Stakeholder feedback at four ePRO-naïve healthcare institutions about the need, effectiveness, and barriers to usage of a fully EHR-integrated ePRO tool.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 165-165
Author(s):  
Deborah Schrag ◽  
Raymond U. Osarogiagbon ◽  
Sandra L. Wong ◽  
Hannah Hazard ◽  
Jessica J Bian ◽  
...  
Keyword(s):  
Language Proficiency ◽  
Symptom Management ◽  
Computer Literacy ◽  
English Language ◽  
Medical Center ◽  
Cancer Center ◽  
Patient Acceptance ◽  
Future Research ◽  
Multiple Choice Questions ◽  
Patient Reported

165 Background: Collecting patient-reported outcomes (PROs) is a proven method to enhance doctor-patient communication and care. With the influx of technology and usage of telehealth services, electronic PROs (ePROS) have become the mainstay for ascertaining how a patient is doing at home. Collection of ePROs is particularly valuable for providers caring for rural and vulnerable populations with limited access to high quality care. A fully EHR-integrated ePRO collection system could help bridge the gap. Methods: To inform the design, function, and deployment of a new EHR-integrated ePRO symptom management system, focus groups with stakeholders were conducted at four institutions caring for largely rural-based populations (Baptist Cancer Center, West Virginia University Cancer Institute, Dartmouth-Hitchcock Medical Center, Maine Medical Center). Sessions were conducted 2 to 3 months prior to the launch of a new ePRO platform and included oncologists, surgeons, practice nurses, tech analysts, operations staff, and institutional leadership. Each group included a 30-minute overview of the new tool followed by a 30-minute discussion with qualitative open-ended questions and clicker-enabled multiple-choice questions. Developed questions utilized the CFIR and RE-AIM implementation frameworks. Results: In total, 134 stakeholders participated from the four institutions. RNs made up nearly half of respondents (47%). 97% of participants felt a new ePRO system would complement existing healthcare initiatives and 64% felt it would be extremely effective/very effective in improving symptom management. Each group was asked to rate the barriers to patient usage of an ePRO system in the home-care setting. Computer literacy (51%) and access to an internet-enabled device (48%) ranked as the highest barriers. Other barriers perceived to be of less significance included privacy, distrust, and limited English-language proficiency. Consequently, two-thirds of respondents felt patients would only be somewhat likely/not so likely to use an ePRO system; one-third felt patients would be likely/extremely likely to utilize the system. Conclusions: From the perspective of stakeholders at four engaged institutions, an integrated ePRO tool is considered a widely acceptable symptom management solution, but uncertainty remains around patient acceptance and uptake. Future research will include post-implementation discussions with stakeholders and evaluation of patient utilization and clinical outcomes.

An Empirical Study of Reading Habits and Interests of Saudi University EFL Learners

2015 ◽  
Vol 7 (2) ◽  
pp. 1 ◽  
Author(s):  
Hussam Rajab ◽  
Alhasan Al-Sadi
Keyword(s):  
Language Proficiency ◽  
English Language ◽  
Future Research ◽  
Small Scale ◽  
Reading Habits ◽  
Efl Learners ◽  
Academic Reading ◽  
Preparatory Year ◽  
The University ◽  
L1 And L2

<p align="left">This small-scale, quantitative study investigated the reading habits and interests of Saudi English-as-a-foreign-language (EFL) students at a university-level preparatory year program (PYP). The study aimed to identify certain habits and preferences of EFL learners with regard to various personal practices of the reading process in first language (L1) as well as in second language (L2). The study utilized a custom-designed, 10-item questionnaire on a Likert scale format in order to gain more insights into the manners with which students may or may not approach reading. The participants were newly-registered, male and female students (<em>n=330</em>) on the university PYP course with mixed English Language proficiency. Analysis of the data collected using descriptive statistical tools indicated several issues relating to the reading habits in general, including students’ lack of interest as well as lack of motivation towards ‘academic reading’ in both L1 and L2. However, the analysis revealed a greater level of engagement in reading in social media contexts. The study has several implications for future research and pedagogy in EFL reading as well as implications for the EFL classroom. </p>

Development of self-management tip sheets for medical oncology and surgical patients electronically reporting symptoms in the home-care recovery setting.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 299-299
Author(s):  
Deborah Schrag ◽  
Raymond U. Osarogiagbon ◽  
Sandra L. Wong ◽  
Hannah Hazard ◽  
Jessica J Bian ◽  
...  
Keyword(s):  
Home Care ◽  
Health Systems ◽  
Symptom Management ◽  
Medical Oncology ◽  
Medical Center ◽  
Care Team ◽  
Surgical Patients ◽  
Self Management ◽  
Patient Portal ◽  
Patient Reported

299 Background: Patients receiving cancer treatments, including chemotherapy and surgery, often face immense morbidities. Poor symptom control frequently leads to decreased quality of life and an increased need for acute care services. For patients undergoing chemo, adverse side effects can deter them from receiving life-saving therapies. Similarly, poorly managed postoperative symptoms can delay recovery and timely receipt of adjuvant therapies. Empowering patients to proactively monitor, electronically report, and effectively treat symptoms in the home-care setting is critical to improving clinical outcomes. Methods: Through the NCI’s Moonshot-funded IMPACT consortium, 6 health systems developed a library of 70 open source symptom management tip sheets for medical oncology and surgical patients. The study team went through an iterative process with medical oncologists, surgeons, practice nurses, health educators, and patient advocates. Careful attention was paid to minimize the usage of regional dialects or idioms to ensure scalability and acceptability. The tip sheets achieved passing scores on two validated healthy literacy and readability tools. Results: Tip sheets were accessible to patients participating in the novel eSyM (electronic symptom management) program, a fully EHR-integrated ePRO model.eSyM and the incorporated tips were deployed at four health systems between fall 2019 and spring 2020 (Baptist Cancer Center, West Virginia University, Dartmouth-Hitchcock Medical Center, and Maine Medical Center). Patients enrolled in eSyM had access to the tip sheet library through their patient portal and could view them at any time. In addition, after completing an ePRO questionnaire, patients were given dedicated links to the tips for symptoms they reported. Each developed tip sheet included 4 sections: 1) things you can do on your own, 2) with over-the-counter medications, 3) with the help of your care team, 4) when to call your care team for help. This simplified structure allowed patients to determine how to manage symptoms on their own and when to seek out assistance. Conclusions: Presenting self-management tip sheets in response to patient-reported symptoms through a fully integrated patient portal platform is a novel approach to symptom management. Future efforts will include deploying the library and platform at two additional health institutions and evaluating the adoption, acceptability, and utilization of the tip sheets and their impact on clinical care outcomes.

scholarly journals Physical Activity as a Nonpharmacological Symptom Management Approach in Myeloproliferative Neoplasms: Recommendations for Future Research

2016 ◽  
Vol 16 (4) ◽  
pp. 439-450 ◽  
Author(s):  
Ryan Eckert ◽  
Jennifer Huberty ◽  
Krisstina Gowin ◽  
Ruben Mesa ◽  
Lisa Marks
Keyword(s):  
Physical Activity ◽  
Symptom Management ◽  
Myeloproliferative Neoplasms ◽  
Symptom Burden ◽  
Preliminary Evidence ◽  
Cardiovascular Fitness ◽  
Future Research ◽  
Cell Transplant ◽  
Patient Reported ◽  
Hematological Cancers

Purpose: Essential thrombocythemia, polycythemia vera, and myelofibrosis are rare chronic hematological malignancies known as myeloproliferative neoplasms (MPNs) and are characterized by deregulated myeloid lineage cell production, splenomegaly, and heterogeneous symptom profiles. MPN patients suffer from a significant symptom burden (eg, fatigue, depressive symptoms, early satiety) and an impaired overall quality of life (QoL). Current treatments typically include pharmacological approaches, which may come with additional side effects and may be limited by treatment-associated toxicities (ie, cytopenias). Nonpharmacological approaches such as physical activity may be beneficial for reducing symptom burden and improving QoL. To date, no studies have examined physical activity as a nonpharmacological approach in MPN patients despite preliminary evidence supporting its benefit in other hematological cancers. The purpose of this article is to (1) review the literature related to physical activity and specific hematological cancer subtypes and to (2) make suggestions for future research involving physical activity in MPN patients as a symptom management strategy. Methods: A brief review of studies examining physical activity in leukemias, lymphomas, and myelomas (excluding stem-cell transplant patients) was conducted. Results: There is preliminary evidence to suggest that physical activity may be an effective approach to improve patient-reported outcomes (fatigue, depression, anxiety, sleep), physical fitness (cardiovascular fitness, balance, body composition), and overall QoL in other hematological cancers. Conclusions: Based on encouraging findings in other hematological cancers, future research should examine the feasibility and effectiveness of physical activity in MPN patients.

scholarly journals The Professional Development of English Language Teachers in Colombia: A Review of the Literature

2019 ◽  
Vol 1 (21) ◽  
pp. 89-102 ◽  
Author(s):  
Ximena Paola Buendia ◽  
Diego Fernando Macías
Keyword(s):  
Professional Development ◽  
Teacher Professional Development ◽  
Language Proficiency ◽  
English Language ◽  
Empirical Studies ◽  
Integrated Approach ◽  
Language Teachers ◽  
Future Research ◽  
Teacher Professional ◽  
English Language Teachers

This article offers a review of 25 empirical studies to identify the areas and findings of professional development initiatives for in-service English teachers in Colombia. The reviewed studies suggest that language teacher professional development has focused on six major areas: language proficiency, research skills and reflective practice, teachers’ beliefs and identities, an integrated approach to teacher professional development, pedagogical skills and teaching approaches, and emerging technologies. Results suggest that there is a need to move from traditional master-apprentice, content-oriented, teacher-centered models of professional development towards initiatives that allow teachers to critically analyze their particular context and needs, and devise their own local alternatives so that they can become more active agents of their own process of change. Issues that constitute possible alternatives for future research in the professional development of English language teachers are discussed.

A health system wide approach to the delivery of survivorship care plans.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 42-42
Author(s):  
Jennifer R. Klemp ◽  
Heather Vanbebber ◽  
Tanya Folker ◽  
Lisa Serig ◽  
Tim Metcalf ◽  
...  
Keyword(s):  
Health System ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cancer Center ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Clinical Patient ◽  
Care Plans ◽  
Accreditation Standards ◽  
Patient Reported

42 Background: Survivorship care plans (SCPs) are recognized by organizations including the American Society of Clinical Oncology and the American College of Surgeons Commission on Cancer, as a best practice for improving survivor care. Little evidence supports this and hospitals and cancer centers are scrambling to meet deadlines for SCP development and delivery. The University of Kansas Cancer Center (KUCC) addressed this utilizing electronic health record (EHR) integration, developing a health system wide approach to education and delivery, and building referral workflows to primary care and specialists. We report on this approach to developing and growing a survivorship care program. Methods: KUCC is a NCI designated cancer center within an academic medical center and health system, with 11 outpatient locations across the Kansas City. Under the guidance of a multidisciplinary team: providers, health care informatics, administrators, nursing, tumor registry, quality improvement, and researchers, KUCC developed a step-wise process to deliver comprehensive survivorship care across the health system. This multi-year initiative aligned with institutional accreditation standards and an ongoing focus on expanding evidence based, comprehensive cancer and supportive care. Results: In 2014 a formal survivorship program plan was put into action: Support from leadership, providers, research priority; Staff and patient survivorship education & training; Integrated delivery of survivorship care at all locations with direct interaction and feedback from cancer care teams; Short & long-term programmatic goals; Management and referral of late effects of cancer; EPIC integrated SCP template: auto-populated, customized, personalized; treatment summary uses tools that pull in data stored discreetly in the patient "file"; SCP delivery targeting COC phase-in timeline: 2015: n= 539 (10% projection n= 434); 2016: n= 1,355 (25% projection n=1,253). Conclusions: This step-wise, integrated approach to survivorship care has resulted in a health system wide delivery of SCPs and meeting national accreditation standards. Next steps include the evaluation of cost and clinical/patient reported outcomes.

scholarly journals Computer Supported Collaborative Writing: Does it Work among ESL Learners?

2018 ◽  
Vol 10 (3) ◽  
pp. 35
Author(s):  
Nur Hazirah Che Ithnin ◽  
Farhanahbinti Mohamad Fikray ◽  
Noor Zainab Abdul Razak
Keyword(s):  
Language Proficiency ◽  
English Language ◽  
Collaborative Writing ◽  
Future Research ◽  
Writing Assessments ◽  
Writing Skill ◽  
Post Test ◽  
Research Findings ◽  
User Friendly ◽  
Esl Learners

This study examines the effectiveness of using Wiki as a platform to enhance EL learners’ writing skill in English language. In particular, the aim of this research is to examine learners’ performance in composing English language essays as well as to identify the challenges which the students faced throughout the process of writing through Wiki. This study involved the respondents from secondary school who were in Form 2 and it consists of three levels of language proficiency which the researchers have identified. Specifically, the research data is collected through writing assessments (pre-test and post-test). For pre-test and post-test, the website selected as a platform was ZOHO Wiki which is a free user friendly online server designed for collaborative writing. The data from pre-test and post-test was analysed according to the marks obtained. Particularly, the research findings showed that students positively show an encouraging improvement in their English language essays and writing skill. Besides, some   challenges on the Wiki website and technological related issues that occurred during the process of Wiki mediated writing have also been identified such as difficulties in terms of Wiki tools software, technological related problem, collaborative writing issues, and other relevant challenges related to the research topic. In addition, the pedagogical implications, limitations as well as recommendations on the future research which are relevant to the present study are discussed and elaborated. In short, collaborative learning through Wiki provides learners with an interactive platform for writing English language composition.

scholarly journals Dental Students’ Perceptions of ESP Material and its Impact on Their Language Proficiency: A Case Study of a Saudi Arabian University

2020 ◽  
Author(s):  
Uzma M Hashmi ◽  
Hussam Rajab ◽  
Asrar Ehsan Sindi
Keyword(s):  
Language Proficiency ◽  
English Language ◽  
Research Question ◽  
Saudi Arabian ◽  
Dental Students ◽  
Future Research ◽  
Structured Interviews ◽  
Main Research ◽  
Classroom Activities ◽  
The Impact

The paper aims to explore the dental English for Specific Purposes (ESP) students’ perceptions of the ESP material and its influence on their English proficiency in the dentistry department of a Saudi Arabian university. The study adopts a qualitative technique of semi-structured interviews to elicit the views of 12 purposively chosen participants. The process of a thematic analysis of the qualitative data led to the emergence of three overarching themes that aimed to answer the main research question which is how the dental students in the Saudi context perceive the ESP materials and the impact these materials have on their language proficiency. The key findings indicate that the ESP learners in the dentistry department have a very positive attitude towards learning the English language in general and ESP in particular. Their awareness of their linguistic needs makes it a significant study in the field of ESP in Saudi Arabia. The results also suggest that the coursebook contents and material are outdated and inappropriate for the ESP learners in the Saudi English as a Foreign Language (EFL) context. The findings illustrate that the ESP teachers need to use the English language in classrooms and introduce learner-centred interactive activities to encourage students to participate in classroom activities. In light of the findings, the study outlines the implications and gives directions for future research.

scholarly journals Implementation of a cloud-based electronic patient-reported outcome (ePRO) platform in patients with advanced cancer

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Olga Generalova ◽  
Mohana Roy ◽  
Evan Hall ◽  
Sumit A. Shah ◽  
Kristen Cunanan ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Supportive Care ◽  
Healthcare Utilization ◽  
Advanced Cancer ◽  
Data Privacy ◽  
Medical Center ◽  
Academic Medical Center ◽  
Ease Of Use ◽  
Cancer Center ◽  
Patient Reported

Abstract Background Patient reported outcomes (PROs) have been associated with improved symptom management and quality of life in patients with cancer. However, the implementation of PROs in an academic clinical practice has not been thoroughly described. Here we report on the execution, feasibility and healthcare utilization outcomes of an electronic PRO (ePRO) application for cancer patients at an academic medical center. Methods We conducted a randomized trial comparing an experimental ePRO arm to standard of care in patients with advanced cancer in the thoracic, gastrointestinal, and genitourinary oncology groups at Stanford Cancer Center from March 2018 to November 2019. We describe the pre-implementation, implementation, and post-implementation phases of the ePRO arm, technological barriers, electronic health record (EHR) integration, clinician burden, and patient data privacy and security. Feasibility was pre-specified to be at least 70% completion of all questionnaires. Acceptability was based on patient and clinician feedback. Ambulatory healthcare utilization was assessed by reviewing numbers of phone messages, electronic portal messages, and referrals for supportive care. Results Of 617 ePRO questionnaires sent to 72 patients, 445 (72%) were completed. Most clinicians (87.5%) and patients (93%) felt neutral or positive about the ePRO tool’s ease of use. Exposure to ePRO did not cause a measurable change in ambulatory healthcare utilization, with a median of less than two phone messages and supportive care referrals, and 5–6 portal messages. Conclusions Web-based ePRO tools for patients with advanced cancer are feasible and acceptable without increasing clinical burden. Key lessons include the importance of pilot testing, engagement of stakeholders at all levels, and the need for customization by disease group. Future directions for this work include completion of EHR integration, expansion to other centers, and development of integrated workflows for routine clinical practice.

The Role of Order and Sequence of Options in Multiple-choice Questions for High-stakes Tests of English Language Proficiency

2020 ◽  
Vol 9 (6) ◽  
pp. 110
Author(s):  
Talip Karanfil ◽  
Steve Neufeld
Keyword(s):  
Language Proficiency ◽  
English Language ◽  
Multiple Choice ◽  
High Volume ◽  
English Language Proficiency ◽  
Proficiency Tests ◽  
Multiple Choice Questions ◽  
High Stakes ◽  
Test Items ◽  
Two Factors

High-stakes and high-volume English language proficiency tests typically rely on multiple-choice questions (MCQs) to assess reading and listening skills. Due to the Covid-19 pandemic, more institutions are using MCQs via online assessment platforms, which facilitate shuffling the order of options within test items to minimize cheating. There is scant research on the role that order and sequence of options plays in MCQs, so this study examined the results of a paper-based, high-stakes English proficiency test administered in two versions. Each version had identical three-option MCQs but with different ordering of options. The test-takers were chosen to ensure a very similar profile of language ability and level for the groups who took the two versions. The findings indicate that one in four questions exhibited significantly different levels of difficulty and discrimination between the two versions. The study identifies order dominance and sequence priming as two factors that influence the outcomes of MCQs, both of which can accentuate or diminish the power of attraction of the correct and incorrect options. These factors should be carefully considered when designing MCQs in high-stakes language proficiency tests and shuffling of options in either paper-based or computer-based testing.

scholarly journals The Commodification of Chinese in Thailand’s Linguistic Market: A Case Study of How Language Education Promotes Social Sustainability

2020 ◽  
Vol 12 (18) ◽  
pp. 7344
Author(s):  
Shujian Guo ◽  
Hyunjung Shin ◽  
Qi Shen
Keyword(s):  
Language Learners ◽  
Language Proficiency ◽  
Low Income ◽  
English Language ◽  
Chinese Language ◽  
Language Education ◽  
Social Sustainability ◽  
Future Research ◽  
Critical Approach ◽  
Chinese Language Learners

In recent decades, the commodification of the English language has aroused intensive research interest in the sociolinguistics on a global scale, but studies on the commodification of the Chinese language are relatively rare. Most studies take a critical approach in relation to its adverse impacts on minority rights and social justice. This study examined the language landscape in Chiangmai, Thailand, and the linguistic beliefs of local Thai Chinese language learners. Based on their feedback, this study investigated the commodification of Chinese language education in the community of Chinese language learners in Chiangmai. We found that from a less critical perspective, the commodification of a second language provides more accessible and affordable educational opportunities for learners, especially those from low-income families, and at the same time language proficiency can broaden learners’ career choices and provide employees with additional value in industries, such as tourism, commerce, and services. This finding implies that language commodification, rather than typically being associated with linguistic imperialism and unbalanced socio-economic status, can be a contributing factor in promoting higher-education availability and social sustainability in certain circumstances. There may be some mediating factors between the commodification of language and changes in the sustainable balance of language, opening up space for future research to explore.

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