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:
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.