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Mangham W, Parikh KA, Motiwala M, Gienapp AJ, Roach J, Barats M, Lillard J, Khan N, Arthur A, Michael LM. A Scoping Review of Professionalism in Neurosurgery. Neurosurgery 2024; 94:435-443. [PMID: 37819083 DOI: 10.1227/neu.0000000000002711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/10/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The Accreditation Council for Graduate Medical Education's Milestones provides a foundation for professionalism in residency training. Specific professionalism concepts from neurosurgery could augment and expand milestones for the specialty. We reviewed the current literature and identified professionalism concepts within the context of neurosurgical practice and training. METHODS We used a scoping review methodology to search PubMed/MEDLINE and Scopus and identify English-language articles with the search terms "professionalism" and "neurosurgery." We excluded articles that were not in English, not relevant to professionalism within neurosurgery, or could not be accessed. Non-peer-reviewed and qualitative publications, such as commentaries, were included in the review. RESULTS A total of 193 articles were included in the review. We identified 6 professionalism themes among these results: professional identity (n = 53), burnout and wellness (n = 51), professional development (n = 34), ethics and conflicts of interest (n = 27), diversity and gender (n = 19), and misconduct (n = 9). CONCLUSION These 6 concepts illustrate concerns that neurosurgeons have concerning professionalism. Diversity and gender, professional identity, and misconduct are not specifically addressed in the Accreditation Council for Graduate Medical Education's Milestones. This review could be used to aid the development of organizational policy statements on professionalism.
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Affiliation(s)
- William Mangham
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Kara A Parikh
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Mustafa Motiwala
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Andrew J Gienapp
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis , Tennessee , USA
| | - Jordan Roach
- College of Medicine, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Michael Barats
- College of Medicine, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Jock Lillard
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Nickalus Khan
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Semmes Murphey, Memphis , Tennessee , USA
| | - Adam Arthur
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Semmes Murphey, Memphis , Tennessee , USA
| | - L Madison Michael
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Semmes Murphey, Memphis , Tennessee , USA
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Ethics for Thoracic Surgeons in the Management of Lung Cancer. Thorac Surg Clin 2021; 31:333-336. [PMID: 34304842 DOI: 10.1016/j.thorsurg.2021.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Lung cancer is a terrible disease, with less than 20% of patients with a diagnosis of lung cancer able to have a resection but many relapsing, making it one of the most biologically aggressive cancers known. Thoracic surgeons do not see all the other 80% but are often consulted and have to make recommendations, and sometimes have to intervene. Thoracic surgeons should be well informed about the ethical framework and participate actively in the discussion. Ethics is an important aspect of surgical practice and has implications for patients, surgeons, and surgical teams, as well as for society.
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Boakye KG, Qin H, Blankson C, Hanna MD, Prybutok VR. Operations-oriented strategies and patient satisfaction: the mediating effect of service experience. INTERNATIONAL JOURNAL OF QUALITY AND SERVICE SCIENCES 2021. [DOI: 10.1108/ijqss-11-2020-0186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this study is to explore the direct and indirect effects of perceived provider professionalism and service recovery in enhancing patient satisfaction in a developing country.
Design/methodology/approach
This study used a survey method to investigate satisfaction among health-care consumers. This study used data collected from 210 health-care consumers to empirically test the hypotheses via structural equation modeling
Findings
This study found that service recovery has a significant direct effect on patient satisfaction. Though this study did not find perceived provider professionalism to have a direct effect on patient satisfaction, it found an indirect effect in the relationship via service experience. Thus, service experience fully/completely mediates the relationship between perceived provider professionalism and patient satisfaction, while partially mediating the significant relationship between service recovery and patient satisfaction.
Originality/value
The results further underscore the need for health-care organizations in developing countries to focus on mindfully developing operations-oriented strategies that lead to the delivery of memorable service experiences for patients.
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Urff M, Krüger A, Ruchholtz S, Stibane EC. Catering to the patient - development, validation and psychometric properties of an innovative assessment instrument. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc69. [PMID: 33824905 PMCID: PMC7994873 DOI: 10.3205/zma001465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/14/2020] [Accepted: 09/21/2020] [Indexed: 06/12/2023]
Abstract
Introduction: It has been shown that communication skills acquired during undergraduate medical education are of great importance. Hence, many countries require teaching communication as part of their medical curricula. To assess students' learning progress, "Catering to the Patient", as an aspect of showing empathy, should be evaluated. Since there was no description of a validated instrument fitting for this purpose, one had to be developed. To describe its process of development and its psychometric properties were the aims of this study. Methods: Based on the Calgary-Cambridge Observation Guide (CCOG), items describing catering to the patient were selected and modified. Cognitive pretest interviews were conducted to check understandability. Therefore, 7 raters assessed 1 video each (R=7, V=1). In a following pilot study (R=3, V=10) first psychometric properties were evaluated and necessary corrections in the preliminary evaluation form were carried out before the final evaluation form was used to assess students' ability to cater to the patient and psychometric properties were described in detail (R=2, V=35). Results: The final assessment instrument, "catering to the patient - Marburg evaluation form", contains 11 checklist items and two global ratings (items 12 and 13). In the final evaluation the inter-rater reliability (IRR) ranged from 0 to 0.562, the median was r=0.305. Concerning item 13 (a global rating), 88.6% of the videos were scored with the maximum difference of one point. The internal consistency was very high (Cronbach's α: α=0.937 and α=0.962), and the correlation between the checklist items and the global rating was high (Pearson's r: r=0.856 and r=0.898). Discussion: The assessment instrument "catering to the patient" is suitable for giving feedback and for using it in formative examinations. Its use for summative examinations can be considered. Further examinations should evaluate if a three-point Likert scale could reach higher values and if item 13 can be used as a stand-alone item.
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Affiliation(s)
- Miriam Urff
- Universitätsklinik Freiburg, Klinik für Psychiatrie, Psychotherapie und Psychosomatik im Kindes- und Jugendalter, Freiburg, Germany
| | - Antonio Krüger
- Asklepios Klinik Lich, Unfallchirurgie, Orthopädie, Wirbelsäulen- und Kindertraumatologie, Lich, Germany
| | - Steffen Ruchholtz
- UKGM Standort Marburg, Zentrum für Orthopädie und Unfallchirurgie, Marburg, Germany
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Alkindi M. Preoperative informed consent for mandibular third molar surgeries: A survey analysis in a subset of dentists and oral surgeons in Saudi Arabia. Saudi Dent J 2019; 31:204-211. [PMID: 30983830 PMCID: PMC6445441 DOI: 10.1016/j.sdentj.2018.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/17/2018] [Accepted: 11/27/2018] [Indexed: 11/15/2022] Open
Abstract
Objectives The objective of this study was to identify patterns of obtaining preoperative informed consent from patients undergoing mandibular third molar surgeries, in a subset of general dentists and oral surgeons in Saudi Arabia, and to compare the consenting patterns based on the clinician’s rank, years of experience, place of work and gender. Methods A prospective questionnaire based study was designed and data was obtained through an online survey from 102 participants who were selected for the study. Demographic information, clinician experience, type of informed consent obtained and information related to discussion of legal implications and complications were collected. Descriptive analysis of the obtained data and statistical comparisons using cross tabulation and Pearson Chi-Square test with a 95% significance level (P < 0.05) were done between the independents demographic variables and dependent variables pertaining to patterns of preoperative consenting. Results The survey response rate was 81.3% (n = 83), with 59.04% general dentists and 40.96% oral surgeons. The ratio of male to female respondents was approximately 3:1. Majority of the respondents reported a clinical experience of less than 10 years (77.11%) and were reportedly working in the private sector (73.49%). Nearly 80% of the respondents (79.52%) mentioned obtaining preoperative consent for mandibular third molar surgeries and was significantly higher (p-value – 0.018) among clinicians with more than 5 years of experience (90%). While 38.5% of the respondents indicated obtaining both a written and verbal consent, 53.01% obtained only a verbal consent. Majority of the respondents were aware of the legal implications of obtaining informed consent (81.93%) and disclosed incidental complications to their patients (91.57%). However, differences in the perceived post-operative complications associated with mandibular third molar surgeries were observed between general dentists and oral surgeons. Conclusion The results of this study indicate a good level of knowledge about informed consent for mandibular third molar surgery and its legal implications among the dentists and oral surgeons who were surveyed. However, to avoid painful medico-legal disputes, a written informed consent signed by patients along with a witness should be considered mandatory.
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Affiliation(s)
- Mohammed Alkindi
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Angelos P. “Clinical” Surgical Ethics. THE JOURNAL OF CLINICAL ETHICS 2019. [DOI: 10.1086/jce2019301049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Tebbs J. Videoconferenced Telebehavioral Health Referral Process Adherence. Mil Med 2018; 183:92-98. [PMID: 29635554 PMCID: PMC6927841 DOI: 10.1093/milmed/usx141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 09/19/2017] [Accepted: 12/22/2017] [Indexed: 11/13/2022] Open
Abstract
Background In 2015, the Army mandated 100% digital storage of telehealth consent forms (DA4700) in the Health Artifact and Image Management Solution (HAIMS) system, and a telebehavioral health (TBH) hub clinic set an aim to accomplish this by improving adherence to referral procedures essential to expanding patient access to videoconferenced (VC) behavioral health care. Methods The Knowledge-to-Action (KTA) planned action framework underpinned development of a two-phase, PDSA (Plan-Do-Study-Act) quality improvement project to increase the rates of TBH new intake consent form completeness and upload adherence. First, a provider education initiative addressed form uploads. Second, TBH consultants prepared (signed and sent) intake forms to referring sites for their patients to finalize during the initial VC encounter. A chart review of consecutive new intake encounters compared data extracted from CY2015 Q1 baseline records (n = 65) with data from CY2016 Q1 improvement period records (n = 40). A total of 352 forms were reviewed. Results Referrals (N = 118) that resulted in kept new VC TBH intake visits (n = 105), originated from three military behavioral health clinic referral sites. In CY2016 Q1, all DA4700 consent forms were uploaded to HAIMS. Telehealth treatment and medication consent form upload adherence increased from 94% and 68%, respectively, to 100% (p > 0.05). Form completeness increased from 36% to 95% (p < 0.001), and multiple linear regression analysis predicted an average 59% increase across the three referral sites (sr2 = 0.54). Conclusion Consultant preparation of telehealth new intake consent forms effectively improved form completeness and increased adherence to new intake referral processes essential to this hub clinic expanding patient access to TBH care.
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Affiliation(s)
- Jeffrey Tebbs
- Department of Psychosocial and Community Health, University of Washington School of Nursing, Box 357263, Seattle, WA 98195-7266
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Surgical ethics and the future of surgical practice. Surgery 2018; 163:1-5. [DOI: 10.1016/j.surg.2017.09.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 09/06/2017] [Indexed: 11/22/2022]
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Brandt ML. Sustaining a career in surgery. Am J Surg 2017; 214:707-714. [PMID: 28693842 DOI: 10.1016/j.amjsurg.2017.06.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 06/25/2017] [Accepted: 06/26/2017] [Indexed: 11/29/2022]
Abstract
Surgery is a demanding career with great rewards and equally great challenges. In order to sustain our careers as well as the careers of our colleagues, it is important to understand and address the physical, psychological and spiritual challenges of surgery. With rare exception, the majority of surgery residents and practicing surgeons who prematurely leave surgery do so because they find the work to be physically, emotionally or spiritually incompatible with the vision they have for their life. Understanding these issues and providing solutions to improve surgeon wellness can help prevent societal loss of these highly trained professionals and suffering for surgeons and their families.
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Affiliation(s)
- Mary L Brandt
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
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Thiels CA, Bergquist JR, Pandian TK, Heller SF. Improving Communication Skills and Professionalism Among General Surgery Residents, One Page at a Time. Mayo Clin Proc 2016; 91:539-41. [PMID: 27046531 DOI: 10.1016/j.mayocp.2016.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 01/25/2016] [Accepted: 02/08/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Cornelius A Thiels
- Department of Surgery, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Surgical Outcomes Program, Mayo Clinic, Rochester, MN
| | | | - T K Pandian
- Department of Surgery, Mayo Clinic, Rochester, MN
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