The present systematic review is based on the premise that a variety of neurodegenerative diseases are accompanied by grey matter atrophy in the brain and meditation may impact this. Given that age is a major risk factor for many of these progressive and neurodegenerative diseases and that the percentage of the population over the age of 65 is quickly increasing, there is an obvious need for prompt treatment and prevention advances in research. As there is currently no cure for Alzheimer's disease and other neurodegenerative diseases, many are seeking non-pharmacological treatment options in attempts to offset the disease-related cognitive and functional declines. On the basis of a growing body of research suggesting that meditation is effective in increasing grey matter volume in healthy participants, this paper systematically reviewed the literature regarding the effects of meditation on restoring grey matter volume in healthy individuals and those affected by neurodegeneration. This review searched PubMed, CINAHL, and APA PsycNET to identify original studies that included MRI imaging to measure grey matter volume in meditators and post-mindfulness-based intervention participants compared to controls. Thirteen studies were considered eligible for review and involved a wide variety of meditation techniques and included participants with and without cognitive impairment. All studies reported significant increases in grey matter volume in the meditators/intervention group, albeit in assorted regions of the brain. Limited research exists on the mechanisms through which meditation affects disease-related neurodegeneration, but preliminary evidence suggests that it may offset grey matter atrophy.
Introduction: Health professions training programmes increasingly rely on standardised patient (SP) programmes to integrate equity-deserving groups into learning and assessment opportunities. However, little is known about the optimal approach, and many SP programmes struggle to meet these growing needs. This study explored insights from health care educators working with SP programmes to deliver curricular content around equity-deserving groups.Methods: We interviewed 14 key informants in 2021 who were involved in creating or managing SP-based education. Verbatim transcripts were analysed in an iterative coding process, anchored by qualitative content analysis methodology and informed by two theoretical frameworks: sociologic translation and simulation design.Repeated cycles of data collection and analyses continued until themes could be constructed, aligned with existing theories and grounded in empirical data, with sufficient relevance and robustness to inform educators and curricular leads.Results: Three themes were constructed: (i) creating safety for SPs paid to be vulnerable, (ii) fidelity as an issue broader than who plays the role and (iii) engaging equity-deserving groups. SP work involving traditionally marginalised groups risk re-traumatization, highlighting the importance of (i) informed consent in recruiting SPs, (ii) separating role portrayal from lived experiences, (iii) adequately preparing learners and facilitators, (iv) creating time-outs and escapes for SPs and (v) building opportunity for de-roling with community support.Conclusions: SP programmes are well positioned to be allies and advocates to equity-deserving groups and to collaborate and share governance of the educational development process from its outset. SP programmes can support the delivery of curricular content around equity-deserving groups by advocating with curricular leadership, building relationships with community partners, facilitating co-creation and co-delivery of educational content and building safety into simulation.
BackgroundAn important aspect of developing and maintaining a high-quality standardized patient (SP) program is incorporating quality assurance processes. Trainer and instructor feedbacks are considered critical in achieving these goals. The aim of this study is to determine programmatic and systematic issues in the scope of quality assurance and improvement through trainer and instructor feedback on SP performance. We also presented a logic model based on a synthesis of the current literature to ensure the development and maintenance of a quality management culture in the SP program. MethodsA retrospective analysis of SP scoring was conducted, and written feedback forms completed by trainers and instructors in a large Canadian university's SP program were collected. The previous six years (2014-2020) of SP feedback forms in the scope of quality assurance were reviewed and analyzed. Descriptive statistics were utilized to analyze the ratings. Thematic analysis was conducted on the data gathered from the written feedback. ResultsA total of 138 feedback forms were reviewed and analyzed in the study. The mean ratings given by the trainers for feedback and professionalism were 4.27 ± 1.29 and 4.77 ± 0.8, respectively. The mean ratings given by the instructors for knowledge of case information, appropriate responses, and affect were 4.84 ± 0.64, 4.86 ± 0.35, and 4.71 ± 0.76, respectively (from a range of 1 to 5). Four key themes emerged from the written feedback: nonverbal behaviors in simulation activity or feedback sessions, providing feedback from the patient perspective, consistency between role portrayal and scenario, and adapting easily to changing situations. ConclusionsComponent scoring on SP performance did not discriminate individual issues, but the qualitative comments identified certain specific issues. Further research is needed to establish standards of continuous quality improvement (CQI) within an SP program.
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