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Thind K, Bauer P, Titus H, Niess M, Hasan R. Early longitudinal experiences increase medical student self-efficacy. MEDEDPUBLISH 2021; 10:142. [PMID: 38486608 PMCID: PMC10939551 DOI: 10.15694/mep.2021.000142.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Background: The purpose of this study was to investigate the impact of early longitudinal preceptorship experiences on the evolution of general self-efficacy and patient-centeredness self-efficacy through medical school. Methods:Validated surveys for general self-efficacy and patient-centeredness self-efficacy were administered in an allopathic medical school at three timepoints. These data were stratified by traditional and longitudinal preceptorship groups and analyzed using Generalized Estimating Equations. Qualitative analysis of narrative medicine essays by the same cohort during their preceptorship experiences was also performed. Results: While general self-efficacy remained largely unchanged over time, patient-centeredness self-efficacy measures increased throughout medical school in the whole cohort (N=157). The longitudinal preceptorship group had higher gains in patient-centeredness self-efficacy, especially in the domain of exploring patient perspectives (p<0.05). The qualitative analysis of narrative medicine essays showed those in longitudinal preceptorships were more likely to discuss health care systems issues, consider psychosocial factors, and perceive themselves as active members of the care team. Discussion:Our study indicates greater patient-centeredness attitudes over time among students who have early longitudinal experiences, perhaps due to the self-efficacy building nature of these experiences. Our research suggest that medical school programs should consider incorporating opportunities for early longitudinal clinical experiences for their students.
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Zengin Akkus P, Ilter Bahadur E, Coskun A, Koken G, Karahan S, Ozmert EN. Family-centred service: Perspectives of paediatric residents from a non-Western country. Child Care Health Dev 2020; 46:275-282. [PMID: 31984522 DOI: 10.1111/cch.12753] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 01/10/2020] [Accepted: 01/11/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The concept of family-centred service (FCS), which is recognized as the standard of paediatric health care, emerged from Western countries, and integration of FCS can be challenging especially in non-Western countries. This study aims to explore family-centred behaviours of paediatric residents and their perspectives on FCS being trained in a non-Western country before and 6 months after an educational workshop. It was hypothesized that the workshop will increase the awareness of paediatric residents regarding FCS and improve their self-reported family-centred practices. STUDY DESIGN Ninety-nine residents who are in a 4-year paediatric residency program were included. A 2-hr interactive workshop was conducted for all participants. The measure of processes of care for service providers was used to measure self-reported family-centred practices of paediatric residents, and a study specific questionnaire was utilized to understand their perspectives towards FCS prior to and 6 months after the workshop. RESULTS There were statistically significant increases in the measure of processes of care for service providers scores suggesting improvements in self-reported family-centred practices of participants 6 months after the workshop. Moreover, the percentage of participants describing themselves as knowledgeable and competent increased. Viewpoints of paediatric residents on the implementation of FCS and several challenges perceived by participants were highlighted. CONCLUSION This is the first study conducted in a non-Western country exploring perspectives of paediatric residents towards the implementation of FCS and measuring their self-reported family-centred practices before and after an educational workshop. The study revealed that although a 2-hr interactive workshop improved the self-reported family-centred practices of participants, they still found FCS challenging.
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Affiliation(s)
- Pinar Zengin Akkus
- Department of Pediatrics, Division of Developmental Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Evin Ilter Bahadur
- Department of Pediatrics, Division of Developmental Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Aysenur Coskun
- Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gizem Koken
- Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sevilay Karahan
- Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Elif Nursel Ozmert
- Department of Pediatrics, Division of Developmental Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Humanization interventions in general pediatric wards: a systematic review. Eur J Pediatr 2019; 178:607-622. [PMID: 30949888 DOI: 10.1007/s00431-019-03370-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 02/23/2019] [Accepted: 03/20/2019] [Indexed: 02/07/2023]
Abstract
Humanization of care (HOC) interventions have rarely been evaluated and compared. We systematically reviewed the outcomes of published interventions aimed to improve the HOC for hospitalized children. PubMed and Scopus were used as data sources. Studies published between January 1, 2000, and February 28, 2018, were considered eligible if they reported analysis of results vs. either a control group or baseline, or if they measured patient/family/staff satisfaction. Neonatal age, emergency departments, and subspecialty settings were excluded. Data were extracted using a standardized data extraction form including study design, sample size, intervention, outcome/objective, and evaluation of results or pre- post-intervention satisfaction. Twenty-eight of the 12,012 retrieved articles met the inclusion criteria. Most studies were of moderate to low quality. Only six studies were of high quality. Areas of interest dealt with environment (n = 4), provider-patient relationship (n = 6), pet therapy (n = 5), technology (n = 5), family-centered rounds (n = 2), psychological support (n = 3), and staff training (n = 3). The overall trend of the results indicated that interventions were mostly effective and likely to have beneficial effects on several aspects of pediatric hospitalization.Conclusions: Pending further studies of better research quality, the findings of this review may have policy and practice implications for planning HOC interventions by pediatric healthcare professionals. What is Known: • In pediatrics, humanization of care (HOC) provides assistance focused not only on the child as a patient, but on the whole family. • HOC programs have been developed, but information on the overall outcome of local projects aiming to improve in a practical way the hospital taking charge of pediatric patients is still lacking. What is New: • Local HOC interventions are mostly effective and have beneficial effects on several aspects of hospitalization in general pediatrics wards. • The findings of this review may have practice implications for planning HOC interventions by pediatric healthcare professionals.
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Turchi RM, Narayan A, Esquivel M, Serwint JR. Needs Assessment for a Medical Home Curriculum for Pediatric Residents. Glob Pediatr Health 2017; 4:2333794X17740301. [PMID: 29164176 PMCID: PMC5682582 DOI: 10.1177/2333794x17740301] [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: 10/09/2017] [Accepted: 10/09/2017] [Indexed: 11/16/2022] Open
Abstract
Several studies and the Accreditation Council for Graduate Medical Education recommend integration of medical home (MH) concepts into pediatric resident training. There is a paucity of research depicting the current landscape of pediatric resident MH education. We hypothesized formal MH curricula in pediatric residency education are limited and pediatric residency programs desire incorporating MH education into curricula. A national needs assessment of pediatric residency programs was conducted assessing inclusion of MH concepts in training. Outcomes assessed were perceived importance of including MH concepts, satisfaction of current curriculum, content taught, resources available, and barriers encountered. Fifty-six programs (28%) completed the survey, majority academic programs. Nearly 75% indicated interest in incorporating MH concepts. Fifty-one percent of programs reported faculty knowledgeable in MH concepts/implementation and 11% reported access to readily available resources. Barriers included resident schedules, faculty teaching time, funding, and not faculty priority. Pediatric program directors report interest and need for improved MH training but identify implementation barriers.
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Affiliation(s)
- Renee M. Turchi
- St. Christopher’s Hospital for Children, Philadelphia, PA, USA
- Drexel University School of Public Health, Philadelphia, PA, USA
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Wang J, Zou R, Fu H, Qian H, Yan Y, Wang F. Measuring the preference towards patient-centred communication with the Chinese-revised Patient-Practitioner Orientation Scale: a cross-sectional study among physicians and patients in clinical settings in Shanghai, China. BMJ Open 2017; 7:e016902. [PMID: 28928188 PMCID: PMC5623567 DOI: 10.1136/bmjopen-2017-016902] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/30/2017] [Accepted: 07/14/2017] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To adapt the Patient-Practitioner Orientation Scale (PPOS), to a Chinese context, and explore the preference towards patient-centred communication among physicians and patients with the Chinese-revised Patient-Practitioner Orientation Scale (CR-PPOS). DESIGN A cross-sectional questionnaire-based study. SETTING Clinical settings from eight medical units, including four community hospitals and four general hospitals, in Shanghai, China. PARTICIPANTS 1018 participants, including 187 physicians and 831 patients, completed this study in two successive stages. OUTCOME MEASUREMENTS Psychometric properties of the CR-PPOS and participants' score on the CR-PPOS. RESULTS Compared with the original PPOS, the 11-item CR-PPOS obtained better psychometric indices. Physicians and patients scored differently on both the total CR-PPOS and its two subscales. Compared with physicians, the scores of patients were more influenced by their personal characteristics, such as age and education. CONCLUSIONS The CR-PPOS is a better instrument in a Chinese context than the original translated version. The divergence in the extent to which patient-centred communication is preferred among Chinese physicians and patients should be noted. Adapting physicians' communication strategy to patients' preferences based on their personal characteristics can be a viable approach towards improving clinical efficiency.
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Affiliation(s)
- Jie Wang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Runyu Zou
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hua Fu
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Haihong Qian
- School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Yueren Yan
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
- School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Fan Wang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
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Tripodi M, Siano MA, Mandato C, De Anseris AGE, Quitadamo P, Guercio Nuzio S, Viggiano C, Fasolino F, Bellopede A, Annunziata M, Massa G, Pepe FM, De Chiara M, Siani P, Vajro P. Humanization of pediatric care in the world: focus and review of existing models and measurement tools. Ital J Pediatr 2017; 43:76. [PMID: 28854953 PMCID: PMC5577665 DOI: 10.1186/s13052-017-0394-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 08/17/2017] [Indexed: 12/31/2022] Open
Abstract
Background The term “humanization” indicates the process by which people try to make something more human and civilized, more in line with what is believed to be the human nature. The humanization of care is an important and not yet a well-defined issue which includes a wide range of aspects related to the approach to the patient and care modalities. In pediatrics, the humanization concept is even vaguer due to the dual involvement of both the child and his/her family and by the existence of multiple proposed models. Objective The present study aims to analyze the main existing humanization models regarding pediatric care, and the tools for assessing its grade. Results The main Humanization care programs have been elaborated and developed both in America (Brazil, USA) and Europe. The North American and European models specifically concern pediatric care, while the model developed in Brazil is part of a broader program aimed at all age groups. The first emphasis is on the importance of the family in child care, the second emphasis is on the child’s right to be a leader, to be heard and to be able to express its opinion on the program’s own care. Several tools have been created and used to evaluate humanization of care programs and related aspects. None, however, had been mutually compared. Conclusions The major models of humanization care and the related assessment tools here reviewed highlight the urgent need for a more unifying approach, which may help in realizing health care programs closer to the young patient’s and his/her family needs. Electronic supplementary material The online version of this article (10.1186/s13052-017-0394-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marina Tripodi
- Cattedra di Pediatria, Dipartimento di Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana", Università di Salerno , Via Allende, Baronissi (Salerno), 84081, Italy
| | - Maria Anna Siano
- Cattedra di Pediatria, Dipartimento di Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana", Università di Salerno , Via Allende, Baronissi (Salerno), 84081, Italy
| | - Claudia Mandato
- Pediatria Sistematica AORN "Santobono-Pausilipon", Naples, Italy
| | | | - Paolo Quitadamo
- Pediatria Sistematica AORN "Santobono-Pausilipon", Naples, Italy
| | | | - Claudia Viggiano
- Cattedra di Pediatria, Dipartimento di Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana", Università di Salerno , Via Allende, Baronissi (Salerno), 84081, Italy
| | - Francesco Fasolino
- Cattedra di Pediatria, Dipartimento di Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana", Università di Salerno , Via Allende, Baronissi (Salerno), 84081, Italy
| | | | - Maria Annunziata
- Pediatria AOU "S.Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Grazia Massa
- Pediatria AOU "S.Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | | | - Maria De Chiara
- Pediatria AOU "S.Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Paolo Siani
- Pediatria Sistematica AORN "Santobono-Pausilipon", Naples, Italy
| | - Pietro Vajro
- Cattedra di Pediatria, Dipartimento di Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana", Università di Salerno , Via Allende, Baronissi (Salerno), 84081, Italy. .,Pediatria AOU "S.Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy.
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