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1.
Aust Occup Ther J ; 70(6): 644-660, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37365675

RESUMEN

BACKGROUND: Currently, paediatric health care aims to use a child-centred tailor-made approach. In order to design tailored occupational therapy, the implementation of personalised occupation-based measurements that guide and evaluate goal setting and are responsive to change is necessary. PURPOSE: Primarily, this study explored the potential of the Perceive, Recall, Plan, and Perform (PRPP) assessment to measure the change in the performance of children with multiple disabilities. As a secondary evaluation, the feasibility of the PRPP-Intervention in a home-based program to enable activities was described. The overall aim is to show the potential of the PRPP-Assessment as an outcome measure to use as a base for designing tailor-made person-centred care. METHODS: An exploratory longitudinal multiple case series mixed-methods design was used. The PRPP-Assessment, scored by multiple raters, was conducted based on parent-provided videos. The assessed activities were chosen by the child and/or parents. Responsiveness was evaluated by hypotheses formulated a priori and by comparing measured change with change on concurrent measures: Goal Attainment Scaling (GAS) and Canadian Occupational Performance Measure (COPM). Over a 6-week period, children and their parents (or caregivers) participated in an online home-based video coaching program where parents were coached in the implementation of the training, based on the PRPP-Intervention, by paediatric occupational therapists on a weekly basis. The feasibility of the intervention was explored using semi-structured interviews with children, parents, and the treating occupational therapists and was analysed by directed content analysis. RESULTS: Three out of 17 eligible children agreed to participate and completed post-intervention measurement, of which two completed the intervention. Quantitative results showed that eight out of nine activities improved on the PRPP-Assessment and the COPM, and nine improved on the GAS. In total, 13 out of 15 hypotheses for responsiveness were accepted. Participants experienced the intervention as successful and acceptable. Facilitators and concerns over demand, implementation, practicality, integration, and adaptation were shared. CONCLUSION: The PRPP-Assessment showed the potential to measure change in a heterogeneous group of children. The results indicated a positive tendency for the intervention and also provide directions for further development.


Asunto(s)
Terapia Ocupacional , Humanos , Niño , Terapia Ocupacional/métodos , Canadá , Actividades Cotidianas , Padres , Evaluación de Resultado en la Atención de Salud
2.
BMC Pediatr ; 22(1): 380, 2022 06 29.
Artículo en Inglés | MEDLINE | ID: mdl-35768858

RESUMEN

BACKGROUND: Although early home-based upper limb training programs are promising, in-depth understanding of parents' experiences with these programs is still limited. We developed an early home-based upper limb training program for infants and toddlers (8-36 months) with or at risk of unilateral cerebral palsy using video coaching for parents. The aim of this qualitative study was to evaluate parents' experiences with the home-based training program using a video coaching approach in order to optimize implementation strategies. METHODS: We held semi-structured interviews with parents of 13 children with unilateral cerebral palsy, who participated in our program in the period from 2014 - 2017. On average, parents had delivered two training periods of the program at the time of the interviews. Interviews were analyzed using inductive thematic content analysis. RESULTS: We identified three overarching interacting themes that shaped the experiences of parents with the program: 1) Parental learning comprising the subthemes parents' training competencies and the facilitative and reinforcing role of video coaching, 2) Parental load comprising the subthemes flexibility of the program, supportive network, competing demands, and child's mood and functional capacities, and 3) Parental perseverance comprising the subthemes beliefs and expectancies and seeing child's functional improvements. CONCLUSIONS: For successful implementation of an early home-based upper limb training program using video coaching, support in delivering home-training from a therapist or from others within parents' social network, is needed to relieve parental load. Seeing functional improvements of their child on the videos increased parents' motivation to continue with the training. Positively phrased feedback from an occupational therapist stimulated parents' perseverance and training competency.


Asunto(s)
Parálisis Cerebral , Tutoría , Parálisis Cerebral/terapia , Preescolar , Humanos , Lactante , Padres/educación , Investigación Cualitativa , Extremidad Superior
3.
Prev Sci ; 23(6): 1029-1040, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35107694

RESUMEN

Children with developmental delays or disabilities (DD) are at risk for self-regulation difficulties and behaviour problems compared to typically developing children. Intervening early is crucial to prevent long-term adjustment challenges across home and school contexts. Parenting has been identified as a malleable target of intervention for improving children's adaptive functioning across behavioural, emotional and cognitive domains. Although parent management training (PMT) is an identified best-practice, key questions remain about the critical components of interventions and how novel approaches like video feedback may offer additional benefits. Using a pre-test-post-test one group and superiority design, we evaluated the efficacy of two models of the Keeping Parents Trained and Supported (KEEP) preschool program with parent-only components among 175 families with children diagnosed or at-risk for DD. KEEP-P included core PMT (Oregon Model) methods and KEEP-V integrated KEEP with Filming Interactions to Nurture Development video coaching methods for enhancing developmentally supportive interactions. Intervention outcomes on children's behaviour problems and executive functioning, parenting stress and parent-child relationship quality were compared between groups. Both groups demonstrated significant reductions over time in child behavioural problems, developmental problems and parenting stress. Significant improvements were observed in children's executive functioning, parents' sense of competence and mindfulness in parenting. Group differences were observed in parent's sense of competence, with individuals receiving KEEP-P displaying greater increases over time. Higher intervention dosage predicted a greater reduction in stressful child behaviours and greater improvements in children's inhibitory control.


Asunto(s)
Tutoría , Problema de Conducta , Preescolar , Humanos , Relaciones Padres-Hijo , Responsabilidad Parental/psicología , Padres/educación
4.
BMC Med Educ ; 22(1): 85, 2022 Feb 08.
Artículo en Inglés | MEDLINE | ID: mdl-35135521

RESUMEN

BACKGROUND: Despite a growing call to train clinicians in interpersonal communication skills, communication training is either not offered or is minimally effective, if at all. A critical need exists to develop new ways of teaching communication skills that are effective and mindful of clinician time pressures. We propose a program that includes real-time observation and video-based coaching to teach clinician communication skills. In this study, we assess acceptability and feasibility of the program using clinician interviews and surveys. METHODS: The video-based coaching intervention targets five patient-centered communication behaviors. It uses trained communication coaches and live feed technology to provide coaching that is brief (less than 15 min), timely (same day) and theory-informed. Two coaches were trained to set up webcams and observe live video feeds of clinician visits in rooms nearby. As coaches watched and recorded the visit, they time stamped illustrative clips in real time. Video clips were a critical element of the program. During feedback sessions, coaches used video clips to promote discussion and self-reflection. They also used role play and guided practice techniques to enforce new tips. Clinicians included residents (n = 15), fellows (n = 4), attending physicians (n = 3), and a nurse practitioner (n = 1) at two primary care clinics in Houston, Texas. We administered surveys to clinicians participating in the program. The survey included questions on quality and delivery of feedback, and credibility of the coaches. We also interviewed clinicians following the intervention. We used rapid analysis to identify themes within the interviews. RESULTS: Survey measures showed high feasibility and acceptability ratings from clinicians, with mean item scores ranging from 6.4 to 6.8 out of 7 points. Qualitative analysis revealed that clinicians found that 1) coaches were credible and supportive, 2) feedback was useful, 3) video-clips allowed for self-reflection, 4) getting feedback on the same day was useful, and 5) use of real patients preferred over standardized patients. CONCLUSIONS: Video-based coaching can help clinicians learn new communication skills in a way that is clinician-centered, brief and timely. Our study demonstrates that real-time coaching using live feed and video technology is an acceptable and feasible way of teaching communication skills.


Asunto(s)
Tutoría , Comunicación , Estudios de Factibilidad , Retroalimentación , Humanos , Encuestas y Cuestionarios
5.
J Surg Educ ; 79(3): 717-724, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34972670

RESUMEN

OBJECTIVE: This review discusses the literature on Video-Based Coaching (VBC) and explores the barriers to widespread implementation. DESIGN: A search was performed on Scopus and PubMed for the terms "operation," "operating room," "surgery," "resident," "house staff," "graduate medical education," "teaching," "coaching," "assessment," "reflection," "camera," and "video" on July 27, 2021, in English. This yielded 828 results. A single author reviewed the titles and abstracts and eliminated any results that did not pertain to operative VBC or assessment. All bibliographies were reviewed, and appropriate manuscripts were included in this study. This resulted in a total of 52 manuscripts included in this review. SETTING/PARTICIPANTS: Original, peer-reviewed studies focused on VBC or assessment. RESULTS: VBC has been both subjectively and objectively found to be a valuable educational tool. Nearly every study of video recording in the operating room found that subjects, including surgical residents and seasoned surgeons alike, overwhelmingly considered it a useful, non-redundant adjunct to their training. Most studies that evaluated skill acquisition via standardized assessment tools found that surgical residents who underwent a VBC program had significant improvements compared to their counterparts who did not undergo video review. Despite this evidence of effectiveness, fewer than 5% of residency programs employ video recording in the operating room. Barriers to implementation include significant time commitments for proposed coaching curricula and difficulty with integration of video cameras into the operating room. CONCLUSIONS: VBC has significant educational benefits, but a scalable curriculum has not been developed. An optimal solution would ensure technical ease and expediency, simple, high-quality cameras, immediate review, and overcoming entrenched surgical norms and culture.


Asunto(s)
Internado y Residencia , Tutoría , Competencia Clínica , Educación de Postgrado en Medicina/métodos , Humanos , Tutoría/métodos , Grabación en Video
6.
J Surg Educ ; 79(3): 708-716, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34952818

RESUMEN

OBJECTIVE: Video coaching has been demonstrated to improve resident and attending skills and is overwhelmingly well received by the participants. However, misperceptions about its utility among those who do not use video coaching may be a barrier to widespread implementation. DESIGN: Cross-sectional web-based survey SETTING: National survey PARTICIPANTS: Surgical program director members of the Association of Program Directors of Surgery STUDY DESIGN: The survey was developed via a deductive approach after a literature review and was piloted with surgical attendings and residents. All Likert scale were averaged and comparisons between groups was performed via independent t-tests. RESULTS: There were 52 responses from PDs. 27/52(51.9%) PDs reported their program supported video coaching of residents. PDs from residences with video coaching programs were more likely to believe that video coaching was useful in identifying their own strengths and weakness (p = 0.005), was a useful adjunct for resident feedback (p = 0.024), and a personal library of video recordings would be helpful (p = 0.015) when compared to PDs from residencies without video coaching. Programs without video coaching were more likely to believe barriers to implementation included it being ineffective (p = 0.024) and that the technology was unavailable (p = 0.006). Over 50% of respondents from both groups believed expense, difficulty with set up, time required, and patient privacy were "Very" or "Extremely" likely to be barriers to implementation. CONCLUSIONS: This is the first national survey of PDs regarding the use of video coaching. Residency programs without video coaching may underestimate the utility of video coaching in training surgical residents.


Asunto(s)
Internado y Residencia , Tutoría , Estudios Transversales , Retroalimentación , Humanos , Encuestas y Cuestionarios , Estados Unidos , Grabación en Video
7.
Prev Sci ; 2021 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-33961176

RESUMEN

Many existing preventive intervention programs focus on promoting responsive parenting practices. However, these parenting programs are often long in duration and expensive, and meta-analytic evidence indicates that families facing high levels of adversity typically benefit less. Moreover, due to a lack of specification and evaluation of conceptual models, the mechanisms underlying program-related changes in caregivers and their children often remain unclear. The current study aimed to test the effectiveness of a video feedback parenting intervention program, Filming Interactions to Nurture Development (FIND), in improving caregivers' self-efficacy and reducing children's behavioral problems. Data derived from a randomized controlled trial using pretest-posttest design with low-income families reporting high levels of stress (N = 91, children aged 4 to 36 months old, 41.8% female). Families were randomly assigned to an active control or FIND intervention group. Results indicated that caregivers in the FIND group exhibited significant improvement in self-report sense of parenting competence and self-efficacy in teaching tasks. These program impacts were particularly pronounced among caregivers who experience high levels of childhood adversity. Findings provide preliminary support for the FIND conceptual model. Specifically, caregivers' improved self-efficacy in teaching tasks was linked to children's reduced internalizing and externalizing problems (notably, direct FIND intervention effects on children's behavioral outcomes were not observed). Overall, results support the effectiveness of FIND in enhancing caregivers' sense of parenting competence and potentially promoting optimal child development.

8.
J Surg Educ ; 77(3): 652-660, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31859226

RESUMEN

OBJECTIVE: A video coaching (VC) system has been developed in surgical education. This study compares the educational effect on technical and nontechnical skills of the VC method for teaching laparoscopic surgery. DESIGN: We conducted a prospectively randomized study of an education program to teach laparoscopic procedures. SETTING: The study was performed at the Chang Gung Memorial Hospital, a university hospital in Taiwan. PARTICIPANTS: We enrolled sixteen first- or second-year surgical residents.The participants were randomized into VC and conventional teaching (CT) groups, and their surgical skills were judged by the Global Operation Assessment of Laparoscopic Skills (GOALS) and the Objective Structured Assessment of Technical Skills (OSATS). Nontechnical skills were evaluated by the Non-Technical Skills for Surgeons (NOTSS) assessment and self-efficacy questionnaires (SEQs). After the program, posttraining scores were compared to assess improvements. RESULTS: The 16 enrolled participants finished the entire course and completed all the videos during the study period. Comparing the VC and CT groups, we found that the pretraining GOALS, OSATS, NOTSS and SEQ scores were similar between both groups. However, after training, the OSATS score gain was higher in the VC groupthan in the CT group (9.25 ± 2.05 vs. 6.50 ± 1.51, p=0.009). Regarding nontechnical skills, the NOTSS score improved more in the VC group than in the CT group (5.50 ± 0.93 vs. 4.25 ± 0.89, p=0.015). The SEQ score was also higher in the VC group (32.13 ± 2.10) than in the CT group (29.50 ± 1.77), with a significant difference (p=0.018). CONCLUSION: VC can help surgeons build their expertise using a more accessible method. Additionally, VC can shorten the learning curve and improve self-efficacy, thereby contributing to surgeons' education.


Asunto(s)
Internado y Residencia , Laparoscopía , Tutoría , Competencia Clínica , Educación de Postgrado en Medicina , Humanos , Taiwán
9.
Front Pediatr ; 8: 567257, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33585359

RESUMEN

The growth of the randomized controlled trial (RCT) as the "gold standard" for evaluation has justly been praised as an advance in the professionalization of social programs and projects, an "adoption of science" - in the words of the Lancet. None the less, the emphasis on the RCT biases funding for projects that distribute private goods and which focus on "low hanging fruit" in health, nutrition, and sanitation, simply because those areas lend themselves to the sort of measurement that works with RCTs. As a result, many project developers in the government and NGO sectors lament that a hegemonic focus on RCTs impedes creativity or new models that challenge traditional paradigms. This case study of CanalCanoa, a community video coaching project for indigenous parents of young children in the Rio Negro region of the Amazon Basin, offers techniques to measure for innovation. Instead of developing a new RCT for an extremely diverse population (27 ethnic groups) where traditional childcare methods are in historical flux because of urbanization, CanalCanoa measured variables shown by previous RCTs to be causally connected with positive development results. By researching the impact of the intervention on nutrition, language (multilingualism, use of traditional songs and stories), and social network expansion, CanalCanoa measured upstream indicators, thus mixing scientific rigor with an opportunity for innovation and providing important insight and reform of a theory of change.

10.
Front Behav Neurosci ; 13: 16, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30853903

RESUMEN

Although interventions that promote child-supportive parenting for children have been shown to positively impact caregiving behaviors as well as child behavioral and neurobiological functioning, less is known about which aspects of maternal brain functioning are affected by such interventions. In the present study, we conducted a preliminary evaluation of the impact of the Filming Interactions to Nurture Development (FIND) video coaching program on mothers with at least one child age four or younger. We employed a waitlist control design with pre-post data. Compared to mothers in the control condition (n = 16), mothers who received FIND (n = 16) showed changes in neural measures of inhibitory control and behavioral measures of parenting self-evaluation during a series of functional neuroimaging tasks. Specifically, we found a group by time interaction in clusters in the left inferior frontal gyrus (IFG) and insula for the Correct Stop > Correct Go contrast of the stop signal task (SST), where FIND increased brain activity associated with inhibitory control compared to mothers in the control condition; and FIND increased mothers' endorsement of child-supportive parenting traits in the parenting self-evaluation task (PSET). Exploratory moderators, study limitations, and the implications of these findings for strength-based parenting programs are discussed.

11.
J Surg Educ ; 76(3): 607-619, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30833204

RESUMEN

BACKGROUND: Video coaching has been found to be an effective teaching method because it incorporates many of the established principles of successful adult learning. The goal of our study was to assess the feasibility and effectiveness of using a point-of-view video camera (Google Glass) to improve the surgical skills education of orthopaedic surgery residents. METHODS: Forty-two residents from 4 institutions participated in a partially blinded randomized control trial performing an intra-articular distal tibial fracture reduction task while wearing Google Glass to record the performance. Participants underwent a structured coaching session with 20 participants (intervention group) using the recorded video to augment this session, and 22 participants (control group) receiving verbal coaching alone. The task was repeated again immediately after the coaching session. Performance was scored using an Objective Structured Assessment of Technical Skills checklist, Global Rating Scale, fluoroscopic usage, and reduction quality. A semistructured interview was then performed to assess experience of participants. RESULTS: There was no significant difference (p > 0.05) seen in score improvement in the Objective Structured Assessment of Technical Skills checklist, Global Rating Scale, fluoroscopic usage, or reduction quality between the control and intervention groups. Thematic analysis of interview showed majority of participants found video coaching increased effectiveness in understanding of goals, developing techniques and strategies, and process of self-reflection. Their involvement was seen overall as a positive experience, with participants wanting to see more inclusion of video coaching within surgical education. CONCLUSIONS: No difference in performance improvement between the 2 groups was seen, but majority of participants found the video coaching sessions valuable and could have potential beneficial role in education.


Asunto(s)
Educación de Postgrado en Medicina/métodos , Procedimientos Ortopédicos/educación , Gafas Inteligentes , Grabación en Video , Adulto , Competencia Clínica , Curriculum , Evaluación Educacional , Femenino , Humanos , Internado y Residencia , Curva de Aprendizaje , Masculino , Tutoría , Entrenamiento Simulado , Estados Unidos
12.
J Surg Educ ; 74(2): 365-371, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-27720404

RESUMEN

BACKGROUND: As surgical training is evolving and operative exposure is decreasing, new, effective, and experiential learning methods are needed to ensure surgical competency and patient safety. Video coaching is an emerging concept in surgery that needs further investigation. DESIGN: In this randomized controlled trial conducted at a single teaching hospital, participating residents were filmed performing a side-to-side intestinal anastomosis on cadaveric dog bowel for baseline assessment. The Surgical Video Coaching (SVC) group then participated in a one-on-one video playback coaching and debriefing session with a surgeon, during which constructive feedback was given. The control group went on with their normal clinical duties without coaching or debriefing. All participants were filmed making a second intestinal anastomosis. This was compared to their first anastomosis using a 7-category-validated technical skill global rating scale, the Objective Structured Assessment of Technical Skills. A single independent surgeon who did not participate in coaching or debriefing to the SVC group reviewed all videos. A satisfaction survey was then sent to the residents in the coaching group. SETTING: Department of Surgery, HôpitalMaisonneuve-Rosemont, tertiary teaching hospital affiliated to the University of Montreal, Canada. PARTICIPANTS: General surgery residents from University of Montreal were recruited to take part in this trial. A total of 28 residents were randomized and completed the study. RESULTS: After intervention, the SVC group (n = 14) significantly increased their Objective Structured Assessment of Technical Skills score (mean of differences 3.36, [1.09-5.63], p = 0.007) when compared to the control group (n = 14) (mean of differences 0.29, p = 0.759). All residents agreed or strongly agreed that video coaching was a time-efficient teaching method. CONCLUSIONS: Video coaching is an effective and efficient teaching intervention to improve surgical residents' technical skills.


Asunto(s)
Competencia Clínica , Procedimientos Quirúrgicos del Sistema Digestivo/educación , Educación de Postgrado en Medicina/métodos , Internado y Residencia/métodos , Entrenamiento Simulado/métodos , Grabación en Video , Anastomosis Quirúrgica/educación , Animales , Canadá , Perros , Hospitales de Enseñanza , Humanos , Aprendizaje Basado en Problemas , Estudios Prospectivos , Método Simple Ciego
13.
Child Dev Perspect ; 10(4): 251-256, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28936231

RESUMEN

In this article, we focus on applying methods of translational neuroscience to two-generation, family-based interventions. In recent years, a small but growing body of evidence has documented the reversibility of some of the neurobiological effects of early adversity in the context of environmental early interventions. Some of these interventions are now being implemented at scale, which may help reduce disparities in the face of early life stress. Further progress may occur by extending these efforts to two-generation models that target caregivers' capabilities to improve children's outcomes. In this article, we describe the content and processes of the Filming Interactions to Nurture Development (FIND) video coaching intervention. We also discuss the two-generation, translational neuroscience framework on which FIND is based, and how similar approaches can be developed and scaled to mitigate the effects of adversity.

14.
Wideochir Inne Tech Maloinwazyjne ; 8(3): 200-10, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24130633

RESUMEN

INTRODUCTION: Surgical education has become one of the most important directions in modern surgery evolution. To meet growing need for appropriate training in laparoscopic and, even more importantly, classic surgical skills, a curriculum involving contemporary tuition methods is needed. Advanced, structuralised training, which includes advanced technologies like virtual reality training, video coaching and motivative aspects of competition, seems to be important for an adequate education programme. MATERIAL AND METHODS: In academic years 2009/2010 and 2010/2011 the Department of General, Endocrine and Transplant Surgery of the Medical University of Gdansk together with the Pomeranian Foundation for Progress in Surgery organized 4480 h of training in that area of classic (2744) and laparoscopic (1736) skills. Both groups were involved in the programme of training in which the two most important aspects were reliable evaluation of the results and effective motivation to work. Skill evaluation at different stages of the programme were based on completion time and quality measurements. Apart from that, at the end of the course, the participants completed a questionnaire on their subjective perspective on this innovative curriculum, the quality and stability of the skills they obtained. RESULTS: In both arms of the programme (laparoscopic and classic) a statistically significant improvement was obtained as early as after the second and third sessions in half of the exercises. The acquired skills were stable over time, as proved by the plateau of completion time achieved in 11 out of 12 exercises. The results of the post-training questionnaire revealed that the participants were very satisfied with the structuralised form of training and appreciated the motivational role of competition. CONCLUSIONS: Contemporary surgical training should be organized as a systematic, well-evaluated and goal-oriented programme similar to the one proposed by our team. The use of contemporary training aids should be utilized in training of every surgical skill, not only laparoscopy. This form of training, associated with the component of competition, enables good and stable results to be achieved, as well as high satisfaction of trainees.

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