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Kiourtidis K, Nikolaidou S, Rouka E, Lange J, Griva K, Liakopoulos V, Zarogiannis SG. Assessment of the perceptions of health-related quality of life in Greek patients undergoing automated peritoneal dialysis with remote monitoring: A qualitative study. Ther Apher Dial 2024. [PMID: 38923684 DOI: 10.1111/1744-9987.14180] [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: 02/20/2024] [Revised: 05/27/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND This study aimed to explore in depth the lived experience and quality of life outcomes in patients receiving automated peritoneal dialysis (APD) treatment. METHODS The study adhered to the standards of the Consolidated Criteria for Reporting Qualitative Research. A total of 19 APD patients were recruited and assessed using in-depth semi-structured interviews on various aspects of life with respect to APD modality. The interviews were transcribed verbatim and analyzed using Interpretive Phenomenological Analysis. RESULTS Study findings generated five superordinate themes: (a) treatment-free daily routine, (b) sleep disturbances, (c) remote care, (d) limitations of peritoneal dialysis, and (e) the dimension of chronic disease. Further analysis of the material revealed the relationship of these themes with individual patient characteristics. CONCLUSIONS Overall, our findings suggest that APD characteristics contribute to the perceptions of quality of life in patients under dialysis considerably.
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Affiliation(s)
- Kyriakos Kiourtidis
- Primary Health Care Postgraduate Program, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, Larissa, Greece
| | - Sofia Nikolaidou
- Primary Health Care Postgraduate Program, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, Larissa, Greece
| | - Erasmia Rouka
- Department of Nursing, School of Health Sciences, University of Thessaly, GAIOPOLIS, Larissa, Greece
| | | | - Konstantina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Vassilios Liakopoulos
- 2nd Department of Nephrology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sotirios G Zarogiannis
- Primary Health Care Postgraduate Program, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, Larissa, Greece
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, Larissa, Greece
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Yarris LM, Balmer D, Gottlieb-Smith R, Sullivan GM. Editors' Guidance for Submitting Qualitative Research to the Journal of Graduate Medical Education. J Grad Med Educ 2024; 16:246-250. [PMID: 38882410 PMCID: PMC11173034 DOI: 10.4300/jgme-d-24-00389.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/18/2024] Open
Affiliation(s)
- Lalena M Yarris
- is Deputy Editor, Journal of Graduate Medical Education (JGME), and Professor of Emergency Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Dorene Balmer
- is Associate Editor, JGME, Professor of Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Co-Director of Research on Education, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Rachel Gottlieb-Smith
- is Associate Editor, JGME, and Clinical Associate Professor, Department of Pediatrics, Division of Pediatric Neurology, University of Michigan, Ann Arbor, Michigan, USA; and
| | - Gail M Sullivan
- is Editor-in-Chief, JGME, Associate Director for Education, Center on Aging, and Professor of Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA
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Nachtergaele S, De Roo N, Allart J, De Vriendt P, Embo M, Cornelis E. Clinical leadership in nursing homes: A qualitative study of healthcare professionals' perspectives on concept and characteristics. Nurs Open 2024; 11:e2166. [PMID: 38845465 PMCID: PMC11157163 DOI: 10.1002/nop2.2166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 10/03/2023] [Accepted: 04/16/2024] [Indexed: 06/10/2024] Open
Abstract
AIM(S) To conceptualise and identify characteristics of clinical leadership in the nursing home setting. DESIGN A qualitative study using semi-structured focus group interviews and a thematic analysis. METHODS Five semi-structured focus group interviews were conducted with 41 healthcare professionals from nursing and other healthcare disciplines working in nursing homes (such as nurse assistants, licensed practical nurses, registered nurses (RNs), occupational therapists, recreational therapists, psychologists and gerontologists). Qualitative thematic content analysis of the gathered data was done. RESULTS Clinical leaders in nursing homes can be defined as passionate healthcare professionals providing person-centred care with strong communication skills. They are clinical experts in their field and motivated to engage in lifelong learning. They are team players with informal leadership skills. They are visionary, committed, resilient and responsive. Awareness of the definition and the main characteristics of clinical leadership is necessary to facilitate the identification, support and development of healthcare professionals. Focussing on the development of competencies, training courses and monitoring and assessment methods is necessary to improve the evidence of clinical leadership in nursing homes.
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Affiliation(s)
- Sabrina Nachtergaele
- Research and Innovation Centre Health and CareArtevelde University of Applied SciencesGhentBelgium
- Nursing DepartmentArtevelde University of Applied SciencesGhentBelgium
| | - Nele De Roo
- Research and Innovation Centre Health and CareArtevelde University of Applied SciencesGhentBelgium
- Nursing DepartmentArtevelde University of Applied SciencesGhentBelgium
| | - Jolien Allart
- Research and Innovation Centre Health and CareArtevelde University of Applied SciencesGhentBelgium
- Occupational Therapy DepartmentArtevelde University of Applied SciencesGhentBelgium
| | - Patricia De Vriendt
- Research and Innovation Centre Health and CareArtevelde University of Applied SciencesGhentBelgium
- Occupational Therapy DepartmentArtevelde University of Applied SciencesGhentBelgium
- Frailty in Ageing (FRIA) Research Group, Mental Health and Wellbeing Research Group (MENT), Gerontology DepartmentVrije Universiteit BrusselJette (Brussels)Belgium
- Department of Rehabilitation Sciences, Occupational Therapy Research Group, Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium
| | - Mieke Embo
- Research and Innovation Centre Health and CareArtevelde University of Applied SciencesGhentBelgium
- Department of Educational Studies, Faculty of Psychology and Educational SciencesGhent UniversityGhentBelgium
| | - Elise Cornelis
- Research and Innovation Centre Health and CareArtevelde University of Applied SciencesGhentBelgium
- Occupational Therapy DepartmentArtevelde University of Applied SciencesGhentBelgium
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Lyons PG, Gause SA, Eakin MN, O’Brien BC, Santhosh L. Seven Practical Recommendations for Designing and Conducting Qualitative Research in Medical Education. ATS Sch 2024; 5:231-241. [PMID: 38957495 PMCID: PMC11215997 DOI: 10.34197/ats-scholar.2023-0144ps] [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: 12/12/2023] [Accepted: 03/28/2024] [Indexed: 07/04/2024] Open
Abstract
Qualitative research seeks to provide context, nuance, and depth of understanding in regard to systems, behaviors, and/or lived experiences. As such, it plays a key role in many areas of medical education. Composed of myriad methods and methodologies, each of which may be valuable for some areas of inquiry but less so for others, qualitative research can be challenging to design, conduct, and report. This challenge can be conceptualized as ensuring that the study design, conduct, and reporting are "fit for purpose," following directly from a well-formulated research question. In this Perspective, we share seven important and practical recommendations to enhance the design and conduct of high-quality qualitative research in medical education: 1) craft a strong research question, 2) link the study design to this question, 3) assemble a team with diverse expertise, 4) prioritize information power when selecting recruitment and sampling strategies, 5) collect data carefully, 6) rigorously analyze data, and 7) disseminate results that tell a complete story.
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Affiliation(s)
- Patrick G. Lyons
- Department of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Sherie A. Gause
- Department of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Michelle N. Eakin
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Bridget C. O’Brien
- Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Lekshmi Santhosh
- Department of Medicine, University of California, San Francisco, San Francisco, California
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Woodberry N, Bogard C, Cropsey M, DeTemple N, Oster A, Rindflesch A. Understanding Pediatric Physical Therapists' Experiences With Middle Eastern Patients and Arabic Interpreters: A Qualitative Study. Pediatr Phys Ther 2024:00001577-990000000-00084. [PMID: 38743935 DOI: 10.1097/pep.0000000000001108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
PURPOSE The purpose of this study was to explore pediatric physical therapists' (PTs') experiences including successes, challenges, and barriers with cross-cultural communication with Arabic-speaking Middle Eastern children and their families who require interpreter services. METHODS Eight PTs consented to participate in qualitative dyadic interviews. Transcription and interviews were conducted virtually in Microsoft Teams. Quality criteria included member checking for validity and trustworthiness and bracketing to minimize investigator bias. Inductive thematic analysis was used to identify meaning units and major themes. RESULTS The 6 themes that emerged were: fostering therapeutic relationships, practicing culturally sensitive care, communicating intentionally, experiencing successes, recognizing challenges, and tailoring a physical therapy plan of care. Representative quotations support each theme. CONCLUSIONS Therapists perceive their experiences with Arabic-speaking children, families, and interpreters positively despite challenges related to cultural and language barriers. In sharing their experiences, therapists demonstrated self-reflection, openness to learning, and desire to build strong therapeutic alliances.
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Affiliation(s)
- Natalie Woodberry
- Physical Therapy Program, Mayo Clinic School of Health Sciences, Mayo Clinic, Rochester, Minnesota, United States
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Longo UG, Corradini A, Marchetti A, Di Sarno C, D’Angelo C, Arias C, De Marinis MG, de Sire A, Denaro V. I Am Afraid I Will Not Be Able to Walk, That Is What Worries Me-The Experience of Patients with Knee Osteoarthritis before Total Knee Arthroplasty: A Qualitative Study. J Clin Med 2024; 13:2878. [PMID: 38792420 PMCID: PMC11122229 DOI: 10.3390/jcm13102878] [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: 12/27/2023] [Revised: 02/02/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Knee osteoarthritis is the most prevalent type of osteoarthritis. Patients frequently encounter pain triggered by movement that evolves into impaired joint function. Needing persistent rest or having night-time pain signifies advanced disease. Qualitative research is considered the most effective method for comprehending patients' needs and contexts. Methods: This study employed a qualitative research design, allowing the researchers to acquire insights into the patients' beliefs and values, and the contextual factors influencing the formation and expression of these beliefs and values. Results: A cohort of nine patients awaiting total knee replacement (TKR) surgery was included and they were interviewed until data saturation was achieved. The results of the phenomenological analysis resulted in the identification of three themes: "The existence of pain impedes the capacity to participate in daily life activities"; "TKR induced fears and uncertainties regarding the progression of the disease"; "Severe nighttime pain compromising sleep quality". Conclusions: This study analyzes the experiences of people awaiting TKR surgery, emphasizing the importance of addressing their unique needs to improve preoperative education and rehabilitation. In this way, patients' recovery during the postoperative phase can be improved.
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Affiliation(s)
- Umile Giuseppe Longo
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (A.C.); (V.D.)
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Roma, Italy; (C.D.S.); (C.D.)
| | - Alessandra Corradini
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (A.C.); (V.D.)
| | - Anna Marchetti
- Research Unit Nursing Science, Campus Bio-Medico University, 00128 Rome, Italy; (A.M.); (M.G.D.M.)
| | - Chiara Di Sarno
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Roma, Italy; (C.D.S.); (C.D.)
| | - Carlotta D’Angelo
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Roma, Italy; (C.D.S.); (C.D.)
| | - Claudia Arias
- Hospital Nacional Edgardo Rebagliati Martins, Lima 15072, Peru;
| | - Maria Grazia De Marinis
- Research Unit Nursing Science, Campus Bio-Medico University, 00128 Rome, Italy; (A.M.); (M.G.D.M.)
| | - Alessandro de Sire
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Vincenzo Denaro
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (A.C.); (V.D.)
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Roma, Italy; (C.D.S.); (C.D.)
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Simons M, Fisher G, Spanos S, Zurynski Y, Davidson A, Stoodley M, Rapport F, Ellis LA. Integrating training in evidence-based medicine and shared decision-making: a qualitative study of junior doctors and consultants. BMC MEDICAL EDUCATION 2024; 24:418. [PMID: 38637798 PMCID: PMC11027546 DOI: 10.1186/s12909-024-05409-y] [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: 09/04/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND In the past, evidence-based medicine (EBM) and shared decision-making (SDM) have been taught separately in health sciences and medical education. However, recognition is increasing of the importance of EBM training that includes SDM, whereby practitioners incorporate all steps of EBM, including person-centered decision-making using SDM. However, there are few empirical investigations into the benefits of training that integrates EBM and SDM (EBM-SDM) for junior doctors, and their influencing factors. This study aimed to explore how integrated EBM-SDM training can influence junior doctors' attitudes to and practice of EBM and SDM; to identify the barriers and facilitators associated with junior doctors' EBM-SDM learning and practice; and to examine how supervising consultants' attitudes and authority impact on junior doctors' opportunities for EBM-SDM learning and practice. METHODS We developed and ran a series of EBM-SDM courses for junior doctors within a private healthcare setting with protected time for educational activities. Using an emergent qualitative design, we first conducted pre- and post-course semi-structured interviews with 12 junior doctors and thematically analysed the influence of an EBM-SDM course on their attitudes and practice of both EBM and SDM, and the barriers and facilitators to the integrated learning and practice of EBM and SDM. Based on the responses of junior doctors, we then conducted interviews with ten of their supervising consultants and used a second thematic analysis to understand the influence of consultants on junior doctors' EBM-SDM learning and practice. RESULTS Junior doctors appreciated EBM-SDM training that involved patient participation. After the training course, they intended to improve their skills in person-centered decision-making including SDM. However, junior doctors identified medical hierarchy, time factors, and lack of prior training as barriers to the learning and practice of EBM-SDM, whilst the private healthcare setting with protected learning time and supportive consultants were considered facilitators. Consultants had mixed attitudes towards EBM and SDM and varied perceptions of the role of junior doctors in either practice, both of which influenced the practice of junior doctors. CONCLUSIONS These findings suggested that future medical education and research should include training that integrates EBM and SDM that acknowledges the complex environment in which this training must be put into practice, and considers strategies to overcome barriers to the implementation of EBM-SDM learning in practice.
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Affiliation(s)
- Mary Simons
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia.
- Australian Institute of Health Innovation, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia.
| | - Georgia Fisher
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Samantha Spanos
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Yvonne Zurynski
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Andrew Davidson
- Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, VIC, 3050, Australia
| | - Marcus Stoodley
- Department of Clinical Medicine, Macquarie University, Sydney, NSW, 2109, Australia
| | - Frances Rapport
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Louise A Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
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Alhassan AI. Analyzing the application of mixed method methodology in medical education: a qualitative study. BMC MEDICAL EDUCATION 2024; 24:225. [PMID: 38438987 PMCID: PMC10910730 DOI: 10.1186/s12909-024-05242-3] [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: 04/15/2023] [Accepted: 02/28/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Interest in mixed methods methodology within medical education research has seen a notable increase in the past two decades, yet its utilization remains less prominent compared to quantitative methods. This study aimed to investigate the application and integration of mixed methods methodology in medical education research, with a specific focus on researchers' perceptions, strategies, and readiness, including the necessary skills and expertise. This study adheres to the COREQ guidelines for reporting qualitative research. METHODS Faculty members from King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Saudi Arabia, across its three campuses in Riyadh, Jeddah, and Al Ahsa, participated in this study during the 2021-2022 academic year. We conducted 15 in-depth, one-on-one interviews with researchers who had previously used mixed methods in their medical education research. Theoretical saturation was reached with no refusals or dropouts. Data were collected using a semi-structured interview guide developed from literature review and mixed methods guidelines. Thematic analysis was employed to analyze the data, enabling a comprehensive understanding of the participants' perspectives. RESULTS The thematic analysis of the interviews yielded three key themes. The first theme, 'Understanding and Perceptions of Mixed Methods in Medical Education Research,' delved into researchers' depth of knowledge and conceptualization of mixed methods. The second theme, 'Strategies and Integration in Mixed Methods Implementation,' explored how these methodologies are applied and the challenges involved in their integration. The final theme, 'Mastery in Mixed Methods: Prerequisites and Expert Consultation in Research,' highlighted the gaps in readiness and expertise among researchers, emphasizing the importance of expert guidance in this field. CONCLUSION Findings indicate a varied understanding of mixed methods among participants. Some lacked a comprehensive grasp of its application, while others perceived mixed methods primarily as a means to enhance the publication prospects of their studies. There was a general lack of recognition of mixed methods as a guiding methodology for all study aspects, pointing to the need for more in-depth training and resources in this area.
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Affiliation(s)
- Abdulaziz Ibrahim Alhassan
- Department of Medical Education, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
- College of Medicine, Department of Medical Education King Saud bin, Abdulaziz University for Health Sciences (KSAU-HS), KSAU-HS- Riyadh, 11481, +966-11- 4299999, Riyadh, P.O. Box 3660, Saudi Arabia.
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Barroso-Corroto E, Laredo-Aguilera JA, Cobo-Cuenca AI, Carmona-Torres JM. Experiences of nursing students who are victims of dating violence: a qualitative study. BMC Nurs 2024; 23:28. [PMID: 38195560 PMCID: PMC10775457 DOI: 10.1186/s12912-023-01688-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 12/25/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Dating Violence (DV) is a type of Intimate Partner Violence that occurs between young people, and they are those behaviours that cause physical, sexual or psychological harm. OBJECTIVE/AIM To know the experience of university students around dating violence. DESIGN AND METHODS Qualitative study with a phenomenological approach was conducted through semi-structured individual interviews with nursing students' victims of dating violence with the same starting categories. The public involve in this study were nursing students who freely agreed to participate in the interviews and gave their informed consent. RESULTS Eleven nursing students participated, the sample was heterogeneous for gender and sexual diversity. Obtaining results about their experience with dating violence, manifestations of dating violence and cyber violence in their relationships, consequences, formal and informal help seeking and proposals for help as nursing students, among others. CONCLUSION Dating violence is a serious problem that seriously affects the victims and requires the creation of prevention programs. The experiences of university students about DV are mainly painful experiences, with serious consequences for those involved, needing help from their close environment and professional help to overcome the problems generated by their partners. IMPLICATIONS It is important due to the high prevalence of this phenomenon, also among nursing students, to provide key points to future health professionals and victims of dating violence on the correct way to act against violence due to lack of knowledge on the subject. This study clarifies the experiences of dating violence and how to offer help to victims from the informal and professional sphere. TRIAL REGISTRATION This study was approved by the Ethics Committee of Clinical Research of the Health Area of Talavera de la Reina (Toledo) with code 01/2021.
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Affiliation(s)
- Esperanza Barroso-Corroto
- Hospital Universitario de Toledo, Toledo, 45007, Spain
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, Toledo, 45071, Spain
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Toledo, 45071, Spain
| | - José Alberto Laredo-Aguilera
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, Toledo, 45071, Spain
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Toledo, 45071, Spain
| | - Ana Isabel Cobo-Cuenca
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, Toledo, 45071, Spain.
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Toledo, 45071, Spain.
| | - Juan Manuel Carmona-Torres
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, Toledo, 45071, Spain
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Toledo, 45071, Spain
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Lulua DR, Moch S. Symbolic access: medical students' awareness of institutional culture and its influence on learning, a phenomenographic study. BMC MEDICAL EDUCATION 2024; 24:27. [PMID: 38178107 PMCID: PMC10768196 DOI: 10.1186/s12909-023-05001-w] [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: 04/26/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND The discussion of access in medical education has its focus largely on physical and epistemological access, leaving a qualitative gap regarding sociocultural factors which enable access in this context. This study introduces and defines symbolic access, a concept with a specific lens on sociocultural inclusion, and the influence it has on student learning within the South African medical education landscape. METHODS A phenomenographic design was used to explore students' conceptions of symbolic access and its impact on learning. One-on-one exploratory interviews were conducted with fifteen final year medical students at the University of Witwatersrand in Johannesburg. Interviews were analysed using Sjöström and Dahlgren's seven-step phenomenography model. RESULTS Four categories of description were induced, which described students' understanding of symbolic access, these were rejection, disregard, invalidation, and actualization. Four dimensions of variation were discovered expressing the diversity of events which informed the collectives' understanding of the phenomenon. These dimensions were; interactions with educators, peer relationships, educational environment, and race. Categories of description and dimensions of variation formed the Outcome Space, a visual representation of the student experience of symbolic access. The outcome space had a double narrative related to symbolic access; exclusion (major) and actualization (minor). Medical student's chief experience within the medical community was exclusion, however clinical immersion, meaningful participation, peer-relationships, and clinical skills lessons facilitated community enculturation, and impacted learning. CONCLUSION Despite deeply exclusionary experiences throughout their programme, medical students articulated a paradox of both awareness and no awareness of symbolic access. The awareness of symbolic access was predominantly influenced by clinical experiences and clinical immersion during the pre-clinical and clinical years of study. Further, descriptions of valuable learning experiences were connected to clinical events and the involvement with patient care. This study suggests that the actualization of symbolic access and description of meaningful learning experiences are linked. Medical educationalists should design undergraduate curricula with early clinical immersion at the fore and explore symbolic concepts pertaining to access, as they are linked to transformative learning experiences for the medical student.
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Affiliation(s)
- Dina-Ruth Lulua
- Health Science Education and Social Accountability, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Shirra Moch
- Centre for Health Science Education, University of Witwatersrand, Johannesburg, South Africa
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Ibrahim K, Weller S, Elvidge E, Tavener M. Using collaborative autoethnography to explore the teaching of qualitative research methods in medicine. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2023; 28:1467-1483. [PMID: 37106221 PMCID: PMC10136391 DOI: 10.1007/s10459-023-10224-z] [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: 07/12/2022] [Accepted: 03/12/2023] [Indexed: 06/19/2023]
Abstract
This article explores experiences of teaching qualitative research (QR) broadly, and qualitative methods (QM) more specifically in medicine, highlighting the challenges faced, and offering recommendations for overcoming them. Using collective online interviews, collaborative autoethnography (CAE) was employed to generate data comprising educator's reflective accounts of teaching QM in medical schools across two continents. Three main themes were identified through collaborative thematic analysis: making meaningful contributions from a marginalized position; finding our pedagogical feet; and recognizing the translational applicability and value of QR. We reflected on the marginalized positioning of QM in medical curricula and the underestimation of the value of QR to understanding pressing health issues. Analysis of these reflections pointed to a lack of formal training for educators and curriculum space for qualitative approaches. Our teaching pedagogies, developed through our own research experiences, self-reflection and student feedback, were primarily student-centered employing a range of novel approaches designed to foster skills and interest in the craft of QR, and introduce a greater appreciation of the significance of QR approaches to medicine. CAE further allowed us to identify some key recommendations that could help medical educators plan for teaching QM and other research methods more effectively in medicine. Future curriculum development should consider the benefits of exposing learners to a range of methods and approaches from across the qualitative-quantitative spectrum.
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Affiliation(s)
- Kinda Ibrahim
- School of Primary Care, Population Science, and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK.
- National Institute of Health and Care Research (NIHR) Applied Research Collaboration (ARC) Wessex, Southampton, UK.
| | - Susie Weller
- Clinical Ethics, Law and Society - Southampton, Faculty of Medicine, University of Southampton, Southampton, UK
- Clinical Ethics, Law and Society - Oxford, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Elissa Elvidge
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW, Australia
| | - Meredith Tavener
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW, Australia
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Walraven JEW, Verhoeven RHA, van der Hoeven JJM, van der Meulen R, Lemmens VEPP, Hesselink G, Desar IME. Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings. Front Oncol 2023; 13:1178165. [PMID: 37274246 PMCID: PMC10233094 DOI: 10.3389/fonc.2023.1178165] [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: 03/02/2023] [Accepted: 04/27/2023] [Indexed: 06/06/2023] Open
Abstract
Introduction Nowadays nearly every patient with cancer is discussed in a multidisciplinary team meeting (MDTM) to determine an optimal treatment plan. The growth in the number of patients to be discussed is unsustainable. Streamlining and use of computerised clinical decision support systems (CCDSSs) are two major ways to restructure MDTMs. Streamlining is the process of selecting the patients who need to be discussed and in which type of MDTM. Using CCDSSs, patient data is automatically loaded into the minutes and a guideline-based treatment proposal is generated. We aimed to identify the pros and cons of streamlining and CCDSSs. Methods Semi-structured interviews were conducted with Dutch MDTM participants. With purposive sampling we maximised variation in participants' characteristics. Interview data were thematically analysed. Results Thirty-five interviews were analysed. All interviewees agreed on the need to change the current MDTM workflow. Streamlining suggestions were thematised based on standard and complex cases and the location of the MDTM (i.e. local, regional or nationwide). Interviewees suggested easing the pressure on MDTMs by discussing standard cases briefly, not at all, or outside the MDTM with only two to three specialists. Complex cases should be discussed in tumour-type-specific regional MDTMs and highly complex cases by regional/nationwide expert teams. Categorizing patients as standard or complex was found to be the greatest challenge of streamlining. CCDSSs were recognised as promising, although none of the interviewees had made use of them. The assumed advantage was their capacity to generate protocolised treatment proposals based on automatically uploaded patient data, to unify treatment proposals and to facilitate research. However, they were thought to limit the freedom to deviate from the treatment advice. Conclusion To make oncological MDTMs sustainable, methods of streamlining should be developed and introduced. Physicians still have doubts about the value of CCDSSs.
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Affiliation(s)
- Janneke E. W. Walraven
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands
| | - Rob H. A. Verhoeven
- Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands
- Department of Medical Oncology, Amsterdam University Medical Center location University of Amsterdam, Amsterdam, Netherlands
| | | | - Renske van der Meulen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Valery E. P. P. Lemmens
- Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands
| | - Gijs Hesselink
- Department of Intensive Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Ingrid M. E. Desar
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, Netherlands
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Obele M, Mahmoudzadeh S, Parrill A, Ayyanar S, Anuniru O, Sekhri S, Bangar R, Korie I. The Psychosocial Impact of Treating Patients with COVID-19 on Psychiatry Residents in a Community Hospital: a Qualitative Study. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023:1-7. [PMID: 37059966 PMCID: PMC10104691 DOI: 10.1007/s40596-023-01763-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 02/28/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE The authors explored the experiences of psychiatry residents caring for patients during the COVID-19 pandemic on a medical unit. METHODS From June 2020 through December 2020, structured, individual interviews were conducted with psychiatry residents deployed to internal medicine wards in a community hospital to provide medical care to COVID-19 patients for greater than or equal to 1 week. Interviews were recorded, transcribed verbatim, and analyzed using thematic analytical methods. RESULTS Psychiatry residents (n = 16) were interviewed individually for approximately 45 min each. During the interviews, many residents described emotions of fear, anxiety, uncertainty, lack of preparedness, and difficulty coping with high patient mortality rates. Many of the residents expressed concerns regarding insufficient personal protective equipment, with the subsequent worries of their own viral exposure and transmission to loved ones. Multiple residents expressed feeling ill-equipped to care for COVID-19 patients, in some cases stating that utilizing their expertise in mental health would have better addressed the mental health needs of colleagues and patients' families. Participants also described the benefits of processing emotions during supportive group sessions with their program director. CONCLUSIONS The COVID-19 pandemic represents a public health crisis with potential negative impacts on patient care, professionalism, and physicians' well-being and safety. The psychiatry residents and fellows described the overwhelmingly negative impact on their training. The knowledge gained from this study will help establish the role of the psychiatrist not only in future crises but in healthcare as a whole.
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Affiliation(s)
- Marusa Obele
- Nassau University Medical Center, East Meadow, NY, USA.
| | | | | | | | | | - Shiana Sekhri
- Nassau University Medical Center, East Meadow, NY, USA
| | - Rahul Bangar
- Nassau University Medical Center, East Meadow, NY, USA
| | - Ijendu Korie
- Henry Mayo Newhall Hospital, Santa Clarita, CA, USA
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Yao X, Li H, Wen L, Tian Y, Zhang Y, Zhang X, Du S, Li J, Fu H, Yin Z. What learning strategies are commonly used by hospital pharmacists in the process of self-directed learning? A multicentre qualitative study. BMJ Open 2023; 13:e069051. [PMID: 37041050 PMCID: PMC10106029 DOI: 10.1136/bmjopen-2022-069051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
OBJECTIVE As lifelong learners, hospital pharmacists must continually improve their self-directed learning skills. Reasonable learning strategies have been proven to enhance self-directed learning (SDL) significantly. Therefore, this study aims to investigate the SDL strategies used by hospital pharmacists in depth to provide them with a reference for the development of their SDL skills. SETTING The study was conducted in three tertiary hospitals in Henan, China. DESIGN AND PARTICIPANTS This study employed a multicentre qualitative design and lasted 12 months. One-on-one interviews and focus group discussions were used to collect data. All interviews were transcribed verbatim, and the interview data were analysed using the thematic analysis method. Purposive sampling was used to select interviewees (n=17) from three tertiary hospitals in Henan province in central China. RESULTS After conducting data analysis, we summarised 12 learning strategies related to SDL, which were grouped into four themes: use of information resources, application of cognitive strategies, development of learning plans and use of learning platforms. CONCLUSION The findings suggest that classic learning strategies, such as cognitive strategies and the development of learning plans, remain the cornerstones of hospital pharmacists' SDL abilities, while contemporary advances in information technology and changes in learning concepts have enriched the learning resources and learning platforms that are available to hospital pharmacists and have confronted contemporary hospital pharmacists with certain challenges.
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Affiliation(s)
- Xiali Yao
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Hongye Li
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Linlin Wen
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yutong Tian
- Zhengzhou University, Zhengzhou, Henan, China
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yan Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaojian Zhang
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Shuzhang Du
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jun Li
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Hang Fu
- Institute for Hospital Management of Henan Province, Zhengzhou, Henan, China
| | - Zhao Yin
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Institute for Hospital Management of Henan Province, Zhengzhou, Henan, China
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Longo UG, Marchetti A, Corradini A, Candela V, Salvatore G, De Marinis MG, Denaro V. Patients' Perceptions and Experiences during the Pre-Admission Phase for Total Hip Replacement Surgery: A Qualitative Phenomenological Study. J Clin Med 2023; 12:jcm12082754. [PMID: 37109091 PMCID: PMC10145484 DOI: 10.3390/jcm12082754] [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: 03/09/2023] [Revised: 03/30/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
Osteoarthritis negatively impacts the patient's quality of life. Qualitative research is an effective tool in detecting the various emotions experienced by patients with osteoarthritis. Such studies play a crucial role in promoting comprehension of the patient's experiences of health and illness among healthcare professionals, including nurses. The purpose of this study is to examine patients' perceptions during the pre-admission process for total hip replacement (THR). The study utilized a qualitative descriptive methodology with a phenomenological approach. A sample of patients awaiting THR consented to participate in the study and were interviewed until data saturation was achieved. The results of the phenomenological analysis resulted in the identification of three themes: 1-Surgery generates mixed feelings; 2-Pain negatively impacts daily life activities; 3-Pain requires personal strategies to be alleviated. Patients awaiting THR demonstrate frustration and anxiety. They experience intense pain during daily activities, which persists even during night rest.
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Affiliation(s)
- Umile Giuseppe Longo
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Anna Marchetti
- Research Unit Nursing Science, Campus Bio-Medico University, Via Alvaro del Portillo, 21, 00128 Rome, Italy
| | - Alessandra Corradini
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
| | - Vincenzo Candela
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Giuseppe Salvatore
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Maria Grazia De Marinis
- Research Unit Nursing Science, Campus Bio-Medico University, Via Alvaro del Portillo, 21, 00128 Rome, Italy
| | - Vincenzo Denaro
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
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Lin S, Zimmerman E, Datta S, Selby M, Chan T, Fant A. Curated collections for educators: Nine key articles and article series for teaching qualitative research methods. AEM EDUCATION AND TRAINING 2023; 7:e10862. [PMID: 37013134 PMCID: PMC10066497 DOI: 10.1002/aet2.10862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 02/13/2023] [Accepted: 02/23/2023] [Indexed: 06/19/2023]
Abstract
Background Qualitative research explains observations, focusing on how and why phenomena and experiences occur. Qualitative methods go beyond quantitative data and provide critical information inaccessible through quantitative methods. However, at all levels of medical education, there is insufficient exposure to qualitative research. As a result, residents and fellows complete training ill-equipped to appraise and conduct qualitative studies. As a first step to increasing education in qualitative methods, we sought to create a curated collection of papers for faculty to use in teaching qualitative research at the graduate medical education (GME) level. Methods We conducted literature searches on the topic of teaching qualitative research to residents and fellows and queried virtual medical education and qualitative research communities for relevant articles. We searched the reference lists of all articles found through the literature searches and online queries for additional articles. We then conducted a three-round modified Delphi process to select papers most relevant to faculty teaching qualitative research. Results We found no articles describing qualitative research curricula at the GME level. We identified 74 articles on the topic of qualitative research methods. The modified Delphi process identified the top nine articles or article series most relevant for faculty teaching qualitative research. Several articles explain qualitative methods in the context of medical education, clinical care, or emergency care research. Two articles describe standards of high-quality qualitative studies, and one article discusses how to conduct the individual qualitative interview to collect data for a qualitative study. Conclusions While we identified no articles reporting already existing qualitative research curricula for residents and fellows, we were able to create a collection of papers on qualitative research relevant to faculty seeking to teach qualitative methods. These papers describe key qualitative research concepts important in instructing trainees as they appraise and begin to develop their own qualitative studies.
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Affiliation(s)
- Sophia Lin
- Department of Emergency MedicineWeill Cornell MedicineNew YorkNew YorkUSA
| | - Elise Zimmerman
- Division of Emergency Medicine, Department of PediatricsUniversity of California at San DiegoSan DiegoCaliforniaUSA
| | - Suchismita Datta
- Department of Emergency MedicineNew York University Long Island School of MedicineMineolaNew YorkUSA
| | - Maurice Selby
- Department of Emergency MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Teresa Chan
- Division of Emergency Medicine, Division of Education and Innovation, Department of MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Abra Fant
- Department of Emergency MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
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Walraven JEW, Verhoeven RHA, van der Meulen R, van der Hoeven JJM, Lemmens VEPP, Hesselink G, Desar IME. Facilitators and barriers to conducting an efficient, competent and high-quality oncological multidisciplinary team meeting. BMJ Open Qual 2023; 12:bmjoq-2022-002130. [PMID: 36759037 PMCID: PMC9923284 DOI: 10.1136/bmjoq-2022-002130] [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: 09/26/2022] [Accepted: 02/01/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Optimal oncological care nowadays requires discussing every patient in a multidisciplinary team meeting (MDTM). The number of patients to be discussed is rising rapidly due to the increasing incidence and prevalence of cancer and the emergence of new multidisciplinary treatment options. This puts MDTMs under considerable time pressure. The aim of this study is therefore to identify the facilitators and barriers with regard to performing an efficient, competent and high-quality MDTM. METHODS Semistructured interviews were conducted with Dutch medical specialists and residents participating in oncological MDTMs. Purposive sampling was used to maximise variation in participants' professional and demographic characteristics (eg, sex, medical specialist vs resident, specialty, type and location of affiliated hospital). Interview data were systematically analysed according to the principles of thematic content analysis. RESULTS Sixteen medical specialists and 19 residents were interviewed. All interviewees agreed that attending and preparing MDTMs is time-consuming and indicated the need for optimal execution in order to ensure that MDTMs remain feasible in the near future. Four themes emerged that are relevant to achieving an optimal MDTM: (1) organisational aspects; (2) participants' responsibilities and requirements; (3) competences, behaviour and team dynamics and (4) meeting content. Good organisation, a sound structure and functioning information and communication technology facilitate high-quality MDTMs. Multidisciplinary collaboration and adequate communication are essential competences for participants; a lack thereof and the existence of a hierarchy are hindering factors. CONCLUSION Conducting an efficient, competent and high-quality oncological MDTM is facilitated and hindered by many factors. Being aware of these factors provides opportunities for optimising MDTMs, which are under pressure due to the increase in the number of patients to discuss.
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Affiliation(s)
- Janneke E W Walraven
- Department of Medical Oncology, Radboudumc, Nijmegen, The Netherlands .,Department of Research & Development, IKNL, Utrecht, The Netherlands
| | - Rob H A Verhoeven
- Department of Research & Development, IKNL, Utrecht, The Netherlands,Department of Medical Oncology, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | | | - Gijs Hesselink
- Department of Intensive Care, Radboudumc, Nijmegen, The Netherlands,Department of IQ healthcare, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Ingrid M E Desar
- Department of Medical Oncology, Radboudumc, Nijmegen, The Netherlands
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Artificial Intelligence Curriculum Needs Assessment for a Pediatric Radiology Fellowship Program: What, How, and Why? Acad Radiol 2023; 30:349-358. [PMID: 35753935 DOI: 10.1016/j.acra.2022.04.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/16/2022] [Accepted: 04/30/2022] [Indexed: 01/11/2023]
Abstract
RATIONALE AND OBJECTIVES Artificial intelligence (AI) holds enormous potential for improvements in patient care, efficiency, and innovation in pediatric radiology practice. Although there is a pressing need for a radiology-specific training curriculum and formalized AI teaching, few resources are available. The purpose of our study was to perform a needs assessment for the development of an AI curriculum during pediatric radiology training and continuing education. MATERIALS AND METHODS A focus group study using a semistructured moderator-guided interview was conducted with radiology trainees' and attending radiologists' perceptions of AI, perceived competence in interpretation of AI literature, and perceived expectations from radiology AI educational programs. The focus group was audio-recorded, transcribed, and thematic analysis was performed. RESULTS The focus group was held virtually with seven participants. The following themes we identified: (1) AI knowledge, (2) previous training, (3) learning preferences, (4) AI expectations, and (5) AI concerns. The participants had no previous formal training in AI and variability in perceived needs and interests. Most preferred a case-based approach to teaching AI. They expressed incomplete understanding of AI hindered its clinical applicability and reiterated a need for improved training in the interpretation and application of AI literature in their practice. CONCLUSION We found heterogeneity in perspectives about AI; thus, a curriculum must account for the wide range of these interests and needs. Teaching the interpretation of AI research methods, literature critique, and quality control through implementation of specific scenarios could engage a variety of trainees from different backgrounds and interest levels while ensuring a baseline level of competency in AI.
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Kabba JA, Koroma MM, James PB, Kitchen C, Xu S, Chang J, Saeed A, Malik UR, Jiang M, Fang Y. Pilot drug and therapeutic committee programme in Sierra Leone: A descriptive mixed method study. Br J Clin Pharmacol 2023; 89:20-33. [PMID: 33398910 DOI: 10.1111/bcp.14716] [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: 09/10/2020] [Revised: 10/30/2020] [Accepted: 11/29/2020] [Indexed: 11/29/2022] Open
Abstract
AIMS Irrational medicine use is a global crisis, but incidences are proportionately higher in low- and middle-income countries such as Sierra Leone. This study explores the structure, functions and challenges of drug and therapeutics committees (DTCs), an intervention towards irrational medicine use recently piloted in Sierra Leone. METHODS A 2-phase mixed-method study design was used in this study. Firstly, a cross-sectional survey was conducted on all pharmacists who have worked for at least 1 year in DTC-piloted hospitals, using an online questionnaire to assess DTCs' structure, indicators and challenges. In phase 2, all eligible pharmacists were invited for a semistructured online interview using the WhatsApp messaging application to get deeper insights into the key issues that emerged from the survey; however, only 5 of the 7 consented to participate. MS Excel 2019 and NVivo version 12 were respectively used for data management and analysis. RESULTS A total of 6 survey responses and 5 interviews were included in the analysis. Participants are pharmacists from the 7 hospitals in Sierra Leone where DTC was piloted. Most DTCs are comprised of a minimum of 10 members consisting of both medical and hospital administrative staff. The main functions of DTCs are ensuring rational medicines use, monitoring and reporting adverse drug reactions. All 7 hospitals with established pilot DTCs have different subcommittees operating at varying functionality levels, ranging from effective to nonfunctional. The main challenges in DTC functions and maintenance are funding (n = 6), DTC decision implementation (n = 4), and unmotivated members (n = 4). Strategies suggested to improve DTCs at public hospitals and nationwide include resource allocation, monitoring and evaluating DTC functions and its members' capacity building. CONCLUSION DTCs present a compelling opportunity towards achieving rational medicines use at the hospital level in Sierra Leone. Nonetheless, the lack of funding and operational resources are significant limitations that must be noted by policymakers before expanding DTC programmes to other hospitals in Sierra Leone.
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Affiliation(s)
- John Alimamy Kabba
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, China
| | - Mark Momoh Koroma
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Peter Bai James
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Chenai Kitchen
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, China
| | - Sen Xu
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, China
| | - Jie Chang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, China
| | - Amna Saeed
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, China
| | - Usman Rashid Malik
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, China
| | - Minghuan Jiang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, China
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Luo Y, Ran H, Deng Y, Li H, Zhang M, Zhao L. Paid caregivers' experiences of falls prevention and care in China's senior care facilities: A phenomenological study. Front Public Health 2023; 11:973827. [PMID: 36875422 PMCID: PMC9978790 DOI: 10.3389/fpubh.2023.973827] [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: 06/20/2022] [Accepted: 01/25/2023] [Indexed: 02/18/2023] Open
Abstract
Background In China, as population aging accelerates, senior care facilities have gradually become a mainstream option. According to the World Health Organization (WHO), the annual rate of falls has increased from 30 to 50% in senior care facilities. A study found that older adults who live in senior care facilities are three times more likely to fall than those who live in the community. The quality of care is highly related to the occurrence of falls. Therefore, exploring paid caregivers' experiences is very important to prevent falls in senior care facilities. Objective The aim of this study was to explore paid caregivers' experiences of fall prevention and care in China's senior care facilities. Furthermore, we discussed the situation and provided suggestions. Design This is a phenomenological study using face-to-face, in-depth, semi-structured interviews. Setting The study was conducted at four senior care facilities in Changsha, Hunan, China. Participants Fourteen paid caregivers in four senior care facilities, including nursing assistants and senior nurses, participated in this study. Methods A purposive sample method was used to select 14 nursing assistants and senior nurses from four different senior care facilities in Changsha from March to April 2022. Every participant individually completed a face-to-face, in-depth, semi-structured interview. Based on the phenomenological research methodology, the thematic analysis method and the Colaizzi analysis method were used for data analysis and theme extraction. Results Based on interview data, a total of seven themes were distilled: (1) paid caregivers' professional requirements; (2) paid caregivers' attitude toward falls; (3) paid caregivers' fall training and education; (4) paid caregivers' knowledge about falls; (5) paid caregivers' fall risk assessment; (6) paid caregivers' fall prevention; and (7) paid caregivers' fall treatment. Conclusion In China's senior care facilities, paid caregivers to need to be responsible and pay appropriate attention to older adults. First, senior nurses and nursing assistants need to enhance communication and cooperation. Second, they must learn about deficiencies in fall risk assessment and try their best to improve their capability. Third, they must adopt appropriate education methods to improve fall prevention capability. Finally, the protection of privacy should be taken seriously.
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Affiliation(s)
- Yuan Luo
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Haiye Ran
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Yuqian Deng
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Huan Li
- Xiang Ya Second Hospital of Central South University, Changsha, Hunan, China
| | - Mengxi Zhang
- Xiang Ya Second Hospital of Central South University, Changsha, Hunan, China
| | - Liping Zhao
- Xiang Ya Second Hospital of Central South University, Changsha, Hunan, China
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Paranathala MP. Letter to the Editor Regarding "The Value and Potential of Qualitative Research Methods in Neurosurgery". World Neurosurg 2022; 167:231-232. [PMID: 36793163 DOI: 10.1016/j.wneu.2022.07.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022]
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Kazemi SY, Jafari A, Rabiei L, Nikfarjam M, Omidi M, Masoudi R. Exploring the Concept of Spiritual Sensitivity from the Perspectives of Healthcare Providers in Iran. JOURNAL OF RELIGION AND HEALTH 2022; 61:3806-3821. [PMID: 34449006 DOI: 10.1007/s10943-021-01404-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/20/2021] [Indexed: 06/13/2023]
Abstract
Spiritual sensitivity (SS) is defined as attention to the available spiritual values in a conflicting situation and awareness of one's roles and responsibilities in that situation. It helps differentiate between the right and the wrong and leads to sound practice. This study explored the concept of SS from the perspectives of healthcare providers in Iran. This qualitative study was carried out in 2017-2019 using conventional content analysis. Twenty-two physicians, faculty members with clinical work experience, and healthcare providers were purposefully recruited. Data were collected using unstructured interviews and were analyzed using conventional content analysis. Participants' experiences of the concept of SS were grouped into three main themes, namely sense of value, spiritual growth and morale boosting, and SS as a motivator for purposeful service delivery. The findings of the present study will help healthcare managers develop programs for improving healthcare providers' spiritual sensitivity and also will help healthcare providers develop spirituality-based holistic care plans.
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Affiliation(s)
- Seyed Yahya Kazemi
- School of Allied Medical Sciences, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Amirgholi Jafari
- Department of Islamic Studies, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Leili Rabiei
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Masoud Nikfarjam
- Department of Psychiatry, School of Medicine, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Maryam Omidi
- Islamic Medical Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Reza Masoudi
- Community-Oriented Nursing Midwifery Research Center, Department of Adult and Geriatric Nursing, Nursing and Midwifery School, Shahr-e-Kord University of Medical Sciences, Rahmath, Chaharmahal Bakhtiari, Shahr-e-Kord, Iran.
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Yang R, Kabba JA, Yao X, Yang C, Chang J, Ji W, Jiang M, Zhao M, Wen J, Fang Y. Current situation and future development of the biopharmaceutical industry in China: A mixed-method study. Front Pharmacol 2022; 13:911165. [PMID: 36071832 PMCID: PMC9442039 DOI: 10.3389/fphar.2022.911165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/04/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction: The biomedical industry has grown significantly both globally and in China; however, there are still challenges. This study aimed at evaluating the biopharmaceutical sector of China, in terms of ability to innovate, current sales volume, investment, and R&D expenditure, as well as providing a case study detailing the progress and challenges of the industry in Shaanxi province. Method: A cross-sectional mixed-method study design was used to generate a comprehensive profile of the nature of biopharmaceutical innovation capacity and development in China by triangulating country-wide survey and interview data from Shaanxi province. Only biopharmaceutical companies that are currently marketing or conducting research and development were eligible for inclusion, and Shaanxi province was selected for conducting the interviews. Categorical and continuous variables were analyzed descriptively. Interviews were thematically analyzed by using NVivo version 12. Results: The analysis includes responses from 77 biopharmaceutical enterprises; the majority (36, 46.8%) are in Eastern China, followed by 26 (33.8%) in Central China. In 2018, the total sales of biological products amounted to 26.28 billion yuan, and in 2019, a slight increase was observed (30.34 billion); the amount doubled in 2020 to about 67.91 billion yuan. The top three biopharmaceutical products on sale in 2020 were Camrelizumab (5.14 billion yuan), human albumin (4.56 billion yuan), and human immunoglobulin for injection (3.78 billion yuan). Expenditure on R&D has also increased; it amounted to 1657.7 million yuan in 2018, which more than doubled in 2019 to 3572.1 million yuan and further increased to 5857.7 million yuan in 2020. Nonetheless, the progress is not uniform across all provinces, as shown from the results from Shaanxi province, because of lack of local government policies that will impact on the funding, incentives, and market share that motivate the producers. Conclusion: China’s biopharmaceutical industry has expand significantly. The increase in sales indicates that there is an increase in demand for biologicals; moreover, R&D funding is increasing. These are key indicators that influence innovation and development. However, the sector’s capacity to innovate and develop needs to be improved, particularly in the western region, where research and production are relatively weak.
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Affiliation(s)
- Ruomeng Yang
- Department of Industrial Economics and Trade, School of Economics and Finance, Xi’an Jiaotong University, Xi’an, China
| | - John Alimamy Kabba
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an, China
| | - Xuelin Yao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an, China
| | - Caijun Yang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an, China
| | - Jie Chang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an, China
| | - Wenjing Ji
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an, China
| | - Minghuan Jiang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an, China
| | - Mingyue Zhao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an, China
| | - Jun Wen
- Department of Industrial Economics and Trade, School of Economics and Finance, Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Jun Wen, ; Yu Fang,
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an, China
- *Correspondence: Jun Wen, ; Yu Fang,
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Walraven JEW, van der Meulen R, van der Hoeven JJM, Lemmens VEPP, Verhoeven RHA, Hesselink G, Desar IME. Preparing tomorrow's medical specialists for participating in oncological multidisciplinary team meetings: perceived barriers, facilitators and training needs. BMC MEDICAL EDUCATION 2022; 22:502. [PMID: 35761247 PMCID: PMC9238222 DOI: 10.1186/s12909-022-03570-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/20/2022] [Indexed: 05/27/2023]
Abstract
INTRODUCTION The optimal treatment plan for patients with cancer is discussed in multidisciplinary team meetings (MDTMs). Effective meetings require all participants to have collaboration and communication competences. Participating residents (defined as qualified doctors in training to become a specialist) are expected to develop these competences by observing their supervisors. However, the current generation of medical specialists is not trained to work in multidisciplinary teams; currently, training mainly focuses on medical competences. This study aims to identify barriers and facilitators among residents with respect to learning how to participate competently in MDTMs, and to identify additional training needs regarding their future role in MDTMs, as perceived by residents and specialists. METHODS Semi-structured interviews were conducted with Dutch residents and medical specialists participating in oncological MDTMs. Purposive sampling was used to maximise variation in participants' demographic and professional characteristics (e.g. sex, specialty, training duration, type and location of affiliated hospital). Interview data were systematically analysed according to the principles of thematic content analysis. RESULTS Nineteen residents and 16 specialists were interviewed. Three themes emerged: 1) awareness of the educational function of MDTMs among specialists and residents; 2) characteristics of MDTMs (e.g. time constraints, MDTM regulations) and 3) team dynamics and behaviour. Learning to participate in MDTMs is facilitated by: specialists and residents acknowledging the educational function of MDTMs beyond their medical content, and supervisors fulfilling their teaching role and setting conditions that enable residents to take a participative role (e.g. being well prepared, sitting in the inner circle, having assigned responsibilities). Barriers to residents' MDTM participation were insufficient guidance by their supervisors, time constraints, regulations hindering their active participation, a hierarchical structure of relations, unfamiliarity with the team and personal characteristics of residents (e.g. lack of confidence and shyness). Interviewees indicated a need for additional training (e.g. simulations) for residents, especially to enhance behavioural and communication skills. CONCLUSION Current practice with regard to preparing residents for their future role in MDTMs is hampered by a variety of factors. Most importantly, more awareness of the educational purposes of MDTMs among both residents and medical specialists would allow residents to participate in and learn from oncological MDTMs. Future studies should focus on collaboration competences.
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Affiliation(s)
- Janneke E W Walraven
- Department of Medical Oncology, Radboud University Medical Center, Postbus 9101, huispost 415, 6500, HB, Nijmegen, The Netherlands.
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, Goldebaldkwartier 419, Utrecht, DT, 3511, The Netherlands.
| | - Renske van der Meulen
- Department of Medical Oncology, Radboud University Medical Center, Postbus 9101, huispost 415, 6500, HB, Nijmegen, The Netherlands
| | - Jacobus J M van der Hoeven
- Department of Medical Oncology, Radboud University Medical Center, Postbus 9101, huispost 415, 6500, HB, Nijmegen, The Netherlands
| | - Valery E P P Lemmens
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, Goldebaldkwartier 419, Utrecht, DT, 3511, The Netherlands
| | - Rob H A Verhoeven
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, Goldebaldkwartier 419, Utrecht, DT, 3511, The Netherlands
- Department of Medical Oncology, Cancer Centers Amsterdam, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | - Gijs Hesselink
- Department of Intensive Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Postbus 9101, huispost 707, 6500, HB, Nijmegen, The Netherlands
| | - Ingrid M E Desar
- Department of Medical Oncology, Radboud University Medical Center, Postbus 9101, huispost 415, 6500, HB, Nijmegen, The Netherlands
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Owolabi J, Ojiambo R, Seifu D, Nishimwe A, Masimbi O, Okorie CE, Ineza D, Bekele A. African Medical Educators and Anatomy Teachers' Perceptions and Acceptance of the Anatomage Table as an EdTech and Innovation: A Qualitative Study. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:595-607. [PMID: 35693029 PMCID: PMC9186529 DOI: 10.2147/amep.s358702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 05/27/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND This article presents a qualitative study of African anatomists and anatomy teachers on the Anatomage Table-a modern medical education technology and innovation, as an indicator of African anatomy medical and anatomy educators' acceptance of EdTech. The Anatomage Table is used for digital dissection, prosection, functional anatomy demonstration, virtual simulation of certain functions, and interactive digital teaching aid. MATERIALS AND METHODS Anatomy teachers [n=79] from 11 representative African countries, Ghana, Nigeria [West Africa], Ethiopia, Kenya, Rwanda [East Africa], Namibia [South Africa], Zambia [Southern Africa], Egypt [North Africa], and Sudan [Central Africa], participated in this study. Focus group discussions [FGDs] were set up to obtain qualitative information from stakeholders from representative institutions. In addition, based on the set criteria, selected education leaders and stakeholders in representative institutions participated in In-depth Interviews [IDIs]. The interview explored critical issues concerning their perceptions about the acceptance, adoption, and integration of educational technology, specifically, the Anatomage Table into the teaching of Anatomy and related medical sciences in the African continent. Recorded interviews were transcribed and analyzed using the Dedoose software. RESULTS African anatomists are generally technology inclined and in favor of EdTech. The most recurring opinion was that the Anatomage Table could only be a "complementary teaching tool to cadavers" and that it "can't replace the real-life experience of cadavers." Particularly, respondents from user institutions opined that it "complements the traditional cadaver-based approaches" to anatomy learning and inquiry, including being a good "complement for cadaveric skill lab" sessions. Compared with the traditional cadaveric dissections a majority also considered it less problematic regarding cultural acceptability and health and safety-related concerns. The lifelikeness of the 3D representation is a major factor that drives acceptability.
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Affiliation(s)
- Joshua Owolabi
- Department of Anatomy, Division of Basic Medical Science, University of Global Health Equity, Butaro, Rwanda
| | - Robert Ojiambo
- Department of Physiology, Division of Basic Medical Science, University of Global Health Equity, Butaro, Rwanda
| | - Daniel Seifu
- Department of Biochemistry, Division of Basic Medical Science, University of Global Health Equity, Butaro, Rwanda
| | - Arlene Nishimwe
- Division of Basic Medical Science, University of Global Health Equity, Butaro, Rwanda
| | - Ornella Masimbi
- The UGHE Simulation Centre, University of Global Health Equity, Butaro, Rwanda
| | | | - Darlene Ineza
- Division of Basic Medical Science, University of Global Health Equity, Butaro, Rwanda
| | - Abebe Bekele
- School of Medicine, University of Global Health Equity, Butaro, Rwanda
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Solotke MT, Crabtree J, Cron J, Kallen A, Encandela J, Vash-Margita A. Multifaceted Approach to Evaluation in a Pediatric and Adolescent Gynecology Rotation for Medical Students. J Pediatr Adolesc Gynecol 2022; 35:270-276. [PMID: 34906684 DOI: 10.1016/j.jpag.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 11/02/2021] [Accepted: 12/02/2021] [Indexed: 11/18/2022]
Abstract
STUDY OBJECTIVE We evaluated whether and to what extent a novel medical student rotation in pediatric and adolescent gynecology (PAG) increases clinical knowledge and skills and meets student needs and expectations. DESIGN Constructivist prospective pre-post study and post-rotation student survey SETTING: Academic medical center PARTICIPANTS: Pilot study of 9 medical students, which represents the entire population of those who completed the rotation. INTERVENTIONS Four-week clinical rotation in PAG MAIN OUTCOME MEASURES: Changes in clinical knowledge were measured by a pre- and post-intervention multiple-choice assessment, and clinical skills were assessed before and after the intervention using entrustable professional activities (EPAs); these data were analyzed with paired Student's t tests. Student evaluations of the rotation were measured through an anonymous, end-of-rotation, closed- and open-ended survey and were analyzed using descriptive statistics. RESULTS A statistically significant increase in clinical knowledge was observed post-rotation, with a mean pretest score of 67.0% (standard deviation [SD] 1.7%) and a mean posttest score of 75.2% (SD 3.2%, P = 0.02). Statistically significant increases were observed for all EPAs between the first and final day of the rotation. Eight students who completed the post-rotation survey rated the rotation favorably (5 on a scale from 1 to 5). CONCLUSION A multipronged evaluation showed that a new PAG clinical rotation significantly increased medical students' clinical skills and knowledge. This multifaceted evaluation method provides valuable insights to educators on how best to tailor a rotation to individual learners' levels of clinical skills and knowledge. If comparable rotations could be instituted and similarly evaluated in other medical schools, a noticeable knowledge/skill gap among trainees might be addressed.
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Affiliation(s)
- Michael T Solotke
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Janice Crabtree
- Department of Obstetrics, Gynecology, & Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut
| | - Julia Cron
- Department of Obstetrics & Gynecology, Weill Cornell Medical College, New York, New York
| | - Amanda Kallen
- Department of Obstetrics, Gynecology, & Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut
| | - John Encandela
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; Teaching & Learning Center, Yale School of Medicine, New Haven, Connecticut
| | - Alla Vash-Margita
- Department of Obstetrics, Gynecology, & Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut.
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Reid JR, Gokli A. Elevating Radiology Education Research Through a Dedicated Research Fellowship: Adding Professional Identity as Essential for Success. Acad Radiol 2022; 29 Suppl 5:S48-S57. [PMID: 33277111 DOI: 10.1016/j.acra.2020.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 11/01/2020] [Accepted: 11/02/2020] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVES Education research has been undervalued in radiology, with few radiology journals having dedicated space for such research and barriers to production including dedicated time, resources, grant funding, and mentorship. As radiologists, we have an opportunity to study education in our unique learning environments and create more effective ways to teach that are grounded in established education theory, solid assessment methodologies, and a focus on merit as well as worth. MATERIALS AND METHODS The growth of education research in our field requires a two-pronged approach; We must cultivate leaders in education research from within our specialty, and continue to submit high quality work to radiology journals to increase exposure of the reviewers and readership to education methodologies. RESULTS We have created the first radiology education research fellowship to this end. This manuscript details the fellowship creation process, the first education research fellow experience, and in-depth analysis of the inaugural year via a qualitative program review. CONCLUSION We were successful in supporting an inaugural fellow in attaining the knowledge and skills to become a productive education researcher. Beyond this, the fellowship experience was a catalyst in developing her unique professional identity as an education master which will further raise the status of education research in pediatric radiology.
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Patel MD, Jordan SG. Medical Education Research Design. J Am Coll Radiol 2022; 19:693-698. [DOI: 10.1016/j.jacr.2022.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 10/18/2022]
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Gin BC, Tsoi S, Sheu L, Hauer KE. How supervisor trust affects early residents' learning and patient care: A qualitative study. PERSPECTIVES ON MEDICAL EDUCATION 2021; 10:327-333. [PMID: 34297348 PMCID: PMC8633204 DOI: 10.1007/s40037-021-00674-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Trust between supervisors and trainees mediates trainee participation and learning. A resident (postgraduate) trainee's understanding of their supervisor's trust can affect their perceptions of their patient care responsibilities, opportunities for learning, and overall growth as physicians. While the supervisor perspective of trust has been well studied, less is known about how resident trainees recognize supervisor trust and how it affects them. METHODS In this qualitative study, 21 pediatric residents were interviewed at a single institution. Questions addressed their experiences during their first post-graduate year (PGY-1) on inpatient wards. Each interviewee was asked to describe three different patient care scenarios in which they perceived optimal, under-, and over-trust from their resident supervisor. Data were analyzed using thematic analysis. RESULTS Residents recognized and interpreted their supervisor's trust through four factors: supervisor, task, relationship, and context. Optimal trust was associated with supervision balancing supervisor availability and resident independence, tasks affording participation in decision-making, trusting relationships with supervisors, and a workplace fostering appropriate autonomy and team inclusivity. The effects of supervisor trust on residents fell into three themes: learning experiences, attitudes and self-confidence, and identities and roles. Optimal trust supported learning via tailored guidance, confidence and lessened vulnerability, and a sense of patient ownership and team belonging. DISCUSSION Understanding how trainees recognize supervisor trust can enhance interventions for improving the dialogue of trust between supervisors and trainees. It is important for supervisors to be cognizant of their trainees' interpretations of trust because it affects how trainees understand their patient care roles, perceive autonomy, and approach learning.
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Affiliation(s)
- Brian C Gin
- Department of Pediatrics, University of California-San Francisco, San Francisco, CA, USA.
| | - Stephanie Tsoi
- Department of Pediatrics, University of California-San Francisco, San Francisco, CA, USA
| | - Leslie Sheu
- Department of Medicine, University of California-San Francisco, San Francisco, CA, USA
| | - Karen E Hauer
- Department of Medicine, University of California-San Francisco, San Francisco, CA, USA
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Peng CR, Schertzer KA, Caretta-Weyer HA, Sebok-Syer SS, Lu W, Tansomboon C, Gisondi MA. Assessment of Entrustable Professional Activities Using a Web-Based Simulation Platform During Transition to Emergency Medicine Residency: Mixed Methods Pilot Study. JMIR MEDICAL EDUCATION 2021; 7:e32356. [PMID: 34787582 PMCID: PMC8663509 DOI: 10.2196/32356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The 13 core entrustable professional activities (EPAs) are key competency-based learning outcomes in the transition from undergraduate to graduate medical education in the United States. Five of these EPAs (EPA2: prioritizing differentials, EPA3: recommending and interpreting tests, EPA4: entering orders and prescriptions, EPA5: documenting clinical encounters, and EPA10: recognizing urgent and emergent conditions) are uniquely suited for web-based assessment. OBJECTIVE In this pilot study, we created cases on a web-based simulation platform for the diagnostic assessment of these EPAs and examined the feasibility and acceptability of the platform. METHODS Four simulation cases underwent 3 rounds of consensus panels and pilot testing. Incoming emergency medicine interns (N=15) completed all cases. A maximum of 4 "look for" statements, which encompassed specific EPAs, were generated for each participant: (1) performing harmful or missing actions, (2) narrowing differential or wrong final diagnosis, (3) errors in documentation, and (4) lack of recognition and stabilization of urgent diagnoses. Finally, we interviewed a sample of interns (n=5) and residency leadership (n=5) and analyzed the responses using thematic analysis. RESULTS All participants had at least one missing critical action, and 40% (6/15) of the participants performed at least one harmful action across all 4 cases. The final diagnosis was not included in the differential diagnosis in more than half of the assessments (8/15, 54%). Other errors included selecting incorrect documentation passages (6/15, 40%) and indiscriminately applying oxygen (9/15, 60%). The interview themes included psychological safety of the interface, ability to assess learning, and fidelity of cases. The most valuable feature cited was the ability to place orders in a realistic electronic medical record interface. CONCLUSIONS This study demonstrates the feasibility and acceptability of a web-based platform for diagnostic assessment of specific EPAs. The approach rapidly identifies potential areas of concern for incoming interns using an asynchronous format, provides feedback in a manner appreciated by residency leadership, and informs individualized learning plans.
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Affiliation(s)
- Cynthia R Peng
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Kimberly A Schertzer
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Holly A Caretta-Weyer
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Stefanie S Sebok-Syer
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - William Lu
- Cornell University College of Engineering, Ithaca, NY, United States
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Velez-Florez MC, Reid JR, Gokli A. The value of qualitative inquiry in medical education research: evaluation of three successful publications. Pediatr Radiol 2021; 51:1284-1289. [PMID: 33630104 DOI: 10.1007/s00247-021-05002-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/16/2020] [Accepted: 02/08/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Maria C Velez-Florez
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.
| | - Janet R Reid
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Ami Gokli
- Department of Radiology, Staten Island University Hospital, Staten Island, NY, USA
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Glasofer A, Townsend AB. Determining the level of evidence: Nonexperimental research designs. Nursing 2021; 51:62-65. [PMID: 33953103 DOI: 10.1097/01.nurse.0000731852.39123.e1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT To support evidence-based nursing practice, the authors provide guidelines for appraising research based on quality, quantity, and consistency. This article, the second of a three-part series, focuses on nonexperimental research designs.
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Affiliation(s)
- Amy Glasofer
- Amy Glasofer is a nurse scientist at Virtua Center for Learning in Mt. Laurel, N.J., and Ann B. Townsend is an adult NP with The Nurse Practitioner Group, LLC
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Experience of women with breast cancer undergoing chemotherapy: a systematic review of qualitative research. Qual Life Res 2021; 30:1249-1265. [DOI: 10.1007/s11136-020-02754-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 01/26/2023]
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Goldhaber-Fiebert SN, Bereknyei Merrell S, Agarwala AV, De La Cruz MM, Cooper JB, Howard SK, Asch SM, Gaba DM. Clinical Uses and Impacts of Emergency Manuals During Perioperative Crises. Anesth Analg 2020; 131:1815-1826. [PMID: 33197160 DOI: 10.1213/ane.0000000000005012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Performing key actions efficiently during crises can determine clinical outcomes, yet even expert clinicians omit key actions. Simulation-based studies of crises show that correct performance of key actions dramatically increases when emergency manuals (EMs) are used. Despite widespread dissemination of EMs, there is a need to understand in clinical contexts, when, how, and how often EMs are used and not used, along with perceived impacts. METHODS We conducted interviews with the anesthesia professionals involved in perioperative crises, identified with criterion-based sampling, occurring between October 2014 and May 2016 at 2 large academic medical centers with a history of EM training and implementation. Our convergent, mixed-methods study of the interview data extracted quantitative counts and qualitative themes of EM use and nonuse during clinical crises. RESULTS Interviews with 53 anesthesia professionals yielded 80 descriptions of applicable clinical crises, with varying durations and event types. Of 69 unique patients whose cases involved crises, the EM was used during 37 (54%; 95% confidence interval [CI], 41-66). Impacts on clinician team members included decreased stress for individual anesthesia professionals (95%), enabled teamwork (73%), and calmed atmosphere (46%). Impacts on delivery of patient care included specific action improvements, including catching errors of omission, for example, turning off anesthetic during cardiac arrest, only after EM use (59%); process improvements, for example, double-checking all actions were completed (41%); and impediments (0%). In 8% of crises, EM use was associated with potential distractions, although none were perceived to harm delivery of patient care. For 32 EM nonuses (46%; 95% CI, 34-59), participants self-identified errors of omission or delays in key actions (56%), all key actions performed (13%), and crisis too brief for EM to be used (31%). CONCLUSIONS This study provides evidence that EMs in operating rooms are being used during many applicable crises and that clinicians perceive EM use to add value. The reported negative effects were minimal and potentially offset by positive effects.
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Affiliation(s)
- Sara N Goldhaber-Fiebert
- From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Sylvia Bereknyei Merrell
- Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Aalok V Agarwala
- Department of Anesthesia, Massachusetts Eye and Ear, Boston, Massachusetts.,Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Monica M De La Cruz
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Jeffrey B Cooper
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Steven K Howard
- From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California.,Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Steven M Asch
- Division of Primary Care and Population Health, Veterans Affairs Palo Alto Health Care System, Stanford University School of Medicine, Stanford, California
| | - David M Gaba
- From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California.,Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
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Demystifying research in medical education: a novel framework, resources, and ethical challenges. Int Anesthesiol Clin 2020; 58:46-51. [PMID: 32804874 DOI: 10.1097/aia.0000000000000289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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