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Sickle cell disease is a genetic blood disorder primarily affecting individuals of African descent. Studies of healthcare providers suggest there is inadequate knowledge about the pathophysiology and clinical presentations of the disease, and misperceptions of patients' behaviors and communication during crisis that have led to inappropriate staff attitudes and thus become major barriers to the delivery of optimal care. In this article, the authors describe the effect of an educational module on improving healthcare staffs' attitudes toward patients with sickle cell disease.

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PURPOSE OF STUDY: The purpose of this study was to determine the prevalence of complementary and alternative medicine (CAM), folk medicine, and other nontraditional therapy use by the elderly population. PRIMARY PRACTICE SETTING: For all case managers who coordinate health care for the elderly as they transition from one setting to another and participate in health promotion and prevention activities. METHODOLOGY AND SAMPLE: A computerized database search of MEDLINE, CINAHL, ProQuest, and PsycINFO was completed before writing the integrative review. Six hundred ninety-seven abstracts were identified. Forty-five articles were further screened. Twenty-five articles met the criteria for inclusion. RESULTS: The integrative review is composed of 25 articles. Support for folk medicine and CAM use by older adults is located at Levels 5 and 6 of Melynk and Fine-Overholt's Hierarchy of Evidence. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: Folk medicine and CAM are used by the elderly for self-care purposes. A combination of both nontraditional and traditional medical interventions is used by the elderly. Although the choice to use folk medicine and CAM seems to transcend culture, the specific therapies chosen often emerge from the individual's cultural or ethnic heritage. Traditional health care providers may be unaware of elders' use of CAM or folk medicine alternatives. Case managers as coordinators of care across the health continuum are in a unique position to encourage, support, and enhance the use of folk medicine and CAM that complements traditional medical interventions for the elderly.

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BACKGROUND: The use of games as an educational strategy has the potential to improve health professionals' performance (e.g. adherence to standards of care) through improving their knowledge, skills and attitudes. OBJECTIVES: The objective was to assess the effect of educational games on health professionals' performance, knowledge, skills, attitude and satisfaction, and on patient outcomes. SEARCH METHODS: We searched the following databases in January 2012: MEDLINE, AMED, CINAHL, Cochrane Central Database of Controlled Trials, EMBASE, EPOC Register, ERIC, Proquest Dissertations & Theses Database, and PsycINFO. Related reviews were sought in DARE and the above named databases. Database searches identified 1546 citations. We also screened the reference lists of included studies in relevant reviews, contacted authors of relevant papers and reviews, and searched ISI Web of Science for papers citing studies included in the review. These search methods identified an additional 62 unique citations for a total of 1608 for this update. SELECTION CRITERIA: We included randomized controlled trials (RCT), controlled clinical trials (CCT), controlled before and after (CBA) and interrupted time-series analysis (ITS). Study participants were qualified health professionals or in postgraduate training. The intervention was an educational game with "a form of competitive activity or sport played according to rules". DATA COLLECTION AND ANALYSIS: Using a standardized data form we extracted data on methodological quality, participants, interventions and outcomes of interest that included patient outcomes, professional behavior (process of care outcomes), and professional's knowledge, skills, attitude and satisfaction. MAIN RESULTS: The search strategy identified a total of 2079 unique citations. Out of 84 potentially eligible citations, we included two RCTs. The game evaluated in the first study used as a reinforcement technique, was based on the television game show "Family Feud" and focused on infection control. The study did not assess any patient or process of care outcomes. The group that was randomized to the game had statistically higher scores on the knowledge test (P = 0.02). The second study compared game-based learning ("Snakes and Ladders" board game) with traditional case-based learning of stroke prevention and management. The effect on knowledge was not statistically different between the two groups immediately and 3 months after the intervention. The level of reported enjoyment was higher in the game-based group. AUTHORS' CONCLUSIONS: The findings of this systematic review neither confirm nor refute the utility of games as a teaching strategy for health professionals. There is a need for additional high-quality research to explore the impact of educational games on patient and performance outcomes.

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BACKGROUND: The use of games as an educational strategy has the potential to improve health professionals' performance (e.g. adherence to standards of care) through improving their knowledge, skills and attitudes. OBJECTIVES: The objective was to assess the effect of educational games on health professionals' performance, knowledge, skills, attitude and satisfaction, and on patient outcomes. SEARCH METHODS: We searched the following databases in January 2012: MEDLINE, AMED, CINAHL, Cochrane Central Database of Controlled Trials, EMBASE, EPOC Register, ERIC, Proquest Dissertations & Theses Database, and PsycINFO. Related reviews were sought in DARE and the above named databases. Database searches identified 1546 citations. We also screened the reference lists of included studies in relevant reviews, contacted authors of relevant papers and reviews, and searched ISI Web of Science for papers citing studies included in the review. These search methods identified an additional 62 unique citations for a total of 1608 for this update. SELECTION CRITERIA: We included randomized controlled trials (RCT), controlled clinical trials (CCT), controlled before and after (CBA) and interrupted time-series analysis (ITS). Study participants were qualified health professionals or in postgraduate training. The intervention was an educational game with "a form of competitive activity or sport played according to rules". DATA COLLECTION AND ANALYSIS: Using a standardized data form we extracted data on methodological quality, participants, interventions and outcomes of interest that included patient outcomes, professional behavior (process of care outcomes), and professional's knowledge, skills, attitude and satisfaction. MAIN RESULTS: The search strategy identified a total of 2079 unique citations. Out of 84 potentially eligible citations, we included two RCTs. The game evaluated in the first study used as a reinforcement technique, was based on the television game show "Family Feud" and focused on infection control. The study did not assess any patient or process of care outcomes. The group that was randomized to the game had statistically higher scores on the knowledge test (P = 0.02). The second study compared game-based learning ("Snakes and Ladders" board game) with traditional case-based learning of stroke prevention and management. The effect on knowledge was not statistically different between the two groups immediately and 3 months after the intervention. The level of reported enjoyment was higher in the game-based group. AUTHORS' CONCLUSIONS: The findings of this systematic review neither confirm nor refute the utility of games as a teaching strategy for health professionals. There is a need for additional high-quality research to explore the impact of educational games on patient and performance outcomes.

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BACKGROUND: An educational game is 'an instructional method requiring the learner to participate in a competitive activity with preset rules.' A number of studies have suggested beneficial effects of educational games in medical education. AIM: The objective of this study was to systematically review the effect of educational games on medical students' satisfaction, knowledge, skills, attitude, and behavior. METHODS: We used the best evidence medical education (BEME) collaboration methods for conducting systematic reviews. We included randomized controlled trials (RCT), controlled clinical trials, and interrupted time series. Study participants were medical students. Interventions of interest were educational games. RESULTS: The title and abstract screening of the 1019 unique citations identified 26 as potentially eligible for this article. The full text screening identified five eligible papers, all reporting RCTs with low-to-moderate methodological quality. Findings in three of the five RCTs suggested but did not confirm a positive effect of the games on medical students' knowledge. CONCLUSION: The available evidence to date neither confirm nor refute the utility of educational games as an effective teaching strategy for medical students. There is a need for additional and better-designed studies to assess the effectiveness of these games and this article will inform this research.

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Leadership or management courses for undergraduate baccalaureate nursing students are often relegated to the last semester of study. The authors discuss how leadership and management constructs were integrated throughout the students' upper-division, 2-year nursing curriculum via 3 leadership/management courses. The purpose of this innovative leadership education model is to facilitate the acquisition of both leadership and management behaviors and provide opportunity for students to practice these skills in clinical settings. The authors describe the underpinnings of this model, exemplars of leadership and management principles used in this curriculum, and the barriers to implementing this curriculum.

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The purpose of this article was to describe the design, implementation, and outcomes of one strategy used to promote careers in nursing among minority high-school-aged teens-namely, a workshop for guidance counselors in a large urban school system. All guidance counselors in an urban inner city school system were invited to attend a workshop on careers in nursing as part of their monthly continuing education requirements. Thirty-nine (39%) participated in the half-day workshop held at a school of nursing. Most informative were the guidance counselor comments about perceptions of nursing careers that create barriers to recruitment. Guidance counselors reported that (a) many students and parents view nursing as a "dangerous field," (b) negative stereotypes about nursing persist, (c) many students do not plan for the prerequisites for baccalaureate entrance, (d) nursing is perceived as a "narrow" field with few opportunities for advancement, and (e) there is a preference of 2-year programs to get "quick income" over baccalaureate programs and long-term career planning. Faculty and students addressed these issues. Faculty collaboration with guidance counselors is an excellent mechanism to uncover barriers to minority recruitment at the local level. Nursing recruitment activities should be tailored to address these community concerns. In the last 4 years, 24 students from the targeted high school system were offered admission to the University at Buffalo and of this group 17 enrolled in nursing.

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This paper describes a select population of Western New York (WNY) Registered Nurses' (RN) perspectives on the use of healthcare informatics and the adoption of a regional electronic health record (EHR). A three part class assignment on healthcare informatics used a Strengths, Weaknesses, Opportunities, Threats (SWOT) Analysis, and a Healthcare Informatics Schemata: A paradigm shift over time(c) timeline to determine RN perspectives about healthcare informatics use at their place of employment. Qualitative analysis of 41 RNs who completed the SWOT analysis provided positive and negative themes related to perceptions about healthcare informatics and EHR use at their place of employment. 29 healthcare organizations were aggregated by year on the timeline from 1950 through 2000. Information suggests that, RNs have the capacity to positively drive the adoption of EHRs and healthcare informatics in WNY.

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The purpose of this article is to describe the incorporation of healthcare informatics into the strategic planning process in nursing education. An exemplar from the University at Buffalo, the State University of New York School of Nursing, is interwoven throughout the article. The challenges and successes inherent in a paradigm shift embracing the multifaceted adoption of technology in higher education are illustrated. The paradigm shift that necessitated this change, the need for informatics standards and competencies identified by regulatory agencies and the relationship of the triad mission of the Academy which includes research, teaching and service are then elucidated. Information pertinent to the strategic planning process is described including the use of a strengths, weaknesses, opportunities and threats (SWOT) analysis to facilitate the integration of a healthcare informatics model into a nursing curriculum.

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The Integrated Services Digital Network H.323 (ISDN), which has been in use for the past 20 years often requires a dedicated telephone line and other equipment to implement. Consequently, expansion of ISDN-based videoconferencing requires infrastructure not always accessible in those areas that are most in need of technological connections. New H.323 technology using Internet Protocol H.320 (IP) connectivity can accommodate the use in a variety of videoconferencing software and fill this void as demonstrated by an experiment conducted live at the Syllabus Web '99 conference. When a faculty group were unable to secure ISDN connections to demonstrate their clinical evaluation of Family Nurse Practitioner (FNP) students using videoconferencing technology, an ad hoc group of computer experts, educators, instructional design specialists, and corporate sponsors collaborated to design a multipoint PC-based connection using IP connectivity. This article describes the first application of this technology, the evolution of ISDN and IP systems in nursing education and practice, and suggests appropriate future trends for their utility in nursing.

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Healthcare providers need information to guide the management of patient health while administrators focus on resource management. The underpinning of economic analysis, in the clinical setting, is that resources are scarce. The allocation of resources requires delivered services to provide more benefits than cost and hence, the need to demonstrate a return on investment (ROI) for disease management programs. This article describes the ROI for a prenatal program developed at a Western New York Managed Care Organization (MCO). A positive ROI for the program under study will be demonstrated using a model of economic analysis.

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