9 research outputs found
Physician associate (PA) students’ perceptions of team-based learning (TBL) for teaching in Geriatric medicine
Get PDFData availability:
The survey results are provided within the supplementary material section (Supplementary material, Figure S2).Supplementary Information is available online at: https://link.springer.com/article/10.1186/s12909-025-06787-7#Sec15 .Background:
Physician Associates have recently been introduced to the UK healthcare workforce. Their curriculum includes important topics in Geriatric medicine. As they undertake a 2-year intensive postgraduate course we wanted to explore if Team-based Learning is an effective and efficient learning strategy. In addition, we wanted to know how this approach compares to their current learning methods, namely Problem-based learning and lectures.
Methods:
This was a qualitative study of Physician associate student perceptions of Team-Based Learning. After introducing four TBL sessions in the specialty of Geriatric medicine we sent students anonymous questionnaires asking them about their TBL experience and how it compared to PBL and lectures. We then undertook a thematic analysis of the responses.
Results:
Twenty students responded to our online questionnaire. The thematic analysis utilised themes from previous studies as well as emergent ones. The key themes were that TBL requires more preparation, TBL is effective, TBL is preferred to PBL and lectures, but students did not want TBL to replace all their teaching.
Conclusions:
TBL is an effective learning strategy that can be used alongside other teaching methods. While Physician Associate students preferred TBL over PBL and lectures, they wanted to have TBL alongside lectures at least. This information is important when planning teaching for an intensive 2-year course.Open access agreement was provided by Brunel University London
Rehabilitation using virtual gaming for Hospital and hOME Based training for the Upper limb post Stroke (RHOMBUS II): a feasibility randomised controlled trial
Get PDFMeeting abstract presented at the 17th UK Stroke Forum Conference, 29th November – 1st December 2022, Liverpool ACC, UK.Introduction: Stroke survivors can experience persistent upper-limb (UL) weakness. Intense practice and repetition of movement are key to effective UL rehabilitation. Yet, practice falls short of the dosage needed to drive recovery. Technology offers solutions to increase training opportunities. The NeuroBall is a co-designed portable device for all-in-one arm training through a uniquely designed rehabilitation gaming app, displayed on a tablet computer. This study aimed to determine the safety, feasibility and acceptability of the NeuroBall in the subacute inpatient and ESD stroke pathways when practice can be most effective.
Method: Single-site feasibility RCT with non-blinded outcomes at seven weeks. Twenty-four sub-acute stroke with new unilateral weakness were randomised (Intervention n=16; control n=8). Both groups received UL usual care; the intervention group, once trained, used the NeuroBall for seven weeks. Outcomes included arm impairment, arm function, pain, fatigue and self-efficacy for exercising alone, participant satisfaction, device usage and adverse events (AEs) and missing data.
Results: Twenty-four participants were recruited, eighteen completed all stages. Outcome measures were suitable, and there was minimal missing data (less than 10%). Participants undertook an additional 13 hours of UL rehabilitation, completing an average of 15, 133 UL repetitions. The mean satisfaction score (QUEST) was 35/40. Eight AEs were reported, six in the intervention group and two in the control, five were unrelated, one related, one probable and one possibly.
Conclusion: The NeuroBall is safe, enjoyable and easy to use for training the UL in the subacute stroke pathway both as an inpatient and early weeks at home
Rehabilitation using virtual gaming for Hospital and hOMe-Based training for the Upper limb in acute and subacute Stroke (RHOMBUS II): results of a feasibility randomised controlled trial
Get PDFData availability statement:
Data are available upon reasonable request. Data will be made available on the Figshare data repository.Objective: To investigate the safety, feasibility and acceptability of the Neurofenix platform for upper-limb rehabilitation in acute and subacute stroke.
Design: A feasibility randomised controlled trial with a parallel process evaluation.
Setting: Acute Stroke Unit and participants’ homes (London, UK).
Participants: 24 adults (>18 years), acute and subacute poststroke, new unilateral weakness, scoring 9–25 on the Motricity Index (elbow and shoulder), with sufficient cognitive and communicative abilities to participate.
Interventions: Participants randomised to the intervention or control group on a 2:1 ratio. The intervention group (n=16) received usual care plus the Neurofenix platform for 7 weeks. The control group (n=8) received usual care only.
Outcomes: Safety was assessed through adverse events (AEs), pain, spasticity and fatigue. Feasibility was assessed through training and support requirements and intervention fidelity. Acceptability was assessed through a satisfaction questionnaire. Impairment, activity and participation outcomes were also collected at baseline and 7 weeks to assess their suitability for use in a definitive trial.
Randomisation: Computer-generated, allocation sequence concealed by opaque, sealed envelopes.
Blinding: Participants and assessors were not blinded; statistician blinded for data processing and analysis.
Results: 192 stroke survivors were screened for eligibility, and 24 were recruited and randomised. Intervention group: n=16, mean age 66.5 years; median 9.5 days post stroke. Control group: n=8, mean age 64.6 years; median 17.5 days post stroke. Three participants withdrew before the 7-week assessment, n=21 included in the analysis (intervention group n=15; control group n=6). No significant group differences in fatigue, spasticity, pain scores or total number of AEs. The median (IQR) time to train participants was 98 (64) min over 1–3 sessions. Participants trained with the platform for a median (range) of 11 (1-58) hours, equating to 94 min extra per week. The mean satisfaction score was 34.9 out of 40.
Conclusion: The Neurofenix platform is safe, feasible and well accepted as an adjunct to usual care in acute and subacute stroke rehabilitation. There was a wide range of engagement with the platform in a cohort of stroke survivors which was varied in age and level of impairment. Recruitment, training and support were manageable and completion of data was good, indicating that a future randomised controlled trial would be feasible.
Trial registration number: ISRCTN11440079.This work was supported by The Stroke Association and MedCity grant number SA MC 21\10001
Rehabilitation Using Virtual Gaming For Hospital And Home- Based Training For The Upper Limb In Acute And Subacute Stroke (Rhombus Ii): Results Of A Feasibility RCT
Get PDFConference poster presented at the 19th UK Stroke Forum Conference, 1st–3rd December 2024, Liverpool ACC, UK.Introduction: Current provision of upper-limb (UL) rehabilitation during the early period post stroke is insufficient to optimise potential for recovery. Virtual reality systems, such as the Neurofenix platform, can help increase the intensity of UL rehabilitation across the stroke pathway.
Method: A feasibility RCT was undertaken to determine the safety, feasibility and acceptability of the Neurofenix platform. Stroke survivors with UL weakness were recruited from in-patient or early supported discharge stroke teams. Both groups received usual care, the intervention group also had the Neurofenix platform for 7-weeks. Outcomes were assessed at baseline and 7-weeks. Safety was assessed through adverse events (AEs), pain, spasticity and fatigue. Feasibility was determined through training and support requirements, and acceptability through intervention fidelity and a satisfaction questionnaire.
Results: 24 participants were randomised, n=16 to the intervention (13 women; mean (SD) age 66.5 (15) years; median (range) 9.5 (1-42) days post-stroke) and n=8 control group (4 women; mean (SD) age 64.6 (13.6) years; median (range) 17.5 (4-23) days post-stroke). 3 participants withdrew before 7-weeks, with 21 (intervention group n=15; control group n=6) included in the analysis. No significant between group differences in fatigue, spasticity, pain scores or total number of AEs. Median (IQR) time to train participants was 98 (64) minutes over 1-3 sessions. Participants trained with the platform for a median (range) of 11 (1-58) hours, equating to 94 minutes extra per week.
Conclusion: The Neurofenix platform is safe, feasible and well-accepted across the hospital and home settings, supporting increased dose and intensity of essential early UL stroke rehabilitation
Early Analgesic and Anti-Emetic Prescriptions for New Surgical Admissions: A Closed Loop Audit
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