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Oh A, Chou B. Patient perceptions regarding the use of eyeglasses among ophthalmologists. Asia Pac J Ophthalmol (Phila) 2024:100099. [PMID: 39307284 DOI: 10.1016/j.apjo.2024.100099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 07/31/2024] [Accepted: 09/17/2024] [Indexed: 09/26/2024] Open
Affiliation(s)
- Andrew Oh
- School of Medicine, University of Washington, Seattle, WA, United States
| | - Brian Chou
- School of Medicine, University of Washington, Seattle, WA, United States; Department of Ophthalmology, University of Washington, Seattle, WA, United States.
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Lian G, Xiao Y, Huang Y, Wang H, Huang L, Yang H, Zhu C, Mei W, Huang R. Attitudes toward communication skills with learner needs assessment within radiology residency programs in China: a cross-sectional survey. BMC Res Notes 2024; 17:114. [PMID: 38654288 PMCID: PMC11036608 DOI: 10.1186/s13104-024-06779-8] [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: 01/30/2024] [Accepted: 04/17/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Communication skills (CS) represent a core competency in radiology residency training. However, no structured curriculum exists to train radiology residents in CS in China. The aim of this study was to evaluate the status and prevalence of doctor-patient communication training among radiology residents in nine Chinese accredited radiology residency training programs and to determine whether there is a perceived need for a formalized curriculum in this field. METHODS We administered a cross-sectional online survey to radiology residents involved in CS training at nine standard residency training programs in China. The questionnaire developed for this study included CS training status, residents' demographics, attitudes toward CS training, communication needs, and barriers. Residents' attitudes toward CS training were measured with the Communication Skills Attitude Scale (CSAS) and its subscales, a positive attitude scale (PAS) and negative attitude scale (NAS). RESULTS A total of 133 (48.36%) residents participated in the survey. The mean total scores on the two dimensions of the CSAS were 47.61 ± 9.35 in the PAS and 36.34 ± 7.75 in the NAS. Factors found to be significantly associated with the PAS included receiving previous training in CS, medical ethics, or humanities and the doctor's attire. We found that first-year residents and poor personal CS were the most influential factors on the NAS. Only 58.65% of participants reported having previously received CS training during medical school, and 72.93% of respondents reported failure in at least one difficult communication during their residency rotation. Most of those surveyed agreed that CS can be learned through courses and were interested in CS training. Some of the most common barriers to implementing formal CS training were a lack of time, no standardized curriculum, and a lack of materials and faculty expertise. CONCLUSIONS Most residents had a very positive attitude toward CS training and would value further training, despite the limited formal CS training for radiology residents in China. Future efforts should be made to establish and promote a standard and targeted CS curriculum for Chinese radiology residents.
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Affiliation(s)
- GengPeng Lian
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Yubin Xiao
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Yingling Huang
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Huanpeng Wang
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Lipeng Huang
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Hongwu Yang
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Chunmin Zhu
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Wei Mei
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China.
| | - Ruibin Huang
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China.
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Nguyen DL, Yoon SC, Baker JA, Destounis SV, Grimm LJ. Patient Preferences of Breast Radiologists' Attire and Appearance. Acad Radiol 2024; 31:1239-1247. [PMID: 37914625 DOI: 10.1016/j.acra.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/03/2023] [Accepted: 10/04/2023] [Indexed: 11/03/2023]
Abstract
RATIONALE AND OBJECTIVES To assess patient preferences for breast radiologists' attire and appearance. MATERIALS AND METHODS A multi-institutional anonymous, voluntary 19-question survey was administered to patients undergoing screening and diagnostic mammography examinations over a 5-week period. Using a 5-point Likert scale, respondents were asked about their preferences for gender-neutral attire (white coat), male-presenting attire (scrubs, dress shirt with tie, or dress shirt without tie), and female-presenting attire (scrubs, dress, blouse with pants, and blouse with skirt). Patient responses were compared to demographic data using bivariable analysis and multivariable regression. RESULTS Response rate was 84.7% (957/1130). Mean respondent age was 57.2 years±11.9. Most respondents agreed/strongly agreed that the breast radiologist's appearance mattered (52.5%, 502/956) followed by being indifferent (28.1%, 269/956). Respondents with greater education levels felt less strongly (p=0.001) about the radiologist's appearance: 63.3% (70/110) less than college cared about appearance compared to 53.5% (266/497) college/vocational and 47.4% (165/348) graduate. Most respondents felt indifferent about a breast radiologist wearing a white coat (68.9%, 657/954) or about male-presenting breast radiologists wearing a tie (77.1%, 734/952) without significant demographic differences. Almost all respondents either prefer/strongly prefer (60.1%, 572/951) or were indifferent (39.6%, 377/951) to all breast radiologists wearing scrubs when performing procedures. While respondents approved of all attire choices overall, most respondents preferred scrubs for both male- and female-presenting breast radiologists (64.0%, 612/957 and 64.9%, 621/957, respectively). CONCLUSION A variety of breast radiologists' attire can be worn while maintaining provider professionalism and without compromising patient expectations.
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Affiliation(s)
- Derek L Nguyen
- Department of Radiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, North Carolina, 27710, USA.
| | - Sora C Yoon
- Department of Radiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, North Carolina, 27710, USA
| | - Jay A Baker
- Department of Radiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, North Carolina, 27710, USA
| | - Stamatia V Destounis
- Elizabeth Wende Breast Care, University of Rochester Medical Center, Rochester, New York, 14620, USA
| | - Lars J Grimm
- Department of Radiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, North Carolina, 27710, USA
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Xu X, Lu Z, Liu Z, Han Y, Zhang Y, Shen L. Patient Preferences for Anesthesiologist Attire During Preoperative Visits in China: A Cross-Sectional Survey. Patient Prefer Adherence 2023; 17:2421-2431. [PMID: 37808275 PMCID: PMC10557984 DOI: 10.2147/ppa.s430942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/23/2023] [Indexed: 10/10/2023] Open
Abstract
Background It is important for anesthesiologists to leave good impressions and build rapport with patients during preoperative visits. However, patient preferences for anesthesiologist attire have not been well studied in China. Purpose To characterize patient perceptions of anesthesiologist attire during preoperative visits. Patients and Methods In this cross-sectional survey, we included adult patients who underwent elective operations in various surgical departments. We presented photographs of both male and female models wearing six combinations of attire (formal in a white coat buttoned, formal in a white coat unbuttoned, casual in a white coat buttoned, casual in a white coat unbuttoned, scrubs in a white coat buttoned, and scrubs in a coat of the same green color buttoned) in a randomized sequence. Participants were asked to rate each attire combination in five domains, including professionalism, experience, attitude, approachability, and caring. Results Of the 541 surveys distributed, 516 (95.4%) were completed and included in the analysis. The majority of respondents were female [389 (75.4%)] and aged 31-45 years [234 (45.3%)]. The combination of scrubs in a buttoned coat of the same color had the highest composite rating score [median (interquartile range): 50 (45, 50), adjusted P<0.001 compared with the other five combinations]. There was no significant difference in preference for standardized disposable or personalized cloth operating caps. Respondents' age was independently associated with the perceived importance of anesthesiologist attire (46-60 years vs 18-35 years: odds ratio 2.17, 95% confidence interval 1.12-4.18, P=0.021). Conclusion Patients prefer anesthesiologists wearing scrubs in coats of the same color. Standardizing anesthesiologist attire based on these findings may improve patient satisfaction.
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Affiliation(s)
- Xiaohan Xu
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Zhilong Lu
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Zijia Liu
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Yue Han
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Yuelun Zhang
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Le Shen
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of China
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Kramer LL, van Velsen L, Mulder BC, Ter Stal S, de Vet E. Optimizing appreciation and persuasion of embodied conversational agents for health behavior change: A design experiment and focus group study. Health Informatics J 2023; 29:14604582231183390. [PMID: 37625392 DOI: 10.1177/14604582231183390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
Embodied Conversational Agents (ECAs) can increase user engagement and involvement and can strengthen the effect of an intervention on health outcomes that is provided via an ECA. However, evidence regarding the effectiveness of ECAs on health outcomes is still limited. In this article, we report on a study that has the goal to identify the effect of a match between a health topic and the ECAs' appearance on ratings of personality characteristics, persuasiveness and intention to use. We report on an online experiment with three different ECAs and three different health topics, conducted among 732 older adults. We triangulated the quantitative results with qualitative insights from a focus group. The results reveal that older adults prefer an ECA that has an appearance matching a certain health topic, resulting in higher ratings on persuasiveness and intention to use. Personality characteristics should be measured embedded within a health topic, but are not rated higher because of a match. We furthermore provide guidelines for designing the content of the ECA.
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Affiliation(s)
- Lean L Kramer
- Wageningen University & Research, Wageningen, Netherlands
| | - Lex van Velsen
- Roessingh Research and Development, Enschede, Netherlands
| | - Bob C Mulder
- Wageningen University & Research, Wageningen, Netherlands
| | - Silke Ter Stal
- Roessingh Research and Development, Enschede, Netherlands
| | - Emely de Vet
- Wageningen University & Research, Wageningen, Netherlands
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Muacevic A, Adler JR, Alahmari BM, Alzahrani MA, Alshehri HG, Farahat JS, Merdad GA, Aalam A. Patients' Impression of Health Care Providers' Attire in the Emergency Department. Cureus 2022; 14:e32844. [PMID: 36694510 PMCID: PMC9867566 DOI: 10.7759/cureus.32844] [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] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background The level of patient satisfaction and, ultimately, the assessment of the quality of care are greatly influenced by physicians' capacity to leave a positive impression on patients during provider-patient interactions. The way doctors dress affects how people view their care. There have been few studies on the impact of doctors' attire on patient confidence and trust. The objective of this study is to assess patients' preferences concerning specific cultural attire and its influence on patients' trust, compliance, and perceptions of the quality of care in the emergency department. Methods A cross-sectional study was performed using the survey methodology for patients in emergency departments. Participants completed a written survey after reviewing doctors' portraits in different dress styles. Respondents were asked questions about the importance of the health service providers' attire in the emergency department on the patient's perception. The Statistical Package for Social Sciences version 21 (SPSS; IBM Inc., Armonk, New York) was used to perform the analysis after the data were entered into Microsoft Excel 2016 (Microsoft, Redmond, Washington). The categorical analysis was performed using the Chi-squared test to explore for relationships between the results and various variables. Result A self-administered questionnaire was completed by 395 patients; two responses were excluded for lack of completeness of the answers in it: 33.8%) were males (66.2%) were females (56.7%) were married (73.8%) completed university education (44.8%) were employed and (74.5%) with excellent health conditions. The questionnaire was devoted to the local setting, with pictures of the health care provider (male and female), in different types of doctor's attire included. Respondents overwhelmingly prefer male emergency physicians to dress in medical scrub (50%, p=.0001) and prefer female emergency physicians to dress in a medical scrub with a white coat (68.7%, p=.0001). Conclusion First impressions based on a physician's appearance serve as the foundation for assumptions about trust, confidence, and competency, particularly in circumstances when patients or family members do not already have a relationship with the provider.
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Clothes Make the Man-What Impact Does the Dress of Interprofessional Teams Have on Patients? Healthcare (Basel) 2022; 10:healthcare10102109. [PMID: 36292556 PMCID: PMC9601812 DOI: 10.3390/healthcare10102109] [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: 09/04/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/04/2022] Open
Abstract
Physicians’ attire seems to play an important role in the success of patient treatment. The classic doctor’s white coat initiates a strong signal to the patient and can have a determining effect on a successful doctor–patient relationship. In a quantitative online questionnaire study comprising 52 questions, participants were shown four photos of an interprofessional German family medicine team in varying attire. One important study feature relating to the ongoing coronavirus pandemic was that the team was portrayed wearing FFP2 masks in one photo. We measured core values regarding the team’s perception in terms of sympathy, competence, trust, choosing the practice as a personal health care provider, and wanting to participate in the team. The questionnaire was posted online between March and May 2021. It was accessed 1435 times and 906 sheets were qualified for statistical analysis. For the first time in this field of research, a practice team’s attire was investigated. We found a significant influence of different clothing on the perception of sympathy, competence, trust, elective practice, and team participation. Wearing an FFP2 mask promotes feelings of security and competence. The study shows that in times of fast social changes due to rapid digitalization and an ongoing pandemic, we should present ourselves in different ways as a medical team depending on the patient groups we are targeting and the feelings we want to evoke.
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Houchens N, Saint S, Petrilli C, Kuhn L, Ratz D, De Lott L, Zollinger M, Sax H, Kamata K, Kuriyama A, Tokuda Y, Fumagalli C, Virgili G, Fumagalli S, Chopra V. International patient preferences for physician attire: results from cross-sectional studies in four countries across three continents. BMJ Open 2022; 12:e061092. [PMID: 36192090 PMCID: PMC9535197 DOI: 10.1136/bmjopen-2022-061092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The patient-physician relationship impacts patients' experiences and health outcomes. Physician attire is a form of nonverbal communication that influences this relationship. Prior studies examining attire preferences suffered from heterogeneous measurement and limited context. We thus performed a multicentre, cross-sectional study using a standardised survey instrument to compare patient preferences for physician dress in international settings. SETTING 20 hospitals and healthcare practices in Italy, Japan, Switzerland and the USA. PARTICIPANTS Convenience sample of 9171 adult patients receiving care in academic hospitals, general medicine clinics, specialty clinics and ophthalmology practices. PRIMARY AND SECONDARY OUTCOME MEASURES The survey was randomised and included photographs of a male or female physician dressed in assorted forms of attire. The primary outcome measure was attire preference, comprised of composite ratings across five domains: how knowledgeable, trustworthy, caring and approachable the physician appeared, and how comfortable the respondent felt. Secondary outcome measures included variation in preferences by country, physician type and respondent characteristics. RESULTS The highest rated forms of attire differed by country, although each most preferred attire with white coat. Low ratings were conferred on attire extremes (casual and business suit). Preferences were more uniform for certain physician types. For example, among all respondents, scrubs garnered the highest rating for emergency department physicians (44.2%) and surgeons (42.4%). However, attire preferences diverged for primary care and hospital physicians. All types of formal attire were more strongly preferred in the USA than elsewhere. Respondent age influenced preferences in Japan and the USA only. CONCLUSIONS Patients across a myriad of geographies, settings and demographics harbour specific preferences for physician attire. Some preferences are nearly universal, whereas others vary substantially. As a one-size-fits-all dress policy is unlikely to reflect patient desires and expectations, a tailored approach should be sought that attempts to match attire to clinical context.
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Affiliation(s)
- Nathan Houchens
- Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Sanjay Saint
- Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Latoya Kuhn
- Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - David Ratz
- Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | | | - Marc Zollinger
- Psychiatric University Hospital Zurich Department of Social and General Psychiatry Zurich West, Zurich, Switzerland
| | - Hugo Sax
- Department of Infectious Diseases, Inselspital University Hospital Bern, Bern, Switzerland
| | - Kazuhiro Kamata
- Department of Pediatrics, Niigata University Faculty of Medicine Graduate School of Medical and Dental Science, Niigata, Japan
- Department of General Internal Medicine, Fukushima Medical University Aizu Medical Center, Fukushima, Japan
| | - Akira Kuriyama
- Emergency and Critical Care Center, Kurashiki Central Hospital, Okayama, Japan
| | - Yasuharu Tokuda
- Department of Medicine, Muribushi Project for Okinawa Residency Programs, Okinawa, Japan
| | - Carlo Fumagalli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Gianni Virgili
- Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Stefano Fumagalli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Vineet Chopra
- Department of Medicine, University of Colorado, Denver, Colorado, USA
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Martens C, Delcourt C, Petermans A. Maternity Healthscapes: Conceptualization and Index Development. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 15:183-203. [PMID: 35996350 DOI: 10.1177/19375867221117248] [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: 11/16/2022]
Abstract
OBJECTIVES This article provides a conceptualization and an index of the multidimensional concept of maternity healthscapes (MHS). BACKGROUND Healthscape has emerged as a potential key aspect to improve patient experience. Surprisingly, there has been little effort to delineate the concept of MHS from a design perspective, while maternity wards have unique characteristics and particular challenges. Indeed, patients in maternity wards are usually not acutely ill but can feel highly vulnerable due to the pain, stress, and the many uncertainties surrounding labor and delivery-which can heighten patients' need for intimacy, supporter comfort, and additional supporting services. Thus, healthscapes need to be designed to account for the specificities of childbearing and needs of those patients and their family. METHODS A multidisciplinary literature review and 39 in-depth interviews were conducted with various stakeholders-mothers, midwives, heads of midwives, and chief executives. RESULTS The authors develop a conceptualization to establish a comprehensive understanding of the dimensionality of MHSs. Based on that comprehensive conceptualization, the authors develop an index providing a census of the aspects in the MHS that various stakeholders-such as healthcare providers, designers, and architects-should take into account when conceiving MHS. CONCLUSIONS Healthcare providers, designers, and architects can use this conceptualization and index to closely monitor and measure for evaluations and further improvements of the MHS, thereby enhancing patient experience in maternity wards.
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Affiliation(s)
- Carmen Martens
- Faculty of Architecture and Arts, Hasselt University, Belgium.,Department of Marketing, HEC Liège, Management School of the University of Liège, Belgium
| | - Cécile Delcourt
- Department of Marketing, HEC Liège, Management School of the University of Liège, Belgium
| | - Ann Petermans
- Faculty of Architecture and Arts, Hasselt University, Belgium
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Park KY, Shin J, Park HK, Kim YM, Hwang SY, Shin JH, Heo R, Ryu S, Mercer SW. Validity and reliability of a Korean version of the Consultation and Relational Empathy (CARE) measure. BMC MEDICAL EDUCATION 2022; 22:403. [PMID: 35614452 PMCID: PMC9134586 DOI: 10.1186/s12909-022-03478-5] [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: 11/25/2021] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND No validated tool is available to assess patients' perception of physician empathy in Korea. The objective of this study was to establish a Korean version of the Consultation and Relational Empathy (CARE) measure-originally developed in English and widely used internationally-and to examine its reliability and validity. METHODS The CARE measure was translated into Korean and tested on 240 patients from one secondary care hospital and one tertiary care hospital in Korea. Internal consistency by Cronbach's alpha, exploratory analysis, and confirmatory factor analysis were conducted to verify the 10 items of the Korean CARE measure. RESULTS The Korean CARE measure demonstrated high acceptability and face validity, excellent internal reliability (Cronbach's alpha = 0.97) and moderate test-retest reliability (Pearson correlation coefficient = 0.53; Spearman correlation coefficient = 0.51). Distribution of scores showed negative skewedness. Corrected item-total correlations ranged from 0.77-0.92, indicating homogeneity. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.949, and Bartlett's test of sphericity was good (χ2 = 3157.11, P < 0.001). Factor analysis yielded a single dimensional structure of physician empathy with all factor loadings exceeding 0.80 and showing excellent goodness of fit. CONCLUSION This study supports the reliability and validity of the Korean CARE measure in a university hospital setting in Korea.
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Affiliation(s)
- Kye-Yeung Park
- Department of Family Medicine, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, South Korea
| | - Jinho Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Hoon-Ki Park
- Department of Family Medicine, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, South Korea.
| | - Yu Mi Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | | | - Jeong-Hun Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea
| | - Ran Heo
- Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Soorack Ryu
- Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul, South Korea
| | - Stewart W Mercer
- Centre for Population Health Sciences, Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, Scotland
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11
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Dayani F, Thawanyarat K, Mirmanesh M, Spargo T, Saia W, Nazerali R. Dress to Impress: Public Perception of Plastic Surgeon Attire. Aesthet Surg J 2022; 42:697-706. [PMID: 34849557 DOI: 10.1093/asj/sjab408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Physician attire has been shown to impact patients' perceptions of their provider with regards to professionalism, competency, and trustworthiness in various surgical subspecialties, except in plastic and reconstructive surgery. OBJECTIVES The authors sought to address this knowledge gap and obtain objective information regarding patients' preferences. METHODS A survey was distributed to adult, English-speaking participants in the United States using the Amazon MTurk platform from February 2020 to December 2020. Participants were asked to evaluate with a 5-point Likert scale 6 attires (scrubs, scrubs with white coat, formal attire, formal attire with white coat, casual, casual with white coat) in terms of professionalism, competency, and trustworthiness for male and female plastic surgeons during their first encounter in clinic. RESULTS A total of 316 responses were obtained from 43.4% men and 56.6% women. The mean age of participants was 53.2 years. The highest scores across all metrics of professionalism, competency, trustworthiness, willingness to share information, confidence in the provider, and confidence in surgical outcomes were given to the formal attire with white coat group, with average scores of 4.85, 4.71, 4.69, 4.73, 4.79, and 4.72, respectively. The lowest scores across all metrics belonged to the casual attire group with scores of 3.36, 3.29, 3.31, 3.39, 3.29, and 3.20, respectively. Patients preferred formal attire for young plastic surgeons (P = 0.039). CONCLUSIONS This study suggests that physician attire impacts patients' perception of plastic surgeons regarding their professionalism, competency, and trustworthiness. White coats continue to remain a powerful entity in clinical settings given that attires with white coats were consistently ranked higher.
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Affiliation(s)
- Fara Dayani
- UCSF School of Medicine, San Francisco, CA, USA
| | | | - Michael Mirmanesh
- Division of Plastic and Reconstructive Surgery, UC Davis School of Medicine, Davis, CA, USA
| | - Tavish Spargo
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Whitney Saia
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Rahim Nazerali
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Ejigu EF, Haile AW, Bayable SD. Assessment of the Influence of Physicians' Attire on Surgical Patients' Perception. Across-Sectional Study in Aabet Hospital, AddisAbeba, Ethiopia, 2021. Patient Prefer Adherence 2022; 16:605-614. [PMID: 35283628 PMCID: PMC8904439 DOI: 10.2147/ppa.s353609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/23/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In Ethiopia, physicians commonly wear formal attire, surgical scrubs, casual attire, or business attire during patient care, but there is no evidence to show which attire is preferred within the patients. So this study aims to assess the influence of physicians' attire on patients' perceptions. METHODOLOGY After ethical approval, a cross-sectional study was conducted with written informed consent; data were collected and checked for its completeness, later entered into SPSS version 25 for statistical analysis. Descriptive statistics was presented with frequency, percentage, tables, graphs, and texts based on the nature of the data. All the four attires were compared using the Friedman test and pair wise comparisons were conducted with Bonferroni correction for multiple comparisons, and Mann-Whitney U-test was used to know the preferred attire on patients' perception about physicians' skill, with 95% confidence and a p-value of less than 0.05 were considered as statistically significant. RESULTS In this study, out of the total respondents 66.7% are males and 71.9%, 50.3% of the respondents were degree or diploma holders, and aged 18-34 years respectively. Among participants' 77.1% and 55.9% preferred formal attire and surgical scrub respectively. For male surgeons, formal attire and surgical scrub have an equal preference in surgical patients (p<0.001), but business and casual attire have no statistically significant difference. The patients' preference in male formal physician attire in surgeon's confidence, willingness to discuss confidential information and safeties of the surgeon were 76.2%, 75.7%, and 70.5% respectively, and for female surgeons, formal attire on surgical patients' confidence in the surgeon, safety, and willingness to discuss confidential information were 74.9%, 73.8%, and 71.8% respectively. CONCLUSION Physician attire is one of the important factors that inspire surgical patient confidence, smartness, surgical skill, discussion of confidential information, and caring ability in physicians. Formal attire and surgical scrub were the most preferred physician's outfits.
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Affiliation(s)
- Endalamaw Fentie Ejigu
- Department of Orthopedics and Traumatology, St. Paul Millennium Medical College, Addis Ababa, Ethiopia
| | - Abiy Worku Haile
- Department of Orthopedics and Traumatology, St. Paul Millennium Medical College, Addis Ababa, Ethiopia
| | - Samuel Debas Bayable
- Department of Anesthesia School of Medicine and Health Science Debre Markos University, Debre Markos, Ethiopia
- Correspondence: Samuel Debas Bayable, Email
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Marques Caetano Carreira L, Dinis S, Correia A, Pereira A, Belo R, Madanelo I, Brito D, Gomes R, Monteiro L, Correia G, Maia C, Marques T, Sousa R, Abreu D, Matias C, Constantino L, Rosendo I. Does the white coat influence satisfaction, trust and empathy in the doctor-patient relationship in the General and Family Medicine consultation? Interventional study. BMJ Open 2021; 11:e031887. [PMID: 34937710 PMCID: PMC8705075 DOI: 10.1136/bmjopen-2019-031887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To understand the influence of the white coat on patient satisfaction, opinions about medical clothing, perception about confidence, empathy and medical knowledge and the satisfaction and comfort level of physicians in consultation. SETTING An interventional study was conducted with a representative sample of the population attending primary care in central Portugal. PARTICIPANTS The sample was composed by 286 patients divided into two groups exposed or not to a doctor wearing a white coat. The first and last patients in consultation every day for 10 consecutive days were included. INTERVENTIONS Every other day the volunteer physicians consulted with or without the use of a white coat. At the end of the consultation, a questionnaire was distributed to the patient with simple questions with a Likert scale response, the Portuguese version of the 'Trust in physician' scale and the Jefferson Scale of Patient Perceptions of Physician Empathy - Portuguese Version (JSPPPE-VP scale). A questionnaire was also distributed to the physician. OUTCOMES Planned and measured primary outcomes were patient satisfaction, trust and perception about empathy and secondary outcomes were opinion about medical clothing, satisfaction and comfort level of physicians in consultation. RESULTS The sample was homogeneous in terms of sociodemographic variables. There were no statistically significant differences between the groups in terms of satisfaction, trust, empathy and knowledge perceived by the patients. There were differences in the opinion of the patients about the white coat, and when the physician was wearing the white coat this group of patients tended to think that this was the only acceptable attire for the physician (p<0.001). But when the family physician was in consultation without the white coat, this group of patients tended to agree that communication was easier (p=0.001). CONCLUSIONS There was no significant impact of the white coat in patient satisfaction, empathy and confidence in the family physician. TRIAL REGISTRATION NUMBER ClinicalTrials.gov ID number: NCT03965416.
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Affiliation(s)
| | - Sara Dinis
- UCSP Porto de Mós (Polo Mira de Aire), Mira de Aire, Portugal
| | - António Correia
- UCSP Porto de Mós (Polo Mira de Aire), Mira de Aire, Portugal
| | | | | | - Inês Madanelo
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- UCSP Vouzela, Vouzela, Portugal
| | | | | | - Luís Monteiro
- USF Esgueira Mais, Aveiro, Portugal
- CINTESIS - Centre for Health Technology and Services Research, Faculty of Medicine University of Porto, Porto, Portugal
| | - Gil Correia
- USF Marquês de Marialva, Cantanhede, Portugal
| | | | | | | | - Diogo Abreu
- UCSP Oliveira do Hospital, Oliveira do Hospital, Portugal
| | - Catarina Matias
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- USF Coimbra Centro, Coimbra, Portugal
| | | | - Inês Rosendo
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- CINTESIS - Centre for Health Technology and Services Research, Faculty of Medicine University of Porto, Porto, Portugal
- USF Coimbra Centro, Coimbra, Portugal
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Shimizu A, Takeuchi M, Kurosaki F, Tamba K, Sata N, Shimizu M, Lefor AK. Physician Attire Influences Patient and Family Perceptions of Care in the Palliative Care Unit in Japan. Am J Hosp Palliat Care 2021; 39:907-912. [PMID: 34706586 DOI: 10.1177/10499091211051670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Physician attire influences perceptions of care. This study was conducted to evaluate the impact of physician attire on perceptions of care by patients and families in a Japanese palliative care unit. METHODS From November 2018 to February 2020, patients and family members admitted to the Palliative Care Unit at Jichi Medical University Hospital were recruited and completed a survey consisting of 4 demographic questions and 15 questions regarding perceptions of care. A 7-point Likert scale (1 = strongly agree, 4 = neutral, 7 = strongly disagree) was used to judge attire (name tag, long sleeve white coat, short sleeve white coat, scrubs, scrub color, jeans, sneakers) addressing patient and overall impact on perception of care. RESULTS Of 203 patients admitted, 79 were enrolled. Surveys were received from 23 patients and 52 family members. Patients and families want physicians to wear name tags (median, interquartile range) (2, 1-2) and white coats (3, 2-4). Patients want to be addressed by surnames (2, 1.5-4). Patients and family members have neutral opinions about short sleeve white coats (4, 4-4) and scrubs (4, 4-4). Jeans were not liked (4, 4-6) while sneakers are acceptable (3, 2-4). The impact of attire on perceptions of care is significantly (p = .04) greater for patients (3, 2-4) than family members (4, 3-4). CONCLUSION Patients and family members prefer their physicians to wear name tags and white coats and address patients by surnames. Physician attire has a significantly greater impact on perceptions of care for patients than family members in a palliative care unit.
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Affiliation(s)
- Atsushi Shimizu
- Department of Surgery, Jichi Medical University, Tochigi, Japan.,Division of Palliative Care, Jichi Medical University, Tochigi, Japan
| | - Mitsue Takeuchi
- Division of Palliative Care, Jichi Medical University, Tochigi, Japan
| | - Fumio Kurosaki
- Division of Palliative Care, Jichi Medical University, Tochigi, Japan
| | - Kaichiro Tamba
- Division of Palliative Care, Jichi Medical University, Tochigi, Japan
| | - Naohiro Sata
- Department of Surgery, Jichi Medical University, Tochigi, Japan
| | - Motoko Shimizu
- Department of General Education, Jichi Medical University, Tochigi, Japan
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Yoshikawa Y, Matsuhisa T, Takahashi N, Sato J, Ban N. A survey of Japanese physician preference for attire: what to wear and why. NAGOYA JOURNAL OF MEDICAL SCIENCE 2021; 82:735-745. [PMID: 33311804 PMCID: PMC7719463 DOI: 10.18999/nagjms.82.4.735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Many studies have examined the impression made on patients by physicians' attire. Regardless of practice location, many patients express most confidence in physicians who wear white coats. The number of physicians in Japan who choose not to wear white coats in practice has been increasing, particularly in primary care settings. However, very few studies have examined physician preference for attire. To clarify Japanese general practitioners' preference for attire by practice setting, we conducted a survey of physician preferences and reasons for attire selection. Subjects were 794 general practitioners certified by the Japan Primary Care Association and recruited from a mailing list. We conducted a web-based questionnaire survey. Physicians were asked to choose one of four different dress styles (semi-formal, white coat, scrubs, and casual) for different practice settings and state the reasons for selection. The response rate was 19.3% (n = 153; men 112). Most subjects chose white coats as usual attire for hospital practice (52%), mainly because of custom and professionalism. In contrast, most subjects chose non-white coats for clinics (59%) and home care (hospital-provided, 58%; clinic-provided, 71%). More subjects chose casual dress for clinic and home care practice, mainly to appear empathic. Most subjects chose white coats as the most appropriate hospital attire (54%), mainly because of patient perceptions of this attire being professional. Most subjects considered non-white coat attire more appropriate for clinic and home care practice. The findings indicate that general practitioners choose their clothes depending on practice location.
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Affiliation(s)
- Yuki Yoshikawa
- Department of General Medicine/Family & Community Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takaharu Matsuhisa
- Department of General Medicine/Family & Community Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Noriyuki Takahashi
- Department of Education for Community-Oriented Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Juichi Sato
- Department of General Medicine/Family & Community Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobutaro Ban
- Medical Education Center, Aichi Medical University School of Medicine, Nagakute, Japan
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Xun H, Chen J, Sun AH, Jenny HE, Liang F, Steinberg JP. Public Perceptions of Physician Attire and Professionalism in the US. JAMA Netw Open 2021; 4:e2117779. [PMID: 34328503 PMCID: PMC8325071 DOI: 10.1001/jamanetworkopen.2021.17779] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE In recent years, casual physician attire (fleece jackets and softshell jackets) has become increasingly popular, but to our knowledge, public perceptions of these garments have not been studied. Furthermore, gender biases may result in differing expectations and perceptions of female and male physicians and may be associated with patient rapport and trust building. OBJECTIVE To characterize public perceptions of casual physician attire and implicit gender biases in public assessment of physicians' professional attire. DESIGN, SETTING, AND PARTICIPANTS This survey study used a population-based survey administered via Amazon Mechanical Turk from May to June 2020 among individuals aged 18 years or older who were US residents and for whom English was the primary language. INTERVENTION Survey featuring photographs of a male or female model wearing various types of physician attire (white coat, business attire, and scrubs). MAIN OUTCOMES AND MEASURES Respondents' ratings of professionalism, experience, and friendliness of the male and female models in various attire and perceptions of the models' most likely health care profession. Preference scores for various outfits were calculated as the difference between the preference score for an outfit and the mean preference score for the outfit-role pairing. RESULTS Of 522 surveys completed, 487 were included for analysis; the mean (SD) age of respondents was 36.2 (12.4) years, 260 (53.4%) were female, and 372 (76.4%) were White individuals. Respondents perceived models of health care professionals wearing white coats vs those wearing fleece or softshell jackets as significantly more experienced (mean [SD] experience score: white coat, 4.9 [1.5]; fleece, 3.1 [1.5]; softshell, 3.1 [1.5]; P < .001) and professional (mean [SD] professionalism score: white coat, 4.9 [1.6]; fleece, 3.2 [1.5]; softshell, 3.3 [1.5]; P < .001). A white coat with scrubs attire was most preferred for surgeons (mean [SD] preference index: 1.3 [2.3]), whereas a white coat with business attire was preferred for family physicians and dermatologists (mean [SD] preference indexes, 1.6 [2.3] and 1.2 [2.3], respectively; P < .001). Regardless of outerwear, female models in business attire as inner wear were rated as less professional than male counterparts (mean [SD] professionalism score: male, 65.8 [25.4]; female, 56.2 [20.2]; P < .001). Both the male and the female model were identified by the greater number of respondents as a physician or surgeon; however, the female model vs the male model was mistaken by more respondents as a medical technician (39 [8.0] vs 16 [3.3%]; P < .005), physician assistant (56 [11.5%] vs 11 [2.3%]; P < .001), or nurse (161 [33.1%] vs 133 [27.3%]; P = .050). CONCLUSIONS AND RELEVANCE In this survey study, survey respondents rated physicians wearing casual attire as less professional and experienced than those wearing a white coat. Gender biases were found in impressions of professionalism, with female physicians' roles being more frequently misidentified. Understanding disparate public perceptions of physician apparel may inform interventions to address professional role confusion and cumulative career disadvantages for women in medicine.
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Affiliation(s)
- Helen Xun
- Department of Plastic & Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jonlin Chen
- Department of Plastic & Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alexander H. Sun
- Department of Plastic & Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Hillary E. Jenny
- Department of Plastic & Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Fan Liang
- Division of Plastic Surgery, R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore
| | - Jordan P. Steinberg
- Department of Plastic & Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Matsuhisa T, Takahashi N, Takahashi K, Yoshikawa Y, Aomatsu M, Sato J, Mercer SW, Ban N. Effect of physician attire on patient perceptions of empathy in Japan: a quasi-randomized controlled trial in primary care. BMC FAMILY PRACTICE 2021; 22:59. [PMID: 33789572 PMCID: PMC8011374 DOI: 10.1186/s12875-021-01416-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 03/16/2021] [Indexed: 12/30/2022]
Abstract
Background There is limited quantitative research on the effect of physician attire on patient–physician relationships. This study aimed to measure the influence of Japanese family physicians’ attire on the “human” aspects of medical care in terms of patient-perceived relational empathy. Methods This was a multicenter, prospective, controlled trial conducted in primary clinics in Japan. We explored the effects of family physician attire (white coat vs. casual attire) on patient-perceived empathy. Family physicians were allocated to alternate weeks of wearing a white coat or casual attire during consultations. Patients’ perceptions of physician empathy were evaluated using the self-rated Japanese Consultation and Relational Empathy (CARE) Measure. We used a linear mixed model to analyze the CARE Measure scores, adjusting for cluster effects of patients nested within doctor, age, and sex of patients, and doctors’ sex and years of clinical experience. We used the same method with Bonferroni adjustment to analyze patient sex differences in perceived empathy. Results A total of 632 patients of seven family physicians were allocated to white coat-wearing consultations (n = 328), and casual attire-wearing consultations (n = 304). There was no difference in CARE Measure scores between white coat and casual primary care consultations overall (p = 0.162). Subgroup analysis of patient sex showed that CARE Measure scores of male patients were significantly higher in the Casual group than in the White coat group (adjusted p-value = 0.044). There was no difference in female patient scores between White coat and Casual groups (adjusted p-value = 1.000). Conclusions This study demonstrated that physician attire (white coat or casual attire) in a primary care setting did not affect patient-perceived relational empathy overall. However, male patients of physicians wearing casual attire reported higher physician empathy. Although empathy cannot be reduced to simple variables such as attire, white coats may have a negative effect on patients, depending on the context. Family physicians should choose their attire carefully. Trial registration Japanese University Hospital Medical Information Network (UMIN-ICDR). Clinical Trial identifier number UMIN000037687 (Registered August 14, 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042749). The study was prospectively registered.
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Affiliation(s)
- Takaharu Matsuhisa
- Department of General Medicine/Family & Community Medicine, Nagoya University Hospital, Tsurumai-cho 65, Showa-ku, Nagoya, 466-8560, Japan.
| | - Noriyuki Takahashi
- Department of Education for Community-Oriented Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Kunihiko Takahashi
- M&D Data Science Center, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Yuki Yoshikawa
- Department of General Medicine/Family & Community Medicine, Nagoya University Hospital, Tsurumai-cho 65, Showa-ku, Nagoya, 466-8560, Japan
| | - Muneyoshi Aomatsu
- Department of Medical Education, Saku Central Hospital, 197 Usuda, Saku, 385-0051, Japan
| | - Juichi Sato
- Department of General Medicine/Family & Community Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Stewart W Mercer
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, Scotland
| | - Nobutaro Ban
- Medical Education Center, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan
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Abstract
BACKGROUND A number of factors have been shown to affect how surgeons are subjectively viewed, including their appearance in clinic. Patient preference for pediatric orthopaedic surgeon attire has not previously been studied, nor has its influence on initial perception of the surgeon. METHODS At 5 pediatric regional sites across the United States, parents and patients presenting to the pediatric orthopaedic clinic were given anonymous surveys showing 8 photos of surgeons in different clinical dress including in business or scrub dress, each with or without white coat (WC). Subjects reported their demographics, single preferred photo, rated characteristics of the surgeons in each photo on a 5-point Likert scale, and answered specific questions on scrubs and WCs. The first consecutively completed 100 parent and 100 patient surveys were included from each site. RESULTS One thousand surveys were collected from patients (500) and parents (500). The majority felt a surgeon's clinical dress would not affect how they are cared for (83%), and that it was ok to wear scrubs in clinic (90%). Overall, WC was preferred to those without no matter the age, but there was no difference between scrub and business choices. Of those stating a preference, woman in business and WC (24%) and woman in scrubs and WC (21%) were most selected, with the only geographic difference being the midwest's preference for man in business and WC. Females were more likely to prefer women photographs (P<0.0001). CONCLUSIONS In general, pediatric orthopaedic patients and parents do not have a strong specific preference toward what their surgeon wears to clinic, including whether or not we are dressed in scrubs, but some initial biases exist. When asked to choose, the traditional WC worn over any attire is preferred, and female patients and parents uncover a preference for a surgeon of their own sex. LEVEL OF EVIDENCE Level III.
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Patient Attitudes and Preferences for Orthopaedic Surgeon Greetings. J Am Acad Orthop Surg 2021; 29:e126-e131. [PMID: 32649437 DOI: 10.5435/jaaos-d-20-00230] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/03/2020] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Numerous studies have demonstrated that patient-centered interaction promotes higher satisfaction and improved health outcomes, whereas poor communication behaviors have been associated with decreased satisfaction and an increased risk of malpractice claims. To our knowledge, no such study has investigated patient preferences for greetings and handshakes in the outpatient orthopaedic setting. METHODS A survey was generated with ranking and Likert scale questions regarding the initial patient-orthopaedic surgeon outpatient interaction. The survey was offered to adult patients at an urban, academic, outpatient orthopaedic surgery clinic. Surveys were completed by subjects while in the waiting room and returned before the first interaction with their orthopaedic surgeon. RESULTS Completed surveys were collected from 160 patients over a 3-month period. Overall, medical knowledge was valued above other physician attributes, including the physician greeting (P < 0.001). Subjects preferred a more formal introduction by their physician, with the use of title and first and last name preferred to the physician's first name only (P < 0.001), first and last name only (P < 0.001), and title and last name only (P < 0.001). Patients strongly preferred their physician address them by their first name only compared with first and last name (P < 0.001). Shaking hands was determined to be moderately important and did not vary by any demographic category. CONCLUSIONS Patients in this cohort considered their orthopaedic surgeon's greeting to be less important than their surgeon's medical knowledge, but more important than their appearance and attire. Respondents preferred their orthopaedic surgeon introduce themselves with their title, first name, and last name but to use the patient's first name only. The results of our study should be taken into consideration when greeting patients to facilitate rapport-building and improve the patient experience. LEVEL OF EVIDENCE Level IV, cross-sectional survey study.
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Nuno J, Fernandes S, Silva TR, Guimarães AC, Pereira BM, Laureano-Alves S, de Sousa ICV, Brito D, Firmino-Machado J. What attributes do patients prefer in a family physician? A cross-sectional study in a northern region of Portugal. BMJ Open 2021; 11:e035130. [PMID: 33514569 PMCID: PMC7849883 DOI: 10.1136/bmjopen-2019-035130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To determine which modifiable and non-modifiable attributes patients prefer in a family physician, as well as to analyse participants' characteristics associated with their choices. DESIGN Cross-sectional study. SETTING Family healthcare units (FHU) in the city of Braga and Barcelos (Northern Portugal). PARTICIPANTS Adults aged 18 years or more, enrolled in the selected FHU. MAIN OUTCOME MEASURES The preferred attributes were assessed with a questionnaire delivered in the FHU. These attributes included gender, age and nationality and the importance of being Portuguese, of greeting with a handshake, of welcoming in the waiting area, of using an identification badge and of wearing a white coat. RESULTS A total of 556 questionnaires were included in the analysis; 66% and 58% of the participants had no preference for the gender or age of the family physician, respectively. Using a multinomial logistic regression, male participants were 3.8 times more likely to have a preference for a male physician than having no preference, in comparison to female participants (OR 3.864, 95% CI 1.96 to 7.61). More than 69% of the participants considered greeting with a handshake, using an identification badge and wearing a white coat important or very important. There was a statistically significant association between being Portuguese and the major importance given to the use of an identification badge (β=0.68, 95% CI 0.23 to 1.12). CONCLUSIONS Our data show that modifiable attributes of the family physician (greeting, presence of an identification badge and wearing a white coat) are important for patients. Potential changes in family physician attitude in consultation could ultimately affect patient-physician relationship.
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Affiliation(s)
- Joana Nuno
- Family Health Unit 7fontes, Northern Regional Health Administration, Braga, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Susana Fernandes
- Family Health Unit 7fontes, Northern Regional Health Administration, Braga, Portugal
| | - Teresa Rei Silva
- Family Health Unit Gualtar, Northern Regional Health Administration, Braga, Portugal
| | | | | | - Sara Laureano-Alves
- Family Health Unit Ruães, Northern Regional Health Administration, Braga, Portugal
| | | | - Dinis Brito
- Family Health Unit 7fontes, Northern Regional Health Administration, Braga, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - João Firmino-Machado
- EPIUnit -The Epidemiology Research Unit, University of Porto, Porto, Portugal
- Western Oporto Public Health Unit, Northern Regional Health Administration, Porto, Portugal
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Scheive M, Gillis J, Gillis S, Legault GL. Patient Perception of Physician Attire in a Military Ophthalmology Clinic. Cureus 2021; 13:e12472. [PMID: 33552788 PMCID: PMC7857148 DOI: 10.7759/cureus.12472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction The purpose of this study is to investigate patient preferences of physician attire in an outpatient military ophthalmology clinic to determine how these preferences affect patients’ perceptions of physician competence and their overall clinical experience. Materials and methods This study is a prospective survey administered to patients at the ophthalmology clinic at Brooke Army Medical Center. USA. Patients who were willing to participate in a volunteer survey were included in this study. Demographic information and survey questions were utilized in this study along with words and pictures for patients to select a preference in physician attire in the clinic setting (scrubs, military uniform, or civilian professional attire) and surgical setting (surgical cap or a surgical bouffant). The survey asks patients if physician attire impacts patient confidence in physician abilities (yes or no) and if surgeon attire impacts the likelihood of the patient taking the surgeon’s advice (yes or no). Results The demographic distribution includes 57-77 years old participants (53%), females (61%), retirees (49%), and dependent spouses (40%). The racial distribution includes 46% - Caucasian, 20% - African American, 22% - Hispanic, 6 - % Asian, and 6% - other. Most patient appointment types were established follow-up (77%) with only 12% new and 11% walk-in. The survey results (N=308) indicate that most patients (64%) did not have a preference in physician clinical attire, while 22% preferred scrubs, 11% preferred military uniform, and 3% preferred civilian attire. Most patients (66%) did not have a preference for surgical headwear, while 27% preferred the surgical cap, and 7% preferred the surgical bouffant. Only 9% of the patients surveyed indicated that physician attire impacted their confidence in their physician’s ability, and 12% reported that attire impacted the likelihood of taking advice. Conclusions Most patients in an outpatient military ophthalmology clinic do not have a preference for physician attire or surgical headwear when surveyed. The majority of patients did not feel physician attire impacted their perception of physician's ability or their likelihood of taking advice. When indicating a preference, patients tended to prefer scrubs to outpatient civilian attire or military attire and trended towards preferring surgical cap over surgical bouffant for headwear.
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Affiliation(s)
- Melanie Scheive
- Ophthalmology, Indiana University School of Medicine, Indianapolis, USA
| | - John Gillis
- Ophthalmology, Wilford Hall Eye Center, Lackland, USA
| | - Sarah Gillis
- Endocrinology, University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - Gary L Legault
- Ophthalmology, Brooke Army Medical Center, San Antonio, USA
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Suresh Babu YS, Gulati Y, Raina P. Need for appropriate hospital attire in orthopedic patients. APOLLO MEDICINE 2021. [DOI: 10.4103/am.am_10_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Coe JB, O'Connor R, Pizzolon CN, Hester KA, Nogueira Borden LJ, Haley D. Investigation of the effects of veterinarians' attire on ratings of trust, confidence, and comfort in a sample of pet owners in Canada. J Am Vet Med Assoc 2020; 256:1268-1276. [PMID: 32412872 DOI: 10.2460/javma.256.11.1268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To examine companion animal owners' perceptions of appropriate veterinarian attire and investigate potential associations between a veterinarian's attire and clients' ratings of trust in, confidence in, and comfort with a veterinarian. SAMPLE 449 pet owners. PROCEDURES Participants were randomly assigned to complete a questionnaire containing photos of a male or female model veterinarian photographed in 8 attire types (formal attire, white dress shirt with black pants, white casual shirt with khaki pants, surgical scrubs, white casual shirt with jeans, surgical scrub top with jeans, surgical scrub top with khaki pants, and white laboratory coat with khaki pants). Participants were asked to rate their trust in, confidence in, and comfort with the pictured individual on a response scale of 1 (low) to 7 (high), rank photos according to their preferences for attire, and provide input on the importance of attire and other appearance-related subjects. Attire and gender of photographed individual and participant demographics were investigated for associations with trust, confidence, and comfort scores. RESULTS Most (317/445 [71%]) respondents indicated veterinarians' attire was important. Attire type was significantly associated with respondents' trust, confidence, and comfort scores. Model veterinarian gender and participant education level were also associated with trust and comfort scores. CONCLUSIONS AND CLINICAL RELEVANCE Veterinarians' attire is a form of nonverbal communication that is likely to inform clients' first impressions and may influence clients' trust in, confidence in, and comfort with a veterinarian. Veterinary personnel and veterinary management should consider how attire and general appearance represent staff members or their practice.
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Sorrell S, Ibrahim H. First year medical students' perceptions of the impact of wearing scrubs on professional identity: a narrative analysis in the United Arab Emirates. BMJ Open 2020; 10:e039357. [PMID: 33148751 PMCID: PMC7640520 DOI: 10.1136/bmjopen-2020-039357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Medical school serves as a critical developmental period for future physicians, during which students begin to form a professional identity. Just as personal appearance, particularly clothing, is an important external expression of one's personal identity, 'uniforms' in healthcare, including white coats and scrubs, symbolise status and a group identity. There are, however, limited studies on the impact of physician attire on medical students' formation of professional identity. Accordingly, through qualitative analysis of written narratives, we sought to analyse medical students' experiences of wearing professional physician attire, namely scrubs, and how the uniform impacted their confidence level, performance and behaviours, as well as their identity as future physicians. DESIGN Qualitative analysis of medical student's written narratives. SETTING Khalifa University College of Medicine and Health Sciences (KU CMHS) is a new medical school in the United Arab Emirates, with an inaugural class of 30 students admitted in August 2019. It is the only medical school in the city of Abu Dhabi, and the only school in the country that follows a postgraduate medical curriculum. PARTICIPANTS All first year medical students at KU CMHS were purposively sampled. METHODS Students completed a voluntary online anonymous questionnaire. We employed a social identity approach to data analysis. Thematic content analysis was conducted on their narratives to identify themes. RESULTS We identified three major themes, namely (1) emotions, (2) logistics and (3) interpersonal relationships. CONCLUSIONS Medical students form early perceptions regarding physician attire and its impact on their professional identity. Engaging in conversations regarding professional attire with educators or mentors could provide an important opportunity for students to discuss and explore professional identity early in training.
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Affiliation(s)
- Sara Sorrell
- College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Halah Ibrahim
- Department of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
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Kumar MS, Krishnamurthy S, Dhruve N, Somashekar B, Gowda MR. Telepsychiatry Netiquette: Connect, Communicate and Consult. Indian J Psychol Med 2020; 42:22S-26S. [PMID: 33354059 PMCID: PMC7736736 DOI: 10.1177/0253717620958170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Globally, telepsychiatry has been around since the 1950s. It is in the COVID era that it has gained the relevance and much-needed momentum amongst mental health care professionals. Given the restrictions imposed by the global lockdown owing to the fear of contracting the virus, the ease of access and safety offered by telepsychiatry makes it both appealing and "the new normal." Despite some hesitation from mental health professionals, there is adequate research to support the role of telehealth services in the management of various mental health disorders. As with any formal system, the practice of telepsychiatry is regulated by professional guidelines to show the way forward to both health provider and seeker. The manuscript examines the ways telepsychiatry is redefining our virtual conduct. It emphasizes the evolving "netiquette" needed to navigate online consultations. It also elucidates the challenges faced by health professionals, and possible ways of maneuvering and circumventing the same. Telepsychiatry, a dynamic process which is interactive and personalized, adds a third dimension to the practice of modern medicine. It is here to stay. So, it is not a question of "if" instead "how soon" we can adapt to and get conversant with this revolutionary mode of connection, communication, and consultation, which will make all the difference.
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Affiliation(s)
- Mohan Sunil Kumar
- Clinical Division, Augmenta Health (P) Ltd., Bengaluru, Karnataka, India
| | | | - Nitya Dhruve
- Clinical Division, Augmenta Health (P) Ltd., Bengaluru, Karnataka, India
| | - Bettahalasoor Somashekar
- Adult Community Mental Health Services, Swanswell Point Coventry and Warwickshire Partnership NHS Trust Coventry, England, UK
| | - Mahesh R Gowda
- Dept. of Psychiatry, Spandana Health Care, Bengaluru, Karnataka, India
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Bentley E, Kellihan H, Longhurst C, Chun R. Effect of attire on client perceptions of veterinarians. Vet J 2020; 265:105550. [PMID: 33129551 DOI: 10.1016/j.tvjl.2020.105550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 11/28/2022]
Abstract
This study examined the effect that veterinarian attire and gender had on clients' perceptions of veterinarians in a large academic specialty hospital. Clients volunteered to answer a survey in the small animal waiting area over a 3-month period. The survey consisted of demographic information, information about the nature of their appointment with their pet, and questions regarding clients' levels of comfort with and the perceived trustworthiness of a Caucasian male and Caucasian female model in four different types of attire: surgical scrubs, surgical scrubs with white lab coat, business casual, and business casual with white lab coat. Relevant effects of interest were estimated using linear mixed models. Five hundred and five clients participated in the survey, yielding a total of 6217 completed survey questions. Clients perceived veterinarians wearing white lab coats as more competent and reported more comfort with those veterinarians (P < 0.0001). When comparing surgical scrubs with no white lab coat to business attire with no white lab coat, surgical scrubs resulted in higher perceived competence and comfort levels (P < 0.0001). Wearing a white lab coat over both surgical scrubs and business casual increased clients' perceived competency and comfort levels compared to not wearing a white lab coat.
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Affiliation(s)
- E Bentley
- School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr, Madison, WI 53706, USA.
| | - H Kellihan
- School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr, Madison, WI 53706, USA
| | - C Longhurst
- Biostatistics and Medical Informatics, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53792, USA
| | - R Chun
- School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr, Madison, WI 53706, USA
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Bernstein MH, Locher C, Kube T, Buergler S, Stewart-Ferrer S, Blease C. Putting the 'Art' Into the 'Art of Medicine': The Under-Explored Role of Artifacts in Placebo Studies. Front Psychol 2020; 11:1354. [PMID: 32774310 PMCID: PMC7387723 DOI: 10.3389/fpsyg.2020.01354] [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: 09/30/2019] [Accepted: 05/22/2020] [Indexed: 12/28/2022] Open
Abstract
Research in social psychology demonstrates that physical environmental factors – or “artifacts” such as provider clothing and office décor – can influence health outcomes. However, the role of artifacts in augmenting or diminishing health outcomes is under-explored in the burgeoning discipline of placebo studies. In this paper, we argue that a careful consideration of artifacts may carry significant potential in informing how placebo effects can be maximized, and nocebo effects minimized in clinical settings. We discuss the potential mechanisms, including classical conditioning, response expectancy, and mindsets, by which artifacts might enhance or diminish these effects. Next, we propose testable hypotheses to investigate how placebo and nocebo effects might be elicited by artifacts in care settings, and conclude by providing innovative research designs to advance this novel research agendum.
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Affiliation(s)
- Michael H Bernstein
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI, United States
| | - Cosima Locher
- School of Psychology, University of Plymouth, Plymouth, United Kingdom.,Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Tobias Kube
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.,Pain and Psychotherapy Research Lab, University of Koblenz-Landau, Landau, Germany
| | - Sarah Buergler
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Sif Stewart-Ferrer
- Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
| | - Charlotte Blease
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.,School of Psychology, University College Dublin, Dublin, Ireland
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Alzahrani HM, Mahfouz AA, Farag S, Awadalla NJ, Melha AA, Almobarak M, Meri MH, Omair OM, Alqarni AS, Alqahtani FM. Patients' perceptions and preferences for physicians' attire in hospitals in south western Saudi Arabia. J Family Med Prim Care 2020; 9:3119-3123. [PMID: 32984183 PMCID: PMC7491852 DOI: 10.4103/jfmpc.jfmpc_166_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 03/13/2020] [Accepted: 04/06/2020] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Data regarding patients' perception and satisfaction about physicians providing the medical care based on their attires in Southern Region of Saudi Arabia are scarce and even lacking. The aim of this study was to assess the patients' opinion regarding the suitable attires of physicians. MATERIALS AND METHODS A descriptive cross-sectional survey was performed on a random sample of patients from Aseer Central Hospital, Southern Military Hospital and Abha Maternity Hospital. The questionnaire collected data on their perception of physicians' attire as well as reflection of dress on trust and willingness to discuss personal issues. RESULTS The study included 248 patients. The majority (81.9%) of the participants agreed on the importance for physicians to wear their medical attires. Also 84.3% of them confirmed that physician's appearance is important source of their confidence. Skirt plus lab coat was the most favored for female physicians (39.3%). As for male physicians, scrub plus lab coat was the most preferred (33.6%) attire. CONCLUSION Patients attending hospitals in southwestern Saudi Arabia preferred for their physicians to wear formal attire with white coats, rather than the Saudi national dress. Skirt plus lab coat was the most preferred for female physicians. As for male physicians, scrub plus lab coat was the most preferred attire. Patients approved the importance for physicians to wear their medical attires and confirmed that physician's appearance is important source for their confidence. The study recommends that physicians should adopt formal attire and the institutional dress code policy should be modified to fit these preferences.
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Affiliation(s)
| | - Ahmed A. Mahfouz
- Department of Family and Community Medicine, King Khalid University, Abha, Saudi Arabia
- High Institute of Public Health, Alexandria University, Alexandria Governorate, Egypt
| | - Shehata Farag
- Department of Family and Community Medicine, King Khalid University, Abha, Saudi Arabia
- High Institute of Public Health, Alexandria University, Alexandria Governorate, Egypt
| | - Nabil J. Awadalla
- Department of Family and Community Medicine, King Khalid University, Abha, Saudi Arabia
- Department of Community Medicine, College of Medicine, Mansoura University, Dakahlia Governorate, Egypt
| | | | | | | | - Othman M. Omair
- Emergency Medicine, Aseer Central Hospital, Abha, Saudi Arabia
| | - Afnan S. Alqarni
- Medical Intern, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Fatma M. Alqahtani
- Medical Intern, College of Medicine, King Khalid University, Abha, Saudi Arabia
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Kamata K, Kuriyama A, Chopra V, Saint S, Houchens N, Petrilli CM, Kuhn L, Snyder A, Ishimaru N, Takahashi H, Tokuda Y. Patient Preferences for Physician Attire: A Multicenter Study in Japan. J Hosp Med 2020; 15:204-210. [PMID: 32118558 DOI: 10.12788/jhm.3350] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Previous studies have shown that patients have specific expectations regarding physician dress. Japan has a cultural background that is in many ways distinct from western countries. Thus, physician attire may have a different impact in Japan. METHODS We conducted a multicenter, cross-sectional study to examine patients' preferences for and perceptions of physician attire in Japan. The questionnaire was developed using photographs of either a male or female physician dressed in seven different forms of attire, and it was randomly distributed to inpatients and outpatients. Respondents were asked to rate the provider pictured; they were also asked to provide preferences for different forms of attire in varied clinical settings. Preference was evaluated for five domains (knowledgeable, trustworthy, caring, approachable, and comfortable). We also assessed variation in preferences for attire by respondent characteristics. RESULTS A total of 1,233 (61%) patients indicated that physician dress was important, and 950 (47%) patients agreed that it influenced their satisfaction with care. Compared with all forms, casual attire with a white coat was the most preferred dress. Older patients more often preferred formal attire with a white coat in primary care and hospital settings. In addition, physician attire had a greater impact on older respondents' satisfaction and experience. CONCLUSION The majority of Japanese patients indicated that physician attire is important and influenced their satisfaction with care. Geography, settings of care, and patient age appear to play a role in patient preferences.
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Affiliation(s)
- Kazuhiro Kamata
- Emerging and Re-emerging Infectious Diseases Unit, National Institute for Infectious Diseases "Lazzaro Spallanzani," Rome, Italy
| | - Akira Kuriyama
- Emergency and Critical Care Center, Kurashiki Central Hospital, Okayama, Japan
| | - Vineet Chopra
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Sanjay Saint
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Nathan Houchens
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Christopher M Petrilli
- Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Division of General Internal Medicine and Clinical Innovation, Department of Medicine, NYU Langone Health, New York, New York, USA
| | - Latoya Kuhn
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Ashley Snyder
- Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Naoto Ishimaru
- Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan
| | - Hiromizu Takahashi
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yasuharu Tokuda
- Department of Medicine, Muribushi Project for Okinawa Residency Programs, Okinawa, Japan
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Azhar A, Tanco K, Haider A, Park M, Liu D, Williams JL, Bruera E. Challenging the Status Quo of Physician Attire in the Palliative Care Setting. Oncologist 2020; 25:627-637. [PMID: 32073181 DOI: 10.1634/theoncologist.2019-0568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/07/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND, AIM, AND HYPOTHESIS This randomized controlled trial aimed to compare the impact of a physician's attire on the perceptions of patients with cancer of compassion, professionalism, and physician preference. Our hypothesis was that patients would perceive the physician with formal attire as more compassionate than the physician wearing casual attire. MATERIALS AND METHODS One hundred five adult follow-up patients with advanced cancer were randomized to watch two standardized, 3-minute video vignettes with the same script, depicting a routine physician-patient clinic encounter. Videos included a physician in formal attire with tie and buttoned-up white coat and casual attire without a tie or white coat. Actors, patients, and investigators were all blinded to the purpose and videos watched, respectively. After each video, patients completed validated questionnaires rating their perception of physician compassion, professionalism, and their overall preference for the physician. RESULTS There were no significant differences between formal and casual attire for compassion (median [interquartile range], 25 [10-31] vs. 20 [8-27]; p = .31) and professionalism (17 [13-21] vs. 18 [14-22]; p = .42). Thirty percent of patients preferred formal attire, 31% preferred casual attire, and 38% had no preference. Subgroup analysis did not show statistically significant differences among different cohorts of age, sex, marital status, and education level. CONCLUSION Doctors' attire did not affect the perceptions of patients with cancer of physician's level of compassion and professionalism, nor did it influence the patients' preference for their doctor or their trust and confidence in the doctor's ability to provide care. There is a need for more studies in this area of communications skills. Clinical trial identification number. NCT03168763 IMPLICATIONS FOR PRACTICE: The significance of physician attire as a means of nonverbal communication has not been well characterized. It is an important element to consider, as patient preferences vary geographically, are influenced by cultural beliefs, and may vary based on particular care settings. Previous studies consisted of nonblinded surveys and found increasing confidence in physicians wearing a professional white coat. Unfortunately, there are no randomized controlled trials, to the authors' knowledge, to confirm the survey findings. In this randomized, blinded clinical trial the researchers found that physician's attire did not affect patients' perception of the physician's level of compassion and professionalism. Attire also did not influence the patients' preferences for their doctor or their trust and confidence in the doctor's ability to provide care.
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Affiliation(s)
- Ahsan Azhar
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kimberson Tanco
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ali Haider
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Minjeong Park
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Diane Liu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Janet L Williams
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Sax L, Wong K, Shetty KR, Devaiah AK, Levi J, Grillone GA. Investigating Patient Preferences in Medical Student Attire in the Outpatient Otolaryngology Setting. EAR, NOSE & THROAT JOURNAL 2019; 100:NP269-NP273. [PMID: 31569983 DOI: 10.1177/0145561319871911] [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: 11/17/2022] Open
Abstract
BACKGROUND The authors sought to investigate patient preferences on physician and medical student attire in the outpatient otolaryngology setting. METHODS A prospective sample of 50 (23 males, 27 females) patients presenting to an otolaryngology clinic in a North American teaching hospital, Boston, MA, were included. Patients were seen by a researcher wearing a white coat and either (1) a shirt and tie or (2) surgical scrubs, then completed a Likert-style survey evaluating feelings of trust, comfort, and professionalism. Statistical significance was set at α = 0.05. RESULTS Most patients (82%, 41/50) believed that attire was important. Men and older patients were significantly more likely to believe attire was important (P = .01 and .005, respectively). Patients were significantly more comfortable when seen by a provider wearing a shirt and tie compared to scrubs (U = 109.5, P = .021); however, there was no difference in feelings of trust or professionalism (P = .5* and .6*, respectively). CONCLUSIONS Physician attire is important for patients presenting to otolaryngology clinic. Patients favored a white coat with a shirt and tie. Level of Evidence: NA.
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Affiliation(s)
- Leah Sax
- 12259Boston University School of Medicine, MA, USA.,Department of Otolaryngology-Head and Neck Surgery, 12259Boston University Medical Center, MA, USA
| | - Kevin Wong
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kunal R Shetty
- 12259Boston University School of Medicine, MA, USA.,Department of Otolaryngology-Head and Neck Surgery, 12259Boston University Medical Center, MA, USA
| | - Anand K Devaiah
- 12259Boston University School of Medicine, MA, USA.,Department of Otolaryngology-Head and Neck Surgery, 12259Boston University Medical Center, MA, USA
| | - Jessica Levi
- 12259Boston University School of Medicine, MA, USA.,Department of Otolaryngology-Head and Neck Surgery, 12259Boston University Medical Center, MA, USA
| | - Gregory A Grillone
- 12259Boston University School of Medicine, MA, USA.,Department of Otolaryngology-Head and Neck Surgery, 12259Boston University Medical Center, MA, USA
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Lands VW, Malige A, Nwachuku CO, Matullo KS. The Effect of an Orthopedic Hand Surgeon's Attire on Patient Confidence and Trust. Hand (N Y) 2019; 14:675-683. [PMID: 29343100 PMCID: PMC6759972 DOI: 10.1177/1558944717750918] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Multiple studies have concluded that patients are more likely to understand and trust physicians who dress in more formal attire (shirt and tie) as opposed to casual attire (t-shirts and jeans). The white coat has repeatedly been reported as a major source of trust and confidence in a patient's eyes. Methods: This study explores the effect an orthopedic hand surgeon's attire has on a patient's perception of their surgeon's clinical values. All patients 18 years of age and older who visited our orthopedic hand surgeon's suburban outpatient practice were asked to participate in our survey-based study. Results: Ninety-seven surveys were completed and included. A majority of our responders are female (n = 59, 60.8%), Caucasian (n = 83, 85.6%) between the ages of 55 and 74 years (n = 40, 41.2%), currently employed (n = 59, 60.8%) with private health insurance (n = 69, 71.1%), and married (n = 64, 66.0%). Patients rated male and female hand surgeons wearing a white coat highest using the Likert scale and when asked about their perceived clinical qualities. Patients consistently poorly rated their surgeons wearing casual attire. Patients did note that the white coat, or any specific attire, was not necessary during the initial encounter to build a strong patient-surgeon relationship. Finally, goatees and beards do not positively or negatively impact a surgeon's patient-constructed image. Conclusions: Combining strong clinical skills with appropriate clinical attire highlighted by the physician wearing a white coat appears to be an effective way to enhance patient satisfaction while ultimately gaining the trust and respect needed to properly care for patients.
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Affiliation(s)
- Vince W. Lands
- St. Luke’s University Health Network,
Bethlehem, PA, USA
| | - Ajith Malige
- St. Luke’s University Health Network,
Bethlehem, PA, USA
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Abstract
BACKGROUND Prior research suggests that physician attire has an important effect on patient perceptions, and can influence the patient-physician relationship. Previous studies have established the effect of specialty, location, and setting on patient preferences for physician attire, and the importance of these preferences and perceptions on both the physician-patient relationship and first impressions. To date, no studies have examined the influence of attire in the inpatient orthopaedic surgery setting on these perceptions. QUESTIONS/PURPOSES (1) Do differences in orthopaedic physician attire influence patient confidence in their surgeon, perception of trustworthiness, safety, how caring their physician is, how smart their surgeon is, how well the surgery would go, and how willing they are to discuss personal information with the surgeon? (2) Do patients perceive physicians who are men and women differently with respect to those endpoints? METHODS Ninety-three of 110 patients undergoing orthopaedic surgery at an urban academic medical center participated in a three-part survey. In the first part, each patient was randomly presented 10 images of both men and women surgeons, each dressed in five different outfits: business attire (BA), a white coat over business attire (WB), scrubs alone (SA), a white coat over scrubs (WS), and casual attire (CA). Respondents rated each image on a five-point Likert scale regarding how confident, trustworthy, safe, caring, and smart the surgeon appeared, how well the surgery would go, and the patient's willingness to discuss personal information with the surgeon. In the second part, the respondent ranked all images, by gender, from the most to least confident based on attire. RESULTS Pair-wise comparisons for women surgeons demonstrated no difference in patient preference between white coat over business attire compared with white coat over scrubs or scrubs alone, though each was preferable to business attire and casual attire (WS versus WB: mean difference [MD], 0.1 ± 0.6; 95% CI, 0.0-0.2; p = 1.0; WS versus SA: MD, 0.2 ± 0.7; 95% CI, 0-0.3; p = 0.7; WB versus SA: 0.1 ± 0.9; 95% CI, -0.1 to 0.2; p = 1.0). The same results were found when rating the surgeon's perceived intelligence, skill, trust, confidentiality, caring, and safety. In the pair-wise comparisons for male surgeons, white coat over scrubs was not preferred to white coat over business attire, scrubs alone, or business attire (WS versus WB: MD, -0.1 ± 0.6; 95% CI, 0-0.1; p = 1.0; WS versus SA: MD, 0 ± 0.4; 95% CI, -0.2 to 0; p = 1.0; WS versus BA: MD, 0.2 ± 0.8; 95% CI, 0-0.4; p = 0.6). WB and SA were not different (MD, 0.0 ± 0.6; 95% CI, -0.1 to 0.2; p = 1.0), though both were preferred to BA and CA (WB versus BA: MD, 0.3 ± 0.8; 95% CI, 0.1-0.5; p = 0.02; WB versus CA: 1.0 ± 1.0; 95% CI, 0.8-1.2; p < 0.01). We found no difference between SA and BA (MD, 0.3 ± 0.7; 95% CI, 0.1-0.4; p = 0.06). We found that each was preferred to CA (SA versus CA: 0.9 ± 1.0; 95% CI, 0.7-1.2; p < 0.01; BA versus CA: 0.7 ± 1.0; 95% CI, 0.5-0.9; p < 0.01), with similar results in all other categories. When asked to rank all types of attire, patients preferred WS or WB for both men and women surgeons, followed by SA, BA, and CA. CONCLUSIONS Similar to findings in the outpatient orthopaedic setting, in the inpatient setting, we found patients had a moderate overall preference for physicians wearing a white coat, either over scrubs or business attire, and, to some extent, scrubs alone. Respondents did not show any difference in preference based on the gender of the pictured surgeon. For men and women orthopaedic surgeons in the urban inpatient setting, stereotypical physician's attire such as a white coat over either scrubs or business attire, or even scrubs alone may improve numerous components of the patient-physician relationship and should therefore be strongly considered to enhance overall patient care. LEVEL OF EVIDENCE Level II, therapeutic study.
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Goyal S, Khot SC, Ramachandran V, Shah KP, Musher DM. Bacterial contamination of medical providers' white coats and surgical scrubs: A systematic review. Am J Infect Control 2019; 47:994-1001. [PMID: 30850250 DOI: 10.1016/j.ajic.2019.01.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/23/2019] [Accepted: 01/23/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Horizontal transmission of bacteria, especially multidrug-resistant organisms (MDROs), remains an important concern in hospitals worldwide. Some studies have implicated provider attire in the transmission of organisms within hospitals, whereas others have suggested that evidence supporting this notion is limited. METHODS PubMed was searched for publications between 1990 and 2018 to identify studies of bacterial contamination of, or dissemination of, bacteria from physician, nursing, or trainee attire, with a specific focus on white coats and surgical scrubs. A total of 214 articles were identified. Of these, 169 were excluded after abstract review and 33 were excluded after in-depth full manuscript review. RESULTS Twenty-two articles were included: 16 (73%) cross-sectional studies, 4 (18%) randomized controlled trials, and 2 (9%) cohort studies. Results are organized by microbial contaminants, antibiotic resistance, types of providers, fabric type, antimicrobial coating, and laundering practices. Provider attire was commonly colonized by MDROs, with white coats laundered less frequently than scrubs. Studies revealed considerable differences among fabrics used and laundering practices. CONCLUSIONS Findings suggest that provider attire is a potential source of pathogenic bacterial transmission in health care settings. However, data confirming a direct link between provider attire and health care-associated infections remain limited. Suggestions outlined in this article may serve as a guideline to reduce the spread of bacterial pathogens, including MDROs, that have the potential to precipitate hospital-acquired infections.
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Affiliation(s)
- Shreya Goyal
- Office of Undergraduate Medical Education, Baylor College of Medicine, Houston, TX.
| | - Sharwin C Khot
- Office of Undergraduate Medical Education, Baylor College of Medicine, Houston, TX
| | - Vignesh Ramachandran
- Office of Undergraduate Medical Education, Baylor College of Medicine, Houston, TX
| | - Kevin P Shah
- Office of Undergraduate Medical Education, Baylor College of Medicine, Houston, TX
| | - Daniel M Musher
- Department of Medicine, Baylor College of Medicine, Houston, TX; Medical Care Line (Infectious Disease Section), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX; Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX
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Sugerman-McGiffin T, Hybki GC, Castro J, Murphy LA, Tansey C, Patlogar JE, Nakamura RK, Chen DY. Clients' attitudes toward veterinarians' attire in the small animal emergency medicine setting. J Am Vet Med Assoc 2019; 253:355-359. [PMID: 30020007 DOI: 10.2460/javma.253.3.355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine how veterinarians' attire affected clients' perceptions and trust in the small animal emergency medicine setting. DESIGN Cross-sectional study. SAMPLE 154 clients of a 24-hour small animal emergency clinic in a rural location. PROCEDURES A survey was administered to clients in the waiting room over a 1-month period to elicit their impressions of veterinarians' attire in various clinical scenarios and whether that attire would affect their perceptions. Respondents completed the survey after examining photographs of 1 male and 1 female veterinarian in 5 styles of attire (business, professional, surgical, clinical, and smart casual). RESULTS 83 (53.9%) respondents were female, and 71 (46.1%) were male; age was evenly distributed. Across all clinical scenarios, the most common response was no preference regarding the way a male or female veterinarian was dressed and that this attire would have no effect on the respondents' trust in their veterinarian. Most respondents were indifferent or preferred that their veterinarians not wear neckties and white coats. Twenty-six percent (40/154) of respondents indicated that they believed their veterinarian's attire would influence their opinion of the quality of care their pet received. CONCLUSIONS AND CLINICAL RELEVANCE In this small animal emergency medicine setting, most clients indicated no preference regarding their veterinarian's attire, yet approximately one-fourth indicated this attire would influence their perception of the quality of care their pet received. Further studies are warranted in other practice settings and locations to determine whether these findings are generalizable or unique to this particular setting.
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Robb KA, Rossi TA, Tansey C, Hybki GC, Murphy LA, Nakamura RK, Chen DY. Evaluation of owners' attitudes towards veterinarian attire in the small animal specialty setting in North America. Vet Med Sci 2018; 5:48-60. [PMID: 30394693 PMCID: PMC6376145 DOI: 10.1002/vms3.130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Previous studies in human medicine have found that patients prefer their doctors to be more formally attired, and that this influences their trust and confidence in their physician. The purpose of this study was to evaluate how veterinarians' attire affected owners' impressions and trust in the small animal specialty medicine setting. A questionnaire based study conducted during a 2-month period at an urban based small animal private practice specialty hospital. Respondents completed a written survey after reviewing pictures of the same male and female veterinarian in five different dress styles. Respondents were asked for their preference for male and female veterinarian attire in different clinical scenarios and whether it would affect their willingness to discuss sensitive issues. Two hundred and thirty-eight questionnaires were completed during the study period with 76.1% of respondents being female. Female respondents did not have a preference to how a male or female veterinarian was attired with the attire examples provided. However, male respondents tended to have fairly equal response rates between no preference and preferring a male veterinarian to be in either clinical or professional attire. Male owners either had no preference or preferred their male veterinarian to be attired in clinical or professional attire and had no preference or preferred their female veterinarian to be clinical attire. Most respondents do not feel it is necessary for a veterinarian to wear a white coat or neck ties and most do not feel it is inappropriate for a veterinarian to wear blue jeans, have coloured hair, or have visible tattoos.
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Affiliation(s)
- Kathryn A Robb
- Southern California Veterinary Specialty Hospital, Irvine, California, USA
| | - Tracey A Rossi
- Southern California Veterinary Specialty Hospital, Irvine, California, USA
| | - Colleen Tansey
- Inland Valley Veterinary Specialists, Upland, California, USA
| | | | - Lisa A Murphy
- Orange County Veterinary Specialists, Tustin, California, USA
| | | | - Dillon Y Chen
- Rady Children's Hospital, University of California at San Diego, San Diego, California, USA
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Wollmann L, Hauser L, Mengue SS, Agostinho MR, Roman R, Van Der Feltz-Cornelis CM, Harzheim E. Cross-cultural adaptation of the Patient-Doctor Relationship Questionnaire (PDRQ-9) in Brazil. Rev Saude Publica 2018; 52:71. [PMID: 30066809 PMCID: PMC6063713 DOI: 10.11606/s1518-8787.2018052000380] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/21/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To describe the process of cross-cultural adaptation of the Patient-Doctor Relationship Questionnaire (PDRQ-9), as well as compare the agreement between two different types of application. METHODS This is a cross-sectional study with 133 adult users of a Primary Health Service in Porto Alegre, State of Rio Grande do Sul, Brazil. The PDRQ-9 was answered by the participants as a self-administered questionnaire and in an interview. The instrument was also validated by interview, using data from 628 participants of the Mais Médicos Program Evaluation Research, which is a cross-sectional study with a systematic sample of Primary Care Services in all regions of Brazil. We evaluated the semantic, conceptual, and item equivalence, as well as factor analysis and reliability. RESULTS All items presented factor loading > 0.5 in the different methods of application and populations in the factor analysis. We found Cronbach's alpha of 0.94 in the self-administered method. We found Cronbach's alpha of 0.95 and 0.94 in the two different samples in the interview application. The use of PDRQ-9 with an interview or self-administered was considered equivalent. CONCLUSIONS The cross-cultural adaptation of the PDRQ-9 in Brazil replicated the factorial structure found in the original study, with high internal consistency. The instrument can be used as a new dimension in the evaluation of the quality of health care in clinical research, in the evaluation of services and public health, in health management, and in professional training. Further studies can evaluate other properties of the instrument, as well as its behavior in different populations and contexts.
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Affiliation(s)
- Lucas Wollmann
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
| | - Lisiane Hauser
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
| | - Sotero Serrate Mengue
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
| | - Milena Rodrigues Agostinho
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
| | - Rudi Roman
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
| | | | - Erno Harzheim
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
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Petrilli CM, Saint S, Jennings JJ, Caruso A, Kuhn L, Snyder A, Chopra V. Understanding patient preference for physician attire: a cross-sectional observational study of 10 academic medical centres in the USA. BMJ Open 2018; 8:e021239. [PMID: 29844101 PMCID: PMC5988098 DOI: 10.1136/bmjopen-2017-021239] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Several large studies have shown that improving the patient experience is associated with higher reported patient satisfaction, increased adherence to treatment and clinical outcomes. Whether physician attire can affect the patient experience-and how this influences satisfaction-is unknown. Therefore, we performed a national, cross-sectional study to examine patient perceptions, expectations and preferences regarding physicians dress. SETTING 10 academic hospitals in the USA. PARTICIPANTS Convenience sample of 4062 patients recruited from 1 June 2015 to 31 October 2016. PRIMARY AND SECONDARY OUTCOMES MEASURES We conducted a questionnaire-based study of patients across 10 academic hospitals in the USA. The questionnaire included photographs of a male and female physician dressed in seven different forms of attire. Patients were asked to rate the provider pictured in various clinical settings. Preference for attire was calculated as the composite of responses across five domains (knowledgeable, trustworthy, caring, approachable and comfortable) via a standardised instrument. Secondary outcome measures included variation in preferences by respondent characteristics (eg, gender), context of care (eg, inpatient vs outpatient) and geographical region. RESULTS Of 4062 patient responses, 53% indicated that physician attire was important to them during care. Over one-third agreed that it influenced their satisfaction with care. Compared with all other forms of attire, formal attire with a white coat was most highly rated (p=0.001 vs scrubs with white coat; p<0.001 all other comparisons). Important differences in preferences for attire by clinical context and respondent characteristics were noted. For example, respondents≥65 years preferred formal attire with white coats (p<0.001) while scrubs were most preferred for surgeons. CONCLUSIONS Patients have important expectations and perceptions for physician dress that vary by context and region. Nuanced policies addressing physician dress code to improve patient satisfaction appear important.
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Affiliation(s)
- Christopher M Petrilli
- Department of Internal Medicine, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Sanjay Saint
- Department of Internal Medicine, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Joseph J Jennings
- Division of Gastroenterology, Department of Medicine, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Andrew Caruso
- Section of General Internal Medicine, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Latoya Kuhn
- Department of Internal Medicine, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Ashley Snyder
- Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Vineet Chopra
- Department of Internal Medicine, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
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Karunakaran I, Thirumalaikolundusubramanian P, Nalinakumari SD. A preliminary survey of professionalism teaching practices in anatomy education among Indian Medical Colleges. ANATOMICAL SCIENCES EDUCATION 2017; 10:433-443. [PMID: 28165673 DOI: 10.1002/ase.1679] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 11/08/2016] [Accepted: 12/22/2016] [Indexed: 05/17/2023]
Abstract
Professionalism and ethics have gained widespread recognition as competencies to be fulfilled, taught, and assessed within medical education. The role of the anatomy course in developed nations has evolved over time and now encompasses multiple domains, including knowledge, skills, and the inculcation of professionalism and ethics. The Medical Council of India recently recommended the integration of professionalism teaching in undergraduate medical curricula. The authors investigated whether the initial orientation lectures and instructions given by faculty at the outset of undergraduate medical anatomy courses throughout India served a "hidden curriculum" regarding professionalism practices, and whether these orientation messages could serve as an early exposure to medical professionalism and ethics for medical students. An online survey was carried out among 102 anatomy faculty members across India requesting details about specific professionalism protocols and instructions regarding behavior in the dissection hall that are routinely given to preclinical students, as well as the importance that they placed on professional behavior. It was found that most faculty members regularly instruct students regarding expected behavior during the anatomy course, including dissection practices. These instructions stress attributes of professionalism like humanism, accountability, and honesty. However, there needs to be a more concentrated effort by educators to prohibit such unprofessional practices like dissection hall photography, and better information is required regarding biomedical waste disposal. Despite the absence of clear guidelines for professionalism teaching in medical education in India, the existing framework of anatomy education provides an opportunity to introduce the concept of professionalism to the first-year medical student. This opportunity may provide an early foundation for designing a professionalism-integrated curriculum. Anat Sci Educ 10: 433-443. © 2017 American Association of Anatomists.
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Affiliation(s)
- Ilavenil Karunakaran
- Department of Anatomy, Chennai Medical College Hospital and Research Centre, Irungalur, Tiruchirapalli, Tamil Nadu, India
| | | | - Sheela Das Nalinakumari
- Department of Anatomy, Chennai Medical College Hospital and Research Centre, Irungalur, Tiruchirapalli, Tamil Nadu, India
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Kim J, Eom YJ, Lee YS, Nam D, Chae Y. The Current Status of Quality of Reporting in Acupuncture Treatment Case Reports: An Analysis of the Core Journal in Korea. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2017; 2017:5810372. [PMID: 28642800 PMCID: PMC5469983 DOI: 10.1155/2017/5810372] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 05/11/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The present study aimed to evaluate the overall quality of case reports concerning acupuncture treatment in Korea. METHODS We selected a representative Korean journal and retrieved eligible case reports on acupuncture treatment published from 2009 to 2015. We assessed the quality of reporting based on CAse REport (CARE) and STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guideline checklists. RESULTS A total of 93 eligible case reports of acupuncture treatment were identified among the 107 articles screened. Overall quality of reporting in the case reports was generally acceptable (75.4% on CARE, 67.7% on STRICTA), but several crucial items remained substantially underreported. CONCLUSIONS Endorsement of the CARE and STRICTA guidelines is needed to improve the completeness of reporting. Our findings will be helpful in developing a more appropriate reporting guideline for case reports in acupuncture treatment.
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Affiliation(s)
- Jeongjoo Kim
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Yoon-Ji Eom
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Ye-Seul Lee
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Dongwoo Nam
- Department of Acupuncture and Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Younbyoung Chae
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
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Kraft-Todd GT, Reinero DA, Kelley JM, Heberlein AS, Baer L, Riess H. Empathic nonverbal behavior increases ratings of both warmth and competence in a medical context. PLoS One 2017; 12:e0177758. [PMID: 28505180 PMCID: PMC5432110 DOI: 10.1371/journal.pone.0177758] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 05/03/2017] [Indexed: 01/10/2023] Open
Abstract
In medicine, it is critical that clinicians demonstrate both empathy (perceived as warmth) and competence. Perceptions of these qualities are often intuitive and are based on nonverbal behavior. Emphasizing both warmth and competence may prove problematic, however, because there is evidence that they are inversely related in other settings. We hypothesize that perceptions of physician competence will instead be positively correlated with perceptions of physician warmth and empathy, potentially due to changing conceptions of the physician’s role. We test this hypothesis in an analog medical context using a large online sample, manipulating physician nonverbal behaviors suggested to communicate empathy (e.g. eye contact) and competence (the physician’s white coat). Participants rated physicians displaying empathic nonverbal behavior as more empathic, warm, and more competent than physicians displaying unempathic nonverbal behavior, adjusting for mood. We found no warmth/competence tradeoff and, additionally, no significant effects of the white coat. Further, compared with male participants, female participants perceived physicians displaying unempathic nonverbal behavior as less empathic. Given the significant consequences of clinician empathy, it is important for clinicians to learn how nonverbal behavior contributes to perceptions of warmth, and use it as another tool to improve their patients’ emotional and physical health.
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Affiliation(s)
- Gordon T. Kraft-Todd
- Empathy and Relational Science Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Psychology, Yale University, New Haven, Connecticut, United States of America
- * E-mail:
| | - Diego A. Reinero
- Empathy and Relational Science Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Psychology, New York University, New York, New York, United States of America
| | - John M. Kelley
- Empathy and Relational Science Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, United States of America
- Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Psychology, Endicott College, Beverly, Massachusetts, United States of America
| | - Andrea S. Heberlein
- Empathy and Relational Science Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Psychology, Boston College, Chestnut Hill, Massachusetts, United States of America
| | - Lee Baer
- Empathy and Relational Science Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, United States of America
| | - Helen Riess
- Empathy and Relational Science Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, United States of America
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Aldrees T, Alsuhaibani R, Alqaryan S, Alzahrani H, Alharethy S, Alghunaim A, Alohali S, Bawazeer M. Physicians' attire. Parents preferences in a tertiary hospital. Saudi Med J 2017; 38:435-439. [PMID: 28397953 PMCID: PMC5447199 DOI: 10.15537/smj.2017.4.15853] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To assess Saudi mother's preferences regarding Saudi children's physicians' attire, and its influence on the parents' level of trust and confidence. Methods: A cross-sectional survey was conducted from January to April 2014. Our sample comprised mothers of pediatric patients in both inpatient and outpatient settings at National Guard Hospital, Riyadh, Kingdom of Saudi Arabia. Mothers answered multiple questions, including their preferences regarding male and female pediatric physicians' attire, their preferences regarding their children's physician's gender, and the impact of physician's appearance on mothers' confidence. Results: There were 259 female participants. Of all caregivers, 51.4% were 32-years-old or younger. Of those, 170 (65.6%) were educated (had completed high school or higher). Forty-four percent preferred that male physicians wear scrubs, while 5.4% preferred formal attire (tie, shirt, and trousers) and 27.8% preferred Saudi national attire (Thobe and shemagh). Most caregivers (57.9%) preferred that female physicians wear long skirts. Most caregivers (87.6%) preferred physicians to wear a white coat. Most (89.2%) believed that a physician's appearance is very important. Conclusion: Gender of the treating physician is insignificant to mothers. However, the level of trust in a physician is related to his/her external appearance. Most mothers prefer their children's physicians to wear scrubs.
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Affiliation(s)
- Turki Aldrees
- Department of Otolaryngology, Medical College, Prince Sattam bin Abdulaziz University, Alkharj, Kingdom of Saudi Arabia. E-mail.
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Van De Car W, Starostanko A, Wendling A. Rural Patient Preference for Physician Attire. PRIMER : PEER-REVIEW REPORTS IN MEDICAL EDUCATION RESEARCH 2017; 1:3. [PMID: 32944689 DOI: 10.22454/primer.2017.1.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Introduction Physicians need to foster healthy relationships with patients to optimize care, with time constraints and workloads being barriers. Studies have shown the importance of first impressions, which are influenced by attire. Studies of physician attire have previously been conducted in metropolitan populations. This study's goal was to investigate patient preferences for physician attire among rural populations. Methods A cross-sectional study of patients was conducted in waiting rooms of five ambulatory clinics dispersed throughout rural northern Michigan. Anonymous surveys contained a series of photos of a male and a female physician, with photos within the series differing only by apparel. Participants indicated which male and female physician they would prefer in various scenarios. Participants provided demographic information and indicated their own physician's usual attire. Responses were analyzed using comparative statistics and logistic regression. Results Survey response rate was 78% (92/118). Similar to metropolitan studies, patients preferred professional attire including white coat in almost all scenarios. For most scenarios, participants preferred professional attire for both male and female physicians, however respondents were more tolerant of casual attire for female physicians. Older participants and those whose physician dressed casually tended to be more tolerant of casual attire. Patients preferred surgical attire only in emergency situations. Conclusions This study of a rural population showed a clear preference for professional physician attire. In general, rural physicians should consider wearing professional attire with white coat in order to best meet patient expectations. Further investigations are needed to enhance the generalizability of study findings.
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Affiliation(s)
| | | | - Andrea Wendling
- Michigan State University College of Human Medicine, East Lansing, MI
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Jennings JD, Ciaravino SG, Ramsey FV, Haydel C. Physicians' Attire Influences Patients' Perceptions in the Urban Outpatient Orthopaedic Surgery Setting. Clin Orthop Relat Res 2016; 474:1908-18. [PMID: 27116208 PMCID: PMC4965372 DOI: 10.1007/s11999-016-4855-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 04/18/2016] [Indexed: 01/31/2023]
Abstract
BACKGROUND Previous work has established that physician attire influences patients' perceptions of their physicians. However, research from different specialties has disagreed regarding what kinds of physician attire might result in increased trust and confidence on the part of patients. QUESTIONS/PURPOSES The purpose of this study was to investigate how surgeon attire affects patients' perceptions of trust and confidence in an urban orthopaedic outpatient setting. METHODS Eighty-five of 100 patients solicited completed a three-part questionnaire in the outpatient orthopaedic clinic at an urban teaching hospital. In the first section, participants viewed eight images, four of a male surgeon and four of a female surgeon wearing a white coat over formal attire, scrubs, business attire, and casual attire, and rated each image on a five-level Likert scale. Participants were asked how confident, trustworthy, safe, caring, and smart the surgeon appeared, how well the surgery would go, and how willing they would be to discuss personal information with the pictured surgeon. The participant ranked all images from most to least confident in the second part and the last section obtained demographic information from the patients. Surveys were scored using a five-level Likert scale and a Friedman test was used to detect statistical significance when comparing all attires. For multiple pairwise comparisons, a Bonferroni correction was applied. RESULTS The white coat on the male surgeon elicited modestly higher ratings in confidence (mean difference [MD], 0.367 ± 0.737; 95% CI, 0.202-0.532; p < 0.001), intelligence (MD, 0.216 ± 0.603; 95% CI, 0.077-0.356; p = 0.027), surgical skill (MD, 0.325 ± 0.658; 95% CI, 0.175-0.474; p < 0.001), trust (MD, 0.312 ± 0.613; 95% CI, 0.173-0.451; p < 0.001), ability to discuss confidential information (MD, 0.253 ± 0.742; 95% CI, 0.087-0.419; p = 0.023), caring (MD, 0.279 ± 0.655; 95% CI, 0.124-0.432; p = 0.006), and safety (MD, 0.260 ± 0.594; 95% CI, 0.125-0.395; p = 0.002) compared with business attire. Similarly, the white coat was preferred to casual attire in all categories (confidence: MD, 0.810 ± 0.921; smart: MD, 0.493 ± 0.801; surgical skill: MD, 0.640 ± 0.880; ability to discuss: MD, 0.564 ± 0.988; trust: MD, 0.545 ± 0.836; safety: MD, 0.581 ± 0.860; caring: MD, 0.479 ± 0.852; p < 0.001 for all comparisons). For the female surgeon, white coat and scrubs were not different, however the white coat was preferred to business attire in four of seven categories. Casual clothing was widely disliked in all categories for surgeons (men and women). When attire was compared for confidence on a scale, the white coat ranked higher than business (MD, 0.439 ± 1.491; p = 0.006) and casual attire (MD, 1.043 ± 2.054; p < 0.001), but not scrubs (MD, 0.169 ± 1.230; p = 1.000). CONCLUSIONS In this urban outpatient orthopaedic practice, patients' preferences varied based on the sex of the pictured surgeon in the survey. Overall, however, modest preferences were observed for the white coat in terms of confidence, intelligence, trust, and safety. Furthermore patients are more willing to discuss personal information and believe that their surgery will go better if the surgeon wears a white coat or scrubs. These results are consistent with those of several studies in other settings and therefore may be generalizable in other locations and specialties. Given the increasing awareness and concern for physician-spread hospital infection, this study lends support to scrub attire over business or casual attire if physicians do not wear a white coat. LEVEL OF EVIDENCE Level II, therapeutic study.
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Affiliation(s)
- John D. Jennings
- Department of Orthopaedics & Sports Medicine, Temple University Hospital, 3401 North Broad Street, Zone B 5th Floor, Philadelphia, PA 19140 USA
| | - Sophia G. Ciaravino
- Department of Clinical Sciences, Temple University School of Medicine, Philadelphia, PA USA
| | - Frederick V. Ramsey
- Department of Clinical Sciences, Temple University School of Medicine, Philadelphia, PA USA
| | - Christopher Haydel
- Department of Orthopaedics & Sports Medicine, Temple University Hospital, 3401 North Broad Street, Zone B 5th Floor, Philadelphia, PA 19140 USA
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Iram S, Prakash WD, Ali MJ, Dave TV, Naik MN. Preferences of ophthalmic plastics patients and their caregivers toward the doctors' attire and initial communications: A tertiary eye care study. Indian J Ophthalmol 2016; 64:448-51. [PMID: 27488153 PMCID: PMC4991175 DOI: 10.4103/0301-4738.187674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose: The aims of this study were to determine the acceptability levels of different styles of the doctors’ dress and the expectations from the initial phases of physician-patient encounter. Methods: The study design was a cross-sectional descriptive type using the survey methodology. A survey based on a five-point questionnaire was performed on all consecutive patients or their caregivers, aged ≥15, visiting the ophthalmic plastics outpatient clinics at a tertiary eye care institute. The participants were shown three sets of photographs and were required to answer a questionnaire which consisted of five questions. Data collected include participant demographics and their preferences with regards to the physician's attire and initial communications. Results: A total of 300 consecutive responses were analyzed. The mean age of the participants was 37.2 years. Among the participants, 87.6% (263/300) and 90.3% (271/300) preferred a white coat for the male and female physicians, respectively (P < 0.001). The most common second preference was scrubs for both the males and female physicians. 92.3% (277/300) preferred the attire to have an identification display. The overwhelming majority of respondents (95.6%, 287/300) preferred the physicians to address them by their name and 98.6% (296/300) liked if their physicians smiled while addressing them. Conclusions: White coat was the main preferred attire among respondents. Increased awareness of the patient's expectations plays a crucial role in enhancing their satisfaction.
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Affiliation(s)
- Sadiya Iram
- Department of Ophthalmic Plastics Surgery, Ophthalmic Plastics Surgery Service, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Winston D Prakash
- Department of Ophthalmic Plastics Surgery, Ophthalmic Plastics Surgery Service, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Mohammad Javed Ali
- Department of Ophthalmic Plastics Surgery, Ophthalmic Plastics Surgery Service, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Tarjani Vivek Dave
- Department of Ophthalmic Plastics Surgery, Ophthalmic Plastics Surgery Service, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Milind N Naik
- Department of Ophthalmic Plastics Surgery, Ophthalmic Plastics Surgery Service, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
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Snider KT. Establishing a Professionalism Score in an Osteopathic Manipulative Medicine Curriculum. J Osteopath Med 2016; 116:106-13. [DOI: 10.7556/jaoa.2016.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
As osteopathic medical education shifts to competency-based learning, course curriculums must adapt to measure behavioral milestones in addition to traditional knowledge and technical skills. Of the core competencies, medical professionalism or lack thereof has been shown to correlate with future state disciplinary board action; therefore, early identification of poor professionalism and intervention is imperative. However, performance indicators, such as humanistic behavior and primacy of patient need, are difficult to measure in most first- and second-year medical school courses. Therefore, A.T. Still University–Kirksville College of Osteopathic Medicine developed a rubric to objectively measure professionalism within the first- and second-year osteopathic manipulative medicine curriculum. The rubric assesses such measures as timeliness and professional appearance. In the present article, the author describes the grading rubric and the methods for implementing a professionalism score within an osteopathic manipulative medicine curriculum.
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Atasoy N, Şenormanci Ö, Saraçli Ö, Doğan V, Kaygisiz İ, Atik L, Örsel S. The Effect of Dressing Styles and Attitudes of Psychiatrists on Treatment Preferences: Comparison between Patients and Psychiatrists. Noro Psikiyatr Ars 2015; 52:380-385. [PMID: 28360744 DOI: 10.5152/npa.2015.8767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 06/20/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Recently, different dressing styles and attitudes of psychiatrists have been proposed to enhance the interaction between patients and the physician. The aim of the present study was to investigate the preferences of dressing style and attitudes of a psychiatrist of the patients referred to an outpatient psychiatry clinic and the perception of psychiatrists regarding the preferences of the patients. METHODS One hundred and fifty-three patients referred to the outpatient psychiatry clinic of the Bülent Ecevit University School of Medicine, and 94 psychiatrists have been included in the present study. RESULTS When the images of psychiatrists were evaluated in terms of referral for treatment, trust in treatment, and willingness to share their confidential matters, both groups gave minimum scores to causal/sports dress style. While psychiatrists preferred to dress in a suit, casuals, and white coat, the preference order was white coat, casual dress, and suit in the patient group. There was a significant difference between the groups with respect to three dressing styles. CONCLUSION It can be suggested that psychiatrists assume that patients are traditional in terms of their preference of the dressing style of a doctor and doctor-patient relationship, and a white coat is important to enhance the treatment adherence of patients.
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Affiliation(s)
- Nuray Atasoy
- Department of Psychiatry, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey
| | - Ömer Şenormanci
- Department of Psychiatry, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey
| | - Özge Saraçli
- Department of Psychiatry, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey
| | - Veysel Doğan
- Department of Psychiatry, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey
| | - İsmet Kaygisiz
- Department of Psychiatry, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey
| | - Levent Atik
- Department of Psychiatry, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey
| | - Sibel Örsel
- Department of Psychiatry, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey
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Palacios-González C, Lawrence DR. Substance over style: is there something wrong with abandoning the white coat? JOURNAL OF MEDICAL ETHICS 2015; 41:433-436. [PMID: 25048814 PMCID: PMC4453716 DOI: 10.1136/medethics-2013-101900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 06/13/2014] [Accepted: 07/02/2014] [Indexed: 06/03/2023]
Abstract
In this paper, we address points raised by Stephanie Dancer's article in The BMJ in which she claimed that by 'dressing down', physicians fail to adhere to the dignitas of the medical profession, and damage its reputation. At the beginning of this paper, we distinguish between two different senses in which a person can be, as she terms it, 'scruffy'; and then we address Dancer's three main claims. First, we argue that in regard to the medical profession it is fallacious to assume, as she appears to do, that someone is incompetent or irresponsible when such a judgement is grounded in the fact that a physician is not dressed in a formal way. Second, we argue, contrary to her claim, that the dignified nature of the medical profession is in no coherent way linked to sartorial elegance or lack thereof, but rather, that such dignity is bound to the value of the medical practice in itself, to patients, and to society at large. Third, we examine two ways in which doctors can 'dress down' and show that 'scruffiness' does not necessarily intimates a lack of personal hygiene. Finally, we show that pointing to mere statistical correlation without causation, cannot be used as an argument against scruffiness. We conclude by suggesting that in the medical context, it is more appropriate to educate patients than to chastise practitioners for not following arbitrary cultural mores.
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Affiliation(s)
| | - David R Lawrence
- Institute for Science Ethics and Innovation, The University of Manchester, Manchester, UK
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Petrilli CM, Mack M, Petrilli JJ, Hickner A, Saint S, Chopra V. Understanding the role of physician attire on patient perceptions: a systematic review of the literature--targeting attire to improve likelihood of rapport (TAILOR) investigators. BMJ Open 2015; 5:e006578. [PMID: 25600254 PMCID: PMC4312788 DOI: 10.1136/bmjopen-2014-006578] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Despite a growing body of literature, uncertainty regarding the influence of physician dress on patients' perceptions exists. Therefore, we performed a systematic review to examine the influence of physician attire on patient perceptions including trust, satisfaction and confidence. SETTING, PARTICIPANTS, INTERVENTIONS AND OUTCOMES We searched MEDLINE, Embase, Biosis Previews and Conference Papers Index. Studies that: (1) involved participants ≥18 years of age; (2) evaluated physician attire; and (3) reported patient perceptions related to attire were included. Two authors determined study eligibility. Studies were categorised by country of origin, clinical discipline (eg, internal medicine, surgery), context (inpatient vs outpatient) and occurrence of a clinical encounter when soliciting opinions regarding attire. Studies were assessed using the Downs and Black Scale risk of bias scale. Owing to clinical and methodological heterogeneity, meta-analyses were not attempted. RESULTS Of 1040 citations, 30 studies involving 11 533 patients met eligibility criteria. Included studies featured patients from 14 countries. General medicine, procedural (eg, general surgery and obstetrics), clinic, emergency departments and hospital settings were represented. Preferences or positive influence of physician attire on patient perceptions were reported in 21 of the 30 studies (70%). Formal attire and white coats with other attire not specified was preferred in 18 of 30 studies (60%). Preference for formal attire and white coats was more prevalent among older patients and studies conducted in Europe and Asia. Four of seven studies involving procedural specialties reported either no preference for attire or a preference for scrubs; four of five studies in intensive care and emergency settings also found no attire preference. Only 3 of 12 studies that surveyed patients after a clinical encounter concluded that attire influenced patient perceptions. CONCLUSIONS Although patients often prefer formal physician attire, perceptions of attire are influenced by age, locale, setting and context of care. Policy-based interventions that target such factors appear necessary.
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Affiliation(s)
- Christopher Michael Petrilli
- Division of General Internal Medicine, The Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Megan Mack
- Division of General Internal Medicine, The Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Jennifer Janowitz Petrilli
- Division of General Internal Medicine, The Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Andy Hickner
- Division of General Internal Medicine, The Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Cushing/Whitney Medical Library, Yale University, New Haven, Connecticut, USA
| | - Sanjay Saint
- Division of General Internal Medicine, The Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Vineet Chopra
- Division of General Internal Medicine, The Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
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