be monitored at home and detection of early deterioration. All participants had a good understanding of the device’s purpose and knowledge about its use and the device was found to be easy to use. However, users also identified factors negatively impacting the accurate use of the PO (e.g. patient age).
Conclusions: The use of the PO for COVID-19 remote monitoring was described as easy and highly acceptable to patients and clinicians. Additional education may be necessary for some patient cohorts
Co-design of a digital workplace wellness intervention in Malaysia
No full textBackground: Malaysia is currently experiencing high, and growing, rates of chronic disease. Lifestyle risk factors, such as obesity, lack of physical activity, smoking, and poor diet all contribute to the onset of these conditions and to worse outcomes. Previous studies suggest that workplace wellness initiatives can benefit both individuals and employers (e.g., through lower healthcare costs and reductions in absenteeism).
Aims: This abstract outlines phase one of the study, which aims to co-design a socially-driven digital health intervention to promote healthy behavior in a workplace in Malaysia.
Methods: In this co-design phase, a total of 12 interviews were completed with employees to understand the barriers and facilitators to healthy behaviors in the workplace, including social factors (drawing on social cognitive theory and other social influence theories). Next, co-design workshops were developed, based on the findings from the interviews, and conducted with employees to design workplace wellness activities that fit the company culture and constraints.
Results: The employee interviews uncovered barriers to healthy behaviors, such as limited availability of healthy food options, and facilitators, such as co-workers participating together in activities. Co-design workshops explored how these factors could be leveraged or addressed in the design of wellness activities for the company. While not an initial focus of the study, an additional theme that emerged from both interviews and co-design workshops was the need for more mental health support for employees.
Conclusions: The co-design process uncovered important barriers, facilitators, and ideas while designing a culturally-relevant digital workplace wellness intervention in Malaysia
Offering disadvantaged adolescents hope for a better future through eHealth interventions targeting poor diet, alcohol use, tobacco smoking and vaping: Findings from a systematic review
No full textIntroduction: Chronic disease burden disproportionately affects disadvantaged adolescent populations. Preventing chronic disease risk behaviours including poor diet, alcohol use, tobacco smoking and vaping in adolescence is critical. Universal eHealth interventions provide effective prevention, and are a potentially viable option to reach disadvantaged adolescents. However, it is unclear whether they adequately serve disadvantaged adolescents, including those from lower socioeconomic and geographically remote contexts.
Aims: We aimed to synthesise evidence for the effectiveness of eHealth interventions targeting disadvantaged adolescents in preventing poor diet, alcohol use, tobacco smoking and vaping.
Methods: Seven electronic databases were systematically searched. Eligible studies were randomised controlled trials and quasi-experimental trials of eHealth interventions targeting diet, alcohol use, tobacco smoking and vaping among adolescents, that reported at least one marker of socioeconomic status or geographical remoteness. Two reviewers screened, extracted data, and assessed risk of bias.
Results: 3278 articles were identified and fifteen were included for extraction. Nine trials were among adolescents of low socioeconomic status (targeting poor diet [n=6]; alcohol use [n=2], and tobacco smoking [n=1]), four were among adolescents living in geographically remote areas (targeting poor diet [n=3], and alcohol use [n=1]), and one study focused on adolescents of low socioeconomic and geographically remote backgrounds (targeting alcohol and tobacco smoking). No studies targeted vaping.
Conclusions: There is a lack of eHealth interventions targeting adolescents from disadvantaged backgrounds in preventing poor diet, alcohol use, tobacco smoking and vaping. Addressing these risk behaviours among disadvantaged adolescents has the potential to improve future health and narrow health inequities