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Nursing students can complete nursing operations in their actual clinical activities with the aid of the laboratory function, which is essential for clinical learning and practice. This study intends to ascertain the relationship between laboratory skill performance and actual clinical performance among College of Nursing student at the University of Cebu Lapu-Lapu and Mandaue throughout their on-the-job training program. The findings of this study revealed that section (A) students need to do better in their laboratory skills exercises while the majority of Section (B) only obtained a Satisfactory rating despite doing well. However, both sections were rated Very Satisfactory on their actual clinical duties. The findings further revealed that section (A) has a positive correlation between laboratory and clinical performance, while section (B) has no significant association. The study revealed significant differences between section (A) and (B) laboratory performances while no difference in both clinical performances. The study concludes that even though there is a positive correlation between laboratory and clinical performance, students still need to understand how to effectively carry out their clinical responsibilities regardless of how well they perform on laboratory skill exercises. Even some did not perform well in the lab, they still did a good job when performing their actual clinical duties, which is why this study considers personal, emotional, and behavioral abilities in addition to laboratory functions as additional predictors for nurses' actual clinical performance during their on-the-job training program.

AimsHeart failure (HF) remains a major public health problem with increasing prevalence in China. This study evaluated the clinical performance and quality measures for HF management to identify gaps in the standardization of care for patients hospitalized for HF in China.Methods and resultsFollowing the results of China-HF stage I (2012-2015), the second stage of the China-HF was launched in 2017. Among 113 hospitals with ≥100 cases, the China-HF Stage II assessed the quality of care measures for HF and compared results with previous data in China and the US-based Get with The Guidelines-Heart Failure (GWTG-HF) registries. In total, 34 938 patients hospitalized with HF were enrolled from January 2017 to October 2020. Echocardiographic left ventricular function and natriuretic peptide test were performed in 93.7% and 93.0% of the cases, respectively. Adherence to standardized guidelines in China-HF stage II was higher than that in the China-HF stage I, but generally lower than GWTG-HF registry with 78.2% of eligible patients was prescribed oral diuretics, 78.7% renin-angiotensin-system inhibitors, and 82.2% beta-blockers. Implantable cardioverter-defibrillators and cardiac resynchronization devices were implanted in 3.9% and 14.6%, respectively. In contrast, the proportion of eligible patients discharged with spironolactone (87.8%) was higher than GWTG-HF. The median length of hospitalization was 9 (6, 12) days, and 938 (2.8%) patients died or withdrew from treatment during hospitalization.ConclusionsDespite significant improvements in the use of guideline-recommended testing and therapy, there remain major gaps in quality of care for patients hospitalized for HF in China that are generally larger than gaps observed in the United States.

Background: The demand for RT-PCR testing has been unprecedented during the SARS-CoV-2 pandemic. Fully automated antigen tests (AAT) are less cumbersome than RT-PCR, but data on performance compared to RT-PCR are scarce. Methods: The study consists of two parts. A retrospective analytical part, comparing the performance of four different AAT on 100 negative and 204 RT-PCR positive deep oropharyngeal samples divided into four groups based on RT-PCR cycle of quantification levels. In the prospective clinical part, 206 individuals positive for and 199 individuals negative for SARS-CoV-2 were sampled from either the anterior nasal cavity (mid-turbinate) or by deep oropharyngeal swabs or both. The performance of AATs was compared to RT-PCR. Results: The overall analytical sensitivity of the AATs differed significantly from 42% (95% CI 35–49) to 60% (95% CI 53–67) with 100% analytical specificity. Clinical sensitivity of the AATs differed significantly from 26% (95% CI 20–32) to 88% (95% CI 84–93) with significant higher sensitivity for mid-turbinate nasal swabs compared to deep oropharyngeal swabs. Clinical specificity varied from 97% to 100%. Conclusion: All AATs were highly specific for detection of SARS-CoV-2. Three of the four AATs were significantly more sensitive than the fourth AAT both in terms of analytical and clinical sensitivity. Anatomical test location significantly influenced the clinical sensitivity of AATs.

Bullying is universally identified as a persistent problem in the nursing profession which basically impacts the antithesis of the compassionated essence of nursing. Bullying negatively affects the clinical learning and educational life of nursing students. A descriptive cross-sectional quantitative design was utilized to accomplish this study. The design was employed to identify the impact of bullying on clinical performance of nursing students. The study also examined the types, frequencies, perpetrators of bullying and coping behavior of nursing students towards bullying. The highest bullying behaviors of the nursing students experienced were verbal abuse and humiliation in front of other people. Bullying results in various types of long term and short-term consequences. Most importantly it affects the skill development among nurses. It is recommended that there must be clear, written SOP’s for the staff working in the clinical facility. This type of documentation should be available for everyone and should be the part of professional training. This can reduce the incidence of the bullying. Another thing is the establishment of healthy relationship between the junior and senior staff members because most of the time it is seen that the senior and junior staff is involved in bullying. Next is the proper training of the nurses about their roles and responsibilities at student level.

The SARS-CoV-2 pandemic has created an unprecedented need for rapid large-scale diagnostic testing to prompt clinical and public health interventions. Currently, several quantitative reverse-transcription polymerase chain reaction (RT-qPCR) assays recommended by the World Health Organization are being used by clinical and public health laboratories and typically target regions of the RNA-dependent RNA polymerase (RdRp), envelope (E) and nucleocapsid (N) coding region. However, it is currently unclear if results from different tests are comparable. This study aimed to clarify the clinical performances of the primer/probe sets designed by US CDC and Charité/Berlin to help clinical laboratories in assay selection for SARS-CoV-2 routine detection. We compared the clinical performances of the recommended primer/probe sets using one hundred nasopharyngeal swab specimens from patients who were clinically diagnosed with COVID-19. An additional 30 "pre-intervention screening" samples from patients who were not suspected of COVID-19 were also included in this study. We also performed sequence alignment between 31064 European SARS-CoV-2 and variants of concern genomes and the recommended primer/probe sets. The present study demonstrates substantial differences in SARS-CoV-2 RNA detection sensitivity among the primer/probe sets recommended by the World Health Organization especially for low-level viral loads. The alignment of thousands of SARS-CoV-2 sequences reveals that the genetic diversity remains relatively low at the primer/probe binding sites. However, multiple nucleotide mismatches might contribute to false negatives. An understanding of the limitations depending on the targeted genes and primer/probe sets may influence the selection of molecular detection assays by clinical laboratories.

Background/objectiveBurnout is common among resident physicians, which has the potential to translate into diagnostic and management errors. Our study investigates the relationship between sleepiness, depression, anxiety, burnout, and lack of professional fulfillment with clinical performance during a critically ill patient simulation. Methods/Approach: Emergency medicine residents were recruited to participate in a high-fidelity simulation case of a critically ill patient. A survey with validated wellbeing measures (National Institutes of Health Patient-Reported Outcomes Measurement Information System (NIH PROMIS), Linzer burnout measure, and professional fulfillment index) was administered prior to the simulation. Each encounter was video-recorded and analyzed by two blinded raters based on a binary critical-actions checklist. Time-to-intubation, management errors, and misdiagnosis rates were assessed.ResultsTwenty residents participated, with most subjects endorsing sleepiness (70%) and less than half reporting depression (40%) and anxiety (45%). Burnout was identified to be in 50% of participants by the Linzer measure and 85% by the professional fulfillment index. No significant difference was found between mean performance scores in sleepy, depressed, and anxious cohorts in comparison to groups without those symptoms. Similarly, burnout and professional fulfillment did not yield any significant difference, nor did comparisons with time to intubation, management errors, and frequency of misdiagnosis.ConclusionResident burnout, depression, anxiety, sleepiness, and lack of professional fulfillment did not appear to have a measurable impact on clinical performance in managing a critically ill patient. There is no evidence from this study that the lack of resident physician well-being adversely impacts patient care by increasing errors in management or misdiagnoses during this high-fidelity simulation.

The importance of biopharmaceutical considerations in pharmaceutical development and drug characterization has been well recognized both by pharmaceutical industry and regulatory authorities as a tool to establish predictive relationships between drug product quality attributes (in vitro data) and its clinical performance (in vivo data). In the present paper, contemporary biopharmaceutics toolkit including in vivo predictive dissolution testing, Biopharmaceutics Classification System, physiologically based pharmacokinetic and biopharmaceutics modeling and simulation, in vitro-in vivo correlation and biowaiver, are reviewed with regards to relevant general principles and applicability. The recently introduced innovative strategy for patient-centric drug development using an integrated systems approach grounded in fundamental biopharmaceutics concepts, clinical insights and therapeutic drug delivery targets, described as Biopharmaceutics Risk Assessment Roadmap (BioRAM) is also presented. Further development in the field will benefit from joint efforts and exchange of knowledge and experiences between pharmaceutical industry and regulatory authorities for the common goal to accelerate development of effective and safe drug products designed in accordance with patients’ needs and expectations., Značaj biofarmaceutskih razmatranja u razvoju i karakterizaciji lekova s ciljem uspostavljanja korelacije i mogućnosti predviđanja odnosa između in vitropodataka, odnosno karakteristika kvaliteta leka i njegovog in vivoponašanja/kliničkog učinka, prepoznata je kako od strane farmaceutske industrije, tako i od strane odgovarajućih regulatornih tela. U radu je dat pregled savremenih biofarmaceutskih alata,uključujući prediktivno ispitivanje brzine rastvaranja lekovite supstance iz farmaceutskog oblika leka, Biofarmaceutski sistem klasifikacije, fiziološki zasnovano farmakokinetičko i biofarmaceutsko modelovanje i simulacije, in vitro-in vivokorelaciju i mogućnost izostavljanja in vivostudija bioekvivalencije (engl. biowaiver) iz aspekta opštih principa i mogućnosti primene u razvoju i karakterizaciji lekova.Predstavljena je i nedavno osmišljena inovativna strategija za razvoj leka usmerena ka pacijentu, uz primenu integrisanog sistemskog pristupa zasnovanog na osnovnim biofarmaceutskim konceptima, uvidu u kliničku situaciju i definisanim terapijskim ciljevima označena kao Plan aktivnosti za procenu biofarmaceutskog rizika (engl. Biopharmaceutics Risk Assessment Roadmap, BioRAM). Očekuje se da će daljem razvoju u ovoj oblasti najviše doprineti združene aktivnosti i razmena znanja i iskustava između farmaceutskih kompanija i regulatornih agencija sa zajedničkim ciljem da se ubrza razvoj efikasnih i bezbednihlekova dizajniranih u skladu sa potrebama i očekivanjima pacijenata.

Performance in the classroom may not always be reflective of nursing students' clinical competence. On this perspective, this study was conducted to determine the relationship between academic performance in the classroom and clinical performance of nursing students in a selected college of nursing in the Philippines. A descriptive-correlational research design was used and the records of all 212 second-year nursing students in their Maternal and Child Nursing course were reviewed. Data were analyzed using SPSS and Pearson's r correlation result indicated that academic performance had a statistically significant relationship with clinical performance. Academic performance has a significant role in the clinical performance of nursing students. Nursing schools should ensure that students are provided with good theoretical instruction in nursing courses to enhance and facilitate success in the actual clinical placements.

The acronym DIGEST (discuss, invite, generate, explore, strategize, time) integrates motivational interviewing (MI) spirit, skill, and style to guide the student and instructor through discussions about clinical performance. This article aligns salient qualities of feedback and self-reflection in a relational approach to formative evaluation that is guided by MI. DIGEST is a strategy to promote self-reflection, provide clarity on areas for performance enhancement, and develop student capacity to integrate insights into subsequent practice.

Worldwide places in medical school are scarce and medical education and training are expensive for providers and learners. Therefore, medical schools aim to offer the places available only to those applicants with the highest probability of successful medical training and subsequent career. To reach this goal, medical schools have developed several selection procedures, including interviews, admission tests and other measures of personal competencies. Uniquely in the Netherlands, selection was organised nationally based on a lottery that is weighted for academic attainment. However, both the lottery and the unproven selection procedures have been described as unfair to medical school applicants, as neither includes any truly objective criteria for predicting future performance. The Dutch situation in which access to medical school was granted by lottery and the possibility to select up to 50% of the students by a selection procedure provided a unique opportunity to form a control group of randomly admitted students to compare with those selected. We developed an evidence-based selection procedure addressing non-academic (i.e. motivation) as well as academic skills. The former evaluated motivation through the determination of the candidate’s active involvement in extracurricular activities, the latter by tests concerning the study skills of candidates in a medical school context. The main outcome was that the relative risk for dropping out of medical school was significantly lower in selected students than in controls admitted by lottery. Those selected obtained a higher mean grade than the lottery admitted students on their clerkships. Thereby selected students participated more often in extracurricular activities, which was also associated with higher clerkship grades.

Background: Patient safety education, as well as the safety climate at clinical rotations, has an impact on students' attitudes. We explored medical students' self-reported motivation to participate in simulation-based teamwork training (SBTT), with the hypothesis that high scores in patient safety attitudes would promote motivation to SBTT and that intrinsic motivation would increase after training. Methods: In a prospective cohort study we explored Swedish medical students' attitudes to patient safety, their motivation to participate in SBTT and how motivation was affected by the training. The setting was an integrated SBTT course during the surgical semester that focused on non-technical skills and safe treatment of surgical emergencies. Data was collected using the Situational Motivation Scale (SIMS) and the Attitudes to Patient Safety Questionnaire (APSQ). Results: We found a positive correlation between students' individual patient safety attitudes and self-reported motivation (identified regulation) to participate in SBTT. We also found that intrinsic motivation increased after training. Female students in our study scored higher than males regarding some of the APSQ sub-scores and the entire group scored higher or on par with comparable international samples. Conclusion: In order to enable safe practice and professionalism in healthcare, students' engagement in patient safety education is important. Our finding that students' patient safety attitudes show a positive correlation to motivation and that intrinsic motivation increases after training underpins patient safety climate and integrated teaching of patient safety issues at medical schools in order to help students develop the knowledge, skills and attitudes required for safe practice.

Several medical schools include candidates’ extracurricular activities in their selection procedure, with promising results regarding their predictive value for achievement during the clinical years of medical school. This study aims to reveal whether the better achievement in clinical training of students selected on the basis of their extracurricular activities could be explained by persistent participation in extracurricular activities during medical school (msECAs). Lottery-admitted and selected student admission groups were compared on their participation in three types of msECAs: (1) research master, (2) important board positions or (3) additional degree programme. Logistic regression was used to measure the effect of admission group on participation in any msECA, adjusted for pre-university GPA. Two-way ANCOVA was used to examine the inter-relationships between admission group, participation in msECAs and clerkship grade, with pre-university GPA as covariate. Significantly more selected students compared to lottery-admitted students participated in any msECA. Participation in msECAs was associated with a higher pre-university GPA for lottery-admitted students only, whereas participation in msECAs was associated with higher clerkship grades for selected students only. These results suggest that persistent participation in extracurricular activities of selected students favours better clinical achievement, supporting the inclusion of ECAs in the selection procedure. More insight in the rationale behind participation in extracurricular activities during medical school may explain differences found between lottery-admitted and selected students.

PURPOSE: To establish the clinical impact of three different methods of manufacture used to produce soft contact lenses. METHODS: Clinical performance of five lens types was investigated by undertaking a prospective, double-masked, randomized, crossover study. Three of the lenses were made from poly(hydroxyethyl methacrylate) (pHEMA) by three different manufacturing processes (lathing, spin casting, and cast molding), and the remaining two lenses were cast molded from different materials-hydroxyethyl methacrylate/methacrylic acid and hydroxyethyl methacrylate/glycerol methacrylate (HEMA/GMA). All lenses were specially fabricated for this work at the same manufacturing plant. Thirty-four soft contact lens wearers wore each lens for 1 month on a daily-wear basis. Several clinical variables, such as ocular response, visual acuity, lens fitting, prelens tear film, lens surface dehydration, subjective response, and protein deposition, were measured. RESULTS: In general, the spun-cast pHEMA lens performed inferiorly compared with the other pHEMA lenses. This lens induced significantly more limbal and conjunctival hyperemia than the cast-molded lens and provided poorer low contrast visual acuity (LCVA) than the other two lenses. It dehydrated more and had the least on-eye movement. However, the spun-cast lens deposited the least protein of the pHEMA lenses. In general, the HEMA/GMA lens performed inferiorly compared with the other cast-molded lenses. LCVA was worse with this lens, and subjective responses showed that this lens was thought to give the worst visual performance of the cast-molded lenses. It was also thought to be the most difficult lens to handle. Significantly more breakages occurred with this lens than any other. CONCLUSIONS: Overall, this work has shown that manufacturing method and material composition have a fundamental effect on many clinical properties of a lens. Therefore, method of manufacture is also an important consideration in the overall product

Solution of clinical problems by use of implants and other medical devices. Systematic use of cell-matrix control volumes. The role of stress analysis in the design process. Anatomic fit: shape and size of implants. Selection of biomaterials. Instrumentation for surgical implantation procedures. Preclinical testing for safety and efficacy: risk/benefit ratio assessment. Evaluation of clinical performance: design of clinical trials. Project materials drawn from orthopedic devices, soft tissue implants, artificial organs, and dental implants.