Enhancing the student experience through sustainable Communities of Practice

Introduction: The switch to online off-campus teaching for universities worldwide due to COVID-19 will transform into more sustainable and predictable delivery models where virtual and local student contact will continue to be combined. Institutions must do more to replace the full student experience and benefits of learners and educators being together. Methods: Our centre has been delivering distance blended and online learning for more than 40 years and has over 4000 alumni across five continents. Our students and alumni come from varied healthcare disciplines and are at different stages of their career as educators and practitioners. Whilst studying on the programme students work together flexibly in randomly arranged peer groups designed to allow the establishment of Communities of Practice (CoP) through the use of online Discussion Boards. Results: We found Discussion Boards encouraged reflection on learning, sharing of ideas with peers and tutors, reduce anxiety, support progression, and enable benchmarking. This led to a highly effective student sense of belonging to each other, our educators, and the wider University, with many highlighting an excellent student experience and maintaining a thriving CoP within the alumni body. Conclusion: Despite being based on one large postgraduate programme in medical education, our CoP approach is relevant to any undergraduate programme, particularly those that lead to professional qualification. With our mix of nationalities, we can ‘model the way’ for enabling strong CoP’s to share ideas about best practice with a strong student and alumni network which can be shared across the international healthcare community.

Upgrading Classroom Environments for Tomorrow's Learners

Educational structure in the P-12 environment has not changed in a century. However, with the onset of the coronavirus pandemic, school districts were forced to become innovative in their lesson delivery models. That necessary shift has provided innovative thinking for administrators and teacher leaders about what classrooms of tomorrow might look like, supported by a hybrid model or completely online courses. This chapter will outline how to design and implement courses for a potential hybrid or online class from a teacher perspective. Further, suggestions for administrators to support the ever-evolving role of the teacher will be shared.

Is Telehealth an Effective Way to Increase Accessibility to Counseling Services?

Providing telehealth is often a means to increase the accessibility to and availability of clinical mental healthcare services. Due to the COVID-19 pandemic, telehealth has been globally implemented into healthcare systems. Today, almost 390 million individuals have at least one mental illness. There are many challenges to seeking clinical mental healthcare, including availability and accessibility, anonymity, finances and insurance, stigma, and travel and transportation. Due to these barriers, many individuals have untreated mental health conditions, which can burden healthcare systems. By utilizing innovative delivery models such as telehealth technologies, the disparities experienced by individuals when attempting to seek clinical mental healthcare services can decrease.

Higher Education Leadership in a Changing World

The coronavirus pandemic remains one of the most significant and unpredictable global public health crises. The disease (COVID-19) caused by the virus represents a complex and ambiguous adaptive crisis that prompted the rise of the allostatic higher education leader. These leaders were able to learn from the pandemic and inspire faculty to exhibit similar leadership behaviors such as connecting with people, distributing leadership, and communicating clearly. COVID-19 provided higher education leadership with the opportunity for mission-driven changes related to course delivery models, pedagogy, student choices, affordability, access, and opportunity, and the post-COVID-19 institute of higher education will be a better place to work, and more student-centric. Those academic leaders with the adaptive capacity to see the crisis as an opportunity will envision a continued role for new and disruptive technologies. The pandemic has also provided faculty leaders with an opportunity for self-reflection that in many cases was long overdue.

The relationship between healthcare service provision models and patient experience

PurposeUser experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on whether and how the organizational model of healthcare service delivery can affect the patient experience is at an early stage. This study investigates the relationship between healthcare service provision models and patient experience by focusing on the nursing care delivery.Design/methodology/approach65 nurses' coordinators were involved to map the nursing models adopted in the healthcare organizations of in an Italian region, Tuscany. This dataset was merged with patient experience measures reported by 9,393 individuals discharged by the same organizations and collected through a Patient-Reported Experience Measures Observatory. The authors run a series of logistic regression models to test the relationships among variables.FindingsPatients appreciate those characteristics of care delivery related to a specific professional nurse. Having someone who is in charge of the patient, both the reference nurse and the supervisor, makes a real difference. Purely organizational features, for instance those referring to the team working, do not significantly predict an excellent experience with healthcare services.Research limitations/implicationsDifferent features referring to different nursing models make the difference in producing an excellent user experience with the service.Practical implicationsThese findings can support managers and practitioners in taking decisions on the service delivery models to adopt. Instead of applying monolithic pure models, mixing features of different models into a hybrid one seems more effective in meeting users' expectations.Originality/valueThis is one of the first studies on the relationship between provision models of high-contact and relational-intensive services (the healthcare services) and users' experience. This research contributes to the literature on healthcare service management suggesting to acknowledge the importance of hybridization of features from different, purely theoretical service delivery models, in order to fit with providers' practice and users' expectations.Highlights This is one of the first studies on the relationship between provision models of nursing care and patient experience.Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.

Envisioning Post-pandemic Digital Neurological, Psychiatric and Mental Health Care

The SARS-Cov-2 pandemic placed a dramatic burden on managed healthcare and perhaps nowhere as evident as in neurological and psychiatric disease care. This said, the duration of the pandemic mandated adaptability of the entire care system and the oft-vaunted benefits of telehealth and telemedicine were subjected to deep scrutiny at scale. Positive experiences were reported by both patients and providers from routine check-ups, to use of cognitive behavioral therapy associated with mental disorders, and management of complex diseases such as multiple sclerosis and other neurological and psychiatric conditions. Integration into standard care looks likely in the post pandemic era with many healthcare systems moving to expand reimbursement categories and develop equitable incentive models for developers and providers. In this commentary we share perspective on how the future of care may evolve through hybrid delivery models, and the advent of new therapeutic approaches which can address pain points identified during the pandemic.

The early-stage comprehensive costs of routine PrEP implementation and scale-up in Zambia

Introduction: Pre-exposure prophylaxis (PrEP) is effective at preventing HIV infection, but PrEP cost-effectiveness is sensitive to PrEP implementation and program costs. Preliminary studies indicate that, in addition to direct delivery cost, PrEP provision requires substantial demand creation and user support to encourage PrEP initiation and persistence. We estimated the cost of providing PrEP in Zambia through different PrEP delivery models. Methods: Taking a guidelines-based approach for visits, labs and drugs assuming fidelity to the expanded 2018 Zambian PrEP guidelines, we estimated the annual cost of providing PrEP per client for five delivery models: one focused on key populations (men-who-have-sex-with-men (MSM) and female sex workers (FSW), one on adolescent girls and young women (AGYW), and three integrated programs (operated within the HIV counselling and testing service at primary healthcare centres). Program start-up, provider, and user support costs were based on program expenditure data and number of PrEP sites and clients in 2018. PrEP clinic visit costs were based on micro-costing at two PrEP delivery sites (in 2018 USD). Results: The annual cost per PrEP client varied greatly by program type, from $394 (AGYW) to $760 in an integrated program. Cost differences were driven largely by volume (i.e. the number of clients initiated/model/site) which impacted the relative costs of program support and technical assistance assigned to each PrEP client. Direct service delivery costs, including staff and overheads, labs and monitoring, drugs and consumables ranged narrowly from $208-217/PrEP-user. Service delivery costs were a key component in the cost of PrEP, representing 36-65% of total costs. Reductions in service delivery costs per PrEP client are expected with further scale-up. Conclusions: The results show that, even when integrated into full service delivery models, accessing vulnerable, marginalised populations at substantial risk of HIV infection is likely to cost more than previously estimated due to the programmatic costs involved in community sensitization and user support. Improved data on individual client resource usage (e.g. drugs, labs, visits) and outcomes (e.g. initiation, persistence) is required to get a better understanding of the true resource utilization, cost and expected outcomes and annual costs of different PrEP programs in Zambia.