Underserved populations continue to be at disproportionate risk for adverse health outcomes. We have known for quite some time that increasing the diversity of the health care workforce is an important solution to this problem. Students from underrepresented groups continue to experience lack of access and barriers to persistence in their education pathways, which results in limited representation in the health professions and ultimately contributes to the health outcome disparities experienced by African American, American Indian/Alaska Native, Hispanic/Latino, Pacific Island, and other groups.1Jackson and Gracia explained, “Racial/ethnic diversity in the health-care workforce [sic] has been well correlated with the delivery of quality care to minority populations.”
Public responses to social distancing and face mask requirements as preventive measures against the novel coronavirus, SARS-COV-2 (the organism that causes COVID-19), hearken back to similar reactions to laws related to raising the legal age to purchase tobacco products, requirements to wear seat belts, bans on indoor smoking, and laws regarding motorcycle helmets. The reasons for resistance given by our patients when discussing preventive measures often center on the issue of autonomy. An evidence-based motivational interview (EBMI) offers helpful strategies to educate patients in a manner that respects their self-determination while prompting healthy behaviors.
Topics: Health Professions
The COVID-19 pandemic has demonstrated the importance of research regarding accuracy of diagnostic tests, and the importance of understanding, applying, and teaching the related subject matter. An often-recommended mnemonic for interpreting biostatistics associated with diagnostic modalities is SpPIn-SnNOut, which stands for Specific/Positive rule In (SpPIn) and Sensitive/Negative rule Out (SnNOut). In other words, a positive result from a test with high specificity (Sp) can be trusted. A negative result from a test with high sensitivity (Sn) can be trusted. The mnemonic is based on the Sn and Sp characteristics of any diagnostic test when compared with a gold standard test or other data source that is known to be accurate. The following contingency table and formulas represent how such tests are performed.
I have taught an online course in evidence-based practice (EBP) for undergraduate health sciences students (from various majors) twice a year for the last nine years. I was able to continue teaching the course this spring during the first months of the COVID-19 pandemic due to its online format. This semester teaching EBP took on a deep feeling of urgency for me as our society grappled with questions regarding the relative hazard of COVID-19 versus seasonal influenza, and the accuracy (and rapidity) of diagnostic and immune marker testing.
The subject matter of a course, in itself, might be perceived as having an inherent level of difficulty based on an array of factors, such as the degree of abstraction of the concepts to be learned or the experience students have in their prior educational history.1,2 Some topics are widely recognized by students as more challenging, such as biochemistry, calculus, and thermodynamics. Research has demonstrated that effective design and delivery can overcome the difficulty perception. Wyse3 found courses identified by students (at the 100 and the 300 levels) when asked to describe the hardest class you have ever taken have the following characteristics:
What you should know
On Wednesday, March 11, 2020, the World Health Organization (WHO) announced that COVID-19, or Coronavirus Disease 2019; caused by the SARS-CoV-2 virus, has reached pandemic status. A pandemic is defined as a disease that has spread beyond the borders of countries where it has already reached epidemic status and led to disease cases worldwide. The last WHO-announced pandemic was due to the H1N1 strain of influenza in 2009. In general, Coronaviruses cause mild self-limiting cold-like symptoms in previously recognized pathogenic strains, such as 229E, OC43, HKUI, and NL 63, while SARS-CoV and MERS-CoV have been shown to produce significant respiratory symptoms.
If you teach science subject matter to students in health professional programs, there’s a good chance you’ve heard the lament, “Why do I have to learn this? I’ll never use this information.” It can be surprising and concerning to hear future health professionals declare topics such as statistics, research, biology, chemistry, and others in their programs as "irrelevant" to their intended careers—in some cases before they have worked a single day in that career. Even more concerning, it’s not unusual for there to be high failure rates associated with these subjects for health professional students.
What is Evidence-Based Practice?
Evidence-Based Practice (EBP) is“the process of combining the best available research evidence with your knowledge and skill to make collaborative, patient- or population-centered decisions within the context of a given healthcare situation” (Howlett, Rogo, Shelton, 2020). EBP is used across health professions as an applied, critical thinking skill for making decisions in individual cases, educating patients, developing population health initiatives, and more.
The medical terminology course is designed to introduce medical vocabulary and terms to students who are beginning their career in in allied health, nursing, and medical fields.
Topics: allied health
Children with speech sound disorders comprise a large portion of caseloads for speech-language pathologists working with pre-school and school-age children. Selecting the most appropriate approach in order to yield the maximum change in the child’s phonological system is important to achieve optimal outcomes. Due to the importance and scope of the topic, I am constantly fielding the question, ‘How do I determine targets for the multiple opposition contrast approach?’ I hope my response below can be of use to you if you are encountering the same problem.
Children with phonological disorders often present challenges to SLPs in determining the most effective and efficient intervention approach, including the targets that will best facilitate significant progress. For some children, the loss of phonemic contrasts represents the core of the phonological disorder. Loss of phonemic contrasts is evident when production errors impact the intended meaning of a word, phrase or sentence. For example, a child may say [ti] for “tea”, but also for “key” and “see”. The words are produced as homonyms and the phonemes [k] and [s] are not use contrastively to create the different meanings represented in the words “key” and “see”.
Children who demonstrate extensive loss of contrast may produce one phoneme for many target phonemes. A collapse of phonemes is identified when a child produces one sound across several different target sounds, thus representing loss of the contrasts needed to create different words. The phoneme identified as the substitution for the target phoneme can also be referred to as the preferred phoneme. For example, an extensive collapse might be represented in a child that substitutes [b] for [d, k, g, m, n, s, l, r, ʃ, ʧ, j, h]. Thus, the targets of do, coo, goo, moo, new, Sue, loo, roo, shoe, chew, you, and who are all produced as boo. The phoneme [b] is the preferred phoneme. This extensive collapse of contrast results in extensive homonymy. Rather than attempt to develop a list of target words for this extensive collapse, phonemes are selected from the error phonemes to represent different phoneme classes. A key feature of the contrast approaches is to promote generalization across sound classes, thus each individual phoneme in the collapse does not need to be targeted. Further examination of the significant collapse where the child substitutes the preferred phoneme [b] for [d, k, g, m, n, s, l, r, ʃ, ʧ, j, h], the collapse represents multiple errors related to the following phoneme classes:
stops [d, k, g],
nasals [m, n],
fricatives [s, ʃ, h],
liquids [l, r],
glides [j], and