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Abstract Background Longitudinal integrated clerkships (LICs) and traditional block rotations (TBRs) employ different designs that provide various learning experiences for students. In this study, we explored students’ clinical participation and interpersonal interactions in LICs and TBRs at 2 metropolitan hospitals in Taiwan. Methods In April 2018, we enrolled 15 LIC and 29 TBR students. We conducted a cross-sectional survey which required the students to outline a typical daily schedule during their internal medicine rotations and draw an ecomap of the clinical team members. With the patient in the center as a reference, the size of each circle in an ecomap indicated the importance of the member; the distances and number of connecting lines between two circles represented the relationship and frequency of interaction, respectively, between the corresponding members. We analyzed the results and compared the responses of the LIC and TBR students. Results The LIC students spent more time on direct patient care and in the outpatient clinic/operation room, whereas the TBR students participated more in educational activities and in observation behind their seniors. In the ecomap analysis, the LIC students had a closer relationship with attending physicians and had better interactions with patients and preceptors than did the TBR students. Conversely, the TBR students felt closer to and interacted more frequently with interns and residents. Conclusions The LIC students had more opportunities to care for patients directly and engaged in interactions with patients and attending physicians more frequently than did the TBR students. Trial registration Ethical approval for the study was obtained from the Institutional Review Board of Tri-Service General Hospital (TSGHIRB 2–106–05–018).

Background: Longitudinal integrated clerkships (LICs) and traditional block rotations (TBRs) employ different designs that provide various learning experiences for students. In this study, we explored students' clinical participation and interpersonal interactions in LICs and TBRs at 2 metropolitan hospitals in Taiwan. Methods: In April 2018, we enrolled 15 LIC and 29 TBR students. We conducted a cross-sectional survey which required the students to outline a typical daily schedule during their internal medicine rotations and draw an ecomap of the clinical team members. With the patient in the center as a reference, the size of each circle in an ecomap indicated the importance of the member; the distances and number of connecting lines between two circles represented the relationship and frequency of interaction, respectively, between the corresponding members. We analyzed the results and compared the responses of the LIC and TBR students. Results: The LIC students spent more time on direct patient care and in the outpatient clinic/operation room, whereas the TBR students participated more in educational activities and in observation behind their seniors. In the ecomap analysis, the LIC students had a closer relationship with attending physicians and had better interactions with patients and preceptors than did the TBR students. Conversely, the TBR students felt closer to and interacted more frequently with interns and residents. Conclusions: The LIC students had more opportunities to care for patients directly and engaged in interactions with patients and attending physicians more frequently than did the TBR students. Trial registration: Ethical approval for the study was obtained from the Institutional Review Board of Tri-Service General Hospital (TSGHIRB 2–106–05–018). [ABSTRACT FROM AUTHOR]

The purpose of this article is to present an application of two tools the ecomap (Hartman, 1995) and cultural ecogram (Yasui, 2015) used sequentially so that it may help in the process of assisting health professionals in determining ways to improve culturally informed, instead of culturally competent healthcare provision. Both tools have been developed in the context of clinical delivery of social services, have some known research that points to the benefits of their use in health and mental healthcare (Lloyd, 2005), but have not yet been applied to promoting the cultural sensitivity with awareness in healthcare management of diabetes type 2 with urban African American grandparents who are caretakers of children. [ABSTRACT FROM AUTHOR]

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In the United States (U.S.), the maintenance of forest cover is a legal mandate for federally managed forest lands. More broadly, reforestation following harvesting, recent or historic disturbances can enhance numerous carbon (C)-based ecosystem services and functions. These include production of woody biomass for forest products, and mitigation of atmospheric CO2 pollution and climate change by sequestering C into ecosystem pools where it can be stored for long timescales. Nonetheless, a range of assessments and analyses indicate that reforestation in the U.S. lags behind its potential, with the continuation of ecosystem services and functions at risk if reforestation is not increased. In this context, there is need for multiple independent analyses that quantify the role of reforestation in C sequestration, from ecosystems up to regional and national levels. Here, we describe the methods and report the findings of a large-scale data synthesis aimed at four objectives: (1) estimate C storage in major ecosystem pools in forest and other land cover types; (2) quantify sources of variation in ecosystem C pools; (3) compare the impacts of reforestation and afforestation on C pools; (4) assess whether these results hold or diverge across ecoregions. The results of our synthesis support four overarching inferences regarding reforestation and other land use impacts on C sequestration. First, in the bigger picture, soils are the dominant C pool in all ecosystems and land cover types in the U.S., and soil C pool sizes vary less by land cover than by other factors, such as spatial variation or soil wetness. Second, where historically cultivated lands are being reforested, topsoils are sequestering significant amounts of C, with the majority of reforested lands yet to reach their capacity relative to the potential indicated by natural forest soils. Third, the establishment of woody vegetation delivers immediate to multi-decadal C sequestration benefits in aboveground woody biomass and coarse woody debris pools, with two- to three-fold C sequestration benefits in biomass during the first several decades following planting. Fourth, opportunities to enhance C sequestration through reforestation vary among the ecoregions, according to current levels of planting, typical forest growth rates, and past land uses (especially cultivation). Altogether, our results suggest that an immediate, but phased and spatially targeted approach to reforestation can enhance C sequestration in forest biomass and soils in the U.S. for decades to centuries to come. [ABSTRACT FROM AUTHOR]

This article describes the conceptual foundations and evolution of a mixed methods research (MMR) tool--the ecomap--from an intervention activity to a developmentally, culturally, and contextually adaptable MMR data collection strategy. Guided by ecologicaldevelopmental theory (Bronfenbrenner, 1989, 1999), a model of psychological well-being that accounts for individual and cultural factors (Nastasi, Varjas, Sarkar, & Jayasena, 1998), rights-respecting research (Alderson, 2012), and culturally sensitive research (D'Augelli, 2003), our international work with school-age children and youth from 12 countries necessitated the use of a tool that could appropriately engage and capture their perspectives about their social experiences related to stress, support, and coping. In the context of this international study, we modified the intervention tool for data collection purposes and developed procedures for mixed methods analysis. The ecomap consists of a self-generated drawing to depict an individual's social network, including the type and quality of relationships. The drawing was coded quantitatively to depict size of social network, balance of stress and support within the network, and types of relationships. Descriptions of the relationships and related stories about stressful and supportive experiences were coded qualitatively for culturally valued competencies, stressors, supports, and reactions to stress and support. The mixed methods procedures permitted examination of patterns of stress and support across age, gender, context, and site. In this article, we describe the ecomap protocol and data analysis procedures for its use as an MMR tool, providing illustrations from programmatic research. The article concludes with discussion of limitations and future directions. [ABSTRACT FROM AUTHOR]

Public health nurses in New Zealand practice in urban and rural communities promoting health and wellbeing for school aged children and their families. Despite employing a family-centred approach little is known about the use or efficacy of family nursing tools in public health nurses’ practice. One such tool, the 15 minute family interview, was the focus of this qualitative, collaborative, educative study. The aim of the study was to explore 16 public health nurses’ knowledge and use of the five components of the 15 minute interview; manners, therapeutic questions, therapeutic conversations, commendations, and a genogram and ecomap. Focus groups were used to gather data in pre and post-intervention phases with PHNs using either a genogram or ecomap in practice over a three month period during the intervention phase. Several themes emerged from a thematic analysis of pre and post-intervention data. The latter analysis reinforced the former themes. The unrealistic nature of a 15 minute interview in public health nursing practice became apparent as the study progressed. Nevertheless participants consistently used four of the five components; manners, therapeutic questions, therapeutic conversations and commendations. Moreover the fifth component, an ecomap and genogram, while not consistently used, became the study’s focus from which a hybrid ‘ecogram’ emerged. Furthermore the study illustrated the changing and uncertain context in which public health nurses practice with increasingly complex and vulnerable families. Despite having limited transferability the findings reveal possibilities inherent in using family nursing tools to enhance relational practice, which, in turn, can improve family health outcomes. [ABSTRACT FROM AUTHOR]

An ecomap is a social work data collection tool that is used to gather data about a participant's environment. Derived from Bronfenbrenner's ecological system theory, the ecomap can be used in adult education and human resource development to record information of in-and-out-of-work and learning experiences and show how these interactions support or hurt an individual. Information about important interactions in an individual's life can help the staffs in organizations understand employees or adult learners in ways that may not surface with merely work or educational interactions. This first-hand knowledge of an individual's strengths or weaknesses can help the staff learn how to individualize employee and adult learner development. This personal knowledge can be an important part of an employee's and adult learner's performance, and personal and professional growth. [ABSTRACT FROM AUTHOR]