BACKGROUND: The exclusive breastfeeding rates is low in some countries. Low breastfeeding rates results in higher healthcare expenses and adverse health outcomes for individuals and society. Co-parenting is effective in promoting breastfeeding as it involves shared responsibility and collaboration between parents in raising children. However, the current breastfeeding co-parenting intervention programs exhibits significant variations in components, timing, and duration across studies. An evidence-based breastfeeding co-parenting intervention program is essential for enhancing breastfeeding-related outcomes.
OBJECTIVE: To develop an evidence-based breastfeeding co-parenting intervention program for healthcare providers to guide parents with primiparas on breastfeeding.
METHODS: To form an initial version of the intervention program, a systematic literature review was conducted to consolidate information on current intervention programs. Two rounds of Delphi method were followed to gather expert comments for the program modification to establish the formal version.
RESULTS: Fourteen articles published between 1995 and 2022 were screened. Details of these researches, including starting and ending time, duration and specific contents, were integrated to developed the initial program. Then, six experts completed the two rounds consultation with a positive coefficient of 85.71%, coefficient judgment basis of 0.93, familiarity coefficient of 0.87, authority coefficient of 0.90 and the Kendall\'s W of 0.62. Finally, an evidence-based breastfeeding co-parenting intervention program was constructed in this study, consisting of breastfeeding co-parenting courses, individual counselling and a father\'s support group.
CONCLUSIONS: This research developed a breastfeeding co-parenting intervention program for healthcare providers to guide primiparous parents to improve breastfeeding rates. Through a systematic literature review and Delphi method with good reliability, the program integrates breastfeeding courses, individual counseling, and a father\'s support group. Future research will focus on evaluating its impact and scalability to benefit maternal and infant health globally.
BACKGROUND: ChiCTR.org.cn (ChiCTR2300069648). Registration date: 2023-03-22.

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OBJECTIVE: This study aimed to develop a Hybrid Clinical Practicum Environment Scale for Nursing Students (HCPES-NS) and verify its validity and reliability.
METHODS: The HCPES-NS was constructed following the DeVellis guidelines. The initial items were written based on a literature review and individual in-depth interviews. Content validity was verified through an expert panel review. To confirm the validity and reliability of the scale, a survey was conducted with 449 nursing students enrolled in 12 nursing colleges. Data were analyzed using item analysis, exploratory factor analysis, confirmatory factor analysis, concurrent validity, and reliability tests.
RESULTS: Factor analysis showed that the HCPES-NS consists of 15 items on five subdomains: clinical site atmosphere, interpersonal relationship, alternative online practicum contents, provision of learning information, and clinical performance facilitation. A higher score indicated a more positive perception of the clinical practicum environment. The concurrent validity of the HCPES-NS was confirmed by its positive correlation with the Clinical Learning Environment Scale (r = .77). The Cronbach\'s α reliability of the HCPES-NS was .84.
CONCLUSIONS: The HCPES-NS is both valid and reliable. This scale reflects the clinical practicum environment and includes an online practicum factor. It may be used effectively by faculty members and educators to evaluate nursing students\' perceptions of clinical practicum environments.

OBJECTIVE: This study aimed to implement and evaluate the outcomes, perceptions, and satisfaction of the Capstone Program developed at the Catholic University of Korea, which integrates career exploration and medical humanities.
METHODS: This study was conducted with fourth-year medical students from 2017 to 2019. First, the study analyzed the trends in the results of Capstone Projects conducted by students as part of their career exploration, where they independently explored areas of interest and selected topics. Second, it qualitatively analyzed the content of individual reports in which students reflected on their experiences from a \"medical humanities perspective\" through the Capstone Program. Third, it examined students\' perceptions and satisfaction with the Capstone Program.
RESULTS: The analysis revealed that students chose research topics from a wide range of fields, including basic medicine, clinical medicine, global healthcare, and integrated healthcare systems and innovation. The students reported positive perceptions of their career exploration and research experiences through the Capstone Program, particularly valuing sessions like \"Meetings with Seniors\" within the conference framework. Students indicated that the Capstone Program enhanced their ability to think introspectively from a humanities perspective, deepening their understanding of their roles and responsibilities as medical professionals.
CONCLUSIONS: The Capstone Program provides a significant opportunity for medical students to explore their career paths and engage in introspective reflection from the viewpoint of medical humanities and social sciences. Thus, the integration of programs like capstone into the broader medical curriculum, focusing on career guidance and the reinforcement of medical humanities education, is imperative.

OBJECTIVE: This study aimed to develop a competency-based global health education (GHE) program for medical students and analyze its effectiveness.
METHODS: The study had a pretest-posttest control group design. The program was developed based on the eight global health competency domains for medical students and implemented for 18 hours over 6 weeks beginning in September 2023. The intervention and control groups comprised 34 students and 41 students, respectively. The analytical methods used were t-test, chi-square test, and analysis of covariance.
RESULTS: Experience with global health activities and pretest scores were controlled as covariates to exclude the effects of participants\' general characteristics and pretest scores. The intervention group had outscored the control group on interest in a global health career and the necessity of GHE and also showed significantly higher posttest scores on global competence, global citizenship, and global health competence. Students were generally satisfied with the GHE program.
CONCLUSIONS: A global health competency-based GHE program effectively increases medical students\' interest in global health careers, their understanding of the need for GHE, and their global competence, global citizenship, and global health competence. This study is expected to promote GHE program development and research.

In the Long-Term Care (LTC) setting, comprehensive primary care is often provided by Nurse Practitioners (NPs). NPs are uniquely positioned to meet the evolving primary care needs of LTC residents. However, caring for this population requires additional education and training due to its special considerations. To meet the learning needs of NPs entering the LTC workplace, a Certificate Program was designed to enhance primary care competencies within the LTC setting. The aim of the program is to increase knowledge, capacity, and confidence of NPs to deliver quality, evidence-based, integrated, and interprofessional primary care to LTC residents. This curriculum is anticipated to address the growing need for LTC services and improve the delivery of high-quality primary care.

Registered nurses\' practice in primary care varies and is sometimes sub-optimal. To fill the gap in primary care-specific knowledge, we co-constructed a national educational program to reinforce the nursing workforce. We based our project on the knowledge-to-action approach. Many lessons were learned during the development phase: (1) The experiential knowledge of patient partners and stakeholders allows an education program based on real needs; (2) The development of a national education program requires high-intensity investment from all involved persons; (3) An in-person meeting at the beginning of the project enables robust discussions and optimal co-creation; and (4) In a country where two official languages are spoken, it\'s essential to create a safe environment and a translation infrastructure that allows everyone to express themselves in the language of their choice. Finally, other initiatives in healthcare education or professional practice improvement could leverage our findings to realize national-scale projects using knowledge creation approaches.

Canada\'s 50,000+ pharmacists play a crucial role in the comprehensive delivery of primary care. Recognizing this, a program in alignment with the Team Primary Care national initiative was developed to enhance their skills and knowledge in collaborative care, aiming to cultivate advanced primary care pharmacist leaders. The curriculum development involved aligning activities with pharmacist roles and competencies, emphasizing interprofessional teamwork. A mixed-methods evaluation revealed positive outcomes: 14/15 pharmacists completed the program, reporting improved readiness for team-based care. All non-pharmacist team members expressed a desire for continued pharmacist collaboration. Overall, satisfaction was high among participants and team members, indicating success in training. The program\'s comprehensive approach, covering primary care landscape, clinical skills, teaching, change management, and advocacy, empowered pharmacists to integrate team-based care and contribute to positive change in primary care settings. Training more pharmacists with this program is one of the many strategies to further establish and optimize team-based primary care.

UNASSIGNED: Explore facilitators and barriers to development and integration of an inpatient music therapy (MT) program from the perspective of the patient, family member, and health care professional.
UNASSIGNED: This qualitative study recruited patients on acute neurosciences/neurorehabilitation units having participated in the hospital MT program, their family, and members of their health care team. Semi-structured individual interviews and focus groups were conducted with 35 participants (14 patients, 5 family members, 16 health care professionals). Interviews/focus groups were audio recorded and transcribed verbatim. Data were coded in duplicate and a codebook was developed through an iterative process.
UNASSIGNED: Four dominant themes emerged from the data: (1) facilitators of program operations; (2) barriers to program establishment; (3) perceived positive impact on patient outcomes; and (4) opportunity for improvement. Facilitator sub-themes included a love for music that encouraged participation, broad appeal of MT, and support of the health care team.
UNASSIGNED: Patients, health care professionals, and family members accepted MT as a treatment modality. While there is growing evidence for MT in neurorehabilitation, practical challenges remain in developing inpatient MT services, including funding, and optimal integration of music therapists into existing care teams.
Music therapy (MT) is a therapy modality that can be used to target breath control, speech, motor control, and emotional regulation goals in neurorehabilitation.Development of an MT program was facilitated by the broad appeal of the therapy and support from the health care team.Multi-pronged education efforts are needed to increase staff awareness of specific indications and benefits of MT.MT sessions should be offered more than once per week on neurorehabilitation units.

Advance care planning in the acute hospital: A qualitative analysis of terms and conditions Abstract: Background: Advance Care Planning (ACP) is an internationally established concept aimed to facilitate anticipatory care planning in the event of future inability to consent. In Germany, ACP is currently not regularly offered to patients in acute care hospitals. Aim: We aimed to identify preconditions for implementation of ACP in acute care hospitals in Germany through review of the international literature and expert interviews. Methods: A systematic literature search was carried out in the databases MEDLINE and CINAHL for internationally used strategies for implementing ACP in acute care hospitals. Consecutively, a guide for interviews with experts to evaluate the strategies was developed. Interviews were analyzed by qualitative content analysis according to Mayring. Results: Out of 13 included publications, 17 preconditions were identified and assigned to 16 categories after evaluation by experts. In international ACP programs, it was described how to proceed and organize the ACP conversation. German experts emphasized that appropriate preconditions, such as sufficient time resources and training, must be granted, whereas the literature search revealed the conversation process and organization as important determinants. Conclusions: The implementation of ACP programs is conceivable, but requires specific conditions as legal regulation and defining and structuring of the processes.
Zusammenfassung: Hintergrund: Advance Care Planning (ACP) ist ein international etabliertes Konzept mit dem Ziel einer vorausschauenden Versorgungsplanung für den Fall einer zukünftigen Einwilligungsunfähigkeit. In Deutschland wird ACP aktuell noch nicht regelhaft im akutstationären Setting angeboten. Fragestellung/Ziel: Ziel ist es, Voraussetzungen für die Implementierung eines ACP-Programmes in Akutkliniken in Deutschland durch Sichten internationaler Initiativen und Führen von Experteninterviews zu identifizieren und zu bewerten. Methoden: In den Datenbanken MEDLINE und CINAHL erfolgte eine systematische Literaturrecherche nach international angewandten Strategien zur Umsetzung von ACP in Akutkrankenhäusern. Konsekutiv wurde ein Leitfaden für Interviews mit Expert_innen zur Bewertung der Strategien entwickelt. Die Analyse erfolgte mittels qualitativer Inhaltsanalyse nach Mayring. Ergebnisse: Aus 13 eingeschlossenen Publikationen wurden 17 Voraussetzungen identifiziert und nach der Bewertung durch Expert_innen 16 Kategorien zugeordnet. Die Expert_innen hoben insbesondere hervor, dass passende Rahmenbedingungen, wie ausreichende Zeitressourcen und Schulungen, geschaffen werden müssen, wohingegen die Literaturrecherche zeigte, dass eher Voraussetzungen aus dem Bereich Gesprächsablauf und -organisation im Vordergrund standen. Schlussfolgerungen: Die Implementierung von ACP im akutstationären Setting erscheint machbar, unterliegt aber umfassenden settingspezifischen Bedingungen und Herausforderungen, wie einer gesetzlichen Regelung sowie der Definition und Strukturierung der Prozesse.