Journal of evaluation in clinical practice
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Healthcare systems are facing unprecedented need to respond to an ever-evolving context of providing safe person-centred care to its citizens and staff. This transformation requires a rethink of healthcare leadership. Systems leaders are critical for culture change; to support safe patient care, facilitate innovation, build person-centred teams, and develop a collaborative workforce. ⋯ However, a global model would translate this role within health systems more broadly. Potential exists for integrated expertise to enable quality care across the system to meet the needs of their local communities. With this in mind, this scoping review aimed at exploring the Multi Professional Consultant Practitioner role-what it is and how it contributes to system transformation.
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Medication adherence is a crucial factor in managing and treating chronic diseases in older adults. Health literacy (HL) skills and rational drug use (RDU) knowledge are important for individuals to make informed decisions about medication adherence behaviours. ⋯ The study found that medication adherence among older adults residing in nursing homes was moderate, RDU knowledge and HL levels were low, and medication adherence increased as RDU knowledge and HL levels increased.
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The COVID-19 pandemic necessitated rapid adaptation of clinical competence assessments, including the transition of Objective Structured Clinical Examinations (OSCE) from in-person to virtual formats. This study investigates the construct equivalence of a high-stakes OSCE, originally designed for in-person delivery, when adapted for a virtual format. ⋯ The study found that while examinee ability and case difficulty estimates exhibited some invariance between in-person and virtual OSCE formats, criteria involving physical assessments faced challenges in maintaining construct equivalence. These findings highlight the need for careful consideration in adapting high-stakes clinical assessments to virtual formats to ensure fairness and reliability.
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Dysfunctional exercise (DEX) is common among individuals with an eating disorder (ED) and poses significant challenges to treatment and recovery. While safe and nutritionally supported physical activity can enhance treatment outcomes without hindering weight restoration, clinicians often hesitate to address DEX with their patients. This mixed-method study aimed to evaluate the impact of a Safe Exercise at Every Stage (SEES) informed training on clinician knowledge and self-efficacy in managing DEX during ED treatment. ⋯ DEX continues to be preceived as a core ED symptom. To improve its managment clinician training and shifts in overarching field ideologies are needed. Providing programme-wide training is fundamental to equipping clinicians with the skills needed to address DEX and ultimately improve patient outcomes.
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Chronic non-cancer pain (CNCP) is a leading driver of disability. Primary care clinicians treat most patients with CNCP. Yet, they are often unable to identify appropriate pain treatments, mainly due to concerns about the safety and effectiveness of available medications. Clinical practice guidelines (CPGs) can be useful tools to guide primary care clinicians in selecting pain treatments based on the best available evidence. ⋯ Most CPGs focused on opioid management, with contradictory recommendations for non-opioid management based on low-quality evidence. Additional research is needed to strengthen the evidence for using non-opioid and non-pharmacological interventions to manage patients with CNCP.