Interprofessional co-debriefing, whereby facilitators from different healthcare professional backgrounds jointly facilitate debriefings, is increasingly common in simulation-based education. This approach can enhance learning by incorporating diverse perspectives and distributing cognitive workload, but it may also expose tensions linked to professional identity, hierarchy and power dynamics between debriefers. While learner outcomes and debriefing strategies in general are well studied, little is known about faculty experiences of interprofessional co-debriefing or how sociocultural factors influence this practice. Addressing this gap is crucial to optimise faculty development and support effective interprofessional education. This study will qualitatively explore the experiences and perceptions of simulation educators engaged in interprofessional co-debriefing, with a focus on the influence of sociocultural factors on their practice.
This UK-based qualitative study will recruit up to 30 healthcare simulation educators with experience of interprofessional co-debriefing. Participants will be purposively sampled from simulation networks, centres and academic institutions, with snowball sampling to broaden reach. Semistructured interviews will be conducted online via Microsoft Teams, guided by a topic framework developed by the research team. Interviews will be audio-recorded, transcribed verbatim and anonymised. Underpinned by constructivist and constructionist paradigms, data will be analysed using reflexive thematic analysis following Braun and Clarke’s six-phase approach. Three researchers will independently code transcripts, with themes refined through iterative team discussions to ensure rigour and transparency.
Ethical approval has been granted by the University of Glasgow School of Medical and Life Sciences Ethics Committee (Ref No: 200240285). All participants will provide informed written consent, and data will be handled in accordance with data protection regulations. Findings will be disseminated via peer-reviewed publications, conference presentations and professional networks, with a summary provided to participants. This study will offer novel insights into the underexplored area of interprofessional co-debriefing, specifically how sociocultural dynamics may influence and shape practice, potentially informing faculty development and best practice moving forward.
Rare diseases (RD) are collectively common and often genetic. Families value and can benefit from precise molecular diagnoses. Prolonged diagnostic odysseys exacerbate the burden of RD on patients, families and the healthcare system. Genome sequencing (GS) is a near-comprehensive test for genetic RD, but existing care models—where consultation with a medical geneticist is a prerequisite for testing—predate GS and may limit access or delay diagnosis. Evidence is needed to guide the optimal positioning of GS in care pathways. While initiating GS prior to geneticist consultation has been trialled in acute care settings, there are no data to inform the utility of this approach in outpatient care, where most patients with RD seek genetics services. We aim to evaluate the diagnostic yield, time to diagnosis, clinical and personal utility and incremental cost-effectiveness of GS initiated at the time of referral triage (pre-geneticist evaluation) compared with standard of care.
200 paediatric patients referred to one of two large genetics centres in Ontario, Canada, for suspected genetic RD will be randomised into a 1:1 ratio to the intervention (GS first) or standard of care (geneticist first) arm. An unblinded, permuted block randomisation design will be used, stratified within each recruitment site by phenotype and prior genetic testing. The primary outcome measure is time to genetic diagnosis or to cessation of active follow-up. Survival analysis will be used to analyse time-to-event data. Additional measures will include patient-reported and family-reported measures of satisfaction, understanding and perceived test utility, clinician-reported measures of perceived test utility and management impact, and healthcare system utilisation and costs.
This study was approved by Clinical Trials Ontario. Results will be disseminated, at minimum, via peer-reviewed journals, professional conferences and internal reports to funding bodies. Efforts will be made to share aggregated study results with participants and their families.
To evaluate the effectiveness of nutrition care delivered by general practitioners (GPs) compared with usual or no care on dietary and health outcomes in adults with diet-related chronic conditions or risk states and to examine which intervention components are associated with effectiveness.
A systematic review of randomised controlled trials (RCTs).
CINAHL, Embase, MEDLINE and ProQuest Nursing and Allied Health databases were searched in October 2021 and updated in February 2024 for articles related to GPs, nutrition care and diet-related health outcomes.
Published RCTs were included according to the following criteria: adults with or at risk of diet-related chronic conditions; nutrition care delivered by GPs in the primary care setting; usual or no care as comparators; and dietary and/or health outcomes with a minimum 3-month follow-up. No restriction was placed on the date of publication.
Duplicates were reconciled in EndNote. Two reviewers independently screened the titles, abstracts and full texts in Covidence. Two independent reviewers completed the critical appraisal and data extraction. Disagreements were resolved through discussion or with a third reviewer. The Motivation Actions and Prompts (MAP) framework was used to analyse the behaviour change components of study interventions. Results were reported using narrative synthesis and certainty in findings was summarised using GRADEpro GDT software.
Seven RCTs met the inclusion criteria (5744 patients). The trials were conducted in Australia, Italy and the USA from 1991 to 2013, with follow-up periods from 3 to 12 months. A consistent effect in favour of the intervention was found for diet scores (2 RCTs, 3038 participants). Other outcomes had mixed effects: (1) fat intake (2 RCTs, 2299 participants) – one study with an effect in favour of the intervention and one with mixed effects; (2) blood pressure (3 RCTs, 3063 participants) – one study with mixed effects and two with no effect; (3) body mass index (6 RCTs, 5538 participants) – two studies with an effect in favour of the intervention, two with no effect and two reporting no between group differences; (4) body weight (2 RCTs, 511 participants) – one study with an effect in favour of the intervention and one with no effect and (5) cholesterol (4 RCTs, 2505 participants) – one study with an effect in favour of the intervention and three with mixed effects and/or limited reporting. All studies had a motivation and action route to behaviour change and two had a prompted component, according to the MAP framework. The interventions spanned nine behaviour change groupings and 16 behaviour change techniques. There was a very low certainty of findings in all cases and the studies were of low to moderate methodological quality.
There is mixed evidence of the effectiveness of GP-delivered nutrition care among adults with diet-related chronic conditions or risk states. Additionally, most interventions did not include prompting and had a limited range of behaviour change techniques. The effectiveness of nutrition care delivered by GPs is an understudied area that warrants greater experimental investigation and requires more robust methods and reporting.
CRD42021289011.