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- Ekblad, Solvig, et al.
(författare)
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Educational potential of a virtual patient system for caring for traumatized patients in primary care
- 2013
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Ingår i: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 13, s. 110-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Virtual Patients (VPs) have been used in undergraduate healthcare education for many years. This project is focused on using VPs for training professionals to care for highly vulnerable patient populations. The aim of the study was to evaluate if Refugee Trauma VPs was perceived as an effective and engaging learning tool by primary care professionals (PCPs) in a Primary Health Care Centre (PHC). Methods: A VP system was designed to create realistic and engaging VP cases for Refugee Trauma for training refugee patient interview, use of established trauma and mental health instruments as well as to give feedback to the learners. The patient interview section was based on video clips with a Bosnian actor with a trauma story and mental health problems. The video clips were recorded in Bosnian language to further increase the realism, but also subtitled in English. The system was evaluated by 11 volunteering primary health clinicians at the Lynn Community Health Centre, Lynn, Massachusetts, USA. The participants were invited to provide insights/feedback about the system's usefulness and educational value. A mixed methodological approach was used, generating both quantitative and qualitative data. Results: Self-reported dimensions of clinical care, pre and post questionnaire questions on the PCPs clinical worldview, motivation to use the VP, and IT Proficiency. Construct items used in these questionnaires had previously demonstrated high face and construct validity. The participants ranked the mental status examination more positively after the simulation exercise compared to before the simulation. Follow up interviews supported the results. Conclusions: Even though virtual clinical encounters are quite a new paradigm in PHC, the participants in the present study considered our VP case to be a relevant and promising educational tool. Next phase of our project will be a RCT study including comparison with specially prepared paper-cases and determinative input on improving clinical diagnosis and treatment of the traumatized refugee patient.
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| 2. |
- Mollica, Richard, et al.
(författare)
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Using the Virtual Patient to Improve the Primary Care of Traumatized Refugees
- 2017
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Ingår i: Journal of Medical Education and Research. - 0972-1177. ; 16:1, s. 2-16
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Tidskriftsartikel (refereegranskat)abstract
- Background: Refugees who have experienced traumatic life experiences have entered into the United States’ primary health care system. Primary care providers (PCPs) have limited training in their diagnoses and treatment. Assessing and caring for the health and mental health of refugees in a culturally effective way in a time limited health care environment is challenging. We conducted a study on the role of the Virtual Patient (VP) as a training instrument for improving the diagnoses and treatment of refugee patients.Methods: This was a descriptive and quantitative study of PCPs at a local neighborhood health care center in Massachusetts. A sample of PCPs initially reviewed an alpha Virtual Patient refugee prototype. An improved β-VP prototype was offered in training. The PCPs performance on pre- and post-diagnosis and treatment planning was assessed after studying the β-VP. 10 PCPs studied the alpha VP prototype; an additional 14 PCPs studied the β-VP prototype (N=24). The Karolinska Institutet Virtual Patient Learning Experience Questionnaire (KI-VP-LEQ) assessed feasibility, and motivation to use the VP. A Trauma-BPPS (Trauma -Bio-Psycho-Social- Spiritual scale) scale measured the PCP’s perception of the patient’s trauma history, and medical, psycho-social and spiritual domains. Pre- and post-VP training using refugee paper clinical cases was performed. Concluding telephone interviews were conducted. Analysis included qualitative methods and significance testing.Results: PCPs were receptive and motivated to use the VP in training. Prior to VP training, respondents scored highly on medical diagnosis and treatment planning (Medical domain); followed by the psychological domain. Respondents scored lower on the social domain and lowest on the trauma and spiritual domains. All five domain scores significantly improved for those PCPs who devoted ≥90 minutes studying the VP. Telephone interviews conducted after training revealed PCPs felt they did not have enough time and/or clinical training to properly diagnose or treat refugee patients in the primary health care setting.Conclusions: The PCPs in this pilot study demonstrated the ability to improve their treatment plan for traumatized refugee patients in the medical and psychological domains after VP training. Devotion of time with the VP training instrument was significantly associated with improvement in all domains.
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| 3. |
- Panziaras, Ioannis, et al.
(författare)
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A pilot study of user acceptance and educational potentials of virtual patients in transcultural psychiatry
- 2012
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Ingår i: International Journal of Medical Education. - : International Journal of Medical Education. - 2042-6372. ; 3, s. 132-140
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The purpose of this pilot study was to evaluate user acceptance, educational potentials and face and con-struct validity of a dedicated Virtual Patient system for refugee trauma cases, designed to enhance clinical, interper-sonal, social and cultural competence.Methods: We developed a Virtual Patient system portraying a female refugee – mediated by a still image and pre-recorded voice – that was evaluated by an invited group of physicians (n=9) working as residents in Psychiatry (n=8) and General Medicine (n=1). The participants were invited to provide insights/feedback about the system’s usefulness and its educational value.Results: Scores across our sample were high regarding the Virtual Patient system’s realistic nature (median value: 5 on a 7-point scale) as well as the Virtual Patient’s ability to mirror the course of a real clinical investigation (median value: 6 on a 7-point scale). The system was said to provide a good environment for safe training of clinical and com-municative skills. The system’s face and construct validity were also demonstrated. Proposed future improvements will include the implementation of detailed feedback from a Virtual Advisor and/or the Virtual Patient him/herself, the use of video-simulated patients and the ability to formulate clinical questions in free text.Conclusions: This dedicated Virtual Patient system was well received by the participants. They appraised it as having a good potential for training in relationship to the clinical encounter and the management of traumatized refugees.
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| 4. |
- Valeriani, Giuseppe, et al.
(författare)
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Addressing Healthcare Gaps in Sweden during the COVID-19 Outbreak : On Community Outreach and Empowering Ethnic Minority Groups in a Digitalized Context
- 2020
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Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 8:4
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Tidskriftsartikel (refereegranskat)abstract
- Since its early stages, the COVID-19 pandemic has interacted with existing divides by ethnicity and socioeconomic statuses, exacerbating further inequalities in high-income countries. The Swedish public health strategy, built on mutual trust between the government and the society and giving the responsibility to the individual, has been criticized for not applying a dedicated and more diverse strategy for most disadvantaged migrants in dealing with the pandemic. In order to mitigate the unequal burden on the marginalized members of society, increasing efforts have been addressed to digital health technologies. Despite the strong potential of providing collective public health benefits, especially in a highly digitalized context as Sweden, need for a stronger cooperation between the public health authorities and migrant community leaders, representatives of migrant associations, religious leaders and other influencers of disadvantaged groups has emerged. Suggestions are presented on more culturally congruent, patient-centered health care services aimed to empower people to participate in a more effective public health response to the COVID-19 crisis.
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| 5. |
- Valeriani, Giuseppe, et al.
(författare)
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Tackling Ethnic Health Disparities Through Community Health Worker Programs : A Scoping Review on Their Utilization During the COVID-19 Outbreak
- 2022
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Ingår i: Population health management. - : Mary Ann Liebert. - 1942-7891 .- 1942-7905. ; 25:4, s. 517-526
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Forskningsöversikt (refereegranskat)abstract
- The coronavirus disease (COVID-19) outbreak has magnified existing health inequities linked to social determinants of health, with racial and ethnic minorities being disproportionately affected by the pandemic. A proposed strategy to address these inequities is based on the implementation of community health worker (CHW) programs able to bridge the gaps between marginalized communities and the formal health care systems. A scoping review was conducted through searching 4 databases: PubMed, Scopus, Web of Science, and Science Direct. Inclusion criteria focused on studies defining any kind of adopted CHW intervention to address inequities related to racial/ethnic groups during the COVID-19 crisis, published from December 31, 2019, to October 31, 2021. Narrative synthesis was undertaken to summarize the findings. In total, 23 studies met the inclusion out of the 107 search results. Data converged on the relevant potential of CHWs on engaging with community leaders, addressing social determinants of health, and issues related to structural racism, promoting culturally tailored health information, and encouraging institutions to policy change in favor of people left behind. Although vulnerability of racial and ethnic minorities was already present before the COVID-19 outbreak, the pandemic has represented a wakeup call to address it more efficiently. In recent years, CHWs have increasingly been acknowledged as valuable members of the health care workforce. As health disparities may increase after our multicultural societies begin to recover from COVID-19, CHWs may play a crucial role in addressing system-level changes to have broad and lasting effects on health outcomes.
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| 6. |
- Valeriani, Giuseppe, et al.
(författare)
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Unconventional Answers to Unprecedented Challenges: The Swedish Experience During the COVID-19 Outbreak
- 2020
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Ingår i: Journal of Preventive Medicine and Public Health. - : Korean Society for Preventive Medicine. - 1975-8375 .- 2233-4521. ; 53:4, s. 233-235
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Forskningsöversikt (refereegranskat)abstract
- Since its early stages, the coronavirus disease 2019 (COVID-19) pandemic has posed immense challenges in meeting the public health and healthcare and social care needs of migrants. In line with other reports from United Kingdom and United States, data from Swedens health authority show that migrants have been disproportionately affected by COVID-19. Following the World Health Organizations statements, as well as the European Public Health Associations call for action, several centres in Swedens most populated areas have activated tools to implement national plans for community outreach through initiatives targeting migrants and ethnic minority groups. Unconventional means should be promoted to mitigate the impact of COVID-19 on migrants and the health of the public at large.
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