Journal of evaluation in clinical practice
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Competency-based education (CBE) is currently being implemented across Canadian postgraduate medical education programmes through Competence by Design (CBD).1 Queen's University received permission to initiate CBE in all programmes simultaneously starting in 2017; an institutional initiative termed Competency-based medical education (CBME).2 We describe our initial experiences to highlight perceptions and barriers and facilitate implementation at other centers. ⋯ Our results indicate that faculty were concerned about the reluctance of residents to actively participate in CBE, while residents were hesitant to assume such a role because of lack of familiarity and perceived benefit. This discrepancy indicates attention should be devoted to (a) institutional administrative/educational supports, (b) faculty development around feedback/assessment, and (c) resident development to foster ownership of their learning and familiarity with CBE.
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Empathic communication in health care may enhance positive patient and health care professional relationships, patient satisfaction and can buffer professional burnout. The Jefferson Scale of Empathy (JSE) was developed based on the need to quantitatively measure levels of empathy, particularly in health care settings. Evaluating the utility of empathy is underpinned by the psychometric rigour of the instruments used to measure it. The aim of this study was to critically evaluate the current evidence on the measurement properties of the JSE. ⋯ The JSE demonstrates robust structural validity, internal consistency, and convergent validity. These measurement properties are generally well reported in the literature in studies of good methodological quality, and thus may be interpreted with relative confidence when used in empathy research. However, current evidence is limited for the properties of reliability, measurement error, and cross-cultural validity. Thus, a degree of caution should be considered in drawing conclusions when using the JSE with regard to these properties. It is recommended that future examinations of the JSE refer to the COSMIN guidelines to ensure complete and well-reported psychometric data are included.
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Background This article responds to one by Graham Martin and colleagues, who offered a critique of my previous publications on face coverings for the lay public in the Covid-19 pandemic. Their paper reflects criticisms that have been made of face coverings policies more generally. Method Narrative rebuttal. ⋯ I challenge my critics' apparent assumption that a particular kind of systematic review should be valorised over narrative and real-world evidence, since stories are crucial to both our scientific understanding and our moral imagination. Conclusion I conclude by thanking my academic adversaries for the intellectual sparring match, but exhort them to remember our professional accountability to a society in crisis. It is time to lay straw men to rest and embrace the full range of evidence in the context of the perilous threat the world is now facing.
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Review
The effect of acute coronary syndrome care pathways on in-hospital patients: A systematic review.
Health care institutions need to construct management strategies for patients diagnosed with acute coronary syndrome (ACS) that focus on evidence-based treatments, adherence to treatment guidelines, and organized care. These help to reduce variations as well as the mortality and morbidity rates, which indicates the critical need for standardized care and adherence to evidence-based practices for patients hospitalized with ACS. The care pathways translate research and guidelines into clinical practice to close the gap between the guidelines and the clinical practices. ⋯ Implementing ACS care pathway helps to organize care processes and decrease treatment delays as well as improve the patient outcomes without adverse consequences for patients or additional resources and costs. While the current level of evidence is inadequate to warrant a formal recommendation, there is a need for more studies with an emphasis on well-designed randomization to measure patient outcomes.
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To assess the association of the quality of allocation concealment with heterogeneity in age, the P value of the primary outcome and statistical significance of the primary outcome. ⋯ There is evidence of an association between poor allocation concealment methods and statistical significance of the primary outcome. Trials that use inadequate allocation concealment methods are more likely to have statistically significant P values compared with trials using good or adequate allocation concealment methods.