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Carrillo I, Serpa P, Landa-Ramírez E, Guilabert M, Gómez-Ayala Y, López-Pineda A, Mira JJ. Speaking Up About Patient Safety, Withholding Voice and Safety Climate in Clinical Settings: a Cross-Sectional Study Among Ibero-American Healthcare Students. Int J Public Health 2024; 69:1607406. [PMID: 39011389 PMCID: PMC11246871 DOI: 10.3389/ijph.2024.1607406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 06/17/2024] [Indexed: 07/17/2024] Open
Abstract
Objectives To explore speaking up behaviours, barriers to openly expressing patient safety concerns, and perceived psychological safety climate in the clinical setting in which healthcare trainees from Ibero-America were receiving their practical training. Methods Cross-sectional survey of healthcare trainees from Colombia, Mexico, and Spain (N = 1,152). Before the field study, the Speaking Up About Patient Safety Questionnaire (SUPS-Q) was translated into Spanish and assessed for face validity. A confirmatory factor analysis was conducted to establish the construct validity of the instrument, and the reliability was assessed. The SUPS-Q was used to evaluate voice behaviours and the perceived psychological safety climate among Ibero-American trainees. Descriptive and frequency analyses, tests for contrasting means and proportions, and logistic regression analyses were performed. Results Seven hundred and seventy-one trainees had experience in clinical settings. In the previous month, 88.3% had experienced patient safety concerns, and 68.9% had prevented a colleague from making an error. More than a third had remained silent in a risky situation. Perceiving concerns, being male or nursing student, and higher scores on the encouraging environment scale were associated with speaking up. Conclusion Patient safety concerns were frequent among Ibero-American healthcare trainees and often silenced by personal and cultural barriers. Training in speaking up and fostering safe interprofessional spaces is crucial.
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Affiliation(s)
- Irene Carrillo
- Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain
| | - Piedad Serpa
- Department of Clinical Management and Patient Safety, School of Medicine, Universidad de Santander, Bucaramanga, Colombia
| | - Edgar Landa-Ramírez
- Facultad de Psicología, National Autonomous University of Mexico, Mexico City, Mexico
- Programa de Psicología Urgencias, Hospital General Dr. Manuel Gea Gonzalez, Mexico City, Mexico
| | - Mercedes Guilabert
- Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain
| | - Yesenia Gómez-Ayala
- Facultad de Psicología, National Autonomous University of Mexico, Mexico City, Mexico
| | - Adriana López-Pineda
- Clinical Medicine Department, School of Medicine, Miguel Hernández University of Elche, Elche, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - José Joaquín Mira
- Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain
- ATENEA Research Group, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
- Alicante-Sant Joan Health District, Alicante, Spain
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2
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Klinner C, Dario AB, Bell A, Nisbet G, Penman M, Monrouxe LV. Beyond mere respect: new perspectives on dignity for healthcare workplace learning. Front Med (Lausanne) 2024; 10:1274364. [PMID: 38293301 PMCID: PMC10824899 DOI: 10.3389/fmed.2023.1274364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/27/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction Although dignity in workplace learning in healthcare is gathering interest, we know little about stakeholders' conceptualizations in this area across professional groups. Dignity breaches in workplace learning are common, often with serious and long-lasting consequences for the affected. Conceptualizations shape behaviours and experiences. To prevent dignity violations in students' learning, it is thus important to understand stakeholders' understandings of the topic. This study therefore explores the dignity conceptualizations around workplace learning that students, placement educators and university staff hold across seven allied health professional groups. Methods Using a social constructionist perspective, we conducted individual and group narrative interviews (n = 51) with students, placement educators and university workplace learning staff from seven allied health professional groups. We used the 5-step Framework Analysis to explore and develop themes, identifying differences and similarities across stakeholder groups. Results We identified eight distinct, yet interrelated, dimensions of dignity from participants' narratives: dignity as respect, dignity as self-x (the various relationships we have with ourselves), dignity as feeling safe, dignity as understanding otherness, dignity as supporting others, dignity as equality, dignity as professionalism, and dignity as belonging. Dignity as respect was identified across all participants, although mutual respect and a culture of respect were only present in academic participants' talk. The remaining seven dimensions all present important factors extending our understanding of the construct of dignity. Discussion In line with existing research, our study identifies the absence of an unambiguous, positive conceptualization of dignity in workplace learning among stakeholders. It adds novelty in two ways: by identifying dignity dimensions that require informed action beyond respecting others, and by revealing a tension between dignity as professionalism and dignity as equality. We suggest revising existing dignity concepts in workplace learning to address this tension and to reinforce that active care, team integration and skilled support are all non-negotiable elements of dignified behaviour within workplace learning.
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Díaz Olavarrieta C, Villa AR, Guerrero López B, Vargas Huicochea I, García-Medina S, Aburto Arciniega M, Alonso Catalán M, Fajardo Dolci GE, Medina-Mora Icaza ME. Dating Violence among Undergraduate Medical Students at a Public University in Mexico City: An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3104. [PMID: 36833800 PMCID: PMC9963753 DOI: 10.3390/ijerph20043104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
Gender-based violence (GBV) and cyber-aggression are growing problems in Mexico, but there is a dearth of information on their associated risks. We aimed to determine the prevalence of dating violence (DV) and cyber-aggression in a public campus and compared students' acceptability of abusive DV based on their sex and sexual orientation. We employed a cross-sectional design to survey 964 first-year medical students attending a public university. We analyzed who found "acceptable" abusive behaviors from a dating partner and carried out descriptive analyses of sample characteristics by sex. We included 633 women and 331 men. Homosexual and bisexual orientation was lower among women (1.5%, 4.8%) vs. men (16.9%, 7.2%). Of women and men, respectively, 64.2% and 35.8% reported having been in a dating relationship. Experiencing abusive behaviors in the year prior to the study was associated with students' level of "acceptability". A total of 43.5% of the students who experienced cyber-aggression did not report any mental health consequences, 32.6% did not seek professional help, and 17.4% reported feeling depressed. Students that accepted emotionally abusive DV behaviors displayed a fourfold risk of experiencing physical abuse. Women and sexual minorities are more at risk of experiencing GBV and DV. More male students reported being victims of cyber-aggression.
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Affiliation(s)
- Claudia Díaz Olavarrieta
- Department of Psychiatry and Mental Health, Faculty of Medicine, National Autonomous University of Mexico, 3000 Ave. Universidad, Copilco Universidad, Coyoacán, Ciudad Universitaria, Mexico City 04510, Mexico
| | - Antonio Rafael Villa
- Research Division, Faculty of Medicine, National Autonomous University of Mexico, 3000 Ave. Universidad, Copilco Universidad, Coyoacán, Ciudad Universitaria, Mexico City 04510, Mexico
| | - Benjamin Guerrero López
- Department of Psychiatry and Mental Health, Faculty of Medicine, National Autonomous University of Mexico, 3000 Ave. Universidad, Copilco Universidad, Coyoacán, Ciudad Universitaria, Mexico City 04510, Mexico
| | - Ingrid Vargas Huicochea
- Department of Psychiatry and Mental Health, Faculty of Medicine, National Autonomous University of Mexico, 3000 Ave. Universidad, Copilco Universidad, Coyoacán, Ciudad Universitaria, Mexico City 04510, Mexico
| | - Sandra García-Medina
- National School of Biological Sciences, National Polytechnic Institute, Prolongación de Carpio y, Plan de Ayala Street, Santo Tomás, Miguel Hidalgo, Mexico City 11340, Mexico
| | - Monica Aburto Arciniega
- Research Division, Faculty of Medicine, National Autonomous University of Mexico, 3000 Ave. Universidad, Copilco Universidad, Coyoacán, Ciudad Universitaria, Mexico City 04510, Mexico
| | - María Alonso Catalán
- Department of Psychiatry and Mental Health, Faculty of Medicine, National Autonomous University of Mexico, 3000 Ave. Universidad, Copilco Universidad, Coyoacán, Ciudad Universitaria, Mexico City 04510, Mexico
| | - Germán E. Fajardo Dolci
- Faculty of Medicine, National Autonomous University of Mexico, 3000 Ave. Universidad, Copilco Universidad, Coyoacán, Ciudad Universitaria, Mexico City 04510, Mexico
| | - Ma. Elena Medina-Mora Icaza
- Faculty of Psychology, National Autonomous University of Mexico, 3000 Circuito Ciudad Universitaria, Mexico City 04510, Mexico
- National Institute of Psychiatry, Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
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Blalock AE, Leal DR. Redressing injustices: how women students enact agency in undergraduate medical education. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022:1-18. [PMID: 36394683 PMCID: PMC9672615 DOI: 10.1007/s10459-022-10183-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
This study presents descriptions of epistemic injustice in the experiences of women medical students and provides accounts about how these students worked to redress these injustices. Epistemic injustice is both the immediate discrediting of an individual's knowledge based on their social identity and the act of persistently ignoring possibilities for other ways of knowing. Using critical narrative interviews and personal reflections over an eight-month period, 22 women students during their first year of medical school described instances when their knowledge and experience was discredited and ignored, then the ways they enacted agency to redress these injustices. Participants described three distinct ways they worked to redress injustices: reclaiming why they belong in medicine, speaking up and calling out the curriculum, and uplifting one another. This study has implications for recognizing medical students as whole individuals with lived histories and experiences and advocates for recognizing medical students' perspectives as valuable sources of knowledge.
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Affiliation(s)
- A Emiko Blalock
- Office of Medical Education Research and Development, Michigan State University College of Human Medicine, 964 Wilson Road, Fee Hall A214, East Lansing, MI, 48824, USA.
| | - Dianey R Leal
- Michigan State University College of Education, East Lansing, USA
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Politis M, El Brown M, Huser CA, Crawford L, Pope L. 'I wouldn't know what to do with the breasts': the impact of patient gender on medical student confidence and comfort in clinical skills. EDUCATION FOR PRIMARY CARE 2022; 33:316-326. [PMID: 36443928 DOI: 10.1080/14739879.2022.2129460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous research has found a relationship between students' gender and attitudes surrounding peer physical examination, but relationship between patient gender and confidence/comfort is less clear. We explored whether patient gender affects medical students' levels of confidence and comfort in clinical examination skills. METHODS An electronic survey and focus groups were conducted with medical students from one UK institution. Students reported levels of confidence/comfort when carrying out clinical examinations on men/women. An inductive thematic analysis was performed. RESULTS Of a total of 1500 students provided with the opportunity to participate, ninety (6%) responded. For cardiovascular and respiratory examinations, confidence/comfort were higher when examining male-presenting patients. The opposite was true for mental state examinations. Barriers to confidence/comfort included perceiving males as a norm, difficulty navigating breasts, tutors' internalised gendered attitudes and a wider sociocultural issue. Facilitators of confidence/comfort included students relating to patients, embodying a professional role, gender blindness, and authentic clinical environments. Fewer than 20% (n = 18) of students felt they had enough opportunity to practice clinical skills on women, versus 90% (n = 82) on men. CONCLUSION Our study identified an area where students' confidence and comfort in clinical examinations could be enhanced within medical education. Changes were implemented in the institution under study's vocational skills teaching, which is rooted in general practice. Information on gender and clinical skills was provided within course handbooks, time was scheduled to discuss gender and clinical skills in small group settings, and equitable gender representation was ensured in clinical assessment.
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Affiliation(s)
- Marina Politis
- Undergraduate Medical School, University of Glasgow, Glasgow, UK
| | - Megan El Brown
- Buckingham Medical School, Buckingham Medical School, University of Buckingham, Buckingham, UK.,Medical Education Innovation and Education Centre (MEdIC), Imperial College London, London, UK
| | - Camille Am Huser
- Undergraduate Medical School, University of Glasgow, Glasgow, UK
| | - Lynsay Crawford
- Undergraduate Medical School, University of Glasgow, Glasgow, UK
| | - Lindsey Pope
- Undergraduate Medical School, University of Glasgow, Glasgow, UK
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Tomé-Fernández M, Ortiz-Marcos JM, Fernández-Leyva C. Correlational study on cyberbullying and social abilities in intercultural teenagers. Front Psychol 2022; 13:848678. [PMID: 35967670 PMCID: PMC9374137 DOI: 10.3389/fpsyg.2022.848678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022] Open
Abstract
This article analyzes the relationship between cyberbullying profile by racist reasons and social abilities in a group of intercultural teenagers living in Spain (N = 1478). The study includes participants aged between 12 and 16 years old (M = 13.99; SD = 1.352). Of these, 738 were male (49.9%) and 740 were female (50.1%). A correlational study was carried out using online tools with suitable psychometrics parameters (content-construct validity and reliability). The first one was a scale that measured social abilities, and the second one evaluated racist or xenophobic cyberbullying, differentiating the victim and aggressor profiles. The results indicated five main findings: (1) generally, the participants analyzed present all their social abilities; (2) for the most part, these participants do not normally experience cyberbullying; (3) a positive correlation exists between the majority of social abilities analyzed and the cybervictim profile. It was also observed a negative correlation between the social ability associated with the ability of making requests and this profile; (4) there is a positive correlation among the six social abilities analyzed and the cyberaggressor profile; (5) the racist or xenophobic cyberbullying are driven not only by the absence of social abilities, but in some cases, they are also driven by socio-demographic variables (i.e., age and gender). Likewise, this work shows how the absence of some social abilities in some participants involve racist or xenophobic experiences as victims and as aggressors, which may be of interest for the analysis of teenagers’ behavior in intercultural contexts, as well as according to age and gender. More transcultural research need to be carried out to know the global perspective of the link between social abilities and the different profiles of racist and xenophobic cyberbullying, framed in the context of social psychology and studies of mass communication.
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Affiliation(s)
- María Tomé-Fernández
- Department of Research Methods and Diagnosis in Education, Faculty of Education and Sports Sciences, University of Granada, Melilla, Spain
| | - José Manuel Ortiz-Marcos
- Department of Development and Educational Psychology, Faculty of Education and Sports Sciences, University of Granada, Melilla, Spain
- *Correspondence: José Manuel Ortiz-Marcos,
| | - Christian Fernández-Leyva
- Department of Research Methods and Diagnosis in Education, Faculty of Education Sciences, University of Granada, Granada, Spain
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7
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Monrouxe LV, Chandratilake M, Chen J, Chhabra S, Zheng L, Costa PS, Lee YM, Karnieli-Miller O, Nishigori H, Ogden K, Pawlikowska T, Riquelme A, Sethi A, Soemantri D, Wearn A, Wolvaardt L, Yusoff MSB, Yau SY. Medical Students' and Trainees' Country-By-Gender Profiles: Hofstede's Cultural Dimensions Across Sixteen Diverse Countries. Front Med (Lausanne) 2022; 8:746288. [PMID: 35211478 PMCID: PMC8862177 DOI: 10.3389/fmed.2021.746288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose The global mobility of medical student and trainee populations has drawn researchers' attention to consider internationalization in medical education. Recently, researchers have focused on cultural diversity, predominately drawing on Hofstede's cross-cultural analysis of cultural dimensions from general population data to explain their findings. However, to date no research has been specifically undertaken to examine cultural dimensions within a medical student or trainee population. This is problematic as within-country differences between gender and professional groups have been identified within these dimensions. We address this gap by drawing on the theoretical concept of national context effects: specifically Hofstede's six-dimensional perspective. In doing so we examine medical students' and trainees' country profiles across dimensions, country-by-gender clustering, and differences between our data and Hofstede's general population data. Methods We undertook a cross-cultural online questionnaire study (eight languages) containing Hofstede's 2013 Values Survey. Our questionnaire was live between 1st March to 19th Aug 2018, and December 2018 to mitigate country holiday periods. We recruited undergraduate medical students and trainees with at least 6-months' clinical training using school-specific methods including emails, announcements, and snowballing. Results We received 2,529 responses. Sixteen countries were retained for analyses (n = 2,307, 91%): Australia, Chile, China, Hong Kong, India, Indonesia, Ireland, Israel, Japan, Malaysia, New Zealand, Pakistan, South Africa, South Korea, Sri-Lanka, Taiwan. Power distance and masculinity are homogenous across countries. Uncertainty avoidance shows the greatest diversity. We identified four country clusters. Masculinity and uncertainty are uncorrelated with Hofstede's general population data. Conclusions Our medical student and trainee data provides medical education researchers with more appropriate cultural dimension profiles than those from general population data. Country cluster profiles stimulate useful hypotheses for further research, especially as patterning between clusters cuts across traditional Eastern-Western divides with national culture being stronger than gendered influences. The Uncertainty dimension with its complex pattern across clusters is a particularly fruitful avenue for further investigation.
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Affiliation(s)
- Lynn V Monrouxe
- Faculty of Medicine and Health, The University of Sydney, NSW, Australia.,Chang Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Linkou, Taiwan
| | | | - Julie Chen
- Department of Family Medicine and Primary Care, Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Shakuntala Chhabra
- Department of Obstetrics and Gynaecology, Mahatma Gandhi Institute of Medical Sciences, Wardha, India
| | - Lingbing Zheng
- Department of Education, Peking University Health Science Center, Beijing, China
| | - Patrício S Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Largo do Paço, Portugal.,Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, South Korea
| | - Orit Karnieli-Miller
- Department of Medical Education, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hiroshi Nishigori
- Center for Medical Education, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kathryn Ogden
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, TAS, Australia
| | - Teresa Pawlikowska
- Health Professions Education Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Arnoldo Riquelme
- Department of Gastroenterology, Centre for Medical Education and Health Sciences, Department of Health Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ahsan Sethi
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Diantha Soemantri
- Department of Medical Education, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.,Medical Education Center, Faculty of Medicine, Indonesian Medical Education and Research Institute, Jakarta, Indonesia
| | - Andy Wearn
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Liz Wolvaardt
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Sze-Yuen Yau
- Chang Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Linkou, Taiwan
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Rishard M, Fahmy FF, Senanayake H, Ranaweera AKP, Armocida B, Mariani I, Lazzerini M. Correlation among experience of person-centered maternity care, provision of care and women's satisfaction: Cross sectional study in Colombo, Sri Lanka. PLoS One 2021; 16:e0249265. [PMID: 33831036 PMCID: PMC8031099 DOI: 10.1371/journal.pone.0249265] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 03/15/2021] [Indexed: 11/19/2022] Open
Abstract
Person-centered maternity care (PCMC) is defined as care which is respectful of and responsive to women's and families' preferences, needs, and values. In this cross-sectional study we aimed to evaluate the correlations among the degree of PCMC implementation, key indicators of provision of care, and women's satisfaction with maternity care in Sri Lanka. Degree of PCMC implementation was assessed using a validated questionnaire. Provision of good key practices was measured with the World Health Organization (WHO) Bologna Score, whose items include: 1) companionship in childbirth; 2) use of partogram; 3) absence of labor stimulation; 4) childbirth in non-supine position; 5) skin-to-skin contact. Women's overall satisfaction was assessed on a 1-10 Likert scale. Among 400 women giving birth vaginally, 207 (51.8%) had at least one clinical risk factor and 52 (13.0%) at least one complication. The PCMC implementation mean score was 42.3 (95%CI 41.3-43.4), out of a maximum score of 90. Overall, while 367 (91.8%) women were monitored with a partogram, and 293 (73.3%) delivered non-supine, only 19 (4.8%) did not receive labour stimulation, only 38 (9.5%) had a companion at childbirth, and 165 (41.3%) had skin-to-skin contact immediately after birth. The median total satisfaction score was 7 (IQR 5-9). PCMC implementation had a moderate correlation with women's satisfaction (r = 0.58), while Bologna score had a very low correlation both with satisfaction (r = 0.12), and PCMC (r = 0.20). Factors significantly associated with higher PCMC score were number of pregnancies (p = 0.015), ethnicity (p<0.001), presence of a companion at childbirth (p = 0.037); absence of labor stimulation (p = 0.019); delivery in non-supine position (p = 0.016); and skin-to-skin contact (p = 0.005). Study findings indicate evidence of poor-quality care across several domains of mistreatment in childbirth in Sri Lanka. In addition, patient satisfaction as an indicator of quality care is inadequate to inform health systems reform.
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Affiliation(s)
- Mohamed Rishard
- University Obstetrics Unit, De Soysa Hospital for Women, Colombo, Sri Lanka
- Department of Obstetrics & Gynaecology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- * E-mail:
| | - Fathima Fahila Fahmy
- Department of Obstetrics & Gynaecology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Hemantha Senanayake
- University Obstetrics Unit, De Soysa Hospital for Women, Colombo, Sri Lanka
- Department of Obstetrics & Gynaecology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Benedetta Armocida
- Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”—Trieste, Italy
| | - Ilaria Mariani
- Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”—Trieste, Italy
| | - Marzia Lazzerini
- Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”—Trieste, Italy
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9
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Brown MEL, Hunt GEG, Hughes F, Finn GM. 'Too male, too pale, too stale': a qualitative exploration of student experiences of gender bias within medical education. BMJ Open 2020; 10:e039092. [PMID: 32792453 PMCID: PMC7430333 DOI: 10.1136/bmjopen-2020-039092] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To explore medical student perceptions and experiences of gender bias within medical education. SETTING Gender bias-'prejudiced actions or thoughts based on the perception that women are not equal to men'-is a widespread issue. Within medicine, the pay gap, under-representation of women in senior roles and sexual harassment are among the most concerning issues demonstrating its presence and impact. While research investigating experiences of clinicians is gaining traction, investigation of medical students' experiences is lacking. This qualitative study analyses medical students' experiences of gender bias within their education to discern any patterns to this bias. Illuminating the current state of medical education gender bias will hopefully highlight areas in which student experience could be improved. Constructivist thematic analysis was used to analyse data, informed by William's patterns of gender bias, intersectional feminism and communities of practice theory. PARTICIPANTS Thirty-two medical students from multiple UK medical schools participated in individual interviews. Nine faculty members were also interviewed to triangulate data. RESULTS Gender bias has an overt presence during medical student education, manifesting in line with William's patterns of bias, impacting career aspirations. Physical environments serve to manifest organisational values, sending implicit messages regarding who is most welcome-currently, this imagery remains 'too male, too pale…too stale'. Existing gender initiatives require careful scrutiny, as this work identifies the superficial application of positive action, and a failure to affect meaningful change. CONCLUSIONS Despite progress having been made regarding overt gender discrimination, implicit bias persists, with existing positive action inadequate in promoting the advancement of women. Institutions should mandate participation in implicit bias education programmes for all staff and must strive to revise the imagery within physical environments to better represent society. Gender initiatives, like Athena Scientific Women's Academic Network, also require large-scale evaluation regarding their impact, which this work found to be lacking.
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Affiliation(s)
- Megan E L Brown
- Health Professions Education Unit, Hull York Medical School, York, UK
| | - George E G Hunt
- Health Professions Education Unit, Hull York Medical School, York, UK
| | - Ffion Hughes
- Health Professions Education Unit, Hull York Medical School, York, UK
| | - Gabrielle M Finn
- Health Professions Education Unit, Hull York Medical School, York, UK
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10
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Munk N, Church A, Nemati D, Zabel S, Comer AR. Massage perceptions and attitudes of undergraduate pre-professional health sciences students: a cross-sectional survey in one U.S. university. BMC Complement Med Ther 2020; 20:213. [PMID: 32641024 PMCID: PMC7346672 DOI: 10.1186/s12906-020-03002-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Attitudes and beliefs about massage therapy have been explored among health professionals and health profession students, but not for undergraduate preprofessional health sciences students. METHODS This cross-sectional survey sought to determine pre-professional health students' attitudes and perceptions toward massage therapy and determine the extent demographic variables such as age, gender, race, along with lifetime massage experience are associated with neutral/negative perceptions. RESULTS N = 129 undergraduate students completed the Attitudes Toward Massage scale and 7 supplemental items pertaining to sexuality and therapist gender preference along with questions regarding lifetime massage utilization. Prevalence of massage therapy utilization was 35.6% (lifetime) and 18.6% (last 12-months). Overall, positive attitudes towards massage therapy was observed with participants reporting massage experience expressing more positive massage attitudes (lifetime; p = 0.0081, the past 12 months; p = 0.0311). Participants with no massage experience were more likely to report neutral/negative attitudes toward massage (p = 0.04). Men were more likely to prefer their massage therapist to be of the opposite sex (38.9%) compared to women (2.1%) (p = < 0.0001). Men were less confident than women in their concern of becoming sexually aroused during massage (p = 0.0001) and in the belief that massage is sexually arousing (p = 0.048). Both genders expressed comfort with female and/or male massage therapists, but if given a choice, both prefer a female massage therapist. CONCLUSIONS Undergraduate pre-professional health sciences students have generally positive attitudes towards massage therapy however more research is needed regarding implicit gender bias and/or preferences. This work should inform future research designs examining the impact of attitudes and beliefs on patient referrals to massage therapy.
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Affiliation(s)
- Niki Munk
- Department of Health Sciences, School of Health and Human Sciences, Indiana University - IUPUI, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA. .,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Massage & Myotherapy Australia Fellow and Visiting Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - Abby Church
- Department of Health Sciences, School of Health and Human Sciences, Indiana University - IUPUI, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA
| | - Donya Nemati
- Department of Health Sciences, School of Health and Human Sciences, Indiana University - IUPUI, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA
| | - Samantha Zabel
- Department of Health Sciences, School of Health and Human Sciences, Indiana University - IUPUI, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA
| | - Amber R Comer
- Department of Health Sciences, School of Health and Human Sciences, Indiana University - IUPUI, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA.,Indiana University Robert H. McKinney School of Law, 530 W. New York St, Indianapolis, IN, 46202, USA.,Regenstrief Institute, Inc., 1101 W. 10th St, Indianapolis, IN, 46202, USA
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