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24 pages, 1074 KiB  
Article
Effective BIM Curriculum Development for Construction Management Program Transformation Through a Change Management Lens
by Ki Pyung Kim, Rob Freda and Seoung-Wook Whang
Buildings 2025, 15(15), 2775; https://doi.org/10.3390/buildings15152775 - 6 Aug 2025
Abstract
Integrating BIM curriculum into traditional construction management (CM) programs is essential to meet the increasing industry demand for BIM-ready graduates. However, academia struggles with BIM curriculum integration due to unfamiliar emerging BIM technologies, and the increased workload associated with curriculum transformation. Disciplines including [...] Read more.
Integrating BIM curriculum into traditional construction management (CM) programs is essential to meet the increasing industry demand for BIM-ready graduates. However, academia struggles with BIM curriculum integration due to unfamiliar emerging BIM technologies, and the increased workload associated with curriculum transformation. Disciplines including nursing, health science, and medical overcame the same challenges using the ability-desire-knowledge-ability-reinforcement (ADKAR) change management model, while CM programs have not explored this model for BIM curriculum development. Thus, this research introduces the ADKAR change management lens to BIM curriculum development by proposing a practically modified and replicable ADKAR model for CM programs. Focus group interviews with 14 academics from the UK, USA, Korea, and Australia, revealed establishing a sense of urgency by appointing a BIM champion is the most critical step before the BIM curriculum development. Instant advice demystifying uncertain BIM concepts is recognised the most effective motivation among academia. Well-balanced BIM concept integrations is ‘sine qua non’ since excessively saturating BIM aspects across the program can dilute students’ essential domain knowledge. Students’ evaluation over the BIM curriculum were collected through a six-year longitudinal focus group interviews, revealing that progressive BIM learnings scaffolded from foundational concepts to advanced applications throughout their coursework is the most valuable. Full article
(This article belongs to the Section Construction Management, and Computers & Digitization)
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13 pages, 2893 KiB  
Article
Vaccine Attitudes, Knowledge, and Confidence Among Nursing, Pediatric Nursing, and Midwifery Undergraduate Students in Italy
by Ersilia Buonomo, Daniele Di Giovanni, Gaia Piunno, Stefania Moramarco, Giuliana D’Elpidio, Ercole Vellone, Enkeleda Gjini, Mariachiara Carestia, Cristiana Ferrari and Luca Coppeta
Vaccines 2025, 13(8), 813; https://doi.org/10.3390/vaccines13080813 - 30 Jul 2025
Viewed by 200
Abstract
Background: Vaccine hesitancy (VH) represents a growing concern among healthcare professionals and students, potentially undermining public health efforts. Nursing, pediatric nursing, and midwifery students are future vaccinators and educators, making it essential to understand their attitudes, knowledge, and confidence toward vaccination. This study [...] Read more.
Background: Vaccine hesitancy (VH) represents a growing concern among healthcare professionals and students, potentially undermining public health efforts. Nursing, pediatric nursing, and midwifery students are future vaccinators and educators, making it essential to understand their attitudes, knowledge, and confidence toward vaccination. This study aims to assess vaccine-related perceptions and behaviors among these student populations in an Italian university. Methods: A cross-sectional survey was conducted between November 2022 and February 2024 at the University of Rome “Tor Vergata”. A structured, anonymous questionnaire, including the Vaccination Attitudes Examination (VAX) scale, vaccine knowledge items, and sources of information, was administered to students in nursing (n = 205), pediatric nursing (n = 46), and midwifery (n = 21). Statistical analyses included descriptive statistics, ANOVA, post hoc tests, and Mann–Whitney U tests. Results: Among the 272 participants, 20.6% reported refusing at least one recommended vaccine, and 18.4% delayed vaccination for non-medical reasons. Vaccine knowledge and confidence increased significantly with academic progression (p < 0.001). Midwifery students showed both the highest concern for long-term vaccine effects and the greatest confidence in vaccine safety. Institutional and scientific sources were the most trusted, though traditional and non-institutional media also influenced perceptions, particularly among midwifery students. Conclusions: Despite high COVID-19 vaccine uptake, VH persists among health professional students. Discipline-specific patterns highlight the need for early, targeted educational strategies to enhance vaccine literacy and reduce hesitancy. Tailored training may empower future professionals to become informed and credible advocates for vaccination. Full article
(This article belongs to the Special Issue Acceptance and Hesitancy in Vaccine Uptake: 2nd Edition)
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14 pages, 243 KiB  
Article
Building Safe Emergency Medical Teams with Emergency Crisis Resource Management (E-CRM): An Interprofessional Simulation-Based Study
by Juan Manuel Cánovas-Pallarés, Giulio Fenzi, Pablo Fernández-Molina, Lucía López-Ferrándiz, Salvador Espinosa-Ramírez and Vanessa Arizo-Luque
Healthcare 2025, 13(15), 1858; https://doi.org/10.3390/healthcare13151858 - 30 Jul 2025
Viewed by 301
Abstract
Background/Objectives: Effective teamwork is crucial for minimizing human error in healthcare settings. Medical teams, typically composed of physicians and nurses, supported by auxiliary professionals, achieve better outcomes when they possess strong collaborative competencies. High-quality teamwork is associated with fewer adverse events and [...] Read more.
Background/Objectives: Effective teamwork is crucial for minimizing human error in healthcare settings. Medical teams, typically composed of physicians and nurses, supported by auxiliary professionals, achieve better outcomes when they possess strong collaborative competencies. High-quality teamwork is associated with fewer adverse events and complications and lower mortality rates. Based on this background, the objective of this study is to analyze the perception of non-technical skills and immediate learning outcomes in interprofessional simulation settings based on E-CRM items. Methods: A cross-sectional observational study was conducted involving participants from the official postgraduate Medicine and Nursing programs at the Catholic University of Murcia (UCAM) during the 2024–2025 academic year. Four interprofessional E-CRM simulation sessions were planned, involving randomly assigned groups with proportional representation of medical and nursing students. Teams worked consistently throughout the training and participated in clinical scenarios observed via video transmission by their peers. Post-scenario debriefings followed INACSL guidelines and employed the PEARLS method. Results: Findings indicate that 48.3% of participants had no difficulty identifying the team leader, while 51.7% reported minor difficulty. Role assignment posed moderate-to-high difficulty for 24.1% of respondents. Communication, situation awareness, and early help-seeking were generally managed with ease, though mobilizing resources remained a challenge for 27.5% of participants. Conclusions: This study supports the value of interprofessional education in developing essential competencies for handling urgent, emergency, and high-complexity clinical situations. Strengthening interdisciplinary collaboration contributes to safer, more effective patient care. Full article
13 pages, 252 KiB  
Article
Perspectives of Healthcare Students on Childhood Vaccines: Insights from a Cross-Sectional Study in Bulgaria
by Maria Rohova, Nikolay L. Mihaylov, Antoniya Dimova and Rouzha Pancheva
Vaccines 2025, 13(8), 804; https://doi.org/10.3390/vaccines13080804 - 29 Jul 2025
Viewed by 290
Abstract
Background/Objectives: Medical and nursing students, as future healthcare professionals, influence public trust and vaccine acceptance. Knowledge gaps or misconceptions regarding immunization may undermine their confidence and effectiveness in addressing vaccine hesitancy. This study explores perceptions and attitudes toward childhood vaccination among Bulgarian healthcare [...] Read more.
Background/Objectives: Medical and nursing students, as future healthcare professionals, influence public trust and vaccine acceptance. Knowledge gaps or misconceptions regarding immunization may undermine their confidence and effectiveness in addressing vaccine hesitancy. This study explores perceptions and attitudes toward childhood vaccination among Bulgarian healthcare students and factors shaping these outcomes. Methods: A cross-sectional survey was conducted in 2024, using an online self-administered questionnaire completed by 374 medical and nursing students. Descriptive statistics were used to analyze vaccine-related responses, comparing attitudes between healthcare programs and education years. Binomial logistic regression was applied to identify predictors of support for mandatory vaccination, first considering demographic and academic variables, and then adding students’ beliefs and common misconceptions. Results: Medical students showed more positive attitudes toward vaccination than nursing students, with 96.8% of medical students versus 89.4% of nursing students believing vaccines are effective (p = 0.005). Students in advanced years demonstrated stronger belief in vaccine effectiveness (p = 0.038). Additionally, misbeliefs about the measles vaccine causing autism decreased significantly, with most students in higher years rejecting this misconception (p = 0.009). Logistic regression revealed that belief in following the vaccine schedule (OR = 22.71; p < 0.001) and confidence in vaccine effectiveness (OR = 10.20; p < 0.001) were the strongest predictors of support for mandatory vaccination, with attitudinal factors explaining over half of the variance. Conclusions: Healthcare students’ attitudes about vaccination influence public health outcomes, as their perspectives reflect experience and beliefs. Targeted vaccine education helps address misconceptions and improve vaccination rates. Full article
(This article belongs to the Special Issue Acceptance and Hesitancy in Vaccine Uptake: 2nd Edition)
11 pages, 239 KiB  
Article
Medical Brain Drain in Albania: Migration Attitudes Among Medical and Nursing Students
by Vasilika Prifti, Denada Selfo, Aurela Saliaj, Sonila Qirko, Emirjona Kicaj, Rudina Çerçizaj, Juljana Xhindoli and Liliana Marcela Rogozea
Nurs. Rep. 2025, 15(8), 264; https://doi.org/10.3390/nursrep15080264 - 22 Jul 2025
Viewed by 353
Abstract
Background: The migration of healthcare professionals poses a serious threat to health systems worldwide. This study examines attitudes toward brain drain and the factors influencing migration tendencies among medical and nursing students in Albania, with particular attention to nursing workforce implications. Methods [...] Read more.
Background: The migration of healthcare professionals poses a serious threat to health systems worldwide. This study examines attitudes toward brain drain and the factors influencing migration tendencies among medical and nursing students in Albania, with particular attention to nursing workforce implications. Methods: A cross-sectional study was conducted with 610 students in the 2024–2025 academic year using the 16-item Brain Drain Attitude Scale (BDAS). Socio-demographic and academic data were also collected. Results: The mean BDAS score was 53.43 ± 16.88. Pull factors (mean: 40.25 ± 12.76) were stronger motivators than push factors (mean: 13.19 ± 4.13). A total of 487 nursing, 73 midwifery-nursing, and 50 medical students participated (95% response rate). Nearly 40% expressed a desire to work abroad, citing financial prospects (48.2%), better living standards (46%), and personal freedom (42.1%) as reasons. Higher migration tendencies were seen in females (β = 0.50, p = 0.049), medical students (β = 1.01, p = 0.001), and third-year students (β = 0.46, p = 0.011). Conclusions: Migration tendencies are high among future Albanian healthcare professionals, with significant implications for the nursing workforce. Targeted policies are urgently needed to address brain drain through workforce investment and retention strategies. Full article
21 pages, 1589 KiB  
Review
Virtual Reality in Medical Education, Healthcare Education, and Nursing Education: An Overview
by Georgios Lampropoulos, Antonio del Bosque, Pablo Fernández-Arias and Diego Vergara
Multimodal Technol. Interact. 2025, 9(7), 75; https://doi.org/10.3390/mti9070075 - 20 Jul 2025
Viewed by 617
Abstract
Virtual reality is increasingly used in health sciences education, including healthcare, nursing, and medical education. Hence, this study provides an overview of the use of virtual reality within healthcare education, nursing education, and medical education through the analysis of published documents from 2010 [...] Read more.
Virtual reality is increasingly used in health sciences education, including healthcare, nursing, and medical education. Hence, this study provides an overview of the use of virtual reality within healthcare education, nursing education, and medical education through the analysis of published documents from 2010 to 2025. Based on the outcomes of this study, virtual reality emerged as an effective educational tool that can support students and health professionals. The immersive, realistic, and safe environments created in virtual reality allowed learners to enhance their knowledge and practice their skills, patient interactions, and decision-making without risking patient safety. Improvements in learning outcomes, including performance, clinical skills development, critical thinking, and knowledge acquisition were observed. Virtual reality also positively contributes toward a more holistic health sciences education as it increases students’ empathy and behavioral understanding. Finally, eight main research topics were identified and research gaps and future research directions are presented. Full article
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22 pages, 1028 KiB  
Article
Revisiting Public Trust and Media Influence During COVID-19 Post-Vaccination Era—Waning of Anxiety and Depression Levels Among Skilled Workers and Students in Serbia
by Miljan Adamovic, Srdjan Nikolovski, Stefan Milojevic, Nebojsa Zdravkovic, Ivan Markovic, Olivera Djokic, Slobodan Tomic, Ivana Burazor, Dragoslava Zivkov Saponja, Jasna Gacic, Jelena Petkovic, Snezana Knezevic, Marko Spiler, Snezana Svetozarevic and Ana Adamovic
Behav. Sci. 2025, 15(7), 939; https://doi.org/10.3390/bs15070939 - 11 Jul 2025
Viewed by 414
Abstract
Infectious disease outbreaks amplify the influence of stressors on psychological conditions. The purpose of this study was to analyze the disturbing influence of COVID-19 outbreak-related information and the influence of trust on the Serbian healthcare system and COVID-19 preventive measures on anxiety and [...] Read more.
Infectious disease outbreaks amplify the influence of stressors on psychological conditions. The purpose of this study was to analyze the disturbing influence of COVID-19 outbreak-related information and the influence of trust on the Serbian healthcare system and COVID-19 preventive measures on anxiety and depression. An anonymous online questionnaire assessing the demographic information, disturbance level and causes, and levels of anxiety and depression has been distributed to the participants, divided into student and non-student groups. The non-student group was further divided into healthcare, military, and education workers. Anxiety and depression levels, as well as the level of decreased trust in COVID-19-related preventive measures, were higher among students compared to non-students (p = 0.011). Higher anxiety and depression levels, and higher influence of the COVID-19 outbreak on those levels, were observed in education and healthcare workers, compared to military personnel. Medical doctors reported a higher level of trust in the healthcare system compared to nurses (p = 0.023). Trust in the healthcare system increased more frequently compared to the pre-vaccination period among medical doctors, compared to nurses (p = 0.040). Higher anxiety and depression and lower public trust levels in students and workers in education and the healthcare sector indicate a need to focus on these important society members during public health emergencies. Full article
(This article belongs to the Section Social Psychology)
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8 pages, 210 KiB  
Article
The Effect of Community Nurse Practice for Medical Students Who Rotate in Emergency Medicine
by Yoshiaki Iwashita, Haruka Saigusa, Moe Fusayama, Hiroshi Miyamoto, Rie Sato, Nobuhiro Kodani, Noriaki Yamada, Tetsuya Makiishi and Akiko Yata
Int. Med. Educ. 2025, 4(3), 24; https://doi.org/10.3390/ime4030024 - 23 Jun 2025
Viewed by 578
Abstract
Background: Emergency medicine in Japan traditionally emphasizes critically ill patients, but recent trends show an increase in minor illness cases influenced by social factors. This study assessed integrating community nurse (CN) training into an emergency medicine elective to evaluate its effect on students’ [...] Read more.
Background: Emergency medicine in Japan traditionally emphasizes critically ill patients, but recent trends show an increase in minor illness cases influenced by social factors. This study assessed integrating community nurse (CN) training into an emergency medicine elective to evaluate its effect on students’ self-achievement and communication skills. Methods: Medical students rotating in the emergency department participated. Those choosing the CN training spent one week in the community, while others remained hospital-based. Surveys evaluated self-achievement of Shimane University emergency medicine objectives and communication skills per the Model Core Curriculum. Analyses used t-tests. Results: Of 35 students, 21 (60%) completed surveys. Satisfaction levels did not differ significantly between CN and non-CN groups (4.0 ± 0.70 vs. 4.5 ± 0.63, p = 0.15). Regression analysis indicated satisfaction correlated only with online practice availability. No significant differences emerged for goals or communication items (all p > 0.05), although CN participants tended to rate higher on patient proximity, communication, and social engagement. Discussion: CN training maintained overall satisfaction and slightly enhanced communication and social aspects, aligning with shifts toward psychosocial care in emergency medicine. Conclusions: Integrating CN practice did not significantly impact emergency medicine knowledge or skill satisfaction but showed a trend toward improved communication and social purpose satisfaction. Larger-scale studies are needed for validation. Full article
13 pages, 236 KiB  
Article
Serbian Healthcare Students’ Perceptions of and Readiness to Care for People with Intellectual Disabilities: A Cross-Sectional Study
by Dragana Milutinović, Dragana Simin, Katarzyna Ćwirynkało, Monika Parchomiuk, Zdzisław Kazanowski, Agnieszka Żyta and Špela Golubović
Healthcare 2025, 13(11), 1315; https://doi.org/10.3390/healthcare13111315 - 1 Jun 2025
Viewed by 432
Abstract
Background/Objectives: The perspective from which future healthcare professionals view intellectual disabilities affects how people with intellectual disabilities (PWIDs) are perceived and informs care policies and practices. This study aimed to assess healthcare science students’ perceptions of the rights of PWIDs, the students’ social [...] Read more.
Background/Objectives: The perspective from which future healthcare professionals view intellectual disabilities affects how people with intellectual disabilities (PWIDs) are perceived and informs care policies and practices. This study aimed to assess healthcare science students’ perceptions of the rights of PWIDs, the students’ social distances toward PWIDs in healthcare, and the students’ competence in providing care, exploring differences by study programs and demographics and examining correlations between them. Methods: The convenience sample comprised 221 medical and 120 nursing students. A general questionnaire for obtaining sociodemographic data, the scale of beliefs about the rights of PWIDs in healthcare (BS), the scale of social distance toward PWIDs (SD), and the “self-assessment of competency (CS) to provide care for PWIDs” scale were used as students’ report measures. Results: The students’ scores on the BS, SD, and CS scales revealed that they generally recognized the rights of PWIDs in healthcare but expressed a moderate level of social distance and limited self-perceived competence in providing care. Medical students demonstrated slightly more progressive beliefs regarding the rights of PWIDs than nursing students (r = 0.12), while nursing students reported higher self-assessed competence levels (r = 0.19). A small gender-related difference was observed in social distance, with female students showing more favorable attitudes. Significant positive correlations were found between beliefs about the rights of PWIDs and social distance (p = 0.435; p < 0.01) and between social distance and self-assessed competence (p = 0.234, p < 0.01), suggesting that students who felt more competent tended to report less social distance. Conclusions: This study provides new data for understanding healthcare science students’ perceptions and readiness to care for PWIDs in the healthcare sector in Serbia. Namely, our students had moderately positive beliefs and a moderate social distance toward PWIDs and reported low competence in providing care. Full article
15 pages, 5650 KiB  
Article
Enhancing Interprofessional Communication in Healthcare Using Large Language Models: Study on Similarity Measurement Methods with Weighted Noun Embeddings
by Ji-Young Yeo, Sungkwan Youm and Kwang-Seong Shin
Electronics 2025, 14(11), 2240; https://doi.org/10.3390/electronics14112240 - 30 May 2025
Viewed by 331
Abstract
Large language models (LLMs) are increasingly applied to specialized domains like medical education, necessitating tailored approaches to evaluate structured responses such as SBAR (Situation, Background, Assessment, Recommendation). This study developed an evaluation tool for nursing student responses using LLMs, focusing on word-based learning [...] Read more.
Large language models (LLMs) are increasingly applied to specialized domains like medical education, necessitating tailored approaches to evaluate structured responses such as SBAR (Situation, Background, Assessment, Recommendation). This study developed an evaluation tool for nursing student responses using LLMs, focusing on word-based learning and assessment methods to align automated scoring with expert evaluations. We propose a three-stage biasing approach: (1) integrating reference answers into the training corpus; (2) incorporating high-scoring student responses; (3) applying domain-critical token weighting through Weighted Noun Embeddings to enhance similarity measurements. By assigning higher weights to critical medical nouns and lower weights to less relevant terms, the embeddings prioritize domain-specific terminology. Employing Word2Vec and FastText models trained on general conversation, medical, and reference answer corpora alongside Sentence-BERT for comparison, our results demonstrate that biasing with reference answers, high-scoring responses, and weighted embeddings improves alignment with human evaluations. Word-based models, particularly after biasing, effectively distinguish high-performing responses from lower ones, as evidenced by increased cosine similarity differences. These findings validate that the proposed methodology enhances the precision and objectivity of evaluating descriptive answers, offering a practical solution for educational settings where fairness and consistency are paramount. Full article
(This article belongs to the Special Issue Deep Learning Approaches for Natural Language Processing)
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9 pages, 363 KiB  
Article
“Put Me in, Coach”: A Discussion of Deprescribing Roles, Responsibilities, and Motivations Based on a Qualitative Study with Healthcare Professional Students
by Devin Scott, Amy Hall, Rachel Barenie, Crystal Walker, Muneeza Khan, Paul Koltnow, William R. Callahan and Alina Cernasev
Pharmacy 2025, 13(3), 77; https://doi.org/10.3390/pharmacy13030077 - 29 May 2025
Viewed by 477
Abstract
As the US population ages, the number of prescriptions managed by patients and healthcare teams is increasing. Thus, discontinuing or reducing medications that are considered to pose more risks than benefits can be achieved through deprescribing. Despite increasing calls for a stronger focus [...] Read more.
As the US population ages, the number of prescriptions managed by patients and healthcare teams is increasing. Thus, discontinuing or reducing medications that are considered to pose more risks than benefits can be achieved through deprescribing. Despite increasing calls for a stronger focus on deprescribing in healthcare education, current discussions highlight the lack of training on this topic within healthcare curricula. This is a significant barrier to effectively implementing the deprescribing process. This study aimed to characterize healthcare professional students (HPSs)’s perspectives on deprescribing within an interprofessional healthcare team, particularly regarding the motivations and roles of these future practitioners. Methods: Focus groups were conducted with HPSs at the University of Tennessee Health Science Center. The data collection, guided by a conceptual model, took place over three months in 2022. Data analysis was performed using thematic analysis, during which themes were identified through inductive coding. Results: Participants (n = 36) represented various faculties, including medicine, pharmacy, health professions, nursing, and dentistry. Two themes emerged: (1) Healthcare Team Members’ Roles and Responsibilities (2) “Put Me in, Coach”: Patient Safety Motivates Deprescribing. Conclusion: Data from HPSs highlighted the importance of an interprofessional healthcare team approach to deprescribing. Based on these insights, educators and practitioners should focus on establishing strong interprofessional healthcare teams that privilege open communication. Teams should consider deprescribing as a patient safety concern, as this may galvanize the team and provide additional motivation for performing the necessary work of deprescribing. Full article
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14 pages, 829 KiB  
Review
Evaluating Eye Tracking Technology in Nursing Education: A Scoping Review on Medication Administration Training
by Jiranut Chaichana, Rob Eley, Chris Watling and Linda Ng
Nurs. Rep. 2025, 15(6), 185; https://doi.org/10.3390/nursrep15060185 - 27 May 2025
Viewed by 1303
Abstract
Background: Eye tracking technology, when used in nursing, helps to reduce medication errors by analyzing eye movements. In education, it provides insights into student learning, cognitive load, and instructional design, allowing for more personalized learning. Despite challenges such as the need for technical [...] Read more.
Background: Eye tracking technology, when used in nursing, helps to reduce medication errors by analyzing eye movements. In education, it provides insights into student learning, cognitive load, and instructional design, allowing for more personalized learning. Despite challenges such as the need for technical expertise, privacy concerns, and cost, eye tracking offers real-time feedback that enhances both teaching and learning effectiveness. Objectives: To explore the current evidence on the application of eye tracking technology in training nursing students for drug administration. Methods: Eligible studies included peer-reviewed empirical papers, both qualitative and quantitative, and reports published in English. Excluded were studies involving Non-Eye Glass Tracking, non-nursing students, or non-English articles. Searches were conducted in nine databases. The risk of bias was assessed using the JBI SUMARI tool, and the results were synthesized narratively, presented with the PRISMA-P flow diagram. Results: From 739 studies, 10 focusing on medication training were identified. Eye tracking helped to reveal differences in visual focus between novice and expert nurses, with certain interventions shown to improve attention and concentration. Conclusions: Eye tracking has strong potential in nursing education, especially for improving attention and enhancing situational awareness in medication administration. However, limitations such as small sample sizes, technical barriers, and a lack of long-term data remain. Future research should address these gaps with larger, more diverse samples and extended follow-ups. Full article
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15 pages, 632 KiB  
Article
Psychometric Validation of the Iowa Infant Feeding Attitude Scale Among Healthcare Students in Vietnam
by My Thi Thuy Dang, Marianne Lin-Lewry, Cai Thi Thuy Nguyen, Gabrielle T. Lee, Su-Ru Chen and Shu-Yu Kuo
Healthcare 2025, 13(11), 1233; https://doi.org/10.3390/healthcare13111233 - 23 May 2025
Viewed by 519
Abstract
Background: The Iowa Infant Feeding Attitude Scale (IIFAS) is widely used to assess breastfeeding attitudes, which are linked to positive breastfeeding practices. However, its psychometric validation in Southeast Asian healthcare students remains limited. Objectives: To investigate the reliability and validity of the IIFAS [...] Read more.
Background: The Iowa Infant Feeding Attitude Scale (IIFAS) is widely used to assess breastfeeding attitudes, which are linked to positive breastfeeding practices. However, its psychometric validation in Southeast Asian healthcare students remains limited. Objectives: To investigate the reliability and validity of the IIFAS among Vietnamese healthcare students. Methods: A cross-sectional study was conducted at three medical universities in Vietnam. A total of 542 healthcare students, including medical, nursing, and midwifery students, participated. The students completed the Iowa Infant Feeding Attitude Scale, Breastfeeding Knowledge Scale, and Generalized Anxiety Disorder Scale. The reliability was assessed through the internal consistency and test–retest reliability. The construct validity was tested using exploratory and confirmatory factor analysis. The divergent validity, convergent validity, and known-group comparison were also assessed. Results: The IIFAS showed an excellent internal consistency (Cronbach’s α = 0.94) and test–retest reliability (intraclass correlation = 0.91). A two-factor structure of the Vietnamese IIFAS was identified using exploratory and confirmatory factor analysis with satisfactory fit indices (χ2/df = 1.318, comparative fit index = 0.985, Tucker–Lewis Index = 0.983, and Root Mean Square Error of Approximation = 0.034). Breastfeeding attitudes positively correlated with breastfeeding knowledge (r = 0.74, p < 0.001) and negatively correlated with anxiety symptoms (r = −0.13, p = 0.04). Students who were older, in a higher academic year, and majoring in medicine had significantly higher breastfeeding attitude scores (ps < 0.05). Conclusions: The Vietnamese version of the IIFAS demonstrates excellent reliability and validity, making it a robust tool for assessing breastfeeding attitudes and informing tailored educational programs among healthcare students. Full article
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13 pages, 455 KiB  
Article
Thirty Years of Emergency Medicine in Romania—A Bridge Between the Behavior of Emergency Department Professionals and the Health System Management Strategy: A Survey Study
by Adela Golea, Raluca M. Tat, Ștefan C. Vesa, Daniela Mitrofan, Cristian Boeriu, Luciana T. Rotaru, Diana C. Cimpoeșu, Silvia Nica, Alina Petrică, Monica Puticiu, Daniela Ionescu, Andrea Kazamer and Iris C. Mureșan
J. Clin. Med. 2025, 14(10), 3316; https://doi.org/10.3390/jcm14103316 - 9 May 2025
Viewed by 767
Abstract
Background/Objectives: Over the past three decades, emergency medicine in Romania has evolved from a developing specialty into a cornerstone of the national healthcare system. As we reflect on these 30 years, it becomes evident that the lessons learned and the systems developed form [...] Read more.
Background/Objectives: Over the past three decades, emergency medicine in Romania has evolved from a developing specialty into a cornerstone of the national healthcare system. As we reflect on these 30 years, it becomes evident that the lessons learned and the systems developed form a vital foundation for the future. This study aims to explore how the accumulated experience can guide us toward building a more resilient emergency medical system, one that prioritizes quality, ensures patient and provider safety, and embraces modern principles of healthcare management. The objectives of this study were to explore the long-term perspectives of physicians and nurses working in emergency departments (EDs), to determine the triggering factors that may lead to abandoning the specialty, and to identify of malpractice risks arising from doctor–patient interaction. Methods: This study employed an observational design and utilized an opinion questionnaire to assess the participants’ perspectives. Qualitative data were presented as frequencies and percentages. Quantitative data were expressed as means and standard deviations after verifying normal distribution with the Shapiro–Wilk test. Comparisons between groups for qualitative variables were conducted using the chi-square test. For comparisons of quantitative variables between two groups, Student’s t-test was employed following confirmation of homogeneity of variances with Levene’s test. A p-value of < 0.05 was considered statistically significant. Results: Out of 1228 estimated responders, 641 completed the questionnaire. A total of 577 of participants met the inclusion criteria: 256 (44.4%) nurses and 321 (55.6%) doctors, with an average age of the responders of 40.06 years. Nurses reported the highest level of managerial support (83.2%, p < 0.001). EPs had the highest rate of non-participation in working groups for procedures/protocols/guidelines (49.5%, p < 0.001). Intensive care unit medical doctors (ICU-MDs) and EPs were the main groups reporting a deficiency in employer-provided resources to manage conflict situations (63.7%, 61.7%; p <0.001). EPs (28%) reported practicing defensive medicine (inadequate educational support, the absence of clear protocols). Workplace burnout was reported by the ICU-MDs and EPs responders (96.3%; 93.4%; p < 0.001), and 26% of EPs expressed interest in professional reorientation. Conclusions: This study highlights four strategic directions for rebuilding a resilient healthcare system focused on improving quality of care and safety: development of procedures/protocols, managerial reorganization, restoration of healthcare professionals’ trust through new strategies, and academic development. Full article
(This article belongs to the Section Emergency Medicine)
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12 pages, 879 KiB  
Article
Development of a Technology-Based, Interactive Intervention to Reduce Substance Use Disorder Stigma Among Medical Students
by Angela Caldwell, Cerelia Donald, Gabrielle Simcoe, Lillia Thumma, Amber R. Green, Alison J. Patev, Kristina B. Hood, Madison M. Marcus and Caitlin E. Martin
Int. Med. Educ. 2025, 4(2), 15; https://doi.org/10.3390/ime4020015 - 3 May 2025
Viewed by 481
Abstract
High levels of stigma among the healthcare workforce impede efforts to increase access to effective substance use disorder (SUD) treatments. Education on SUDs that (1) is tailored to physicians in training and (2) directly addresses and attempts to combat SUD stigma may help [...] Read more.
High levels of stigma among the healthcare workforce impede efforts to increase access to effective substance use disorder (SUD) treatments. Education on SUDs that (1) is tailored to physicians in training and (2) directly addresses and attempts to combat SUD stigma may help produce lasting reductions in SUD stigmatization within the healthcare setting. This study aims to describe the development of a technology-based, interactive SUD stigma intervention for medical students, created in collaboration with medical students, practicing clinicians, and experts in the fields of psychology and addiction medicine. This intervention is unique in its interactive application-based approach and the use of a computerized intervention authorizing system (CIAS) to guide the participant through the training. The final intervention includes four interactive online modules focused on SUD education using a biopsychosocial model, including stigma acknowledgment, an examination of patient perspectives, and the application of skills. Planned future studies will examine the feasibility, acceptability, and preliminary efficacy of the intervention among medical students. This intervention leverages the existing CIAS to provide interactive training that can be used as a part of medical student training and be expanded to other healthcare professionals (e.g., nurses and community health workers). Ultimately, this work will be used to drive a reduction in SUD stigma in medical settings. Full article
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