1
|
Roumen C, Offermann C, Eekers DB, Spreeuwenberg MD, Fijten R. Difficult medical encounters in oncology: What physicians need. An exploratory study. PEC INNOVATION 2023; 3:100202. [PMID: 37705725 PMCID: PMC10495654 DOI: 10.1016/j.pecinn.2023.100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/14/2023] [Accepted: 08/20/2023] [Indexed: 09/15/2023]
Abstract
Objective The objective of this study was to assess how often-medical oncology professionals encounter difficult consultations and if they desire support in the form of training. Methods In February 2022, a survey on difficult medical encounters in oncology, training and demographics was set up. The survey was sent to 390 medical oncology professionals part of the OncoZON network of the Southeast region of the Netherlands. Results Medical oncology professionals perceive a medical encounter as difficult when there is a dominant family member (n = 27), insufficient time (n = 24), or no agreement between medical professional and patient (n = 22). Patients involved in these encounters are most often characterized with low health literacy (n = 12) or aggressive behavior (n = 10). The inability to comprehend difficult medical information or perceived difficult behavior complicates encounters. Of the medical oncology professionals, 27-44% preferred a training as a physical group meeting (24%) or an individual virtual meeting (19%). Conclusion Medical oncology professionals consider dominant or aggressive behavior and the inability to comprehend medical information by patients during consultations as difficult encounters for which they would appreciate support. Innovation Our results highlight concrete medical encounters in need of specific education programs within daily oncology practice.
Collapse
Affiliation(s)
- Cheryl Roumen
- Department of Health Services Research, Maastricht University, Maastricht, the Netherlands
| | - Claudia Offermann
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Reproduction, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Daniëlle B.P. Eekers
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Reproduction, Maastricht University Medical Centre, Maastricht, the Netherlands
| | | | - Rianne Fijten
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Reproduction, Maastricht University Medical Centre, Maastricht, the Netherlands
| |
Collapse
|
2
|
Ng R, O'Reilly CL, Collins JC, Roennfeldt H, McMillan SS, Wheeler AJ, El-Den S. Mental Health First Aid crisis role-plays between pharmacists and simulated patients with lived experience: a thematic analysis of debrief. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1365-1373. [PMID: 36928545 PMCID: PMC10423112 DOI: 10.1007/s00127-023-02443-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Healthcare professionals, including pharmacists, can recognise and assist people experiencing mental health crises. Despite this, little is known about how pharmacists assist and engage with people presenting with signs and symptoms of mental health crises. This study aimed to (i) examine pharmacists' mental health crisis assessment language during simulated patient role-plays (SPRPs) and (ii) explore participants' experiences of participating in SPRPs of Mental Health First Aid (MHFA) scenarios. METHODS Fifty-nine MHFA-trained pharmacy staff participated in audio-recorded SPRPs of three crisis scenarios enacted by a mental health consumer educator (MHCE). Post-SPRP, pharmacy staff members (including role-playing and observing participants), engaged in reflective debrief discussions with the facilitator and MHCEs. Debrief discussions were transcribed verbatim and analysed using inductive thematic analysis and suicide assessment language was explored. RESULTS The majority of role-playing pharmacists asked about suicidal ideation using appropriate, direct language (n = 8). Qualitative analyses of debrief discussions yielded four themes: (i) Relationship with the consumer, (ii) Verbal and non-verbal communication, (iii) Challenges with crisis assessment, which included difficulties associated with initiating conversations about suicide and mania, and (iv) Reflective learning. CONCLUSION While pharmacists demonstrated the appropriate suicide assessment language post-MHFA training, pharmacists felt uncomfortable initiating conversations around suicide and lacked confidence during crisis assessments. SPRPs provided pharmacists with opportunities to reflect on and practice MHFA skills in a safe learning environment. Future research exploring how MHFA training and SPRPs impact pharmacists' ability to provide MHFA in real-world settings is warranted.
Collapse
Affiliation(s)
- Ricki Ng
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia.
| | - Claire L O'Reilly
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia
| | - Jack C Collins
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia
| | - Helena Roennfeldt
- Menzies Health Institute Queensland, Nathan Campus, Griffith University, Nathan, Australia
- Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Sara S McMillan
- Menzies Health Institute Queensland, Nathan Campus, Griffith University, Nathan, Australia
- School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, Australia
- Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Amanda J Wheeler
- Menzies Health Institute Queensland, Nathan Campus, Griffith University, Nathan, Australia
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Sarira El-Den
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia
| |
Collapse
|
3
|
Gallimore CE, Rotzenberg K. Cultivating patient-centered care skills through engagement in difficult conversations. CURRENTS IN PHARMACY TEACHING & LEARNING 2023; 15:91-100. [PMID: 36914445 DOI: 10.1016/j.cptl.2023.02.013] [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: 12/29/2021] [Revised: 09/30/2022] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND PURPOSE Appropriately engaging with patients around sensitive, challenging, or uncomfortable topics, often termed "difficult conversations," is a facet of patient-centered care. Development of such skills prior to practice often occurs in the hidden curriculum. Instructors implemented and evaluated a longitudinal simulation-based module aimed at advancing students' understanding and abilities to use patient-centered care skills to navigate difficult conversations within the formal curriculum. EDUCATIONAL ACTIVITY AND SETTING The module was embedded within the third professional year of a skills-based laboratory course. Four simulated patient encounters were revised to increase opportunities to practice patient-centered skills during difficult conversations. Preparatory discussions and pre-simulation assignments delivered foundational knowledge, and post-simulation debriefing allowed for feedback and reflection. Students completed pre- and post-simulation surveys to measure understanding of patient-centered care, empathy, and perceived ability. Instructors assessed student performance in eight skill areas using the Patient-Centered Communication Tools. FINDINGS Of 137 students, 129 completed both surveys. Students' definitions of patient-centered care grew in accuracy and detail following module completion. Eight of the 15 empathy items were significantly changed from pre- to post-module, signifying enhanced empathy. Student perception of ability to perform patient-centered care skills significantly improved from baseline to post-module. Across the semester, student performance on simulations significantly improved on six out of eight patient-centered care skills. SUMMARY Students deepened their understanding of patient-centered care, grew in aspects of empathy, and improved actual and perceived ability to deliver care that is patient-centered during challenging encounters.
Collapse
Affiliation(s)
- Casey E Gallimore
- University of Wisconsin-Madison, 777 Highland Ave, Madison, WI 53705, United States.
| | - Katherine Rotzenberg
- University of Wisconsin-Madison, 777 Highland Ave, Madison, WI 53705, United States.
| |
Collapse
|
4
|
Crowl A, Robertson A, Go S, Barnes J, Shrader S. Evaluation of a simulation-based learning activity for communicating about at-risk opioid behaviors in a community pharmacy setting. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:1512-1517. [PMID: 36402697 DOI: 10.1016/j.cptl.2022.10.008] [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: 08/29/2021] [Revised: 08/22/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The purpose of our study was to evaluate a learning activity that included an objective structured learning examination (OSLE) focused on identifying and communicating at-risk opioid behaviors in a community pharmacy setting through student perceptions and OSLE performance. METHODS The activity included a didactic lecture and an OSLE with two opioid use patient cases. Third-year pharmacy students' communication skills were evaluated using faculty-created rubrics. A voluntary, anonymous pre-/post-survey evaluated students' skills confidence and OSLE satisfaction. Responses were analyzed using independent t-tests. An inductive conventional content analysis identified the impact on students' perceptions and future behaviors from post-simulation reflections. RESULTS One hundred forty-three and 111 students completed the pre- and post-surveys, respectively. Students self-reported confidence in their ability to identify red flags and assess at-risk opioid behaviors, counsel on opioid risk behaviors, refuse opioid prescription fills, and respond to patients' nonverbal responses, all significantly improved pre-to-post. Students reported the OSLE was beneficial to their learning. The mean overall OSLE score was 34.2 out of 45 points (SD ± 6.21). Identified student reflection themes included: importance of patient-centered care, pharmacists' role in patients with at-risk opioid behaviors, recognition of judgement against patients taking opioids, and importance of communication and empathy as strategies to mitigate conflict. CONCLUSIONS Implementing a new learning activity focused on communication regarding at-risk opioid behaviors allowed students to engage in difficult conversations with standardized patients in a safe simulation environment. Students demonstrated competent skills, increased their self-reported confidence, and were highly satisfied with the learning activity.
Collapse
Affiliation(s)
- Ashley Crowl
- Pharmacy Practice, University of Kansas School of Pharmacy, 2010 Becker Dr., Lawrence, KS 660475, United States.
| | - Amy Robertson
- Pharmacy Practice, University of Kansas School of Pharmacy- Wichita Regional Campus, 1010 N. Kansas St, Wichita, KS 67214, United States.
| | - Shelby Go
- Pharmacy student at time of submission, University of Kansas School of Pharmacy, 2010 Becker Dr., Lawrence, KS 66047, United States.
| | - Jessica Barnes
- Pharmacy Practice, University of Kansas School of Pharmacy, 2010 Becker Dr., Lawrence, KS 660475, United States.
| | - Sarah Shrader
- Pharmacy Practice, University of Kansas School of Pharmacy, 2010 Becker Dr., Lawrence, KS 660475, United States.
| |
Collapse
|
5
|
Phanudulkitti C, Kebodeaux C, Vordenberg SE. Use of the Virtual Simulation Tool 'MyDispense' By Pharmacy Programs in the United States. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2022; 86:ajpe8827. [PMID: 34992068 PMCID: PMC10159388 DOI: 10.5688/ajpe8827] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 01/02/2022] [Indexed: 05/06/2023]
Abstract
Objective. Pharmacy programs are increasingly using virtual simulation to provide a safe and realistic environment for students to practice critical patient care skills. The aim of this study was to describe the use of MyDispense, a virtual simulation tool, by pharmacy programs across the United States.Methods. Researchers developed a 16-item survey focused on program characteristics and MyDispense integration in pharmacy curricula. It was sent to MyDispense administrators of pharmacy programs in the United States. Descriptive statistics were used to analyze the results.Results. Administrators from 36 pharmacy programs responded to the survey (72%). MyDispense was most commonly integrated into one or two courses for first- or second-year students. The most common skills that students practiced were medication dispensing, communication with patients, and drug information skills. Validation exercises were most commonly followed by dispensing and over-the-counter exercises. The number of pharmacy schools using MyDispense suggests the potential for collaboration among instructors to increase efficiencies in the delivery of course materials as well as evaluate student learning.Conclusion. Instructors most used MyDispense in courses for first- and second-year students to teach medication dispensing, communication with patients, use of drug information resources, application of pharmacy laws, and how to make recommendations about over-the-counter medications.
Collapse
Affiliation(s)
- Chamipa Phanudulkitti
- Burapha University, Faculty of Pharmaceutical Sciences, Chon Buri, Thailand
- University of Michigan, College of Pharmacy, Ann Arbor, Michigan
| | - Clark Kebodeaux
- University of Kentucky, College of Pharmacy, Lexington, Kentucky
| | | |
Collapse
|
6
|
Smith KJ, Neely S, Dennis VC, Miller MM, Medina MS. Use of Situational Judgment Tests to Teach Empathy, Assertiveness, Communication, and Ethics. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2022; 86:8761. [PMID: 34785498 PMCID: PMC10159436 DOI: 10.5688/ajpe8761] [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] [Received: 06/08/2021] [Accepted: 10/08/2021] [Indexed: 05/06/2023]
Abstract
Objective. The objectives of this study were to develop situational judgment test (SJT) scenarios for use in teaching empathy, assertiveness, and interprofessional communication in second-year pharmacy (P2) students and ethics in third-year pharmacy (P3) students, determine whether the SJTs developed were effective at measuring students' communication skills and ethical judgment, compare the performance of individual third-year students to the performance of teams of third-year students on the ethics SJT, and evaluate student feedback about SJTs as a teaching tool.Methods. Pharmacy faculty developed five SJT scenarios related to communications and five SJT scenarios related to ethics and piloted the scenarios with P2 and P3 students, respectively. Second-year students completed SJTs individually, while P3 students completed SJTs individually and in teams. Scenarios and responses were discussed with faculty after completion of the SJTs, and students completed a questionnaire to provide feedback on the SJTs.Results. The communications SJT was completed by 59 P2 students with a mean score of 67.5%. The ethics SJT was completed by 57 P3 students with a mean score of 80.1%. The ethics SJT was also completed by 10 teams of P3 students resulting in a mean score of 93.2%. Students indicated the SJT content was realistic and the tests provided the opportunity to reflect on how to approach challenging situations.Conclusion. Situational judgment tests were useful for teaching empathy, assertiveness, interprofessional communication, and ethics in pharmacy students. Future research should focus on predictive validity of SJTs for these content areas.
Collapse
Affiliation(s)
- Kathryn J Smith
- University of Oklahoma, College of Pharmacy, Oklahoma City, Oklahoma
| | - Stephen Neely
- University of Oklahoma, College of Pharmacy, Oklahoma City, Oklahoma
| | - Vincent C Dennis
- University of Oklahoma, College of Pharmacy, Oklahoma City, Oklahoma
| | - Misty M Miller
- University of Oklahoma, College of Pharmacy, Oklahoma City, Oklahoma
| | - Melissa S Medina
- University of Oklahoma, College of Pharmacy, Oklahoma City, Oklahoma
- Associate Editor, American Journal of Pharmaceutical Education, Arlington, Virginia
| |
Collapse
|
7
|
Dula CAC, Porter AL. Addressing Challenges in Skills-based Education Through Innovation and Collaboration. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2021; 85:8788. [PMID: 34544750 PMCID: PMC8499659 DOI: 10.5688/ajpe8788] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Colleen A Clark Dula
- The Ohio State University College of Pharmacy, Columbus, Ohio
- Guest Editor, Skills-based Education Theme Issue, American Journal of Pharmaceutical Education
| | - Andrea L Porter
- University of Wisconsin - Madison School of Pharmacy, Madison, Wisconsin
- Guest Editor, Skills-based Education Theme Issue, American Journal of Pharmaceutical Education
| |
Collapse
|